Distribution and correlates of lipoprotein-associated phospholipase A2 in an elderly cohort: the Cardiovascular Health Study.
OBJECTIVE
To determine whether high levels of lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) are associated with prevalent cardiovascular disease (CVD) and to evaluate factors most influencing Lp-PLA(2) levels in a community-based cohort of older adults.


METHODS
Cross-sectional.


METHODS
The Cardiovascular Health Study (CHS), a population-based cohort study of men and women aged 65 and older.


METHODS
Five thousand five hundred thirty-one CHS participants.


METHODS
Levels of Lp-PLA(2) activity were determined using stored blood samples from the baseline examination.


RESULTS
Mean Lp-PLA(2) was higher in participants with electrocardiographically determined ventricular conduction defect and major Q-wave abnormality and was positively correlated with left ventricular (LV) mass. It was high in those with echocardiographically determined abnormal LV ejection fraction, which persisted after adjustment. Mean Lp-PLA(2) was also higher in participants with mild renal insufficiency and kidney disease. After multivariable adjustment, there was a modest but significant 27% greater risk of prevalent CHF per standard deviation increment of Lp-PLA(2) and a modest but significant 12% greater risk of prevalent myocardial infarction. Lp-PLA(2) was weakly but mainly most strongly correlated with cholesterol and lipoproteins, but those correlations were not especially strong. Lp-PLA(2) was weakly positively correlated with soluble intercellular adhesion molecule-1 but not interleukin-6. In total, all factors considered could explain only 29% of Lp-PLA(2) activity.


CONCLUSIONS
Novel findings in the study are the associations, in those aged 65 and older, between Lp-PLA(2) activity and LV dysfunction, CHF, and renal disease. CVD risk factors only minimally explain levels of Lp-PLA(2).
Furberg
Curt D
CD
Division of Public Health Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27157-1063, USA. cfurberg@wfubmc.edu
Nelson
Jeanenne J
JJ
Solomon
Cam
C
Cushman
Mary
M
Jenny
Nancy Swords
NS
Psaty
Bruce M
BM
D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood*; D000368:Aged; D050197:Atherosclerosis / Q000175:diagnosis / Q000201:enzymology / Q000453:epidemiology; D015992:Body Mass Index; D002303:Cardiac Output, Low / Q000175:diagnosis / Q000201:enzymology / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000201:enzymology* / Q000453:epidemiology; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000201:enzymology / Q000453:epidemiology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000201:enzymology / Q000453:epidemiology; D008133:Long QT Syndrome / Q000175:diagnosis / Q000201:enzymology / Q000453:epidemiology; D008297:Male; D012016:Reference Values; D051437:Renal Insufficiency / Q000175:diagnosis / Q000201:enzymology / Q000453:epidemiology; D012307:Risk Factors; D013223:Statistics as Topic; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase