Are Lipoprotein(a) levels decreased in insulin resistance and type 2 diabetes?

IF 3.8 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Current opinion in lipidology Pub Date : 2025-05-19 DOI:10.1097/MOL.0000000000000996

Pablo Corral, María Gabriela Matta, Laura Schreier

{"title":"Are Lipoprotein(a) levels decreased in insulin resistance and type 2 diabetes?","authors":"Pablo Corral, María Gabriela Matta, Laura Schreier","doi":"10.1097/MOL.0000000000000996","DOIUrl":null,"url":null,"abstract":"Purpose of review: Lipoprotein(a) [Lp(a)] is a significant player in cardiovascular disease (CVD) and type 2 diabetes (T2D). While Lp(a) contributes to residual cardiovascular risk in T2D, lower levels paradoxically increase the risk of developing T2D. This review explores Lp(a)'s dual role in cardiometabolic disease, its association with T2D, and emerging Lp(a)-lowering therapies.Recent findings: Large-scale studies confirm Lp(a) as a potent risk factor for cardiovascular events in T2D, with lower Lp(a) thresholds increasing risk compared to nondiabetic individuals. Observational and genetic studies reveal an inverse relationship between Lp(a) and T2D risk, linked to insulin dynamics, Kringle IV-type-2 repeat variants, and metabolic pathways. Emerging evidence suggests a connection between Lp(a), nonalcoholic fatty liver disease, and statin use. However, Mendelian randomization analyses have yielded conflicting results, leaving key mechanistic questions unresolved.Summary: Lp(a) plays a complex role in cardiometabolic health, acting as both a cardiovascular hazard and a potential metabolic marker in T2D. The paradoxical association of low Lp(a) with increased T2D risk challenges conventional perspectives and raises concerns regarding Lp(a)-lowering interventions. Further research is needed to clarify causality, refine risk stratification, and guide clinical decisions for Lp(a) modulation in T2D patients.","PeriodicalId":11109,"journal":{"name":"Current opinion in lipidology","volume":" ","pages":""},"PeriodicalIF":3.8000,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current opinion in lipidology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MOL.0000000000000996","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"BIOCHEMISTRY & MOLECULAR BIOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose of review: Lipoprotein(a) [Lp(a)] is a significant player in cardiovascular disease (CVD) and type 2 diabetes (T2D). While Lp(a) contributes to residual cardiovascular risk in T2D, lower levels paradoxically increase the risk of developing T2D. This review explores Lp(a)'s dual role in cardiometabolic disease, its association with T2D, and emerging Lp(a)-lowering therapies.

Recent findings: Large-scale studies confirm Lp(a) as a potent risk factor for cardiovascular events in T2D, with lower Lp(a) thresholds increasing risk compared to nondiabetic individuals. Observational and genetic studies reveal an inverse relationship between Lp(a) and T2D risk, linked to insulin dynamics, Kringle IV-type-2 repeat variants, and metabolic pathways. Emerging evidence suggests a connection between Lp(a), nonalcoholic fatty liver disease, and statin use. However, Mendelian randomization analyses have yielded conflicting results, leaving key mechanistic questions unresolved.

Summary: Lp(a) plays a complex role in cardiometabolic health, acting as both a cardiovascular hazard and a potential metabolic marker in T2D. The paradoxical association of low Lp(a) with increased T2D risk challenges conventional perspectives and raises concerns regarding Lp(a)-lowering interventions. Further research is needed to clarify causality, refine risk stratification, and guide clinical decisions for Lp(a) modulation in T2D patients.

查看原文本刊更多论文

胰岛素抵抗和2型糖尿病患者脂蛋白(a)水平降低吗？

综述目的：脂蛋白(a) [Lp(a)]在心血管疾病（CVD）和2型糖尿病（T2D）中起着重要作用。虽然Lp(a)有助于T2D的剩余心血管风险，但较低的水平反而增加了发生T2D的风险。这篇综述探讨了Lp(a)在心脏代谢疾病中的双重作用，它与T2D的关系，以及新兴的Lp(a)降低疗法。近期发现：大规模研究证实Lp(a)是T2D患者心血管事件的一个潜在危险因素，与非糖尿病患者相比，较低的Lp(a)阈值会增加风险。观察性和遗传学研究揭示了Lp(a)和T2D风险之间的反比关系，与胰岛素动力学、Kringle iv -2型重复变异和代谢途径有关。新出现的证据表明Lp(a)、非酒精性脂肪肝和他汀类药物的使用之间存在联系。然而，孟德尔随机化分析产生了相互矛盾的结果，留下了关键的机制问题尚未解决。总结：Lp(a)在心脏代谢健康中起着复杂的作用，在T2D中既是心血管危险因素，也是潜在的代谢标志物。低脂蛋白(a)与T2D风险增加的矛盾关系挑战了传统观点，并引起了人们对降低脂蛋白(a)干预措施的关注。需要进一步的研究来澄清因果关系，完善风险分层，并指导T2D患者Lp(a)调节的临床决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Current opinion in lipidology 医学-内分泌学与代谢

CiteScore

6.70

自引率

4.50%

发文量

审稿时长

6-12 weeks

期刊介绍： With its easy-to-digest reviews on important advances in world literature, Current Opinion in Lipidology offers expert evaluation on a wide range of topics from six key disciplines including nutrition and metabolism, genetics and molecular biology, and hyperlipidaemia and cardiovascular disease. Published bimonthly, each issue covers in detail the most pertinent advances in these fields from the previous year. This is supplemented by a section of Bimonthly Updates, which deliver an insight into new developments at the cutting edge of the disciplines covered in the journal.