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Association between interleukin-6 and carotid atherosclerosis in hemodialysis patients
Akihiko Kato1, Mari Odamaki, Takako Takita
1First Department of Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192 Japan. akato@hama-med.ac.jp
Insights
Interleukin-6 (IL-6) is elevated in hemodialysis patients and linked to atherosclerosis. Higher IL-6 levels correlate with increased carotid intima-media thickness and area, suggesting a role in cardiovascular complications.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Immunology
Background:
- Interleukin-6 (IL-6) is implicated in cardiovascular disease.
- Hemodialysis (HD) patients exhibit elevated IL-6, but its role in atherosclerosis is unclear.
Purpose of the Study:
- To investigate the association between circulating IL-6 and carotid atherosclerosis in HD patients.
- To explore the relationship between IL-6, Chlamydia pneumoniae antibodies, and atherosclerotic markers.
Main Methods:
- Cross-sectional study of 156 HD patients.
- Measured serum IL-6, anti-Chlamydia IgG/IgA titers, and carotid intima-media thickness (IMT) and area (IMarea) via ultrasonography.
Main Results:
- HD patients had significantly higher IL-6 than controls.
- IL-6 levels positively correlated with IMT and IMarea.
- IL-6 predicted IMT and IMarea, and correlated with anti-Chlamydia antibody titers.
Conclusions:
- IL-6 is associated with carotid atherosclerosis severity in HD patients.
- Chronic chlamydial infection may contribute to carotid plaque progression in dialysis patients.
Background:
Interleukin-6 (IL-6) is associated with cardiovascular complications in general subjects. Although blood IL-6 is greatly elevated in hemodialysis (HD) patients, the role of IL-6 in the advance of atherosclerosis remains to be determined.
Methods:
We conducted a cross-sectional study to investigate the relationship between circulating IL-6 and carotid atherosclerotic changes in 156 HD patients (age 58 +/- 1 years; time on HD treatment 13 +/- 1 years; 97 males and 59 females). Serum IL-6, IgG and IgA titers of Chlamydia pneumoniae antibodies, the intima-media thickness (IMT) and the cross-sectional intima-media area (IMarea) of the carotid arteries were measured by ultrasonography in each patient.
Results:
Serum IL-6 levels were significantly higher in HD patients (2.04 +/- 0.16 pg/mL) compared to normal age-matched control subjects (0.31 +/- 0.06 pg/mL, N = 24). Circulating log IL-6 levels were positively correlated with IMT (r = 0.278, P < 0.01) and IMarea (r = 0.344, P < 0.01), respectively. A stepwise multiple regression analysis revealed that IL-6 became significant predictors for IMT and IMarea but not for aortic wall calcification at L2/3 vertebrae. Serum log IL-6 was significantly correlated with IgG (r = 0.277, P < 0.01) and IgA titers of anti-Chlamydia antibodies (r = 0.192, P < 0.02). Serum IgA anti-Chlamydia titers were also correlated with the maximal diameter of carotid plaque (r = 0.293, P < 0.04).
Conclusions:
These findings suggested that IL-6 is associated with the severity of carotid atherosclerosis in HD patients. Persistent chronic chlamydial infection may be related, in part, to the advance of carotid plaque enlargement in dialysis patients.