The role of DHEAS and interlukin-6 in atherosclerosis

الملخص EN

Background : Inflammatory phenomenon at sites of atherosclerotic plaques is increasingly thought to be a major determinant of the progression and clinical outcome of atherosclerotic disease.

Interleukin-6 (JL-6), one of the major mediators of inflammation, plays a central role in inflammation and tissue injury.

Dehydroepiandrosterone (DHEA) and its sulphated ester DHEAS are the most abundant circulating adrenal steroids.

High DHEA and DHEAS levels have been suggested to be protective for cardiovascular disease.

Objective: The aim of this work is to evaluate of the role of DHEAS and IL-6 inpatients with clinical manifestations of atherosclerosis and to assess interrelationship between immunosenescence and endocrinosenescence in the pathogenesis of this common disease which carries high morbidity.

Study Design: The study was conducted in Ain Shams University hospital on 85 atherosclerotic patients with various clinical presentations and 15 healthy subjects as control group.

They were divided into 5 groups : 20 patients with acute cerebrovascular stroke (CVS), 20 patients with old CVS, 15 patients with acute myocardial infarction (AMI), 30 patients with old MI and 15 control subjects.

All subjects were subjected to the following: ECG, carotid duplex, CT brain to patients with CVS, total cholesterol (TC), LDLc, HDLc and TG, highly sensitive C-reactive protein by ELISA, IL-6 by ELISA and DHEAS by radioimmunoassay.

Results: In the present study CRP is clearly increased in atherosclerotic disease of the coronary and cerebral arteries.

Tfiere is highly significant increase of log CRP inpatients with acute CVS (1.18 + 0.54), old CVS (1.01 ± 0.33), AMI (1.2*0.52) and old MI(1.1±0.43) compared to controls (0.3 ± 0.1, p = 0.0001).

log CRP is positively correlated to carotid IMT in patients with MI whether acute (r = 0.8, p = 0.0001) or old (r = 0.5, p = 0.001).

log IL-6 showed highly significant increase in patients with acute CVS, old CVS, acute MI and old MI (1.34 ± 0.22, 1.66 ± 0.32, 1.35 ± 0.24, 1.63 ± 0.3, respectively) compared to controls (0.8 ± 0.2, p=0.0001 for all).

There is highly significant decrease of log DHEA-S in patients with acute CVS (1.86 + 0.55), old CVS (1.96+0.48), and old Ml (1.94 + 0.48), compared to controls (2.5+0.2, p = 0.0001)).

Conclusions : Increased levels of IL-6 and CRP present an inflammatory sign of atherosclerotic disease.

CRP is a significant independent predictor of atherosclerosis.

Levels of DHEA-S are decreased in most of the atherosclerotic patients.