Lipoprotein(a) as a Higher Residual Risk for Coronary Artery Disease in Patients with Type 2 Diabetes Mellitus than without

Figures & data

Table 1 Baseline Information

	Non-CAD n = 418	CAD n = 1104	P-value
Age, year	61.89 (10.84)	63.55 (10.47)	0.006
Male sex	236 (56.46%)	827 (74.91%)	<0.001
Smoking	111 (26.56%)	409 (37.05%)	<0.001
Alcohol use	26 (6.22%)	64 (5.80%)	0.755
Hypertension	219 (52.39%)	690 (62.50%)	<0.001
T2DM	106 (25.36%)	423 (38.32%)	<0.001
Chronic kidney disease	4 (0.96%)	49 (4.44%)	0.001
Stroke	19 (4.55%)	83 (7.52%)	0.038
Serum creatinine, μmol/L	79.69 (26.50)	96.55 (67.90)	<0.001
HbA1c, % (mmol/mol)	6.2 (1.0) [44 (11)]	6.5 (1.4) [48 (15)]	<0.001
Glucose, mmol/L	5.61 (1.64)	6.02 (2.13)	<0.001
Lp(a), mg/L	115.67 (153.18)	178.21 (198.65)	<0.001
Lg Lp(a), mg/L	2.11 (0.40)	2.27 (0.42)	<0.001
TG, mmol/L	1.57 (1.17)	1.65 (1.22)	0.294
TC, mmol/L	4.59 (1.19)	4.41 (1.24)	0.012
LDL-C, mmol/L	2.66 (1.04)	2.58 (1.05)	0.227
HDL-C, mmol/L	1.15 (0.28)	1.04 (0.27)	<0.001
Medications
ACEI/ARB	62 (14.83%)	196 (17.75%)	0.175
β-blocker	58 (13.88%)	205 (18.57%)	0.031
CCB	48 (11.48%)	166 (15.04%)	0.075
Diuretic	19 (4.55%)	39 (3.53%)	0.357
Statin	76 (18.18%)	474 (42.93%)	<0.001

Abbreviations: Lg Lp(a), logarithmic transformation of Lp(a); T2DM, type 2 diabetes mellitus; HbA1c, glycated hemoglobin; Lp(a), lipoprotein(a); TG, triglyceride; TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin II receptor blockers; CCB, calcium channel blockers.

Figure 1 Study flowchart.

Table 2 Odds Ratios (ORs [95% CIs]) of Lp(a) and CAD

	All	Non-T2DM	T2DM
All
Model 1	2.55 (1.92, 3.37), p < 0.001	3.08 (2.19, 4.34), p < 0.001	2.14 (1.27, 3.60), p = 0.004
Model 2	2.56 (1.92, 3.40), p < 0.001	3.10 (2.18, 4.40), p < 0.001	2.18 (1.28, 3.71), p = 0.004
Model 3	2.72 (2.01, 3.68), p < 0.001	3.42 (2.36, 4.95), p < 0.001	1.98 (1.12, 3.49), p = 0.019
LDL-C < 1.8 mmol/L
Model 1	2.39 (1.24, 4.61), p = 0.009	2.90 (1.22, 6.89), p = 0.016	2.29 (0.78, 6.70), p = 0.131
Model 2	2.55 (1.30, 5.00), p = 0.006	2.64 (1.09, 6.39), p = 0.013	2.86 (0.92, 8.91), p = 0.069
Model 3	2.46 (1.20, 5.04), p = 0.014	2.82 (1.09, 7.26), p = 0.032	2.23 (0.66, 7.53), p = 0.194
LDL-C ≥ 1.8 mmol/L
Model 1	2.64 (1.93, 3.61), p < 0.001	3.16 (2.17, 4.59), p < 0.001	2.12 (1.16, 3.88), p = 0.015
Model 2	2.60 (1.89, 3.58), p < 0.001	3.22 (2.19, 4.74), p < 0.001	2.14 (1.15, 3.97), p = 0.016
Model 3	2.85 (2.03, 3.99), p < 0.001	3.55 (2.37, 5.34), p < 0.001	2.08 (1.07, 4.04), p = 0.030

Notes: Model 1: unadjusted; Model 2: adjusted for age and sex; Model 3: adjusted for age, sex, smoking, hypertension, chronic kidney disease, stroke, serum creatinine, TG, TC and HDL-C.

Abbreviation: Lg Lp(a), logarithmic transformation of Lp(a).

Figure 2 Association of Lp(a) with CAD in all patients and subgroups of different LDL-C level. Odds ratios and 95% CIs derived from restricted cubic spline regression, with knots placed at the 5th, 35th, 65th, and 95th percentiles of the distribution of Lg Lp(a). The reference point for Lg Lp(a) is located at OR=1. Ref is an abbreviation for reference. The lowest 2.5% and highest 2.5% of participants are not shown in the figures for small sample sizes.

Figure 3 Association of Lp(a) with CAD in Non-T2DM patients and subgroups of different LDL-C level. Odds ratios and 95% CIs derived from restricted cubic spline regression, with knots placed at the 5th, 35th, 65th, and 95th percentiles of the distribution of Lg Lp(a). The reference point for Lg Lp(a) is located at OR=1. Ref is an abbreviation for reference. The lowest 2.5% and highest 2.5% of participants are not shown in the figures for small sample sizes.

Figure 4 Association of Lp(a) with CAD in T2DM patient and subgroups of different LDL-C level. Odds ratios and 95% CIs derived from restricted cubic spline regression, with knots placed at the 5th, 35th, 65th, and 95th percentiles of the distribution of Lg Lp(a). The reference point for Lg Lp(a) is located at OR=1. Ref is an abbreviation for reference. The lowest 2.5% and highest 2.5% of participants are not shown in the figures for small sample sizes.