title: Carotid intima media thickness is associated with plasma lipoprotein-associated phospholipase A2 mass in nondiabetic subjects but not in patients with type 2 diabetes.
abstract: BACKGROUND
  A recent meta-analysis showed that both plasma lipoprotein-associated phospholipase A(2) (Lp-PLA(2) ) mass and activity independently predict cardiovascular events. Notably, Lp-PLA(2) activity but not mass was found to be a determinant of cardiovascular outcome in type 2 diabetes mellitus. We questioned whether relationships of carotid intima media thickness (IMT), a measure of subclinical atherosclerosis, with Lp-PLA(2) mass differ between diabetic and nondiabetic subjects.
  
  
  METHODS
  Relationships of IMT with plasma Lp-PLA(2) mass (turbidimetric immunoassay) were compared in 74 patients with type 2 diabetes and in 64 nondiabetic subjects.
  
  
  RESULTS
  IMT was increased (P=0·016), but plasma Lp-PLA(2) mass was decreased in patients with diabetes compared to nondiabetic subjects (277±66 vs. 327±62μgL(-1) , P<0·001). In nondiabetic subjects, IMT was correlated positively with Lp-PLA(2) (r=0·325, P<0·009); multiple linear regression analysis confirmed an independent association of IMT with Lp-PLA(2) (ß=0·192, P=0·048). In contrast, IMT was unrelated to Lp-PLA(2) in patients with diabetes (r=0·021, P=0·86), and the relationship of IMT with Lp-PLA(2) was different in diabetic and control subjects (P<0·001). The relationship of Lp-PLA(2) with the total cholesterol/high-density lipoprotein (HDL) cholesterol ratio also differed between diabetic and nondiabetic subjects (P<0·001).
  
  
  CONCLUSIONS
  Plasma Lp-PLA(2) may relate to early stages of atherosclerosis development. In diabetes mellitus, in contrast, the association of IMT with plasma Lp-PLA(2) mass is abolished, which could be partly ascribed to redistribution of Lp-PLA(2) mass from apolipoprotein B-containing lipoproteins towards HDL. These findings raise questions about the usefulness of plasma Lp-PLA(2) mass measurement as a marker of subclinical atherosclerosis in type 2 diabetes mellitus.
authors.affiliation: Department of Endocrinology Department of Cardiology Laboratory Center, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Alexander
authors.initials: A
authors.lastname: Constantinides
authors.forename: L Joost
authors.initials: LJ
authors.lastname: van Pelt
authors.forename: Jeroen J J
authors.initials: JJ
authors.lastname: van Leeuwen
authors.forename: Rindert
authors.initials: R
authors.lastname: de Vries
authors.forename: René A
authors.initials: RA
authors.lastname: Tio
authors.forename: Iwan C C
authors.initials: IC
authors.lastname: van der Horst
authors.forename: Wim J
authors.initials: WJ
authors.lastname: Sluiter
authors.forename: Robin P F
authors.initials: RP
authors.lastname: Dullaart
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood*; D000368:Aged; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D044465:White People
chemical_list: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase