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

Background: Elevated lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) may be positively associated with risk of coronary artery disease, yet little is known about potentially modifiable factors related to Lp-PLA(2). Objective: The aim of this study was to determine dietary, lifestyle, and clinical measures associated with Lp-PLA(2) activity. Design: We measured Lp-PLA(2) 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-PLA(2). 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-PLA(2) (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-PLA(2) activity (95% CI: -6.4, -2.4). Smoking (beta = 10.2; 95% CI: 4.8, 15.5), being overweight (beta = 7.5; 95% CI: 3.6, 11.3), aspirin use (beta = 6.0; 95% CI: 2.1, 10.0), hypercholesterolemia (beta = 15.0; 95% CI: 11.3, 18.8), and age (beta = 2.5; 95% CI: 1.34, 3.74) were associated with elevated Lp-PLA(2) activity, whereas postmenopausal hormone use (beta = -15.8; 95% CI: -19.4, -12.1) and cholesterol medication use (beta = -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/m(2)) <= 25, increased alcohol consumption, and increased protein consumption all represent potential modifiable factors that may favorably influence Lp-PLA(2) activity. Am J Clin Nutr 2010; 91: 786-93.