Tsimikas Sotirios, Willeit Johann, Knoflach Michael, Mayr Manuel, Egger Georg, Notdurfter Marlene, Witztum Joseph L, Wiedermann Christian J, Xu Qingbo, Kiechl Stefan
Division of Cardiology, University of California San Diego, La Jolla, CA, USA.
Eur Heart J. 2009 Jan;30(1):107-15. doi: 10.1093/eurheartj/ehn502. Epub 2008 Nov 19.
To identify factors that influence plasma levels and assess the prognostic value of lipoprotein-associated phospholipase A2 (Lp-PLA2) activity in a prospective, population-based survey of the epidemiology and pathogenesis of atherosclerosis.
The Bruneck study is a prospective, population-based survey initiated in 1990. Lp-PLA2 activity and baseline variables for the current analysis were measured in 765 subjects aged 45-84 years in 1995. Incident cardiovascular disease (CVD) (cardiovascular death, myocardial infarction, stroke, and transient ischaemic attack) and rates of non-CVD mortality were assessed between 1995 and 2005. Subjects with incident CVD had higher levels of Lp-PLA2 activity (884 +/- 196 vs. 771 +/- 192 micromol/min/L, P < 0.001). Increased Lp-PLA2 activity was significantly related to incident CVD [age- and sex-adjusted hazard ratio (95%CI) 2.9 (1.6-5.5); third vs. first tertile group; P < 0.001] and with vascular mortality but not with non-CVD mortality. Lp-PLA2 activity was enhanced in subjects with the metabolic syndrome and showed highly significant positive associations with LDL-C, apoB-100, ferritin, and HOMA-IR, and inverse associations with HDL-C and anti-oxidant levels.
Increased Lp-PLA2 activity is associated with metabolic syndrome and incident fatal and non-fatal CVD, but not with non-CVD mortality. Furthermore, Lp-PLA2 activity is strongly influenced by ferritin levels, LDL-C, and apoB-100 supporting its integral role in lipid peroxidation. Clinical utility of Lp-PLA2 activity for prediction of cardiovascular risk has to be explored in future studies.
在一项关于动脉粥样硬化流行病学和发病机制的前瞻性、基于人群的调查中，确定影响血浆水平的因素，并评估脂蛋白相关磷脂酶A2（Lp-PLA2）活性的预后价值。
布伦内克研究是一项始于1990年的前瞻性、基于人群的调查。1995年对765名年龄在45 - 84岁的受试者测量了Lp-PLA2活性及用于当前分析的基线变量。评估了1995年至2005年间的心血管疾病（CVD）（心血管死亡、心肌梗死、中风和短暂性脑缺血发作）及非CVD死亡率。发生CVD的受试者Lp-PLA2活性水平更高（884±196对771±192微摩尔/分钟/升，P<0.001）。Lp-PLA2活性增加与发生CVD显著相关[年龄和性别调整后的风险比（95%CI）2.9（1.6 - 5.5）；第三组与第一组三分位数组相比；P<0.001]，与血管死亡率相关，但与非CVD死亡率无关。代谢综合征患者的Lp-PLA2活性增强，且与低密度脂蛋白胆固醇（LDL-C）、载脂蛋白B-100（apoB-100）、铁蛋白和胰岛素抵抗指数（HOMA-IR）呈高度显著正相关，与高密度脂蛋白胆固醇（HDL-C）和抗氧化剂水平呈负相关。
Lp-PLA2活性增加与代谢综合征及致命和非致命性CVD相关，但与非CVD死亡率无关。此外，Lp-PLA2活性受铁蛋白水平、LDL-C和apoB-100的强烈影响，支持其在脂质过氧化中的重要作用。未来研究必须探索Lp-PLA2活性在预测心血管风险方面的临床应用价值。
