Elevated Nuclear Factor Kappa B1 Gene expression and Dysregulated Metabolic Profiles in Coronary Artery Disease: A Case - Control Study

Objectives: Coronary artery disease (CAD) remains a significant public health challenge globally, with South Asians, particularly in regions like Kerala, India, experiencing disproportionately high incidence and severity. While epidemiological data from Kerala are available, there is limited insight into this population’s molecular and metabolic alterations underpinning CAD. This study aimed to evaluate the expression of a genetic marker, specifically nuclear factor kappa-light-chain-enhancer of activated B-cells 1 (NF-kB1), and its association with metabolic dysregulation in CAD subjects. Materials and Methods: A case–control study involving a total of 300 participants-CAD subjects ( n = 150) and healthy controls ( n = 150) was conducted. NF-κB1 gene expression was quantified through real-time polymerase chain reaction, and serum tumor necrosis factor-alpha (TNF-a) levels were assessed using enzyme-linked immunosorbent assay. Fasting glucose and lipid profiles were also measured. Statistical analyses included group comparisons, correlation studies, and receiver operating characteristic (ROC) analysis. Results: CAD patients exhibited significantly elevated NF-κB1 gene expression (1.6 ± 0.6 vs. 1.0 ± 0.2; P < 0.001), TNF-a levels, fasting glucose, triglycerides, and low-density lipoprotein-cholesterol (LDL-C), alongside significantly lower high-density lipoprotein-cholesterol (HDL-C). NF-kB1 expression showed positive correlations with glucose, triglycerides, LDL-C, and TNF-a and a negative correlation with HDL-C. ROC analysis revealed that NF-kB1 had the highest diagnostic accuracy among all markers studied. Conclusion: Our findings reveal a strong link between NF-kB1-mediated inflammation and metabolic dysregulation in CAD. NF-kB1 may be a promising biomarker for early detection and risk stratification, particularly in high-risk South Asian populations. This study provides region-specific molecular insights that could inform targeted prevention and management strategies for CAD in Kerala.