Biomarkers of inflammation may be of use for identification of more severe peripheral arterial occlusive disease

Abstract

Background: Atherosclerosis is a multifactorial disease with an inflammatory pathophysiological basis. Cytokines released during the atherosclerotic process induce production of C-reactive protein (CRP) in the liver, which is an important marker of inflammation. Objective: We tested whether inflammatory biomarkers were associated with deterioration of peripheral arterial occlusive disease (PAOD) in a population at high cardiovascular risk. Methods: 1,330 subjects ≥30 years of age underwent clinical and laboratory examinations as part of a population-based study of the prevalence of diabetes. PAOD was defined as an ankle-brachial index (ABI) ≤0.90. After application of exclusion criteria, the sample comprised 1,038 subjects. Traditional risk factors, CRP and interleukin 6 (IL-6) were also compared across three ABI categories (≤0.70; 0.71-0.90; ≥0.90). Mean values for these variables were compared by presence/absence of DAOP (Student' s t test) and by ABI categories (ANOVA). Poisson regression and logistic regression models were used to test for associations between risk factors and DAOP and between risk factors and the ABI categories. Pearson' s linear correlation coefficients were calculated for the relationship between CRP and IL-6 levels. Results: Mean age was 56.8±12.9 years, 54% of the sample were women and the prevalence of DAOP was 21.0% (95%CI 18.4-24.1). Individuals with ABI ≤0.70 had higher concentrations of CRP-us (2.1 vs. 1.8) and of IL-6 (1.25 vs. 1.17). Concentrations of CRP and IL-6 were only correlated in patients with DAOP, (p=0.004). Conclusions: The finding that CRP and IL-6 levels were only elevated among people with advanced DAOP may suggest that these biomarkers have a role to play as indicators of more severe disease. Prospective studies are needed to test this hypothesis.

Influência dos fatores de risco para aterosclerose na distribuição anatômica da doença arterial periférica em pacientes com isquemia crônica crítica de membros: um estudo transversal

“…Estudos sugerem diferenças em alguns biomarcadores para aterosclerose nos distintos gêneros, apontando a proteína C reativa (PCR) como um fator relacionado à DAP em mulheres 20 . No Brasil, estudo transversal que incluiu mais de 1.000 participantes acima dos 30 anos encontrou maiores concentrações de PCR entre mulheres 21 . Os fatores de risco para aterosclerose também têm prevalência diferente entre os gêneros.…”

Citocinas en la salud del adulto mayor

“…Otras citocinas se ven aumentadas en el hombre con los mismos efectos. Algunas variaciones genotípicas de la IL-6 no son tan benevolentes con el adulto mayor, ya que se relacionan con mayor incidencia con cáncer de pulmón, fibrilación auricular (Li et al, 2012) y enfermedad arterial oclusiva periférica (Garofolo, Ferreira, y Miranda Junior, 2014). Por su parte, el TNF-α se liga con mayor deficiencia auditiva en adultos mayores, participando en la patogénesis de la respuesta inflamatoria inadecuada y en el desequilibrio entre la proliferación celular y apoptosis (Uchida Y. et al, 2014).…”