Abstract

Objective. Monocyte chemoattractant protein-1 (MCP-1/CCL2) is a chemokine involved into the pathogenesis of atherosclerosis, and bears a 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 (age: 61±12 ys, BMI: 30.1±6.6 kg/m², 15% with T2DM and 12% with impaired glucose tolerance) of a population survey carried out in 1990-1991 in Lombardy, Italy (Cremona Study), and cardiovascular (CVD) mortality was assessed in 2006 through Regional Health Registry files.

Results. At baseline MCP-1/CCL2 was increased in T2DM (P<0.05) and showed significant correlations with biochemical risk markers of atherosclerosis. After 15 years, among the 363 subjects 82 deaths occurred 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 and 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 C-reactive protein (CRP) was 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.