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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2006;26:631.)
© 2006 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Lipoprotein-Associated Phospholipase A2 and Measures of Extracoronary Atherosclerosis

The Rotterdam Study

Isabella Kardys; Hok-Hay S. Oei; Irene M. van der Meer; Albert Hofman; Monique M.B. Breteler; Jacqueline C.M. Witteman

From the Department of Epidemiology and Biostatistics, Erasmus MC, Rotterdam, The Netherlands.

Correspondence to Dr J.C.M. Witteman, Department of Epidemiology and Biostatistics, Erasmus MC, PO Box 1738, 3000 DR Rotterdam, The Netherlands. E-mail j.witteman{at}erasmusmc.nl

Objective— Lipoprotein-associated phospholipase A2 (Lp-PLA2) may be a new and independent predictor of cardiovascular events. The effect of Lp-PLA2 may be exerted through effects of the enzyme on the development of atherosclerosis. Therefore, we investigated the association between Lp-PLA2 activity and measures of extracoronary atherosclerosis.

Methods and Results— Lp-PLA2 activity was determined in a random sample of 1820 participants from the Rotterdam Study, a population-based cohort study in men and women 55 years. Common carotid intima-media thickness, carotid plaques, ankle-arm index, and aortic calcification were examined. Atherosclerosis status could be assigned in 1609 participants. The age-adjusted odds ratio of having atherosclerosis at any site for the highest versus the lowest tertile of Lp-PLA2 activity was 1.86 (95% CI, 1.01 to 3.43) in men and 1.60 (95% CI, 1.08 to 2.37) in women. After additional adjustment for cholesterol, these associations attenuated or even disappeared. The odds ratios of having atherosclerosis at specific sites (carotid arteries and aortic-iliac-femoral tract) followed a similar pattern.

Conclusions— Although Lp-PLA2 has been found to be independently associated with cardiovascular events, the association with measures of subclinical extracoronary atherosclerosis found in this study strongly attenuated or even disappeared after adjustment for cholesterol.

Within the population-based Rotterdam Study, we investigated the association between lipoprotein-associated phospholipase A2 activity and presence of atherosclerosis as derived from common carotid intima-media thickness, carotid plaques, ankle-arm index, and aortic calcification. Associations were present after adjustment for age and sex. They strongly attenuated or even disappeared after adjustment for cholesterol.

Key Words: atherosclerosis • inflammation • lipoprotein-associated phospholipase A2 • epidemiology

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