Association Between Plasma Monocyte Chemoattractant Protein-1 Concentration and Cardiovascular Disease Mortality in Middle-Aged Diabetic and Nondiabetic Individuals
- Lorenzo Piemonti, MD1,
- Giliola Calori, MD2,
- Guido Lattuada, PHD3,
- Alessia Mercalli, PHD1,
- Francesca Ragogna, PHD3,
- Maria Paola Garancini, MD4,
- Giacomo Ruotolo, MD2,5,
- Livio Luzi, MD1,3,6 and
- Gianluca Perseghin, MD1,3,6
- 1Diabetes Research Institute, Istituto Scientifico H San Raffaele, Milan, Italy;
- 2Cardiovascular Department, Istituto Scientifico H San Raffaele, Milan, Italy;
- 3Nutrition/Metabolism, Istituto Scientifico H San Raffaele, Milan, Italy;
- 4Medical Direction, Istituto Scientifico H San Raffaele, Milan, Italy;
- 5AstraZeneca R&D, Molndal, Sweden;
- 6Department of Sport, Nutrition and Health, Università degli Studi di Milano, Milan, Italy.
- Corresponding author: Gianluca Perseghin, perseghin.gianluca{at}hsr.it.
Abstract
OBJECTIVE Monocyte chemoattractant protein-1 (MCP-1/CCL2) is a chemokine involved into the pathogenesis of atherosclerosis and has prognostic value in the acute and chronic phases in patients with acute coronary syndromes.
RESEARCH DESIGN AND METHODS MCP-1/CCL2 concentration was measured in plasma fractions of 363 middle-aged overweight/obese individuals (aged 61 ± 12 years, BMI 30.1 ± 6.6 kg/m2, 15% with type 2 diabetes, and 12% with impaired glucose tolerance) of a population survey carried out in 1990–1991 in Lombardy, Italy (Cremona Study), and cardiovascular disease (CVD) mortality was assessed in 2006 through Regional Health Registry files.
RESULTS At baseline MCP-1/CCL2 was increased in individuals with type 2 diabetes (P < 0.05) and showed significant correlations with biochemical risk markers of atherosclerosis. After 15 years, among the 363 subjects, there were 82 deaths due to CVD. In univariate analysis age, sex, fasting glucose and insulin, fibrinogen, glucose tolerance status, smoking habit, and MCP-1/CCL2 were associated with CVD mortality. Age, sex, fasting serum glucose, MCP-1/CCL2, and smoking habit maintained an independent association with CVD mortality in multiple regression analysis. In a subgroup of 113 subjects in whom data for C-reactive protein (CRP) were available, its level was not predictive of CVD mortality.
CONCLUSIONS In middle-aged overweight/obese individuals MCP-1/CCL2 was independently associated with CVD mortality. Further studies will be necessary to establish its role as a surrogate biomarker and as a potential therapeutic target.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received April 23, 2009.
- Accepted July 12, 2009.
- © 2009 by the American Diabetes Association.
