The Association Between Serum Gal-3 Level And Metabolic Syndrome In Systemic Lupus Erythematosus

IntrodutionSystemic lupus erythematosus(SLE)is a heterogeneous autoimmune disease,in which breakdown of self-tolerance leads to out of control activity of innate and adaptive immunity and multi-organ damage.Compared to the general population,these patients are 5 to 10 times more likely to experience cardiovascular disease(CVD),which could reach 50 times greater in younger SLE patients.The pathogenesis of CVD in lupus is multifactorial and includes traditional cardiovascular risk factors,as well as inflammatory-and lupus-related factors.Metabolic syndrome(MetS)comprises a set of aggregated risk factors,including hypertension,central obesity,abnormal fasting glucose,and dyslipidemia that were highly correlated with the increasing cardiovascular morbidity and mortality in general population.MetS is also more prevalent in SLE than in general populations,and may therefore contribute to the pro-atherogenic environment in SLE.Considerable interest has recently arisen in galectin-3(Gal-3)because of its role in the pathogenesis of inflammatory response,metabolism and immune disorders recently.A large community-based cross-sectional research reported that serum Gal-3 was associated with MetS,which was not proved in SLE patients.The aim of this study was to investigate the differences in serum Gal-3 levels between SLE patients and the general population and to analyze their relationship with Met S.ObjectivesTo investigate the differences in serum Gal-3 levels between SLE patients and the general population and to analyze their relationship with MetS.Methods1.80 patients,aged ? 18 years,who fulfilled the 2009 American College of Rheumatology(ACR)revised criteria for the classification of SLE,were enrolled from the Department of Rheumatology,the First Affiliated Hospital of Zhengzhou University.General condition,clinical manifestions and the results of laboratory examination of all the SLE patients were collected.80 contral subjects of healthy volunteers were randomly selected from the Medical Center,the first Affiliated Hospital of Zhengzhou University.General condition and the results of laboratory examination of all the volunteers were collected.The serum galctin-3 concentration in the SLE group and the contral group was detected by enzyme-linked immunosorbent assay(ELISA)2.SLE group was divided into two groups: SLE patiens with and without MetS were included in SLE+MetS group and SLE-MetS group respectively,and the contral group was also divided into healthy control(HC)group and MetS group.The difference of serum Gal-3 concentration between the SLE patients and contral group were analyzed.The correlation between serum Gal-3 level and MetS components in SLE patients were evaluated.3.We compared the difference of disease activity,organ damage index and drug usage between SLE+MetS group and SLE-MetS group statistically,and analyzed the association between serum Gal-3 level with MetS and its components respectively.Results1.There was no significant difference in age and sex constituent ratio between SLE group and control group.The prevalence of MetS(33.8% vs 16.3%,P<0.05)and serum Gal-3 level(9.0 ± 3.1 vs 6.6 ± 1.8 ng/ml,P <0.05)in SLE group were significantly higher than that in contral group.2.The levels of Gal-3 in the SLE+MetS group were higher than that in the SLE-MetS group,with significant statistical difference(10.5 ± 3.3 vs 8.3 ± 2.8 ng/ml,P<0.05).SLE Disease Activity Index(SLEDAI)and Systemic Lupus International Collaborating Clinc/American College of Rheumatology Damage Index(SDI)were significantly higher in SLE+Met S group than those in SLE-MetS group.SLE-MetS group had a higher proportion of hydroxychloroquine(HCQ)usage than SLE+MetS group,and there were no significant difference in current and cumulative dosage of prednisone between two groups.3.Gal-3 was associated with increased MS prevalence,decreased level of HDL,and higher level of BP(OR = 1.266,P = 0.005;OR = 1.056,P =0.031;OR = 1.197,P =0.024).These associations were still detectible after the adjustment with confounding factors,such as age,BMI,duration of disease,renal involvement,SLEDAI,CRP,complements and drug use(OR = 1.396,P = 0.002;OR = 1.243,P = 0.020;OR = 1.068,P = 0.038).Conclusions(1)SLE patients have an elevated level of serum Gal-3 than general population.(2)The increase/decrease of serum Gal-3 is correlated with the development of MetS in SLE patients.