Objectives Lipoprotein-associated phospholipase A2 (Lp-PLA2) has been shown to be associated with an increased risk of clinical cardiovascular events. We aimed to investigate whether Lp-PLA2 is also associated with the progression of subclinical atherosclerosis in a general population free of clinical cardiovascular disease.
Methods In a prospective cohort study in Beijing, carotid plaque and maximal intima-media thickness (IMT) were measured twice over a 5-year interval in 913 participants aged 45 to 74 years at baseline. Association of plasma Lp-PLA2 activity and the progression of carotid plaque and IMT was assessed in men and women after adjusting for traditional Framingham risk factors (including age, smoking, diabetes, hypertension, LDL-C, and HDL-C) and high-sensitivity C-reactive protein (hsCRP).
Results During 5 years of follow-up, carotid plaque progression was found in 58.5% of men and 48.3% of women, and the median level of carotid IMT increased by 0.62 mm in men and 0.46 mm in women. Progression increased with quartiles of Lp-PLA2 in men (P <0.05 for trend) but not in women. After adjustment for traditional risk factors and hsCRP, the odds ratio for plaque progression associated with increase in Lp-PLA2 by one unit was 1.03 (95% CI = 1.00-1.06, P = 0.026) in men and 0.99 (95% CI = 0.96-1.01, P = 0.273) in women, and the regression coefficient for IMT progression was 0.016 (P = 0.008) in men and -0.007 (P = 0.143) in women, when baseline IMT was further adjusted. The risk of atherosclerosis progression was the highest in men with a higher level of Lp-PLA2 activity combined with either higher LDL-C or lower HDL-C, the lowest in men with a lower Lp-PLA2 activity coupled with either lower LDL-C level or higher HDL-C, with the rest in the middle.
Conclusions Lp-PLA2 is associated with the progression of subclinical atheroslcerosis in men. It may play an important role in the pathogenesis of atherosclerosis and may be a potential target for early prevention of CVD.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.