Correlation between serum lipoprotein associated phospholipase A2 level and renal damage in elders with type 2 diabetes mellitus

Objective To explore the correlation between serum lipoprotein associated phospholipase A2 (Lp-PLA2) and renal damage of diabetic kidney disease (DKD) in elders with type 2 diabetes mellitus (T2DM). Methods A total of 118 T2DM elders were recruited and divided into three groups according to urinary albumin/creatinine ratio. That is, group DM, n=52, urine albumin to creatinine ratio (UACR) <30 mg/g;group DKD1, n=38, 30 mg/gn=28, UACR > 300 mg/g. The differences of clinical parameters,renal function and Lp-PLA2 level were compared among three groups. And the correlation between Lp-PLA2 and clinical parameters was analyzed. Logistic regression analysis was performed for screening the risk factors of DKD in T2DM elders. Results Compared with simple DM group, the level of Lp-PLA2 was significantly higher in group DKD1/DKD2 DM group:(215.7±32.9) ng/mL;DKD1 group:(266.9±46.7) ng/mL;DKD2 group:(294.2±76.1) ng/mL. With an advancing stage of diabetic nephropathy, the level of Lp-PLA2 rose gradually and the level of Lp-PLA2 was higher in group DKD2 than that in group DKD1 DKD1 group:(266.9±46.7) ng/mL;DKD2 group:(294.2±76.1) ng/mL. Pearson's correlation analysis revealed that the level of Lp-PLA2 was correlated positively with total cholesterol (TC,r=0.27,P=0.01), low-density lipoprotein-cholesterol (LDL-C,r=0.47,P<0.01) and UACR (r=0.54,P<0.01) and negatively with estimated glomerular filtration rate (eGFR,r=-0.61,P<0.01). Logistic regression analysis indicated that body mass index (BMI), HbA1c and Lp-PLA2 were the risk factors for predicting DKD in T2DM elders. Conclusion Lp-PLA2 is probably involved in the occurrence and development of DKD. And regular monitoring of Lp-PLA2 has important clinical implications for preventing and treating DKD in T2DM elders.