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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Tate, Jillian R. / Tsongalis, Gregory J.

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Dual activity of serum lipoprotein-associated phospholipase A2 yielding positive and inverse associations with cardiometabolic risk

1, 2 / Gülay Hergenç3 / Günay Can4 / Murat Uğur5 / Filiz Nartop6

1Turkish Society of Cardiology, Istanbul, Turkey

2Department of Cardiology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey

3Department of Biology, Yildiz Technical University, Istanbul, Istanbul, Turkey

4Department of Public Health, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey

5Siyami Ersek Center for Cardiovascular Surgery, Istanbul, Turkey

6Biochemistry Laboratory, Göztepe Educational Hospital, Istanbul, Turkey

Corresponding author: Prof. Dr. Altan Onat, Nisbetiye cad. 59/24, Etiler 34335, İstanbul, Turkey Phone: +90 212 351 6217

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 49, Issue 8, Pages 1349–1357, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2011.110, July 2011

Publication History

Published Online:


Background: The clinical relevance of serum lipoprotein-associated phospholipase A2 (Lp-PLA2) in populations prone to cardiometabolic risk needs exploration. We determined major covariates of Lp-PLA2 mass, and its associations with cardiometabolic disorders.

Methods: In 736 Turkish adults, serum total Lp-PLA2 mass was determined by immunoassay. Its association with cardiometabolic risk was assessed in three categories. In a second sample of 98 subjects, enzyme protein in high-density lipoprotein (HDL) was also assayed after precipitation.

Results: Significant inverse correlation existed with high triglyceride/low HDL cholesterol dyslipidemia, waist girth, apolipoprotein C-III, homeostatic model assessment, and linear inverse associations in women with lipoprotein (a) and fibrinogen, suggesting that Lp-PLA2 mass reflected insulin sensitivity and that HDL bound enzyme mass dominated the associations. Among men, positive linear association with total cholesterol suggested additional association with low-density lipoprotein (LDL)-bound enzyme. High (>450 ng/mL) opposed to low (<210 ng/mL) circulating Lp-PLA2 mass was associated with prevalent and incident coronary heart disease (CHD) in men. One SD increment in Lp-PLA2 was associated with a 1.64-fold (95% CI 1.00; 2.70) likelihood of CHD, after adjustment for potential confounders. Furthermore, Lp-PLA2 categories were significantly, independently and inversely associated in men with diabetes only (OR 0.61) and in women with metabolic syndrome only (OR 0.68), for a 1-SD increment.

Conclusions: Serum total Lp-PLA2 mass may indicate either elevated or diminished cardiometabolic risk, specific for gender, depending on its partitioning in lipoprotein groups.

Keywords: atherogenic dyslipidemia; coronary heart disease; diabetes type-2; lipoprotein-associated phospholipase A2 mass

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European Journal of Internal Medicine, 2014, Volume 25, Number 6, Page 556

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