Lipid Markers in Men and Women with Peripheral Arterial Disease

Sammanfattning: Introduction Lipoprotein(a) (Lp(a)) and oxidized LDL (oxLDL) are circulating lipoproteins known to promote development of atherosclerosis. LDL can be oxidized in several ways, including enzymatic oxidation by myeloperoxidase (MPO). The knowledge regarding these biomarkers in men and women with different presentations of peripheral arterial disease (PAD) is scarce. Aim To investigate sex differences in plasma levels of MPO, Lp(a) and oxLDL in patients undergoing open vascular surgery. A secondary aim was to elucidate how indication for surgery, risk factors and comorbidity influenced the levels of lipid markers. Methods A multicenter observational study done within the framework of an ongoing study targeting atherosclerosis, where lipids and inflammation are studied in patients undergoing open vascular surgery for either PAD (intermittent claudication (IC) or critical limb ischemia (CLI)) or carotid artery stenosis, having an ankle brachial pressure index <0.9 or >1.4. Participants were included 2019-2020, with blood samples collected immediately before surgery. Results A total of 30 men and 26 women were included. The indication for surgery was CLI (50.0%), IC (30.4%) and carotid stenosis (19.6%). Women and men displayed similar levels of Lp(a), MPO and oxLDL. Lp(a) was lower among CLI patients as compared to IC in univariate (P=0.038) but not in multivariate analysis. Oxidized LDL levels and LDL, Lp(a) and cholesterol correlated significantly. Conclusions There were no statistically significant differences in lipid markers between sexes. Levels of Lp(a) differed between the surgical indication groups and were lowest among the more severely diseased patients (CLI). Our findings need further evaluation in larger cohorts, taking effects of lipid-lowering therapies into consideration.