Published Online
on January 29, 2004

A more recent version of this article appeared on March 1, 2004

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Submitted on October 15, 2003
Accepted on November 19, 2003

Higher Levels of Interleukin-6 Are Associated With Lower Echogenicity of Carotid Artery Plaques

Hiroshi Yamagami MD^*; Kazuo Kitagawa MD, PhD; Yoji Nagai MD, PhD; Hidetaka Hougaku MD, PhD; Manabu Sakaguchi MD; Keisuke Kuwabara MD, PhD; Kimito Kondo MD; Tohru Masuyama MD, PhD; Masayasu Matsumoto MD, PhD; and Masatsugu Hori MD, PhD

From the Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, Suita (H.Y., K. Kitagawa, Y.N., H.H., K. Kondo, T.M., M.H.); Department of Neurology, Kobe City General Hospital, Kobe (M.S.); Nishizawa Medical Office, Osaka (K. Kuwabara); and Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Science, Hiroshima (M.M.), Japan.

^* To whom correspondence should be addressed. E-mail: yamagami{at}medone.med.osaka-u.ac.jp.

Background and Purpose--Echo-lucent carotid plaques can be fragile and vulnerable to rupture, representing a risk factor for ischemic stroke. Given the studies showing that elevated levels of circulating inflammatory markers are predictive of cardiovascular events, we sought to determine whether higher levels of serum interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) are associated with lower echogenicity of carotid plaques.

Methods--The study comprised 246 patients who had carotid atherosclerotic plaques as evidenced by ultrasound. Using acoustic densitometry, we quantified the echogenicity of the largest plaque in each patient by integrated backscatter analysis. Serum IL-6 and hsCRP levels were determined in all patients.

Results--Both log-transformed IL-6 and hsCRP concentrations were negatively correlated with carotid plaque echogenicity (r=-0.28, P<0.001, and r=-0.14, P<0.05, respectively). When traditional atherosclerotic risk factors, plaque thickness, and medication use were controlled for, IL-6 levels were inversely associated with plaque echogenicity (=-0.21, P<0.01), whereas such an association was of borderline significance for hsCRP (=-0.12, P=0.06).

Conclusions--Higher IL-6 levels, in addition to hsCRP levels, appear to be associated with lower echogenicity of carotid plaques, suggesting a link between inflammation and potential risk of plaques.

Key words: atherosclerosis • carotid arteries • inflammation • interleukins • ultrasonography

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