RELATIONSHIP OF LIPOPROTEINE-ASSOCIATED PHOSPHOLIPASE A2 WITH CORONARY AND CAROTID ATHEROSCLEROSIS IN KIRGIZ ETHNIC GROUP

Aim. To study the association of the level (mass) of lipoproteine-associated phospholipase A2 with coronary and carotid atherosclerosis in the patients with essential arterial hypertension in Kirgiz ethnic group.
Material and methods. Totally 52 patients studied with arterial hypertension (AH); mean age — 54,9±6,7, of those 26 men and 26 women. CHD, confirmed by exercise tests or coronary arteriography, had 19 patients, atherosclerosis of carotid arteries – 28. All patients underwent height measurement, weight and waist circumference, BP and HR measurement, also measurement of some biochemical values: fibrinogene level, sugar, creatinine of the blood and lipid profile (levels of total cholesterol, LDL, HDL and triglycerides). Measurement of LP-PLA2 was done using “PLAC” test by “DiaDexus” (USA) with immuneturbodimetry method “ELISA”. Duplex scanning of carotid arteries was done with Sequoia-512 by “Accuson” (USA).
Results. There was direct correlation of LP-PLA2 correlation with the age (r=0,27; p<0,05), HDL concentration (r=0,30; p<0,05) and LDL (r=0,28; p<0,05) and negative association with triglycerides (r=-0,28; p<0,05). Significant differences by gender in LP-PLA2 were not found (p>0,05). Patients with CHD had higher level oftotal cholesterol (5,64±0,97 mmol/l vs. 5,23±1,33 mmol/l, р=0,057), LDL (3,63±0,89 mmol/l vs. 3,16±0,98 mmol/l, p<0,01), and the mass of LP-PLA2 (296±70 ng/ml vs. 237±76 ng/ml, p<0,005) comparing to the patients with EH and CHD. In multifactorial regression analysis it was shown that only concentration of LP-PLA2 independently associated with CHD among native inhabitants of the Republic (β=0,66; p<0,001). We did not found association of LP-PLA2 with presence and prominence of carotid atherosclerosis and carotid intima-media thickness (p>0,05).
Conclusion. In Kirgiz ethnic group there is association of LP-PLA2 with CHD, but not with carotid atherosclerosis.

1. Lazzini A, Lazzini S. Cardiovascular disease: an economical perspective. Curr. Pharm. Des. 2009; 15, 10:1142-56.

2. Khot UN, Khot MB, Bajzer CT, et al. Prevalence of conventional risk factors in patients with coronary heart disease. JAMA. 2003; 290(7): 898-904.

3. MсMacphee CH. Lipoprotein-associated phospholipase A2: a potential new risk factor for coronary artery disease and a therapeutic target. Curr Opin Pharmacol 2001; 1: 121-5.

4. Caslake MJ, Packard CJ. Lipoprotein-associated phospholipase A2 as a biomarker for coronary disease and stroke. Nat Clin Pract Cardiovasc Med. 2005 Oct; 2(10): 529-35.

5. Quinn MT, Parthasarathy S, Steinberg D. Lysophosphatidylcholine: a chemotactic factor for human monocytes and its potential role in atherogenesis. Proc Natl Acad Sci U S A 1988; 85(8): 2805-9.

6. Thompson A, Gao P, Orfei L, et al. Lipoprotein-associated phospholipase A(2) and risk of coronary disease, stroke, and mortality: collaborative analysis of 32 prospective studies. Lancet 2010 May 1; 375(9725): 1536-44.

7. Campo S, Sardo MA, Bitto A, et al. Platelet-activating factor acetylhydrolase is not associated with carotid intima-media thickness in hypercholesterolemic Sicilian individuals. Clin Chem. 2004 Nov; 50(11): 2077-82.

8. Kiortsis DN, Tsouli S, Lourida ES, et al. Lack of association between carotid intimamedia thickness and PAF-acetylhydrolase mass and activity in patients with primary hyperlipidemia. Angiology. 2005 Jul-Aug; 56(4): 451-8.

9. Caslake MJ, Packard CJ, Suckling KE, et al. Lipoprotein-associated phospholipase A(2), platelet-activating factor acetylhydrolase: a potential new risk factor for coronary artery disease. Atherosclerosis 2000; 150(2): 413-9.

10. Singh U, Zhong S, Xiong M, et al. Increased plasma non-esterified fatty acids and plateletactivating factor acetylhydrolase are associated with susceptibility to atherosclerosis in mice. Clin Sci (Lond) 2004; 106(4): 421-32.

11. Brilakis ES, Khera A, Saeed B, et al. Association of Lipoprotein-associated Phospholipase A2 mass and activity with coronary and aortic atherosclerosis: finding from the Dallas Heart Study. Clin Chem 2008; 54(12): 1975-81.

12. Ballantyne CM, Hoogeveen RC, Bang H, et al. Lipoprotein-associated phospholipase A2, highsensitivity C-reactive protein, and risk for incident coronary heart disease in middle-aged men and women in the Atherosclerosis Risk in Communities (ARIC) study. Circulation 2004; 109(7): 837-42.

13. Persson M, Hedblad B, Nelson JJ, et al.. Elevated Lp-PLA2 levels add prognostic information to the metabolic syndrome on incidence of cardiovascular events among middle-aged nondiabetic subjects Arterioscler Thromb Vasc Biol. 2007 Jun; 27(6): 1411-6.

14. Oldgren J, James SK, Siegbahn A, et al. Lipoprotein-associated phospholipase A2 does not predict mortality or new ischaemic events in acute coronary syndrome patients. Eur Heart J 2007 Mar; 28(6): 699-704.

15. O’Donoghue M, Morrow DA, Sabatine MS, et al. Lipoprotein-associated phospholipase A2 and its association with cardiovascular outcomes in patients with acute coronary syndromes in the PROVE IT-TIMI 22 (PRavastatin Or atorVastatin Evaluation and Infection Therapy-Thrombolysis In Myocardial Infarction) trial. Circulation 2006; 113(14): 1745–52.

16. Muzzio ML, Miksztowicz V, Brites F, et al. Metalloproteases 2 and 9, Lp-PLA(2) and lipoprotein profile in coronary patients. Arch Med Res. 2009; 40(1): 48-53

17. Yamamoto I, Fujitsu J, Nohnen S, et al. Association of plasma PAF acetylhydrolase gene polymorphism with IMT of carotid arteries in Japanese type 2 diabetic patients. Diabetes Res Clin Pract. 2003 Mar; 59(3): 219-24.

18. Kardys I, Oei HH, van der Meer IM, et al. Lipoprotein-associated phospholipase A2 and measures of extracoronary atherosclerosis: the Rotterdam Study. Thromb Vasc Biol. 2006 Mar; 26(3): 631-6.

19. Garg PK, McClelland RL, Jenny NS, et al. Association of lipoprotein-associated phospholipase A(2) and endothelial function in the Multi-Ethnic Study of Atherosclerosis (MESA). Vasc Med. 2011 Aug; 16(4): 247-52.