Lp-PLA2 is an enzyme associated with low-density lipoproteins (LDL), which plays a dual role:
Functions:
- Pro-inflammatory activity:
- It breaks down oxidized phospholipids into LDL, releasing lysophosphatidylcholine and oxidized fatty acids. :
- Attract macrophages to the walls of blood vessels.
- Contribute to the formation of atherosclerotic plaques.
- Risk biomarker:
- A high level of Lp-PLA2 indicates instability of plaques and the risk of their rupture (heart attack, stroke).
Where is it produced?
- Mainly in macrophages and lymphocytesassociated with atherosclerotic lesions.
Symptoms and consequences of Lp-PLA2 imbalance
In excess (high risk of vascular events)
- Atherosclerosis:
- Progression of plaques in the coronary and carotid arteries.
- Risk of acute coronary syndromes (infarction).
- Stroke:
- Association with inflammation in the cerebral vessels.
- Absence of external symptoms before the catastrophe develops (analysis is the only way to identify the risk).
In case of shortage (extremely rare)
- It is not clinically relevant, as Lp-PLA2 is not a vital enzyme.
Lp-PLA2 standards in analyses
The level is measured in the blood (serum or plasma) by two methods:
- Enzyme activity (nmol / min / ml):
- The norm: < 150 nmol / min / ml.
- High risk: > 200 nmol / min / ml.
- Mass concentration (ng / ml):
- Low risk: < 200 ng / ml.
- Moderate risk: 200-235 ng / ml.
- High risk: > 235 ng / ml.
When is the test scheduled?
- Assessment of the risk of cardiovascular diseases (especially in patients with intermediate risk on the SCORE scale).
- Control of atherosclerosis, diabetes, hypertension.
- Monitoring the effectiveness of statins (reduce Lp-PLA2).
What should I do with elevated Lp-PLA2?
- LDL Reduction:
- Statins (atorvastatin, rosuvastatin).
- Ezetimibe (cholesterol absorption inhibitor).
- Anti-inflammatory therapy:
- Dapagliflozin (an SGLT2 inhibitor) reduces Lp-PLA2 in diabetics.
- Changing your lifestyle:
- Mediterranean diet (olive oil, omega-3).
- Smoking cessation (increases LDL oxidation).
Interesting facts
- Lp-PLA2 is independent of C-reactive protein (CRP), making it an independent marker of vascular inflammation.
- The test is especially useful for patients with normal cholesterol, but a high risk of heart attack.
Conclusion
Lp-PLA2 is an enzyme that increases inflammation in atherosclerotic plaques.
Rules:
- By activity: < 150 nmol / min / ml.
- By weight: < 200 ng / ml** (low risk). **Increase (>235 ng / ml) — a signal for aggressive prevention of heart attack/stroke.
Correction: statins, LDL control, anti-inflammatory diet.
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