Lipoprotein-associated phospholipase A2 mass is significantly reduced in dyslipidemic patients treated with lifestyle modification and combination lipid-modifying drug therapy.

Lipoprotein-associated phospholipase A2 (Lp-PLA2) mass is a novel inflammatory biomarker. In human blood, Lp-PLA2 is predominately associated with low-density lipoprotein (LDL). This study examines the ability of lifestyle modification (diet and exercise) and combination lipid therapy to reduce Lp-PLA2 levels while also determining the relationship between changes in LDL cholesterol and Lp-PLA2. Thirty dyslipidemic patients who received lifestyle intervention and combination lipid therapy for an average of 6 months were included in these analyses (mean age, 60.9 years); 40% had stable angiographically established coronary artery disease, 40% had the metabolic syndrome, and 70% were men. Drug therapy included omega-3 fish oil, extended-release niacin, colesevelam hydrochloride, and a fixed combination of 10-mg ezetimibe and 40-mg simvastatin. The study revealed a 33% reduction in mean Lp-PLA2 values (baseline 224.9±47.5 vs posttreatment 149.5±35.5 ng/mL; P<.001). Significant changes in mean LDL cholesterol from baseline (127.9±49.3 vs posttreatment 65.2±32.1 mg/dL; P<.001) were also observed. However, regression analysis revealed only a weak positive relationship between changes in LDL cholesterol and Lp-PLA2 mass (R2=0.29; P<.01).Thus, Lp-PLA2 mass is significantly reduced with lifestyle and combination lipid therapy. Changes in Lp-PLA2 were only partially explained by the changes observed for LDL cholesterol. Prev Cardiol. 2010;13:130–134.©2009 Wiley Periodicals, Inc.