Creator: Dr. Anshul Varshney
Published: 2017-10-21T12:22:18-04:00

Q. What is Lp-PLA2?

Answered by

Dr. Anshul Varshney

and medically reviewed by iCliniq medical review team.

This is a premium question & answer published on Oct 21, 2017 and last reviewed on: Jul 13, 2019

Patient's Query

Hi doctor,

I am a 47 year old female. My height is 5'4" and weight is 120 pounds. I have slightly elevated cholesterol level and so I had a blood test done before three months for Lp-PLA2, which came back high. I had it repeated this week, exactly three months later and it came back double high. I am so scared and need some assistance. Please help.

Answer

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology

Hi,

Welcome to icliniq.com.

We are here to help you.

Lp-PLA2 (lipoprotein-associated phospholipase A2) is a marker of inflammation and can be raised in any atherosclerosis or even inflammatory conditions like rheumatoid arthritis. However predominantly it is used as a cardiac marker.

I need few details to help you better. For what symptom was the test performed?

Do you have any history of heart disease, high blood pressure, joint pains or diabetes? Are you suffering from any other disease?

Do you have any family history of cardiac issues? Have you been taking any medicines?

Revert back with the answers for the above questions to a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist

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Patient's Query

Hi doctor,

Other than slightly elevated cholesterol, I do not find anything wrong with my health. But, to be sure of things I will revert back to you as soon as possible with the detailed history. Thank you.

Answer

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology

Hi,

Welcome back to icliniq.com.

Yeah, sure. I am comfortable with that. Hope to hear from you soon. Take care.

Revert back with detailed history to a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist

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Patient's Query

Hi doctor,

The following laboratory results were drawn three months ago. Total cholesterol 209, triglycerides 45, lipids LDL-C 116, LDL-P 1039, HDL-C 84, LDL and HDL particles = HDL-P (total) 34.8, small LDL-P is less than 90, LDL size 21.8, LP + non-HDL cholesterol total 200, triglycerides 46, HDL cholesterol 87, VLDL cholesterol cal 9, LDL cholesterol cal 104, non-HDL cholesterol 113, lipoprotein (a) 73 and apolipoprotein 78. I had the D-Dimer blood test which was less than 0.20. I had a normal EKG, echocardiogram, stress test on treadmill and calcium scoring CT was 0. My Lp-PLA2 level three months ago was 224 and now it is 405. Is there a possibility for laboratory error? Also, I have an eating disorder and not sure if that can affect my cholesterol and PLA2 level. I exercise excessively, while eating a very low fat and low calorie diet. I would say I have no more than 15 grams of fat a day and around 1000 calories and I burn around 600 calories through exercise. Please help.

Answer

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology

Hi,

Welcome back to icliniq.com.

These are indirect markers of inflammation that is inflammation in your body. Now that could be your heart arteries or even other parts of your body.

Since your all cardiac evaluation including calcium scoring is normal then there is nothing to worry as such.

Yes, this could be a laboratory error or could be due to your recent fever or infection causing inflammation and rise in the levels.

If we talk about practicality then in case of normal cardiac evaluation this rise is just a link to future risk of heart diseases and the treatment warranted is a low calorie diet and regular exercises. Nothing else needs to be done.

If a person has any other associated risk factor then we need to put the person on Aspirin or Atorvastatin.

For further information consult a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist

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Patient's Query

Hi doctor,

I have low blood pressure. My resting heart rate is usually around 55. I do not smoke or drink or use any drugs. I am not on any medication and have no disease. I do have aches and pains in my back, knees, etc. The vitamins I take daily are lysine, vitamin D, vitamin C, mushroom extract, and probiotics. My dad has heart disease and high blood pressure, as well as my mom is having high blood pressure. My paternal grandparents died of stroke and my maternal grandmother has heart disease and diabetes. Do you think any of the vitamins would be causing the elevated cholesterol and PLA2 levels?

Answer

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology

Hi,

Welcome back to icliniq.com.

Your family history is significant for heart diseases.

It is very unlikely that any vitamin would cause rise in PLA2 levels. However, in clinical practice we see this rise often.

As I have been saying that irrespective of the levels treatment at this state would be the same that is a healthy lifestyle and regular stress tests. Nothing else needs to be done.

You should get a repeat PLA2 test after two months and write to me again. Remember that you should avoid going for the test after a recent fever or viral.

Revert back after two months to a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist

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