Lipoprotein-associated Phospholipase A2 Activity Contributes to the Coronary Artery Disease with Metabolic Syndrome

Abstract

Background: Coronary artery disease (CAD) is an inflammatory process characterized by atherosclerosis in coronary arteries and it is a major cause of death and disability in developed countries. Lipoprotein-associated phospholipase A2 (Lp-PLA2) has been consistently associated with CAD risk factors and predictive of CVD outcomes; additionally, it is consistently higher among type 2 diabetics than nondiabetics. However, the relationships of circulating Lp-PLA2 activity with incident CAD among patients with metabolic syndrome (MetSynd) have not been examined sufficiently. Objective: The aim is to determine contribution of Lp-PLA2 to coronary artery disease (CAD) in patients with Metabolic Syndrome (MetSynd). Subjects and methods: This is a cohort prospective study based on 412 patients male and female were eligible and aged 25-75 years old patients and gave consent to participate in study. The study included socio-demographics, clinical biochemistry and the presence of co-morbid diseases. The data were analyzed using descriptive and multivariate analyses. Results: There was a significant difference between MetSynd Positive and normal subjects with respect to age groups, gender, BMI, smoking, nargile use, thyroid, COPD, CAD, hypertension, diabetic and stroke. Also, there was a significant difference between MetSynd versus normal subjects with respect to BMI, Waist Circumference, hemoglobin, HbA1c, vitamin B12, fasting blood glucose, vitamin D, calcium, creatinine, triglyceride, uric acid,  ferritin, systolic BP (mm Hg) and diastolic BP (mm Hg), creatine kinase-myocardial band (CK-MB) (p=0.001); Lp-PLA2 activity, (p=0.001); HOMA-IR index,(p=0.004), insulin (p=0.001); C-reactive protein (p=0.004);White blood cell (WBC) (p=0.008); Platelet p= 0.018) Mean Plate Volume (p= 0.032); red cell distribution width (p=0.001);  and vitamin D levels (p=0.018), respectively. The multivariate stepwise regression analysis indicated that Lp-PLA2 (p<0.001), BMI (kg/m2) (p<0.001), systolic BP (p<0.001), MetSynd (p=0.002), CK-MB (p=0.019), Calcium) (p= 0.023), Triglyceride (p= 0.029), Total-cholesterol (p= 0.046) were considered as risk predictors of the CAD patients after adjusting for age and gender. Conclusion: Lp-LPA2 contributes to CAD in the presence of MetSynd, as well as Lp-PLA2 could be utilized as a useful predictor in cases of CAD with MetSynd.