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Associations of osteoprotegerin with coronary artery calcification among women with systemic lupus erythematosus and healthy controls

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Poornima IG1, Shields K2, Kuller LH3, Manzi SM2, Ramsey-Goldman R4, Richardson C5, Rhew E6, Dunlop DD7, Song J8, Edmundowicz D9, Kondos GT10, Carr JJ11, Langman CB12, Price H13, Chung AH4, Santelices LB2, Mackey RH14. Lupus. 2018 Jan 1:961203317751060. doi: 10.1177/0961203317751060. [Epub ahead of print]

Abstract

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1 1 92594 Allegheny Health Network Cardiovascular Institute , Department of Cardiology, Pittsburgh, PA, USA.

2 2 6596 Allegheny Health Network , Department of Medicine, Pittsburgh, PA, USA.

3 3 6614 University of Pittsburgh , Department of Epidemiology, Graduate School Public Health, Pittsburgh, PA, USA.

4 4 12244 Northwestern University Feinberg School of Medicine , Department of Rheumatology, Chicago, IL, USA.

5 5 23236 Johns Hopkins Hospital and Health System , Department of Medicine-Rheumatology, Baltimore, MD, USA.

6 6 166943 Northwestern University, Departments of Medicine and Rheumatology , Chicago, IL, USA.

7 7 Northwestern University Feinberg School of Medicine, Department of Medicine (Rheumatology) and Preventive Medicine, Chicago, IL, USA.

8 8 Northwestern University-Evanston, Departments of Epidemiology, Public Health, and Rheumatology, Evanston, IL, USA.

9 9 25139 Temple University Hospital , Department of Medicine, Philadelphia, PA, USA.

10 10 12247 University of Illinois at Chicago College of Medicine , Department of Medicine, Chicago, IL, USA.

11 11 166943 Northwestern University, Departments of Medicine and Interventional Radiology, Chicago, IL, USA.

12 12 12244 Northwestern University Feinberg School of Medicine , Department of Pediatrics (Kidney Diseases), Chicago, IL, USA.

13 13 2429 Ann and Robert H. Lurie Children's Hospital of Chicago , Department of Medicine, Chicago, IL, USA.

14 14 199716 University of Pittsburgh, Departments of Medicine and Epidemiology, Pittsburgh, PA, USA.

Abstract

Objective We tested the hypothesis that higher circulating levels of osteoprotegerin (OPG) are related to higher levels of coronary artery calcification (CAC) among women with systemic lupus erythematosus (SLE) compared with healthy controls (HCs). Methods Among 611 women in two age- and race-matched SLE case-control studies, OPG was assayed in stored blood samples (HEARTS: plasma, n cases/controls = 122/124, and SOLVABLE: serum, n cases/controls = 185/180) and CAC was measured by electron beam computed tomography. Results In both studies, SLE patients had higher OPG and CAC levels than HCs. Higher OPG was associated with high CAC (>100 vs.100) among SLE, and with any CAC (>0 vs. 0) among HCs. Multivariable-adjusted OR (95% CI) for OPG tertile 3 vs. 1 was 3.58 (1.19, 10.76), p trend = 0.01 for SLE, and 2.28 (1.06, 4.89), p trend = 0.04 for HCs. Associations were attenuated when age-adjusted, but remained significant for HC women aged ≥ 40 and SLE women aged ≥ 50. ROC analyses identified 4.60 pmol/l as the optimal OPG cutpoint for predicting high CAC (>100) among SLE patients with sensitivity = 0.74 and specificity = 0.61, overall, but 0.92 and 0.52, respectively, for SLE patients aged ≥ 50. Conclusion Our cross-sectional results suggest that higher OPG levels are related to higher CAC levels among women with SLE vs. healthy controls.