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. 2024 Jan 15:14:1337469.
doi: 10.3389/fendo.2023.1337469. eCollection 2023.

Association between Lipoprotein(a) and diabetic nephropathy in patients with type 2 diabetes

Meng Li  1 , Yanjun Wang  2 , Qianqian Yao  1 , Qian Liang  1 , Yuanyuan Zhang  1 , Xin Wang  2 , Qian Li  2 , Wei Qiang  1 , Jing Yang  1   2 , Bingyin Shi #  1 , Mingqian He #  1   2
Affiliations

Association between Lipoprotein(a) and diabetic nephropathy in patients with type 2 diabetes

Meng Li et al. Front Endocrinol (Lausanne). .

Abstract

Background: Diabetic nephropathy (DN) is one of the most prevalent and severe microvascular complications of type 2 diabetes (T2DM). However, little is currently known about the pathogenesis and its associated risk factors in DN. The present study aims to investigate the potential risk factors of DN in patients with T2DM.

Methods: A total of 6,993 T2DM patients, including 5,089 participants with DN and 1,904 without DN, were included in this cross-sectional study. Comparisons between the two groups (DN vs. non-DN) were carried out using Student's t-test, Mann-Whitney U-test, or Pearson's Chi-squared test. Spearman's correlation analyses were performed to assess the correlations of serum lipids and indicators of renal impairment. Logistic regression models were applied to assess the relationship between blood lipid indices and the presence of DN.

Results: T2DM patients with DN were older, and had a longer duration of diagnosed diabetes compared to those without DN. Of note, the DN patients also more likely develop metabolic disorders. Among all serum lipids, Lipoprotein(a) [Lp(a)] was the most significantly correlated indicators of renal impairment. Moreover, univariate logistic regression showed that elevated Lp(a) level was associated with an increased risk of DN. After adjusted for confounding factors, including age, gender, duration of T2DM, BMI, SBP, DBP and lipid-lowering drugs usage, Lp(a) level was independently positively associated with the risk of DN [odds ratio (OR):1.115, 95% confidence interval (CI): 1.079-1.151, P=6.06×10-11].

Conclusions: Overall, we demonstrated that serum Lp(a) level was significantly positively associated with an increased risk of DN, indicating that Lp(a) may have the potential as a promising target for the diagnosis and treatment of diabetic nephropathy.

Keywords: Lipoprotein(a); diabetic nephropathy; dyslipidemia; renal impairment; type 2 diabetes mellitus.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The Lipid Indices on the occurrence of diabetic nephropathy. OR, odds ratio; CI, confidence interval; DN, diabetic nephropathy; ApoE, apolipoprotein E;Lp(a), Lipoprotein(a); TC, total cholesterol; TG, triglyceride; HDL-c, high-density lipoprotein cholesterol; LDL-c, low-density lipoprotein cholesterol. Univariate logistic regression analyses were used to investigate the association of blood lipid indices and DN.
Figure 2
Figure 2
Correlations between Lp(a) and indicators of renal impairment. eGFR, estimated glomerular filtration rate; UACR, urinary albumin creatinine ratio; 24hU-TP, 24-hour urine protein; Lp(a), Lipoprotein(a). Spearman’s correlation analyses were used to analyze the correlations of serum lipids and indicators of renal impairment.
See this image and copyright information in PMC

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