title: Increased levels of pregnancy-associated plasma protein-A in patients with hypercholesterolemia: the effect of atorvastatin treatment.
abstract: BACKGROUND
  Serum levels of pregnancy-associated plasma protein-A (PAPP-A) have recently been linked to plaque instability and are increased in acute coronary syndromes. The relation between PAPP-A levels and coronary risk factors, namely blood lipids, has not been studied to date. We have therefore investigated whether serum PAPP-A levels are increased in asymptomatic hypercholesterolemic subjects and whether PAPP-A levels are influenced by atorvastatin therapy.
  
  
  METHODS
  We examined 27 subjects with isolated hypercholesterolemia free of manifest vascular disease and 29 age-matched healthy control subjects. Patients were examined at baseline and after 10 weeks of atorvastatin treatment (20 mg/d).
  
  
  RESULTS
  In untreated hypercholesterolemic subjects, PAPP-A levels were significantly higher than in control subjects (8.02 +/- 1.86 mU/L vs 6.50 +/- 2.54 mU/L, P =.018). There was no correlation between PAPP-A levels and serum lipid levels. Atorvastatin treatment reduced total and LDL-cholesterol by 31% and 40%, respectively. Despite this profound lipid lowering, there was no significant change in the serum PAPP-A levels.
  
  
  CONCLUSIONS
  PAPP-A levels are elevated in hypercholesterolemic subjects without clinical signs of atherosclerosis. PAPP-A may therefore not only reflect plaque instability but also serve as a marker of total atherosclerotic burden in asymptomatic subjects with hyperlipidemia. However, PAPP-A levels are not influenced by atorvastatin treatment.
authors.affiliation: Third Department of Internal Medicine, Charles University, Prague, Czech Republic. TSTULC@LF1.CUNI.CZ
authors.forename: Tomás
authors.initials: T
authors.lastname: Stulc
authors.forename: Ivan
authors.initials: I
authors.lastname: Malbohan
authors.forename: Jan
authors.initials: J
authors.lastname: Malík
authors.forename: Lenka
authors.initials: L
authors.lastname: Fialová
authors.forename: Jirina
authors.initials: J
authors.lastname: Soukupová
authors.forename: Richard
authors.initials: R
authors.lastname: Ceska
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D000069059:Atorvastatin; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D011758:Pyrroles / Q000627:therapeutic use*
chemical_list: D000924:Anticholesteremic Agents; D015415:Biomarkers; D006538:Heptanoic Acids; D011758:Pyrroles; D000069059:Atorvastatin; D011266:Pregnancy-Associated Plasma Protein-A