PUB - Publikationen an der Universität Bielefeld

**Abstract**
Lipoprotein‐associated phospholipase A2 (Lp‐PLA2) was identified as a strong predictor for cardiovascular events. Furthermore, it is highly associated with obesity. The role of Lp‐PLA2 in diabetes mellitus is controversial and analyses, especially in adolescents with type 2 diabetes (T2D), are missing. Therefore, we compared Lp‐PLA2 activity between two obese age‐, sex‐, and BMI‐matched cohorts of adolescents with and without T2D. Relationships between Lp‐PLA2 activity and age, BMI, hemoglobin A1c, lipids, and adipokines were evaluated. Lp‐PLA2 activity was analyzed in serum of 72 obese adolescents without T2D (mean age 15.2 ± 1.6 years) and in 65 obese adolescents with T2D (mean age 15.5 ± 1.8 years). Clinical data were obtained from the Diabetes‐Patienten‐Verlaufsdokumentation (DPV) registry. Surprisingly, obese adolescents with T2D had lower levels of Lp‐PLA2 activity than obese children without T2D (160.2 ± 45.0 versus 180.9 ± 35.6 nmol/min/ml,p= 0.003), but this decrease could only be detected in male (158.8 ± 45.3 versus 190.8 ± 31.3 nmol/min/ml,p< 0.001) and not in female adolescents (162.1 ± 45.5 versus 167.7 ± 37.1 nmol/min/ml,p= 0.60). In multiple linear regression analysis, differences in Lp‐PLA2 activity between cohorts remained large and significant (ß‐coefficient: −31.60, 95% confidence interval [−49.27;−13.93],p< 0.001). Furthermore, Lp‐PLA2 activity was positively associated with BMI (ß‐coefficient: 2.04 [0.68;3.40],p= 0.004) and negatively associated with the adipokines leptin (ß‐coefficient: −0.53 [−0.89;−0.17], p = 0.004) and adiponectin (ß‐coefficient: −3.06, [−5.63;−0.48],p= 0.02). Elevated mean glucose concentrations in adolescents with T2D were not associated with an increase but with a decrease of Lp‐PLA2 activity. Hence, in young patients with T2D the Lp‐PLA2 activity as a risk predictor for cardiovascular events needs further investigation.