Association between lipoprotein-associated phospholipase A2 and lower extremity arterial disease in type 2 diabetes mellitus

Abstract

Background: Lipoprotein-associated phospholipase A₂ (Lp-PLA₂) is closely related to the development of cardiovascular diseases, and the association between Lp-PLA₂ and lower extremity arterial disease (LEAD) in type 2 diabetes mellitus (T2DM) is inconsistent among previous studies. Thus, the present study aimed to investigate whether the increase in Lp-PLA₂ is related to the occurrence of LEAD in patients with T2DM.

Methods: A total of 519 patients with T2DM (173 patients with LEAD and 346 patients without LEAD) were enrolled in this study. The demographics, medical history, serum lipids, glycosylated hemoglobin, Lp-PLA₂, and ankle-brachial index (ABI) were recorded and analyzed.

Results: The diabetes duration, prevalence of female, prevalence of hypertension, and Lp-PLA₂ concentration in the LEAD group were significantly higher than those in the non-LEAD group (duration of diabetes: 15 [10-20] vs 8 [2-12] years, prevalence of female: 49.13% vs 38.73%, prevalence of hypertension: 58.38% vs 38.11%, Lp-PLA₂: 145 [108-178] vs 125 [107-138] ng/ml, p < 0.05). Lp-PLA₂ was negatively correlated with ABI (r = -0.308, p < 0.001). Results of multivariate logistic regression analysis showed that serum Lp-PLA₂ was an independent factor for the development of LEAD (odds ratio: 1.018 [1.007-1.029], P = 0.001).

Conclusions: Increased serum Lp-PLA₂ concentrations are associated with LEAD in patients with T2DM. They are an independent risk factor for the occurrence of LEAD.

Keywords: Lipoprotein-associated phospholipase A2; Lower extremity arterial disease; Type 2 diabetes mellitus.