Association Of C-reactive Protein Levels Research Articles

Association of C-reactive Protein in Preeclampsia

Introduction: Preeclampsia is a multisystemic disorder that complicate about 7-10 percent of human pregnancies.Worldwide this syndrome contributes high maternal and perinatal mortality and morbidity. C-reactive protein, a marker of tissue damage and inflammation, is elevated in seurm in overt preeclampsia. It is used as an objective and sensitive index of overall inflammatory activities in the body. Aims and Objectives: To explore the association of C-reactive protein level with the preeclampsia patients. Materials and Methods: The present study was a Case–Control study, conducted in the Department of Obstetrics and Gynaecology in collaboration with the Department of clinical pathology of Sir Salimullah Medical College Hospital, Mitford, Dhaka during the period of January 2013 to December 2013.The study population was pregnant women with preeclampsia and normal term pregnant patients admitted during study period. A total of 66 patients were included in the study. Among them 33 were clinically diagnosed preeclampsia women grouped as Cases and another 33 were age, parity and BMI matched term pregnant women as Controls. Eastmation of serum C-reactive protein was done by Nyco Card Reader-II method (Appendix-11). Statisticians analysis was perform by using SPSS. Results: C-reactive protein concentration (mg/L) was found significantly higher (p<0.001) in case group (17.93±10.5) than control group (7.45±1.80). Creactive protein was _ 6mg/L in 29(87.9%) in case group and 9 (27.3%) in control group and C-reactive protein values showed significant positive correlation with systolic and diastolic blood pressure (p<0.001) in case group. C-reactive protein concentration was found significantly higher (p<0.001) in severe preeclampsia group than mild preeclampsia group. Conclusion: Therefore, it can apparently be concluded from this study that increased maternal serum C-reactive protein level might be a strong risk factor for preeclampsia, although the precise role of C-reactive protein in this regard whether causal or consequential, is yet to be determined. Finding of this study might be helpful for formulating a guideline for management of pregnant women with preeclampsia. Medicine Today 2024, Vol.36 (2): 67-71

Association of C-reactive protein level with adverse outcomes in patients with atrial fibrillation: A meta-analysis

BackgroundStudies on the association between C-reactive protein (CRP) level and poor outcomes have been yielded controversial results in patients with atrial fibrillation (AF). This meta-analysis sought to investigate the utility of elevated CRP level in predicting adverse outcomes in AF patients. MethodsTwo authors systematically searched PubMed and Embase databases (until December 10, 2022) for studies evaluating the value of elevated CRP level in predicting all-cause mortality, cardiovascular death, stroke, or major adverse cardiovascular events (MACEs) in AF patients. The predictive value of CRP was expressed by pooling adjusted hazard ratio (HR) with 95% confidence intervals (CI) for the highest versus the lowest level or per unit of log-transformed increase. ResultsTen studies including 30,345 AF patients satisfied our inclusion criteria. For the highest versus the lowest CRP level, the pooled adjusted HR was 1.57 (95% CI 1.34-1.85) for all-cause mortality, 1.18 (95% CI 0.92-1.50) for cardiovascular death, and 1.57 (95% CI 1.10-2.24) for stroke, respectively. When analyzed the CRP level as continuous data, per unit of log-transformed increase was associated with a 27% higher risk of all-cause mortality (HR 1.27; 95% CI 1.23-1.32) and 16% higher risk of MACEs (HR 1.16; 95% CI 1.05-1.28). ConclusionsElevated CRP level may be an independent predictor of all-cause mortality, stroke, and MACEs in patients with AF. CRP level at baseline can provide important prognostic information in risk classification of AF patients.

Obesity is positively Associated with Depression in Older Adults: Role of Systemic Inflammation*

ObjectiveWe aimed to explore the association between obesity and depression and the role of systemic inflammation in older adults. MethodsAdults ≥ 65 years old (n = 1,973) were interviewed at baseline in 2018 and 1,459 were followed up in 2021. General and abdominal obesity were assessed, and serum C-reactive protein (CRP) levels were measured at baseline. Depression status was assessed at baseline and at follow-up. Logistic regression was used to analyze the relationship between obesity and the incidence of depression and worsening of depressive symptoms, as well as the relationship between obesity and CRP levels. The associations of CRP levels with the geriatric depression scale, as well as with its three dimensions, were investigated using multiple linear regressions. ResultsGeneral obesity was associated with worsening depression symptoms and incident depression, with an odds ratio (OR) [95% confidence interval (CI)] of 1.53 (1.13–2.12) and 1.80 (1.23–2.63), especially among old male subjects, with OR (95% CI) of 2.12 (1.25–3.58) and 2.24 (1.22–4.11), respectively; however, no significant relationship was observed between abdominal obesity and depression. In addition, general obesity was associated with high levels of CRP, with OR (95% CI) of 2.58 (1.75–3.81), especially in subjects free of depression at baseline, with OR (95% CI) of 3.15 (1.97–5.04), and CRP levels were positively correlated with a score of specific dimension (life satisfaction) of depression, P < 0.05. ConclusionGeneral obesity, rather than abdominal obesity, was associated with worsening depressive symptoms and incident depression, which can be partly explained by the systemic inflammatory response, and the impact of obesity on depression should be taken more seriously in the older male population.

C- REACTIVE PROTEIN - AN OUTCOME PREDICTOR IN ACUTE INTRA CEREBRAL HEMORRHAGE

Background Inammation is considered to play an important role in the pathogenesis of cerebrovascular disease. C-reactive protein (CRP) is a hallmark of acute inammatory response. There are growing evidences that inammations are involved in atherosclerosis, plaque formation and ischemic event. There are many studies showing that the levels of CRP (hsCRP) have been found to be raised in cerebral ischemia, but there are few studies about the association of CRP level and intracerebral hemorrhage. This study was done to observe the levels of CRP (hsCRP) in patients with acute intracerebral hemorrage, and to assess the severity and outcome. Methods Study was conducted in 30 patients admitted in medical ward and medical ICU of LLR and associated hospitals, G.S.V.M. medical college Kanpur. All patients of acute intra cerebral hemorrhage fullling the Inclusion and exclusion criteria were enrolled in the study. Serum CRP (hs-CRP) was measured by Turbidimetric immunoassay. Statistical analysis was done by using T test and chi square test. Results Maximum numbers of our patients were in the age group of 40-79 years with mean age of 64 years. Intra cerebral hemorrhage was more prevalent in males. CRP level was found to be elevated statistically signicant in intra cerebral hemorrhage patients as compared to controls. There was signicant rise from rst day to third day (P&lt;0.05). Mean CRP level of expired patients was elevated as compared to whole study group (P&lt;0.05). Conclusions We concluded that higher C reactive protein level may be associated with worse prognosis and poor outcome in intra cerebral hemorrhage patients and CRP level can be an important factor of prognostic signicance in these patients.

C-Reactive Protein levels in Acute Stroke: Ischemic vs Hemorrhagic in a Tertiary Care Hospital

There is growing evidence of the prognostic importance of C-reactive protein (CRP) in ischemic stroke. However, the independent value of CRP in ischemic vs hemorrhagic stroke has not been established. Objective: To assess the diagnostic value of CRP as biomarker in ischemic stroke in comparison to hemorrhagic stroke Methods: This prospective study was conducted from March 2020 to March 2022 in the Department of Medicine, Ayub Medical College. Sample size of 71 was calculated including patients of both genders having age 22-105 years admitted with first-ever acute stroke within the first 24 hours of onset. Data was analyzed using SPSS latest version. Quantitative variables are shown as frequency and percentages. Paired T Test was applied to see the association of CRP levels with effect on CT- Scan of Brain. p value less than 0.05 was considered significant Results: 69% of the participants were women, far outnumbering the men. 45 patients found to have ischemic stroke (63.38%) whereas 26 (36.62%) reported having Hemorrhagic stroke. Paired t test applied to see the association of CRP Levels with CT Scan Brain was found significant having p value 0.002 Conclusions: CRP levels are important in the diagnosis of stroke based on data. CRP levels must be compared to those of other stroke biomarkers in order to make this determination. The serum CRP level within 24 hours can be used to predict severity in ischemic but not hemorrhagic stroke.

Association of C-reactive protein levels with angiographic findings among patients with non-ST-segment elevation myocardial infarction

C-reactive protein (CRP) is an objective marker widely used for screening inflammatory levels in several diseases. Evidence suggests that inflammation plays a key role in the pathogenesis of atherosclerosis. The inflammatory process may promote plaque rupture causing acute coronary syndrome (ACS). Multiple studies have cleared that CRP is an independent risk predictor of cardiovascular events. Therefore, the inflammatory assessment is essential to improve the management of coronary artery disease patients. The aim of this study is to assess the usefulness of CRP for the screening of anatomical complexity CAD regarding patients admitted for ACS. It's a retrospective study conducted between September 2020 and February 2021 including all the patients admitted for NSTEMI and undergoing coronary angiography in the cardiology department of IBN ROCHD University hospital. ACC/AHA classification was used to determine the anatomical complexity of CAD. In total, 74 patients were included. Mean age was 59 years old, with male predominance (sex ratio = 2.08). Among the patients, 44.6% had past medical history of hypertension, while 28.4% were diabetic. Among the patients, 38% were chronic smokers and 9% were weaned. Among the patients, 63% were admitted for high-risk NSTEMI. Mean troponin level was 10,566 pg/L and mean CRP value was 45.2 mg/L. Among the patients, 8.1% had normal coronary angiography, 33.8% had one vessel disease while 58.1% had multivessel disease. Elevated CRP level was significantly associated to the anatomical complexity of CAD ( P = 0.019). Mean value of CRP was 25 mg/L in the simple CAD group versus 57.6 mg/L in the complex CAD group with a significant difference between groups ( P = 0.028). The severity of CAD was positively correlated with the level of CRP. Therefore, these findings suggest its value as a biomarker for predicting CAD. Serum CRP could be useful for risk stratification and may help for the management of CAD.

Cord blood DNA methylation reflects cord blood C-reactive protein levels but not maternal levels: a longitudinal study and meta-analysis

BackgroundPrenatal inflammation has been proposed as an important mediating factor in several adverse pregnancy outcomes. C-reactive protein (CRP) is an inflammatory cytokine easily measured in blood. It has clinical value due to its reliability as a biomarker for systemic inflammation and can indicate cellular injury and disease severity. Elevated levels of CRP in adulthood are associated with alterations in DNA methylation. However, no studies have prospectively investigated the relationship between maternal CRP levels and newborn DNA methylation measured by microarray in cord blood with reasonable epigenome-wide coverage. Importantly, the timing of inflammation exposure during pregnancy may also result in different effects. Thus, our objective was to evaluate this prospective association of CRP levels measured during multiple periods of pregnancy and in cord blood at delivery which was available in one cohort (i.e., Effects of Aspirin in Gestation and Reproduction trial), and also to conduct a meta-analysis with available data at one point in pregnancy from three other cohorts from the Pregnancy And Childhood Epigenetics consortium (PACE). Secondarily, the impact of maternal randomization to low dose aspirin prior to pregnancy on methylation was assessed.ResultsMaternal CRP levels were not associated with newborn DNA methylation regardless of gestational age of measurement (i.e., CRP at approximately 8, 20, and 36 weeks among 358 newborns in EAGeR). There also was no association in the meta-analyses (all p > 0.5) with a larger sample size (n = 1603) from all participating PACE cohorts with available CRP data from first trimester (< 18 weeks gestation). Randomization to aspirin was not associated with DNA methylation. On the other hand, newborn CRP levels were significantly associated with DNA methylation in the EAGeR trial, with 33 CpGs identified (FDR corrected p < 0.05) when both CRP and methylation were measured at the same time point in cord blood. The top 7 CpGs most strongly associated with CRP resided in inflammation and vascular-related genes.ConclusionsMaternal CRP levels measured during each trimester were not associated with cord blood DNA methylation. Rather, DNA methylation was associated with CRP levels measured in cord blood, particularly in gene regions predominately associated with angiogenic and inflammatory pathways.Trial registrationClinicaltrials.gov, NCT00467363, Registered April 30, 2007, http://www.clinicaltrials.gov/ct2/show/NCT00467363

An hs-TNT Second Peak Associated with High CRP at Day 2 Appears as Potential Biomarkers of Micro-Vascular Occlusion on Magnetic Resonance Imaging after Reperfused ST-Segment Elevation Myocardial Infarction

Introduction: Micro-vascular occlusion (MVO) in a myocardial infarction (MI) is associated with an increased risk of heart failure and mortality. Hs-T-troponin has a double peak kinetic after MI. The aim was to determine if this kinetic was correlated to MVO evaluated by cardiac magnetic resonance imaging (MRI) after MI. Methods: This is a monocentric retrospective study. Inclusion criteria were hospitalization for MI, Thrombolysis In Myocardial Infarction flow 0 at coronary angiography, reperfusion within 12 h from the onset of chest pain, cardiac MRI within the first month, and a 5-days’ biological follow-up with at least hs-T-Troponin and C-reactive protein (CRP). Statistics were performed using the R software. Results: Ninety-eight patients were included. Fifty-three patients (54.1%) had MVO at MRI. The existence of MVO was associated with a trend of more kissing procedure during primary percutaneous coronary intervention (p = 0.06), a significantly more frequent second peak of troponin (p = 0.048), a significantly higher CRP level (p < 0.0001) and a longer time to balloon (p = 0.01). The association of CRP level above 40 mg/L at day 2 and the observation of a second peak of troponin were associated to 95% of MVO in ST-segment elevation MI patients. By contrast, in the absence of these 2 criteria, MVO was absent in 78% of the cases. This score was associated with a higher rate of hospitalisation at 2 years. Conclusion: A biological score integrating hs-TNT second peak and CRP might help to predict MVO and predict outcomes after reperfused MI in our population.

Association of C-Reactive Protein Level and Short Term Clinical Outcome among Spontaneous Intracerebral Haemorrhage Patients

Background: C-reactive protein is a biomarker among the spontaneous intracerebral haemorrhage patients.Objective: The purpose of this present study was to see the association of CRP level with the short term clinical outcome among spontaneous intracerebral haemorrhage patients.Methodology: This prospective cohort study was conducted in the Department of Neurology at Dhaka Medical College and Hospital, Dhaka, Bangladesh from July 2012 to June 2014 for a period of two (02) years. Patients presented with first ever spontaneous intracerebral haemorrhage with the age group of more than or equal to 18 years with both sexes and hospital admission within 48 hours of onset were included for this study. Admission plasma CRP was measured and study population were divided into group I (plasma CRP≥6 mg/L) and group II (plasma CRP&lt;6 mg/L). The patients were observed daily till 1 week after admission with special attention to vital parameters and clinical outcome which were mortality, functional outcome and early neurological worsening. Finally findings were analyzed and clinical outcome were compared in patient with different level of admission plasma CRP.Result: Early neurological worsening at the end of first week was 37(38%) patients. Poor functional outcome (GOS 2-3) at the end of first week was found in 51(52%) patients. Overall mortality within that period was 16(17%) patients. Elevated CRP level was associated with higher proportion of GCS score &lt; 9 at day seven. Early neurological worsening and poor functional outcome (GOS2-3) was also found more in these patients.Conclusion: High admission plasma CRP level may be associated with higher proportions of poor short term outcome (GOS 2-3), early neurological worsening at the end of the first week after onset and mortality within this period in the patients with spontaneous intracerebral haemorrhage.Journal of National Institute of Neurosciences Bangladesh, 2017;3(2): 89-93

Predicting Vitality Change in Older Breast Cancer Survivors after Primary Treatment--an Approach Based on Using Time-related Difference of Pro-inflammatory Marker C-reactive Protein.

We aimed to determine prognosis of vitality change and functional status of breast cancer survivors after primary oncological treatment using time-related differences of elevated levels of highly sensitive proinflammatory C-reactive protein (CRP). The test group consisted of 46 elderly breast cancer survivors (median age was 65 years) who completed Vitality Scale of Short Form 36 (SF-36) after completing treatment and another retrospectively at diagnosis. Data on tumor-related factors, treatment, and outcomes were obtained retrospectively from medical records, and linear regression analysis was performed. CRP was followed at diagnosis and one year after primary treatment. Within the scope of this study, clinically important difference in the Vitality Scale was set at five points of change. Results showed a statistically significant relationship between CRP change and vitality component of SF-36 change (rs = - 0.350, p = 0.023) in which a decrease in CRP inversely correlated with the quality of life component. The overall change was 1.078 of the vitality scale score (approximately 1 point) for each 1 unit decrease of CRP (1 mg/ L). Association of CRP levels (before and after treatment, its difference between these time points) with age, number of comorbidities and stage of the disease was analyzed and no statistically significant relationship was found in our study. Preliminary results suggested time-related differences in elevated CRP levels as a potentially suitable predictor for change in vitality status for long term, chronic condition for older breast cancer survivors. We suggest the interpretation schema including an understanding that CRP change of 5 mg/ L and more should be considered a potential risk factor for subsequent negative clinical outcomes.

C-reactive protein estimation: a quantitative analysis for three nonsteroidal anti-inflammatory drugs: a randomized control trial.

C-reactive protein (CRP) estimation for quantitative analysis to assess anti-inflammatory action of nonsteroidal anti-inflammatory drugs (NSAIDs) after surgery in maxillofacial surgery. This study was to evaluate the efficacy of CRP as a quantitative analysis for objective assessment of efficacy of three NSAIDs in postoperative inflammation and pain control. The parallel study group design of randomization was done. Totally 60 patients were divided into three groups. CRP was evaluated at baseline and postoperatively (immediate and 72 h) after surgical removal of impacted lower third molar. The respective group received the drugs by random coding postoperatively. The assessment of pain control and inflammation using NSAIDs postoperatively after surgical removal of impacted lower third molar was qualitatively and quantitatively assessed with CRP levels. The blood sample of the patient was assessed immediate postoperatively and after 72 h. The visual analog scale (VAS) was used for assessment of pain and its correlation with CRP levels. Comparison of difference in levels of CRP levels had P < 0.05 with immediate postoperative and baseline levels. The duration of surgery with association of CRP levels P = 0.425 which was nonsignificant. The pain score was increased with mefenamic acid (P = 0.003), which was significant on VAS. Diclofenac had the best anti-inflammatory action. There was a significant increase in CRP levels in immediate postoperative values and 72 h. CRP test proved to be a useful indicator as a quantitative assessment tool for monitoring postsurgical inflammation and therapeutic effects of various anti-inflammatory drugs. CRP test is a useful indicator for quantitative assessment for comparative evaluation of NSAIDs.

Continuous or Interval Training and Inflammatory Response in Obese Women

Background: Recent studies have shown probable benefits of high intensity, predominantly anaerobic activities in fat oxidation capacity. However, the effect of predominantly anaerobic exercise in reducing obesity and inflammatory condition is still little known. Objectives: To assess the effects of aerobic vs. anaerobic training on the levels of C-reactive protein (CRP) in women with central obesity, and the association of CRP levels with body composition. Methods: Randomized clinical trial with a population composed of adult, sedentary women with central obesity, enrolled at the Teaching-Care Outpatient Facility of Escola Bahiana de Medicina e Saude Publica. A group of 19 women was randomly divided into two groups: Continuous training (CT intensity at 20% of the ventilatory threshold VT) or Interval Training (IT 2-minute stimulus at 120% of VT and 2-minute recovery at 80% of VT) for 10 weeks, twice a week, 20-40-minute sessions. A medical and physical, laboratory and cardiopulmonary assessment was carried out before and after the intervention. Results: Median CRP levels were, respectively, before and after training: CT: 2.2 mg/L (0.6-4.1 mg/L) vs. 2.1 mg/L (0.8-5.5 mg/L) p=0.75; IT: 3.9 mg/L (0.7-8.6 mg/L) vs. 3.2 mg/L (1.2-5.7 mg/L) p=0.90. There was no significant difference when comparing the delta (Δ) CRP levels between groups, p=0.49. There was no association between CRP levels and other pre-intervention variables. Conclusion: Low-volume exercise programs, regardless of their intensity, do not change CRP levels in women with central obesity.

Analysis of secondary outcomes in nested case-control study designs.

One of the main perceived advantages of using a case-cohort design compared with a nested case-control design in an epidemiologic study is the ability to evaluate with the same subcohort outcomes other than the primary outcome of interest. In this paper, we show that valid inferences about secondary outcomes can also be achieved in nested case-control studies by using the inclusion probability weighting method in combination with an approximate jackknife standard error that can be computed using existing software. Simulation studies demonstrate that when the sample size is sufficient, this approach yields valid type 1 error and coverage rates for the analysis of secondary outcomes in nested case-control designs. Interestingly, the statistical power of the nested case-control design was comparable with that of the case-cohort design when the primary and secondary outcomes were positively correlated. The proposed method is illustrated with the data from a cohort in Cardiovascular Health Study to study the association of C-reactive protein levels and the incidence of congestive heart failure.

Pre-operative inflammation and post-operative atrial fibrillation in coronary artery bypass surgery

Post-operative atrial fibrillation (POAF) is the most common complication following coronary artery bypass surgery (CABG) with new onset in approximately 30% of the patients [1]. Accumulating data suggest that there is a close link between AF and inflammation. Several studies have shown that patientswithAF have increased levels of various inflammatory markers such as CRP (C-reactive protein), IL-6 (interleukin-6) and TNF-α (tumor necrosis factor alpha) [2]. Interestingly CRP levels of the patientswith AFare higher compared to thosewith sinus rhythm and in those with persistent AF compared with patients with paroxysmal AF [2]. Although systemic inflammation has been implicated in thedevelopmentof paroxysmal atrialfibrillation, it is unclearwhichkey inflammatory biomarkers have a clinical predictive value that could be used in clinical practice to stratify these patients. In this study we examined the predictive value of circulating levels of monocyte chemoattractant protein 1 (MCP-1), IL-6 and CRP on the development of POAF in patients undergoing CABG. MCP-1 is a chemokine expressed mainly by inflammatory cells and its expression is up-regulated with tissue injury and proinflammatory stimuli [3,4]. The study population consisted of 184 patients undergoing elective CABG. The participants were recruited preoperatively and exclusion criteria were any inflammatory, infective liver or renal disease or malignancy. We also excluded patients receiving non-steroid antiinflammatory drugs and patients who were in sinus rhythm but were under any anti-arrhythmic medication. The patients included to the study were in sinus rhythm and had no history of atrial fibrillation in the past. The demographic characteristics of the participants are demonstrated in Table 1. Blood samples were collected from all the patients the morning before surgery following an 8-hour fasting period. MCP-1 and interleukin-6 (IL-6) levels were determined using ELISA (ELISA kits R&D systems,Wiesbaden–Nordenstadt, Germany). CRP levelsweredeterminedby immunonephelometry (NLatex, Dade-Behring Marburg, Marburg, Germany). The patients were continuously monitored with surface electrocardiography (ECG) for the first 48 h after surgery during their stay in the cardiac intensive care unit (CICU). After their discharge from the CICU and their transfer to the wards, heart rhythm was evaluated every 4 h with ECG or whenever a relevant sign or symptom was reported, until the day of their discharge from the hospital and every incident of POAF was recorded. Normally distributed variables are presented as means ± SEM. Comparisons across 2 groups were performed by unpaired t-test. The predictive value of the measured biomarkers on the development of POAFwas evaluated by plotting the Kaplan–Meier curves and by running a log-rank test. All p-values are two-tailed and SPSS 21.0 was used for all statistical analyses. During follow-up, 37 of the patients developed POAF (20% of the study population). Patients were separated into 3 groups (lower, mid and higher) based on their MCP-1, IL6 and hsCRP values, and Kaplan– Meier curves were generated. Groups with mid and higher values of MCP-1 had significantly less incidents of postoperative AF comparing with the low value group, p b 0.05 (Fig. 1A). The differences between the groups stratified by IL6 and hsCRP levels were not statistically significant, p = NS (Fig. 1B–C). When we compared the group of patients who developed POAF with those who remained in SR throughout their hospital stay, we observed significantly lower preoperative levels of MCP-1 in those who developed POAF compared to those who did not, p b 0.05 (Fig. 2A). Preoperative levels of IL6 and hsCRP were similar between the two groups, p = NS (Fig. 2B–C). Myocardial inflammation especially the inflammation of the right atrium during cardiac surgery causes structural and electrical remodeling to the myocardium, leading to the impairment of the conduction of the electrical stimulus. It has been previously reported that anti-inflammatory therapy has significantly lowered the incidence of POAF [5]. The exact mechanism in which myocardial inflammation causes this heterogeneity of the electrical stimulus conduction, further leading to the development of POAF has not yet been clarified. CRP levels, the most commonly used inflammatory biomarker, have been associated with the development of POAF in patients undergoing CABG [6]. The association of CRP levels with the development of AF was originally believed to be due to the fact that CRP detected in the myocardial cells of the atrium leads to the consequent activation of complement and causes further myocardial injury [7–9]. Moreover, endothelial cells and cardiomyocytes responding to the oxidative stress produce a variety of inflammatory mediators such as MCP-1, which in turn attract further inflammatory molecules into the damaged zone [10,11]. MCP-1 is one of the best studied chemokines. It is produced by many cell types including

Association of C-reactive protein Levels with Fasting and Postload Glucose Levels According to Glucose Tolerance Status

Several studies show that high serum C-reactive protein (CRP) levels are associated with an increased risk of diabetes, data that strongly supports a possible role for inflammation in diabetogenesis. The aim of this study was to determine whether elevated CRP levels are associated with fasting plasma glucose (FPG) and/or postload glucose levels according to the glucose tolerance status. A total of 169 healthy males and non-pregnant females aged 18-65 years were enrolled in a population-based cross-sectional study. Individuals were allocated into groups with a new diagnosis of normal glucose tolerance (NGT) (n = 82), impaired fasting glucose (IFG) (n = 54), and impaired glucose tolerance (IGT) (n = 33). Elevated CRP was defined by CRP levels >3.0 and <10.0 mg/L, IFG by FPG ≥100 and <126 mg/dL, and IGT by plasma glucose concentration 2 h postload ≥140 and <200 mg/dL. A multiple regression linear analysis adjusted by body mass index, waist circumference, and lipid profile was performed to evaluate the association between CRP levels (independent variable) with FPG and 2 h postload glucose levels (dependent variables). Multivariate linear regression analysis showed a significant association between hsCRP levels with FPG (β = 0.536; 95% CI 1.03-5.1, p = 0.005) and 2 h postload glucose (β = 0.209; 95% CI 1.31-2.97, p = 0.01) in the IGT group, but not with FPG (β = 0.147; 95% CI 0.55-2.0, p = 0.25) and 2 h postload glucose (β = 0.151; 95% CI 0.83-3.2, p = 0.24) in the IFG group. Elevated CRP levels are associated with FPG and 2 h postload glucose in the individuals with IGT, but not in subjects with IFG or NGT.

Abstract P148: C-Reactive Protein (CRP) and the Prediction of Cardiovascular Death Among Mexican-Americans

Background: Addition of C-reactive protein (CRP) improves risk stratification provided by traditional Framingham risk factors (FRFs) in some populations, but findings vary by gender and by race/ethnicity. Whether CRP levels can improve risk prediction of cardiovascular mortality (CVD) among elderly Hispanics is unknown. Hypothesis: CRP will add incremental CVD risk prediction in addition to FRFs. Methods: We evaluated whether addition of baseline CRP to the Framingham risk score can improve CVD risk stratification for CVD death among 1,422 participants (536 males, 886 females) from the Sacramento Area Latino Study on Aging (SALSA). SALSA is a well-characterized, NIH funded cohort study of Mexican Americans aged &gt; 60 followed since 1998–1999. Death was ascertained by participant contacts, obituary reviews and cause of death from death certificates. We evaluated the association of CRP levels with CVD death using Cox proportional hazards models adjusting for FRFs stratified by gender. We calculated gender stratified net reclassification improvement (NRI) in models with and without CRP to predict 10-year CVD risks using the established FRFs categories (&lt;5%, 5–10%, 10–20%, &gt; 20%). Results: Mean baseline age was 70.7 and mean CRP level was 5.86 ng/ml. There were 167 CVD male deaths (mortality rate 39.2 per 1,000 person years) and174 among women (mortality rate 27.8 per 1,000 person years). Higher CRP levels were significantly associated with higher CVD mortality risk in men, HR of 1.29 (95% CI 1.11 – 1.50) but not women, HR 0.94 (95% CI 0.81 – 1.08) after adjustment for covariates. Addition of CRP was useful in reclassifying CVD death risk among men defined by FRF alone, and this was due to correct reclassification of those who did not experience CVD death from the highest risk group to a lower risk category. The majority of male participants (619/745=83%) were classified as having &gt;20%risk in the model without CRP. Mortality rate for men initially classified as having &gt; 20% risk was 37.9 per 1,000 person years. After addition of CRP, 6% were reclassified into an intermediate risk category (NRI 7.4%, p&lt; 0.001) and their mortality rate was 10.3 per 1,000 person years. Overall, NRI for men was 4.2% (p=0.05). In contrast, addition of CRP among women was associated with increased misclassification to a higher risk category (NRI= − 13.4%, p=0.0001). Conclusion: A risk prediction model that includes CRP improves cardiovascular risk classification among elderly Mexican-American men but not women as defined by traditional FRFs.

C-reactive protein levels, blood pressure and the risks of gestational hypertensive complications

Aim of this study was to investigate the associations of C-reactive protein levels, as marker of low-grade inflammation, with blood pressure development during pregnancy and the risks of gestational hypertensive complications. We also explored the role of maternal BMI in these associations. High-sensitivity C-reactive protein levels were measured in early pregnancy (median 13.2 weeks, 95% range 9.6-17.6) in 5816 mothers participating in a population-based prospective cohort study in the Netherlands. Blood pressure measurements were performed in each trimester. Information about pregnancy-induced hypertension and preeclampsia was retrieved from hospital charts of the women. Longitudinal analyses showed that C-reactive protein levels were not associated with SBP and DBP patterns throughout pregnancy. Trimester-specific multivariate linear regression models showed that as compared to low C-reactive protein levels (<5.0 mg/l), elevated levels (≥20.0 mg/l) were associated with maternal SBP and DBP. Elevated C-reactive protein levels in early pregnancy were associated with the risks of pregnancy-induced hypertension [odds ratio (OR) 2.78, 95% confidence interval (CI) 1.66-4.66]. After adjustment for maternal BMI, all associations attenuated. Our results suggest that first-trimester C-reactive protein levels are associated with SBP and DBP levels throughout pregnancy and with gestational hypertensive complications, but these associations are largely explained by maternal BMI.

The association of C-Reactive Protein Level with Muscle Strength in Japanese Adult Men

The association of C-Reactive Protein Level with Muscle Strength in Japanese Adult Men

E0420 C-reactive protein for predicting clinical outcomes after drug-eluting stent implantation

BackgroundAlthough C-reactive protein (CRP) has been proposed as a useful biomarker for predicting atherothrombosis, the association of CRP levels and clinical outcomes after drug-eluting stent (DES) implantation has not been...

The Significance of Plasma C-reactive Protein in Patients With Elevated Serum Prostate-specific Antigen Levels

Prostatic infection/inflammation may increase serum prostate-specific antigen (PSA) levels. We hypothesized that prostatic infection/inflammation can be identified by elevated plasma C-reactive protein (CRP) levels. Measuring plasma CRP levels may help to differentiate benign conditions from prostate cancer in patients with elevated serum PSA levels. A total of 139 patients with serum PSA levels greater than 4.0 ng/mL received transrectal ultrasound guided biopsy. All of the patients had plasma high-sensitivity CRP levels measured. CRP levels higher than 0.5 mg/dL were considered abnormal. CRP and PSA levels, and prostate size were compared between benign and malignant groups. The association of CRP levels with cancer stages was also analyzed. Thirty-four out of 139 (24.5%) patients were found to have prostate cancer. There was no significant difference in CRP levels between the malignant and benign groups. Five out of 34 (14.7%) patients with prostate cancer and 13 of 105 (12.4%) patients with benign lesions had elevated CRP levels. The incidence of abnormal CRP levels was not significantly different between the groups ( p = 0.77). Patients with high PSA and CRP levels did not have a higher probability of a benign condition. It is interesting to note that in the malignant group, there was a significant positive correlation between CRP and PSA levels ( r = 0.44, p = 0.01). No significant correlation between CRP levels and cancer stages was noted. Measuring plasma CRP levels does not assist in the identification of benign conditions in patients with elevated PSA levels. However, plasma CRP levels are well-correlated with serum PSA levels in prostate cancer patients, suggesting a potential correlation between prostate inflammation and prostate cancer.