Lipoprotein-associated phospholipase A2, homocysteine, and Alzheimer's disease

Introduction: Lipoprotein-associated phospholipase A2 (Lp-PLA2) and homocysteine (Hcy) have been linked to inflammation and Alzheimer's disease (AD). Using a case-control design, we examined their independent effects and interactions with cardiovascular disease equivalent (CVDE), on AD risk. Methods: AD cases and controls were from the Texas Alzheimer's Research and Care Consortium study. Lp-PLA2 was determined using the PLAC test (diaDexus, Inc), and Hcy by recombinant cycling assay (Roche Hitachi 911). Logistic regression was used to predict AD case status. We assayed for Lp-PLA2 in the brain tissue of cases and controls. Results: AD case status was independently associated with Lp-PLA2 and Hcy above the median (odds ratio [OR] = 1.91; 95% confidence interval [CI] = 1.22-2.97; P <.001 and OR = 1.81; 95% CI = 1.16-2.82; P =.009, respectively). Lp-PLA2, but not Hcy, interacted with CVDE to increase risk. Lp-PLA2 was absent from the brain tissue in both groups. Discussion: Higher Lp-PLA2 and Hcy are independently associated with AD. The association of Lp-PLA2 with AD may be mediated through vascular damage.