Lipoprotein-associated phospholipase A2 is associated with risk of dementia.
OBJECTIVE
High levels of the inflammatory marker lipoprotein-associated phospholipase A2 (Lp-PLA2) have been proposed to be a predictor of coronary heart disease and stroke. Because both inflammation and vascular disease are associated with dementia, the objective of the present study was to examine the association between Lp-PLA2 and the risk of dementia.


METHODS
Within the Rotterdam Study, a population-based prospective cohort study, we performed a case-cohort study. Of the 6,713 participants at risk for dementia, a random sample of 1,742 individuals was drawn. During follow-up (mean, 5.7 years), 302 incident dementia cases were identified. Cox proportional hazard models were used to estimate the association of Lp-PLA2 and dementia.


RESULTS
We found that subjects with higher levels of Lp-PLA2 had an increased risk of dementia. Compared with the first quartile of Lp-PLA2, age- and sex-adjusted hazard ratios (HRs; 95% confidence interval [CI]) for dementia for the second, third, and fourth quartiles were 1.19 (0.78-1.81), 1.15 (0.74-1.79), and 1.56 (1.03-2.37), respectively (p value for trend 0.04). Additional adjustment for cardiovascular and inflammatory factors did not change the estimates.


CONCLUSIONS
This is the first study to our knowledge that shows that Lp-PLA2 is associated with the risk of dementia independent of cardiovascular and inflammatory factors and provides evidence for a potential role of Lp-PLA2 in identifying subjects at risk for dementia.
van Oijen
Marieke
M
Department of Epidemiology and Biostatistics, Erasmus Medical Center, PO Box 1738, 3000 DR Rotterdam, The Netherlands.
van der Meer
Irene M
IM
Hofman
Albert
A
Witteman
Jacqueline C M
JC
Koudstaal
Peter J
PJ
Breteler
Monique M B
MM
D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase; D000368:Aged; D015331:Cohort Studies; D003704:Dementia / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010741:Phospholipases A / Q000097:blood*; D054467:Phospholipases A2; D016016:Proportional Hazards Models; D011897:Random Allocation; D012307:Risk Factors
D010741:Phospholipases A; D054467:Phospholipases A2; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase