Interleukin-6, C-Reactive Protein and Fibrinogen : Novel Insights as Inflammatory Risk Factors in Atherosclerosis and Diabetes

Background/Objectives: Atherosclerosis and diabetes are largely recognized as inflammatory disorders and several inflammatory markers are used in clinical settings. Here we investigate the link of interleukin-6 (IL-6), C-Reactive Protein (CRP) and fibrinogen (FIB) with predisposing factors for atherosclerosis and diabetes; NT-pro-BNP, glycemia, insulin resistance, HDL and LDL respectively. Methods: the literature was collected using PubMed database. Results: CRP provides complementary information to NT-pro-BNP for high risk for major adverse cardiac events (MACE) in post-MI patients. CRP predicts cardiovascular and mortality in type 2 diabetic subjects. CRP binds to LDL triggering structural changes in HDL. CRP is also found in atheromatous plaque. IL-6 is a predictor of incident heart failure (HF) and IL-6 inhibition reduces HF hospitalization. IL-6 is related to a greater body mass index, NT–pro-BNP levels and insulin resistance. By blocking IL-6 may be a strategy for insulin resistance treatment. IL-6 levels correlate with endothelial dysfunction and carotid intima-media thickness, activating LDL-Receptor transcription. The FIB-to-albumin ratio in HF is positively correlated with NT-pro-BNP. Diabetic patients and insulin resistance condition could be related to hyperfibrinogenemia. The glycation level in the fibrinogen molecule is 2–3-fold higher in type 2 diabetic than in non-diabetic individuals, forming fibrin clots with enhanced resistance to fibrinolysis. Finally, because FIB is independently associated with the expression of a more atherogenic lipoprotein subfraction profile, it should be included in the assessment of coronary risk factors. Conclusions: CRP, IL-6 and FIB could be active players and potential targets for antiatherosclerotic and anti-diabetic therapies.