# Lp-PLA2 (Lipoprotein-associated phospholipase A2)

Lp-PLA2 is an enzyme tied to vascular inflammation. (Its other name is platelet-activating factor acetylhydrolase.) It is made mainly by macrophages and lymphocytes, and in your blood about 80% of it rides on LDL. There it chops up oxidized fats on trapped LDL particles, releasing two pro-inflammatory products into the artery wall. Labs measure it two ways: by mass (the FDA-cleared PLAC test, with values above about 200 to 225 ng/mL considered high) or by activity (cutoff around 225 nmol/min/mL). A large pooled analysis (the Lp-PLA2 Studies Collaboration; Thompson 2010, 79,036 people) found each standard-deviation rise carried a risk ratio of about 1.10 to 1.11 for coronary heart disease and ischemic stroke, similar to non-HDL cholesterol. Watch the confounders. Statins lower Lp-PLA2 by about 20 to 30%, as do fibrates, ezetimibe, and weight loss. And a rare loss-of-function variant (PLA2G7 V279F), common in East Asians, lowers it too.

## Sources

- Thompson A, Gao P, Orfei L, et al. (Lp-PLA2 Studies Collaboration). (2010). Lipoprotein-associated phospholipase A(2) and risk of coronary disease, stroke, and mortality: collaborative analysis of 32 prospective studies. Lancet. https://doi.org/10.1016/S0140-6736(10)60319-4
- Huang F, Wang K, Shen J. (2019). Lipoprotein-associated phospholipase A2: The story continues. Medicinal Research Reviews. https://doi.org/10.1002/med.21597

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