First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy.
IRCCS Ospedale Policlinico San Martino Genoa - Italian Cardiovascolar Network, Genoa, Italy.
Eur J Clin Invest. 2019 May;49(5):e13089. doi: 10.1111/eci.13089. Epub 2019 Mar 3.
Ultrasound evaluation of carotid intima-media thickness (cIMT) has been extensively used for potentially improving cardiovascular (CV) risk stratification in several patients' categories. Subjects with systemic lupus erythematosus (SLE) have been investigated by both imaging and molecular biomarker approaches with contrasting results. Here, we focused on the role of osteopontin (OPN) as biomarker of subclinical atherosclerosis associated with SLE.
Eighty females (age 18-65 years) affected by SLE and eighty age-matched healthy female controls without a clinical history of CV disease underwent ultrasound evaluation of cIMT and blood sample assay of high-sensitivity C-reactive protein (hs-CRP) and OPN.
Healthy controls and SLE patients significantly differed for CV risk factors (ie, waist circumference, hypertension and dyslipidaemia) and the inflammatory status. Noteworthy, an opposite association between cIMT and OPN was observed in the two study groups. Whereas OPN was positively associated with mean cIMT (r = 0.364; P = 0.001) in SLE patients, a negative correlation was found in healthy controls. Furthermore, in SLE patients increased circulating levels of OPN were associated with the use of hydroxychloroquine and the positivity for the anti-dsDNA autoantibodies. At linear regression analysis, only OPN remained independently associated with cIMT also after adjustment for age, smoking pack-year, Heart SCORE, disease length and steroid therapy length.
These results indicate that serum OPN levels were strongly associated with subclinical atherosclerosis in patients with LES and it might be a useful CV biomarker that requires additional validation in larger trials.
颈动脉内膜中层厚度(cIMT)的超声评估已广泛用于提高多种患者类别的心血管(CV)风险分层。红斑狼疮患者(SLE)已经通过影像学和分子生物标志物方法进行了研究,但结果却相互矛盾。在这里,我们重点研究了骨桥蛋白(OPN)作为与 SLE 相关的亚临床动脉粥样硬化的生物标志物的作用。
80 名年龄在 18-65 岁之间的女性 SLE 患者和 80 名年龄匹配的无 CV 病史的健康女性对照者接受了 cIMT 的超声评估和血液样本高敏 C 反应蛋白(hs-CRP)和 OPN 的测定。
健康对照组和 SLE 患者在 CV 危险因素(即腰围、高血压和血脂异常)和炎症状态方面存在显著差异。值得注意的是,在两组研究对象中,cIMT 和 OPN 之间存在相反的相关性。虽然 OPN 与 SLE 患者的平均 cIMT 呈正相关(r=0.364;P=0.001),但在健康对照组中则呈负相关。此外,在 SLE 患者中,循环 OPN 水平升高与羟氯喹的使用和抗 dsDNA 自身抗体的阳性有关。在线性回归分析中,仅 OPN 在调整年龄、吸烟包年、心脏 SCORE、疾病长度和类固醇治疗长度后仍与 cIMT 独立相关。
这些结果表明,血清 OPN 水平与 LES 患者的亚临床动脉粥样硬化密切相关,它可能是一种有用的 CV 生物标志物,需要在更大的试验中进一步验证。