title: Lipoprotein-associated phospholipase A(2) mass and activity and risk of cardiovascular disease in a population with high prevalences of obesity and diabetes: the Strong Heart Study.
abstract: OBJECTIVE
  To investigate the association of lipoprotein-associated phospholipase A(2) (LpPLA(2)) mass and activity with incident cardiovascular disease (CVD) in a population with high prevalences of insulin resistance and diabetes, conditions for which epidemiological data remain sparse.
  
  
  METHODS
  We conducted a nested, case-control study (n = 1,008) within a population-based cohort of American Indians. Case subjects were defined by incidence of first-ever CVD up to 10 years later. Control subjects comprised participants free of CVD events during the follow-up period who were frequency matched to case subjects by age, sex, and diabetes status. LpPLA(2) mass and activity were measured using commercially available assays.
  
  
  RESULTS
  LpPLA(2) mass and activity were moderately correlated with each other (r = 0.30), but only LpPLA(2) activity exhibited moderate correlations with lipid fractions. After extensive adjustment for covariates, both LpPLA(2) measures were significantly associated with incident CVD, but the relationship was inverse for LpPLA(2) mass (highest versus lowest tertile, relative risk [RR] 0.55 [95% CI 0.39-0.79]) and positive for LpPLA(2) activity (highest versus lowest tertile, 1.65 [1.12-2.42]). These associations were similar when participants with and without diabetes were examined separately.
  
  
  CONCLUSIONS
  In this population-based cohort enriched with dysmetabolic phenotypes, LpPLA(2) mass and activity showed divergent associations with CVD. The inverse relationship for LpPLA(2) mass is contrary to observations from predominantly nondiabetic populations and will require independent replication. Whether this finding relates to redistribution of LpPLA(2) to lipoprotein classes where it is less atherogenic or reflects incomplete measurement of LpPLA(2) mass associated with altered lipoprotein composition in insulin resistance warrants further investigation.
authors.affiliation: Department of Medicine, Weill Cornell Medical Center, New York, New York, USA. jok2007@med.cornell.edu
authors.forename: Jorge R
authors.initials: JR
authors.lastname: Kizer
authors.forename: Jason G
authors.initials: JG
authors.lastname: Umans
authors.forename: Jianhui
authors.initials: J
authors.lastname: Zhu
authors.forename: Richard B
authors.initials: RB
authors.lastname: Devereux
authors.forename: Robert L
authors.initials: RL
authors.lastname: Wolfert
authors.forename: Elisa T
authors.initials: ET
authors.lastname: Lee
authors.forename: Barbara V
authors.initials: BV
authors.lastname: Howard
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood / Q000737:chemistry / Q000378:metabolism* / Q000502:physiology; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology* / Q000378:metabolism; D016022:Case-Control Studies; D015331:Cohort Studies; D048909:Diabetes Complications / Q000453:epidemiology* / Q000208:ethnology / Q000378:metabolism; D004789:Enzyme Activation; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D009765:Obesity / Q000150:complications* / Q000453:epidemiology* / Q000208:ethnology / Q000378:metabolism; D011153:Population; D015995:Prevalence; D012307:Risk Factors
chemical_list: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase