The role of lipoprotein-associated phospholipase A2 in the metabolic syndrome and diabetes

Objectives: Lipoprotein-associated phospbolipase A(2) (Lp-PLA(2)) is a novel inflammation marker. We investigated its association with other coronary risk factors and evaluated its role as a comprehensive marker of the metabolic syndrome in individuals with type 2 diabetes. Methods: Our cross-sectional study evaluated 92 insulin-treated subjects with type 2 diabetes. Biochemical measurements of Lp-PLA2, glycemic control, lipid profiles, and C-reactive protein were carried out. Seventy-seven subjects were diagnosed as having the metabolic syndrome, which was defined according to the American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Results: Lp-PLA2 was significantly correlated with waist-hip ratio (r = .25), triglycerides (r = .50), high-density lipoprotein cholesterol (r = -.31), and low-density lipoprotein cholesterol (LDL-C; r = .27; all P < .02). In a multiple-regression model, triglycerides and LDL-C levels were the significant predictors of Lp-PLA2. Lp-PLA2 was significantly higher in subjects with the metabolic syndrome than in those without it (268 +/- 23.4 vs. 127 +/- 15.8 ng/ml, P < .001). There was a linear increase in Lp-PLA(2) with an increment of the number of the metabolic syndrome criteria P-trend = .041). Another multiple-regression model showed that the hypertriglyceridemia component was the only predictor of Lp-PLA(2). Conclusions: Our findings suggest that Lp-PLA(2) assay potentially facilitates a more comprehensive assessment of the metabolic syndrome in patients with type 2 diabetes on insulin. (c) 2006 Elsevier Inc. All rights reserved.