Association of lipoprotein-associated phospholipase A2 mass with asymptomatic cerebral artery stenosis.

Youxin Wang,Pingan Zhou,Qinghua Cui,Shouling Wu,Yong Zhou,Bin Zhou,Yingping Liu,Xingquan Zhao,Jichun Yang,Yan Yao

doi:10.1111/jcmm.13521

Abstract

Cerebral artery stenosis (CAS) is the most important causes of ischaemic stroke. Lipoprotein‐associated phospholipase A2 (Lp‐PLA2) plays 2 diverse roles in atherosclerosis (pro‐inflammatory and anti‐inflammatory), and the association between Lp‐PLA2 mass and cardiovascular or cerebrovascular events is inconsistent among previous studies. A cross‐sectional study including 2012 North Chinese adults aged ≥40 years was performed in 2010‐2011 to investigate whether Lp‐PLA2 mass is associated with asymptomatic cerebral artery stenosis (ACAS). Serum Lp‐PLA2 mass was determined by enzyme‐linked immunosorbent assay (ELISA). All participants underwent transcranial Doppler (TCD) and bilateral carotid duplex ultrasound to evaluate intracranial artery stenosis (ICAS) and extracranial arterial stenosis (ECAS). The median serum Lp‐PLA2 mass of the participants was 140.74 ng/mL (interquartile range: 131.79‐158.07 ng/mL). The adjusted odds ratio (OR) when comparing the 4th quartile to the 1st quartile of Lp‐PLA2 was 1.98 (95% confidence interval (CI): 1.42‐2.78), 1.79 (95% CI: 1.08‐2.94) and 1.87 (95% CI: 1.28‐2.73) for the occurrence of ACAS, asymptomatic ECAS and asymptomatic ICAS, respectively, after controlling for vascular risk factors. These independently significant associations remained statistically significant in the male or elderly subgroups, but not in females or middle‐aged participants. Lp‐PLA2 mass is positively correlated with subclinical atherosclerosis determined by ACAS, ICAS and ECAS in North Chinese, particularly in male and older participants, suggesting that serum Lp‐PLA2 mass might be potential biomarker for the detection of ACAS in the adults.

Highlights

Cerebral artery stenosis (CAS) is the most common pathogen of ischaemic stroke worldwide.[1]
We examined asymptomatic cerebral artery stenosis (ACAS), an intermediate indicator that can remain silent for a long period before the occurrence of ischaemic stroke,[25] and suggested that aberrant increase in lipoprotein-associated phospholipase A2 (Lp-PLA2) mass might be associated with ACAS in a vascular disease-free population
Our findings were in part consistent with the findings reported in another population, which showed that Lp-PLA2 mass was independently associated with isolated intracranial artery stenosis (ICAS) (OR, 2.30; 95% confidence interval (CI), 1.144.64) and concurrent extra-intracranial stenosis (OR, 3.93; 95% CI, 1.62-9.51) but not isolated extracranial arterial stenosis (ECAS) (OR, 1.54; 95% CI, 0.68-3.48).[24]

Summary

Introduction

Cerebral artery stenosis (CAS) is the most common pathogen of ischaemic stroke worldwide.[1] Without treatment, cerebral artery stenosis can dramatically increase the risk of transient ischaemic attacks (TIAs), ministrokes or strokes. Establishing an accurate and quick screen procedure in patients with suspected acute ischaemic stroke is very important.[4] Identification of serum biomarkers is one of the primary strategies used to identify populations at risk of ischaemic stroke. Among these strategies, lipoprotein-associated phospholipase A2 (Lp-PLA2) has been identified as a promising soluble blood-based biomarker.[5]

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