Study On The Relationship Between NGAL And MMP-9/NGAL On Symptomatic Carotid Atherosclerosis And Their Roles As Serum Biomarkers For Statins Therapy

Objective Neutrophil gelatinase-associated lipocalin(NGAL)and its complex with metalloproteinase 9(MMP-9),the complex MMP-9/NGAL have been reported to be involved in cardiovascular pathogenesis,and statins have a stabilizing effect on atherosclerotic plaques.In this study,by detecting the levels of NGAL and MMP-9/NGAL complexes in the serum,the correlation between them and the vulnerability of carotid atherosclerotic plaques and the effect of statins on NGAL and MMP-9/NGAL complexes in the serum was investigated,so as to explore therapeutic targets for patients with carotid atherosclerosis.Methods 100 patients with carotid atherosclerosis were selected as subjects.According to the mean expression levels of NGAL and MMP-9/NGAL in patients’ serum,the patients were divided into the high-expression group of NGAL(n = 56)and the low-expression group of NGAL(n = 44),the high-expression group of MMP-9/NGAL(n = 59)and the low-expression group of MMP-9/NGAL(n = 41),and the correlation between serum NGAL and MMP-9/NGAL in patients in different groups was investigated.Secondly,patients were divided into the stale plaque group(n = 42)and the unstable plaque group(n = 55)according to the dual-functional ultrasound test.Enzyme-linked immunosorbent assay(ELISA)was used to compare the expression levels of NGAL and MMP-9/NGAL in the serum of patients with different plaque stability.Moreover,the predictive value of the expression levels of NGAL and MMP-9/NGAL in patients with unstable plaques was evaluated by plotting the receiver operating characteristic curve(ROC).Finally according to the presence of a statin therapy in patients with divided the patients into did not receive a statin group(n = 31)and receive a statin group(n = 69),the expression levels of NGAL and MMP-9/NGAL in serum of patients in different drug treatment groups were detected by ELISA.At the same time,binary logistic regression was used to evaluate the correlation between serum NGAL and MMP-9/NGAL in patients and the symptoms and degree of carotid stenosis.Results(1)The total cholesterol,LDL-cholesterol,plaque stability,absence of carotid stenosis and the degree of carotid stenosis in patients with carotid atherosclerosis were different in patients with different NGAL and MMP-9/NGAL expression levels(P < 0.05)(2)The levels of NGAL and MMP-9/NGAL complex in serum of patients with unstable plaque were higher than those in patients with stable plaques(P < 0.05).(3)Serum levels of NGAL and MMP-9/NGAL in patients with moderate to severe luminal stenosis were significantly higher than those with mild luminal stenosis(P < 0.05).(4)The levels of NGAL and MMP-9/NGAL complex in patients’ serum were significantly positively correlated with the symptoms of carotid stenosis and were independent prognostic factors(P < 0.05).(5)The levels of NGAL and MMP-9/NGAL complex in patients’ serum were significantly positivity correlated with the degree of carotid stenosis,which could be used as their independent influencing factors(P < 0.05).(6)ROC curve analysis confirmed that NGAL and MMP-9/NGAL in serum had certain predictive value in patients with unstable plaques and patients with moderate to severe carotid stenosis(P < 0.05).(7)Statin therapy significantly reduced the levels of NGAL and MMP-9/NGAL complexes in patients’ serum(P < 0.05).Conclusion NGAL and MMP-9/NGAL complexes in serum were significantly associated with carotid plaque vulnerability.Statins can promote the stability of carotid atherosclerotic plaques by reducing the levels of NGAL and MMP-9/NGAL complexes in the serum of patients with carotid atherosclerosis.