Lipoprotein-associated phospholipase A2 combined with D-dimer to fibrinogen ratio to construct a prognostic nomogram model for patients with acute myocardial infarction after percutaneous coronary intervention / 中国医师进修杂志

Objective:To construct acute ST-segment elevation myocardial infarction (STEMI) percutaneous coronary intervention (PCI) by using lipoprotein-associated phospholipase A2 (Lp-PLA2) and D-dimer to fibrinogen ratio (D/F) and other indicators postoperative patient prognosis nomogram model and evaluation of its predictive value.Methods:A total of 291 acute STEMI patients admitted to the BenQ Hospital Affiliated to Nanjing Medical University from January 2017 to January 2020 were retrospectively selected, including but not limited to Lp-PLA2 and D/F, were collected. Receiver operating characteristic (ROC) curve and multivariate Logistic regression were used to analyze the risk factors of death within 90 d after PCI in STEMI patients, and Kaplan-Meier survival curves were drawn to compare the survival of patients in different Lp-PLA2 and D/F groups. The R language software was used to build nomogram model and decision curve.Results:The AUCs of LpPLA2 and D/F for predicting the risk of death from cardiac causes at 90 s after PCI in patients with acute STEMI were 0.896 (95% CI 0.850 to 0.932) and 0.884 (95% CI 0.837 to 0.922), respectively. The values were 59.50 μg/L and 0.46 respectively ( P<0.05); the mortality rates of acute STEMI patients in LpPLA2>59.50 μg/L and D/F>0.46 groups after PCI were higher than those in LpPLA2≤59.50 μg/L group and D/F≤0.46 group ( P<0.05); age (>66 years), left ventricular ejection fraction (LVEF) (≤45%), LpPLA2 (>59.50 μg/L), D/F (>0.46), N-terminal brain natriuretic peptide precursor (>1.55 μg/L) and fasting blood glucose (>7.00 mmol/L) were the risk of death from cardiac causes at 90 d after PCI in patients with acute STEMI ( P<0.05); when the risk thresholds were >0.24, the nomogram model could provide significant additional net clinical benefit. Conclusions:Lp-PLA2 and D/F are closely related to the prognosis of patients with acute STEMI after PCI, and the nomogram model constructed in combination with other clinical indicators can effectively predict the risk of death within 90 d after PCI.

Correlation between smoking and serum lipoprotein-associated phospholipase A2 level in overweight and obese men / 中南大学学报(医学版)

OBJECTIVES@#Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a vaso-specific inflammatory marker that exacerbates atherosclerotic through inflammatory responses. It can be used to predict the occurrence of adverse cardiovascular events and to assess the residual risk of cardiovascular diseases. This study aims to investigate the correlation between smoking and serum Lp-PLA2 levels in overweight and obese men, and to provide evidence for preventing the cardiovascular diseases.@*METHODS@#Male subjects, who participated in health examination at the Health Management Center, Third Xiangya Hospital, Central South University from May 1, 2020 to April 30, 2021, were selected. The smoking status and other information were collected by the Self-test Scale of Physical Examination. According to the smoking status, they were divided into a never-smoking group, a current smoking group, a quit smoking group and a passive smoking group. According to the daily smoking amount, the current smoking subjects were divided into a <10 cigarettes group, a 10 to 20 cigarettes group, a 21 to 30 cigarettes group, and a >30 cigarettes group. According to the smoking years, the current smoking subjects were divided into a <5 years group, a 5 to 10 years group, a 11 to 20 years group, and a >20 years group.Serum Lp-PLA2 levels and other clinical indexes in different smoking groups were measured and compared, the correlation between smoking and serum Lp-PLA2 levels in overweight and obese men was analyzed by logistic regression analysis.@*RESULTS@#Serum Lp-PLA2 levels were significantly different between the never-smoking group and the current smoking group (P<0.05). Logistic regression analysis showed that, before adjusting other influencing factors and in terms of smoking status, the current smoking group (OR=1.81, 95% CI 1.27 to 2.58, P<0.01) and the quit smoking group (OR=2.09, 95% CI 1.12 to 3.90, P<0.05) were positively correlated with serum Lp-PLA2 levels compared with the never-smoking group, while the passive smoking group had no correlation with serum Lp-PLA2 levels (OR=1.27, 95% CI 0.59 to 2.73, P>0.05). In terms of daily smoking amount, the 10 to 20 cigarettes group (OR=2.09, 95% CI 1.40 to 3.12, P<0.001) and the 21 to 30 cigarettes group (OR=1.98, 95% CI 1.22 to 3.20, P<0.01) were positively correlated with serum Lp-PLA2 levels compared with the never-smoking group, while the <10 cigarettes group (OR=1.45, 95% CI 0.81 to 2.60, P>0.05) and the >30 cigarettes group (OR=1.17, 95% CI 0.60 to 2.28, P>0.05) had no correlation with serum Lp-PLA2 levels. In terms of smoking years, the 5 to 10 years group (OR=1.94, 95% CI 1.07 to 3.53, P<0.05), the 11 to 20 years group (OR=2.06, 95% CI 1.33 to 3.18, P<0.01), and the >20 years group (OR=1.66, 95% CI 1.11 to 2.47, P<0.05) were positively correlated with serum Lp-PLA2 levels compared with the never-smoking group, while the <5 years group had no correlation with serum Lp-PLA2 levels (OR=1.12, 95% CI 0.38 to 3.33, P>0.05). After adjusting for age and other indicators, the correlation between smoking years and serum Lp-PLA2 levels was the same as before adjustment among the above smoking groups, except that the correlation between the smoking 5 to 10 years group and serum Lp-PLA2 levels was not significant (OR=1.77, 95% CI 0.95 to 3.29, P>0.05).@*CONCLUSIONS@#Smoking is correlated with serum Lp-PLA2 levels in overweight and obese men.

Serum lipoprotein-associated phospholipase A2 level is positively correlated with the recurrence risk of acute ischemic cerebral infarction in hypertensive patients / 南方医科大学学报

OBJECTIVE@#To explore the relationship between serum lipoprotein-associated phospholipase A2 (Lp-PLA2) level and the risk of acute ischemic stroke (AIS) recurrence in hypertensive patients.@*METHODS@#This retrospective case-control study was conducted among 211 hypertensive patients with AIS treated in Foshan First People's Hospital, including 35 patients with recurrence of AIS during the 1-year follow-up as confirmed by head CT/MR. In the overall patients, 60 had grade 1 hypertension (including 5 recurrent cases), 76 had grade 2 hypertension (with 11 recurrent cases), and 75 had grade 3 hypertension (with 19 recurrent cases). Univariate analysis, multivariate logistic regression analysis, trend analysis, and smooth curve fitting analysis were performed to explore the correlation between serum Lp-PLA2 level within 24 h after admission and the risk of AIS recurrence. The predictive efficacy of serum Lp-PLA2 level for AIS recurrence in different hypertension grades was evaluated using ROC curve analysis.@*RESULTS@#Serum Lp-PLA2 level, age, NIHSS score at admission, mRS scores at 7 days, homocysteine level and smoking status differed significantly between patients with and without AIS recurrence (P < 0.05). After adjustment for confounding factors, multivariate regression analysis showed that the highest tertile of Lp-PLA2 level was associated with a 4.13-fold increase of AIS recurrence risk compared with the lowest tertile (OR=5.13, 95% CI: 1.35-19.40), and each 1 ng/mL increase of Lp-PLA2 level was associated with a 1% increase of AIS recurrence risk (OR= 1.01, 95% CI: 1.01-1.02). Serum Lp-PLA2 level was shown to positively correlate with AIS recurrence risk, and in patients with grade 3 hypertension, its areas under the ROC curve for predicting AIS recurrence was 0.869 with a specificity of 0.893 and a sensitivity of 0.737.@*CONCLUSION@#Serum Lp-PLA2 concentration is an independent risk factor and potentially an effective predictor for AIS recurrence in patients with grade 3 hypertension.

The correlation of serum lipoprotein-associated phospholipase A2 with intra-stent restenosis after drug-eluting stent implantation / 中国医师杂志

Objectives:To investigate the correlation of serum lipoprotein-associated phospholipase A2 (Lp-PLA2) with intra-stent restenosis (ISR) after drug-eluting stent (DES) implantation.Methods:A total of 227 patients with coronary artery disease, who were diagnosed with severe epicardial coronary stenosis by coronary angiography (CAG) and treated by percutaneous coronary intervention (PCI) and DES implantation were enrolled in our study. After follow-up for 1-1.5 years, the CAG was performed and the patients were divided into ISR group and non-ISR (nISR) group according to the consequence of CAG. Biochemical data and multiple serum inflammatory factors such as Lp-PLA2, hypersensitive C-reactive protein (hs-CRP), interleukin 2 (IL-2), interleukin 6 (IL-6) and tumor necrosis factor-α (TNF-α) were analyzed before the CAG. Multivariate logistic regression and multiple linear regression were used to analyze the influencing factors of stent restenosis after DES implantation.Results:The level of serum Lp-PLA2 and the proportion of hypertension in ISR group were significantly higher than those in nISR group, and the level of high density lipoprotein cholesterol (HDL-C) was significantly lower than that in nISR group (all P<0.05), but there was no significant difference in other biochemical indexes and inflammatory factors between the two groups (all P>0.05). The minimum lumen diameter of stent segment in ISR group was significantly lower than that in nISR group ( t=14.975, P<0.01), and the stenosis degree of stent segment diameter was significantly higher than that in nISR group ( P<0.01). Multivariate logistic regression analysis showed that Lp-PLA2 remained an independent predictor for ISR (1.011, 95% CI: 1.005-1.017). Only the serum levels of Lp-PLA2 had linear relationship with the degree of ISR by multivariate linear regression analysis ( β=0.790, P<0.01). Conclusions:Serum Lp-PLA2 level is independently associated with an increased risk of ISR in patients with coronary heart disease.

The Use of Lipoprotein-Associated Phospholipase A2 in a Chinese Population to Predict Cardiovascular Events / 生物医学与环境科学（英文）

Objective@#To explore associations between lipoprotein-associated phospholipase A2 (Lp-PLA2) and the risk of cardiovascular events in a Chinese population, with a long-term follow-up.@*Methods@#A random sample of 2,031 participants (73.6% males, mean age = 60.4 years) was derived from the Asymptomatic Polyvascular Abnormalities Community study (APAC) from 2010 to 2011. Serum Lp-PLA2 levels were determined by enzyme-linked immunosorbent assay (ELISA). The composite endpoint was a combination of first-ever stroke, myocardial infarction (MI) or all-cause death. Lp-PLA2 associations with outcomes were assessed using Cox models.@*Results@#The median Lp-PLA2 level was 141.0 ng/mL. Over a median follow-up of 9.1 years, we identified 389 events (19.2%), including 137 stroke incidents, 43 MIs, and 244 all-cause deaths. Using multivariate Cox regression, when compared with the lowest Lp-PLA2 quartile, the hazard ratios with 95% confidence intervals for developing composite endpoints, stroke, major adverse cardiovascular events, and all-cause death were 1.77 (1.24-2.54), 1.92 (1.03-3.60), 1.69 (1.003-2.84), and 1.94 (1.18-3.18) in the highest quartile, respectively. Composite endpoints in 145 (28.6%) patients occurred in the highest quartile where Lp-PLA2 (159.0 ng/mL) was much lower than the American Association of Clinical Endocrinologists recommended cut-off point, 200 ng/mL.@*Conclusion@#Higher Lp-PLA2 levels were associated with an increased risk of cardiovascular event/death in a middle-aged Chinese population. The Lp-PLA2 cut-off point may be lower in the Chinese population when predicting cardiovascular events.

Early prediction of prognosis of acute type A aortic dissection by lipoprotein-associated phospholipase A2: A prospective cohort study / 中国胸心血管外科临床杂志

@#Objective    To investigate the relationship between lipoprotein-associated phospholipase A2 (Lp-PLA2) level and in-hospital prognosis in patients with acute type A aortic dissection within 24 hours of admission. Methods    Fortysix patients diagnosed with type A aortic dissection were included in our hospital and their Lp-PLA2 levels within 24 hours of admission were measured between January 2017 and June 2019. According to their Lp-PLA2 levels within 24 hours of admission, 23 patients were classified into a high Lp-PLA2 group (Lp-PLA2 > 200 μg/L, 16 males and 7 females at age of 52.0±14.0 years) and 23 patients were into a low Lp-PLA2 group (Lp-PLA2 ≤200 μg/L, 15 males and 8 females at age of 53.0±11.0 years). The relationship between Lp-PLA2 level and clinical outcome was analyzed. Results    The incidences of bleeding, hospital infection, multiple organ dysfunction and mortality in the high Lp-PLA2 group were higher than those in the low Lp-PLA2 group (P<0.05). Seven (15.2%) patients died during 3 months of follow-up. The 3-month survival rate of patients with an increase of Lp-PLA2 was significantly lower than that of the patients with normal Lp-PLA2 (P<0.01), which was an independent predictor of adverse outcomes at 3 months of onset (P<0.01). Conclusion    Lp-PLA2 may be a predictor of disease progression in the patients with acute type A aortic dissection, and the patients with significantly elevated Lp-PLA2 have a higher 3-month mortality than the patients with normal Lp-PLA2.

Development and application of monoclonal antibodies anti-human lipoprotein-associated phospholipase A2 / 生物工程学报

The aim of this study is to prepare monoclonal anti-human Lp-PLA2 antibodies, and establish a rapid and accurate immunochromatographic Lp-PLA2 assay used in community medical institution. The gene sequence of human Lp-PLA2 was obtained from NCBI to construct the expression plasmid. Lp-PLA2 protein expressed in CHO-K1 cells was used to immune BALB/c mice. The monoclonal antibodies were produced in mouse ascites after hybridoma cells screening. Antibodies were evaluated by SDS-PAGE, ELISA and other methods. The Lp-PLA2 test strip was prepared based on sandwich method and evaluated with the portable detection instrument. The affinity of the paired antibodies, PLA1 and PLA5, both reached 1×10⁻⁸. The antibody subclass was IgG1. Both antibodies recognized the Lp-PLA2 protein in the blood specifically. The Lp-PLA2 test strip was prepared based on sandwich method, with linear range of 20-2000 ng/mL. The Lp-PLA2 test strip correlated well with the diaDexus ELISA test kit. In conclusion, the paired antibodies were successfully prepared with high affinity and specificity. The immunochromatographic test of Lp-PLA2 provided a fast and accurate method to detect the concentration of Lp-PLA2 in blood sample for clinical use in the community medical institution and could contribute to the management of cardiovascular diseases.

Lipoprotein-associated phospholipase A2 predicts early neurological deterioration in patients with lacunar infarction / 中国脑血管病杂志

Objective To study the predictive value of lipoprotein-associated phospholipase A2 ( Lp-PLA2)for early neurological deterioration (END) in patients with lacunar infarction. Methods Between January 2016 and July 2018,281 consecutive patients with first-ever acute lacunar infarction admitted to the Department of Neurology, the Second People's Hospital of Lianyungang were enrolled retrospectively. They were divided into END group (n = 75 ) and non-END group ( n = 206) depending on whether END occurred or not. The general data ( age, sex, body mass index,past medical history) ,clinical data (National Institute of Health stroke scale [ NIHSS score] ) , onset to admission time,imaging data (white matter lesion score,cerebral microhemorrhage score and branch atherosclerosis) , treatment methods and laboratory findings such as neutrophil to lymphocyte ratio, total cholesterol,low- density lipoprotein cholesterol, fasting blood glucose, hypersensitive C-reactive protein, homocysteine, and Lp-PLA2 were compared in patients between the two groups. Immunoturbidimetry was used to determine the level of Lp-PLA2 in blood. SPSS 22. 0 software was used to analyze and process the data. Multivariate logistic regression was used to analyze the risk factors for affecting the occurrence of END in patients with lacunar cerebral infarction. Receiver operating characteristic (ROC) curve was used to analyze the value of Lp-PLA2 in predicting the occurrence of END in lacunar infarction. Results Univariate analysis showed that NLR (2. 5 ± 0. 5 vs. 2. 3 ± 0. 5, t = 2. 996) , low-density lipoprotein cholesterol (2. 6 ± 0. 8 mmol/L vs. 2. 3 ± 0. 7 mmol/L, t = 3. 056), NIHSS score on admission ( 3.4 ± 1.5 vs. 3.0 ± 1.4, l = 2. 080), and the proportion of patients with branch atherosclerosis (21. 3% [ 16/75] vs. 7. 3% [ 15/206] #=1 1-061) in the END group were higher than those in the non-END group (240 ± 26 jxg/L vs. 180 ±23 p,g/L, I = 9. 032) ,and the difference was statistically significant (all P <0. 05). Multivariate logistic regression analysis showed that the increased level of NLR (0/,3.927,95% CI 2.918 -5.016,P = 0.020),Lp-PLA2 (OR, 1.026,95% 67 1.019-1.034, P <0.01), low-density lipoprotein cholesterol (OR, 2.715,95% CI 2.193 -3.273, P =0.025) , NIHSS score on admission (OR,2. 831 ,95% CI 2.412 -3. 197, P = 0.028) , and branch atherosclerosis ( OR,4. 552 ,95% CI 2. 934 -7. 017 , P = 0. 002) were the independent risk factors for lacunar infarction occurring END. Receiver operating characteristic ( ROC) curve analysis showed that the area under the curve of Lp-PLA2 predicting END was 0. 799 (95% CI 0. 728 -0. 833 ,P< 0. 01 ) ;the optimal cut-off value was 189 jtg/L, the sensitivity for predicting END was 92. 3% ,and the specificity was 55. 4%. Conclusion The increased level of serum I.p-PLA2 is an independent risk factor for lacunar infarction occurring END,and it has certain predictive value for END.

The correlation between lipoprotein-associated phospholipase A2 and severity of coronary artery diseases / 中华检验医学杂志

Objective To investigate the relationship between lipoprotein-associated phospholipase A2(Lp-PLA2) activity and the severity of coronary artery diseases .Methods A case-control study was conducted to select 231 patients with positive coronary angiography results in Beijing Huaxin Hospital .They were divided into two groups (untreated goup:147 cases; the medication group:84 cases) according to whether taking statins.99 cases were included in the healthy control group .In the untreated group, all male patients were grouped according to the number of diseased coronary branches (43 cases were in single vessel lesion group and 52 cases were in multi vessel disease group ) or to the Gensini score (32 cases were in low score group, 36 cases were in middle score group and 27 cases were in high score group ).The clinical data were collected by detecting serum atherosclerotic markers such as Lp-PLA2, total cholesterol (CHOL), low-density lipoprotein (LDL).The number of vessels involved in coronary artery disease , the position of the lesion and the degree of stenosis were confirmed by percutaneous coronary intervention ( PCI).Statistical evaluations were performed using t-test, variance analysis, Mann-Whitney U test and Spearman correlation analysis.Results The differences among untreated group , the medication group and the control group were statistically significant, of which the Lp-PLA2 level was (561.9 ±158.5) U/L, (373.2 ±124.7) U/L and (467.4 ±130.4) U/L respectively.Compared with single branch disease group , the Lp-PLA2 level in the multiple branches disease group was increased dramatically .Additionally, the level of Lp-PLA2 in high Gensini score group was (618.7 ±165.4) U/L, significantly higher than the low score group (517.3 ± 191.7) U/L.Conclusion Lp-PLA2 activity was associated with the severity of Coronary Artery Diseases, which can provide the evidence for the follow-up treatment programs.

Pilot study on reference interval of serum lipoprotein-associated phospholipase A2 activity in healthy adults of Changsha area, China / 临床检验杂志

Objective To investigate the level of serum lipoprotein-associated phospholipase A2(Lp-PLA2) activity in healthy adults of Changsha area and establish the reference interval of serum Lp-PLA2activity. Methods A total of 424 healthy adults (175 males and 249 females) were classified into five groups by different age, including 20 to 29, 30 to 39, 40 to 49, 50 to 59 and over 60 years old group. Serum Lp-PLA2activity was measured by continuous-monitoring assay. According to the requirements of Clinical and Laboratory Standards Institute (CLSI) C28-A3, the reference interval of Lp-PLA2activity was established by nonparametric method.Results The levels of serum Lp-PLA2activities in both males and females showed normal distribution. The average of Lp-PLA2activity was (478± 135)U/L in 175 males and (402±116)U/L in 249 females with statistically significant difference (t＝6.184, P＜0.01). Z test result showed Z＞Z?, so the reference intervals of males and females were established respectively. There was no statistical difference of Lp-PLA2activities among the varied groups of males (F＝1.259, P＝0.288), but there were statistical differences among the varied groups of females (F＝9.341, P＜0.01). The females of the age over 40 years old showed higher activities than those of age under 40 years old (t＝5.732,P＜0.01). However, there was no statistical significance of serum Lp-PLA2activities in the females between the two groups of the age under 40 and the three groups of age over 40. Therefore, the reference intervals of serum Lp-PLA2activities in healthy adults were established as followed: 217-761 U/L for males, 168-566 U/L for the females of 20 to 39 years old and 203-702 U/L for the fe-males of 40 to 86 years old. Conclusion The reference interval of serum Lp-PLA2activity in physical examination of healthy adults in Changsha area was established.

Study on relationship between the level LP-PLA2 in serum and type H-hypertension ischemic stroke / 国际检验医学杂志

Objective To observe the change of results of lipoprotein-associated phospholipase A2 (Lp-PLA2) ,homocysteine (Hcy ) ,high-sensitivity C-reactive protein (hs-CRP ) ,lipids and other indicators in the patients with normal group ,primary hypertension group ,type H hypertension group and type H hypertension ischemic stroke group ,and search the relationship between LP-PLA2 and type H-hypertension ischemic stroke .Methods From January 2015 to June 2017 ,continuous selected 103 patients with type H hypertension ischemic stroke group ,124 patients with type H hypertension group ,80 patients with primary hypertension group and 50 patients with healthy controls as normal group .Analyzed level of Lp-PLA2 ,Hcy ,hs-CRP and lipids in serum ,compared the difference with each group .A binary Logistic regression analysis was used to an-alyze its correlation with ischemic stroke .Results The serum concentration of total cholesterol(TC) ,low-den-sity lipoproteincholesterol(LDL-C) ,LP-PLA2 in type H hypertension group and type H hypertension ischemic stroke group was higher than primary hypertension group and normal group ,the difference was statistically significant(P＜0 .05) .The serum concentration of triglyceride (TG) in type H hypertension ischemic stroke group was higher than primary hypertension group and normal group ,the difference was statistically signifi- cant(P＜0 .05) .The serum concentration of Hcy in primary hypertension group ,type H hypertension group and type H hypertension ischemic stroke group was higher than normal group ,the difference was statistically significant(P＜0 .05) ;The serum concentration of Hcy in type H hypertension group and type H hypertension ischemic stroke group was higher than primary hypertension group ,the difference was statistically significant (P＜ 0 .05) ;The serum concentration of Hcy ,LP-PLA2 in type H hypertension ischemic stroke group was higher than type H hypertension group ,the difference was statistically significant (P＜0 .05) .The serum con-centration of hs-CRP in type H hypertension group was higher than primary hypertension group and normal group ,the difference was statistically significant (P＜0 .05) ;The serum concentration of hs-CRP in type H hy-pertension ischemic stroke group was higher than type H hypertension group ,primary hypertension group and normal group ,the difference was statistically significant (P＜0 .05) .Two element Logistic regression analysis , Lp-PLA2 were significantly related to type H hypertension ischemic stroke ( SE ＝ 0 .013 ,P ＜ 0 .05 ) . Conclusion LP-PLA2 is an inflammatory biomarker and it is closely related to the occurrence and develop-ment of type H hypertension ischemic stroke .

Clinical value evaluation of joint detection of lipoprotein associated phospholipase A2 and small dense low-density lipoprotein cholesterol levels in the diagnosis of patients with coronary heart disease / 国际检验医学杂志

Objective To investigate the significance of combined detection of serum lipoprotein-associated phospholipase A2 (Lp-PLA2) and small dense low-density lipoprotein cholesterol (sdLDL-C) in the clinical diagnosis of coronary heart disease.Methods 100 patients with coronary heart disease were selected as the ex-periment group ,and 50 healthy subjects who underwent the health assessment were selected as the control group.The levels of serum Lp-PLA2 ,sdLDL-C ,homocysteine (Hcy) ,triglyceride (TG) ,total cholesterol (TC) ,high density lipoprotein cholesterol (HDL-C) ,low density lipoprotein cholesterol (LDL-C) ,and the de-gree of coronary heart disease (CHD) were measured and the correlation was analyzed.Results Compared with the control group ,the level of Lp-PLA2 ,sdLDL-C and Hcy increased significantly ,and the level of HDL-C was lower ,and the difference was statistically significant (P＜0.05) ;there was a positive correlation between Lp-PLA2 and sdLDL-C ,Hcy ,TG ,TC and LDL-C (r=0.430 ,0.633 ,0.259 ,0.450 ,0.269 ,P=0.026 , 0.013 ,0.028 ,0.032 ,0.023).There was a negative correlation between Lp-PLA2 and HDL-C (r= -0.632 , P=0.01).In 0- ＜20 points ,20- ＜40 points and ≥40 points experiment groups ,the levels of Lp-PLA2 and sdLDL-C were significantly higher than those in the control group ,and the differences were significant (P＜0.05) ;there was also a significant difference in the level of Lp-PLA2 and sdLDL-C between 0- ＜20 points ,20- ＜40 points and ≥40 points experiment groups (P＜0.05).The positive rates of the combined detection of Lp-PLA2 and sdLDL-C in the acute coronary syndrome (ACS) group and the stable angina (SAP) group were significantly higher than those of the single test ,and the differences were statistically significant (χ2=4.246 , 4.974 ,P=0.039 ,0.026).Conclusion Lp-PLA2 and sdLDL-C levels are both higher in patients with coronary heart disease than those in healthy people.The combined detection of Lp-PLA2 and sdLDL-C has a certain clinical significance for assessing the development and prognosis of patients with coronary heart disease.

Correlation analysis of high sensitivity C reactive protein,homocysteine, interleukin 2 and lipoprotein associated phospholipase A 2 and coronary heart disease / 国际检验医学杂志

Objective To investigate the high sensitive C reactive protein(hs-CRP),homocysteine(Hcy), interleukin 2(IL-2)and lipoprotein associated phospholipase A 2(Lp-PLA2)analysis and correlation test for coronary heart disease.Methods 147 cases were selected from our hospital in December 2015 to December 2016 in patients with coronary heart disease(observation group).At the same time,we selected 51 healthy persons in our hospital during December 2015 to December 2016 as control group.The content of hs-CRP was determined by immune transmission turbidimetry.The content of Hcy was determined by cyclic enzymatic method.The content of IL-2 was determined by enzyme linked immunosorbent assay(ELISA).The content of Lp-PLA2 was determined by immune transmission turbidimetry.Results The observation group serum levels of hs-CRP,Hcy,IL-2 and Lp-PLA2 were significantly higher than those in the control group,and the differ-ence were statistically significant(P<0.05).The coronary heart disease each group serum levels of hs-CRP, Hcy,IL-2 and Lp-PLA2 were significantly higher than those in the control group,and the differences were sta-tistically significant(P<0.05).The serum levels of hs-CRP,Hcy,IL-2 and Lp-PLA2 of AMI group were sig-nificantly higher than those in UAP group and SAP group,and the differences were statistically significant (P<0.05).The UAP group serum levels of hs-CRP,Hcy,IL-2 and Lp-PLA2 were significantly higher than those in SAP group,and the difference was statistically significant(P<0.05).Conclusion Hs-CRP,Hcy,IL-2,Lp-PLA2 have significant correlation with coronary heart disease.

Clinical value of serum phospholipase A2 in the screening and diagnosis of benign prostatic hyperplasia / 国际检验医学杂志

Objective To investigate the clinical value of serum lipoprotein associated phospholipase A 2 (Lp-PLA2)as a biomarker for benign prostatic hyperplasia(BPH).Methods A total of 65 serum samples of BPH patients were selected as BPH group,64 serum samples of healthy male as control group.The serum lev-el of Lp-PLA2,total prostate specific antigen(tPSA)and free prostate specific antigen(fPSA)in both groups were detected,and the specificity and sensitivity of Lp-PLA2,F/T ratio and combine both were analyzed by ROC curve.Results The serum level of Lp-PLA2,tPSA and fPSA in BPH group were significantly higher than those in control group,the different were significant(P<0.05).ROC curve analyze shown that the area under the curve(AUC)of Lp-PLA2 was 0.763,95% confidence interval(CI)was 0.680-0.833;AUC of F/T ratio was 0.715,95% CI 0.633 -0.795;AUC of Lp-PLA2 combined with F/T ratio was 0.832,95% CI 0.756-0.892.Conclusion The serum level of Lp-PLA2 could be used as a potential diagnostic marker for BPH,and the diagnostic value of Lp-PLA2 combined with F/T ratio was better than ther single indicator. Key words:benign prostatic hyperplasia; lipoprotein associated phospholipase A 2; total prostate spe-cific antigen; free prostate specific antigen; F/T ratio

Analysis on correlation between serum Lp-PLA2 level with ischemic stroke occurrence and prognosis in patients with hypertension / 国际检验医学杂志

Objective To explore the correlation between serum lipoprotein-associated phospholipase A2 (Lp-PLA2) level with the occurrence of ischemic stroke and prognosis in the patients with hypertension . Methods Eighty-eight patients with hypertension in this hospital from January 2013 to January 2016 were se-lected ,including 34 cases of simple hypertension and 54 cases of hypertension complicating ischemic stroke . The Lp-PLA2 level was detected .The severity of ischemic stroke was evaluated on 1 ,14 d after admission by adopting the NIHSS .The patients with hypertension complicating ischemic stroke were divided into the good prognosis group and poor prognosis group according to the NIHSS change situation .Moreover the independent predictive factors of prognosis were evaluated by adopting the Logistic multivariate regression .Results The Lp-PLA2 level in the patients with hypertension complicating ischemic stroke was significantly higher than that in the patients with simple hypertension .The Lp-PLA2 level (OR=1 .523 ,95％ CI=1 .323-1 .657) and NIHSS score (OR=3 .275 ,95％ CI=1 .402 -6 .208) at admission were the independent predictive factors of poor prognosis .Conclusion Serum Lp-PLA2 level is closely correlated with the occurrence and prognosis of ische-mic stroke in the patients with hypertension ,which can serve an evaluation index for the occurrence and prognosis of ischemic stroke in the patients with hypertension and provides an objective basis for the clinical therapy .

Effect of RBP4 on neurocognitive function in diabetic nephropathy with silent cerebral infarction / 重庆医学

Objective To observe the impairment effect of retinol binding protein 4(RBP4) on neurocognitive function in diabetic nephropathy(DN) patients with silent cerebral infarction(SCI) and to explore its mechanism.Methods Sixty patients with newly diagnosed DN and 30 healthy volunteers were selected as the study subjects and the DN cases were divided into the complicating SCI group(SCI,n=30) and non-complicating SCI group(NSCI,n=30) according to the imaging results.The degrees of neurological function deficit and Montreal cognitive assessment(MoCA) were evaluated.Serum RBP4 level was determined by ELISA and expressions of Lp-PLA2 and C-X-C chemokine receptor type 4(CXCR4) were determined by Western blot.Results Compared with the NSCI group,the neurocognitive function in the SCI group was subsided,the expression levels of RBP4,Lp-PLA2 and CXCR4 were increased(P＜0.05).The RBP4 level was positively correlated with the neurocognitive function impairment in SCI patients,moreover,there existed a regression correlation between them.Conclusion Serum RBP4 may serve as the predictive factor of DN complicating SCI and is positively correlated with neurocognitive dysfunction.Lp-PLA2/CXCR4 pathway activation may be one of its pathogenesis.

The relationship between the levels of serum cystatin C,lipoprotein associated phospholipase A2 and lower limb vascular disease in type 2 diabetes mellitus patients / 中国基层医药

Objective To explore the correlation between serum cystatin C,lipoprotein associated phospho-lipase A2 (LP-PLA2) and lower limb vascular disease in patients with type 2 diabetes mellitus.Methods From August 2014 to December 2016,a total of 187 type 2 diabetic patients in Weihai Central Hospital were selected. According to the ankle brachial index (ABI),the patients were divided into without lower limb vascular disease group (SDM group,85 cases) and with lower limb vascular disease group (T2DM+LLVD group,102 cases).Meanwhile,82 healthy people were selected as control group.The cystatin C,LP-PLA2,hemoglobin (HbAlc),triglyceride,total cholesterol,high density lipoprotein cholesterol ( HDL-C) and low density lipoprotein cholesterol ( LDL-C) were calculated.Results Compared with the control group [(0.788 ±0.084)mg/L],the cystatin C was significantly high-er in the SDM group[(0.913 ±0.135)mg/L] and the T2DM +LLVD group[(1.114 ±0.225)mg/L],and the difference was statistically significant (t＝5.511,9.121,all P＜0.01).The cystatin C in T2DM+LLVD group was higher than that in the SDM group ( t ＝7.209,P ＜0.01 ).Compared with the control group [( 342.76 ± 33.49)ng/mL],LP-PLA2 was significantly higher in the T2DM+LLVD group[(513.54 ±94.26)ng/mL],and the difference was statistically significant ( t ＝11.428,P＜0.01 ).Compared with the SDM group [( 352.28 ± 67.82)ng/mL],the cystatin C and LP-PLA2 levels were significantly higher that in the T2DM+LLVD group,and the difference was statistically significant (t＝7.209,13.181,all P＜0.01).Conclusion Cystatin C and LP-PLA2 play important roles in type 2 diabetic patients with lower limb vascular disease.Cystatin C and LP -PLA2 may become the forecast indicators in type 2 diabetic patients with lower limb vascular disease.

Influencing factors of serum Lp-PLA2 level in patients with diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To probe into the related influencing factors of serum lipoprotein associated phospholipase A2(Lp-PLA2)level in patients with diabetic retinopathy. <p>METHODS: Totally 174 cases of patients with type 2 diabetes mellitus and who treated in Department of Endocrinology from September 2015 to September 2017 were selected as the research objects, and were divided into the non-diabetic retinopathy group(NDR), non-proliferative diabetic retinopathy group(NPDR)and proliferative diabetic retinopathy group(PDR)according to the results of fundus examination. Then, the age, sex, body mass index(BMI), blood pressure, blood glucose, blood lipids, vascular endothelial growth factor(VEGF), C-reactive protein(CRP), and Lp-PLA2 levels and other clinical data of three groups of patients were collected and compared. <p>RESULTS: There was significant differences in the duration of diabetes, fasting blood glucose(FBP), 2h postprandial blood glucose(2hBP), HbA1c, triacylglycerol(TG), total cholesterol(TC), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), VEGF, CRP, Lp-PLA2 between the three groups of patients(<i>P</i><0.05). There was no significant difference in serum TG, TC, HDL-C and CRP levels between NPDR group and NDR group(<i>P</i>>0.05). While there was significant difference in biochemical indexes of patients between PDR group and NDR group(<i>P</i><0.05). The VEGF, CRP and Lp-PLA2 in the PDR group were significantly higher than those in the NPDR group, and the difference was statistically significant(<i>P</i><0.05). Pearson correlation analysis found that the serum Lp-PLA2 was positively correlated with age, course of disease, 2hBG, TG, VEGF and CRP(<i>P</i><0.05). Multiple linear regression analysis showed that serum Lp-PLA2 was positively correlated with the course of diabetes mellitus and serum level of VEGF(<i>P</i><0.05). <p>CONCLUSION: The level of serum Lp-PLA2 in patients with diabetic retinopathy are significantly increased, which the level is positively correlated with the duration of diabetes and serum VEGF level, thus it can be used as diagnostic index for diabetic retinopathy.

Change of Inflammatory Factors in Patients with Acute Coronary Syndrome / 中华医学杂志(英文版)

<p><b>Background</b>Acute coronary syndrome (ACS) is closely related to unstable plaques and secondary thrombosis. The inflammatory cells in plaques and their inflammatory products may be the cause for plaque instability and ruptures. The study aimed to disclose the changes of inflammatory factors including serum intracellular adhesion molecule-1 (ICAM-1), chitinase-3-like protein 1 (YKL-40), and lipoprotein-associated phospholipase A2 (Lp-PLA2) in patients with ACS and its clinical significance.</p><p><b>Methods</b>A total of 120 patients with coronary heart disease (CHD) were categorized into 2 groups: 69 with ACS and 51 with stable angina pectoris (SAP); 20 patients with chest pain and normal angiography served as a control group. The 120 patients with CHD were categorized into single-vessel disease group, double-vessel disease group, and three-vessel disease group based on the number of coronary artery stenosis. The severity of coronary artery stenosis was quantified based on coronary angiography using Gensini score. They were further divided into mild CHD group with its Gensini score <26 (n = 36), moderate CHD group with its Gensini score being 26-54 (n = 48) and severe CHD group with its Gensini score >54 (n = 36). Serum levels of ICAM-1, YKL-40, and Lp-PLA2 of different groups were determined by enzyme-linked immunosorbent assay. Correlation between ICAM-1, YKL-40, Lp-PLA2, and Gensini score was analyzed.</p><p><b>Results</b>The levels of serum inflammatory factors ICAM-1, YKL-40, and Lp-PLA2 were significantly higher in the ACS group than those in control group and SAP group (all P < 0.05); and compared with control group, no significant difference was observed in terms of the serum ICAM-1, YKL-40, and Lp-PLA2 levels in the SAP group (P > 0.05).The levels of serum ICAM-1, YKL-40, and Lp-PLA2 were not significantly different among control group, single-vessel disease group, double-vessel disease group, and three-vessel disease group (all P > 0.05). The levels of serum ICAM-1, YKL-40, and Lp-PLA2 were not significantly different among control group, mild CHD group (Gensini score <26), moderate CHD group (Gensini score 26-54), and severe CHD group (Gensini score >54) (all P > 0.05). Nonparametric Spearman correlation analysis showed that the levels of serum ICAM-1, YKL-40, and Lp-PLA2 were not correlated with the Gensini score in CHD patients (r = 0.093, r = -0.149, and r = -0.085, all P > 0.05; respectively).</p><p><b>Conclusions</b>The serum levels of ICAM-1, YKL-40, and Lp-PLA2 were correlated with different clinical types of CHD, but not well correlated the severity and extent of artery stenosis, suggesting that ICAM-1, YKL-40, and Lp-PLA2 might be involved in occurrence of instability of atherosclerotic plaque, and might reflect the severity of CHD mostly through reflecting the plaque stability.</p>

Study on the association of serum ox-LDL and Lp-PLA2 levels with atherosclerosis and neurological deficits in patients with cerebral ischemic stroke / 国际检验医学杂志

Objective To investigate the association of oxidized low density lipoprotein (ox-LDL ) in the serum and lipoprotein associated phospholipase A2 (Lp-PLA2) levels with carotid atherosclerosis and neurologic impairment in patients with cerebral is-chemic stroke .Methods 135 patients with acute cerebral infarction (ACI group) and 150 cases inpatients (control group) from February 2015 to February 2017 in the Traditional Chinese Medicine Hosptical of Xinjiang Uygur Autonomous Region were select-ed to detect serum ox-LDL and Lp-PLA2 levels ,and serum ox-LDL ,Lp-PLA2 and other levels of blood lipid index were compared between ACI group and control group ;carotid artery ultrasonography was conducted ,ox-LDL and Lp-PLA2 levels of non plaque group ,stable plaque group and unstable plaque group were compared ;ox-LDL and Lp-PLA2 levels of mild ,moderate and severe pa-tients according to the score of the National Institutes of Health Stroke Scale (NIHSS) were compared .Results The serum ox-LDL and Lp-PLA2 levels of ACI group were higher than those in the control group ,and the difference was statistically significant (P<0 .01);serum ox-LDL ,Lp-PLA2 levels of stable plaque and unstable plaque were significantly higher than those of non plaque group (P<0 .05);serum ox-LDL ,Lp-PLA2 levels of unstable plaque were higher than those of the stable plaque group (P<0 .05);serum ox-LDL and Lp-PLA2 levels of moderate and severe patients determined by the NIHSS score were significantly higher than that of mild patients (P < 0 .05);serum ox-LDL and Lp-PLA2 levels of severe patients were significantly higher than that of moderate patients (P<0 .05) .Conclusion Serum ox-LDL and Lp-PLA2 levels of patients with cerebral ischemic stroke increased significantly compared with the normal people ,which reflects the severity of carotid atherosclerosis and neurologic impairment .ox-LDL and Lp-PLA2 levels can be used as a serum marker of acute ischemic cerebrovascular disease ,has certain clinical significance in evaluating the severity and prognosis of acute ischemic cerebrovascular disease .