Clinical Chemistry and Laboratory Medicine (CCLM)
Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)
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Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Tate, Jillian R.
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Dual activity of serum lipoprotein-associated phospholipase A2 yielding positive and inverse associations with cardiometabolic risk
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
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
- 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.
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