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Abstract

Background & objective: Atherosclerosis affects the large and medium arteries and is a chronic inflammatory condition. It is intimately linked to dyslipidemia and entails the accumulation of lipid-rich plaques. Its progression is impacted by lipid abnormalities and immune-inflammatory responses. This study focuses on significant lipid indicators, including triglycerides, cholesterol, VLDL, HDL, and Lp-PLA₂. It also looks at different hematological parameters and inflammatory markers like CD40. This study aims to investigate the biochemical relationships between these markers in patients with atherosclerosis and find viable multi-marker panels for better risk prediction.
Methodology: In a case-control study, 90 people between the ages of 45 and 65 were split into three groups: 30 atherosclerosis patients with diabetes and hypertension, 30 pathological controls who had both conditions but no atherosclerosis, and 30 healthy controls. Hematological characteristics, inflammatory markers (Lp-PLA₂, CD40), and lipid profiles were examined in fasting blood samples. Spectrophotometric and ELISA methods were used. Statistical analysis was carried out with SPSS v26.
Results: Lp-PLA₂ and CD40 levels were significantly greater in atherosclerosis patients, suggesting increased vascular inflammation and immunological activation. The patient group had considerably reduced HDL and significantly greater triglycerides, cholesterol, and VLDL. According to hematological data, patients had higher WBC and Hb, while pathological controls had higher lymphocyte counts. Correlation analysis revealed a strong positive association between triglycerides (TG) and total cholesterol (R = 0.722, P < 0.001). In contrast, Lp-PLA₂ showed no significant correlation with lipid parameters, suggesting that it may play an independent role in vascular inflammation. A weak correlation was observed between CD40 and lymphocyte percentage.
Conclusions: The results highlight how crucial it is to combine inflammatory and lipid markers, such as CD40 and Lp-PLA₂, to comprehend the pathophysiology of atherosclerosis. These biomarkers could be helpful in risk assessment and early diagnosis. Lp-PLA₂'s function as a unique inflammatory marker in atherosclerosis is highlighted by the lack of connection it exhibits with conventional lipid markers.
Abbreviations: Lp-PLA₂: Lipoprotein-associated phospholipase A2, HDL: High-density lipoprotein, LDL: Low-density lipoprotein, VLDL: Very-low-density lipoprotein, TG: Triglycerides, CD40: Tumor Necrosis Factor Receptor Superfamily Member 5 (TNFRSF5), Hb: Hemoglobin, WBC: White blood cell, PLT: Platelet, LYM: Lymphocytes
Keywords: Atherosclerosis; Lp-PLA₂; CD40; Lipid profile; Inflammatory biomarkers; Hematological indices
Citation: Abbas ZI, Jaffat HS. Interplay of inflammatory and lipid biomarkers in atherosclerosis: role of Lp-PLA₂, CD40, and hematological indices; a case control study. Anaesth. pain intensive care 2025;29(6):770-778. DOI: 10.35975/apic.v29i7.2960
Received: June 25, 2025; Revised: July 10, 2025; Accepted: July 20, 2025