Comparison of Lipoprotein-Associated Phospholipase A2 and High Sensitive C-Reactive Protein as Determinants of Metabolic Syndrome in Subjects without Coronary Heart Disease: In Search of the Best Predictor

Abstract

High sensitivity C-reactive protein (hsCRP) is a marker of metabolic syndrome (MS) and cardiovascular (CV) disease. Lipoprotein-associated phospholipase A2 (Lp-PLA2) also predicts CV disease. There are no reports comparing these markers as predictors of MS. Methods. Cross-sectional study comparing Lp-PLA2 and hsCRP as predictors of MS in asymptomatic subjects was carried out; 152 subjects without known atherosclerosis participated. Data were collected on demographics, cardiovascular risk factors, anthropometric and biochemical measurements, and hsCRP and Lp-PLA2 activity levels. A logistic regression analysis was performed with each biomarker and receiver operating characteristic (ROC) curves were constructed for MS. Results. Mean age was 46 ± 11 years, and 38% of the subjects had MS. Mean Lp-PLA2 activity was 185 ± 48 nmol/mL/min, and mean hsCRP was 2.1 ± 2.2 mg/L. Subjects with MS had significantly higher levels of Lp-PLA2 (P = 0.03) and hsCRP (P < 0.0001) than those without MS. ROC curves showed that both markers predicted MS. Conclusion. Lp-PLA2 and hsCRP are elevated in subjects with MS. Both biomarkers were independent and significant predictors for MS, emphasizing the role of inflammation in MS. Further research is necessary to determine if inflammation predicts a higher risk for CV events in MS subjects.

Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

“…In prospective or retrospective cohort studies, the following factors have been reported as being directly associated with incident metabolic syndrome, defined by 1 of the major definitions: age, 25 low educational attainment, 128,129 low socioeconomic status, 130 not being able to understand or read food labels, 131 urbanization, 132 smoking, 129,130,133,134 parental smoking, 135 low levels of PA, 129,130,133,134 low levels of physical fitness, 136–138 intake of soft drinks, 139 intake of diet soda, 140 fructose intake, 141 magnesium intake, 142,143 energy intake, 144 carbohydrate intake, 128,134,145 total fat intake, 74,146 Western dietary pattern, meat intake, (red but not white meat 147 ), intake of fried foods, 140 skipping breakfast, 148 heavy alcohol consumption, 149 abstention from alcohol use, 128 parental history of DM, 74 long-term stress at work, 150 pediatric metabolic syndrome, 74 obesity or BMI, 77,88,100,146,151 childhood obesity, 152 intra-abdominal fat, 153 gain in weight or BMI, 135,146 weight fluctuation, 154 heart rate, 155 homeostasis model assessment, 156,157 fasting insulin, 157 2-hour insulin, 157 proinsulin, 157 oxidized LDL-C, 156 lipoprotein-associated phospholipase A2, 158 uric acid, 159,160 γ-glutamyltransf erase, 159,161,162 alanine transaminase, 159,161,163,164 plasminogen activator inhibitor-1, 165 aldosterone, 165 leptin, 166 ferritin, 167 CRP, 168,169 adipocyte–fatty acid binding protein, …”

Energy Intake and Plasma Adiponectin as Potential Determinants of Lipoprotein‐Associated Phospholipase A2 Activity: A Cross‐Sectional Study

“…Associations with sex are consistent across studies, with Lp‐PLA 2 activity being lower in women compared to men (Brilakis et al, ; Lew et al, ; Liu et al, ; Persson et al, ; Steffen et al, ) while the association of Lp‐PLA 2 activity with age is controversial (Anuurad et al, ; Gong et al, ; Persson et al, ). With respect to modifiable cardiometabolic risk factors, Lp‐PLA 2 activity is associated with metabolic syndrome (MetS) components in several cross‐sectional studies; there is a positive association with the body mass index (BMI) (Acevedo et al, ; Rana et al, ), waist circumference (Acevedo et al, ; Persson et al, ; Rana et al, ), total cholesterol (Gong et al, ; Liu et al, ; Tsimikas et al, ), triacylglycerols (Liu et al, ; Persson et al, ; Tsimikas et al, ), glucose (Gong et al, ; Persson et al, ), insulin resistance (homeostasis model assessment of insulin resistance index, HOMA‐IR) (Tsimikas et al, ), systolic blood pressure (SBP) (Liu et al, ; Persson et al, ), and diastolic blood pressure (DBP) (Acevedo et al, ; Liu et al, ). Lp‐PLA 2 activity is associated with the Lp‐PLA 2 ‐carrier lipoprotein particles as expected, albeit in opposite directions; there is a positive association with LDL‐cholesterol (Acevedo et al, ; Chae et al, ; Gong et al, ; Liu et al, ; Rizos et al, ; Tsimikas et al, ) and a negative association with HDL‐cholesterol (Acevedo et al, ; Liu et al, ; Persson et al, ; Tsimikas et al, ).…”

“…With respect to modifiable cardiometabolic risk factors, Lp-PLA 2 activity is associated with metabolic syndrome (MetS) components in several cross-sectional studies; there is a positive association with the body mass index (BMI) (Acevedo et al, 2015;Rana et al, 2011), waist circumference (Acevedo et al, 2015;Persson et al, 2007b;Rana et al, 2011), total cholesterol (Gong et al, 2011;Liu et al, 2014;Tsimikas et al, 2009), triacylglycerols (Liu et al, 2014;Persson et al, 2007b;Tsimikas et al, 2009), glucose (Gong et al, 2011;Persson et al, 2007b), insulin resistance (homeostasis model assessment of insulin resistance index, HOMA-IR) (Tsimikas et al, 2009), systolic blood pressure (SBP) (Liu et al, 2014;Persson et al, 2007b), and diastolic blood pressure (DBP) (Acevedo et al, 2015;Liu et al, 2014). Lp-PLA 2 activity is associated with the Lp-PLA 2carrier lipoprotein particles as expected, albeit in opposite directions; there is a positive association with LDLcholesterol (Acevedo et al, 2015;Chae et al, 2011;Gong et al, 2011;Liu et al, 2014;Rizos et al, 2005;Tsimikas et al, 2009) and a negative association with HDLcholesterol (Acevedo et al, 2015;Liu et al, 2014;Persson et al, 2007b;Tsimikas et al, 2009). LDL-cholesterol is significantly associated with Lp-PLA 2 activity even after adjustments for sex, ethnicity (Brilakis et al, 2008), and MetS components (Gong et al, 2011).…”

“…In relation to lifestyle factors, the association of Lp-PLA 2 activity with smoking remains inconclusive (Acevedo et al, 2015;Persson et al, 2007a;Tselepis et al, 2009). In observational studies, Lp-PLA 2 activity is not significantly associated with the physical activity level (Rana et al, 2011;Steffen et al, 2013;Tselepis et al, 2009;Tsimikas et al, 2009), consumption of foods (Tselepis et al, 2009) and food groups (Detopoulou et al, 2015;Tselepis et al, 2009), or intake of total energy and macronutrients (Detopoulou et al, 2015;Tsimikas et al, 2009).…”

Lipoprotein-Associated Phospholipase A2 Activity Level may be complementary to Cardiactroponin I as a Biomarker for Acute Myocardial Infarction in Chinese Patients with Chest Pain

“…Cardiac troponinis a kind of contractive and adjustive protein exists in the thin myocardial fibre, which subunits will diffuse into venous blood when the myocardial-cell injured (Zheng et al 2011, Acevedo et al 2015, Donato et al 2015. As a highly sensitive and specific indicator of myocardial injury, Cardiac troponin I (cTn I) is a well-known marker for the diagnosis of acute myocardial infarction (AMI).…”