Lipoprotein(a) and incident type-2 diabetes: results from the prospective Bruneck study and a meta-analysis of published literature

Cardiovascular Diabetology

Original Investigation

Siegfried Weger¹  Peter Santer²  Sotirios Tsimikas³  Johann Willeit⁴  Stefan Kiechl⁴  Ellie Paige⁵  Katya L. Masconi⁵  Peter Willeit⁶  Florian Kronenberg⁷ 

[1] Department of Internal Medicine, Bruneck Hospital, Bruneck, Italy;Department of Laboratory Medicine, Bruneck Hospital, Bruneck, Italy;Department of Medicine, University of California San Diego, La Jolla, CA, USA;Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria;Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK;Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK;Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria;Division of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria;

关键词: Lipoprotein(a);    Diabetes;    Prospective study;    Meta-analysis;   

DOI  :  10.1186/s12933-017-0520-z

 received in 2017-01-17, accepted in 2017-03-11,  发布年份 2017

来源: Springer

【 摘 要 】

AimsWe aimed to (1) assess the association between lipoprotein(a) [Lp(a)] concentration and incident type-2 diabetes in the Bruneck study, a prospective population-based study, and (2) combine findings with evidence from published studies in a literature-based meta-analysis.MethodsWe used Cox proportional hazards models to calculate hazard ratios (HR) for incident type-2 diabetes over 20 years of follow-up in 815 participants of the Bruneck study according to their long-term average Lp(a) concentration. For the meta-analysis, we searched Medline, Embase and Web of Science for relevant prospective cohort studies published up to October 2016.ResultsIn the Bruneck study, there was a 12% higher risk of type-2 diabetes for a one standard deviation lower concentration of log Lp(a) (HR = 1.12 [95% CI 0.95–1.32]; P = 0.171), after adjustment for age, sex, alcohol consumption, body mass index, smoking status, socioeconomic status, physical activity, systolic blood pressure, HDL cholesterol, log high-sensitivity C-reactive protein and waist–hip ratio. In a meta-analysis involving four prospective cohorts with a total of 74,575 participants and 4514 incident events, the risk of type-2 diabetes was higher in the lowest two quintiles of Lp(a) concentrations (weighted mean Lp(a) = 3.3 and 7.0 mg/dL, respectively) compared to the highest quintile (62.9 mg/dL), with the highest risk of type-2 diabetes seen in quintile 1 (HR = 1.28 [1.14–1.43]; P < 0.001).ConclusionsThe current available evidence from prospective studies suggests that there is an inverse association between Lp(a) concentration and risk of type-2 diabetes, with a higher risk of type-2 diabetes at low Lp(a) concentrations (approximately <7 mg/dL).

【 授权许可】

CC BY   
© The Author(s) 2017