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半乳糖凝集素-3是系统性硬化症患者生存情况的独立预测指标。

Galectin-3 is an independent predictor of survival in systemic sclerosis.

作者信息

Faludi Réka, Nagy Gabriella, Tőkés-Füzesi Margit, Kovács Krisztina, Czirják László, Komócsi András

机构信息

Heart Institute, Faculty of Medicine, University of Pécs, Pécs, Hungary.

Department of Rheumatology and Immunology, Faculty of Medicine, University of Pécs, Pécs, Hungary.

出版信息

Int J Cardiol. 2017 Apr 15;233:118-124. doi: 10.1016/j.ijcard.2016.12.140. Epub 2016 Dec 28.

Abstract

BACKGROUND

Galectin-3 is a beta-galactoside-binding lectin that may be related to tissue sclerosis or aberrant activation of angiogenesis in systemic sclerosis (SSc). The aim of our study was to determine the associations between galectin-3 levels and patient characteristics, as well as to investigate the long term prognostic value of galectin-3 in a large cohort of SSc patients.

METHODS

152 patients with SSc (55±11years, 138 female) were included in our follow-up study. Blood samples and clinical data were collected at baseline. Primary and secondary outcomes were all-cause and cardiovascular mortality, respectively.

RESULTSS

Galectin-3 levels showed positive correlation with the grade of left ventricular diastolic function (r=0.193; p=0.026), erythrocyte sedimentation rate (r=0.172; p=0.036) and serum level of C-reactive protein (r=0.200; p=0.015) while negative correlation with diffusing capacity for carbon monoxide (r=-0.228; p=0.006), in age, gender and BSA adjusted analyses. During the follow-up of 7.2±2.3years, 35 SSc patients (23%) died. In multivariate Cox regression analyses adjusted for age, gender, BSA, creatinine and NT-proBNP levels, galectin-3 was an independent predictor both of the all-cause mortality (HR: 2.780, 95% CI: 1.320-5.858, p=0.007) and cardiovascular mortality (HR: 3.346, 95% CI: 1.118-10.012, p=0.031). Using receiver-operating characteristic analysis, galectin-3>10.25ng/ml was found to be the best predictor of the all-cause mortality.

CONCLUSIONS

Our results suggest that galectin-3 is an independent predictor of all-cause and cardiovascular mortality in SSc. Validation studies are required to establish whether galectin-3 may be proposed as simple biomarker for identifying patients with high mortality risk in SSc.

摘要

背景

半乳糖凝集素-3是一种β-半乳糖苷结合凝集素,可能与系统性硬化症(SSc)中的组织硬化或血管生成异常激活有关。我们研究的目的是确定半乳糖凝集素-3水平与患者特征之间的关联,并调查半乳糖凝集素-3在一大群SSc患者中的长期预后价值。

方法

152例SSc患者(55±11岁,138例女性)纳入我们的随访研究。在基线时收集血样和临床数据。主要和次要结局分别是全因死亡率和心血管死亡率。

结果

在年龄、性别和体表面积调整分析中,半乳糖凝集素-3水平与左心室舒张功能分级呈正相关(r = 0.193;p = 0.026)、红细胞沉降率(r = 0.172;p = 0.036)和血清C反应蛋白水平呈正相关(r = 0.200;p = 0.015),而与一氧化碳弥散能力呈负相关(r = -0.228;p = 0.006)。在7.2±2.3年的随访期间,35例SSc患者(23%)死亡。在根据年龄、性别、体表面积、肌酐和NT-proBNP水平进行调整的多变量Cox回归分析中,半乳糖凝集素-3是全因死亡率(HR:2.780,95%CI:1.320 - 5.858,p = 0.007)和心血管死亡率(HR:3.346,95%CI:1.118 - 10.012,p = 0.031)的独立预测因子。使用受试者工作特征分析,发现半乳糖凝集素-3>10.25ng/ml是全因死亡率的最佳预测因子。

结论

我们的结果表明,半乳糖凝集素-3是SSc全因死亡率和心血管死亡率的独立预测因子。需要进行验证研究,以确定半乳糖凝集素-3是否可作为识别SSc中高死亡风险患者的简单生物标志物提出。

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