title: Unexpected inverse relationship between impaired glucose metabolism and lipoprotein-associated phospholipase A2 activity in patients with stable vascular disease.
abstract: BACKGROUND
  Elevated lipoprotein-associated phospholipase A2 activity (aLp-PLA2) is associated with increased risk of cardiovascular events. In patients with stable atherovascular disease, we aimed to investigate whether impaired glucose metabolism might be associated with higher risk of elevated aLp-PLA2.
  
  
  METHODS
  We conducted a cross-sectional study in 825 stable patients after acute coronary syndrome, coronary revascularization or after first ischemic stroke (Czech part of EUROASPIRE III surveys). We measured aLp-PLA2 using diaDexus commercial kit.
  
  
  RESULTS
  In multiple step-wise regression analysis, the aLp-PLA2 was significantly positively associated with male gender, current smoking, LDL cholesterol and metabolic syndrome and negatively with statin treatment, body mass index and LDL/apoB ratio. After adjustment for these confounders, we observed an inverse relationship between aLp-PLA2 and fasting glycemia [β coefficient -2.18 (p<0.0001)] or glycated hemoglobin A1c (HbA1c) [β coefficient -5.89 (p<0.0001)]. Moreover, we found a positive association between aLp-PLA2 and pancreatic β cell function [β coefficient +0.10 (p<0.0001)], but not with an insulin sensitivity.
  
  
  CONCLUSIONS
  In present study, we cannot confirm any additive risk of impaired glucose metabolism in terms of increased activity of Lp-PLA2. On the contrary, presence of inadequately controlled diabetes mellitus was independently associated with lower risk of elevated aLp-PLA2 .
authors.affiliation: 2nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czech Republic; Biomedical Center, Medical Faculty of Charles University, Pilsen, Czech Republic. Electronic address: mayero@fnplzen.cz.
authors.forename: Otto
authors.initials: O
authors.lastname: Mayer
authors.affiliation: 2nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czech Republic; Biomedical Center, Medical Faculty of Charles University, Pilsen, Czech Republic.
authors.forename: Jitka
authors.initials: J
authors.lastname: Seidlerová
authors.affiliation: 2nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czech Republic; Biomedical Center, Medical Faculty of Charles University, Pilsen, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Filipovský
authors.affiliation: 2nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czech Republic.
authors.forename: Katarina
authors.initials: K
authors.lastname: Timoracká
authors.affiliation: 2nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czech Republic; Centre for Cardiovascular Prevention of the First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Bruthans
authors.affiliation: 2nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czech Republic.
authors.forename: Jiří
authors.initials: J
authors.lastname: Vaněk
authors.affiliation: Department of Neurology, University Hospital, Pilsen, Czech Republic.
authors.forename: Lenka
authors.initials: L
authors.lastname: Cerná
authors.affiliation: Centre for Cardiovascular Prevention of the First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic; International Clinical Research Centre, St. Anne's University Hospital Brno, Czech Republic.
authors.forename: Peter
authors.initials: P
authors.lastname: Wohlfahrt
authors.affiliation: Centre for Cardiovascular Prevention of the First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic; International Clinical Research Centre, St. Anne's University Hospital Brno, Czech Republic.
authors.forename: Cífková
authors.initials: C
authors.lastname: Renata
authors.affiliation: Department of Clinical Biochemistry and Hematology, University Hospital Pilsen, Czech Republic.
authors.forename: Ladislav
authors.initials: L
authors.lastname: Trefil
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood*; D054058:Acute Coronary Syndrome / Q000097:blood / Q000628:therapy; D000368:Aged; D050197:Atherosclerosis / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism*; D003327:Coronary Disease / Q000097:blood*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood*; D005260:Female; D044882:Glucose Metabolism Disorders / Q000097:blood; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000188:drug therapy; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood*; D008875:Middle Aged; D015999:Multivariate Analysis; D009204:Myocardial Revascularization; D012044:Regression Analysis; D020521:Stroke / Q000097:blood
chemical_list: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C517652:hemoglobin A1c protein, human; C526684:PLA2G7 protein, human
keywords: Coronary heart disease; Diabetes mellitus; EUROASPIRE; Lipoprotein-associated phospholipase A2; Stroke