Relationships between galectin-3, sclerostin and arterial stiffness in children with renal scar

Renal scar can lead to hypertension and cardiovascular disease in children. Arterial stiffness is an important endpoint in the development of cardiovascular diseases and is a guide in the recognition of subclinical cardiovascular events. This study aimed to investigate oscillometric arterial stiffness data and sclerostin and galectin-3 levels in children with renal scar.

Patients aged 5-18 years with renal scar and controls were included. Arterial stiffness parameters were measured by oscillometric method. Sclerostin, galectin-3 and NGAL levels were determined by ELISA method.

108 patients and 66 controls were included. The patients had higher C-reactive protein (CRP) values and lower glomerular filtration rate (GFR) (p = 0.013, p = 0.005, respectively). Serum sclerostin levels, urine NGAL/creatinine (cr) and sclerostin/cr, galectin-3/cr, augmentation index, reflection magnitude and augmentation pressure were higher in patients (p = 0.026, p = 0.047, p = 0.000, p = 0.000, p = 0.013, p = 0.03, p = 0.02, respectively). Serum sclerostin was positively correlated with CRP and augmentation index (r = 0.22, p = 0.044; r = 0.355, p = 0.003, respectively). Urinary galectin-3/cr and NGAL/cr values were positively correlated with each other (r = 0.544, p = 0.000). Urinary galectin-3/cr was higher in patients with proteinuria than in those without proteinuria (p = 0.000). A ROC analysis showed that galectin-3/cr was predictive of proteinuria (area under the curve:0.726 ± 0.075, p = 0.048).

The detection of higher augmentation index and reflection magnitude in scarred patients might support the onset of subclinical atherosclerosis in these children. Higher serum sclerostin levels in scarred patients might be due to increased inflammation or arterial stiffness. Urinary galectin-3/cr could be used as tubular damage markers.