title: Lipoprotein-associated phospholipase A2 activity, ferritin levels, metabolic syndrome, and 10-year cardiovascular and non-cardiovascular mortality: results from the Bruneck study.
abstract: OBJECTIVE
  To identify factors that influence plasma levels and assess the prognostic value of lipoprotein-associated phospholipase A2 (Lp-PLA2) activity in a prospective, population-based survey of the epidemiology and pathogenesis of atherosclerosis.
  
  
  RESULTS
  The Bruneck study is a prospective, population-based survey initiated in 1990. Lp-PLA2 activity and baseline variables for the current analysis were measured in 765 subjects aged 45-84 years in 1995. Incident cardiovascular disease (CVD) (cardiovascular death, myocardial infarction, stroke, and transient ischaemic attack) and rates of non-CVD mortality were assessed between 1995 and 2005. Subjects with incident CVD had higher levels of Lp-PLA2 activity (884 +/- 196 vs. 771 +/- 192 micromol/min/L, P < 0.001). Increased Lp-PLA2 activity was significantly related to incident CVD [age- and sex-adjusted hazard ratio (95%CI) 2.9 (1.6-5.5); third vs. first tertile group; P < 0.001] and with vascular mortality but not with non-CVD mortality. Lp-PLA2 activity was enhanced in subjects with the metabolic syndrome and showed highly significant positive associations with LDL-C, apoB-100, ferritin, and HOMA-IR, and inverse associations with HDL-C and anti-oxidant levels.
  
  
  CONCLUSIONS
  Increased Lp-PLA2 activity is associated with metabolic syndrome and incident fatal and non-fatal CVD, but not with non-CVD mortality. Furthermore, Lp-PLA2 activity is strongly influenced by ferritin levels, LDL-C, and apoB-100 supporting its integral role in lipid peroxidation. Clinical utility of Lp-PLA2 activity for prediction of cardiovascular risk has to be explored in future studies.
authors.affiliation: Division of Cardiology, University of California San Diego, La Jolla, CA, USA.
authors.forename: Sotirios
authors.initials: S
authors.lastname: Tsimikas
authors.forename: Johann
authors.initials: J
authors.lastname: Willeit
authors.forename: Michael
authors.initials: M
authors.lastname: Knoflach
authors.forename: Manuel
authors.initials: M
authors.lastname: Mayr
authors.forename: Georg
authors.initials: G
authors.lastname: Egger
authors.forename: Marlene
authors.initials: M
authors.lastname: Notdurfter
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Witztum
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Wiedermann
authors.forename: Qingbo
authors.initials: Q
authors.lastname: Xu
authors.forename: Stefan
authors.initials: S
authors.lastname: Kiechl
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000401:mortality; D005260:Female; D005293:Ferritins / Q000097:blood*; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000401:mortality; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D005293:Ferritins; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase