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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Editorial Board Member: Gillery, Philippe / Kazmierczak, Steven / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Whitfield, John B.

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Clinical implication of plasma neutrophil gelatinase-associated lipocalin (NGAL) concentrations in patients with advanced carotid atherosclerosis

Constantinos Giaginis1 / Athina Zira1 / Athanasios Katsargyris2 / Chris Klonaris2 / Stamatios Theocharis1

1Department of Forensic Medicine and Toxicology, Medical School, University of Athens, Athens, Greece

2First Department of Surgery, Laikon Hospital, Medical School, University of Athens, Athens, Greece

Corresponding author: Stamatios Theocharis, MD, PhD, Assistant Professor of Forensic Medicine and Toxicology, University of Athens, Medical School, 75, M. Asias street, Goudi, Athens, 11527, Greece Phone: +30 210 7462413, Fax: +30 210 7716098,

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 48, Issue 7, Pages 1035–1041, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2010.211, April 2010

Publication History

Published Online:


Background: Neutrophil gelatinase-associated lipocalin (NGAL) is well established as an early and specific biomarker of kidney disease. Recent evidence further suggests that NGAL may play a crucial role in vascular remodeling and plaque instability during the development of atherosclerosis.

Methods: Plasma NGAL concentrations measured using a solid-phase enzyme-linked immunosorbent assay (ELISA) were correlated with medical history, risk factors and medication intake in 141 patients with advanced carotid atherosclerotic lesions who underwent carotid endarterectomy for vascular repair.

Results: Plasma NGAL concentrations were associated with patient age (Rs=0.2055, p=0.0144), plasma homocysteine (Rs=0.4274, p<0.00001) and serum creatinine (Rs=0.4640, p<0.00001) concentrations and estimated glomerular filtration rate (eGFR) (Rs=−0.4911, p<0.00001). Hypertensive patients, as well as those receiving therapy with angiotensin converting enzyme (ACE) inhibitors, presented with significantly enhanced plasma NGAL concentrations when compared to normotensive (p=0.0341) patients and those not treated (p=0.0004). Enhanced NGAL concentrations did not meet statistical significance for patients with advanced stenosis grade (p=0.0971) or a history of peripheral artery disease (p=0.0827). Multiple regression analysis identified homocysteine, creatinine, eGFR and treatment with ACE inhibitors (p=0.0019, <0.00001, 0.0005 and 0.0219, respectively) as independent predictors of NGAL concentration.

Conclusions: Plasma NGAL concentrations were associated with patient age, hypertension, eGFR, creatinine and homocysteine concentrations and therapy with ACE inhibitors. The role of NGAL in the development of atherosclerosis needs to be further explored taking into consideration the uncontrolled effect of renal disease in atherosclerotic patients with multiple risk factors.

Clin Chem Lab Med 2010;48:1035–41.

Keywords: atherosclerosis; carotid; medical history; NGAL; risk factors

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