Unexpected inverse relationship between impaired glucose metabolism and lipoprotein-associated phospholipase A2 activity in patients with stable vascular disease

Abstract Background Elevated lipoprotein-associated phospholipase A2 activity (aLp-PLA 2 ) is associated with increased risk of cardiovascular events. In patients with stable atherovascular disease, we aimed to investigate whether impaired glucose metabolism might be associated with higher risk of elevated aLp-PLA 2 . Methods We conducted a cross-sectional study in 825 stable patients after acute coronary syndrome, coronary revascularization or after first ischemic stroke (Czech part of EUROASPIRE III surveys). We measured aLp-PLA 2 using diaDexus commercial kit. Results In multiple step-wise regression analysis, the aLp-PLA 2 was significantly positively associated with male gender, current smoking, LDL cholesterol and metabolic syndrome and negatively with statin treatment, body mass index and LDL/apoB ratio. After adjustment for these confounders, we observed an inverse relationship between aLp-PLA 2 and fasting glycemia [β coefficient − 2.18 (p  2 and pancreatic β cell function [β coefficient + 0.10 (p  Conclusion In present study, we cannot confirm any additive risk of impaired glucose metabolism in terms of increased activity of Lp-PLA 2 . On the contrary, presence of inadequately controlled diabetes mellitus was independently associated with lower risk of elevated aLp-PLA 2 .