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Background: The association of lipoprotein-associated phospholipase A2 (Lp-PLA2) with various cardiovascular events has been well-established. However, the exploration of its potential involvement in Chronic obstructive pulmonary disease (COPD) is currently limited. Therefore, our study aims to examine the relationship between Lp-PLA2 and pulmonary conditions, including emphysema, obstructive ventilatory dysfunction as well as small airway dysfunction, to provide further evidence of a possible association with COPD development. Methods: Using data from the Southwest Hospital Health Management Center, spanning January 2013 to July 2024, we analyze relationship of serum Lp-PLA2 levels with diffuse pulmonary emphysema and pulmonary functions. In univariate analysis, group differences were assessed with t-tests for numerical variables and Chi-square tests for categorical data. Variables found to be statistically significant (two-sided P < 0.05) in univariate analysis were subsequently included as covariates in multivariate analysis, performed using a binary logistic regression model. Odds ratios and 95% confidence intervals were calculated to assess the differences. Results: We established 2 case-control populations: the Imaging population (1056 subjects, mean age 57.666 ± 8.700 years old, 89.9% male) selected from 24,670 initial records, and the Pulmonary Function population (279 subjects, mean age 52.082 ± 11.473 years old, 71.4% male) selected from 1868 initial records. Univariate analysis revealed that serum Lp-PLA2 levels were significantly higher in patients with diffuse pulmonary emphysema, obstructive ventilatory dysfunction as well as small airway dysfunction compared to those without (454.682 ± 141.382U/L vs. 423.330 ± 140.658U/L, P < 0.001; 475.059 ± 157.181U/L vs. 420.824 ± 142.119U/L, P = 0.006; 475.31 ± 148.980U/L vs. 439.036 ± 157.977U/L, P = 0.049, respectively). Multivariate analysis further showed higher Lp-PLA2 levels were associated with increased risks of diffuse pulmonary emphysema, obstructive ventilatory dysfunction as well as small airway dysfunction. Using Lp-PLA2 ≤ 300 U/L as reference, odds ratios for the aforementioned conditions showed a gradually increasing trend with every 100U/L increase in Lp-PLA2 levels. Conclusions: Our preliminary study suggests that Lp-PLA2 is independently associated with diffuse pulmonary emphysema, obstructive ventilatory dysfunction as well as small airway dysfunction, which are commonly seen in COPD development. These findings indicated a possible association between Lp-PLA2 and COPD, though further validation is needed in a large cohort of COPD patients. [ABSTRACT FROM AUTHOR]

Abstract Background The association of lipoprotein-associated phospholipase A2 (Lp-PLA2) with various cardiovascular events has been well-established. However, the exploration of its potential involvement in Chronic obstructive pulmonary disease (COPD) is currently limited. Therefore, our study aims to examine the relationship between Lp-PLA2 and pulmonary conditions, including emphysema, obstructive ventilatory dysfunction as well as small airway dysfunction, to provide further evidence of a possible association with COPD development. Methods Using data from the Southwest Hospital Health Management Center, spanning January 2013 to July 2024, we analyze relationship of serum Lp-PLA2 levels with diffuse pulmonary emphysema and pulmonary functions. In univariate analysis, group differences were assessed with t-tests for numerical variables and Chi-square tests for categorical data. Variables found to be statistically significant (two-sided P

Background Hypertension is a common chronic non-communicable disease in clinical practice, and its prevalence is on the rise globally due to population aging and changes in human lifestyles. Prolonged high blood pressure can lead to damage to various target organs such as the heart, brain, kidneys, and retina, severely threatening human health and being a major cause of global disease burden. The left ventricle, as the primary target of end-organ damage, its structural changes are also the pathological basis for the development of many cardiovascular diseases. Objective This study aims to explore the relationship between the atherogenic index of plasma (AIP) and serum lipoprotein-associated phospholipase A2 (Lp-PLA2) levels and left ventricular hypertrophy (LVH) in patients with primary hypertension. Methods A total of 167 patients with primary hypertension who visited the Department of Cardiovascular Medicine at the Second Affiliated Hospital of Zhengzhou University from October 2021 to June 2023 were enrolled in this study. Baseline data of the patients were collected, and fasting venous blood biochemical markers were measured. Echocardiograms were conducted within 24 hours of admission to calculate left ventricular mass (LVM) and left ventricular mass index (LVMI). Patients were divided into non-left ventricular hypertrophy (NLVH) group (87 patients) and LVH group (80 patients) based on LVMI. Pearson correlation test and Spearman rank correlation analysis were used to investigate the correlation between serum Lp-PLA2 level, AIP and echocardiographic parameters. Multivariate Logistic regression analysis was used to explore the influencing factors of LVH in hypertensive patients. Receiver operating characteristic (ROC) curve was plotted to explore the diagnostic value of serum Lp-PLA2 level and AIP in hypertensive patients with LVH, and the area under ROC curve (AUC) was calculated. Results Patients in the LVH group had higher age, duration of hypertension, levels of N-terminal pro B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), left ventricular posterior wall thickness (LVWPT), interventricular septal thickness (IVST), left ventricular end-diastolic diameter (LVEDd), left atrial end-systolic diameter (LAESd), Lp-PLA2 levels, AIP, LVM, and LVMI compared to the NLVH group (P

Objective: To investigate the relationship between serum lipoprotein-associated phospholipase A2 (Lp-PLA2), neurotrophin-3 (NT-3) levels and rapid eye movement sleep behavior disorder (RBD) in patients with Parkinson’s disease (PD). Methods: 150 PD patients admitted to Zigong Hospital Affiliated to Southwest Medical University were selected as the PD group from January 2021 to December 2022, and at the same time, selected 55 healthy individuals who underwent physical examinations in our hospital as the control group. Enzyme linked immunosorbent assay (ELISA) was used to detect the serum levels of Lp-PLA2 and NT-3. The PD group was divided into RBD group and non RBD group based on the physical signs and RBD questionnaire Hong Kong version (RBDQ-HK) score. Univariate and multivariate logistic regression were used to analyze the influencing factors in PD patients concomitant with RBD, and the predictive efficacy of serum Lp-PLA2 and NT-3 in PD patients concomitant with RBD was analyzed by receiver operating characteristic curve (ROC) curve. Results: The serum Lp-PLA2 level in the control group was lower than that in the PD group (P＜0.05), and the serum NT-3 level was higher than that in the PD group (P＜0.05). The results of univariate analysis showed that the PD patients concomitant with RBD was associated with age, course of disease, and serum levels of Lp-PLA2 and NT-3 (P＜0.05). Multivariate logistic regression analysis showed that prolonged course of disease, elevated Lp-PLA2 levels were independent risk factors for PD with RBD, while elevated NT-3 levels were protective factors for PD concomitant with RBD (P＜0.05). The area under the curve (AUC) of serum Lp-PLA2, NT-3,and combined detection for predicting PD concomitant with RBD were 0.830, 0.766, and 0.866, respectively. Conclusion: Serum Lp-PLA2 and NT-3 are associated with PD patients concomitant with RBD. Elevated serum Lp-PLA2 is an independent risk factor, while elevated serum NT-3 is a protective factor. The combined detection of these two indicators has high predictive value for PD concomitant with RBD. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is recognized as a primary and severe comorbidity in patients with type 2 diabetes mellitus (T2DM) and is also identified as a leading cause of mortality within this population. Consequently, the identification of novel biomarkers for the risk stratification and progression of CVD in individuals with T2DM is of critical importance. Methods: This retrospective cohort study encompassed 979 patients diagnosed with T2DM, of whom 116 experienced CVD events during the follow‐up period. Clinical assessments and comprehensive blood laboratory analyses were conducted. Age‐ and sex‐adjusted Cox proportional hazard regression analysis was utilized to evaluate the association between lipoprotein‐associated phospholipase A2 (Lp‐PLA2), C1q/tumor necrosis factor‐related protein 3 (CTRP‐3), and the incidence of CVD in T2DM. The diagnostic performance of these biomarkers was assessed through receiver operating characteristic (ROC) curve analysis and the computation of the area under the curve (AUC). Results: Over a median follow‐up of 84 months (interquartile range: 42 [32–54] months), both novel inflammatory markers, Lp‐PLA2 and CTRP‐3, and traditional lipid indices, such as low‐density lipoprotein cholesterol and apolipoprotein B, exhibited aberrant expression in the CVD‐afflicted subset of the T2DM cohort. Age‐ and sex‐adjusted Cox regression analysis delineated that Lp‐PLA2 (hazard ratio [HR] = 1.007 [95% confidence interval {CI}: 1.005–1.009], p < 0.001) and CTRP‐3 (HR = 0.943 [95% CI: 0.935–0.954], p < 0.001) were independently associated with the manifestation of CVD in T2DM. ROC curve analysis indicated a substantial predictive capacity for Lp‐PLA2 (AUC = 0.81 [95% CI: 0.77–0.85], p < 0.001) and CTRP‐3 (AUC = 0.91 [95% CI: 0.89–0.93], p < 0.001) in forecasting CVD occurrence in T2DM. The combined biomarker approach yielded an AUC of 0.94 (95% CI: 0.93–0.96), p < 0.001, indicating enhanced diagnostic accuracy. Conclusions: The findings suggest that the biomarkers Lp‐PLA2 and CTRP‐3 are dysregulated in patients with T2DM who develop CVD and that each biomarker is independently associated with the occurrence of CVD. The combined assessment of Lp‐PLA2 and CTRP‐3 may significantly augment the diagnostic precision for CVD in the T2DM demographic. [ABSTRACT FROM AUTHOR]

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This study aimed to investigate the correlation between serum lipoprotein-associated phospholipase A2 (Lp-PLA2) and poststroke mild cognitive impairment (PSMCI). The patients included in the study were divided into PSMCI (68 cases) and cognitively normal (CN) (218 cases) groups and followed up for six months. Demographic and clinical data were collected. A logistic regression analysis was performed to determine whether Lp-PLA2 is an independent risk factor for PSMCI. Spearman's correlation analysis was used to examine the correlation between Lp-PLA2 levels and Montreal Cognitive Assessment (MoCA) scores. A receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic threshold value of Lp-PLA2 for PSMCI. Serum Lp-PLA2 levels were significantly higher in the PSMCI group than in the CN group. The logistic regression analysis showed that Lp-PLA2 was an independent risk factor for PSMCI (OR = 1.05, 95% CI = 1.03–1.07). Spearman's correlation analysis revealed a significant correlation between the Lp-PLA2 levels and MoCA scores (R = -0.49). The area under the ROC curve for Lp-PLA2 was 0.849, and the threshold value for PSMCI occurrence was 236.8 ng/ml. Elevated serum Lp-PLA2 is an independent risk factor for PSMCI and may serve as a potential biomarker for PSMCI. [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship between the levels of serum uric acid (UA), cystatin C (CysC) and lipoprotein-associated phospholipase A2 (Lp-PLA2) and prognosis of patients with acute cerebral infarction complicated with leukoaraiosis. Methods: 113 patients with acute cerebral infarction complicated with leukoaraiosis admitted to the 960 Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from March 2020 to December 2022 were selected, the levels of serum UA, CysC and Lp-PLA2 were detected. Followed up for 1 month, the patients were divided into good prognosis group (0 ~ 2 scores, 75 cases) and poor prognosis group (3 scores and above, 38 cases) according to the modified Rankin Scale (mRS) score. Multivariate Logistic regression was used to analyze the risk factors of poor prognosis in patients with acute cerebral infarction complicated with leukoaraiosis, and receiver operating characteristic curve (ROC) was used to analyze the value of serum UA, CysC and Lp-PLA2 in predicting poor prognosis in patients with acute cerebral infarction complicated with leukoaraiosis. Results: The levels of serum UA, CysC, and Lp-PLA2 in the poor prognosis group were higher than those in the good prognosis group (P<0.05). Multivariate Logistic regression analysis showed that severe white matter lesions, high NIHSS score at admission, and high levels of serum UA, CysC, and Lp-PLA2 were risk factors for poor prognosis in patients with acute cerebral infarction complicated with leukoaraiosis (P<0.05). The area under the curve (AUC) of combined serum UA, CysC, and Lp-PLA2 to predict the prognosis of patients with acute cerebral infarction complicated with leukoaraiosis was 0.916, which was higher than the individual prediction. Conclusion: The elevated levels of serum UA, CysC, and Lp-PLA2 in patients with acute cerebral infarction complicated with leukoaraiosis were associated with poor prognosis, the combination of serum UA, CysC, and Lp-PLA2 had a higher predictive value for poor prognosis in patients with acute cerebral infarction complicated with leukoaraiosis. [ABSTRACT FROM AUTHOR]

As a serious cardiovascular disease, atherosclerosis (AS) causes chronic inflammation and oxidative stress in the body and poses a threat to human health. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a member of the phospholipase A2 (PLA2) family, and its elevated levels have been shown to contribute to AS. Lp-PLA2 is closely related to a variety of lipoproteins, and its role in promoting inflammatory responses and oxidative stress in AS is mainly achieved by hydrolyzing oxidized phosphatidylcholine (oxPC) to produce lysophosphatidylcholine (lysoPC). Moreover, macrophage apoptosis within plaque is promoted by localized Lp-PLA2 which also promotes plaque instability. This paper reviews those researches of Chinese medicine in treating AS via reducing Lp-PLA2 levels to guide future experimental studies and clinical applications related to AS. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to analyse the association between lipoprotein-associated phospholipase A2 (Lp-PLA2) and 25-hydroxy-vitamin D (25[OH]D) and early diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM) and evaluate the potential roles of these two biomarkers in the clinical diagnosis of DKD. Methods: A total of 422 inpatients with T2DM were retrospectively enrolled between January 2018 and March 2022 at the First Affiliated Hospital of Nanjing Medical University. The baseline clinical parameters of each patient were determined, and their demographic characteristics were extracted from the hospital information system. The patients were separated into groups according to serum Lp-PLA2 and 25(OH)D levels and binary logistic regression analysis was used to determine independent predictors of early DKD incidence. Results: Levels of Lp-PLA2 significantly increased and those of 25(OH)D significantly decreased with DKD progression (both P

Abstract Background Cardiovascular disease (CVD) is recognized as a primary and severe comorbidity in patients with type 2 diabetes mellitus (T2DM) and is also identified as a leading cause of mortality within this population. Consequently, the identification of novel biomarkers for the risk stratification and progression of CVD in individuals with T2DM is of critical importance. Methods This retrospective cohort study encompassed 979 patients diagnosed with T2DM, of whom 116 experienced CVD events during the follow‐up period. Clinical assessments and comprehensive blood laboratory analyses were conducted. Age‐ and sex‐adjusted Cox proportional hazard regression analysis was utilized to evaluate the association between lipoprotein‐associated phospholipase A2 (Lp‐PLA2), C1q/tumor necrosis factor‐related protein 3 (CTRP‐3), and the incidence of CVD in T2DM. The diagnostic performance of these biomarkers was assessed through receiver operating characteristic (ROC) curve analysis and the computation of the area under the curve (AUC). Results Over a median follow‐up of 84 months (interquartile range: 42 [32–54] months), both novel inflammatory markers, Lp‐PLA2 and CTRP‐3, and traditional lipid indices, such as low‐density lipoprotein cholesterol and apolipoprotein B, exhibited aberrant expression in the CVD‐afflicted subset of the T2DM cohort. Age‐ and sex‐adjusted Cox regression analysis delineated that Lp‐PLA2 (hazard ratio [HR] = 1.007 [95% confidence interval {CI}: 1.005–1.009], p

Abstract Background It has been recently reported that lipoprotein-associated phospholipase A2 (Lp-PLA2) may predict the risk of cardiovascular disease. The effect of multi-strain probiotics on Lp-PLA2 in patients with type 2 diabetes is still not clear. Aims This study aimed to determine the effect of multi-strain probiotic supplementation on lipoprotein-associated phospholipase A2, and glycemic status, lipid profile, and body composition in patients with type 2 diabetes. Methods In this randomized double-blind placebo-controlled clinical trial, 68 participants with type 2 diabetes, in the age group of 50–65 years, were recruited and randomly allocated to take either probiotic (n = 34) or placebo (n = 34) for 12 weeks. The primary outcome was lipoprotein-associated phospholipase A2, and secondary outcomes were glycemic parameters, lipid profile, anthropometric characters, and body composition (fat mass and fat-free mass). Results There was a significant reduction in serum lipoprotein-associated phospholipase A2, in the probiotic group, it dropped by 6.4 units at the end of the study (p

Abstract Background Cardiovascular diseases (CVD) is the leading cause of death among maintenance hemodialysis patients, with dyslipidemia being a prevalent complication. The paradoxical relationship between cardiovascular outcomes and established lipid risk markers, such as low-density lipoprotein cholesterol (LDL-C), complicates lipid management in this population. This study investigated Lipoprotein-associated phospholipase A2 (Lp-PLA2), an emerging biomarker known for its proinflammatory and proatherogenic properties, as a potential cardiovascular prognostic marker in this cohort. In this context, the association between Lp-PLA2 levels and cardiovascular outcomes was evaluated, with the aim to facilitate more accurate stratification and identification of high-risk individuals. Methods From August 2013 to January 2014, 361 hemodialysis patients were prospectively enrolled. Lp-PLA2 activity and laboratory measures at baseline were quantified. Comorbidities and medications were recorded. All patients were followed until the end of April, 2022. The individual and combined effects of Lp-PLA2 activity and LDL-C on patient outcomes were examined. The association between Lp-PLA2 activity and all-cause mortality, cardiovascular mortality, and major adverse cardiovascular events (MACEs) was analyzed. Results The median Lp-PLA2 activity was 481.2 U/L. In subjects with Lp-PLA2 activity over 481.2 U/L, significantly higher total cholesterol (4.89 vs. 3.98 mmol/L; P

Lipoprotein-associated phospholipase A2(Lp-PLA2) is a protein composed of 441 amino acids, which can promote the aggregation of inflammatory cells to the inflammatory response site and the release of inflammatory factors. It can promote the synthesis of matrix metalloproteinases, increase the number of foam cells and extra cellular matrix in atherosclerotic plaque, attenuate plaque fiber cap and prone to rupture, thus promote the onset of acute coronary syndrome(ACS). Therefore, the determination and regulation of Lp-PLA2 levels in patients with ACS are clinically significant.

Objective To discuss the relationship between serum lipoprotein-associated phospholipase A2 (LpPLA2), low-density lipoprotein (LDL), amyloid beta 1-42 (Aβ1-42) and soluble intercellular adhesion molecule-1 (sICAM-1) levels, the National Institutes of Health Stroke Scale (NIHSS) score and prognosis in patients with acute ischemic stroke (AIS). Methods A total of 106 patients with AIS who underwent intravenous thrombolysis (the thrombolysis group), 30 AIS patients without thrombolysis (the non-thrombolysis group) and 95 healthy individuals (the control group) were included in the study. The thrombolysis group was divided into the recanalization group (n=41) and the non-recanalization group (n=65) according to whether the vein was recanalized after thrombolysis. Patients were divided into the mild group (n=45), the moderate group (n=36) and the severe group (n=25) based on the NIHSS score. They were divided into the good prognosis group (n=65) and the poor prognosis group (n=41) based on the modified Rankin Scale (mRS) score. Serum levels of four indexes in different groups were compared. Their relationship with the NIHSS score and the prognosis was analyzed. Results The vein recanalization rate in 106 patients with thrombolysis was 38.68% (41/106). Serum Lp-PLA2, LDL, Aβ1-42 and sICAM-1 levels were lower in the recanalization group than those in the non-canalization group (P＜0.05). Serum LpPLA2, LDL, Aβ1-42 and sICAM-1 levels increased successively in the control group, the thrombolysis group and the nonthrombolysis group (P＜0.05). The 4 serum indexes increased with the aggravation of disease condition, and were positively correlated with NIHSS score (P＜0.05). High serum levels of Lp-PLA2, LDL, Aβ1-42 and sICAM-1 were risk factors for poor prognosis of patients with thrombolysis (P＜0.05). The area under the curve (AUC) and specificity of the combination of 4 serum indexes for predicting poor prognosis of patients with thrombolysis were higher than those of prediction with single index (P＜0.05). Conclusion The expression levels of serum Lp-PLA2, LDL, Aβ1-42 and sICAM-1 in patients with AIS are high. They can be used as important reference indexes for disease condition monitoring and prognosis evaluation. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between serum lipoprotein-associated phospholipase A2 (Lp-PLA2), fibroblast growth factor-23 (FGF-23) and poor maturation of autologous arteriovenous fistula (AVF) in uremic hemodialysis patients. Methods: 170 uremia patients who were received hemodialysis in the Nephrology Department of 908 Hospital of Joint Logistics Support Force from February 2021 to December 2022 were selected, patients were divided into 57 cases of poor maturity group and 113 cases of maturity group according to the maturity of AVF. Serum Lp-PLA2 and FGF-23 levels were detected by enzyme-linked immunosorbent assay. The influencing factors of poor AVF maturation in uremic hemodialysis patients were analyzed by multivariate Logistic regression. The predictive efficacy of serum Lp-PLA2 and FGF-23 levels on poor AVF maturation in uremic hemodialysis patients were analyzed by receiver operating characteristic (ROC)curve. Results: The levels of serum Lp-PLA2 and FGF-23 in poor maturity group were higher than those in maturity group (P<0.05). Multivariate Logistic regression analysis showed that, increased serum phosphorus, low-density lipoprotein cholesterol (LDL-C), Lp-PLA2 and FGF-23 were independent risk factors for poor AVF maturation in uremic hemodialysis patients (P<0.05). ROC curve analysis showed that, the area under the curve(AUC) of serum Lp-PLA2 and FGF-23 levels alone and in combination to predict poor AVF maturation in uremic hemodialysis patients was 0.725, 0.763 and 0.822 respectively, and the AUC of serum Lp-PLA2 and FGF-23 levels combined prediction was the largest. Conclusion: The increase of serum Lp-PLA2 and FGF-23 levels in uremic hemodialysis patients were independently relate to the poor maturation of AVF, the combination of serum Lp-PLA2 and FGF-23 levels had a good predictive effect on the poor maturation of AVF. [ABSTRACT FROM AUTHOR]

Background: It has been recently reported that lipoprotein-associated phospholipase A2 (Lp-PLA2) may predict the risk of cardiovascular disease. The effect of multi-strain probiotics on Lp-PLA2 in patients with type 2 diabetes is still not clear. Aims: This study aimed to determine the effect of multi-strain probiotic supplementation on lipoprotein-associated phospholipase A2, and glycemic status, lipid profile, and body composition in patients with type 2 diabetes. Methods: In this randomized double-blind placebo-controlled clinical trial, 68 participants with type 2 diabetes, in the age group of 50–65 years, were recruited and randomly allocated to take either probiotic (n = 34) or placebo (n = 34) for 12 weeks. The primary outcome was lipoprotein-associated phospholipase A2, and secondary outcomes were glycemic parameters, lipid profile, anthropometric characters, and body composition (fat mass and fat-free mass). Results: There was a significant reduction in serum lipoprotein-associated phospholipase A2, in the probiotic group, it dropped by 6.4 units at the end of the study (p < 0.001) compared to the placebo group. Probiotic supplementation also resulted in a significant improvement in the hemoglobin A1c and high-density lipoprotein cholesterol 1.5% (p < 0.001) and 6 mg/dl (p 0.005), respectively. There were no significant changes in other outcomes. Conclusion: Probiotic supplementation was beneficial for reducing Lp-PLA2 and hemoglobin-A1c and improving high-density lipoprotein cholesterol, which may suggest an improvement in the prognosis in patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Lipoprotein-associated phospholipase A2(Lp-PLA2) is a protein composed of 441 amino acids, which can promote the aggregation of inflammatory cells to the inflammatory response site and the release of inflammatory factors. It can promote the synthesis of matrix metalloproteinases, increase the number of foam cells and extra cellular matrix in atherosclerotic plaque, attenuate plaque fiber cap and prone to rupture, thus promote the onset of acute coronary syndrome(ACS). Therefore, the determination and regulation of Lp-PLA2 levels in patients with ACS are clinically significant. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate diagnosis of lipoprotein-associated phospholipase A2 (Lp-PLA2) in early diabetic nephropathy (DN). A total of 342 type 2 diabetes mellitus (T2DM) patients hospitalized in department of metabolism and nephrology in our hospital from January 2019 to December 2019 were randomly selected. Patients were divided into three groups via urine albumin level: diabetes mellitus (DM) group, simple diabetes group (114 patients, urinary albumin creatinine ratio (UACR) < 30 mg/g); DN1 group, early DN group (114 patients, UACR: 30–300 mg/g); DN2 group: clinical DN group (114 patients, UACR > 300mg/g). Eighty healthy adults were examined at the same time. Lp-PLA2, fasting blood glucose (FBG), creatinine (Cr), triglyceride (TG), total cholesterol (TCHOL), high-density lipoprotein (HDL), low-density lipoprotein (LDL), haemoglobin A1c (HbA1c), blood urea nitrogen/creatinine (BUN/Cr), estimated glomerular filtration rate (eGFR), 24-h urine protein, albumin and creatinine of all subjects were detected and compared. Pearson's correlation analysis and multiple ordered logistic regression were used to investigate the correlation between serum Lp-PLA2 level and DN. The possibility of Lp-PLA2 in the diagnosis of early DN was studied by using the subject working curve. Lp-PLA2 level in DN1 and DN2 groups was significantly higher than that in DM group, with statistical difference (p <.05). With the progression of DN, the level of Lp-PLA2 gradually increased p <.05. Lp-PLA2 was positively correlated with FBG, TG, LDL and HbA1c (R = 0.637, p <.01; R = 0.314, p =.01; R = 0.213, p =.01; R = 0.661, p ≤.01), was negatively correlated with HDL (r = –0.230, p <.01). The results showed that Lp-PLA2 was an independent factor in the evaluation of early DN. The area under the curve for the evaluation of serum Lp-PLA2 level in early DN was 0.841, the optimal critical value was 155.9 ng/mL, the sensitivity was 88% and the specificity was 76.2%. Lp-PLA2 is an independent factor for the evaluation of early DN, and can be used as an important potential specific indicator for the diagnosis of early DN, meanwhile monitoring the progression of DN. [ABSTRACT FROM AUTHOR]

AbstractObjective The aim of this study was to investigate diagnosis of lipoprotein-associated phospholipase A2 (Lp-PLA2) in early diabetic nephropathy (DN).Methods A total of 342 type 2 diabetes mellitus (T2DM) patients hospitalized in department of metabolism and nephrology in our hospital from January 2019 to December 2019 were randomly selected. Patients were divided into three groups via urine albumin level: diabetes mellitus (DM) group, simple diabetes group (114 patients, urinary albumin creatinine ratio (UACR) 300mg/g). Eighty healthy adults were examined at the same time. Lp-PLA2, fasting blood glucose (FBG), creatinine (Cr), triglyceride (TG), total cholesterol (TCHOL), high-density lipoprotein (HDL), low-density lipoprotein (LDL), haemoglobin A1c (HbA1c), blood urea nitrogen/creatinine (BUN/Cr), estimated glomerular filtration rate (eGFR), 24-h urine protein, albumin and creatinine of all subjects were detected and compared. Pearson’s correlation analysis and multiple ordered logistic regression were used to investigate the correlation between serum Lp-PLA2 level and DN. The possibility of Lp-PLA2 in the diagnosis of early DN was studied by using the subject working curve.Results Lp-PLA2 level in DN1 and DN2 groups was significantly higher than that in DM group, with statistical difference (p

OBJECTIVE: This study aims to explore the value of serum lipoprotein-associated phospholipase A2 (Lp-PLA2), ischemia-modified albumin (IMA), and cystatin C (Cys-C) in predicting the risk of coronary heart disease (CHD). PATIENTS AND METHODS: Clinical data from 104 CHD patients admitted to our hospital from January 2020 to December 2022 were analyzed. Of them, 31 patients had stable angina (Group-S), 36 patients were diagnosed with unstable angina (Group-U), and 37 patients had acute myocardial infarction (Group-A). Additionally, clinical data from 35 healthy individuals undergoing physical examination during the same time period were selected as the control group. Levels of blood lipid indicators and serum Lp-PLA2, IMA, and Cys-C levels were compared between the groups. RESULTS: The rates of diabetes, hypertension, and smoking in Group-S, Group-U, and Group-A were significantly higher than those in the control group (p<0.05). Levels of Lp-PLA2, IMA, and Cys-C in Group-S, Group-U, and Group-A were significantly higher than those in the control group (p<0.05). Levels of Lp-PLA2, IMA, and Cys-C in Group-U and Group-A were significantly higher than those in Group-S, and Group-A had the highest value of these indexes (p<0.05). Multivariate logistic regression analysis showed that Lp-PLA2, Cys-C, and IMA were important risk factors for the onset of CHD (p<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of Lp-PLA2, IMA, and Cys-C predicting the occurrence of CHD was 0.775, 0.835, and 0.735, respectively. The combined prediction of the three factors has an AUC of 0.920, which is higher than the individual prediction. CONCLUSIONS: L p-PLA2, I MA, a nd C ys-C are closely related to the onset and progression of CHD. These indicators, therefore, can be used in clinical practice to predict and evaluate CHD. [ABSTRACT FROM AUTHOR]

Objective Reduced left ventricular ejection fraction (LVEF) is common in hemodialysis (HD) patients. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is considered an important determinant of cardiovascular events. The aim of the study was to evaluate the relationship between Lp-PLA2 and LVEF in HD patients. Methods Fifty-seven HD patients with coronary heart disease were enrolled. Predialysis and postdialysis venous whole blood samples were collected. The patients were divided into preserved and reduced LVEF groups. The relationship between Lp-PLA2 and LVEF was assessed. Results A significant difference in C-reactive protein (CRP) and Lp-PLA2 was observed, with higher levels noted in patients with reduced LVEF (P  ≤ .001). Both Lp-PLA2 and CRP were negatively correlated with LVEF in the HD patients. Only Lp-PLA2 remained associated with LVEF in multiple regression analysis. Conclusion Lipoprotein-associated phospholipase A2 levels are associated with LVEF and could potentially be used to evaluate chronic heart failure with reduced LVEF in HD patients for risk stratification management. [ABSTRACT FROM AUTHOR]

Lu Liu,1,&ast; Xiaojiu Zhang,1,2,&ast; Nan Jiang,3,&ast; Yufeng Liu,1 Qing Wang,1 Guanghui Jiang,1 Xuejing Li,4 Liandong Zhao,1 Qijin Zhai1 1Department of Neurology, Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China; 2Department of Neurology, Hongze People’s Hospital, Huai’an, Jiangsu, People’s Republic of China; 3Department of Neurology, Lianshui PEople’s Hospital Affiliated to Kangda College of Nanjing Medical University, Huai’an, Jiangsu, People’s Republic of China; 4Rehabilitation Centre, Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Liandong Zhao; Qijin Zhai, Email zld18796201519@163.com; qjzhai1983@163.comPurpose: The plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) is an inflammatory biomarker of cerebral microbleeds (CMBs) and may be related to the occurrence, development, and prognosis of cognitive impairment. The present study aimed to investigate the impact of plasma Lp-PLA2 level on the cognitive impairment in patients with CMBs.Methods: In this study, 213 patients with CMBs confirmed by 3.0 T brain magnetic resonance imaging (MRI) were analyzed. Lp-PLA2 levels were determined by magnetic particle chemiluminescence immunoassay technology, and cognitive function was assessed using the Montreal Cognitive Assessment Scale (MoCA). The cognitive functions of patients with CMBs were divided into three groups according to the MoCA scale, including normal cognition (NC), mild cognitive impairment (MCI), and moderate-severe cognitive impairment (MSCI). Clinical, laboratory and radiological data of the three groups were analysed. The relationship between plasma Lp-PLA2 and MoCA score in patients with CMBs was investigated through rank correlation analysis and multivariate regression analysis, and receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of Lp-PLA2.Results: CMBs were detected in 213 (30.2%) of 705 patients who underwent 3.0 T MRI. Multiple comparisons showed that plasma Lp-PLA2 in patients with CMBs with normal cognitive scores was significantly lower than that in the other two groups with cognitive impairment (p < 0.05). In the single factor correlation analysis, high level of plasma Lp-PLA2 was negatively correlated with the decrease of MoCA score in patients with CMBs (r =− 0.389, p < 0.01). Multivariate regression analysis showed that high plasma Lp-PLA2 was an independent risk factor for a low MoCA score in patients with CMBs (odds ratio [OR]=1.014; 95% confidence interval [CI], 1.002– 1.026; p=0.025).Conclusion: A high level of plasma Lp-PLA2 is positively correlated with the generation of cognitive impairment in patients with CMBs and negatively correlated with the degree of impairment. Plasma Lp-PLA2 is an important indicator of cognitive impairment in patients with CMBs and may provide a therapeutic target for preventing CMB-induced cognitive impairment.Keywords: cerebral microbleeds, lipoprotein-associated phospholipase A2, cognitive impairment, risk factors, cerebral small vessel disease

Objective: The effect of the daily consumption of a low-fat yogurt (150 g) enriched with Platelet-Activating Factor receptor (PAF-R) antagonists, or the plain one, on gut microbiota and faecal metabolites was investigated in healthy overweight subjects. Methods: A randomized, three-arm, double-blind, placebo-controlled, parallel-group study was performed that lasted 8 weeks. Blood and stools were collected and analyzed before and after the intervention. Results: Our findings revealed that the intake of the enriched yogurt resulted in a significant increase in the levels of Bifidobacterium spp., Clostridium perfringens group and Firmicutes-to-Bacteroidetes (F/B) ratio. On the other hand, a significant increase in the levels of Lactobacillus and C. perfringens group was detected after the intake of the plain yogurt. The increase in the levels of C. perfringens group was inversely associated with the plasma catabolic enzyme of PAF, namely LpPLA2 (lipoprotein-associated phospholipase A2), a cardiovascular risk marker that has been linked with inflammation and atherosclerosis. Moreover, in the enriched with PAF-R antagonists yogurt group, the increased levels of C. perfringens group were also associated with lower PAF action assessed as ex vivo human platelet-rich plasma (PRP) aggregation. Additionally, a higher % increase in molar ratio of Branched Short Chain Fatty Acids (BSCFAs) was detected for both yogurt groups after the 8 week-intervention compared to control. The consumption of the enriched yogurt also resulted in a significant drop in faecal caproic levels and a trend for lower ratio of butyrate to total volatile fatty acids (VFAs) compared to baseline levels. Conclusion: Yogurt consumption seems to favorably affect gut microbiota while its enrichment with PAF-R antagonists from olive oil by-products, may provide further benefits in healthy overweight subjects. Clinical Trial Registration: ClinicalTrials.gov (NCT02259205).

Atherosclerosis（AS） is a common vascular inflammatory disease in clinic, which is an important pathological basis for cardiovascular and cerebrovascular diseases, thromboembolic diseases and other diseases. Lipoprotein-associated phospholipase A2（Lp-PLA2） is a kind of vascular inflammatory factor. The level of plasma Lp-PLA2 can reflect the stability of AS plaque, the severity of inflammation, and the prognosis of the disease. This article reviewed the significance of Lp-PLA2 level in AS and its clinical research progress [ABSTRACT FROM AUTHOR]

Objective To investigate the relationships between serum cysteine-aspartic acid protease-3 (Caspase-3) and lipoprotein-associated phospholipase A2 (Lp-PLA2) levels and the severity and prognosis of sudden deafness (SD) . Methods Totally 100 patients with SD were selected as the SD group. According to the severity of the disease, they were divided into the mild hearing loss group of 20 cases, moderate hearing loss group of 43 cases, severe hearing loss group of 25 cases, and very severe hearing loss group of 12 cases； according to the prognosis, they were divided into the poor prognosis group of 38 cases and good prognosis group of 62 cases； meanwhile, 60 cases of healthy and normal hearing in the same period were selected as the control group. Clinical data of SD patients were collected and serum Caspase-3 and LpPLA2 levels were measured by ELISA. Spearman correlation was used to analyze the correlations between serum Caspase-3 and Lp-PLA2 levels and PTA in SD patients, multi-factor Logistic regression was used to analyze the factors influencing poor prognosis in SD patients, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum Caspase-3 and Lp-PLA2 levels on poor prognosis in SD patients. Results Compared with the control group, se‐rum Caspase-3 and Lp-PLA2 levels increased in the SD group (both P<0. 05) . Serum Caspase-3 and Lp-PLA2 levels increased in the mild, moderate, severe and very severe hearing loss groups in that order (all P<0. 05) . Spearman correlation analysis showed that serum Caspase-3 and Lp-PLA2 levels were positively correlated with PTA in SD patients (rs = 0. 816, 0. 848, both P<0. 05) . Multi-factor Logistic regression analysis showed that increasing age, elevated PTA, total deafness phenotype, elevated Caspase-3, and elevated Lp-PLA2 were independent risk factors for poor prognosis in SD patients (all P<0. 05) . ROC curve analysis showed that the area under the curve of serum Caspase-3 and Lp-PLA2 levels combined in predicting poor prognosis in SD patients was greater than that of Caspase-3 and Lp-PLA2 alone (both P< 0. 05) . Conclusion Elevated serum Caspase-3 and Lp-PLA2 levels in SD patients were correlated with disease severity and prognosis, and may be the prognostic predictors for SD patients. [ABSTRACT FROM AUTHOR]

Context Dietary fatty acids (FAs), primarily n-3 polyunsaturated FAs, have been associated with enrichment of the circulating bioactive lipidome and changes in the enzymatic precursor lipoprotein-associated phospholipase A2 (Lp-PLA2) mass; however, the magnitude of this effect remains unclear. Objective The aim of this systematic review and meta-analysis was to evaluate the effect of different dietary FAs on the bioactive lipid profile of healthy participants and those with cardiovascular disease (CVD) and CVD risk factors. Data sources PubMed, SCOPUS and the Cochrane Library databases were searched for relevant articles published between October 2010 and May 2022. Data extraction Data were screened for relevance and then retrieved in full and evaluated for eligibility by 2 reviewers independently. Data analysis The net difference in the bioactive lipid mean values between the endpoint and the baseline, and the corresponding SDs or SEs, were used for the qualitative synthesis. For the meta-analysis, a fixed-effects model was used. Results Twenty-seven randomized clinical trials (representing >2560 participants) were included. Over 78% of the enrolled participants had ≥1 associated CVD risk factor, whereas <22% were healthy. In the meta-analysis, marine n-3 supplements (dose range, 0.37–1.9 g/d) significantly increased pro-inflammatory lysophosphatidylcholines (lyso-PCs; for lyso-PC(16:0): mean, +0.52 [95% confidence interval (CI), 0.02–1.01] µM; for lyso-PC(18:0): mean, +0.58 [95%CI, 0.09–1.08] µM) in obese participants. Additionally, n-3 supplementation (1–5.56 g/d) decreased plasma Lp-PLA2 mass, a well-known inflammation marker, in healthy (–0.35 [95%CI, –0.59 to –0.10] ng/mL), dyslipidemic (–0.36 [95%CI, –0.47 to –0.25] ng/mL), and stable coronary artery disease participants (–0.52 [95%CI, –0.91 to –0.12] ng/mL). Conclusions Daily n-3 provided as EPA+DHA supplements and consumed from 1 to 6 months reduced plasma Lp-PLA2 mass in healthy participants and those with CVD and CVD risk factors, suggesting an anti-inflammatory effect. However, the saturated lyso-PC response to n-3 was impaired in obese participants. Systematic Review Registration PROSPERO registration no. CRD42021218335 [ABSTRACT FROM AUTHOR]

Despite the informative value of ultrasound examination of atherosclerotic vascular lesions, predicting­ the plaque vulnerabili­ty remains difficult. Circulating blood biomarkers could provide additional criteria that would allow better determination of the risk of recurrent stroke. The aim of our study was to estimate the level of C-reactive protein (CRP), low-density lipoproteins (LDL) and lipoprotein-associated phospholipase A2 (Lp-PLA2) in the blood of patients in the early recovery period of atherothrombotic stroke depending on the density of atherosclerotic plaque according to duplex scanning of cerebral vessels. Clinical and laboratory analysis of 69 men and 61 women aged (60.42 ± 7.40) years in the early recovery period of atherothrombotic stroke was conducted. Depending on the structure of the atherosclerotic plaque the examinees were divided into two groups with stable (n = 80) and unstable (n = 50) atherosclerotic layers. The blood lipid spectrum was examined on a biochemical analyzer Screen master, the level of CRP was determined with a diagnostic kit and that of Lp-PLA2 by ELISA. Significantly higher levels of LDL, CRP and Lp-PLA2 were observed in patients with unstable atherosclerotic plaque compared to patients with stable atherosclerotic plaque in the early recovery period of atherothrombotic stroke. The increased level of LDL, CRP, and Lp-PLA2 in patients with cerebral atherosclerosis can be considered as an indicator of the vulnerability of atherosclerotic plaques, prone to rupture, and as a prognostic marker of repeated acute ischemic events.

目的 探讨TIA患者血清炎症因子、脑血管反应性（cerebrovascular reactivity，CVR）与认知障碍的关系。 方法 前瞻性连续入组在青海大学附属医院住院治疗的TIA患者和体检中心健康体检者各35例，检测两组研究对象血清中可溶性血管细胞黏附分子-1（soluble vascular cell adhesion molecule 1，sVCAM-1）和脂蛋白相关磷脂酶A2（lipoprotein-associated phospholipase A2，Lp-PLA2）的水平；使用TCD检查评估CVR，主要指标为屏气指数（breath holding index，BHI）；使用剑桥神经心理学自动测试仪（Cambridge neuropsychological test automated battery,CANTAB）进行视觉工作记忆、执行功能、注意力等认知功能的评估。比较两组间sVCAM-1和Lp-PLA2两种炎症因子水平、CVR及认知功能的差异，进一步分析TIA组中认知功能、sVCAM-1和Lp-PLA2两种炎症因子、CVR指标之间的相关性。 结果 ①与对照组相比，TIA组sVCAM-1水平（310.04±38.34 ng/mL vs. 208.12±31.10 ng/mL，P

Abstract Background and aims Cerebral microbleeds (CMBs) increase the risk of stroke occurrence and recurrence,and affect the prognosis of stroke patients. Therefore, identifying biological markers that predict CMBs after stroke is urgently needed. This study explored whether high levels of lipoprotein-associated phospholipase A2(Lp-PLA2) are associated with an increased risk of CMBs in patients with acute ischaemic stroke (AIS). Methods From April 2020 to October 2021, we enrolled 242 patients with AIS. At admission, the plasma levels of Lp-PLA2 were measured in all patients as well as the number of CMBs and white matter lesions. According to the results of the Susceptibility Weighted Imaging (SWI), the patients were divided into a CMB group and a no-CMB group. The groups were compared with univariate and multivariate analyses to clarify the correlation between Lp-PLA2 levels and CMBs, and the optimal cut-off value of Lp-PLA2 that predicted CMBs was determined from the receiver-operating characteristic curve. Results CMBs were detected in 71 (29.3%) of the 242 AIS patients. The median Lp-PLA2 level was 182.79 ng/ml. Using the 1st quartile of Lp-PLA2 levels (the lowest levels) as the reference group, univariate logistic regression analysis showed that individuals in the 4th quartile (the highest levels) had a higher risk of CMBs (odds ratio [OR] = 1.460, 95% confidence interval [CI]: 1.188–1.795, P = 0.000). This correlation persisted after adjusting for relevant risk factors (OR = 1.370, 95% CI: 1.096–1.713, P = 0.006). The optimal cut-off value of Lp-PLA2 that predicted the occurrence of CMBs was 184.36 ng/ml; at this threshold, the sensitivity was 69.0%, and the specificity was 60.2%. Conclusions Our data suggest that a high level of Lp-PLA2 in patients with AIS is a potential risk factor for CMBs.

(1) Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a risk factor for predicting cardiovascular diseases. Metabolic syndrome is characterized by a state of chronic inflammation that is related to an increased risk of cardiovascular events and death. In the present study, we aimed to analyze the correlation between cardiometabolic risk factors and Lp-PLA2 levels. (2) We collected the related retrospective medical data of Chinese adults, of which 3983 were men and 2836 were women (aged ≥ 18 years), who underwent health check-ups, and discussed the sex and age-related differences. (3) Data analysis showed that Lp-PLA2 was significantly related to lipoproteins and glutamic pyruvic transaminase (GPT), and that a linear trend was observed with increasing Lp-PLA2 levels for all ages and sexes. However, fasting glucose was significantly related to Lp-PLA2 only in the younger population. The two obesity-related parameters (waist-to-height ratio and waist circumference) also had a greater correlation with Lp-PLA2 levels in the younger groups; however, the correlation weakened in the elderly population. Meanwhile, the correlation between mean arterial pressure and creatinine level and Lp-PLA2 was significant only in younger men. (4) The results show that the expression patterns of Lp-PLA2 differ between sexes and across age groups. [ABSTRACT FROM AUTHOR]

Traditionally cardiovascular disease (CVD) risk has been assessed through blood lipids and inflammatory marker C‐reactive protein (hsCRP). Recent clinical interest in novel pro‐inflammatory markers platelet‐activating factor (PAF) and lipoprotein‐associated phospholipase A2 (Lp‐PLA2) recognizes that vascular damage can exist in the absence of traditional risk factors. This cross‐sectional study investigated the potential relationship between circulating PAF, Lp‐PLA2, hsCRP, and traditional risk factors for CVD. One hundred adults (49 ± 13 years, 31% male) with variable CVD risk were recruited. Fasting inflammatory markers PAF, Lp‐PLA2 and hsCRP and total, high‐density lipoprotein (HDL), low‐density lipoprotein (LDL) cholesterol, and triglycerides were measured. Blood pressure, body mass index, and waist circumference were measured. Medical and physical activity data were self‐reported. Linear and multiple regressions were performed. PAF, Lp‐PLA2, and hsCRP independently correlated with several CVD risk factors. PAF was correlated significantly with risk factors in an unexpected way; there was a medium positive correlation between PAF and HDL cholesterol (r = 0.394, p < 0.001) and medium negative correlations with Total:HDL cholesterol; (r = −0.436, p < 0.001) systolic blood pressure; (r = −0.307, p = 0.001); BMI (r = −0.381, p < 0.001); and waist circumference (r = −0.404, p < 0.001). There were large positive correlations between Lp‐PLA2 and LDL (r = 0.525, p < 0.001) and non‐HDL cholesterol (r = 0.508, p < 0.001). There were large positive correlations between hsCRP and Total:HDL cholesterol (r = 0.524, p < 0.001); BMI (r = 0.668, p < 0.001); and waist circumference (r = 0.676, p < 0.001). PAF, Lp‐PLA2, and hsCRP are implicated in the pathophysiology of inflammation in CVD; however, the relationships between each marker and traditional risk factors were different suggesting they may be involved in different atherogenic pathways. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study aimed to investigate the correlation between lipoprotein-associated phospholipase A2, endothelial progenitor cells, and sudden sensorineural hearing loss. METHODS: The number of endothelial progenitor cells and lipoprotein-associated phospholipase A2 levels collected from peripheral blood samples were measured and compared between sudden sensorineural hearing loss group and control group. RESULTS: The number of endothelial progenitor cells was reduced in sudden sensorineural hearing loss group compared to control group (38.88 ± 10.73 in sudden sensorineural hearing loss group vs. 77.14 ± 8.56 in control group, P <.01). The lipoprotein-associated phospholipase A2 level was markedly increased in sudden sensorineural hearing loss group compared to control group (244.94 ± 59.547 in sudden sensorineural hearing loss group vs. 189.00 ± 50.987 in control group, P <.05). CONCLUSION: The number of endothelial progenitor cells was decreased and lipoprotein-associated phospholipase A2 levels were increased in sudden sensorineural hearing loss patients. Changes in the number of endothelial progenitor cells and lipoprotein-associated phospholipase A2 levels may be involved in the pathogenesis of sudden sensorineural hearing loss. [ABSTRACT FROM AUTHOR]

A wealth of evidence suggests that Lipoprotein-associated phospholipase A2 (Lp-PLA2) plays a relevant role in atherogenesis and inflammation, which in turn are associated with the risk of developing dementia. The aim of this study was to evaluate whether serum Lp-PLA2 activity might be an early and/or late biomarker for different forms of dementia. Serum Lp-PLA2 activity was assessed in older patients with mild cognitive impairment (MCI, n = 166; median clinical follow-up = 29 months), Late-Onset Alzheimer's disease (LOAD, n = 176), vascular dementia (VAD, n = 43), dementia characterized by an overlap between LOAD and VAD (AD-VAD MIXED dementia) (n = 136), other dementia subtypes (n = 45), and cognitively normal controls (n = 151). We found a significant trend towards higher levels of Lp-PLA2 activity in VAD compared with the other groups (ANOVA, p = 0.028). Similarly, Lp-PLA2 activity was greater in MCI converting to VAD compared with those that did not or did convert to the other types of dementia (ANOVA, p = 0.011). After adjusting for potential confounders, high levels of Lp-PLA2 activity were associated with the diagnosis of VAD (O.R. = 2.38, 95% C.I. = 1.06–5.10), but not with other types of dementia. Our data suggest that increased serum Lp-PLA2 activity may represent a potential biomarker for the diagnosis of VAD. [ABSTRACT FROM AUTHOR]

Lipoprotein-associated phospholipase A2 (Lp-PLA2) and superoxide dismutase (SOD) are linked to regulating vascular/neuro-inflammation and stroke. Using a retrospective design, we investigated whether circulating Lp-PLA2 and SOD in cerebral small vessel disease (CSVD) patients were associated with cognitive impairment. Eighty-seven CSVD patients were recruited. Plasma Lp-PLA2 and SOD were determined, and cognitive status was measured by the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). The severity of white matter hypoerintensities (WMHs) in CSVD patients was rated according to Fazekas scales, and Lp-PLA2/SOD levels and MMSE/MoCA were compared. Multiple linear regressions were used to evaluate the relationship between Lp-PLA2 and SOD and the cognitive impairment. Ordinal logistic regression and generalized linear models (OLRGLMs) were applied to confirm whether Lp-PLA2 and SOD are independent risk factors for cognitive impairment in CVSD. Lp-PLA2 and SOD with mild or severe cognitive impairment were lower than those with normal congnition. Lp-PLA2 and SOD in CSVD patients with severe WMHs were significantly lower than those with mild or moderate WMH lesions. We noted positive linear associations of Lp-PLA and SOD with cognitive impairment in CSVD, independent of LDL-C. OLRGLMs confirmed that Lp-PLA2 and SOD were independent risk factors of cognitive impairment in CSVD. Lp-PLA2 and SOD are independently associated with cognitive impairment and WMH lesion, and may be useful for the rapid evaluation of cognitive impairment in CSVD. Lp-PLA2/SOD are modifiable factors that may be considered as therapeutic targets for preventing cognitive impairment in CSVD.

Jing Wang,1 Xing Dong,2 Hong-Yan Wu,1 Wen-Hua Bu,1 Rong Cong,1 Xin Wang,1 Li-Xin Shang,1 Wen Jiang1 1Department of Obstetrics and Gynecology, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China; 2Department of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of ChinaCorrespondence: Wen Jiang, Email jiangwen20110108@163.comBackground: A series of studies has shown that lipoprotein-associated phospholipase A2 (Lp-PLA2) is closely associated with abnormal lipid metabolism and vascular endothelial cell injury, but its role in hypertensive disorders of pregnancy (HDP) remains unclear. This study aims to determine the relationship between placental and serum LP-PLA2 levels and HDP, and to provide a feasible method for predicting HDP.Methods: The placental and serum Lp-PLA2 levels of 63 patients with HDP (20, 25, and 18 cases with gestational hypertension, mild preeclampsia, and severe preeclampsia, respectively) and 20 women with normal pregnancies (control group) were measured via a combination of tissue microarray and immunohistochemistry, real-time quantitative RT-PCR and enzyme-linked immunosorbent assay (ELISA).Results: 1) The gene and protein expression levels of placental LP-PLA2: the HDP group had significantly higher levels than those of the control group (P < 0.05). The mild preeclampsia group had significantly higher levels than those of the control group (P < 0.05); the severe preeclampsia group had significantly higher levels than those of the mild preeclampsia group (P < 0.05). 2) Serum levels of Lp-PLA2: the HDP group had significantly higher levels than those of the control group (P < 0.05). The Lp-PLA2 levels increased gradually with the progression of the HDP; there were significant differences in the four groups using pair-wise comparisons (P < 0.05). 3) Serum levels of LP-PLA2 were positively correlated with placental LP-PLA2 levels in the HDP group (r = 0.435, P < 0.05).Conclusion: Elevated Lp-PLA2 levels may be associated with the occurrence of HDP, and changes of Lp-PLA2 levels in the maternal blood may be regarded as a monitoring indicator for this disease.Keywords: hypertensive disorders of pregnancy, preeclampsia, lipoprotein-associated phospholipase A2, placenta, serum

Objective To investigate the relationships between serum phosphorylated Tau-181 (pTau181), lipopro⁃ tein-associated phospholipase A2 (Lp-PLA2) and vascular dementia (VD) in patients with acute cerebral infarction (ACI) . Methods Totally 163 patients with ACI were divided into the VD group (60 cases) and non-VD group (103 cases) accord⁃ ing to whether VD occurred or not. In the VD group, 15 patients had mild cognitive impairment, 32 patients had moderate cognitive impairment, and 13 patients had severe cognitive impairment. On the next day of enrollment, we collected all sub⁃ jects' fasting elbow vein blood in the morning, and centrifuged the upper serum. The serum pTau181 was detected by ELISA, and serum Lp-PLA2 was detected by up-forwarding light method. Multivariate Logistic regression model was used to analyze the risk factors of VD in patients with ACI, and the predictive value of serum pTau181 and Lp-PLA2 levels for patients with ACI complicated with VD was analyzed using the receiver operating characteristic (ROC) curve. Results The serum pTau181 and Lp-PLA2 levels in the VD group were significantly higher than those in the non-VD group (both P<0. 05) . With the aggravation of cognitive impairment, the serum pTau181 and Lp-PLA2 levels in patients with ACI complicated with VD gradually increased (both P<0. 05) . Multivariate Logistic regression analysis showed that type 2 diabetes mellitus, pTau181 and Lp-PLA2 were all risk factors of VD in ACI patients (all P<0. 05) . The ROC curve analysis showed that the area under the curve of serum pTau181 combined with Lp-PLA2 in predicting VD in patients with ACI was significantly higher than that of serum pTau181 and Lp-PLA2 levels alone (both P<0. 05) . Conclusion Serum pTau181 and Lp-PLA2 levels are independent risk factors for VD in ACI patients, and can be used as biomarkers to predict VD in ACI patients. [ABSTRACT FROM AUTHOR]

Background and aims: Cerebral microbleeds (CMBs) increase the risk of stroke occurrence and recurrence,and affect the prognosis of stroke patients. Therefore, identifying biological markers that predict CMBs after stroke is urgently needed. This study explored whether high levels of lipoprotein-associated phospholipase A2(Lp-PLA2) are associated with an increased risk of CMBs in patients with acute ischaemic stroke (AIS). Methods: From April 2020 to October 2021, we enrolled 242 patients with AIS. At admission, the plasma levels of Lp-PLA2 were measured in all patients as well as the number of CMBs and white matter lesions. According to the results of the Susceptibility Weighted Imaging (SWI), the patients were divided into a CMB group and a no-CMB group. The groups were compared with univariate and multivariate analyses to clarify the correlation between Lp-PLA2 levels and CMBs, and the optimal cut-off value of Lp-PLA2 that predicted CMBs was determined from the receiver-operating characteristic curve. Results: CMBs were detected in 71 (29.3%) of the 242 AIS patients. The median Lp-PLA2 level was 182.79 ng/ml. Using the 1st quartile of Lp-PLA2 levels (the lowest levels) as the reference group, univariate logistic regression analysis showed that individuals in the 4th quartile (the highest levels) had a higher risk of CMBs (odds ratio [OR] = 1.460, 95% confidence interval [CI]: 1.188–1.795, P = 0.000). This correlation persisted after adjusting for relevant risk factors (OR = 1.370, 95% CI: 1.096–1.713, P = 0.006). The optimal cut-off value of Lp-PLA2 that predicted the occurrence of CMBs was 184.36 ng/ml; at this threshold, the sensitivity was 69.0%, and the specificity was 60.2%. Conclusions: Our data suggest that a high level of Lp-PLA2 in patients with AIS is a potential risk factor for CMBs. [ABSTRACT FROM AUTHOR]

Recent studies indicated that bioactive lipids of phosphatidylcholines (PCs) and lysophosphatidylcholines (LysoPCs) predict unhealthy metabolic phenotypes, but results remain inconsistent. To fill this knowledge gap, we investigated whether essential trace elements affect PC-Lyso PC remodeling pathways and the risk of insulin resistance (IR). Anthropometric and blood biochemical data (glucose, insulin, and lipoprotein-associated phospholipase A2 (Lp-PLA2)) were obtained from 99 adults. Blood essential/probably essential trace elements and lipid metabolites were respectively measured by inductively coupled plasma mass spectrometry (ICP-MS), and ultra-performance liquid chromatography-mass spectrometry (UPLC-MS). Except for LysoPC (O-18:0/0:0), an inverse V shape was observed between body weight and PC and LysoPC species. A Pearson correlation analysis showed that essential/probably-essential metals (Se, Cu, and Ni: r =-0.4∼-0.7) were negatively correlated with PC metabolites but positively correlated with LysoPC (O-18:0/0:0) (Se, Cu, and Ni: r =0.85–0.64). Quantile-g computation showed that one quantile increase in essential metals was associated with a 2.16-fold increase in serum Lp-PLA2 (β=2.16 (95 % confidence interval (CI): 0.34, 3.98), p =0.023), which are key enzymes involved in PC/Lyso PC metabolism. An interactive analysis showed that compared to those with the lowest levels (reference), individuals with the highest levels of serum PCs (pooled, M2) and the lowest essential/probably essential metals (M1) were associated with a healthier body composition and had a 76 % decreased risk of IR (odds ratio (OR)=0.24 (95 % CI: 0.06, 0.90), p <0.05). In contrast, increased exposure to LysoPC(O-18:0/0:0) (M2) and essential metals (M2) exhibited an 8.22-times highest risk of IR (OR= 8.22 (2.07, 32.57), p <0.05) as well as an altered body composition. In conclusion, overexposure to essential/probably essential trace elements may promote an unhealthy body weight and IR through modulating PC/LysoPC remodeling pathways. [ABSTRACT FROM AUTHOR]

Paul T Williams Molecular Biophysics & Integrated Bioimaging Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USACorrespondence: Paul T Williams Email ptwilliams@lbl.govPurpose: Heritability (h2, the proportion of the phenotypic variance attributable to additive genetic effects) is traditionally assumed to be constant throughout the distribution of the phenotype. However, the heritabilities of circulating C-reactive protein, interleukin-6, plasminogen activator inhibitor type-1 (PAI-1), and monocyte chemoattractant protein-1 (MCP-1) concentrations depend upon whether the phenotype is high or low relative to their distributions (quantile-dependent expressivity), which may account for apparent gene–environment interactions. Whether the heritabilities of other inflammatory biomarkers linked to cardiovascular disease are quantile-dependent remain to be determined.Patients and Methods: Quantile-specific offspring-parent (βOP) and full-sib regression slopes (βFS) were estimated by applying quantile regression to the age- and sex-adjusted phenotypes of families surveyed as part of the Framingham Heart Study. Quantile-specific heritabilities were calculated as: h2=2βOP/(1+rspouse) and h2={(1+8rspouseβFS)0.5– 1}/(2rspouse).Results: Heritability (h2 ± SE) of lipoprotein-associated phospholipase A2 (Lp-PLA2) mass concentrations increased from 0.11 ± 0.03 at the 10th percentile, 0.08 ± 0.03 at the 25th, 0.12 ± 0.03 at the 50th, 0.20 ± 0.04 at the 75th, and 0.26 ± 0.06 at the 90th percentile, or 0.0023 ± 0.0006 per each one-percent increase in the phenotype distribution (Plinear trend= 0.0004). Similarly, h2 increased 0.0029 ± 0.0011 (Plinear trend= 0.01) for sP-selectin, 0.0032 ± 0.0009 (Plinear trend= 0.0001) for soluble intercellular adhesion molecule 1 (sICAM-1), and 0.0026 ± 0.0006 for tumor necrosis factor receptor 2 (TNFR2) (Plinear trend= 5.0 × 10− 6) per each one-percent increase in their distributions when estimated from βOP. Osteoprotegerin and soluble ST2 heritability also increased significantly with increasing percentiles of their distributions when estimated from βFS. Lp-PLA2 activity, CD40 ligand, TNFα, interleukin-18, and myeloperoxidase heritability showed no significant quantile-dependence.Conclusion: The heritabilities of circulating Lp-PLA2-mass, sP-selectin, sICAM-1, TNFR2, osteoprotegerin and soluble ST2 concentrations are quantile-dependent, which may contribute to purported genetic modulations of: 1) sP-selectin’s relationships to venous thrombosis, pulmonary hypertension, type 2 diabetes and atorvastatin treatment; 2) sICAM-I’s relationships to brain abscess and atorvastatin treatment; and 3) Lp-PLA2’s relationships to myocardial infarction and preeclampsia.Keywords: gene–environment interaction: heritability, P-selectin, intercellular adhesion molecule-1, lipoprotein-associated phospholipase A2, osteoprotegerin

BACKGROUND: Recurrent strokes cause greater complications and worse outcomes by adding to the existing neurological deficit. There is the paucity of data on serum markers of inflammation as predictors of recurrent stroke. This study was planned to analyze the clinico-etiological profile of recurrent noncardioembolic ischemic stroke, estimate aspirin resistance among regular aspirin users and evaluate blood biomarkers high-sensitivity C-reactive protein (hsCRP), Tumor necrosis factor-alpha (TNF-α), Lipoprotein-associated phospholipase A2 (Lp-PLA2) as probable predictors of stroke recurrence. METHODS: Patients of recurrent noncardioembolic ischemic stroke fulfilling the inclusion criteria were enrolled. Detailed history, clinical examination, and investigations were obtained as per protocol. Aspirin resistance was determined by light transmission aggregometry. Serum hsCRP, TNF-α, and Lp-PLA2 levels were estimated. RESULTS: This study included 34 males and 16 females. Majority of the patients were > 60 years (n = 30, 60%). Thirty (60%) cases had a repeat stroke after 1 year of primary event. Thirty-nine (78%) study participants had hypertension, while 15 (30%) had diabetes. Middle cerebral artery (n = 40, 80%) was the most common vascular territory. Thirty-one (62%) cases belonged to TOAST subtype 1 (large artery atherosclerosis). Seventy two percent cases were prescribed aspirin after index stroke, but only 36% were compliant. Median (range) hsCRP level was 7.5 (0.3–155) mg/L with 72% of patients having high hsCRP level (>3 mg/L). Median (range) serum PLA2 level was 11.98 (3.31–87.24) ng/ml in patients and 6.96 (0.15–61.42) ng/ml in controls (P = 0.029). Median (range) serum TNF-α level in patients was significantly higher than controls (68.22 [1.3–287] pg/ml versus 0.098 [0.002–36.31] pg/ml, P < 0.001). Aspirin resistance was found in 41.7% patients while 16.7% were semi-resistant. Mean % platelet aggregation was 34.75 ± 21.58 in patients and 64.75 ± 16.98 for controls (P < 0.001). CONCLUSIONS: Majority of patients with recurrent stroke were elderly (>60 years), hypertensive, and non-compliant with aspirin. Aspirin resistance was an important factor in patients with antiplatelet compliance. Inflammatory biomarkers hsCRP, PLA2, and TNF-α were found to be significantly elevated in patients compared to controls.

Abstract Background The association of lipoprotein(a) [Lp(a)] and stroke functional outcomes was conflicting. The aim of the study was to clarify whether high Lp(a) is associated with unfavorable functional outcomes in patients with ischemic stroke. Methods A total of 9709 individuals from the third China National Stroke Registry cohort were recruited. Plasma level of Lp(a) at admission was measured with enzyme-linked immunosorbent assay. The cut-off was set at the median for Lp(a). Functional outcome was assessed using the modified Rankin scale (mRS) at 3 months and 1 year after ischemic stroke. The association between Lp(a) and functional outcomes was evaluated using a logistic regression model. Results The median age was 63.0 years, and 31.1% participants were women. Patients in higher Lp(a) group had higher incidences of unfavorable functional outcomes at 3 months. In logistic regression model, elevated Lp(a) levels were associated with unfavorable functional outcomes at 3 months (Q4 vs. Q1: odds ratio 1.33, 95% confidence interval 1.11–1.61). Subgroup analysis showed that in the lower Lp-PLA2 group, Lp(a) level was not associated with functional outcomes, but in the higher Lp-PLA2 group, Lp(a) level was significantly associated with functional outcomes. After grouped by different levels of Lp(a) and Lp-PLA2, the Lp(a) high/ Lp-PLA2 high group showed the highest incidence of unfavorable functional outcomes at 3 months and 1 year. Conclusions Elevated Lp(a) level is associated with unfavorable functional outcomes in patients with ischemic stroke. The increment in both Lp(a) and Lp-PLA2 are associated with unfavorable functional outcomes at 3 months and 1 year after ischemic stroke.

Background: Subjects exposed to risk factors such as age, gender, hypertension, diabetes mellitus, and smoking are prone to atherosclerotic events. Aims: The main aim of this longitudinal cohort study was to determine whether the role of novel plasma biomarkers for atherosclerotic carotid artery disease is different in subjects developing symptomatic carotid artery stenosis (CAS), as opposed to those with incident asymptomatic CAS. Methods: The following biomarkers were measured in 5,550 middle-aged subjects in a population-based cohort study: C-reactive protein (CRP), lipoprotein-associated phospholipase A2 mass and activity, proneurotensin, midregional proadrenomedullin (MR-proADM), midregional proatrial natriuretic peptide (MR-proANP), N-terminal pro-B-type natriuretic peptide (NT pro-BNP), copeptin, and cystatin C. After exclusion of those with prevalent CAS, subjects were thereafter followed in national patient registers for 23.4 (interquartile range 19.5–24.3) years regarding incident symptomatic and asymptomatic CAS. Results: Among 110 patients with confirmed incident CAS, 56 were symptomatic and 54 were asymptomatic. When including conventional risk markers in a Cox regression analysis, NT pro-BNP (hazard ratio [HR] 1.59; 95% confidence interval [CI]: 1.20–2.11), MR-proADM (HR 1.40; CI: 1.13–1.73), cystatin C (HR 1.21; CI: 1.02–1.43), and CRP (HR 1.53; CI: 1.13–1.73) were independently associated with incident symptomatic CAS, whereas no plasma biomarker was associated with incident asymptomatic CAS. Conclusion: Plasma biomarkers NT pro-BNP, MR-proADM, cystatin C, and CRP were independently associated with incident symptomatic CAS, whereas no such association could be demonstrated with incident asymptomatic CAS. As these biomarkers indicate future development of clinically relevant atherosclerotic CAS, their potential utility in relation to intensified preventive measures and selection of potential candidates for carotid surgery should be further evaluated. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) is a collection of conditions that includes abdominal obesity, low high-density lipoprotein (HDL) levels, high triglycerides, hypertension, and impaired glucose metabolism, all of which are risk factors for cardiovascular diseases. Of the biomarkers above, lipoprotein-associated phospholipase A2 (Lp-PLA2) has been highlighted as a critical link between inflammation and the pathogenesis of atherosclerosis, which strongly predicts cardiovascular events. Micronutrients like magnesium and zinc are essential in maintaining metabolic and cardiovascular health, but these micronutrient deficiencies occur frequently among individuals with MetS. This study aimed to consider the association between serum magnesium and zinc levels with Lp-PLA2 and how these associations could link pathways in cardiovascular risk among MetS patients., Methods: This was a comparative cross-sectional study of 100 cases diagnosed as MetS and compared with an equal number (n = 100) of age and matched healthy control. Blood magnesium, zinc, and Lp-PLA2 levels were determined by colorimetric assay. We also tested the association of Lp-PLA2 with levels of micronutrients, and we evaluated whether Lp-PLA2 was a mediator in the pathway between MetS and cardiovascular risk. The data were analyzed on IBM Corp. Released 2021. IBM SPSS Statistics for Windows, Version 28.0. Armonk, NY: IBM Corp; the results will be considered statistically significant if p < 0.05., Results: The serum magnesium and zinc concentrations in patients with MetS were significantly lower than in the controls (p < 0.001). The Lp-PLA2 level was much higher in the MetS group than the no-MetS, and it correlated inversely with serum Mg (r = -0.35, p < 0.001) or Zn levels (r = -0.42, p < 0.001). After multivariate analysis, the mediating effect of Lp-PLA2 in the pathway from micronutrient deficiency to cardiovascular risk was maintained, whereby high levels were associated with increased atherogenic index and oxidative stress markers., Conclusions: These results show that Lp-PLA2 is an intermediate step in the relationship between low levels of some micronutrients and cardiovascular risk among MetS patients. Our findings indicate that a sufficient magnesium and zinc status might offer cardiovascular protection through lessening Lp-PLA2 activity. These observations demonstrate the potential benefits of high-risk enrichment and dietary intervention for detecting and controlling micronutrient deficiencies in MetS subjects to impede further cardiovascular diseases., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. MES Academy of Medical Sciences- Perinthalmanna issued approval IEC/MES/52/2020. We approve the study to be conducted. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Manik et al.)

Background: The aim was to investigate the predictive value of serum lipoprotein-associated phospholipase A2 (Lp-PLA2) for type 2 diabetes mellitus (T2DM) complicated with metabolic syndrome (MS) in elderly patients. Methods: A total of 296 patients with T2DM admitted from January 2019 to January 2021 were enrolled and assigned to MS group (n = 181) and non-MS group (n = 115). Their clinical data and laboratory test results were compared. Logistic regression analysis was employed to identify independent risk factors for MS in T2DM patients. Spearman's analysis was utilized to explore the correlations between serum Lp-PLA2 level and detection indicators. The predictive value of Lp-PLA2 for MS was analyzed by plotting receiver operating characteristic (ROC) curve, and Cox regression model was applied to explore the correlation of serum Lp-PLA2 level with MS. The results of data subjected to multivariate analysis were used to construct prediction models. Results: The incidence rate of MS was 61.15% in T2DM patients. MS group had a significantly higher serum level of Lp-PLA2 than non-MS group (p < 0.05). Serum Lp-PLA2 was significantly positively correlated to FBG, glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDLC), FINS, and HOMA-IR, but significantly negatively associated with LDL-C (p < 0.05). The area under the ROC curve of Lp-PLA2 for predicting MS in T2DM patients was 0.724 (95% CI: 0.625 - 0.826, p < 0.05). The sensitivity, specificity, positive predictive value, and negative predictive value of Lp-PLA2 with an optimal cutoff value of 82.96 ng/mL were 73.7%, 85.4%, 77.56%, and 93.24%, respectively. TC, TG, HDL-C, HbA1c, and Lp-PLA2 were independent risk factors for MS (p < 0.05). The area under the ROC curve of the risk prediction model established based on these indicators was 0.823, and the cutoff value, Youden index, sensitivity, and specificity were 0.219, 0.656, 78.87%, and 87.66%, respectively, indicating higher predictive value. Conclusions: Increased serum Lp-PLA2 level is an independent risk factor for MS in T2DM patients. Lp-PLA2 (82.87 ng/mL) has high predictive value for MS. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the effect of Xinshubao capsule combined with bisoprolol on vascular endothelial function and serum Fractalkine (Fractalkine), platelet activating factor (PAF) and lipoprotein-associated phospholipase A2 ( Lp-PLA2) in patients with angina pectoris of coronary heart disease. METHODS: Totally 132 patients with angina pectoris of coronary heart disease admitted to the cardiology department of Brain Hospital Affiliated to Nanjing Medical University from Feb. 2018 to Feb. 2021 were selected to be divided into observation group (n = 66) and control group (n = 66) via the random number table. The control group was treated with bisoprolol, and the observation group was given Xinshubao capsule combined with bisoprolol. The therapeutic effects, the frequency and duration of angina pectoris attacks, the changes of endothelin-1 (ET-1), nitric oxide (NO), thromboxane A2 (TXA2), thromboxane B2 (TXB2) and serum Fractalkine, PAF and Lp-PLA2 levels were observed before and after treatment, and the incidences of adverse drug reactions of the two groups were recorded. RESULTS: The total effective rate of angina pectoris in the observation group was 87. 88%(58 / 66), higher than 72. 73% (48 / 66) in the control group; the total effective rate of electrocardiogram in the observation group was 80. 30%(53 / 66), higher than 63. 64% (42 / 66) in the control group, with statistically significant difference (P<0. 05). The dosage of nitroglycerin in the observation group was lower than that in the control group; the frequency of angina pectoris attacks and the duration in the observation group after treatment were lower and shorter than those before treatment and in the control group, with statistically significant differences (P<0. 05). After treatment, the ET-1, TXA2 and TXB2 levels in the observation group were lower than those before treatment and in the control group, and the serum NO level was higher than that before treatment and in the control group, with statistically significant differences (P<0. 05). The serum Fractalkine, PAF and Lp-PLA2 levels in the observation group after treatment were lower than those before treatment and in the control group, with statistically significant differences (P < 0. 05). The incidences of adverse drug reactions in the observation group was 7. 58%(5/ 66), which had no statistical significance in comparison with 4. 55%(3/ 66) in the control group (P>0. 05). CONCLUSIONS: Patients with angina pectoris of coronary heart disease treated with Xinshubao capsule combined with bisoprolol can effectively improve the angina pectoris, efficacy of electrocardiogram and vascular endothelial function, and further down-regulate the serum Fractalkine, PAF and Lp-PLA2 levels, with high safety. [ABSTRACT FROM AUTHOR]