title: Dual activity of serum lipoprotein-associated phospholipase A(2) yielding positive and inverse associations with cardiometabolic risk.
abstract: BACKGROUND
  The clinical relevance of serum lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) in populations prone to cardiometabolic risk needs exploration. We determined major covariates of Lp-PLA(2) mass, and its associations with cardiometabolic disorders.
  
  
  METHODS
  In 736 Turkish adults, serum total Lp-PLA(2) mass was determined by immunoassay. Its association with cardiometabolic risk was assessed in three categories. In a second sample of 98 subjects, enzyme protein in high-density lipoprotein (HDL) was also assayed after precipitation.
  
  
  RESULTS
  Significant inverse correlation existed with high triglyceride/low HDL cholesterol dyslipidemia, waist girth, apolipoprotein C-III, homeostatic model assessment, and linear inverse associations in women with lipoprotein (a) and fibrinogen, suggesting that Lp-PLA(2) mass reflected insulin sensitivity and that HDL bound enzyme mass dominated the associations. Among men, positive linear association with total cholesterol suggested additional association with low-density lipoprotein (LDL)-bound enzyme. High (>450 ng/mL) opposed to low (<210 ng/mL) circulating Lp-PLA(2) mass was associated with prevalent and incident coronary heart disease (CHD) in men. One SD increment in Lp-PLA(2) was associated with a 1.64-fold (95% CI 1.00; 2.70) likelihood of CHD, after adjustment for potential confounders. Furthermore, Lp-PLA(2) categories were significantly, independently and inversely associated in men with diabetes only (OR 0.61) and in women with metabolic syndrome only (OR 0.68), for a 1-SD increment.
  
  
  CONCLUSIONS
  Serum total Lp-PLA(2) mass may indicate either elevated or diminished cardiometabolic risk, specific for gender, depending on its partitioning in lipoprotein groups.
authors.affiliation: Turkish Society of Cardiology, Istanbul, Turkey.
authors.forename: Altan
authors.initials: A
authors.lastname: Onat
authors.affiliation: Department of Biology, Yildiz Technical University, Istanbul, Istanbul, Turkey.
authors.forename: Gülay
authors.initials: G
authors.lastname: Hergenç
authors.affiliation: Department of Public Health, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Günay
authors.initials: G
authors.lastname: Can
authors.affiliation: Siyami Ersek Center for Cardiovascular Surgery, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Uğur
authors.affiliation: Biochemistry Laboratory, Göztepe Educational Hospital, Istanbul, Turkey.
authors.forename: Filiz
authors.initials: F
authors.lastname: Nartop
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood* / Q000378:metabolism*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000201:enzymology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications; D005260:Female; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood / Q000378:metabolism; D008077:Lipoproteins, LDL / Q000097:blood / Q000378:metabolism; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications; D008875:Middle Aged; D016017:Odds Ratio; D011485:Protein Binding; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase