Influence of race and sex on lipoprotein-associated phospholipase A2 levels: Observations from the Dallas Heart Study

Aims Most lipoprotein-associated phospholipase A2 (Lp-PLA2) studies included mainly white men. We sought to determine whether Lp-PLA2 levels differ according to race and sex. Methods Lp-PLA2 mass and activity were measured in 3332 subjects age 30–65 participating in the Dallas Heart Study, a multiethnic, population-based, probability sample. Lp-PLA2 levels were compared between different race and sex groups. Results Mean age was 45 ± 9 years and 44% were men; 30% were white, 17% hispanic, and 53% black. Mean Lp-PLA2 activity and mass were 146 ± 40 nmol/min/mL and 191 ± 60 ng/mL, respectively. Lp-PLA2 activity was lower in women compared with men (134 ± 35 vs. 161 ± 40, p = 0.001) and was lowest in black (136 ± 38), intermediate in hispanic (151 ± 36), and highest in white subjects (161 ± 39) (trend p = 0.0001). In multivariable linear regression models, after adjusting for age, body mass index (BMI), smoking, total, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, triglycerides and high sensitivity C-reactive protein (hsCRP), Lp-PLA2 activity was 19 nmol/min/mL higher in men vs. women (p < 0.001); compared with black subjects, adjusted Lp-PLA2 activity was 11 and 20 nmol/min/mL higher in white and hispanic subjects, respectively (both p < 0.001). Similar race and sex differences were observed for Lp-PLA2 mass. Conclusion Race and sex independently influence Lp-PLA2 activity and mass. Thresholds to define Lp-PLA2 elevation may need to be sex and race specific.