Dietary, lifestyle, and clinical predictors of lipoprotein-associated phospholipase A2 activity in individuals without coronary artery disease

Abstract

Background: Elevated lipoprotein-associated phospholipase A2 (Lp-PLA2) may be positively associated with risk of coronary artery disease, yet little is known about potentially modifiable factors related to Lp-PLA2. Objective: The aim of this study was to determine dietary, lifestyle, and clinical measures associated with Lp-PLA2 activity. Design: We measured Lp-PLA2 activity in 853 female participants of the Nurses' Health Study and 878 male participants of the Health Professionals Follow-Up Study who were free of cancer and cardiovascular disease. Multivariable linear regression models were used to assess the relation between potentially modifiable factors and Lp-PLA2. Results: The replacement of 5% of energy from carbohydrates with energy from protein was associated with 2.2 nmol · min-1 · mL-1 lower levels of Lp-PLA2 (95% CI: -3.1, -0.4) activity, and every 15-g/d increase in alcohol consumption was associated with 4.4 nmol · min-1 · mL-1 lower levels of Lp-PLA2 activity (95% CI: -6.4, -2.4). Smoking (β = 10.2; 95% CI: 4.8, 15.5), being overweight (β = 7.5; 95% CI: 3.6, 11.3), aspirin use (β = 6.0; 95% CI: 2.1, 10.0), hypercholesterolemia (β = 15.0; 95% CI: 11.3, 18.8), and age (β = 2.5; 95% CI: 1.34, 3.74) were associated with elevated Lp-PLA2 activity, whereas postmenopausal hormone use (β = -15.8; 95% CI: -19.4, -12.1) and cholesterol medication use (β = -9.6; 95% CI: -18.2, -1.1) were inversely associated. Conclusion: We found that not smoking, use of postmenopausal hormones, having a body mass index (in kg/m2) ≤25, increased alcohol consumption, and increased protein consumption all represent potential modifiable factors that may favorably influence Lp-PLA2 activity. © 2010 American Society for Nutrition.