Energy Intake and Plasma Adiponectin as Potential Determinants of Lipoprotein-Associated Phospholipase A2 Activity: A Cross-Sectional Study

Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) is associated with increased risk of cardiovascular diseases (CVD) and type 2 diabetes mellitus. Lp-PLA(2) activity is positively associated with male sex, Caucasian race, the presence of metabolic syndrome (MetS) and low-density lipoprotein (LDL)-cholesterol, but it is negatively associated with high-density lipoprotein (HDL)-cholesterol. Associations with other cardiometabolic risk factors, inflammation markers, and lifestyle factors are few or inconsistent. We investigated potential determinants of Lp-PLA(2) activity among both nonmodifiable and modifiable CVD risk factors in a middle-aged Greek cohort without overt CVD. Two hundred eighty four subjects (159 men, 53 +/- 9 years and 125 women 52 +/- 9 years) participated in a cross-sectional study carried out during 2011-2012 in Athens, Attica. Cardiometabolic risk factors, inflammation markers, lifestyle factors, and Lp-PLA(2) activity were evaluated with established methods. The American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) criteria were used to define MetS. Lp-PLA(2) activity was not associated with MetS, but was associated with MetS components, markers of liver function, and macronutrient intake. Increased total energy intake was associated with increased Lp-PLA(2) activity (odds ratio, 95% confidence interval: 1.07, 1.01-1.14 and 1.10, 1.03-1.16 for the 4th and 3rd quartiles, respectively, compared to the 1st quartile) after adjustments for sex, pack-years of smoking, LDL-cholesterol, and statin treatment. Adiponectin tended to be inversely associated with Lp-PLA(2) activity (0.91, 0.82-1.00, and 4th versus 1st quartile). Our results suggested that total energy intake and adiponectin levels are potential determinants of Lp-PLA(2) activity.