Blood hs-CRP Levels Research Articles

Role of High-Sensitivity C-Reactive Protein as a Biomarker and Endophenotype in Mania.

Objective: To assess the role of high-sensitivity C-reactive protein (hs-CRP) as a biomarker, trait marker, and endophenotype in mania. Methods: Forty patients with mania, 40 of their first-degree relatives, and 30 healthy controls were recruited via a purposive sampling method from May 2020 to February 2021. hs-CRP levels were measured in all groups at baseline. The patient group was evaluated with the Young Mania Rating Scale, and hs-CRP levels were assessed in all participants at baseline, 2 weeks, and 6 weeks. Data were analyzed with SPSS version 25. Results: hs-CRP levels were significantly higher in patients than in controls and first-degree relatives (P = .001). However, hs-CRP levels were not higher in first-degree relatives compared to healthy controls. There was a significant reduction in total YMRS and domain scores and hs-CRP levels in patients at weeks 2 and 6 compared to baseline (P = .02). Conclusions: The blood hs-CRP level is a biomarker in mania, which may be a newer approach to detect disease progression and perhaps guide novel therapies. hs-CRP as an endophenotype requires further evaluation in future studies.

Interleukin-18 (IL-18) Cytokine Serum Concentrations Correlate With Pain Scores and the Number of Analgesic Doses Following Surgery.

Anti- and proinflammatory cytokines and plasma high-sensitivity C-reactive protein (hs-CRP) are used to assess inflammatory stress response (ISR) following surgery. However, the serum IL-18 (interleukin-18) cytokine values versus numeric rating scale (NRS) pain score and number of analgesic doses (NAD) postoperatively are unknown. Blood levels of six interleukins (IL-18, IL-1ra, IL-6, IL-10, IL-1β, and IL-8) and hs-CRP were measured at three time points; before operation (PRE), immediately after operation (POP1), and six hours after operation (POP2) in 114 patients with cholelithiasis. Following surgery, the blood levels of hs-CRP and IL-1ra, IL-6, IL-10, and IL-1β cytokines had a trend for increase (p<0.001 and p=0.014, respectively). The serum IL-18 concentrations inversely correlated to NRS and NAD during the first 24 h postoperatively. The correlation of IL-18 levels to NRS and NAD values supports the hypothesis that ISR and pain are related.

Self-reported periodontitis and C-reactive protein in Parkinson\u2019s disease: a cross-sectional study of two American cohorts

Periodontitis triggers systemic repercussions, such as elevated levels of high-sensitive C-reactive protein (hs-CRP). This has never been studied within Parkinson’s Disease (PD). The aim of this study is to compare hs-CRP levels of self-reported periodontitis cases versus cases without periodontitis in PD patients. Data from the National Health and Nutrition Examination Survey (2015–2016 and 2017–2018 waves) were analyzed. PD cases were identified through medication regimens and periodontitis cases through a validated self-report questionnaire. 51 participants were included (24 females, 27 males, with mean age of 62.96 (14.71)). While the self-reported periodontitis group presented elevated levels of circulating hs-CRP (5.36 vs. 1.99 mg/L, p = 0.031), the self-reported without periodontitis group presented higher lymphocyte levels (29.35 vs. 28.03%, p = 0.007). Blood levels of hs-CRP were significantly higher in PD cases with self-reported periodontitis. Apart from the lymphocyte levels, there were no other significant differences according to the self-reported periodontal status. Future studies shall explore this association using clinical measures.

Association of decreased glomerular filtration rate with renal hemodynamic disorders and inflammatory biomarkers in patients with medically-controlled hypertension of high cardiovascular risk

Aim. To assess markers of chronic kidney disease (CKD) in patients with medically-controlled hypertension (HTN) (&lt;140/90 mm Hg), as well as to analyze potential association of decreased glomerular filtration rate (GFR) &lt;60 ml/min/1,73 m2 with clinical data and therapy; to establish significant determinants of GFR decrease in this category of patients.Material and methods. The study included 70 patients with HTN and office blood pressure (BP) &lt;140/90 mm Hg aged 64 (57; 68) years (men, 48,6%), of whom 40 patients were examined within the Russian multicenter CHRONOGRAPH program. Office BP was 130 (120; 140)/80 (72; 82) mm Hg. GFR and albuminuria were assessed. Twenty-four-hour BP monitoring and Doppler ultrasound of renal blood flow with estimation of resistance indices (RI) were performed. The content of highsensitivity C-reactive protein (hsCRP), interleukins (IL) 1β, 6, 10 and lipid transport function parameters was determined.Results. CKD markers were detected in 31,4% of patients (in 27,1% — a decrease in GFR &lt;60 ml/min/1,73 m2; in 12,9% — pathological albuminuria). Patients with CKD markers were older, had higher office systolic BP and nocturnal pulse pressure, higher blood hsCRP and RI levels throughout the renal flow, and lower high-density lipoprotein cholesterol levels. In the presence of CKD markers, calcium channel blockers, aldosterone receptor antagonists and statins were used more often. The results of correlation analysis were used to determine the determinants of GFR decline. In the general group, GFR values had inverse correlations with age (Rs=-0,58, p&lt;0,0001), segmental intrarenal artery RI (Rs= -0,4232, p=0,0005), blood hsCRP (Rs=-0,3998, p=0,0007), IL-1β (Rs=-0,3139, p=0,0086), office BP and some 24-hour BP parameters. In the presence of CKD markers, a direct association of GFR and IL-10 was determined (Rs=0,4293, p=0,046). In the absence of such markers, GFR had an inverse correlation with IL-1β content (Rs=-0,3110, p=0,0333). A multiple linear regression model included following independent determinants of GFR: age, blood hsCRP and RI in the segmental intrarenal arteries.Conclusion. Among patients with medically-controlled HTN of high cardiovascular risk, a high prevalence of CKD markers was revealed (31,4%). Compared with patients with preserved renal function, in the presence of CKD markers, there were higher levels of office systolic BP, nocturnal pulse pressure, blood hsCRP, and intrarenal artery RI. Associations were established between GFR and the levels of hsCRP, IL-1β and IL-10, which confirms the pathological role of inflammatory biomarkers in developing renal dysfunction in high-risk HTN. Age, elevated blood hsCRP levels, and intrarenal artery RI are independent determinants of decreased GFR in patients with medically-controlled HTN of high and very high cardiovascular risk. The data obtained shows the need for early prescription of combination antihypertensive therapy with nephro- and vasoprotective effects in this category of patients, as well as with an ability to depress the chronic subclinical inflammation.

Analysis of the relationship between the level of high-sensitive C-reactive protein and the risk factors of cardiovascular diseases in young and middle-aged persons

Objective. To evaluate the relationship between the level of high-sensitive C-reactive protein young and middle-aged people without history of cardiovascular complications. Methods. Data from 427 patients aged 30-55 years old (median age -41 years old; men -83%), based on the center of diagnosis and rehabilitation of «Gazprom Transgaz Moscow» LLC from November 2018 to February 2020 were analyzed. All the participants conducted a comprehensive examination in accordance with the employee profession and order No. 302 of the Ministry of Health of the Russian Federation. Blood hs-CRP level was determined by an immunoturbodimetric method with latex amplification, with a lower detection limit of 0.1 mg/l. Results. Hs-CRP in comparison with a normal body weight participants (0.52 [0.32;0.98] mg/l) was significantly higher in overweight persons (1.23 [0.68;2.11] mg/l) and in obese patients (1.84 [1.27;3.11] mg/l), as well as in patients with obesity in comparison with patients with overweight (p=0.0001 in all cases). The hs-CRP level in a group with systolic blood pressure (SBP) 120-129 mm Hg hs-CRP was 0.96 [0.50;1.96] mg/l, in the group with SBP 130-139 mm Hg - 1.52 [0.83;2.77] mg/l, in patients with SBP &gt;140 mm Hg- 1.54 [1.03;2.19] mg/l (p = 0.0002). Similar significant (p=0.0002) relationships are revealed for office diastolic blood pressure (DBP). In patients with a total blood cholesterol &gt;4.9 mmol/l (n=355), the average level of hs-CRP was 1.24 [0.60;2.19] mg/l, and in participant with normal total cholesterol (n=72) - 0.69 mg/l [0.37;1.80] (p = 0.002). Among all the analyzed persons, elevated levels of hs-CRP (&gt; 2 mg/l) were associated with frequent flu (odds ratio (OR) 2.1, 95% confidence interval (CI) 1.2-3.7; p=0.02) and an increase in the erythrocytes sedimentation rate (ESR) (OR 3.5, 95 % CI 1.5-8.03; p=0.004). After adjustment for sex, age and confounders hs-CRP &gt;2 mg/l significantly associated with abdominal obesity (OR 2.2, 95 % CI 1.2-4.2; p=0.01) and hypertension (OR 1.9, 95 % CI 1.1-3.3; p=0.02). Conclusion. In young and middle-aged persons passing PME, hs-CRP is a stable cardiovascular risk marker, associated with overweight, obesity, an increase in the total cholesterol level, office SBP and DBP, ESR, and with history of frequent flu.

Foetal 25-hydroxyvitamin D moderates the association of prenatal air pollution exposure with foetal glucolipid metabolism disorder and systemic inflammatory responses

BackgroundPrevious studies have indicated that systemic inflammation may play an important role in the association between air pollution exposure and glucolipid metabolism disorders, and vitamin D supplementation was beneficial in improving systemic inflammation and glucolipid metabolism. However, the role of foetal 25-hydroxyvitamin D (25(OH)D) and high-sensitivity C-reactive protein (hs-CRP) in the association between prenatal air pollution exposure and foetal glucolipid metabolism disorders is still not clear. ObjectiveTo verify whether foetal 25(OH)D can improve glucolipid metabolism disorders induced by prenatal air pollution exposure by inhibiting the systemic inflammation. MethodsA total of 2,754 mother-newborn pairs were enrolled from three hospitals in Hefei city, China, between 2015 and 2019. We obtained air pollutants (PM2.5, PM10, SO2, CO, and NO2) data from the Hefei City Ecology and Environment Bureau. Cord blood biomarkers (25(OH)D, hs-CRP, C-peptide, HDL-C, LDL-C, TC, and TG) were measured. ResultsWe found that prenatal air pollution exposure was positively associated with foetal glucolipid metabolic index levels after adjusting for confounders. Additionally, an IQR increase in exposure to PM2.5, PM10, SO2, and CO was associated with 20.0% (95% confidence interval (CI): 16.9, 23.6), 20.1% (16.8, 23.3), 22.9% (20.6, 25.3), and 16.7% (14.4, 19.0) higher cord blood hs-CRP levels, respectively, and an SD increase in hs-CRP was associated with 1.4% (0.1, 2.8), 2.2% (1.6, 2.9), 1.4% (0.9, 2.0), and 3.9% (2.8, 4.9) higher C-peptide, LDL-C, TC, and TG levels in the cord blood, respectively. However, there was a monotonic decrease in βs between cord blood 25(OH)D and biomarkers (P for trend < 0.001). Furthermore, mediation analysis revealed that the association between air pollution exposure and foetal glucolipid metabolic indexes mediated by hs-CRP and 25(OH)D was 19.35%. In stratified analyses, the significant negative association between cord blood 25(OH)D with foetal hs-CRP and glucolipid metabolic indexes was observed only at low-medium levels of air pollution exposure. ConclusionsPrenatal air pollution exposure could damage foetal glucolipid metabolic function through systemic inflammation. High foetal 25(OH)D levels may improve foetal systemic inflammation and glucolipid metabolism at low-medium levels of prenatal air pollution exposure.

Prediction of 10-year mortality using hs-CRP in Chinese people with hyperglycemia: Findings from the Da Qing diabetes prevention outcomes study

AimsTo examine whether high-sensitivity C-reactive protein (hs-CRP) can predict all-cause death in Chinese adults with hyperglycemia. MethodsAll the 237 diabetes and 49 prediabetes recruited in the study were evolved from the participants with impaired glucose tolerance in the original Da Qing Diabetes Study. Blood hs-CRP level was measured at 2006. Ten-year outcome of death was traced from 2006 to 2016. Cox model was used to analyse the association between hs-CRP level and the risk of all-cause death occurred over the subsequent 10 years. ResultsDuring the follow-up, death occurred in 36 (37.9%) subjects in the highest hs-CRP tertile group (hs-CRP > 2.16 mg/L) and 19 (20.0%) in the lowest hs-CRP tertile group (hs-CRP < 0.82 mg/L, p < 0.05). The corresponding incidence of all-cause death (per 1,000 person-years) was 44.7 (95% CI 30.1–59.3) and 21.6 (95% CI 11.9–31.3) in the two groups respectively (p < 0.0001). The highest hs-CRP tertile was associated with the increased risk of all-cause death significantly (hazard ratio 1.88, 95% CI 1.07–3.32) after controlling for traditional risk factors. ConclusionsSerum hs-CRP was predictive of 10-year all-cause death in Chinese adults with hyperglycemia, suggesting the impact of low-grade inflammation on mortality deserves more attention.

Low-Grade Systemic Inflammation Interferes with Anabolic and Catabolic Characteristics of the Aged Human Skeletal Muscle.

Aging is associated with the development of chronic low-grade systemic inflammation (LGSI) characterized by increased circulating levels of proinflammatory cytokines and acute phase proteins such as C-reactive protein (CRP). Collective evidence suggests that elevated levels of inflammatory mediators such as CRP, interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α) are correlated with deteriorated skeletal muscle mass and function, though the molecular footprint of this observation in the aged human skeletal muscle remains obscure. Based on animal models showing impaired protein synthesis and enhanced degradation in response to LGSI, we compared here the response of proteolysis- and protein synthesis-related signaling proteins as well as the satellite cell and amino acid transporter protein content between healthy older adults with increased versus physiological blood hs-CRP levels in the fasted (basal) state and after an anabolic stimulus comprised of acute resistance exercise (RE) and protein feeding. Our main findings indicate that older adults with increased hs-CRP levels demonstrate (i) increased proteasome activity, accompanied by increased protein carbonylation and IKKα/β phosphorylation; (ii) reduced Pax7+ satellite cells; (iii) increased insulin resistance, at the basal state; and (iv) impaired S6 ribosomal protein phosphorylation accompanied by hyperinsulinemia following an acute RE bout combined with protein ingestion. Collectively, these data provide support to the concept that age-related chronic LGSI may upregulate proteasome activity via induction of the NF-κB signaling and protein oxidation and impair the insulin-dependent anabolic potential of human skeletal muscle.

The severity of internal carotid artery stenosis is associated with the circulating Th17 level

AimImmune and inflammatory reactions contribute to the progression of atherosclerosis. The walls of the different arteries and segments of the arteries have heterogeneous haemodynamic and histological features. We aimed to explore the relationship between the circulating T-cell subsets and the abundance of carotid atherosclerosis in different segments of carotid arteries. Methods70 patients underwent ultrasound duplex scanning to determine the degree of stenosis of the common carotid artery (CCA), the CCA bifurcation or the internal carotid artery (ICA). The blood frequencies of T-, B-, NK-cells, regulatory T cells (Treg), activated T-helpers (Th), IL10-producing Th, Th1 and Th17, as well as blood levels of hsCRP, sCD25, IL10 and IL17a were assessed. ResultsThe frequencies of Th17 were increased in patients with ICA stenosis >35% and >50% vs. patients with ICA stenosis <35%. Th17 blood level ≥0.55 % of lymphocytes was associated with more severe stenosis of ICA (OR 4.3 (1.0–17.6), p < 0.05 for ICA stenosis of 35–50% and 6.8 (1.3–35.0), p < 0.05 for ICA stenosis >50%). BMI positively correlated with the CCA bifurcation stenosis degree (r = 0.33, p < 0.05). ConclusionThe severity of ICA stenosis can be associated with the circulating Th17 level.

The Incidence and Possible Predictors of Coronary Restenosis

Assess time and possible predictors of restenosis after the implantation of first- and second-generation coronary stents and bare metal stents (BMSs) in patients with stable coronary artery disease after elective coronary stenting. From 2010 to 2014, 3,732 (2,897 males, 60 [53; 68] years old) patients with stable exertional angina of functional class I-III underwent coronary stenting. From 2014 to 2017, 1,487 (1,173 males and 314females) patients returned. Repeat coronary angiography was performed in 699 patients. A total of 644 first-generation stents, 5,321 second-generation stents, and 473 BMSs were implanted. During the control coronary angiography, contrasting was repeated for 193 first-generation stents, 899second-generation stents, and 77 BMSs. Restenosis (stenosis of 50 % or more in the previously stented segment) was detected in 28 (14 % of angiographic control) first-generation drug-eluting stents, 94 (10 %) second-generation drug-eluting stents, and 21 (27 %) BMSs. Patients with BMS restenosis returned significantly earlier than patients with restenosis of the first- and second-generation drug-eluting stents (11 [6, 27] months vs. 32 [11; 48]) months and 24 [12; 42] months, respectively; p&lt;0.05). The initial and repeat levels of high-sensitivity C-reactive protein (hs-CRP) were higher in patients with restenosis (2.2 [1.2, 5.0] mg / L vs. 2.1 [1.0, 4.6] mg / L, respectively; p&gt; 0.05) than inpatients without restenosis (2.0 [0.9, 4.2] mg / L vs. 1.9 [0.7, 3.5] mg / L respectively, p&gt;0.05). Blood levels of hs-CRP ≥2 mg / L according to receiver operating characteristic curve (ROC) analysis atreturn visit were used as a predictor to identify restenosis of stents with a diameter &lt;3 mm and a length &gt;25 mm- area under the curve (AUC) 0.67 (95 % confidence interval (CI) 0.51-0.84), p &lt;0.05, odds ratio 3.7 (95 % CI 1.1-12.1), p&lt;0.05. Stent type had a significant effect on the time to restenosis in the survival analysis (p&lt;0.0005). The time from coronary stenting to the return visit of patients presenting with restenosis after the implantation of first- and second-generation drug-eluting stents is consistent; median time of the return visit of patients with restenosis of the first-generation stents was 2-3 years after coronary stenting. Blood levels of hs-CRP ≥2 mg / L at the return visit is a predictor of restenosis of stents with a diameter &lt;3 mm and a length &gt;25 mm.

Digital Delivery of Meditative Movement Training Improved Health of Cigarette-Smoke-Exposed Subjects.

Many FA who flew prior to the ban on smoking in commercial aircraft exhibit an unusual pattern of long-term pulmonary dysfunction. This randomized controlled study tested the hypothesis that digitally delivered meditative movement (MM) training improves chronic obstructive pulmonary disease (COPD)-related symptoms in flight attendants (FA) who were exposed to second-hand cigarette smoke (SHCS) while flying. Phase I of this two-phase clinical trial was a single-arm non-randomized pilot study that developed and tested methods for MM intervention; we now report on Phase II, a randomized controlled trial comparing MM to a control group of similar FA receiving health education (HE) videos. Primary outcomes were the 6-min walk test and blood levels of high sensitivity C-reactive protein (hs-CRP). Pulmonary, cardiovascular, autonomic and affective measures were also taken. There were significant improvements in the 6-min walk test, the Multidimensional Assessment of Interoceptive Awareness (MAIA) score, and the COPD Assessment Test. Non-significant trends were observed for increased dehydroepiandrosterone sulfate (DHEAS) levels, decreased anxiety scores and reduced blood hs-CRP levels, and increased peak expiratory flow (PEF). In a Survey Monkey questionnaire, 81% of participants who completed pre and post-testing expressed mild to strong positive opinions of the study contents, delivery, or impact, while 16% expressed mild negative opinions. Over the course of the year including the study, participant adoption of the MM practices showed a significant and moderately large correlation with overall health improvement; Pearson's R = 0.62, p < 0.005. These results support the hypothesized benefits of video-based MM training for this population. No adverse effects were reported.Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT02612389

Relationships between low-grade peripheral inflammation and psychotropic drugs in schizophrenia: results from the national FACE-SZ cohort.

Low-grade inflammation has repeatedly been associated with schizophrenia (SZ) and in particular with cognitive impairment. Female gender, overweight and tobacco smoking have been suggested as risk factors to increase inflammation while preclinical inconsistent findings have been found regarding the association with psychotropic drugs. The aim of this study was to explore if psychotropic drugs were associated with inflammation in SZ and to determine which psychotropic drug was associated with inflammation in stable SZ subjects while considering clinical confounding factors. Participants were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia and received a thorough clinical assessment, including recording of current treatment. High-sensitivity CRP (hs-CRP) was measured for each participant as a proxy to define peripheral low-grade inflammation. The zero-inflated Poisson regression model estimated the relationship between low-grade inflammation and psychotropic drug. Four hundred and five stabilized, community-dwelling SZ subjects (mean age=32.6years, 74% male gender) have been included. In total, 148 participants (36.5%) were found with undetectable blood hs-CRP level. The probability of having an undetectable CRP was associated with a lower body mass index (p<0.0001) and no cyamemazine add-on antipsychotic therapy (p=0.001). The other 257 participants (63.5%) were found to have low-grade inflammation (hs-CRP>0mg/L). Low-grade inflammation was significantly associated with female gender (p=0.004), higher body mass index (p<0.0001), current tobacco smoking (p<0.0001), clomipramine (p=0.04), quetiapine (p<0.0001) and hypnotic (p=0.0006) consumption while decreased hs-CRP blood levels was associated with aripiprazole (p=0.004) and valproate/valpromide (p=0.03) consumption. The present study suggests that some psychotropic drugs (quetiapine, cyamemazine, clomipramine) may be associated with increased peripheral low-grade inflammation in SZ patients while others (aripiprazole, valproate) may be associated with decreased peripheral low-grade inflammation. These results should be replicated in SZ and non-SZ populations and the biological underpinnings should be further explored.

Effects of Urtica dioica leaf extract on inflammation, oxidative stress, ESR, blood cell count and quality of life in patients with inflammatory bowel disease

AimsInflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, is a debilitating, chronic relapsing and remitting condition. Although the exact etiology remains unknown, immune and inflammatory factors and oxidative stress are thought to play an important role in its pathogenesis. This study examined the effects of an Urtica dioica leaf extract on high-sensitivity C-reactive protein (hs-CRP), superoxide dismutase (SOD), erythrocyte sedimentation rate (ESR), white blood cells, platelets and quality of life in patients with inflammatory bowel disease. MethodsThis study was a double-blind, placebo-controlled, randomized, clinical trial, conducted on 64 patients with IBD. The participants were divided into a nettle group (n=32) and a placebo group (n=32) by stratified blocked randomization. Subjects received three tablets daily for 12 weeks of either a hydroethanolic nettle extract (400mg) or placebo. Blood levels of hs-CRP, SOD, ESR, platelets, WBC and inflammatory bowel disease questionnaire-9 (IBDQ-9) scores were assessed at baseline and at the end of the study. Results59 participants completed the trial (30 in the nettle and 29 in the placebo group). After 12 weeks, serum levels of hs-CRP and platelet count showed a significant reduction in the nettle group compared to the placebo group (p=0.012 and p=0.023 respectively), whereas the level of SOD only increased significantly in the nettle group (p=0.002). The score of IBDQ-9 also increased significantly in the nettle group compared to the placebo group (p<0.001). No significant differences were found in the levels of WBC and ESR between two groups (p=0.754 and p=0.094 respectively). ConclusionThe present study showed that a hydroethanolic nettle leaf extract can reduce inflammatory markers and platelet count, as well as increase antioxidant enzyme SOD activity and quality of life in patients with IBD. The results suggest that a nettle extract may have therapeutic potential as an adjunctive treatment in IBD and that further clinical studies are warranted.

Cognitive Changes during Prolonged Stay at High Altitude and Its Correlation with C-Reactive Protein.

Hypersensitive C-reaction protein (hsCRP) may be a risk factor for cognitive impairment resulting from Alzheimer’s disease (AD), stroke, and vascular dementia. This study explored the correlation of peripheral blood hsCRP level with cognitive decline due to high altitude exposure. The study was conducted on 100 male military participants who had never been to high altitude. Cerebral oxygen saturation monitoring, event related potentials (P300, N200) detection, and neurocognitive assessment was performed and total hsCRP, interleukin-6 (IL-6), and homocysteine was estimated at 500m altitude, 3650m altitude, 3day, 1, and 3 month post arriving at the base camp (4400m), and 1 month after coming back to the 500m altitude. High altitude increased brain oxygen saturation, prolonged P300 and N200 latencies, injured cognitive functions, and raised plasma hsCRP levels. But they all recovered in varying degrees at 1 and 3 month post arriving at the base camp (4400m). P300 latencies and hsCRP levels were strongly correlated to cognitive performances. These results suggested that cognitive deterioration occurred during the acute period of exposure to high altitude and may recover probably owning to acclimatization after extended stay at high altitude. Plasma hsCRP is inversely correlated to neurological cognition and it may be a potential biomarker for the prediction of high altitude induced cognitive dysfunction.

A Study on Hs-CRP, Carotid Intima Media Thickness, and Lipid Profile in Children of Patients with Premature CAD

Background: This study aimed to evaluate the risk markers of Coronary Artery Disease (CAD), so that appropriate lifestyle changes can be instituted early to prevent or delay development of the disease. Objectives: This study aimed to evaluate the risk markers of CAD based on inflammation and arterial morphology; i.e., high sensitivity C-Reactive Protein (hs-CRP) and carotid artery Intima Media Thickness (IMT), in children of patients with premature CAD. Patients and Methods: This was a case-control study with predetermined end points. It was conducted on 40 subjects randomly selected from the children of premature CAD patients and 40 age- and sex-matched healthy controls. Blood levels of hs-CRP, lipid profile, and carotid IMT were assessed for all the subjects. The relationship among these parameters was evaluated by univariate and multivariate analyses using the SPSS statistical software, version 22.0 and P < 0.05 was considered as statistically significant. Results: The mean values of Total Cholesterol (TC, 139.8 ± 24 vs. 111.3 ± 14.7, P < 0.05), Triglycerides (TG, 81.8 ± 15.3 vs. 63.4 ± 10.8, P < 0.05), Low Density Lipoprotein (LDL, 85.2 ± 22.2 vs. 57.5 ± 14.1, P < 0.05), hs-CRP (1.2 ± 0.77 vs. 0.79 ± 0.27, P < 0.05) and carotid artery IMT (0.49 ± 0.09 vs. 0.422 ± 0.03, P < 0.05) were significantly higher in the cases compared to the controls. Also, both LDL/High Density Lipoprotein (HDL) and TC/HDL ratios were significantly higher in the cases compared to the controls. Moreover, a significant positive correlation was found between carotid IMT and hs-CRP. Conclusions: Children of patients with premature CAD showed a significantly higher incidence of dyslipidemia as well as significantly increased levels of the inflammation marker, hs- CRP, compared to the age- and sex-matched controls. This indicates that atherosclerosis is not only a disease of lipid deposition, but also an inflammatory process. This was further confirmed by demonstration of a significantly raised IMT.

Impact of obesity on bronchial asthma in Indian population.

Background and Objective:Obesity and asthma are common inflammatory conditions, having presence of both local and systemic inflammation and this relationship is not well understood. This study was undertaken to compare pulmonary function parameters, inflammatory marker like C-reactive protein (hs-CRP), exhaled nitric oxide (FENO) and atopic profile between non-obese and obese bronchial asthma patients in Indian population. The study aims to elucidate the association between the systemic and local inflammatory response relating to obesity in asthmatics.Materials and Methods:Sixty bronchial asthma patients were recruited for the study, and were divided equally into obese (BMI>30 kg/m2) and non-obese (BMI<25 kg/m2) groups. These were assessed for pulmonary function parameters, blood hs-CRP levels, exhaled breath analysis of nitric oxide and skin prick testing for atopic profile. The study was approved by institutional ethical committee.Results:The mean body mass index (BMI) for the non-obese and obese group was 21.64 kg/m2 and 34.1 kg/m2 respectively (P = 0.001). The functional residual capacity (FRC% predicted) (100.9 ± 4.21 vs 80.40 ± 4.03; P = 0.009) and expiratory reserve volume (ERV% predicted) (95.13 ± 6.71 vs. 67.03 ± 4.54; P = 0.001) both were significantly lower in the obese group. The non-obese and obese group had hs-CRP levels of 3.01 mg/L and 4.07 mg/L, respectively; the difference being statistically insignificant (P = 0.15). Similarly, FENO levels of non-obese and obese group were 63.20 ppb and 63.75 ppb, respectively; difference was not statistically significant (P = 0.95). Atopic profile of both the groups did not differ significantly.Conclusion:Obesity does not appear to increase the local and systemic inflammatory responses in bronchial asthma patients in Indian population.

Efect of periodontal disease and non surgical periodontal treatment on C-reactive protein. Evaluation of type 1 diabetic patients

Objectives: The purpose of this study was to analyze how anti-infectious periodontal treatment affects C reactive protein (CRP) values in patients with type 1 diabetes, and correlate baseline CRP levels with periodontal disease severity. Study Design: A cohort of fifty three subjects with type 1 diabetes and moderate to severe periodontitis were recruited. Periodontal parameters were measured, and blood samples were obtained to evaluate high-sensitivity C-reactive protein (hs-CRP). Group 1 was treated with scaling, root planning, and systemic administration of doxycycline. Group 2 received only scaling and root planning. Results: Hs-CRP was reduced after periodontal treatment in group 1 (-0.22 mg/l) and 2 (-0.21 mg/l ) but this reduction was not statistically significant, even in the patients with the best response to periodontal treatment. However, significant correlation appeared between hs-CRP and mean probing pocket depth (PPD) (p=0, 01) and mean clinical attachment level (CAL) (p=0,03). Conclusions: Non-surgical periodontal treatment couldn’t reduce hs-CRP values, however, it was found an association between advanced periodontitis and elevated blood hs-CRP levels in patients with type 1 diabetes. It can be speculated that periodontal disease increases production of pro-inflammatory mediators in patients with type 1 diabetes, but other producing sources of these pro-inflammatory substances may exist. Key words:Periodontal disease, periodontitis, diabetes mellitus type 1, periodontal therapy, C reactive protein.

The effects of peridopril on vascular inflammation and vascular endothelium function in mild- to- moderate essential hypertensive patients

ObjectiveTo explore the effects of peridopril tablet on vascular inflammation and vascular endothelium function in mild- to- moderate essential hypertensive (EH) patients.Methods100 EH patients were divided into peridopril group (50...

Very Low Levels of High-sensitivity C-reactive Protein are not Bimodally Distributed but are Significantly Related to Other Metabolic Risk Factors in Japanese

High-sensitivity C-reactive protein (hs-CRP) is an independent risk factor of diabetes and cardiovascular disease and it is proposed as a component of metabolic syndrome. Blood levels of hs-CRP are reported to be much lower in Japanese than in Westerners and bimodally distributed in Japanese. Very low levels of hs-CRP were examined using medical check-up data of 1,360 Japanese men and 821 women whose plasma levels of high-sensitivity C-reactive protein (hs-CRP) were below 10 mg/L. The distribution of hs-CRP levels were skewed but not bimodal in both men and women and very low levels of hs-CRP were significantly related to waist circumference, systolic blood pressure, diastolic blood pressure, fasting glucose, triglycerides, and low-density lipoprotein cholesterol in both men and women. The area under receiver operating characteristic curve of hs-CRP for diagnosing metabolic syndrome and Spearman's correlation coefficients between hs-CRP and components of metabolic syndrome were comparable to those of components of metabolic syndrome in both men and women. Very low levels of hs-CRP were not bimodally distributed but were significantly related to metabolic risk factors in Japanese.

Comparison Between Effect of Glimepiride and Pioglitazone on the C-Reactive Protein Level of Type 2 Diabetic Patient

Background: This study was carried out to see the effect of glimepiride and pioglitazone on the serum hs-CRP level in type 2 diabetic patients. Material and Methods: A non-blind comparative study was conducted among 70 patients with type 2 diabetes (as per WHO criteria) divided into two groups (35 each) to see the effect of glimepiride and pioglitazone on their blood hs-CRP level. Results: 35 type-2 diabetic patients were given glimepiride. Another 35 patients were given pioglitazone. Fasting blood sugar, HbA1c%, hs-CRP and lipid profile were estimated before and 12 weeks after intervention. The mean change of serum hs-CRP was 1.13 mg/L to 0.76 mg/L in pioglitazone group. In glimepiride group the mean change of serum hs-CRP was 0.96 mg/L to 0.94 mg/L after 12 weeks. The change was greater in pioglitazone group in comparison to glimepiride group. Conclusion: Reduction of hs-CRP was significant in the study subjects revealing its future potential in reducing the vascular complications of type - 2 diabetes mellitus. Keyword: Type-2 diabetes; hs-CRP; Glimepiride; Pioglitazone; Cardiovascular complication DOI: 10.3329/jom.v12i1.6929J Medicine 2011; 12 : 30-33