Transforming growth factor beta 1 is associated with subclinical carotid atherosclerosis in patients with systemic lupus erythematosus

Abstract

Background Transforming growth factor beta (TGF-B1) is a multifunctional cytokine that has anti-inflammatory and immunosuppressive effects. TGF-B1 has been linked to cardiovascular disease in the general population. The immunosuppressive effect of TGF-B1 is believed to be dysregulated in patients with systemic lupus erythematosus (SLE). In the present work, we aimed to study the relationship of serum levels of TGF-B1 with subclinical carotid atherosclerosis in patients with SLE.

Methods The study included 284 patients with SLE. Serum levels of TGF-B1 and subclinical carotid atherosclerosis (by carotid ultrasonography) were evaluated. In addition, the complete lipid profile and insulin resistance were analyzed. Multivariable linear and logistic regression analysis was performed to establish the relationship of TGF-B1 with carotid subclinical atherosclerosis adjusting for traditional cardiovascular risk factors that included lipid profile and insulin resistance.

Results Circulating TGF-B1 was positively and significantly associated with higher levels of LDL:HDL cholesterol ratio and atherogenic index. TGF-B1 was also associated with significantly lower levels of HDL cholesterol and apolipoprotein A1. Remarkably, TGF-B1 was associated with the presence of carotid plaque not only after adjustment for demographics (age, sex, body mass index, diabetes, hypertension, and aspirin use) but also after adjustment for relationships of TGF-B1 with lipid profile molecules, insulin resistance, and SLEDAI disease score (odds ratio 1.14 [95% confidence interval 1.003-1.30], p= 0.045).

Conclusion TGF-B1 serum levels are positively and independently associated with the presence of subclinical atherosclerosis disease in patients with SLE