Division of Rheumatology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Division of Rheumatology, Department of Medicine, Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, NY, USA.
Semin Arthritis Rheum. 2024 Apr;65:152357. doi: 10.1016/j.semarthrit.2023.152357. Epub 2024 Jan 15.
Galectin-3 is a beta-galactoside-binding lectin and is a marker of cardiovascular disease (CVD) in the general population. It may also play a role in joint inflammation. We asked whether serum galectin-3 is a useful marker of subclinical vascular disease in patients with rheumatoid arthritis (RA).
RA patients without clinical CVD underwent assessment of coronary artery calcium (CAC) score, aortic inflammation (using 18Fluorodeoxyglucose positron emission-computed tomography [FDG PET/CT]), and myocardial flow reserve (MFR). Aorta FDG uptake was measured as standardized uptake values (SUV). Generalized linear models were constructed to explore the associations of galectin-3 levels with CAC score, aortic SUV, and MFR.
A total of 124 RA patients (mean age 57; 82 % women, 45 % Hispanic; median RA duration 6.8 years; 75 % seropositive; median CDAI 16; 33 % on prednisone; 89 % on DMARDs; median CAC score 0; median aorta SUV 2.59; mean MFR 2.86; median galectin-3 level 8.54 ng/mL) were analyzed. In univariable analysis, higher galectin-3 levels were associated with higher aortic SUV (p = 0.007) but CAC score and MFR were not. In multivariable analysis, higher galectin-3 level remained significantly associated with higher aortic SUV (ß Coefficient=0.1786, p value=0.002).
In our cohort of RA patients without clinical CVD, higher serum galectin-3 levels were independently associated with higher levels of aortic inflammation, but not CAC score or MFR. This suggests that galectin-3 may be a biomarker for an inflammatory and potentially reversible stage, but not a later (calcified) stage, of atherosclerosis in patients with RA.
半乳糖凝集素-3 是一种β-半乳糖苷结合凝集素，是普通人群心血管疾病（CVD）的标志物。它也可能在关节炎症中发挥作用。我们询问了血清半乳糖凝集素-3 是否是类风湿关节炎（RA）患者亚临床血管疾病的有用标志物。
没有临床 CVD 的 RA 患者接受了冠状动脉钙评分（CAC）、主动脉炎症（使用 18 氟脱氧葡萄糖正电子发射计算机断层扫描 [FDG PET/CT]）和心肌血流储备（MFR）评估。主动脉 FDG 摄取以标准化摄取值（SUV）表示。构建了广义线性模型，以探讨半乳糖凝集素-3 水平与 CAC 评分、主动脉 SUV 和 MFR 的相关性。
共分析了 124 例 RA 患者（平均年龄 57 岁；82%为女性，45%为西班牙裔；中位 RA 病程 6.8 年；75%为血清阳性；中位 CDAI 为 16；33%使用泼尼松；89%使用 DMARDs；中位 CAC 评分为 0；中位主动脉 SUV 为 2.59；平均 MFR 为 2.86；中位半乳糖凝集素-3 水平为 8.54ng/mL）。单变量分析显示，较高的半乳糖凝集素-3 水平与较高的主动脉 SUV 相关（p=0.007），但 CAC 评分和 MFR 则不然。多变量分析显示，较高的半乳糖凝集素-3 水平仍与较高的主动脉 SUV 显著相关（β系数=0.1786，p 值=0.002）。
在没有临床 CVD 的 RA 患者队列中，较高的血清半乳糖凝集素-3 水平与主动脉炎症水平升高独立相关，但与 CAC 评分或 MFR 无关。这表明，半乳糖凝集素-3 可能是 RA 患者动脉粥样硬化炎症和潜在可逆转阶段的生物标志物，但不是晚期（钙化）阶段的标志物。
