Elevated Lp-PLA2 levels add prognostic information to the metabolic syndrome on incidence of cardiovascular events among middle-aged nondiabetic subjects
Elevated Lp-PLA2 levels add prognostic information to the metabolic syndrome on incidence of cardiovascular events among middle-aged nondiabetic subjects
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DOI：
10.1161/atvbaha.107.142679
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发表时间：
2007-06-01
影响因子：
8.7
通讯作者：
Berglund, Goran
中科院分区：
文献类型：
--
作者：
Persson, Margaretha;Hedblad, Bo;Berglund, Goran
背景：探讨脂蛋白相关磷脂酶A2 （Lp-PLA(2)）、代谢综合征（MetS）和心血管疾病（CVD）之间的潜在相互关系。方法和结果：4480名非糖尿病马尔默饮食和无心血管疾病史的癌症研究受试者根据国家胆固醇教育计划成人治疗小组III标准定义mets。随访10年，监测首次心血管疾病事件（卒中[130例]或心肌梗死[131]）的发生率。met患者Lp-PLA(2)活性和质量显著增高。与Lp-PLA(2)质量相比，Lp-PLA(2)活性与单个组分的相关性更强，与MetS组分的数量线性增加。考虑到可能的混杂因素后，Lp-PLA(2)活性升高（顶部与底部比较），但Lp-PLA(2)质量没有升高，增加了心血管疾病发生的风险（相对风险，RR: 1.54, 95% CI 1.07至2.24），MetS（1.42, 1.06至1.90）也是如此。与ldl - pla(2)活性或met均未升高的患者相比，met和ldl - pla(2)活性升高的组合增加了CVD的风险（1.97,1.34至2.90）。没有met的ldl - pla(2)活性升高会增加CVD的风险（1.40,1.03 - 1.92），但met没有升高的ldl - pla(2)活性（1.46,0.94 - 2.27）。结论：lp - pla(2)与MetS有关。血浆中较高水平的Lp-PLA(2)增加了发生CVD的风险，无论MetS如何。Lp-PLA(2)活性和MetS同时升高可以确定一个特别高风险的个体。
Background-To explore potential interrelationships between lipoprotein-associated phosholipase A2 (Lp-PLA(2)), the metabolic syndrome (MetS), and incident cardiovascular disease (CVD).Methods and Results-MetS was defined by the National Cholesterol Education Program Adult treatment Panel III criteria in 4480 nondiabetic Malmo Diet and Cancer Study subjects without history of CVD. Incidence of first CVD event (stroke [130 cases] or myocardial infarction [131]) was monitored over 10 years of follow-up. Lp-PLA(2) activity and mass were significantly higher in subjects with MetS. Lp-PLA(2) activity compared with Lp-PLA(2) mass was more strongly correlated to individual components and increased more linearly with number of MetS components. Elevated Lp-PLA(2) activity (top compared with bottom tertile), but not elevated Lp-PLA(2) mass, increased risk for incident CVD (relative risk, RR: 1.54, 95% CI 1.07 to 2.24), as did MetS (1.42, 1.06 to 1.90) after taking possible confounders into account. Relative to those without either elevated Lp-PLA(2) activity or MetS, combination of MetS and elevated Lp-PLA(2) activity increased risk for CVD (1.97, 1.34 to 2.90). Elevated Lp-PLA(2) activity without MetS increased risk for CVD (1.40, 1.03 to 1.92) but not MetS without elevated Lp-PLA(2) activity (1.46, 0.94 to 2.27).Conclusion-Lp-PLA(2) is associated to the MetS. Higher plasma levels of Lp-PLA(2) increased risk for incident CVD regardless of MetS. The simultaneous presence of elevated Lp-PLA(2) activity and MetS may identify an especially high risk individual.