Abstract 4035: Lipoprotein-Associated Phospholipase A2 Does Not Predict Risk of Incident Type 2 Diabetes Mellitus in Apparently Healthy Middle-Aged Men: A More Specific Marker for Vascular Inflammation?
Background. Several prospective studies have demonstrated that Lp-PLA2, an enzyme, circulating primarily bound to LDL cholesterol and generating potent proinflammatory products, might represent an emerging biomarker for the prediction of coronary heart disease (CHD) in various populations. Inflammation has also been found to play a role in the pathogenesis of type 2 diabetes mellitus (T2DM) but the prognostic value of Lp-PLA2 in subjects at risk for T2DM, has not been studied so far.
Methods: Plasma concentrations of Lp-PLA2 were determined by PLAC™ test (ELISA, ng/mL; diaDexus Inc, South San Francisco, CA, USA) in 889 apparently healthy men aged 45– 64 years. Subjects came from the population-based MONICA/KORA Augsburg survey conducted in 1984/84 with follow-up until 2002 (mean follow-up time 13.5 years; SD 5.7).
Results: During this period, 115 men had a newly diagnosed T2DM. Baseline levels of Lp-PLA2 did not differ significantly between subjects with incident T2DM compared to event-free individuals (266 ±84 vs. 262 ± 79 ng/mL, p=0.6). In a Cox model, adjusted for traditional cardiovascular risk factors, a 1 SD increase in Lp-PLA2 was not associated with increased risk of incident T2DM (relative risk (RR) 0.98, 95% confidence interval (CI), 0.80–1.19). Additional controlling for various lipid variables, carried out in different models, did not appreciably alter their risk estimate (e.g. RR 0.93, 05% CI 0.77–1.14 after additional adjustment for TC/HDL).
Conclusion. Thus, in this large population-based cohort study, elevated concentrations of Lp-PLA2 were not independently associated with incident T2DM in apparently healthy middle-aged men from Southern Germany. Since Lp-PLA2 is associated with risk of future CHD but not with incident T2DM, it might represent a more specific marker of vascular inflammation.