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Predictive value of Lp-PLA2 for coronary artery disease in type 2 diabetes mellitus patients: an observational study

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Type 2 diabetes mellitus (T2DM) is a chronic disease characterized by elevated blood glucose levels, which can result in a variety of complications, including coronary artery disease (CAD). Lp-PLA2 is a proinflammatory enzyme associated with low-density lipoprotein (LDL) particles in the circulation and is thought to be a biomarker for CAD risk.


The purpose of this investigation was to evaluate the diagnostic utility of serum lipoprotein-associated phospholipase A2 (Lp-PLA2) levels in type 2 diabetes mellitus (T2DM) patients with and without coronary artery disease (CAD). Utilizing receiver operating characteristic (ROC) curves, the diagnostic efficacy of Lp-PLA2 was evaluated.


Lp-PLA2 levels were substantially higher in T2DM patients without cardiovascular disease (146.7 ng/mL 88.4) compared to HC (103.3 ng/mL 21.7) and T2DM + CAD (124.31 ng/mL 11.7). There was no statistically significant correlation between Lp-PLA2 levels and age, Hba1c, LDL, or Lp(a) in T2DM patients without CAD. Lp-PLA2 levels were not significantly associated with age (p = 0.97), HbA1c (p = 0.41), LDL (p = 0.59), or Lp(a) (p = 0.56), as determined by multiple linear regression analysis. The area under the curve (AUC) for Lp-PLA2 in T2DM without CAD was calculated to be 0.76, with a 95% confidence interval (CI). The sensitivity and specificity of a termination point of > 115 ng/mL were 0.70 and 0.68, respectively. For patients with T2DM + CAD, the AUC was 0.73 with a 95% confidence interval, and a threshold point of > 115 ng/mL yielded sensitivity and specificity values of 0.73 and 0.75, respectively.


In T2DM patients with or without CAD, serum Lp-PLA2 concentrations may serve as a diagnostic marker. The cutoff value of > 115 ng/mL exhibited excellent sensitivity and specificity, especially in T2DM patients without CAD. This finding suggests the clinical utility of Lp-PLA2 as a diagnostic tool for identifying those at risk for CAD in the context of T2DM.

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Data Availability

Data supporting the findings of this study are available within the article text and tables.


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I would like to acknowledge all participants who enrolled in the study, Department of Biochemistry-Nizam's Institute of Medical Sciences for providing infrastructure, Multidisciplinary Research Unit-Nizam's Institute of Medical Sciences for guidance and Institutional Ethics Committee- Nizam's Institute of Medical Sciences for approving the work.

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Authors and Affiliations



Conceptualization: SKM, SN, BA, KP, SS, and VB

Methodology: SKM, SN, and KP

Formal analysis and investigation: SKM, SN, and KP

Writing—original draft preparation: SKM, SN, and KP

Writing—review and editing: SKM, SN, BA, KP, SS, and VB

Supervision: SKM, SN, BA, SS, and VB

Corresponding author

Correspondence to Santhosh Kumar Mallela.

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Ethical clearance and consent of patient

All study procedures complied with the ethical guidelines of the Declaration of Helsinki and the study was approved by hospital/institutional ethics committee ( No :2023/2021). After the subjects were agreed to participate, written informed consent was obtained. All participants underwent a personal interview in conformance with institutional guidelines for studies including human subjects. Data was collected on socio-demographic characteristics, lifestyle behavior, medical history, family history, and physical examination.

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Mallela, S.K., Puranam, K., Neelam, S. et al. Predictive value of Lp-PLA2 for coronary artery disease in type 2 diabetes mellitus patients: an observational study. Int J Diabetes Dev Ctries (2024).

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