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Increased acute phase reactants are associated with levels of lipoproteins and increased carotid plaque volume
M L Grønholdt1, H Sillesen, B M Wiebe
1Department of Vascular Surgery, RK 3112, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark.
Objectives:
to test the hypotheses that increased acute phase reactants predict elevated levels of lipoproteins and increased plaque volume as well as echolucency of carotid plaques.
Materials And Methods:
the study included 258 patients with >or =50% carotid artery stenosis. Acute phase reactants (orosomucoid, C-reactive protein (CRP)) were measured in the fasting state, and ultracentrifugated lipoproteins before and after a standardised fat load test. Echogenicity of carotid plaques was detected using high-resolution B-mode ultrasound and computer-assisted image processing. A subgroup of 81 patients underwent carotid endarterectomy.
Results:
on linear regression analysis orosomucoid levels were positively associated with fasting and postprandial levels of all triglyceride-rich lipoproteins, and negatively associated with HDL cholesterol (p -values <0.0001); results for CRP were less pronounced. Orosomucoid and CRP both predicted the presence of an increased carotid plaque volume on univariate analysis (p =0.01 and p =0.02). Finally, orosomucoid was negatively associated with echolucency of carotid plaques ( p =0.05).
Conclusions:
elevated levels of acute phase reactants are strongly associated with elevated levels of triglyceride-rich lipoproteins, increased plaque volume, and borderline significantly associated with echolucency of carotid plaques. Elevated acute phase reactants possibly predict severity of atherosclerosis, and presence of lipid-rich, rupture-prone plaques.
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