Abstract : BACKGROUND Previous studies have demonstrated that cardiovascular risk is higher with increased lip
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Abstract : BACKGROUND Previous studies have demonstrated that cardiovascular risk is higher with increased lipoprotein(a) Lp(a). Whether Lp(a) concentration is related to type 2 diabetes is unclear.|METHODS In 26 746 healthy US women (mean age 54.6 years) we prospectively examined baseline Lp(a) concentrations and incident type 2 diabetes (n = 1670) for a follow-up period of 13 years. We confirmed our findings in 9652 Danish men and women with prevalent diabetes (n = 419). Analyses were adjusted for risk factors that included age race smoking hormone use family history blood pressure body mass index hemoglobin A(1c) (Hb A(1c)) C-reactive protein and lipids.|RESULTS Lp(a) was inversely associated with incident diabetes with fully adjusted hazard ratios (HRs) and 95 CIs for quintiles 2-5 vs quintile 1 of 0.87 (0.75-1.01) 0.80 (0.68-0.93) 0.88 (0.76-1.02) and 0.78 (0.67-0.91) P for trend 0.002. The association was stronger in nonfasting women for whom respective HRs were 0.79 (0.58-1.09) 0.78 (0.57-1.08) 0.66 (0.46-0.93) and 0.56 (0.40-0.80) P for trend 0.001 P for interaction with fasting status 0.002. When we used Lp(a) gt or =10 mg/L and Hb A(1c) lt5 as reference values the adjusted HRs were 1.62 (0.91-2.89) for Lp(a) lt10 mg/L and Hb A(1c) lt5 3.50 (3.06-4.01) for Lp(a) gt or =10 mg/L and Hb A(1c) 5-lt6.5 and 5.36 (4.00-7.19) for Lp(a) lt10 mg/L and Hb A(1c) 5-lt6.5. Results were similar in nonfasting Danish men and women for whom adjusted odds ratios were 0.75 (0.55-1.03) 0.64 (0.46-0.88) 0.74 (0.54-1.01) and 0.58 (0.42-0.79) for Lp(a) quintiles 2-5 vs quintile 1 P for trend 0.002.|CONCLUSIONS: Our results indicated that Lp(a) was associated inversely with risk of type 2 diabetes independently of risk factors, in contrast to prior findings of positive associations of Lp(a) with cardiovascular risk.|
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