Plasma Lipoprotein-associated Phospholipase A2 in Patients with Metabolic Syndrome and Carotid Atherosclerosis

Abstract

BackgroundLipoprotein-associated phospholipase A2 (Lp-PLA2) is a recently identified and potentially useful plasma biomarker for cardiovascular and atherosclerotic diseases. However, the correlation between the Lp-PLA2 activity and carotid atherosclerosis remains poorly investigated in patients with metabolic syndrome (MetS). The present study aimed to evaluate the potential role of Lp-PLA2 as a comprehensive marker of metabolic syndrome in individuals with and without carotid atherosclerosis.MethodsWe documented 118 consecutive patients with MetS and 70 age- and sex-matched healthy subjects served as controls. The patients were further divided into two groups: 39 with carotid plaques and 79 without carotid plaques to elucidate the influence of Lp-PLA2 on carotid atherosclerosis. The plasma Lp-PLA2 activity was measured by using ELISA method and carotid intimal-media thickness (IMT) was performed by ultrasound in all participants.ResultsLp-PLA2 activity was significantly increased in MetS subgroups when compared with controls, and was higher in patients with carotid plaques than those without plaques (P < 0.05). Furthermore, we found that significant difference in Lp-PLA2 was obtained between patients with three and four disorders of metabolic syndrome (P < 0.01). Age (β = 0.183, P = 0.029), LDL-cholesterol (β = 0.401, P = 0.000) and waist-hip ratio (β = 0.410, P = 0.000) emerged as significant and independent determinants of Lp-PLA2 activity. Multiple stepwise regression analysis revealed that LDL-cholesterol (β = 0.309, P = 0.000), systolic blood pressure (β = 0.322, P = 0.002) and age (β = 0.235, P = 0.007) significantly correlated with max IMT, and Lp-PLA2 was not an independent predictor for carotid IMT.ConclusionsLp-PLA2 may be a modulating factor for carotid IMT via age and LDL-cholesterol, not independent predictor in the pathophysiological process of carotid atherosclerosis in patients with MetS.

Association between the Lipoprotein-Associated Phospholipase A2 Activity and the Progression of Subclinical Atherosclerosis

“…No significant associations were observed between the Lp-PLA2 and baseline IMT values in the current study. Similar negative results have also been reported by some 8,25) , but not all 24) , previous cross-sectional studies of the carotid IMT. The nature of the study design, with only one concurrent measurement of the Lp-PLA2 activity and atherosclerosis, may account for this inconsistency, as such find-…”

“…Despite accumulating evidence showing an increased risk of clinical CVD events to be associated with the Lp-PLA2 level, the association between the Lp-PLA2 level and subclinical atherosclerosis is less established, and the findings of limited cross-sectional and casecontrol studies are inconsistent [7][8][9][10][23][24][25] . In the present analysis, the Lp-PLA2 level was found to be significantly associated with the presence of baseline carotid plaque in men, but not women.…”

“…In the Rotterdam Study 8) , a higher OR of having extracoronary atherosclerosis for the highest versus lowest tertile of the Lp-PLA2 activity was also noted in men (OR=1.42, 95% CI = 0.71-2.86) compared to that observed in women (OR = 0.83, 95% CI = 0.54-1.28) after adjusting for traditional risk factors and the hsCRP level, although the association did not reach statistical significance. Other studies regarding the association between the Lp-PLA2 level and subclinical atherosclerosis did not assess sex-specific relationships 7,11,12,25,26) . However, the CARDIA Study 7) and VADT Study 11) , which found an association between the Lp-PLA2 level and the prevalence and progression of coronary artery calcification, respectively, predominantly consisted of In the multivariate analysis, the Lp-PLA2 activity was found to be independently associated with the progression of plaque in men (p = 0.043), but not women (p = 0.273), after adjusting for traditional risk factors (Table 3).…”

Lipoprotein-associated Phospholipase A2 is Associated with Angiographic Coronary Artery Disease and Coronary Artery Risk Factors in the Elderly

“…It was remarkably expressed in human and rabbit atherosclerotic lesions, especially in the necrotic core of vulnerable plaques and surrounding macrophages 15 . A similar phenomenon was reported among symptomatic patients who suffered from carotid artery plaque, a marker of atherosclerotic disease 16,17 . Most studies have examined the association between the Lp-PLA2 level and the extent of CAD assessed by coronary angiography and found that Lp-PLA2 was associated with the severity of angiographic CAD in univariable analyses 18e21 .…”

Lipoprotein-Associated Phospholipase A2 and Risk of Carotid Atherosclerosis and Cardiovascular Events in Community-Based Older Adults in China

“…Those with low LDL-C but high levels of Lp-PLA2 may therefore be at an increased risk of CVD, which is consistent with results of previous studies. 38,39 In our analysis, we also demonstrated that the highest level of Lp-PLA2 was an independent predictor of MI and CVD death even after adjustment for conventional risk markers and carotid atherosclerosis status. However, we failed to find a significant association of Lp-PLA2 with the risks of overall stroke and total mortality in multivariable-adjusted models.…”