Lipoprotein associated phospholipase A2 and C-reactive protein as predictors of metabolic syndrome in subjects without cardiovascular disease

Abstract

Background: Both, C-reactive protein (usCRP) and lipoprotein-associated phospholipase A2 (LpPLA2) are inflammatory markers. usCRP is a good predictor of the Metabolic Syndrome (MetSyn) mainly associated to visceral obesity. By contrast, LpPLA2 relates principally to LDL. Objective: To compare, in asymptomatic subjects, usCRP and LpPLA2 as determinants of MetSyn. Methods: Cross sectional study in 152 subjects (69 women) without known CHD/CVD. We excluded subjects taking lipid lowering medication, oral contraceptives, hormonal replacement therapy and anti-inflammatory drugs, as well as inflammatory diseases or pregnancy. We determined blood pressure, BMI, waist, plasma creatinine, usCRP, fibrinogen, fasting blood sugar, lipid profile and LpPLA2 activity. MetSyn was defined by ATPIII harmonized definition. Logistic regression analysis was performed and ROC curves were built. Results: Mean age was 46±11; 38% had MetSyn. Mean LpPLA2 and usCRP were 185±48 nmol/ml/min and 2.1±2.2 mg/L respectively. MetSyn subjects had significantly higher levels of both, LpPLA2 (p<0.01) and usCRP (p=0.04). Both biomarkers were independent determinants of MetSyn: Lp-PLA2, OR=2.2 [CI=1.1-4.6] and usCRP, OR=4.4 [IC=2.1-9.6]. ROC curves are shown in the figure (C-index for LpPLA2=0.64 [0.55-0.73] and for usCRP=0.70 [0.62-0.78]). ![Figure][1] Conclusion: Both LpPLA2 and usCRP are elevated in subjects with MetSyn and both are significant and independent determinants of it. usCRP, however, predicts MetSyn more accurately. [1]: pending:yes