Poornima I G, Shields K, Kuller L H, Manzi S M, Ramsey-Goldman R, Richardson C, Rhew E, Dunlop D D, Song J, Edmundowicz D, Kondos G T, Carr J J, Langman C B, Price H, Chung A H, Santelices L B, Mackey R H
1 92594 Allegheny Health Network Cardiovascular Institute , Department of Cardiology, Pittsburgh, PA, USA.
2 6596 Allegheny Health Network , Department of Medicine, Pittsburgh, PA, USA.
Lupus. 2018 Jan 1:961203317751060. doi: 10.1177/0961203317751060.
Objective We tested the hypothesis that higher circulating levels of osteoprotegerin (OPG) are related to higher levels of coronary artery calcification (CAC) among women with systemic lupus erythematosus (SLE) compared with healthy controls (HCs). Methods Among 611 women in two age- and race-matched SLE case-control studies, OPG was assayed in stored blood samples (HEARTS: plasma, n cases/controls = 122/124, and SOLVABLE: serum, n cases/controls = 185/180) and CAC was measured by electron beam computed tomography. Results In both studies, SLE patients had higher OPG and CAC levels than HCs. Higher OPG was associated with high CAC (>100 vs.100) among SLE, and with any CAC (>0 vs. 0) among HCs. Multivariable-adjusted OR (95% CI) for OPG tertile 3 vs. 1 was 3.58 (1.19, 10.76), p trend = 0.01 for SLE, and 2.28 (1.06, 4.89), p trend = 0.04 for HCs. Associations were attenuated when age-adjusted, but remained significant for HC women aged ≥ 40 and SLE women aged ≥ 50. ROC analyses identified 4.60 pmol/l as the optimal OPG cutpoint for predicting high CAC (>100) among SLE patients with sensitivity = 0.74 and specificity = 0.61, overall, but 0.92 and 0.52, respectively, for SLE patients aged ≥ 50. Conclusion Our cross-sectional results suggest that higher OPG levels are related to higher CAC levels among women with SLE vs. healthy controls.
目的 我们检验了这样一个假设：与健康对照者（HCs）相比，系统性红斑狼疮（SLE）女性患者中骨保护素（OPG）循环水平升高与冠状动脉钙化（CAC）水平升高有关。方法 在两项年龄和种族匹配的SLE病例对照研究中的611名女性中，对储存的血液样本（HEARTS研究：血浆，病例/对照n = 122/124；SOLVABLE研究：血清，病例/对照n = 185/180）进行OPG检测，并通过电子束计算机断层扫描测量CAC。结果 在两项研究中，SLE患者的OPG和CAC水平均高于HCs。在SLE患者中，较高的OPG与高CAC（>100 vs.≤100）相关，在HCs中与任何程度的CAC（>0 vs. 0）相关。OPG三分位数3与1相比，多变量调整后的OR（95%CI）在SLE患者中为3.58（1.19，10.76），p趋势 = 0.01，在HCs中为2.28（1.06，4.89），p趋势 = 0.04。年龄调整后，相关性减弱，但在年龄≥40岁的HC女性和年龄≥50岁的SLE女性中仍具有显著性。ROC分析确定，在预测SLE患者高CAC（>100）时，4.60 pmol/l是最佳OPG切点，总体敏感性 = 0.74，特异性 = 0.61，但对于年龄≥50岁的SLE患者，敏感性和特异性分别为0.92和0.52。结论 我们的横断面研究结果表明，与健康对照者相比，SLE女性患者中较高的OPG水平与较高的CAC水平相关。
