Elevated serum Lp(a) levels increase risk of diabetic retinopathy in T2D patients: Study

A new study published in the journal of International Ophthalmology found that elevated serum lipoprotein (a) [Lp(a)] concentration may double the chance of developing diabetic retinopathy (DR) in people with type 2 diabetes. Many medical experts are interested in diabetes since it is a chronic disease that is becoming more and more common worldwide. 

Diabetic retinopathy affects almost all people with type 1 diabetes and more than 60% of people with type 2 diabetes. The apolipoprotein B-100 molecule found in LP(a), an LDL-like lipoprotein, is connected to the big glycoprotein ApoA via a disulfide bond. The patients with diabetes, particularly the ones with poor glycemic control and long-term illness, have higher levels of LP(a), a molecule thought to be more prothrombotic and atherogenic than LDL 10. This meta-analysis was set to elucidate the relationship between diabetic retinopathy and serum lipoprotein(a) levels in type 2 diabetes. 

This research looked for pertinent observational studies assessing the relationship between serum Lp(a) levels and the risk of DR by searching electronic databases such as Web of Science, PubMed, and Embase. The relationship between a high Lp(a) and the probability of DR was shown by summarizing odds ratios (ORs) with 95% confidence intervals (CIs). A random-effects model was used to extract and pool data in order to account for study variability. The I2 statistic was used to measure heterogeneity, while Egger's test and funnel plots were used to measure publication bias.

There were a total of 11 observational studies and T2D patients in the highest Lp(a) group had a greater chance of developing DR than the patients in the lowest Lp(a) category. Subgroup analysis revealed that, rather than cohort studies, this connection was mostly shown in cross-sectional and case-control studies.

Also, there was a similar relationship between Lp(a) and DR regardless of the research nation, Lp(a) cutoff levels, analytic approach (univariate or multivariate), and adjustment for contemporaneous pill consumption. A further meta-analysis revealed a strong correlation between proliferative DR and high Lp(a) levels.

Overall, increasing blood Lp(a) levels were linked to a higher risk of developing DR in T2D patients. DR was 2.05 times more likely to occur in individuals with the highest Lp(a) levels than in those with the lowest values. Also, proliferative DR was linked to elevated Lp(a) levels, suggesting that Lp(a) may serve as a biomarker for DR risk.

Source:

Pang, Y., & Yi, C. (2024). Elevated serum lipoprotein(a) levels as a potential risk factor for diabetic retinopathy in type 2 diabetes: a meta-analysis. In International Ophthalmology (Vol. 44, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1007/s10792-024-03360-x