Serum Calprotectin As Biomarker of Carotid Atherosclerosis in Patients with Primary Sjögren's Syndrome

Gabriela Moreira Balarini¹, Eliana Zandonade², leandro tanure³, gilda Aparecida ferreira³, Wildner Mardegan Sardenberg⁴, Érica Vieira Serrano⁴, Cléia Coelho Dias⁵, Túlio Pinho Navarro³, João Felipe Tonini⁴, Hilde H Nordal⁶, Piotr Mydel⁷, Johan Gorgas Brun⁸, Karl Albert Brokstad⁹, Eva Gerdts⁸, Roland Jonsson^10,11 and Valeria Valim^4,12, ¹Department of Medical Clinic, Federal University of Espírito Santo (UFES), Brazil., cachoeiro de itapemirim, Brazil, ²Department of Statistic, Federal University of Espírito Santo (UFES), Brazil., vitória, Brazil, ³Department of Locomotor System, Federal University of Minas Gerais, Brazil., belo horizonte, Brazil, ⁴Department of Medical Clinic, Federal University of Espírito Santo (UFES), Brazil., vitória, Brazil, ⁵Department of Medical Clinic, Federal University of Espírito Santo (UFES), Brazil., vila velha, Brazil, ⁶Broegelmann Research Laboratory/University of Bergen, Norway, bergen, Norway, ⁷Clinical Science, Broegelmann Research Laboratory, Bergen, Norway, ⁸Department of Clinical Science, University of Bergen, Norway, bergen, Norway, ⁹Department of Clinical Science, University of Bergen, Norway., bergen, Norway, ¹⁰Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway, ¹¹Broegelmann research laboratory, Bergen, Norway, ¹²Rheumatology, Universidade Federal do Espírito Santo, Vitória, Brazil

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Atherosclerosis, Biomarkers, cardiovascular disease and risk assessment, Sjogren's syndrome

Session Information

Date: Sunday, November 8, 2015

Title: Sjögren's Syndrome I: Basic Insights

Session Type: ACR Concurrent Abstract Session

Session Time: 4:30PM-6:00PM

Background/Purpose: The relationship between atherosclerosis, traditional risk factors, disease activity and biomarkers is not well explored. We aimed to identify the association of carotid atherosclerosis with traditional risk factors, disease features, cytokine profile and calprotectin in patients with pSS.

Methods: 63 patients primary pSS and 63 age-sex-matched healthy controls underwent carotid ultrasound, clinical and laboratorial evaluation. Presence of carotid plaques was taken as carotid atherosclerosis. Covariates of carotid atherosclerosis were identified in univariate and multivariate regression. Financing from CAPES (Higher Education Personnel Improvement Coordination-Brazil) and Broegelmann Research Laboratory-Bergen.

Results: Patients with pSS had higher prevalence of carotid atherosclerosis (13% vs. 2%, p<0.05), calprotectin, tumoral necrosis factor receptor 2 (TNF-R2), Hepatocyte growth factor (HGF), and monocyte chemoattractant protein-1 (MCP-1) than controls, while sex, menopause and prevalences of traditional cardiovascular risk factors including smoking, hypertension, diabetes, dyslipidemia, obesity and metabolic syndrome (MetS) did not differ (all p>0.05). In univariate analyses, serum calprotectin (2945.16 ± 1793.36 vs. 1407.09 ± 990.66, p=0.002), most traditional cardiovascular (age, male sex, MetS, hypertension, hypertriglyceridemia, and serum creatinine), and some disease-associated risk factors (glucocorticoid or saliva substitute use, ESSDAI constitutional domain) were associated with higher risk for plaque (Table 1). In multivariate analysis, disease itself and calprotectin were independent risk factors for carotid atherosclerosis. Higher serum calprotectin was associated with carotid atherosclerosis independent of serum creatinine and systolic blood pressure (Table 2).

Conclusion: In patients with pSS, calprotectin is a biomarker of carotid atherosclerosis, which in pSS patients is modulated by traditional cardiovascular risk factors as well as the disease itself.

Table 1. Cardiovascular risk factors for carotid atherosclerosis in primary Sjögren’s syndrome (pSS).

Risk Factor	OR	OR 95%CI	p-value
pSS disease	9.02	1.09-94.41	0.040
Gender	6.4	1.05-39.86	0.040
Age (years)	0.86	0.78-0.95	0.002
Metabolic Syndrome	8.92	1.06-74.86	0.040
Hypertension	5.6	1.11-28.16	0.044
Hypertriglyceridemia	5.8	1.37-24.64	0.017
Familiar history of myocardial infarct	10.27	1.22-86.33	0.002
Glucocorticoid use	11.76	2.68-51.59	0.001
Framingham score	0.84	0.73-0.93	0.009
Serum creatinine (mg/dL)	0.04	0.01-0.55	0.016
Calprotectin (ng/mL)	1.001	0.999-1	0.002

Table 2. Sjögren’s syndrome and calprotectin as independent risk factor for carotid atherosclerosis after adjusting for traditional risk factors.

Model	Risk factor	OR	95% CI Lower Limit	95% CI Upper Limit	p-value
1	Sjögren’s syndrome	28.76	1.689	490.19	0.020
	Age	0.820	0.721	0.940	0.004
	Hypertension	1.890	0.273	13.05	0.519
	Hypertriglyceridemia	10.074	1.162	87.33	0.036
	Serum creatinine	1.072	0.005	23.058	0.965
2	Hypertension	1.040	0.99	1.09	0.004
	Serum creatinine	10.204	0.60	166.666	0.055
	Calprotectin	1.001	1.000	1.001	0.023

Disclosure: G. M. Balarini, None; E. Zandonade, None; L. tanure, None; G. A. ferreira, None; W. M. Sardenberg, None; V. Serrano, None; C. C. Dias, None; T. P. Navarro, None; J. F. Tonini, None; H. H. Nordal, None; P. Mydel, None; J. G. Brun, None; K. A. Brokstad, None; E. Gerdts, None; R. Jonsson, None; V. Valim, None.

To cite this abstract in AMA style:

Balarini GM, Zandonade E, tanure L, ferreira GA, Sardenberg WM, Serrano V, Dias CC, Navarro TP, Tonini JF, Nordal HH, Mydel P, Brun JG, Brokstad KA, Gerdts E, Jonsson R, Valim V. Serum Calprotectin As Biomarker of Carotid Atherosclerosis in Patients with Primary Sjögren’s Syndrome [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/serum-calprotectin-as-biomarker-of-carotid-atherosclerosis-in-patients-with-primary-sjgrens-syndrome/. Accessed .

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