Synergistic Effect Of Lipoprotein Associated Phospholipase A2 With Classical Risk Factors On Coronary Heart Disease A Multi-ethnic Study In Xinjiang

AIMS:We evaluated the synergistic effect of lipoprotein-associated phospholipase A2(Lp-PLA2)in association with classical risk factors in predicting coronary heart disease(CHD)and demonstrated the diagnostic value of Lp-PLA2 for predicting coronary stenotic lesions in subjects with CHD.METHODS:From Marchl,2011 to July 31,2014,blood samples were acquired from 911 consecutive adult subjects(662 males and 249 females)from 11 ethnic groups at the Friendship Hospital of Ili Kazakh Autonomous Prefecture in China.CHD in patients was confirmed using coronary angiography,and the severity of coronary atherosclerosis was assessed using the Gensini scoring system.Lp-PLA2 plasma levels were detected using a commercially available turbidimetric immunoassay(TIA).Data that conformed to the normal distribution were expressed as mean ± standard deviation,and analysis of variance across the various groups.The skewed data were expressed as median and quartile,and the inter-group difference test was performed using the Kruskal-Wallis H test(K-W test).Spearman correlation analysis was used to evaluate the relationship between two quantitative variables.A binary logistic regression was performed to analyse the relationships between Lp-PLA2 and other risk factors.The interaction model was used to evaluate the synergism between Lp-PLA2 and other risk factors was also investigated.RESULTS:There were significant differences in plasma Lp-PLA2 levels among different ethnic groups(p<0.05),among which the Han population was the lowest(182.25(117.63-259.03))and the Uygur population was the highest(229.56(163.11-294.58)).The Spearman correlation analyses indicated that Lp-PLA2 was positively associated with the severity of CHD(r=0.176,p=0.000).A binary logistic regression was performed to analyse the relationships between Lp-PLA2 and other risk factors.A multivariate logistic regression analysis revealed that Lp-PLA2 levels were significantly associated with CHD(OR,1.882;95%CI,1.369-2.587,p=0.000).The area under the receiver operating characteristic curve for Lp-PLA2 was 0.589(95%CI,0.549-0.629,p=0.000).The synergism between Lp-PLA2 and other risk factors were also discovered:age(SI =20.95,SIM =2.89,AP =0.64),sex(SI=1.15,SIM =0.67,AP=0.10),SBP(SI=2.45,SIM＝1.56,AP=0.45),HDL-C(SI=1.22,SIM=0.92,AP=0.13),LDL-C(SI=3.47,SIM=2.00,AP=0.62),FBG(SI=2.27,SIM=1.37,AP=0.47).The proportion of CHD attributable to the interaction of Lp-PLA2 and age was as high as 64%.CONCLUSIONS:Lp-PLA2 levels in human plasma were positively associated with the severity of CHD,and there was a clear positive interaction between Lp-PLA2 and classical risk factors in predicting CHD.Lp-PLA2 may serve as an independent risk marker for diagnosing CHD.