Objective: Carotid atherosclerosis is an important cause of cerebral ischaemic events and asymptomatic diagnosis of patients with advanced carotid artery stenosis is important in preventing stroke-related mortality and morbidity. Galectin-3 is known to increase inflammation by inducing the expression of a number of proinflammatory molecules in plaque pathophysiology. In this study, we aimed to evaluate the utility of serum galectin-3 level as a potential assessment tool for the severity of carotid artery disease.
Material and Methods: This prospective cross-sectional study was conducted between 06.12.2024 and 26.12.2024 in the stroke outpatient clinic of the department of neurology, Health Sciences University Adana City Training and Research Hospital. A total of 109 patients were included in the study, including 69 consecutive patients admitted with advanced (70-99% stenosis) carotid artery stenosis (CAS) and 40 patients without CAS in carotid imaging were included in the control group. An interventional neurologist and an additional neurologist determined the degree of CAS by examining carotid computed tomography angiography or carotid magnetic resonance angiography. The lipid profile (total cholesterol, high molecular weight lipoprotein, low molecular weight lipoprotein, triglycerides, apolipoprotein A1, apolipoprotein B), CRP and albumin levels were recorded. Galectin-3 levels were analysed in serum centrifuged blood.
Results: Age, hypertension incidence rate, triglycerides and Gal-3 values were found to be statistically significantly higher in the advanced CAS group compared to controls. For advanced CAS in ROC analysis; Gal-3 value was found to have a moderate discrimination ability (70-80%).
Conclusion: Our study suggests that Gal-3 levels may be used as a potential marker for the severity of carotid artery disease in CAS patients. Since advanced CAS patients are associated with a high stroke risk in follow-up, it is important that this condition is diagnosed early and treatment is directed.
Ethical approval was granted by Adana City Hospital Ethics Committee on 05.12.2024 with protocol number 247.
References
van Dam-Nolen DHK, Truijman MTB, van der Kolk AG, et al.; PARISK Study Group. Carotid plaque characteristics predict recurrent ischemic stroke and TIA: The PARISK (Plaque At RISK) study. JACC Cardiovasc Imaging. 2022;15(10):1715-1726. doi:10.1016/j.jcmg.2022.04.003
Kadoglou NP, Sfyroeras GS, Spathis A, et al. Galectin-3, carotid plaque susceptibility, and potential effects of statin therapy. Eur J Vasc Endovasc Surg. 2015;49(1):4-9. doi:10.1016/j.ejvs.2014.10.009
Kirisci M. A promising marker for carotid artery disease: Monocyte to high-density lipoprotein cholesterol ratio. Sakarya Med J. 2020;10(1):93-98. doi:10.31832/smj.644699
Hara A, Niwa M, Noguchi K, et al. Galectin-3 as a next-generation biomarker for detection of early stages of various diseases. Biomolecules. 2020;10(3):389. doi:10.3390/biom10030389
MacKinnon AC, Liu X, Hadoke PW, Miller MR, Newby DE, Sethi T. Inhibition of galectin-3 reduces atherosclerosis in apolipoprotein E-deficient mice. Glycobiology. 2013;23:654-663.
Aguilar D, Sun C, Hoogeveen RC, et al. Levels and change in galectin-3 and association with cardiovascular events: The ARIC study. J Am Heart Assoc. 2020;9(13):e015405. doi:10.1161/JAHA.119.015405
Zhuang JJ, Zhou L, Zheng YH, et al. The serum galectin-3 levels are associated with the severity and prognosis of ischemic stroke. Aging (Albany NY). 2021;13:7454-7464. doi:10.18632/aging.202610
Han X, Geng B, Deng F, et al. Galectin-3 is associated with the functional outcome and mortality in stroke patients: A systematic review and meta-analysis. Heliyon. 2023; E13279. doi:10.1016/j.heliyon.2023.e13279
Hutanu A, Iancu M, Balasa R, Maier S, Dobreanu M. Predicting functional outcome of ischemic stroke patients in Romania based on plasma CRP, sTNFR-1, D-dimers, NGAL, and NSE measured using a biochip array. Acta Pharmacol Sin. 2018;39:1228-1236. doi:10.1038/aps.2018.26
Chang X, Feng J, Ruan L, et al. Positive correlation between neovascularization degree of carotid atherosclerosis determined by contrast-enhanced ultrasound and level of serum C-reactive protein. Vasa. 2015;44(3):187-94. doi:10.1024/0301-1526/a000429
Yildirim T, Kiris T, Avci E, et al. Increased serum CRP-albumin ratio is independently associated with severity of carotid artery stenosis. Angiology. 2020;71(8):740-746. doi:10.1177/0003319720926761
Willems S, van der Velden D, Quax PH. Circulating immunoglobulins are not associated with intraplaque mast cell number and other vulnerable plaque characteristics in patients with carotid artery stenosis. PLoS One. 2014;9(2):e88984. doi:10.1371/journal.pone.0088984
Lee YJ, Koh YS, Park HE, et al. Spatial and temporal expression, and statin responsiveness of galectin-1 and galectin-3 in murine atherosclerosis. Korean Circ J. 2013;43(4):223-230. doi:10.4070/kcj.2013.43.4.223
Edsfeldt A, Bengtsson E, Asciutto G, et al. High plasma levels of galectin-3 are associated with increased risk for stroke after carotid endarterectomy. Cerebrovasc Dis. 2016;41(3-4):199-203. doi:10.1159/000443022
Cai Y, Sun Z, Shao C, Wang Z, Li L. Role of galectin-3 in vascular calcification. Glycoconj J. 2023;40(2):149-158. doi:10.1007/s10719-023-10106-x. Epub 2023 Feb 20. Review.
Falcone, C. Lucibello, S. Mazzucchelli, I. Galectin-3 plasma levels and coronary artery disease: A new possible biomarker of acute coronary syndrome. Int J Immunopathol Pharmacol. 2011; 24:905-913.
Gleissner CA, Erbel C, Linden F, Domschke G, Akhavanpoor M, Doesch, AO et al. Galectin-3 binding protein plasma levels are associated with long-term mortality in coronary artery disease independent of plaque morphology. Atherosclerosis, 2016;251, 94–100.
Dong R, Min Z, Hu Q, et al. Galectin-3 as a novel biomarker for disease diagnosis and a target for therapy (Review). Int J Med. 2018;41(2):599-614. doi:10.3892/ijmm.2017.3311
Hernandez P, Passi N, Modarressi T, et al. Clinical management of hypertriglyceridemia in the prevention of cardiovascular disease and pancreatitis. Curr Atheroscler Rep. 2021;23(11):72. doi:10.1007/s11883-021-00962-z
Akivis Y, Alkaissi H, McFarlane SI, Bukharovich I. The role of triglycerides in atherosclerosis: Recent pathophysiological insights and therapeutic implications. Curr Cardiol Rev. 2024;20(2):3949. doi:10.2174/011573403X272750240109052319
Akpinar CK, Kocaturk O, Aykac O, et al. Can C-reactive protein/albumin ratio be a prognostic factor in acute stroke patients undergoing mechanical thrombectomy? Clin Neurol Neurosurg. 2023;231:107856. doi:10.1016/j.clineuro.2023.107856 Epub 2023 Jun 28.
de Liyis BG, Ardhaputra GYB, Liyis S, et al. High C-reactive protein/albumin ratio predicts mortality and hemorrhage in stroke patients undergoing mechanical thrombectomy: A systematic review and meta-analysis. World Neurosurg. 2024;188:211-219.e1. doi:10.1016/j.wneu.2024.05.139 Epub 2024 May 27.
Karotis arter stenozunda galectin-3 düzeyi
Year 2025,
Volume: 15 Issue: 1, 40 - 46, 27.03.2025
Giriş
Karotis aterosklerozu, serebral iskemik olayların önemli bir nedeni olup ileri karotis arter stenozu olan hastaların asemptomatik dönemde tanı alması inmeye bağlı mortalite ve morbiditenin önlenmesinde önemlidir. Galectin-3’ün plak patofizyolojisinde bir dizi proinflamatuar molekülün ekspresyonunu indükleyerek inflamasyonu arttırdığı bilinmektedir. Bu çalışmada, serum galektin-3 düzeyinin karotis arter hastalığının ciddiyetinde potansiyel bir değerlendirme aracı olarak kullanılabilirliğini değerlendirmeyi amaçladık.
Metod
Bu prospektif kesitsel çalışma, 06.12.2024 ve 26.12.2024 tarihleri arasında Sağlık Bilimleri Üniversitesi Adana Şehir Eğitim ve Araştırma Hastanesi Nöroloji Anabilim Dalı'nda inme polikliniğinde gerçekleştirildi. Çalışmaya ileri (%70-99 darlık) karotis arter stenozu (CAS) nedeni ile başvuran ardışık 69 hasta ve karotis görüntülemelerde CAS saptanmayan 40 hasta kontrol grubunu oluşturmak üzere üzere toplam 109 hasta dahil edildi. Girişimsel nörolog ve ek olarak bir nörolog, karotid bilgisayarlı tomografi anjiografisi ya da karotid manyetik rezonans anjiografisini inceleyerek CAS derecesini belirledi. Katılımcıların lipid profili (total kolesterol, yüksek molekül ağırlıklı lipoprotein, düşük molekül ağırlıklı lipoprotein, trigliserit, apolipoprotein A1, apolipoprotein B), CRP ve albümin düzeyleri kaydedildi. Serum santrifüj kanında Galektin-3 düzeyleri çalışıldı.
Bulgular
İleri CAS grubunda yaş, hipertansiyon görülme oranı, trigliserit ve Gal-3 değerleri kontrollere göre istatistiksel açıdan anlamlı olarak yüksek saptanmıştır. ROC analizinde ileri CAS için; Gal-3 değerinin orta düzeyde (%70-80) ayırma yeteneği olduğunu belirlemiştir.
Sonuç
Çalışmamız, Gal-3 düzeylerinin CAS hastalarında karotis arter hastalığının ciddiyetinde potansiyel bir belirteç olarak kullanılabileceğini düşündürmüştür. Takiplerde ileri CAS hastalarının yüksek inme riski ile ilişkilendirilmesi nedeniyle bu durumun erken tanı alması ve tedavinin yönlendirilmesi önem arz etmektedir.
Adana şehir hastanesi etik kurulu tarafından 05.12.2024 tarihinde 247 protokol numarası ile etik alınmıştır.
References
van Dam-Nolen DHK, Truijman MTB, van der Kolk AG, et al.; PARISK Study Group. Carotid plaque characteristics predict recurrent ischemic stroke and TIA: The PARISK (Plaque At RISK) study. JACC Cardiovasc Imaging. 2022;15(10):1715-1726. doi:10.1016/j.jcmg.2022.04.003
Kadoglou NP, Sfyroeras GS, Spathis A, et al. Galectin-3, carotid plaque susceptibility, and potential effects of statin therapy. Eur J Vasc Endovasc Surg. 2015;49(1):4-9. doi:10.1016/j.ejvs.2014.10.009
Kirisci M. A promising marker for carotid artery disease: Monocyte to high-density lipoprotein cholesterol ratio. Sakarya Med J. 2020;10(1):93-98. doi:10.31832/smj.644699
Hara A, Niwa M, Noguchi K, et al. Galectin-3 as a next-generation biomarker for detection of early stages of various diseases. Biomolecules. 2020;10(3):389. doi:10.3390/biom10030389
MacKinnon AC, Liu X, Hadoke PW, Miller MR, Newby DE, Sethi T. Inhibition of galectin-3 reduces atherosclerosis in apolipoprotein E-deficient mice. Glycobiology. 2013;23:654-663.
Aguilar D, Sun C, Hoogeveen RC, et al. Levels and change in galectin-3 and association with cardiovascular events: The ARIC study. J Am Heart Assoc. 2020;9(13):e015405. doi:10.1161/JAHA.119.015405
Zhuang JJ, Zhou L, Zheng YH, et al. The serum galectin-3 levels are associated with the severity and prognosis of ischemic stroke. Aging (Albany NY). 2021;13:7454-7464. doi:10.18632/aging.202610
Han X, Geng B, Deng F, et al. Galectin-3 is associated with the functional outcome and mortality in stroke patients: A systematic review and meta-analysis. Heliyon. 2023; E13279. doi:10.1016/j.heliyon.2023.e13279
Hutanu A, Iancu M, Balasa R, Maier S, Dobreanu M. Predicting functional outcome of ischemic stroke patients in Romania based on plasma CRP, sTNFR-1, D-dimers, NGAL, and NSE measured using a biochip array. Acta Pharmacol Sin. 2018;39:1228-1236. doi:10.1038/aps.2018.26
Chang X, Feng J, Ruan L, et al. Positive correlation between neovascularization degree of carotid atherosclerosis determined by contrast-enhanced ultrasound and level of serum C-reactive protein. Vasa. 2015;44(3):187-94. doi:10.1024/0301-1526/a000429
Yildirim T, Kiris T, Avci E, et al. Increased serum CRP-albumin ratio is independently associated with severity of carotid artery stenosis. Angiology. 2020;71(8):740-746. doi:10.1177/0003319720926761
Willems S, van der Velden D, Quax PH. Circulating immunoglobulins are not associated with intraplaque mast cell number and other vulnerable plaque characteristics in patients with carotid artery stenosis. PLoS One. 2014;9(2):e88984. doi:10.1371/journal.pone.0088984
Lee YJ, Koh YS, Park HE, et al. Spatial and temporal expression, and statin responsiveness of galectin-1 and galectin-3 in murine atherosclerosis. Korean Circ J. 2013;43(4):223-230. doi:10.4070/kcj.2013.43.4.223
Edsfeldt A, Bengtsson E, Asciutto G, et al. High plasma levels of galectin-3 are associated with increased risk for stroke after carotid endarterectomy. Cerebrovasc Dis. 2016;41(3-4):199-203. doi:10.1159/000443022
Cai Y, Sun Z, Shao C, Wang Z, Li L. Role of galectin-3 in vascular calcification. Glycoconj J. 2023;40(2):149-158. doi:10.1007/s10719-023-10106-x. Epub 2023 Feb 20. Review.
Falcone, C. Lucibello, S. Mazzucchelli, I. Galectin-3 plasma levels and coronary artery disease: A new possible biomarker of acute coronary syndrome. Int J Immunopathol Pharmacol. 2011; 24:905-913.
Gleissner CA, Erbel C, Linden F, Domschke G, Akhavanpoor M, Doesch, AO et al. Galectin-3 binding protein plasma levels are associated with long-term mortality in coronary artery disease independent of plaque morphology. Atherosclerosis, 2016;251, 94–100.
Dong R, Min Z, Hu Q, et al. Galectin-3 as a novel biomarker for disease diagnosis and a target for therapy (Review). Int J Med. 2018;41(2):599-614. doi:10.3892/ijmm.2017.3311
Hernandez P, Passi N, Modarressi T, et al. Clinical management of hypertriglyceridemia in the prevention of cardiovascular disease and pancreatitis. Curr Atheroscler Rep. 2021;23(11):72. doi:10.1007/s11883-021-00962-z
Akivis Y, Alkaissi H, McFarlane SI, Bukharovich I. The role of triglycerides in atherosclerosis: Recent pathophysiological insights and therapeutic implications. Curr Cardiol Rev. 2024;20(2):3949. doi:10.2174/011573403X272750240109052319
Akpinar CK, Kocaturk O, Aykac O, et al. Can C-reactive protein/albumin ratio be a prognostic factor in acute stroke patients undergoing mechanical thrombectomy? Clin Neurol Neurosurg. 2023;231:107856. doi:10.1016/j.clineuro.2023.107856 Epub 2023 Jun 28.
de Liyis BG, Ardhaputra GYB, Liyis S, et al. High C-reactive protein/albumin ratio predicts mortality and hemorrhage in stroke patients undergoing mechanical thrombectomy: A systematic review and meta-analysis. World Neurosurg. 2024;188:211-219.e1. doi:10.1016/j.wneu.2024.05.139 Epub 2024 May 27.
Derya Ozdogru
SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ADANA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, NÖROLOJİ ANABİLİM DALI0000-0003-3567-1317Türkiye
Miray Erdem
SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ADANA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, NÖROLOJİ ANABİLİM DALI0000-0001-8369-7816Türkiye