Association between lipoprotein(a) and diabetic peripheral neuropathy in patients with type 2 diabetes: a meta-analysis.

BACKGROUND

Diabetic peripheral neuropathy (DPN) is a common complication of type 2 diabetes (T2D). Lipoprotein(a) [Lp(a)], a known cardiovascular risk factor, has been hypothesized to influence the development of DPN. This meta-analysis aimed to investigate the relationship between Lp(a) levels and DPN in patients with T2D.

METHODS

Following PRISMA 2020 guidelines, a systematic search of PubMed, Embase, Web of Science, Wanfang, and CNKI databases was performed up to October 12, 2024. Observational studies assessing blood Lp(a) levels in T2D patients with and without DPN or evaluating the association between Lp(a) and DPN risk were included. Data synthesis utilized a random-effects model to calculate standardized mean differences (SMDs) and odds ratios (ORs) with corresponding 95% confidence intervals (CIs).

RESULTS

Eleven studies with 18,022 patients were included. Patients with DPN had significantly higher Lp(a) levels than those without DPN (SMD: 0.10, 95% CI: 0.02-0.19, p = 0.01; I² = 43%). High Lp(a) levels were associated with DPN (OR: 1.31, 95% CI: 1.07-1.60, p = 0.009; I² = 62%). Subgroup analyses according to study design, mean age of the patients, methods for measuring Lp(a) concentration, cutoff values of a high Lp(a), and study quality scores showed consistent results (p for subgroup difference all > 0.05). A high Lp(a) was associated with DPN in studies from Asian countries, but not in those from European countries (p for subgroup difference = 0.001).

CONCLUSION

Elevated Lp(a) levels are associated DPN in T2D patients, particularly in studies from Asian countries.