Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.
Department of Neurosurgery, Baotou Eighth Hospital, Baotou, China.
J Cell Mol Med. 2018 Apr;22(4):2329-2336. doi: 10.1111/jcmm.13521. Epub 2018 Feb 9.
Cerebral artery stenosis (CAS) is the most important causes of ischaemic stroke. Lipoprotein-associated phospholipase A2 (Lp-PLA2) plays 2 diverse roles in atherosclerosis (pro-inflammatory and anti-inflammatory), and the association between Lp-PLA2 mass and cardiovascular or cerebrovascular events is inconsistent among previous studies. A cross-sectional study including 2012 North Chinese adults aged ≥40 years was performed in 2010-2011 to investigate whether Lp-PLA2 mass is associated with asymptomatic cerebral artery stenosis (ACAS). Serum Lp-PLA2 mass was determined by enzyme-linked immunosorbent assay (ELISA). All participants underwent transcranial Doppler (TCD) and bilateral carotid duplex ultrasound to evaluate intracranial artery stenosis (ICAS) and extracranial arterial stenosis (ECAS). The median serum Lp-PLA2 mass of the participants was 140.74 ng/mL (interquartile range: 131.79-158.07 ng/mL). The adjusted odds ratio (OR) when comparing the 4th quartile to the 1st quartile of Lp-PLA2 was 1.98 (95% confidence interval (CI): 1.42-2.78), 1.79 (95% CI: 1.08-2.94) and 1.87 (95% CI: 1.28-2.73) for the occurrence of ACAS, asymptomatic ECAS and asymptomatic ICAS, respectively, after controlling for vascular risk factors. These independently significant associations remained statistically significant in the male or elderly subgroups, but not in females or middle-aged participants. Lp-PLA2 mass is positively correlated with subclinical atherosclerosis determined by ACAS, ICAS and ECAS in North Chinese, particularly in male and older participants, suggesting that serum Lp-PLA2 mass might be potential biomarker for the detection of ACAS in the adults.
大脑动脉狭窄(CAS)是缺血性脑卒中最重要的病因。脂蛋白相关磷脂酶 A2(Lp-PLA2)在动脉粥样硬化中发挥着 2 种不同的作用(促炎和抗炎),而之前的研究中 Lp-PLA2 质量与心血管或脑血管事件之间的相关性并不一致。2010 年至 2011 年进行了一项包括 2012 名中国北方 40 岁以上成年人的横断面研究,旨在探讨 Lp-PLA2 质量是否与无症状性大脑动脉狭窄(ACAS)有关。采用酶联免疫吸附试验(ELISA)测定血清 Lp-PLA2 质量。所有参与者均接受经颅多普勒(TCD)和双侧颈动脉双功能超声检查,以评估颅内动脉狭窄(ICAS)和颅外动脉狭窄(ECAS)。参与者的血清 Lp-PLA2 中位数为 140.74ng/mL(四分位距:131.79-158.07ng/mL)。当比较 Lp-PLA2 第 4 四分位与第 1 四分位时,调整后的比值比(OR)分别为 1.98(95%置信区间(CI):1.42-2.78)、1.79(95%CI:1.08-2.94)和 1.87(95%CI:1.28-2.73),用于发生 ACAS、无症状 ECAS 和无症状 ICAS。在控制血管危险因素后,这些与发生 ACAS、无症状 ECAS 和无症状 ICAS 相关的独立显著相关性在男性或老年亚组中仍然具有统计学意义,但在女性或中年参与者中则不然。Lp-PLA2 质量与通过 ACAS、ICAS 和 ECAS 确定的亚临床动脉粥样硬化呈正相关,尤其是在男性和老年参与者中,提示血清 Lp-PLA2 质量可能是检测成年人 ACAS 的潜在生物标志物。