代谢综合征和颈动脉粥样硬化患者的血浆脂蛋白相关磷脂酶 A2。
Plasma lipoprotein-associated phospholipase A2 in patients with metabolic syndrome and carotid atherosclerosis.
机构信息
Department of Cardiology, the Second hospital of Shandong University, Jinan, Shandong 250033, China.
出版信息
Lipids Health Dis. 2011 Jan 19;10:13. doi: 10.1186/1476-511X-10-13.
BACKGROUND
Lipoprotein-associated phospholipase A₂ (Lp-PLA₂) is a recently identified and potentially useful plasma biomarker for cardiovascular and atherosclerotic diseases. However, the correlation between the Lp-PLA₂ activity and carotid atherosclerosis remains poorly investigated in patients with metabolic syndrome (MetS). The present study aimed to evaluate the potential role of Lp-PLA₂ as a comprehensive marker of metabolic syndrome in individuals with and without carotid atherosclerosis.
METHODS
We documented 118 consecutive patients with MetS and 70 age- and sex-matched healthy subjects served as controls. The patients were further divided into two groups: 39 with carotid plaques and 79 without carotid plaques to elucidate the influence of Lp-PLA₂ on carotid atherosclerosis. The plasma Lp-PLA₂ activity was measured by using ELISA method and carotid intimal-media thickness (IMT) was performed by ultrasound in all participants.
RESULTS
Lp-PLA₂ activity was significantly increased in MetS subgroups when compared with controls, and was higher in patients with carotid plaques than those without plaques (P < 0.05). Furthermore, we found that significant difference in Lp-PLA₂ was obtained between patients with three and four disorders of metabolic syndrome (P < 0.01). Age (β = 0.183, P = 0.029), LDL-cholesterol (β = 0.401, P = 0.000) and waist-hip ratio (β = 0.410, P = 0.000) emerged as significant and independent determinants of Lp-PLA₂ activity. Multiple stepwise regression analysis revealed that LDL-cholesterol (β = 0.309, P = 0.000), systolic blood pressure (β = 0.322, P = 0.002) and age (β = 0.235, P = 0.007) significantly correlated with max IMT, and Lp-PLA2 was not an independent predictor for carotid IMT.
CONCLUSIONS
Lp-PLA₂ may be a modulating factor for carotid IMT via age and LDL-cholesterol, not independent predictor in the pathophysiological process of carotid atherosclerosis in patients with MetS.
背景
脂蛋白相关磷脂酶 A₂（Lp-PLA₂）是一种新近发现的、可能对心血管疾病和动脉粥样硬化疾病有用的血浆生物标志物。然而，代谢综合征（MetS）患者的 Lp-PLA₂活性与颈动脉粥样硬化之间的相关性仍研究甚少。本研究旨在评估 Lp-PLA₂作为代谢综合征个体的综合标志物的潜在作用，包括有颈动脉粥样硬化和无颈动脉粥样硬化的个体。
方法
我们记录了 118 例连续的 MetS 患者和 70 例年龄和性别匹配的健康对照者。患者进一步分为两组：39 例有颈动脉斑块，79 例无颈动脉斑块，以阐明 Lp-PLA₂对颈动脉粥样硬化的影响。所有参与者均采用 ELISA 法测定血浆 Lp-PLA₂活性，采用超声测定颈动脉内膜中层厚度（IMT）。
结果
与对照组相比，MetS 亚组的 Lp-PLA₂活性显著升高，且有颈动脉斑块的患者高于无斑块的患者（P < 0.05）。此外，我们发现代谢综合征有三种和四种疾病的患者之间的 Lp-PLA₂差异有统计学意义（P < 0.01）。年龄（β=0.183，P=0.029）、LDL-胆固醇（β=0.401，P=0.000）和腰臀比（β=0.410，P=0.000）是 Lp-PLA₂活性的显著独立决定因素。多元逐步回归分析显示，LDL-胆固醇（β=0.309，P=0.000）、收缩压（β=0.322，P=0.002）和年龄（β=0.235，P=0.007）与最大 IMT 显著相关，而 Lp-PLA2 不是颈动脉 IMT 的独立预测因子。
结论
Lp-PLA₂可能通过年龄和 LDL-胆固醇调节颈动脉 IMT，但不是 MetS 患者颈动脉粥样硬化病理生理过程的独立预测因子。
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