Galectin-3 (Gal-3) is a biomarker associated with fibrosis and vascular inflammation and has been linked to chronic kidney disease (CKD) and peripheral artery disease (PAD), though its relevance in the latter is unclear. Martin Ursli, MD, and colleagues examined serum and urinary Gal-3 and found an association with long-term mortality and severity of peripheral artery disease symptoms in patients.
Their report, published in Atherosclerosis, noted that “Gal-3 was not predictive of long-term mortality but seems to be a marker of PAD severity in patients without critical limb ischemia.”
The investigators measured the levels of Gal-3 in 577 samples (311 serum and 266 urine) from patients with PAD using bead-based multiplex assay. Urinary Gal-3 concentrations were normalized to urine creatinine (cr) levels. The median follow-up duration was 9.2 years.
Regarding PAD symptoms, the authors reported that serum Gal-3 was higher in patients with claudication symptoms (p = 0.001), and also displayed an inverse correlation with the patients’ ankle-brachial index (ratio [R] = –0.168, p = 0.009). Additionally, both serum Gal-3 and urinary Gal-3 (uGal-3/cr) were associated with estimated glomerular filtration rate (R = –0.359, p <0.001; R = –0.285, p <0.001). While Serum Gal-3 was not correlated to all-cause mortality (hazard ratio [HR] = 1.17; 95% confidence interval [CI], 0.96–1.42), uGal-3/cr was associated with all-cause mortality (HR = 1.60; 95% CI, 1.31–1.95). The researchers added that this association persisted through their adjustments for risk factors and renal function (HR = 1.71; 95% CI, 1.35–2.17).
According to the authors, this is the first study to show an association between urinary Gal-3 and long-term mortality and severity of PAD symptoms in patients with PAD without critical limb ischemia.