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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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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Objective

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.

Methods

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.

Results

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.

Conclusions

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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Acknowledgements

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

Authors

Contributions

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.

Ethics declarations

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 (Ref.no:PBAC 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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The authors declare no competing interests.

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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). https://doi.org/10.1007/s13410-024-01312-w

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  • DOI: https://doi.org/10.1007/s13410-024-01312-w

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