LPA and atherosclerosis: This is consistent with other prior studies suggesting that diabetes and metabolic syndrome may attenuate an association between Lp(a) and ASCVD risk.21, 22, 23, 24, 25, 26, 27 Although the exact mechanisms through which diabetes may attenuate an association between Lp(a) and ASCVD risk remain unclear, it has been speculated that this attenuation may be explained by differences in the characteristics of Lp(a) particles and their metabolism.21