Endocrine Abstracts

Background: Type 2 diabetes (T2DM) represents an independent risk factor for cardiovascular diseases (CVD), being characterized by a continuous low-grade inflammation and endothelial activation state. Lipoprotein-associated phospholipase A₂ (Lp-PLA₂) may have a pro-inflammatory role as growing evidence suggests that it acts in several pathways that contribute to atherogenesis.

Objective: The objective is to study Lp-PLA₂ as a possible biomarker for cardiovascular disease in T2DM.

Subjects and methods: A case control study included 45 diabetic subjects who were divided into 3 groups. Group (1): 15 T2DM patients with recent ischemic stroke (<24 h). Group (2): 20 T2DM patients with acute myocardial infarction. Group (3): 10 recently diagnosed uncomplicated T2DM individuals matching age and sex. All individuals were subjected to full history, thorough clinical examination, serum Lp-PLA₂ by enzyme-linked immunosorbent assay (ELISA); serum highly sensitive C-reactive protein (hsCRP) by Nephlometry; lipid profile, fasting (FPG) and postprandial plasma glucose (PPBG), glycated hemoglobin (HbA1c), Electocardiography (ECG), Echocardiography and computerized tomography (CT) of brain. Cardiac enzymes were done for patients with acute myocardial infarction.

Results: The study showed that there was significant difference between patients with either cerebrovascular stroke and acute myocardial infarction in comparison with uncomplicated T2DM subjects respectively as regards Lp-PLA₂, and hsCRP, being higher in patients with cardiovascular complications (P<0.05). Lp-PLA₂ was significantly positively correlated with hsCRP only in patients with cerebrovascular stroke (r: 0.532) (P<0.05) but not in patients with acute myocardial infarction (r: −0.22) (P>0.05).

Conclusion: Levels of Lp-PLA2 and hsCRP may be complementary beyond traditional risk factor in identifying middle aged individuals at increased risk for cardiovascular events in type 2 diabetes mellitus.