Short-term fenofibrate treatment reduces elevated plasma Lp-PLA₂ mass and sVCAM-1 levels in a subcohort of hypertriglyceridemic GOLDN participants

High levels of lipoprotein-associated phospholipase A₂ (Lp-PLA₂) are associated with inflammation, atherosclerosis, and coronary heart disease events. In addition, Lp-PLA₂ has been linked to classical markers of endothelial activation, including soluble vascular cell adhesion molecule-1 (sVCAM-1). Although treatment with fenofibrate reduces Lp-PLA₂ mass, it is unclear whether fenofibrate reduces sVCAM-1 levels or whether an association exists between any changes observed in Lp-PLA₂ and sVCAM-1. Concentrations of Lp-PLA₂ mass and sVCAM-1 levels were measured in plasma at baseline and after 3 weeks of fenofibrate treatment (160 mg/d) in 96 hypertriglyceridemic participants of the Genetics of Lipid-lowering Drugs and Diet Network study. Lp-PLA₂ and sVCAM-1 were stratified by tertiles as determined by baseline levels of the respective target. Fenofibrate treatment resulted in a 30.1% mean increase in Lp-PLA₂ mass (P = 0.0003) and a 14.7% mean increase in sVCAM-1 levels (P = 0.0096) but only in tertile1 of either target. In contrast, Lp-PLA ₂ mass was reduced by 35.3% (P < 0.0001) in tertile 3. Soluble VCAM-1 levels were significantly reduced by 7.74% (P = 0.0109) and 17.2% (P < 0.0001) in tertiles 2 and 3, respectively. No associations were observed between Lp-PLA₂ and sVCAM-1 at baseline or post-treatment. In conclusion, fenofibrate treatment in hypertriglyceridemic subjects reduced the levels of Lp-PLA₂ mass and sVCAM-1, but only in those with elevated baseline levels of these biomarkers. The greatest reductions in Lp-PLA ₂ levels were observed in individuals with Lp-PLA₂ concentrations indicative of increased cardiovascular disease risk (>200 ng/mL).