Increased acute phase reactants are associated with levels of lipoproteins and increased carotid plaque volume

Objectives: to test the hypotheses that increased acute phase reactants pl predict elevated levels of lipoproteins and increased plaque volume as well as echolucency of carotid plaques. Materials and Methods: the study included 258 patients with greater than or equal to 50% carotid artery stenosis. Acute phase reactants (orosomucoid, C-reactive protein (CRP)) were measured in the fasting state, and ultracentrifugated lipoproteins before and after a standardised fat load test. Echogenicity of carotid plaques was detected using high-resolution B-mode ultrasound and computer-assisted image processing. A subgroup of 81 patients underwent carotid endarterectomy. Results: on linear regression analysis orosomucoid levels were positively associated with fasting and postprandial levels of all triglyceride-rich lipoproteins, and negatively associated with HDL cholesterol (p-values <0.001); results for CRP were less pronounced. Orosomucoid and CRP both predicted the presence of an increased carotid plaque volume on univariate analysis (p = 0.01 and p = 0.02). Finally, orosomucoid was negatively associated with echolucency of carotid plaques ( p = 0.05). Conclusions: elevated levels of acute phase reactants are strongly associated with elevated levels of triglyceride-rich lipoproteins, increased plaque volume, and borderline significantly associated with echolucency of carotid plaques. Elevated acute phase reactants possibly predict severity of atherosclerosis, and presence of lipid-rich, rupture-prone plaques.