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Abstract
AimIn patients with Takayasu's arteritis (TA), current biomarkers that properly reflect the progression of the vascular structure remain absent. We aimed to determine the serum leptin level to investigate its relationship with imaging changes and assess its value as a predictor for long‐term radiological progression.MethodThis study included 34 untreated TA patients and 40 age‐matched healthy controls. At baseline and during the 5‐year follow‐up, we assessed disease activity using Kerr's criteria and Indian Takayasu Clinical Activity Score (ITAS2010) and monitored laboratory biomarkers as well as imaging findings. Serum leptin levels were measured by enzyme‐linked immunosorbent assay.ResultsThe baseline serum leptin levels were significantly higher in TA patients than in healthy controls. Leptin was significantly positively correlated with triglyceride and high‐density lipoprotein cholesterol levels and negatively correlated with fibrinogen and C‐reactive protein levels. Patients were subdivided into three groups based on their baseline leptin level. During a 5‐year follow‐up, patients in the high and medium leptin groups showed more radiological progression compared to those in the low leptin group. Cox proportional hazard regression analysis showed that a high serum leptin level was a positive predictor of radiological progression.ConclusionLeptin is a potential biomarker for assessing TA structural progression. Untreated patients with elevated serum leptin levels are at a higher risk of progression in the aorta. Thus, the leptin level can be a predictor of long‐term radiological progression.
Highlights
Takayasu arteritis (TA) is an autoimmune disease characterized by granulomatous inflammation of the all three layers of the aorta and its branches
Disease activity is a major concern in clinical practice and is assessed using inflammatory biomarkers such as erythrocyte sedimentation rate (ESR) and serum C‐reactive protein (CRP), as well as Kerr Criteria established by National Institutes of Health in 1994 and Indian Takayasu Clinical Activity Score (ITAS2010).[1]
Univariate Cox proportional hazard regression analysis showed that high and medium leptin levels were both positive predictors of radiological progression (HR, 10.960 and 7.092; 95% confidence intervals (95% CIs), 1.195‐100.917 and 0.813‐61.858; P = .034 and P = .076, respectively)
Summary
Takayasu arteritis (TA) is an autoimmune disease characterized by granulomatous inflammation of the all three layers of the aorta and its branches. Occlusion, lumen dilation, and vessel wall thickening are substantial characteristics of vessel damage. Disease activity is a major concern in clinical practice and is assessed using inflammatory biomarkers such as erythrocyte sedimentation rate (ESR) and serum C‐reactive protein (CRP), as well as Kerr Criteria established by National Institutes of Health in 1994 and Indian Takayasu Clinical Activity Score (ITAS2010).[1]. Vessel wall structure is currently examined by non‐invasive imaging methods, such as magnetic resonance angiography (MRA), computed tomographic angiography (CTA), color Doppler ultrasound (CDU), and positron emission tomography‐CT (PET‐CT).[2-5]. MRA merits preference in the assessment of vessel damage progression because it affords the unique advantage of real‐time angiography in TA. Biomarkers that can predict radiological progression of TA remain to be elucidated
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