title: Lipoprotein-associated phospholipase A2 mass is significantly reduced in dyslipidemic patients treated with lifestyle modification and combination lipid-modifying drug therapy.
abstract: Lipoprotein-associated phospholipase A2 (Lp-PLA(2)) mass is a novel inflammatory biomarker. In human blood, Lp-PLA(2) is predominately associated with low-density lipoprotein (LDL). This study examines the ability of lifestyle modification (diet and exercise) and combination lipid therapy to reduce Lp-PLA(2) levels while also determining the relationship between changes in LDL cholesterol and Lp-PLA(2). Thirty dyslipidemic patients who received lifestyle intervention and combination lipid therapy for an average of 6 months were included in these analyses (mean age, 60.9 years); 40% had stable angiographically established coronary artery disease, 40% had the metabolic syndrome, and 70% were men. Drug therapy included omega-3 fish oil, extended-release niacin, colesevelam hydrochloride, and a fixed combination of 10-mg ezetimibe and 40-mg simvastatin. The study revealed a 33% reduction in mean Lp-PLA(2) values (baseline 224.9+/-47.5 vs posttreatment 149.5+/-35.5 ng/mL; P<.001). Significant changes in mean LDL cholesterol from baseline (127.9+/-49.3 vs posttreatment 65.2+/-32.1 mg/dL; P<.001) were also observed. However, regression analysis revealed only a weak positive relationship between changes in LDL cholesterol and Lp-PLA(2) mass (R(2)=0.29; P<.01). Thus, Lp-PLA(2) mass is significantly reduced with lifestyle and combination lipid therapy. Changes in Lp-PLA(2) were only partially explained by the changes observed for LDL cholesterol.
authors.affiliation: Reddy Cardiac Wellness, Sugar Land, TX 77479, USA.
authors.forename: Kota J
authors.initials: KJ
authors.lastname: Reddy
authors.forename: Manmeet
authors.initials: M
authors.lastname: Singh
authors.forename: Richard R
authors.initials: RR
authors.lastname: Batsell
authors.forename: Joey R
authors.initials: JR
authors.lastname: Bangit
authors.forename: Rekha A
authors.initials: RA
authors.lastname: Miraskar
authors.forename: Misbah S
authors.initials: MS
authors.lastname: Zaheer
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000187:drug effects* / Q000378:metabolism; D000499:Allylamine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001384:Azetidines / Q000627:therapeutic use; D015415:Biomarkers; D008078:Cholesterol, LDL / Q000187:drug effects* / Q000378:metabolism; D000069472:Colesevelam Hydrochloride; D004359:Drug Therapy, Combination; D050171:Dyslipidemias / Q000188:drug therapy*; D000069438:Ezetimibe; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007249:Inflammation; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009525:Niacin / Q000627:therapeutic use; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D019821:Simvastatin / Q000627:therapeutic use; D013223:Statistics as Topic; D014803:Vitamin B Complex / Q000627:therapeutic use
chemical_list: D000924:Anticholesteremic Agents; D001384:Azetidines; D015415:Biomarkers; D008078:Cholesterol, LDL; D015525:Fatty Acids, Omega-3; D014803:Vitamin B Complex; D009525:Niacin; D000499:Allylamine; D019821:Simvastatin; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase; D000069438:Ezetimibe; D000069472:Colesevelam Hydrochloride