Article Text

PDF
SAT0234 Study of The Role of IL-6 in The Development of Atherosclerosis in Patients with Systemic Sclerosis
  1. J.J. Alegre Sancho1,
  2. M. Robustillo Villarino1,
  3. G. Albert Espí1,
  4. C. Vergara Dangond1,
  5. E. Vicens Bernabeu1,
  6. D. Ybáñez García1,
  7. È. Valls Pascual1,
  8. À. Martínez-Ferrer1,
  9. J.A. Román Ivorra2
  1. 1Rheumatology Department, Hospital Universitari Dr. Peset
  2. 2Rheumatology Department, Hospital Universitari i Politècnic la Fe, Valencia, Spain

Abstract

Background IL-6 is one of the cytokines with greater presence in Systemic Sclerosis (SSc) and also one of the key cytokines in the development of atherosclerosis (AS). A recent study (Schiopu E, et al. Rheumatology 2014;53:704–713) has shown a relationship between IL-6 and carotid AS. However, the number of patients was scarce, the results were not confirmed in a multivariate analysis and whether these results are replicable in different populations in different geographical areas has not been tested.

Objectives To assess the relation between plasma IL-6 and AS findings (carotid ultrasound, ankle-brachial index [ABI] and arterial pressure difference between arms) in patients with SSc.

Methods Transverse descriptive study with analytical components. Study population: a cohort of 115 patients with SSc controlled in the Rheumatology Department of a tertiary hospital. Variables: 1) clinical variables; 2) determination of serum IL-6 (IMMULITE 2000; Siemens Healthcare Diagnostics, UK); 4) vascular study: ABI and carotid doppler ultrasound (ESAOTE MyLab XV70, 7–12 MHz linear transducer, software RFQIMT) measuring intima-media thickness (IMT) and presence of atheroma plaques (Mannheim Consensus). A vascular surgeon measured ABI, and the doppler ultrasound was done by a highly experienced rheumatologist, blind to the rest of findings, in a term of 3 months. Statistical analysis: IBM-SPSS Statistics v22.0 package.

Results 115 patients where included consecutively, of which finally 108 were studied; with a mean age of 60,16 years (SD ±15.16); 99 women (91.7%) and 9 men (8.3%). Mean SSc evolution time was 11.45 years (SD ±8.84). LSSc was most frequently diagnosed (50%), followed by SSc without scleroderma (18.5%) and, decreasingly, DSSc (16.7%), overlap syndrome (9.3%) and pre-SSc (5.6%). 38.9% of patients were hypertensive, 46.3% suffered a DL and 6.3% were diabetic. Mean concentrations of serum IL-6 were 4.34 pg/mL (SD ± 5). Mean right IMT was 0.579 mm (SD ± 0.126), and left 0.657 mm (SD ±0.158); 33.3% had atheroma plaque. In total, 37% had a pathological carotid ultrasound and 39.8% macrovascular damage (atheroma plaque and/or IMT>0.9 mm and/or ABI<0.9).

In the bivariate analysis, serum IL-6 was associated to the IMT as well as the presence of atheroma plaque (p-value = 0.002).This association was maintained when jointly considering an ABI<0.9 (p-value = 0.003). Serum IL-6 was also related to the difference in systolic arterial pressure between both arms (r-Pearson =0.236; p-value = 0.022). In the multivariate analysis, the number of atheroma plaques and the macrovascular damage variable maintained statistical significance in the different models.

Conclusions Serum IL-6 concentrations are independently related to the presence of AS and macrovascular disease in patients with SSc. Blocking the action of IL-6 by means of specific therapies could be a therapeutic option which could reduce macrovascular damage in patients with SSc.

Disclosure of Interest None declared

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.