The correlations between plasma NGAL levels and atherosclerosis and atherogenic index of plasma in rheumatoid arthritis patients

YANG Ping-ping; LI Lin-xuan; LIU Xin-zheng; SONG Sha-wei; FENG Xin-na; WEI Li

doi:10.13820/j.cnki.gdyx.20224543

Abstract：Objective To investigate the correlations between plasma neutrophil gelatinase-associated lipocalin(NGAL)levels and atherosclerosis(AS)and atherogenic index of plasma(AIP)in rheumatoid arthritis(RA)patients.Methods A total of 192 RA patients from January 2017 to September 2020 were selected.Based on the results of carotid intima-media thickness(IMT)ultrasound examination,they were divided into a plaque-free group of 98 cases and a plaque group of 94 cases.Additionally,98 healthy individuals undergoing physical examinations during the same period were included as the control group.Lipid-related indicators,including total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C),were determined;and the AIP was calculated.Laboratory indicators including rheumatoid factor and anti-cyclic citrullinated peptide anti-body were measured for all study subjects.Plasma NGAL levels were detected by ELISA,and the relative expression of nuclear factor kappa-B(NF-κB)mRNA was measured by real-time quantitative PCR.Pearson correlation analysis was conducted to assess the correlation between plasma NGAL levels with IMT,AIP,and other indicators,while multiva-riate stepwise regression analysis was performed to identify factors influencing IMT.Results Compared to the control group,both the plaque group and the plaque-free group had higher levels of TG,LDL-C,C-reactive protein(CRP),erythrocyte sedimentation rate,rheumatoid factor,anti-cyclic citrullinated peptide antibody,and carotid IMT,as well as lower levels of HDL-C(P＜0.001).Furthermore,in the plaque group,disease course,HDL-C,LDL-C,erythro-cyte sedimentation rate,CRP,anti-cyclic citrullinated peptide antibody,rheumatoid factor,and carotid IMT were higher than those in the plaque-free group(P＜0.001).The levels of NGAL and relative expression of NF-κB mRNA in both the plaque group and the plaque-free group were higher than those in the control group(P＜0.05),and the levels of NGAL and relative expression of NF-κB mRNA were higher in the plaque group compared to the plaque-free group(P＜0.05).Pearson correlation analysis indicated that in RA patients,plasma NGAL levels and neutrophil NF-κB mR-NA were positively correlated with TG,LDL-C,erythrocyte sedimentation rate,CRP,rheumatoid factor,anti-cyclic citrullinated peptide antibody,carotid IMT,and AIP,and negatively correlated with HDL-C(P＜0.05).Multivariate stepwise regression analysis revealed that TG,HDL-C,LDL-C,NGAL,NF-κB,AIP,and rheumatoid factor were independent risk factors affecting carotid IMT.Conclusion Plasma NGAL levels are upregulated in RA patients and are closely related to the extent of AS and the AIP.This suggests that NGAL may be involved in the occurrence and develop-ment of AS through the activation of the NF-κB signaling pathway,mediating the inflammatory response process.