Correlation Between Lipoprotein-Related Phospholipase A2 and Metabolic Syndrome

Figures & data

Table 1 Basic Characteristics of the Study Subjects

Variables	Total (n=3549)	Male (n=2182)	Female (n=1367)	p value
Age (year)	44.21±7.01	43.78±7.03	44.90±6.92	<0.001
BMI (kg/m^2)	24.26±3.34	24.98±3.32	23.11±3.05	<0.001
Waist circumference (cm)	83.18±9.97	87.35±8.96	76.54±7.61	<0.001
Waist-to-height ratio	0.50±0.05	0.52±0.05	0.49±0.05	<0.001
SBP (mmHg)	120.24±18.00	124.42±16.46	113.56±18.34	<0.001
DBP (mmHg)	74.61±12.92	78.24±12.20	68.82±11.89	<0.001
MAP (mmHg)	89.82±14.14	93.63±13.12	83.74±13.57	<0.001
Fasting glucose (mmol/L)	5.17±1.26	5.29±1.43	4.98±0.90	<0.001
Total cholesterol (mmol/L)	5.12±0.95	5.20±0.98	4.99±0.90	<0.001
Triglycerides (mmol/L)	1.61±1.43	1.89±1.62	1.16±0.91	<0.001
LDL cholesterol (mmol/L)	3.45±0.87	3.58±0.88	3.25±0.81	<0.001
HDL cholesterol (mmol/L)	1.33±0.32	1.23±0.28	1.49±0.31	<0.001
TG/HDL-C	1.41±1.94	1.74±2.21	0.89±1.22	<0.001
Lp-PLA2 (IU/L)	589.28±157.47	621.45±158.56	537.92±141.33	<0.001
Diabetes, n (%)	1584.45%	1275.82%	312.27%	<0.001
Metabolic Syndrome, n (%)	75,221.19%	58,126.63%	17,112.51%	<0.001

Notes: Continuous data are shown as mean ± SD and compared using independent two samples t-test. Categorical data are shown as n (%) and compared using the Chi-square test.

Abbreviations: SBP, systolic blood pressure; DBP, diastolic blood pressure; MAP, mean arterial pressure; LDL, low-density lipoprotein; HDL, high-density lipoprotein; TG, triglycerides; Lp-PLA2, lipoprotein-associated phospholipase A2.

Table 2 Pearson’s Correlation Coefficients Between Lp-PLA2 Levels and Cardiometabolic Risk Factors in Men and Women

Variables	Male (n=2182)		Female (n=1367)
	r	p value	r	p value
Age (year)	0.02	0.26	0.08	0.002
BMI (kg/m^2)	0.09	<0.001	0.07	0.01
Waist circumference (cm)	0.11	<0.001	0.09	0.001
Waist-to-height ratio	0.10	<0.001	0.09	0.001
SBP (mmHg)	0.05	0.01	0.03	0.26
DBP (mmHg)	0.06	0.01	0.03	0.23
MAP (mmHg)	0.06	0.01	0.03	0.23
Fasting glucose (mmol/L)	0.03	0.14	0.07	0.02
Total cholesterol (mmol/L)	0.38	<0.001	0.34	<0.001
Triglycerides (mmol/L)	0.05	0.01	0.09	0.001
LDL cholesterol (mmol/L)	0.44	<0.001	0.36	<0.001
HDL cholesterol (mmol/L)	−0.11	<0.001	−0.06	0.03
TG/HDL-C	0.04	0.04	0.06	0.02

Abbreviations: Lp-PLA2, lipoprotein-associated phospholipase A2; SBP, systolic blood pressure; DBP, diastolic blood pressure; MAP, mean arterial pressure; LDL, low-density lipoprotein; HDL, high-density lipoprotein; TG, triglycerides.

Table 3 Clinical and Metabolic Characteristics According to Lp-PLA2 Status

Variables	Lp-PLA2 (IU/L)			p value	p trend
	Tertile 1	Tertile 2	Tertile 3
Male	(n=729)	(n=726)	(n=727)
Age (year)	43.40±7.18	43.69±7.05	44.24±6.83	0.07	0.02
BMI (kg/m^2)	24.63±3.43	24.83±3.31	25.49±3.15^a,b	<0.001	<0.001
Waist-to-height ratio	0.51±0.05	0.51±0.05	0.52±0.05^a,b	<0.001	<0.001
MAP (mmHg)	93.27±13.58	93.18±12.89	94.45±12.87	0.12	0.08
Fasting glucose (mmol/L)	5.28±1.38	5.21±1.24	5.38±1.65	0.06	0.15
Total cholesterol (mmol/L)	4.75±0.89	5.08±0.80^a	5.76±0.95^a,b	<0.001	<0.001
Triglycerides (mmol/L)	1.84±1.47	1.80±1.59	2.04±1.77^b	0.01	0.02
LDL cholesterol (mmol/L)	3.11±0.80	3.49±0.65^a	4.15±0.84^a,b	<0.001	<0.001
HDL cholesterol (mmol/L)	1.27±0.32	1.23±0.27^a	1.19±0.25^a,b	<0.001	<0.001
TG/HDL-C	1.67±1.78	1.64±2.06	1.92±2.69^b	0.03	0.03
Diabetes, n (%)	405.49%	354.82%	527.15%	0.15	0.18
Metabolic Syndrome, n (%)	18,525.38%	17,323.83%	22,330.67%^b	0.01	0.02
Female	(n=460)	(n=455)	(n=452)
Age (year)	43.70±7.06	44.99±6.70^a	46.03±6.79^a	<0.001	<0.001
BMI (kg/m^2)	22.88±2.97	22.99±3.05	23.47±3.11^a	0.01	0.003
Waist-to-height ratio	0.48±0.05	0.48±0.05	0.49±0.05^a,b	<0.001	<0.001
MAP (mmHg)	82.87±13.34	83.42±13.21	84.94±14.11	0.06	0.02
Fasting glucose (mmol/L)	4.90±0.66	4.96±0.95	5.09±1.04^a	0.003	0.001
Total cholesterol (mmol/L)	4.58±0.81	4.89±0.69^a	5.52±0.92^a,b	<0.001	<0.001
Triglycerides (mmol/L)	1.06±0.82	1.11±0.80	1.31±1.08^a,b	<0.001	<0.001
LDL cholesterol (mmol/L)	2.87±0.72	3.15±0.59^a	3.74±0.83^a,b	<0.001	<0.001
HDL cholesterol (mmol/L)	1.50±0.31	1.51±0.32	1.45±0.31^b	0.01	0.03
TG/HDL-C	0.80±0.97	0.83±0.94	1.04±1.61^a,b	0.005	0.003
Diabetes, n (%)	51.09%	112.42%	153.32%	0.07	0.02
Metabolic Syndrome, n (%)	459.78%	4810.55%	7817.26%^a,b	0.001	0.001

Notes: ^ap<0.05 when compared with group tertile 1; ^bp<0.05 when compared with group tertile 2.

Abbreviations: Lp-PLA2, lipoprotein-associated phospholipase A2; SBP, systolic blood pressure; DBP, diastolic blood pressure; MAP, mean arterial pressure; LDL, low-density lipoprotein; HDL; high-density lipoprotein; TG, triglycerides.

Table 4 Logistic Regression Analysis of Lp-PLA2 Level and Metabolic Syndrome

Variables	Crude OR (95% CI)	p value	Adjusted OR (95% CI) in Model 1	p value	Adjusted OR (95% CI) in Model 2	p value
Male (n=2182)
Lp-PLA2 (IU/L)	1.00 (1.000–1.001)	0.02	1.00 (1.000–1.001)	0.02	1.00 (1.000–1.001)	0.35
Lp-PLA2 (IU/L), per 100	1.08 (1.014–1.143)	0.02	1.07 (1.011–1.140)	0.02	1.03 (0.964–1.108)	0.36
Female (n=1367)
Lp-PLA2 (IU/L)	1.00 (1.000–1.003)	0.001	1.00 (1.000–1.003)	0.01	1.00 (1.000–1.003)	0.03
Lp-PLA2 (IU/L), per 100	1.20 (1.075–1.338)	0.001	1.17 (1.045–1.314)	0.007	1.16 (1.018–1.310)	0.026

Notes: Model 1: Unadjusted, Model 2: Adjusted for age, Model 3: Adjusted for the variables in model 2 and BMI.

Table 5 Cut-off Value and Prediction Power for TG/HDL-C, Waist-to-Height Ratio (WHtR), and Lipoprotein-Associated Phospholipase A2 (Lp-PLA2)

Variables	AUC	(95% CI)	Cut-off Point According to Youden’s Index	Sensitivity(%)	Specificity (%)
Male
TG/HDL-C	0.86	(0.84–0.88)	1.39	0.88	0.70
WHR	0.84	(0.82–0.86)	0.52	0.83	0.70
Lp-PLA2 (IU/L)	0.53	(0.50–0.56)	685.50	0.38	0.69
Female
TG/HDL-C	0.93	(0.91–0.95)	1.04	0.86	0.87
WHR	0.87	(0.84–0.89)	0.49	0.92	0.67
Lp-PLA2 (IU/L)	0.59	(0.54–0.64)	626.50	0.35	0.82

Figure 1 ROC curves assessing diagnostic performance of TG/HDL-C, WHtR, and Lp-PLA2 Stratified by Gender. ROC curves illustrate the discriminatory ability of TG/HDL-C, WHtR, and Lp-PLA2 for predicting Mets, with gender-specific analysis. In males, TG/HDL-C (C = 0.86, 95% CI: 0.84–0.88) and WHtR (C = 0.84, 95% CI: 0.82–0.86) showed strong performance, while Lp-PLA2 had lower discrimination (C = 0.53, 95% CI: 0.50–0.56). Among females, TG/HDL-C excelled (C = 0.93, 95% CI: 0.91–0.95), surpassing WHtR (C = 0.87, 95% CI: 0.84–0.89). Lp-PLA2 exhibited weaker discrimination (C = 0.59, 95% CI: 0.54–0.64). These findings highlight gender-specific variations in biomarker efficacy for Mets diagnosis, emphasizing the need for gender-specific analyses.