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

Cohort studyCardiovascular diabetology· Jun 2026

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 … Valerie M Schwitzgebel

Pediatric Endocrinology & GrowthCohort studyQ1IF 14.6

Nearly a third of youth with type 1 diabetes showed large swings in Lp(a) levels over time

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

Fanny Iafrate-Luterbacher … Valerie M Schwitzgebel

Cardiovascular diabetology · Jun 2026 · Q1 in General Medicine

Background

Lipoprotein(a) [Lp(a)] is a genetically determined and independent cardiovascular risk factor, traditionally considered stable across the lifespan, supporting a single lifetime measurement strategy.

Purpose

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.

Methods

We conducted a retrospective single-centre cohort study of children and adolescents with type 1 diabetes attending Geneva University Hospitals between 2012 and 2023.

n = 286 participants

32%

Results

32%

about 1 in 3 had Lp(a) swing more than half their peak value

n = 286 participants

More results

A 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).

More results

Reclassification across the 300 mg/l cardiovascular risk threshold occurred in 11.9% of participants.

Modest seasonal variation was observed, with higher concentrations in autumn and winter (P < 0.05).

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Conclusion · 1 of 2

In youth with type 1 diabetes, Lp(a) is not as stable as previously assumed, exhibiting clinically relevant variability over time.

Conclusion · 2 of 2

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.

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

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

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