title: Low phospholipid transfer protein (PLTP) is a risk factor for peripheral atherosclerosis.
abstract: OBJECTIVE
  Phospholipid transfer protein (PLTP) facilitates cholesterol efflux from cells, intravascular HDL remodelling and transfer of vitamin E and endotoxin. In humans, the relationship of PLTP to atherosclerosis is unknown. However, strong coronary risk factors like obesity, diabetes, cigarette smoking and inflammation increase circulating levels of active PLTP. The aim of the present, cross-sectional study was to analyze the relationship of PLTP to peripheral arterial disease, a marker of generalized atherosclerosis, independently of potentially confounding factors like obesity, diabetes and smoking.
  
  
  METHODS
  We performed a case control study in 153 patients with symptomatic peripheral arterial disease (PAD) and 208 controls free of vascular disease. Smokers and patients with diabetes mellitus were excluded. A lipoprotein-independent assay was used for measurement of circulating bioactive PLTP and an ELISA utilizing a monoclonal antibody was used to analyze PLTP mass.
  
  
  RESULTS
  PLTP activity was significantly decreased in patients with PAD 5.5 (4.6-6.4)(median (25th-75th percentile)) versus 5.9 (5.1-6.9) micromol/mL/h in controls (p=0.001). In contrast, PLTP mass was similar in patients with PAD 8.5 microg/mL (7.3-9.5) and in controls 8.3 microg/mL (6.9-9.7) (p=0.665). Multivariate logistic regression analysis revealed that PLTP activity is independently associated with the presence of PAD. PLTP activity was similar in patients with and without lipid-lowering drugs (p=0.396).
  
  
  CONCLUSIONS
  Our results show that in non-diabetic, non-smoking subjects low rather than high PLTP activity is a marker for the presence of peripheral arterial disease and that distribution of PLTP between high-activity and low-activity forms may be compromised in atherosclerosis.
authors.affiliation: Department of Internal Medicine, Medical University Innsbruck, Austria.
authors.forename: Wilfried
authors.initials: W
authors.lastname: Schgoer
authors.affiliation: Department of Laboratory Medicine, Konventhospital Barmherzige Brueder, Linz, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mueller
authors.affiliation: Department of Molecular Medicine, National Public Health Institute, Biomedicum, Helsinki, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Jauhiainen
authors.affiliation: Department of Internal Medicine, Medical University Innsbruck, Austria; Department of Internal Medicine, Landeskrankenhaus Bregenz, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Wehinger
authors.affiliation: Department of Internal Medicine, Medical University Innsbruck, Austria.
authors.forename: Roland
authors.initials: R
authors.lastname: Gander
authors.affiliation: Department of Internal Medicine, Medical University Innsbruck, Austria.
authors.forename: Ivan
authors.initials: I
authors.lastname: Tancevski
authors.affiliation: Department of Internal Medicine, Medical University Innsbruck, Austria.
authors.forename: Karin
authors.initials: K
authors.lastname: Salzmann
authors.affiliation: Department of Internal Medicine, Medical University Innsbruck, Austria.
authors.forename: Philipp
authors.initials: P
authors.lastname: Eller
authors.affiliation: Department of Internal Medicine, Medical University Innsbruck, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Ritsch
authors.affiliation: Department of Laboratory Medicine, Konventhospital Barmherzige Brueder, Linz, Austria.
authors.forename: Meinhard
authors.initials: M
authors.lastname: Haltmayer
authors.affiliation: Department of Molecular Medicine, National Public Health Institute, Biomedicum, Helsinki, Finland.
authors.forename: Christian
authors.initials: C
authors.lastname: Ehnholm
authors.affiliation: Department of Internal Medicine, Medical University Innsbruck, Austria.
authors.forename: Josef R
authors.initials: JR
authors.lastname: Patsch
authors.affiliation: Department of Internal Medicine, Medical University Innsbruck, Austria; Department of Internal Medicine, Landeskrankenhaus Bregenz, Austria. Electronic address: bernhard.foeger@lkhb.at.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Foeger
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000378:metabolism*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D016491:Peripheral Vascular Diseases / Q000378:metabolism*; D049294:Phospholipid Transfer Proteins / Q000097:blood / Q000378:metabolism*
chemical_list: D015415:Biomarkers; C493430:PLTP protein, human; D049294:Phospholipid Transfer Proteins