Vnitr Lek 2013, 59(5):344-351

Distribution of Lipoprotein-Associated Phospholipase A2 in Czech Population and its interaction with conventional cardiovascular risk

O. Mayer jr.^1,*, J. Seidlerová¹, P. Wohlfart², L. Trefil³, J. Bruthans⁴, J. Filipovský¹, R. Cífková²

¹ II. interní klinika Lékařské fakulty UK a FN Plzeň, přednosta prof. MUDr. Jan Filipovský, CSc.

² Centrum kardiovaskulární prevence Thomayerovy nemocnice Praha, přednostka prof. MUDr. Renata Cífková, CSc.

³ Ústav klinické biochemie a hematologie Lékařské fakulty UK a FN Plzeň, přednosta prof. MUDr. Jaroslav Racek, DrSc.

⁴ Pracoviště preventivní kardiologie IKEM Praha, přednostka doc. MUDr. Věra Adámková, CSc.

Introduction:
Lipoprotein-associated phospholipase A2 (Lp-PLA₂) represent new cardiovascular risk factor and potential treatment target. We aimed to analyze the epidemiological situation of this factor in Czech population.

Methods and Results:
The study population consisted from 1 962 subjects, a random samples of general population (postMONICA study), and from patients with manifest coronary or cerebrovascular disease (Czech samples of EUROASPIRE III survey). Lp-PLA₂ activity was estimated using commercial kits by diaDexus Inc. in frozen samples. Increased activity (by definition, i.e. > 195 nmol/min/ml) was observed in 21.1 % of sample, no apparent difference between subject with and without manifest vascular disease was found. Males showed higher Lp-PLA₂ activity, than females (179.6 vs 146, resp., p < 0.0001), while no substantial increase with age was observed. Taking Lp-PLA₂ activity > 195 as dependent variable, following independent variables entered the multiple logistic regression: male gender [with odds ratio 4.26 (3.26-5.58)], low HDL-cholesterol (i.e. < 1.0 mmol/l in males or < 1.2 mmol/l in females) [3.49 (2.62-4.64)], LDL-cholesterol > 2.5 mmol/l [6.95 (4.79-10.07)] and lipid-lowering treatment [0.59 (0.44-0.79)]. In subject without manifest vascular disease, 6.3 % of them showed co-incidence of markedly increased Lp-PLA₂ activity with high conventional risk (SCORE > 10 %). Expanding this group by intermediate risk subjects (ie. with Lp-PLA₂ activity 152-194 and/or SCORE 5-9.9 %) leads to increase of this prevalence to 28.9 % of primary prevention subjects.

Conclusion:
Increased Lp-PLA₂ activity is in Czech population highly prevalent and with exception of lipid parameters, generally independent from conventional cardiovascular risk. However, up to 29 % of subject in primary prevention amalgamate increased Lp-PLA₂ activity with high conventional cardiovascular risk.

Keywords: lipoprotein-associated phospholipase A2; primary prevention; secondary prevention; epidemiology

Received: November 4, 2012; Accepted: March 1, 2013; Published: May 1, 2013  Show citation