title: Serum calprotectin is a biomarker of carotid atherosclerosis in patients with primary Sjögren's syndrome.
abstract: OBJECTIVE
  We aimed to identify the association of carotid atherosclerosis with the traditional risk factors, disease features, cytokine profile, and calprotectin in patients with primary Sjögren's syndrome (pSS).
  
  
  METHODS
  63 primary pSS patients and 63 age- and sex-matched healthy controls underwent carotid ultrasound, clinical and laboratory examination. The presence of carotid plaques was taken as carotid atherosclerosis. The covariates of carotid atherosclerosis were identified in univariate and multivariate regressions.
  
  
  RESULTS
  Patients with pSS had higher prevalence of carotid atherosclerosis (13% vs. 2%, p<0.05) and higher serum levels of calprotectin, tumour necrosis factor receptor 2 (TNF-R2), hepatocyte growth factor (HGF), and monocyte chemoattractant protein-1 (MCP-1) than controls. Sex, menopause, and the prevalence of traditional cardiovascular did not differ between groups (all p>0.05). In univariate analyses, serum calprotectin, most traditional cardiovascular (age, male sex, metabolic syndrome, hypertension, hypertriglyceridaemia, and serum creatinine), and some disease-associated risk factors (glucocorticoid or saliva substitute use, constitutional domain of Eular-Sjögren's syndrome disease activity index - EULAR) were associated with a higher risk for plaque. In a multivariate analysis, having pSS and higher serum calprotectin were associated with carotid atherosclerosis independent of traditional risk factors.
  
  
  CONCLUSIONS
  pSS have a higher prevalence of carotid atherosclerosis, which is associated with higher serum calprotectin level independent of traditional cardiovascular risk factors. Our findings suggest calprotectin as a biomarker of subclinical atherosclerosis in pSS.
authors.affiliation: The Center of Health Science, Federal University of Espírito Santo (UFES), Brazil.
authors.forename: Gabriela M
authors.initials: GM
authors.lastname: Balarini
authors.affiliation: Department of Statistics, Federal University of Espírito Santo (UFES), Brazil.
authors.forename: Eliana
authors.initials: E
authors.lastname: Zandonade
authors.affiliation: Department of Locomotor System, Federal University of Minas Gerais, Brazil.
authors.forename: Leandro
authors.initials: L
authors.lastname: Tanure
authors.affiliation: Department of Locomotor System, Federal University of Minas Gerais, Brazil.
authors.forename: Gilda A
authors.initials: GA
authors.lastname: Ferreira
authors.affiliation: The Center of Health Science, Federal University of Espírito Santo (UFES), Brazil.
authors.forename: Wildner M
authors.initials: WM
authors.lastname: Sardenberg
authors.affiliation: The Center of Health Science, Federal University of Espírito Santo (UFES), Brazil.
authors.forename: Érica V
authors.initials: ÉV
authors.lastname: Serrano
authors.affiliation: The Center of Health Science, Federal University of Espírito Santo (UFES), Brazil.
authors.forename: Cleia C
authors.initials: CC
authors.lastname: Dias
authors.affiliation: Department of Locomotor System, Federal University of Minas Gerais, Brazil.
authors.forename: Túlio P
authors.initials: TP
authors.lastname: Navarro
authors.affiliation: Broegelmann Research Laboratory, University of Bergen, Norway.
authors.forename: Hilde H
authors.initials: HH
authors.lastname: Nordal
authors.affiliation: Broegelmann Research Laboratory; and Department of Clinical Science, University of Bergen, Norway.
authors.forename: Piotr M
authors.initials: PM
authors.lastname: Mydel
authors.affiliation: Broegelmann Research Laboratory; and Department of Clinical Science, University of Bergen, Norway.
authors.forename: Johan G
authors.initials: JG
authors.lastname: Brun
authors.affiliation: Bröegelmann Research Laboratory, University of Bergen, Norway.
authors.forename: Karl A
authors.initials: KA
authors.lastname: Brokstad
authors.affiliation: Department of Clinical Science, University of Bergen, Norway.
authors.forename: Eva
authors.initials: E
authors.lastname: Gerdts
authors.affiliation: Broegelmann Research Laboratory; and Department of Clinical Science, University of Bergen, Norway.
authors.forename: Roland
authors.initials: R
authors.lastname: Jonsson
authors.affiliation: The Center of Health Science, Federal University of Espírito Santo (UFES), Brazil; and Broegelmann Research Laboratory, University of Bergen, Norway. val.valim@gmail.com.
authors.forename: Valéria
authors.initials: V
authors.lastname: Valim
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D002340:Carotid Artery Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D018932:Chemokine CCL2 / Q000097:blood; D005260:Female; D017228:Hepatocyte Growth Factor / Q000097:blood; D006801:Humans; D039841:Leukocyte L1 Antigen Complex / Q000097:blood*; D008297:Male; D008875:Middle Aged; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000097:blood; D012720:Severity of Illness Index; D012859:Sjogren's Syndrome / Q000097:blood / Q000150:complications*
chemical_list: D015415:Biomarkers; D018932:Chemokine CCL2; D039841:Leukocyte L1 Antigen Complex; D047889:Receptors, Tumor Necrosis Factor, Type II; D017228:Hepatocyte Growth Factor