Systemic lupus erythematosus in a multiethnic US Cohort (LUMINA). XXX: association between C-reactive protein (CRP) gene polymorphisms and vascular events

Abstract

Objectives. To determine if a polymorphic GTⁿ repeat in the intron of the C-reactive protein (CRP) gene associates with occurrence of vascular arterial events in systemic lupus erythematosus (SLE). Methods. We performed a nested case–control study on the LUMINA cohort of 546 Hispanic, African-American and Caucasian SLE patients. Twenty-five patients who developed vascular arterial events (i.e. myocardial infarction, angina, coronary artery bypass graft surgery, stroke, claudication, gangrene or significant tissue loss and/or arterial peripheral thrombosis) after enrolment were selected as cases and 32 ethnically matched patients with no previous vascular arterial events served as controls. Their CRP gene GTⁿ polymorphism and plasma CRP was determined. Results. Patients with vascular events had more severe SLE and were more likely to have plasma CRP in the highest quintile of measured values. The overall distribution of GTⁿ alleles for patients with vascular events had a greater number of the GT²⁰ variant compared with controls [26.0% of alleles (13/50) vs 15.6% (10/64)]. This greater number of GT²⁰ in patients with vascular events was observed for African-Americans [29.2% (7/24) vs 21.0% (8/38)] and Hispanics [33.0% (4/12) vs 0% (0/16)] but not for Caucasians [14.3% (2/14) vs 20.0% (2/10)]. For African-Americans and Hispanics combined (45 patients), the frequency of GT²⁰ in those with vascular events (30.6%, 11/36) was significantly higher than in those without them (14.8%, 8/54) (P20 alleles they carried (thus GT²⁰/GT²⁰, GT²⁰/GT^x or GT^x/GT^x, where x is any allele other than GT²⁰), for both African-Americans and Hispanics the likelihood of vascular arterial events increased in proportion with the GT²⁰ dose, and all GT²⁰-homozygous patients developed vascular arterial events. Conclusions. The CRP GT²⁰ variant is more likely to occur in African-American and Hispanic SLE patients than in Caucasian ones, and SLE patients carrying the GT²⁰ allele are more likely to develop vascular arterial events.