Background and aims Previous study has demonstrated Cysteine-rich protein 61(Cyr61) was highly expressed in systemic lupus erythematosus(SLE) patients.However,the role of Cyr61 in pulmonary arterial hypertension (PAH) remains unknown.This study aimed to explore the value of Cyr61 for PAH in SLE patients by comparing the plasma Cyr61 levels in SLE patients with/without PAH.
Methods Plasma samples from two tertiary medical centerswereobtained from 54 patients with definite SLE-PAH, 52 age,gender and SLEDAI matched SLE patients without PAH, and 54 age and gender matched healthy controls. Plasma Cyr61 concentration was measured by enzyme-linked immunosorbent assay.
Results Plasma Cyr61 concentration in SLE-PAH patients was significantly higher than the matched SLE patients and healthy controls(median(IQR): 172.5 (143.8, 218.2), 124.9 (104.1,154.7), 58.17 (28.9, 80.4) respectively, P<0.001) (Figure 1). The sensitivity and specificity of Cyr61 in predicting the presence of PAH in entire SLE patients were 79.6% and 67.3%. Receiver operating characteristic curve analysis showed the area under the curve was 0.757 (95% CI:0.662˜0.852),with 140.6 pg/ml as the cutoff concentration (Figure 2). Further multivariate logistic regression analysesrevealed high Cyr61 level(>140.6) is an independent risk factor for SLE patients to develop PAH (OR:7.822 (95% CI:2.224˜41.138)) (Table 1). Additionally, weak to moderate positive correlations were observed between Cyr61 concentration and serositis, haematological involvement, red blood cell distribution width, right ventricular systolic pressure and right ventricular diameter measured by echocardiography in entire SLE population.
Conclusions Plasma Cyr61 level was significantly higher in SLE-PAH patients than SLE patients without PAH. Cyr61 may be used as a biomarker for PAH complication in SLE patients.
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