Association Of Serum C-reactive Protein Research Articles

Utility of Serum Markers in Obstructive Sleep Apnoea Syndrome: A Case-control Study

Introduction: Obstructive Sleep Apnoea Syndrome (OSAS) consists of cessation of breathing for at least 10 seconds during sleep in spite of inspiratory efforts. The OSAS is an independent risk factor for a number of cardiovascular diseases and cerebrovascular events. The OSAS is diagnosed and assessed by polysomnography which is time consuming and expensive. C-Reactive Protein (CRP) and Creatine Phosphokinase (CPK) are markers of systemic inflammation. Inflammatory component is present in OSA. Biomarkers like CRP and CPK may serve as diagnostic tools which are simpler, cheaper and quicker alternatives. Aim: To study the role of serum markers CRP and CPK in the diagnosis of sleep disordered breathing. Materials and Methods: This was a case-control study, conducted from May 2021 to October 2021, in the Department of Pulmonary Medicine, NRI Medical College, Guntur, Andhra Pradesh, India. Total 50 patients were studied for their various symptoms suggestive of OSAS and confirmed by polysomnography were selected for the study. Total 40 age and weight matched controls were included in the study. The association of serum CRP and CPK with OSA was assessed. The Z-test of difference between two proportions was used to compare gender and smoking status of study participants of the two groups. The p-value <0.05 was reported as statistically significant. Results: The mean CRP in those suffering from obstructive sleep apnoea was 12.075±7 mg/dL with 13.89 in moderate to severe OSAS group and 10.26 in mild cases. The CRP showed statistically significant association (p-value=0.00344) with OSA whereas CPK levels in OSA subjects showed no statistically significant association with OSAS. Sensitivity of CRP and CPK compared to the Apnoea Hypopnea Index (AHI) in the diagnosis of OSAS was 66% and 34%, respectively. Specificity of CRP and CPK was 87.5% for both. Positive predictive value for CRP and CPK was 86.8% and 77.2%, respectively. Conclusion: C-reactive protein, a systemic inflammatory marker has a potential role in the diagnosis of OSAS.

Serum C-Reactive Protein Level Predicts Clinical Outcomes in Patients With Non-Small Cell Lung Cancer Harboring EGFR Mutations

The aim of this study was to assess the association of serum C-reactive protein (CRP) levels with outcomes in 81 patients with epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC). Patients with high serum CRP levels had lower therapeutic responses to EGFR-tyrosine kinase inhibitors (43.8%), and shorter time to treatment failure (TTF; 5.8 months) and overall survival (OS; 14.2 months) than those with low CRP levels. In multivariate analysis, serum CRP level was associated with TTF (hazard ratio [HR] 4.86) and OS (HR 49.42). High serum CRP levels may predict poor outcomes in patients with EGFR-mutated NSCLC.

Evaluation of serum C-reactive protein and lipid profile in patients with myocardial infarction

Background and objective: Myocardial infarction is the irreversible death (necrosis) of heart muscle secondary to prolonged lack of oxygen supply (ischemia), when the blood supply to a part of the heart is interrupted, most commonly due to rupture of a vulnerable plaque. The resulting ischemia or oxygen shortage causes damage and potential death of heart tissue. It is a medical emergency, and the leading cause of death worldwide. In this study, we investigated the association of serum C-reactive protein and serum lipid profile with myocardial infarction. Methods: A cross-sectional study was carried out from January to May 2016 in College of Medicine, Hawler Medical University. The study involved 108 patients with myocardial infarction (70 men and 38 women) in comparison with 50 healthy individuals as the control group (29 men and 21 women). Results: The levels of serum C-reactive protein were significantly higher (P <0.05) in patients with myocardial infarction in both genders when compared with the control group. There was no statistically significant difference in serum total cholesterol, serum triglyceride and serum LDL-C in patients with myocardial infarction and control group. Regarding serum high-density lipoprotein (HDL-C), there was a statistically significant difference (P <0.01) in patients with myocardial infarction when compared with the control group. Conclusion: C-reactive protein may play an important role in providing clinicians and biochemists with valuable information regarding diagnosis and following up the patient with suspected myocardial infarction.

The association of serum C-reactive protein with the occurrence and course of postpartum depression.

CRP has been positively correlated with depressive symptomatology but this has received less study in postpartum depression (PPD). In this secondary analysis of a trial of PPD treatment, depressive symptoms (Structured Interview Guide for the Hamilton Depression Rating Scale-Atypical Depression Symptoms (SIGH-ADS29)) and serum CRP levels were assessed and associations between CRP and SIGH-ADS29 scores evaluated. The associations between baseline log CRP and depression response and remission were also assessed. Of the 35 women included, neither baseline log CRP nor exit log CRP was significantly associated with SIGH-ADS29 score. Baseline CRP was not associated with response or remission. In this sample of women with PPD, CRP was not associated with depressive symptoms nor response to treatment.

Association of Serum C-reactive Protein in Preeclampsia and its Effect on Fetal Birth Weight – A Case Control Study

Objective(s): The aim of this study was to evaluate the association of serum C-reactive protein (CRP) in preeclampsia (PE) and its effect on fetal birth weight.Materials and methods: This case control study was conducted in Chittagong Medical College Hospital, Bangladesh, from July 2013 to June 2014. Study population was pregnant women of third trimester with preeclampsia (case group) and normal blood pressure (control group). The maternal serum C-reactive protein (CRP) levels were measured by immune turbidometric assay between 32 weeks to term. The women were divided into three groups: mild PE, severe PE (according to ACOG criteria) and normal healthy group. The value of CRP and its correlation with birth weight was compared between groups.Results: One hundred and fifty (150) pregnant women were analyzed. Among them 50 were case and 100 control. There was no difference between age of the patients of both groups. The mean systolic blood pressure was 148.40 ± 12.35 mm Hg in case and 122.15 ± 6.44 mmHg in control group. The mean diastolic blood pressure was 100.00 ± 9.74 mmHg in case and 74.05 ± 5.97 mmHg for the control. The systolic and diastolic blood pressure was significantly higher in preeclamptic group (P &lt; 0.000). C-reactive protein was 10.28 ± 7.25 mg/ mL in mild PE and 10.94 ± 6.32 mg/mL in severe PE and 3.45 ± 1.71 mg/mL in normotensive group, which was significantly higher in case than control group (P = 0.000). Preeclamptic women delivered at a significantly shorter gestational age than normal pregnant women. Mean gestational age during delivery for the case group and control group was 39.02 ± 1.6 and 39.58 ± 0.8 weeks respectively. Mean birth weight in PE (2.52 ± 0.42 kg) was significantly lower than normal pregnancies (2.88 ± 0.29 kg). The sensitivity and specificity of CRP were 68% and 98% respectively. Multiple regression analysis showed that there is a strong association between CRP levels and PE and birth weight.Conclusion: This small study showed that in case group CRP was raised in 68% cases which is much higher in comparison to healthy control group where CRP was high only in 2% cases. High CRP has association with low birth weight. Therefore, CRP may be used as cost effective investigation to identify the risk of preeclampsia and its effect on fetal birth weight.Bangladesh J Obstet Gynaecol, 2016; Vol. 31(2) : 75-80

Role of inflammation in the association between the western dietary pattern and metabolic syndrome among Lebanese adults

The aim of this study was to investigate whether inflammation mediates the previously observed direct association between the western dietary pattern (WDP) and metabolic syndrome (MetS) among Lebanese adults. Sociodemographic, lifestyle, dietary pattern scores, anthropometric and biochemical data of 331 adults were used in this study. Inflammation indicators considered were: serum C-reactive protein (CRP) and the dietary inflammatory index (DII). The scores of the WDP were significantly associated with DII (r = .64) but not with serum CRP. Higher CRP levels increased the odds of MetS and four out of five of its components, while no association was found between the DII and MetS.Conclusion: The findings of this study confirmed the association of serum CRP with MetS but did not support mediation effect of inflammation on the association between the WDP and MetS. These findings are important to direct future investigations on diet, inflammation and association with diseases risk.

Serum C-Reactive Protein Predicts Poor Prognosis in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma Treated with Chemoradiotherapy

We aimed to evaluate the association of serum C-reactive protein (crp) with prognosis in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy. We retrospectively reviewed 79 patients with locoregionally advanced nasopharyngeal carcinoma (cT3-4N0-3M0) treated with chemoradiotherapy. Chemoradiotherapy consisted of external-beam radiotherapy to the nasopharynx (70-80 Gy), the lymph node-positive area (60-70 Gy), and the lymph node-negative area (50-60 Gy) combined with 3 cycles of various platinum-based regimens delivered at 3-week intervals. Elevated crp was defined as more than 8 mg/L. The survival rate was calculated using the Kaplan-Meier method, and univariate and multivariate analyses (Cox proportional hazards model) were used to identify factors significantly associated with prognosis. During the median follow-up of 3.9 years (range: 1-5.5 years), 23 patients died from nasopharyngeal cancer. The 5-year cancer-specific survival (css) rate was 62.90%. Before chemoradiotherapy, 18 patients had high serum crp; the css rate in that subgroup was significantly worse than the rate in the remaining patients (p = 0.0002). Multivariate analysis showed that crp was an independent prognostic indicator of css, with a hazard ratio of 3.04 (95% confidence interval: 1.22 to 7.55; p = 0.017). Among the 18 patients with elevated serum crp, 9 achieved normal serum crp after chemoradiotherapy, of whom 5 remained living with no evidence of recurrence or metastasis during follow-up. By contrast, the remaining 9 patients in whom serum crp did not normalize after chemoradiotherapy died within 4.2 years. Elevated serum crp before treatment predicts poor prognosis in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy.

THU0203 Elevated C-Reactive Protein is Associated with Lower Knee Muscle Strength in Patients with Knee Osteoarthritis: A 2 Year Follow up Study in the AMS-OA Cohort

BackgroundIn patients with knee osteoarthritis (OA) lower muscle strength is associated with disease progression and activity limitations. Lower muscle strength in this group of patients is determined by several factors,...

THU0202 Changes in Serum C-Reactive Protein and Erythrocyte Sedimentation Rate do not Associate with Radiographic Progression in Patients with Knee Osteoarthritis: A 2 Years Follow-Up Study in the AMS-OA Cohort

ObjectivesTo examine the associations of elevated serum c-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) with radiographic progression in patients with established knee osteoarthritis (OA), over two-years.MethodsData from 186 patients...

Cross-sectional association of serum C-reactive protein and uric acid with albuminuria in Chinese type 2 diabetic patients

Background Evidences show that subclinical chronic inflammation is involved in the pathogenesis of diabetic nephropathy. The aim of this study was to examine the relationship between serum C-reactive protein (CRP), serum uric acid, and albuminuria in Chinese type 2 diabetic patients. Methods A total of 1162 type 2 diabetic patients were recruited. All participants had relevant clinical and laboratory measurements. CRP was measured using a particle enhanced immunoturbidimetric assay. Results In the multiple linear regression model, natural log-transformed CRP (lnCRP) and uric acid were independent predictors of natural log-transformed urinary albumin to creatinine ratio (lnACR) (β=0.18, 95% CI 0.10-0.27, P &lt;0.001 and β=0.18, 95% CI 0.09-0.27, P &lt;0.001). The interaction of lnCRP with uric acid was also associated with lnACR (β=0.04, 95% CI 0.02-0.06, P &lt;0.001). In the full-adjusted logistic regression model, the OR for albuminuria of the patients in the third tertile levels of CRP and uric acid was 3.94 compared with patients in the first tertile levels of CRP and uric acid (95% CI 1.73-8.94, P &lt;0.001). Conclusions Elevated serum CRP and increased serum uric acid level were associated with albuminuria in Chinese type 2 diabetic patients. Moreover, CRP and uric acid had an interactive effect on albuminuria.

Abdominal adiposity is the main determinant of the C-reactive response to injury in subjects undergoing inguinal hernia repair

BackgroundObesity and serum C-reactive protein (CRP) (a sensitive marker of inflammatory activity) are associated with most chronic diseases. Abdominal adiposity along with age is the strongest determinant of baseline CRP levels in healthy subjects. The mechanism of the association of serum CRP with disease is uncertain. We hypothesized that baseline serum CRP is a marker of inflammatory responsiveness to injury and that abdominal adiposity is the main determinant of this responsiveness. We studied the effect of abdominal adiposity, age and other environmental risk factors for chronic disease on the CRP response to a standardised surgical insult, unilateral hernia repair to not only test this hypothesis but to inform the factors which must be taken into account when assessing systemic inflammatory responses to surgery.Methods102 male subjects aged 24-94 underwent unilateral hernia repair by a single operator. CRP was measured at 0, 6, 24 and 48 hrs. Response was defined as the peak CRP adjusted for baseline CRP.ResultsAge and waist:hip ratio (WHR) were associated both with basal CRP and CRP response with similar effect sizes after adjustment for a wide-range of covariates. The adjusted proportional difference in CRP response per 10% increase in WHR was 1.50 (1.17-1.91) p = 0.0014 and 1.15(1.00-1.31) p = 0.05 per decade increase in age. There was no evidence of important effects of other environmental cardiovascular risk factors on CRP response.ConclusionWaist:hip ratio and age need to be considered when studying the inflammatory response to surgery. The finding that age and waist:hip ratio influence baseline and post-operative CRP levels to a similar extent suggests that baseline CRP is a measure of inflammatory responsiveness to casual stimuli and that higher age and obesity modulate the generic excitability of the inflammatory system leading to both higher baseline CRP and higher CRP response to surgery. The mechanism for the association of baseline CRP and waist:hip ratio to chronic disease outcomes could be through this increase in inflammatory system excitability.

Association of serum C-reactive protein and erythrocyte sedimentation rate with muscle strength in patients with knee osteoarthritis

To examine the association of serum CRP and ESR with muscle strength in patients with knee OA. Cross-sectional data from 285 patients with knee OA from the Amsterdam Osteoarthritis (AMS-OA) cohort were analysed. CRP (mg/l) and ESR (mm/l) were measured in serum from patients' blood samples and the values were dichotomized for the analyses. Strength of quadriceps and hamstring muscles was assessed using an isokinetic dynamometer. Univariable and multivariable linear regression analyses were used to assess the association of CRP and ESR with muscle strength, adjusting for relevant confounders. Elevated levels of serum CRP (β = -0.10; P = 0.04) and ESR (β = -0.12; P = 0.02) were associated with lower muscle strength after adjustment for age, sex, comorbidities and NSAID use. The associations were no longer significant when BMI was incorporated in the adjusted model. Inflammation might influence muscle strength in patients with knee OA. Moreover, the link between inflammation and obesity might explain the effect that BMI has in the associations between inflammatory markers (i.e. CRP and ESR) and muscle strength.

Effect of erythropoietin-stimulating agent on uremic inflammation

BackgroundThe goal of the present study was to explore the effect of medications that are commonly prescribed for CKD patients on uremic state.MethodsThis was a cross-sectional study. From January 2006 to October 2009, 1,623 patients with end-stage kidney disease (ESKD) commenced hemodialysis (HD) at the 9 participating hospitals. The criteria for exclusion from the database were 1) serum C-reactive protein (CRP) > 3 mg/dL, 2) WBC count > 9,000/mm3 or <4,000/mm3, and 3) patients with cancer, immune complex disease, or vasculitis. A total of 900 patients were entered into the final database. We explored the association of serum CRP just before the first HD session with clinical characteristics, laboratory data, and medications for CKD in the predialysis period.ResultsOn univariate analysis, age, CTR, eGFR, and WBC were significantly correlated with CRP. Systolic and diastolic blood pressure, serum albumin, LDL-C, HDL-C, Hb, Cr, and Ca were inversely associated with CRP. Use of erythropoietin-stimulating agents (ESA) using (r = −0.111, p = 0.0015), renin-angiotensin-aldosterone system inhibitors (r = −0.083, p = 0.0154), and calcium channel blockers (r = −0.1, p = 0.0039) was also negatively correlated with CRP. However, only use of ESA showed a significant negative correlation with CRP that was independent of other clinical factors and CKD medications on multiple regression analysis.ConclusionESA may strongly reduce uremic inflammation in addition to improving anemia. To confirm this potential effect, a large-scale longitudinal study would be required.

The association of serum C-reactive protein, uric acid and magnesium with insulin resistance in Chinese postmenopausal women with prediabetes or early untreated diabetes

Objectives This study aimed to evaluate the association of serum inflammatory markers (C-reactive protein (CRP) and uric acid (UA)), magnesium and other CVD risk factors with insulin resistance (IR) among Chinese postmenopausal women with prediabetes. Study design and main outcomes measures This is a cross-sectional analysis of baseline data among 180 postmenopausal women with prediabetes or early untreated diabetes. Major anthropometric and biochemical measures included body mass index (BMI), waist to hip ratio (WHR), fasting and postload glucose and insulin, serum CRP, UA, lipids profile, and magnesium. IR was estimated using fasting glucose and insulin by homeostasis model assessment (HOMA). Results Multivariate linear regression analyses indicated that Lg CRP, WHR, serum triglycerides (TGs) and magnesium were the major predictors of HOMA-IR. A multivariate logistic analyses showed that a CRP level above 3.0 mg/l was significantly associated with a 2.8-fold risk of having higher HOMA-IR (>2.52). BMI plays a key role in mediating the relationship of CRP and IR. Elevated serum TG (>1.71 mmol/l), WHR (>0.88), UA (>357 mmol/l) and lower serum magnesium (<0.78 mg/l) were associated with 5.26 (95%CI: 2.52–10.98, P < 0.05), 3.02 (95%CI: 1.64–5.55, P < 0.05), 1.97 (95%CI: 1.02–3.83, P = 0.05) and 0.51 (95%CI: 0.28–0.81) folds risk of higher HOMA-IR, respectively in the unadjusted model. Serum magnesium, but not UA was an independent risk factor of HOMA-IR. Conclusion The present study in prediabetic or early untreated diabetic Chinese postmenopausal women indicated that IR is significantly associated with increased inflammation (CRP and UA), serum TG, WHR and lower serum magnesium.

Association of Serum C-Reactive Protein Level with Sex-Specific Type 2 Diabetes Risk: A Prospective Finnish Study

Our objective was to assess whether the association of serum C-reactive protein (CRP) with type 2 diabetes risk is modified by sex. We prospectively followed 12,861 Finnish men and women who were 35-74 yr of age, and free of diabetes, coronary heart disease, stroke, and cancer at baseline. Hazard ratios of type 2 diabetes were estimated for different levels of serum CRP. During the follow-up, 208 men and 113 women developed diabetes. The multivariable-adjusted (age, physical activity, education, smoking, alcohol and coffee drinking, family history of diabetes, use of antihypertensive drugs, cholesterol-lowering agents, and hormone replacement therapy in women, systolic blood pressure, serum high-density lipoprotein cholesterol, serum triglycerides, and body mass index) hazard ratios of diabetes at three different levels of CRP (0.05-0.99, 1.0-2.99, and > or =3.0 mg/liter) based on the recommendation by Centers for Disease Control and the American Heart Association were 1.00, 1.46, and 1.85 (P for trend = 0.006) in men, and 1.00, 3.83, and 8.37 (P for trend <0.001) in women, respectively. CRP had a stronger association with diabetes risk in women than men (P for interaction: chi2 = 6.42; 1 df; P < 0.025). This positive association between CRP and diabetes risk did not change when participants were stratified by age group, smoking status, level of obesity, alcohol drinking habit, or family history of diabetes. High baseline level of serum CRP was associated with an increased risk of diabetes among both men and women, but this association was stronger in women than men.

Relationship Between C-Reactive Protein and Atherosclerotic Risk Factors and Oxidative Stress Markers Among Young Persons 10–18 Years Old

This study was undertaken to determine the association of serum C-reactive protein (CRP) with generalized and abdominal obesity, body fat composition, the metabolic syndrome, and oxidative stress markers among young people. We conducted a population-based study of 512 young people, aged 10-18 years. We obtained anthropometric and blood pressure measurements. Fasting blood sugar, total cholesterol (TC), HDL-cholesterol, triglycerides, CRP, malondialdehyde (MDA), and conjugated diene (CDE) were quantified. LDL-cholesterol (LDL-C) was calculated for samples with TG < or =4.52 mmol/L RESULTS: Mean triglycerides, waist and hip circumferences, percentage body fat, subcutaneous fat, and systolic blood pressure increased significantly with increasing body mass index (BMI). In contrast, the mean LDL and TC were higher in underweight than normal weight individuals, and then increased significantly from normal to higher BMI categories. Mean HDL cholesterol significantly decreased with increasing BMI. Overall, CRP, MDA, and CDE were significantly correlated with measures of abdominal obesity. Serum CRP, MDA, and CDE significantly increased in the upper quartiles of waist circumference. Study participants with higher CRP concentrations were more likely to have metabolic syndrome and high oxidative stress markers. We found a significant positive association between CRP and oxidative stress markers in healthy young people, as well as an increase in these markers in the upper quartiles of waist circumference, but not BMI. Oxidative stress and CRP may interact in the early inflammatory processes of atherosclerosis.

Air pollution and serum C-reactive protein concentration in children.

BACKGROUNDFew biological markers that allow evaluation of the effects of air pollution on human health have been identified. This study evaluated the association of serum C-reactive protein (CRP) concentration in children with their respiratory symptoms and air pollution.METHODSRespiratory symptoms and serum concentrations of CRP were examined in 2,094 school children living in 3 communities with different concentrations of air pollutants in Chiba Prefecture, Japan in 2001. The relationships between serum CRP concentration and sex, age, respiratory symptoms, and various environmental factors were analyzed.RESULTSSerum CRP concentration decreased with age, and was significantly higher both in children who were bottle-fed in infancy and whose mothers smoked. Children with wheeze had significantly higher serum CRP concentration than those without wheeze. After adjustment for potential confounding factors, increased serum CRP concentrations of the 90th percentile (1.4 mg/L) or above were significantly associated with atmospheric concentration of suspended particulate matter (SPM) (odds ratio [OR] =1.49 for the range of observed concentrations, 95% confidence interval [Cl]: 1.07-2.06) and sulfur dioxide (SO2) (OR =1.45, 95% Cl: 1.04-2.03). In a two-pollutant model including SPM and nitrogen dioxide (NO2) concentrations, increased serum CRP concentrations were also associated with SPM (OR =1.94, 95% Cl: 1.08-3.50), but no such association was found with NO2 (OR =0.62, 95% Cl: 0.26-1.48).CONCLUSIONSerum CRP concentration is related to wheezing and the degree of air pollution. Because the concentrations of air pollutants are highly correlated, it is difficult to elaborate on which pollutant has a stronger effect on serum CRP concentrations.

Association of Serum C-Reactive Protein (CRP) with Some Nutritional Parameters of Maintenance Hemodialysis Patients

Malnutrition and inflammation are common in hemodialysis patients, and are usually closely associated. Serum C-reactive protein (CRP) concentrations have been found to be significantly elevated in hemodialysis patients and reflects chronic inflammation, and as an acute-phase reactant, is a sensitive and independent marker of malnutrition. To investigate the association of serum CRP level with some nutritional variables in diabetic and non diabetic end-stage renal failure patients undergoing regular hemodialysis, we designed a study of 36 maintenance hemodialysis patients (f = 15 m = 21), consisting of 25 non-diabetic HD patients and 11 diabetic HD patients. In this study we found a near significant difference of CRP between diabetic and non-diabetics of total patients with more values of CRP in diabetics, a significant difference of CRP between diabetic and non-diabetic of female HD patients with more values in diabetics and a significant difference of CRP between males and female of non-diabetic population with more values of CRP in males. An inverse correlation of serum CRP with serum cholesterol and triglyceride levels and a near significant positive correlations of CRP with serum ALP and with serum iPTH were found. An inverse correlation of serum CRP with dialysis efficacy was seen too. No significant association between serum CRP and serum albumin was seen. Compatible with some studies and in contrast to some other studies, the association of serum albumin with serum CRP levels in this study was insignificant. The positive correlation of high serum PTH with inflammation implies further need to control of hyperphosphatemia and secondary hyperparathyroidism in HD patients, also inverse correlation of serum CRP with cholesterol and triglyceride further support the malnutrition-inflammation complex syndrome (MICS) which frequently seen in HD patients.