Familial combined hyperlipidemia patients with higher Lp(a) levels have lower type 2 diabetes risk

A new study by Ioannis Skoumas and team showed that higher Lipoprotein(a) [Lp(a)] levels are associated with a decreased incidence of type 2 diabetes in familial combined hyperlipidemia (FCH) participants. The findings of this study were published in the Journal of Clinical Lipidology.

In the general population, lipoprotein(a) [Lp(a)] seems to have an inverse relationship with the risk of type 2 diabetes mellitus. The purpose of this study was to examine the prognostic value of Lp(a) in relation to the onset of type-2 diabetes in a unique sample of individuals with familial combination hyperlipidemia.

In this cohort analysis, 474 patients with FCH who did not have diabetes at baseline and were followed for an average of 8.2 to 6.8 years were included (mean age, 49.7 to 11.3, 64% male). To determine the lipid profile and Lp(a) levels, venous blood samples were taken during the baseline examination. The coveted outcome was the emergence of diabetes.

The key findings of this study were:

1. Patients with elevated Lp(a) levels ≥30mg/dl had lower triglyceride levels (238 113 vs 268 129 mg/dl, p=0.01), higher levels of high-density lipoprotein (HDL) cholesterol (44 10 vs 41 10 mg/dl, p=0.01), and more cases of hypertension (42% vs 32%, p=0.03).

2. 10.1% (n=48) of those with diabetes developed it for the first time during the follow-up period.

3. After controlling for covariates, a multiple Cox regression analysis showed that higher Lp(a) is an independent predictor of decreased diabetes incidence (HR 0.39, 95% CI 0.17-0.90, p=0.02).

Since increased Lp(a) is associated with lower triglyceride levels, a higher incidence of hypertension, and higher levels of HDL cholesterol, it appears that the presence of increased Lp(a) distinguishes the expression of metabolic syndrome traits in patients with FCH.

Reference:

Skoumas, I., Andrikou, I., Grigoriou, K., Dima, I., Lazarou, E., Vlachopoulos, C., & Tsioufis, K. (2023). Lipoprotein(a), metabolic profile and new-onset type-2 diabetes in patients with familial combined hyperlipidemia: a 9 year follow-up study. In Journal of Clinical Lipidology. Elsevier BV. https://doi.org/10.1016/j.jacl.2023.05.103