Obesity-Related Serum Monocyte Chemoattractant Protein-1 (MCP-1) as a Biomarker of Plaque Instability in Patients Undergoing Carotid Endarterectomy

Atherosclerosis is a major contributor to ischemic stroke. Carotid plaque instability is a critical determinant of cerebrovascular events, yet its identification remains challenging. One chemokine with well-documented proatherogenic properties is MCP-1, whose levels are elevated in patients with conditions such as hypertension, obesity, and atherosclerosis. This study evaluated the association between obesity, serum MCP-1 levels, and carotid plaque instability as determined by ultrasound gray-scale median (GSM) analysis in 77 patients who underwent carotid endarterectomy. Patients were classified by body mass index. Serum MCP-1 concentrations were measured using the enzyme-linked immunosorbent assay technique. Analyses were performed to explore relationships between clinical parameters, biochemical markers, and plaque stability. Increasing body weight was paralleled by higher MCP-1 levels and lower GSM values, indicative of unstable plaques. Moreover, logistic regression analysis identified MCP-1 as one of the independent predictors of plaque instability, particularly in overweight and hypertensive patients. These results indicate the potential usefulness of MCP-1 as a biomarker of carotid plaque instability, confirming the negative effect of obesity in promoting other known cardiovascular risk factors causing plaque instability in patients with carotid atherosclerosis.