Elevated IL-6 levels have been reported in patients with unstable angina where inflammatory processes may facilitate the transition from the clinically stable to unstable atherosclerotic plaques. 3 4 5 6 Whether these molecules play a causative role, or simply act as markers of the acute phase reaction, is debatable. Several studies have shown that elevated plasma levels of fibrinogen, C-reactive protein (CRP), and interleukin-6 (IL-6) are associated with the risk of CHD and the severity of atherosclerosis. Inflammatory processes have important roles in the etiology of coronary heart disease (CHD), 1 2 but the mechanisms underlying this relationship are poorly understood. Moreover, our data support the concept that such a low-level, chronic inflammatory state may induce insulin resistance and endothelial dysfunction and thus link the latter phenomena with obesity and cardiovascular disease. These data suggest that adipose tissue is an important determinant of a low level, chronic inflammatory state as reflected by levels of interleukin-6, tumor necrosis factor-α, and C-reactive protein, and that infection with H pylori, C pneumoniae, and cytomegalovirus is not.
A mean standard deviation score of levels of acute phase markers correlated closely with a similar score of insulin resistance syndrome variables ( r=0.59, P<0.00005), this relationship being weakened only marginally by removing measures of obesity from the insulin resistance score ( r=0.53, P<0.00005). (2) Concentrations of C-reactive protein were related to insulin resistance as calculated from the homoeostasis model assessment model, blood pressure, HDL, and triglyceride, and to markers of endothelial dysfunction (plasma levels of von Willebrand factor, tissue plasminogen activator, and cellular fibronectin). Levels of C-reactive protein were significantly related to those of interleukin-6 ( r=0.37, P<0.0005) and tumor necrosis factor-α ( r=0.46, P<0.0001). We performed a cross-sectional study in 107 nondiabetic subjects: (1) Levels of C-reactive protein, and concentrations of the proinflammatory cytokines interleukin-6 and tumor necrosis factor-α, were related to all measures of obesity, but titers of antibodies to Helicobacter pylori were only weakly and those of Chlamydia pneumoniae and cytomegalovirus were not significantly correlated with levels of these molecules. We have also related levels of C-reactive protein and interleukin-6 to markers of the insulin resistance syndrome and of endothelial dysfunction. In this study we have sought associations of levels of C-reactive protein and interleukin-6 with measures of obesity and of chronic infection as their putative determinants. We have shown that subcutaneous adipose tissue secretes interleukin-6 in vivo. Customer Service and Ordering InformationĪbstract-C-reactive protein, a hepatic acute phase protein largely regulated by circulating levels of interleukin-6, predicts coronary heart disease incidence in healthy subjects.Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.
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