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Clinical Chemistry and Laboratory Medicine (CCLM)

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

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Volume 53, Issue 7


Elevated circulating levels of lipoprotein-associated phospholipase A2 in obese children

Sophia Sakka
  • Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Athens University Medical School, Athens, Greece
  • Other articles by this author:
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/ Tania Siahanidou
  • Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Athens University Medical School, Athens, Greece
  • Other articles by this author:
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/ Chronis Voyatzis / Panagiota Pervanidou
  • Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Athens University Medical School, Athens, Greece
  • Other articles by this author:
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/ Christina Kaminioti / Natalia Lazopoulou
  • Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Athens University Medical School, Athens, Greece
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  • De Gruyter OnlineGoogle Scholar
/ Christina Kanaka-Gantenbein
  • Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Athens University Medical School, Athens, Greece
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/ George P. Chrousos
  • Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Athens University Medical School, Athens, Greece
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/ Ioannis Papassotiriou
Published Online: 2015-01-10 | DOI: https://doi.org/10.1515/cclm-2014-1081


Background: Obesity and cardiovascular disease (CVD) often co-exist, but the pathophysiologic mechanisms that link the two are not fully understood. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is involved in the modification of lipids within atheromatous plaques. Recently, circulating Lp-PLA2 was found to be predictive of thromboembolic episodes in adults, independently of a variety of other potential risk factors, including markers of inflammation, renal function, and hemodynamic stress. However, the function of this lipase and its importance as a biomarker in childhood obesity is much less studied. The aim of the study was to study Lp-PLA2, a non-traditional risk factor of CVD, in obese children.

Methods: Sixty-seven lean [39 boys and 28 girls, mean body mass index (BMI) z-score –0.2±0.8] and 66 obese (32 boys and 34 girls, mean BMI z-score 4.4±1.2) age-matched (p=0.251) children, aged 6–12 years, were studied. BMI z-score was calculated based on the Greek BMI growth curves, and children were categorized as obese according to the Cole criteria. All children underwent physical examination and a fasting morning blood sample was obtained for glucose, insulin, lipid profile, and Lp-PLA2 assessment. Plasma concentrations of Lp-PLA2 were determined by a commercially available Lp-PLA2 enzyme-linked immunosorbent assay kit (PLAC Test), while other measurements were performed using standard methods.

Results: Plasma Lp-PLA2 levels were significantly higher in obese children (322.5±77.8 ng/mL) compared with normal-weight ones (278.0±64.4 ng/mL, p<0.001). Lp-PLA2 concentrations were significantly correlated with the BMI z-score (p=0.004). Receiver operating characteristic analysis on Lp-PLA2 values resulted in significant areas under the curve (AUC) for distinguishing between obese and normal-weight groups of children (AUC, 0.726; p<0.001).

Conclusions: We found significantly higher Lp-PLA2 levels in obese children than lean controls. Interestingly, they all had levels >200 ng/mL, which are considered to correlate with atherosclerosis and a high thromboembolic risk in adults. The positive correlation of Lp-PLA2 with BMI suggests that Lp-PLA2 might be the link between obesity and increased cardiovascular risk, which can be elevated even at a very young age. Measurement of Lp-PLA2 in plasma could therefore represent a further biomarker for assessing increased CVD risk in obese children and adolescents.

Keywords: biomarkers; BMI; cardiovascular risk; children; lipids; lipoprotein-associated phospholipase A2 (Lp-PLA2); obesity


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About the article

Corresponding author: Dr Ioannis Papassotiriou, Department of Clinical Biochemistry, “Aghia Sophia” Children’s Hospital Athens 11527, Greece, Phone/Fax: +30-213-2013171, E-mail: ;

Received: 2014-11-04

Accepted: 2014-12-04

Published Online: 2015-01-10

Published in Print: 2015-06-01

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 53, Issue 7, Pages 1119–1125, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2014-1081.

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