Evidence map›Paper›PMID 42321764›Full record

ArticleCardiovascular diabetology2026

Longitudinal variability of lipoprotein(a) in youth-onset type 1 diabetes: implications for cardiovascular risk stratification.

Fanny Iafrate-Luterbacher, Cecilia Jimenez-Sanchez, Maria Loukia Anastasiadou, Julien Prados, Frida Renström, Michael Brändle, Stefan Bilz, Valerie M Schwitzgebel

Abstract read
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Article in Cardiovascular diabetology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Fanny Iafrate-LuterbacherDivision of General Paediatrics, Department of Paediatrics, Gynaecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.
Cecilia Jimenez-SanchezPediatric Endocrine and Diabetes Unit, Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, University Hospitals of Geneva, Rue Willy-Donzé 6, 1205, Geneve, Switzerland.
Maria Loukia AnastasiadouPediatric Endocrine and Diabetes Unit, Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, University Hospitals of Geneva, Rue Willy-Donzé 6, 1205, Geneve, Switzerland.
Julien PradosBioinformatics Support Platform, University of Geneva, Geneva, Switzerland.
Frida RenströmDivision of Endocrinology and Diabetes, Department of Internal Medicine, Cantonal Hospital St. Gallen, HOCH Health Ostschweiz, St. Gallen, Switzerland.
Michael BrändleDivision of Endocrinology and Diabetes, Department of Internal Medicine, Cantonal Hospital St. Gallen, HOCH Health Ostschweiz, St. Gallen, Switzerland.
Stefan BilzDivision of Endocrinology and Diabetes, Department of Internal Medicine, Cantonal Hospital St. Gallen, HOCH Health Ostschweiz, St. Gallen, Switzerland.
Valerie M SchwitzgebelPediatric Endocrine and Diabetes Unit, Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, University Hospitals of Geneva, Rue Willy-Donzé 6, 1205, Geneve, Switzerland. valerie.schwitzgebel@unige.ch.ORCID 0000-0002-8015-950X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLipoprotein(a) [Lp(a)] is a genetically determined and independent cardiovascular risk factor, traditionally considered stable across the lifespan, supporting a single lifetime measurement strategy. However, its longitudinal behaviour during childhood and adolescence remains poorly characterised, particularly in individuals with type 1 diabetes who face a markedly increased lifetime risk of coronary artery disease. We therefore aimed to characterise intra- and inter-individual trajectories of Lp(a) in a paediatric type 1 diabetes cohort and to assess the implications of Lp(a) variability for cardiovascular risk classification.

methodsWe conducted a retrospective single-centre cohort study of children and adolescents with type 1 diabetes attending Geneva University Hospitals between 2012 and 2023. Annual fasting Lp(a) concentrations were analysed longitudinally. Variability was assessed in participants with ≥ 2 measurements. Clinically relevant thresholds were used to evaluate cardiovascular risk reclassification. Paired Wilcoxon tests, Pearson and Kendall correlations, and Holm-adjusted p-values (P < 0.05) were applied. Analyses were conducted in R.

resultsA total of 286 participants contributed 1403 Lp(a) measurements, with observation periods varying across individuals (median 6.2 years, IQR 2.9-9.6) and between 1 and 13 measurements per participant. At baseline, 26% had elevated Lp(a) (≥ 300 mg/l). Among participants with serial measurements, 32% showed intraindividual fluctuations exceeding 50% of their individual maximum value. Reclassification across the 300 mg/l cardiovascular risk threshold occurred in 11.9% of participants. Lp(a) concentrations peaked between ages 10 and 13 years and declined thereafter. Modest seasonal variation was observed, with higher concentrations in autumn and winter (P < 0.05).

conclusionsIn youth with type 1 diabetes, Lp(a) is not as stable as previously assumed, exhibiting clinically relevant variability over time. These findings challenge the current paradigm of a single lifetime Lp(a) measurement and suggest that repeated assessment, particularly during adolescence, may improve early cardiovascular risk stratification.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 1Lipoprotein(a)AdolescentAge FactorsAge of OnsetBiomarkersChildChild, PreschoolFemaleHeart Disease Risk FactorsHumansLongitudinal StudiesMalePredictive Value of TestsPrognosisBiomarkersLipoprotein(a)LPA protein, humanAdolescenceBiomarker variabilityCardiovascular diseaseCardiovascular riskCoronary artery diseaseDiabetes complicationsDyslipidaemiaHypercholesterolaemiaMacrovascular complicationsPaediatric diabetes

Identifiers

PMID42321764
PMCPMC13523341

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.