The Role of Lp-PLA2 as a Mediator Between Serum Magnesium and Zinc Levels and Cardiovascular Risk in Patients With Metabolic Syndrome.

Abstract

Metabolic syndrome (MetS) is a collection of conditions that includes abdominal obesity, low high-density lipoprotein (HDL) levels, high triglycerides, hypertension, and impaired glucose metabolism, all of which are risk factors for cardiovascular diseases. Of the biomarkers above, lipoprotein-associated phospholipase A2 (Lp-PLA2) has been highlighted as a critical link between inflammation and the pathogenesis of atherosclerosis, which strongly predicts cardiovascular events. Micronutrients like magnesium and zinc are essential in maintaining metabolic and cardiovascular health, but these micronutrient deficiencies occur frequently among individuals with MetS. This study aimed to consider the association between serum magnesium and zinc levels with Lp-PLA2 and how these associations could link pathways in cardiovascular risk among MetS patients. This was a comparative cross-sectional study of 100 cases diagnosed as MetS and compared with an equal number (n = 100) of age and matched healthy control. Blood magnesium, zinc, and Lp-PLA2 levels were determined by colorimetric assay. We also tested the association of Lp-PLA2 with levels of micronutrients, and we evaluated whether Lp-PLA2 was a mediator in the pathway between MetS and cardiovascular risk. The data were analyzed on IBM Corp. Released 2021. IBM SPSS Statistics for Windows, Version 28.0. Armonk, NY: IBM Corp; the results will be considered statistically significant if p < 0.05. The serum magnesium and zinc concentrations in patients with MetS were significantly lower than in the controls (p < 0.001). The Lp-PLA2 level was much higher in the MetS group than the no-MetS, and it correlated inversely with serum Mg (r = -0.35, p < 0.001) or Zn levels (r = -0.42, p < 0.001). After multivariate analysis, the mediating effect of Lp-PLA2 in the pathway from micronutrient deficiency to cardiovascular risk was maintained, whereby high levels were associated with increased atherogenic index and oxidative stress markers. These results show that Lp-PLA2 is an intermediate step in the relationship between low levels of some micronutrients and cardiovascular risk among MetS patients. Our findings indicate that a sufficient magnesium and zinc status might offer cardiovascular protection through lessening Lp-PLA2 activity. These observations demonstrate the potential benefits of high-risk enrichment and dietary intervention for detecting and controlling micronutrient deficiencies in MetS subjects to impede further cardiovascular diseases.