C-reactive Protein Assay Research Articles

Oxidative stress, chronic inflammation, and telomere length in patients with periodontitis

The aim of this study was to determine leukocyte telomere length (LTL) in individuals with periodontitis and controls, exploring its relationship with systemic inflammation and oxidative stress. Five hundred sixty-three participants were recruited for this case–control study: 356 subjects with and 207 subjects without periodontitis. LTL was measured by a qPCR technique from leukocytes' DNA. Global measures of oxidative stress (reactive oxygen metabolites) and biological antioxidant potential in plasma were performed together with high-sensitivity assays for C-reactive protein (CRP). Leukocyte counts and lipid profiles were performed using standard biochemistry. Cases had higher levels of CRP (2.1 ± 3.7 mg/L vs 1.3 ± 5.4 mg/L, P < 0.001) and reactive oxygen metabolites (378.1 ± 121.1 U Carr vs 277.4 ± 108.6 U Carr, P < 0.001) compared to controls. Overall, cases had shorter LTL with respect to controls (1.23 ± 0.42 vs 1.12 ± 0.31 T/ S ratio, P = 0.006), independent of age, gender, ethnicity, and smoking habit. When divided by subgroup of periodontal diagnosis (chronic, n = 285; aggressive, n = 71), only chronic cases displayed shorter LTL ( P = 0.01). LTL was negatively correlated with age ( P = 0.001; R = − 0.2), oxidative stress ( P = 0.008; R = − 0.2), and severity of periodontitis ( P = 0.003; R = − 0.2) in both the whole population and the subgroups (cases and controls). We conclude that shorter telomere lengths are associated with a diagnosis of periodontitis and their measures correlate with the oxidative stress and severity of disease.

Ancestry as a Determinant of Mean Population C-Reactive Protein Values

Background— Eligibility for rosuvastatin treatment for cardiovascular disease prevention includes a C-reactive protein (CRP) concentration &gt;2 mg/L. Most observational studies of CRP and cardiovascular disease have been in Europeans. We evaluated the influence of ancestry on population CRP concentration to assess the implications for statin targeting in non-Europeans. Methods and Results— In a systematic review and meta-analysis among 221 287 people from 89 studies, geometric mean CRP was 2.6 mg/L (95% credible interval, 2.27 to 2.96) in blacks resident in the United States (n=18 585); 2.51 mg/L (95% CI, 1.18 to 2.86) in Hispanics (n=5049); 2.34 mg/L (95% CI, 1.99 to 2.8) in South Asians (n=1053); 2.03 mg/L (95% CI, 1.77 to 2.3) in whites (n=104 949); and 1.01 mg/L (95% CI, 0.88 to 1.18) in East Asians (n=39 521). Differences were not explained by study design or CRP assay and were preserved after adjustment for age and body mass index. At age 60 years, fewer than half of East Asians but more than two thirds of Hispanics were estimated to have CRP values exceeding 2 mg/L. HapMap frequencies of CRP polymorphisms known to associate with CRP concentration but not coronary heart disease events differed by ancestry. In participant data from the Wandsworth Heart and Stroke Study including European, South Asian and African, and Caribbean-descent subjects, body mass index, systolic blood pressure, and smoking contributed to between-group differences in CRP, but the majority of the difference in CRP was unexplained. Conclusions— Differences in CRP concentration in populations of diverse ancestry are sufficiently large to affect statin eligibility, based on a single CRP threshold of 2 mg/L, and only partially influenced by differences in variables related to cardiovascular risk. A single threshold value of CRP for cardiovascular risk prediction could lead to inequalities in statin eligibility that may not accurately reflect underlying levels of cardiovascular risk.

E0406 High sensitivity C-Reactive protein and the risk of stent thrombosis and cardiovascular events

BackgroundC-reactive protein (CRP) is one of the acute phase proteins that increase during systemic inflammation. It's been suggested that testing CRP levels in the blood may be an additional way...

A multiplexed point-of-care assay for C-reactive protein and N-terminal pro-brain natriuretic peptide

Several new plasma protein biomarkers have been associated with increased risk of cardiovascular events. It would be of great value if sets of these markers could be measured in a multiplexed format at point-of-care settings. A major challenge is the extremely wide concentration range in which different plasma biomarkers are present. Two promising biomarkers for cardiac risk prediction are C-reactive protein (CRP) and N-terminal pro-brain natriuretic peptide (NTproBNP). The concentrations of these markers can differ by more than six orders of magnitude. Here we present a chip-based multiplexed assay for CRP and NTproBNP. The high-concentration analyte, CRP, is analyzed in a competitive format, whereas the low-concentration analyte, NTproBNP, is analyzed in a sandwich format. This allows concurrent measurement of the two analytes in a single multiplexed assay. The dynamic ranges for the two assays were optimized to match the relevant serum concentration ranges; thus, no dilutions were needed. Both assays exhibit good precision (5–15% in the clinically relevant concentration ranges), and the limit of detection for the NTproBNP assay was 5 ng/L. Patient plasma samples were used for comparison with clinical methods, resulting in coefficients of determination ( R 2) of 0.9762 and 0.9606 for NTproBNP and CRP, respectively.

Validation of a high-sensitivity assay for C-reactive protein in saliva

Validation of a high-sensitivity assay for C-reactive protein in saliva

The Rationale for Comparative Studies of Accelerated Atherosclerosis in Rheumatic Diseases

The inflammatory pathogenesis of atherosclerosis is now well-established, owing to in vitro and in vivo studies and the application of high sensitivity assays for C-reactive protein (CRP) in the general population and specific groups at risk for cardiovascular disease (CVD). In view of the complexity of inflammation-induced atherosclerosis, the rationale for comparative studies of atherogenesis in rheumatic diseases with diverse inflammatory pathogenesis seems obvious; they are human in vivo models to study inflammatory mechanisms involved in atherosclerosis and the impact of treatment. Factors implicated in atherogenesis in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), familial Mediterranean fever (FMF) and Behçet's disease (BD) are discussed in this review. Evidence suggests that enhanced atherosclerosis causes premature cardiovascular events in the autoimmune disease, SLE, and the "high-grade" inflammatory rheumatic disease, RA. Preliminary data suggest that enhanced atherogenesis may accompany FMF in the absence of sufficient suppression of inflammation by colchicine. In the setting of BD, the role of atherosclerosis in the premature manifestation of coronary pathology has not been confirmed; coronary vasculitis and aneurysms appear to constitute the basis of myocardial infarction (MI) in BD. A variety of established and novel risk factors are believed to influence enhanced atherogenesis in rheumatic diseases. Antiphospholipid antibodies are thought to be intimately involved in atherogenesis in SLE and to a lesser extend in RA. CRP may play a more universal role in all rheumatic diseases. The application of high resolution ultrasound of peripheral arteries and other non-invasive techniques may allow targeted use of statins, ACE inhibitors, antiplatelet agents and other cardioprotective drugs in patients with rheumatic diseases, but this needs to be evaluated specifically in prospective studies.

Anti-CRP antibodies in systemic lupus erythematosus

C-reactive protein (CRP) is an acute-phase protein whose concentration rises sharply during the inflammatory response (1000-fold). CRP belongs to the pentraxin family of proteins, of which a key property is the ability to opsonize apoptotic cells, which can then undergo phagocytosis without triggering an inflammatory response, in marked contrast to the phagocytosis of necrotic cells. The low CRP concentrations in patients with systemic lupus erythematosus (SLE) may contribute to defective clearance of apoptotic particles, thereby promoting the development of autoimmunity to apoptotic vesicle components. In normal populations, serum CRP concentrations remain below 5–10mg/L. Within this normal range, five quintiles of CRP concentrations can be distinguished using an ultrasensitive CRP assay. Individuals who are consistently within the highest quintile are at higher risk for cardiovascular death and recurrent myocardial infarction than are individuals in the lowest quintile. Thus, the ultrasensitive CRP concentration (US-CRP) is a cardiovascular risk factor, together with the classic risk factors identified by the Framingham studies. CRP plays a role in atheroma plaque development via its ability to attract macrophages, which convert to foam cells. Any chronic inflammatory disease associated with increased CRP production can accelerate the development of atheroma. Paradoxically, the inflammatory process in patients with SLE is associated with a fairly small elevation of serum CRP concentrations. Nevertheless, this elevation is sufficient to increase the cardiovascular risk. Anti-CRP autoantibodies, which are found in 35 to 40% of SLE patients, increase the cardiovascular risk by interacting with the monomeric (degraded) form of CRP. CRP/anti-CRP immune complexes developed in the arterial wall may promote growth of the atheroma plaque.

Usefulness of CRP and ESR in Predicting Septic Joints

To determine whether erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), or a combination of both was better in diagnosing a septic joint. A retrospective chart review was done in all patients who had serum assays for ESR or CRP as well as joint fluid analysis over a two-year period. Based on lab and operative findings, patients (cohorts) were categorized as having normal, inflammatory, or septic joints. Sensitivities (SEN), specificities (SP), positive and negative predictive values (PPV, NPV) were obtained using our lab's positive cutoffs of 15 for ESR and 0.8 for CRP. Contingency tables were used for comparisons between predictor variables and the presence of septic joints. Receiver operator curves (ROC) were obtained for CRPs and ESRs. Of 163 patients, 72 had inflammatory joints, 44 had septic joints, and 47 were normal. Fifteen admitted to drug use and 43 to alcohol consumption. There were 120 males and 42 females. The mean CRP for septic joints was 13, 8.5 for inflammatory joints, and 6 for normal. The mean ESR for septic joints was 57, 48 for inflammatory joints, and 43 for normal joints. By univariate analysis, drug use and elevated CRPs were significantly associated with septic joints while alcohol use, ESRs, and gender were not. A regression model with 4 variables indicated that drug use and CRP were predictive of septic joint; alcohol and ESR were not. CRP is helpful in determining the presence of a septic joint; ESR is not.

48 Amplification and overexpression of vinculin are associated with increased tumour cell proliferation and progression in advanced prostate cancer

Atherosclerosis is a chronic disease of the arterial wall that is recognized as the leading cause of mortality and morbidity worldwide. There is an eminent need for better biomarkers that can aid in patient care before the onset of the first cardiovascular event.We used quantitative proteomics to identify proteins with altered concentrations in plasma samples from four groups: 1) Individuals without cardiovascular symptoms and without the presence of coronary calcium, 2) individuals without cardiovascular symptoms, but with high amounts of coronary calcium, 3) individuals operated because of atherosclerotic diseases, and 4) individuals with an acute coronary syndrome. Immunoassays and SRM–MS were used for single patient verification of candidate proteins. Proteins involved in cardiovascular diseases i.e. serum amyloid protein A (SAA), C-reactive protein (CRP), and apolipoprotein(a) [apo(a)] displayed an increased expression profile from groups 1 to 4. The top-most elevated protein, vinculin (Vcl) displayed a similar profile. Immunoassays confirmed the expression profile of apo(a) and CRP. A 5-plex SRM–MS assay for Vcl, SAA, CRP, apo(a) and thrombospondin-4 (TSP-4) was developed for multiplex verification in all 120 individual samples. The 5-plex SRM assay confirmed a statistically significant up-regulation of Vcl in the acute coronary syndrome group.The aim of this study was to identify new candidate plasma markers of atherosclerosis manifestations, which may develop into screening-, diagnostic- or monitoring biomarkers for risk stratification of cardiovascular disease (CVD). At present no studies have elucidated the proteomic changes that occur along with several stages and manifestations of atherosclerotic disease. By using 4-plex iTRAQ, we identified and quantified proteins with altered concentrations in pooled plasma samples from 120 individuals from four middle-aged groups. Proteins involved in cardiovascular diseases i.e. serum amyloid protein A (SAA), C-reactive protein (CRP), and apolipoprotein(a) [apo(a)] displayed an increased expression profile along with increased manifestations of CVD. A novel candidate marker was identified as vinculin (Vcl), a multi-protein linker that connects cell–matrix adhesions and cell–cell adhesions to the actin-based cytoskeleton. Immuno- and SRM-assays were used for single patient validation of candidate proteins. While further studies needs to address the role of Vcl in the development of atherosclerosis, the combined data provided in this report offers a catalog of the proteomic changes that occurs in plasma over several stages and manifestations of atherosclerotic disease.

C-Reactive Protein as a Prognostic Indicator in Dogs with Acute Abdomen Syndrome

The objective of the present study was to measure serum C-reactive protein (CRP) concentrations in 32 dogs with acute abdomen syndrome at presentation and after 48-72 hr. Data were evaluated to determine if there was an association between CRP concentration and outcome, and if CRP concentration correlated with the white blood cell (WBC) count at both time points. An immunoturbidimetric assay for human CRP, previously validated for use in dogs, was used for serum CRP analysis. Increased serum CRP concentrations were found in 21 dogs at presentation. Fifteen of these dogs had declining serum CRP concentrations by 48-72 hr, but 3 of the 15 dogs were later euthanized. Serum CRP concentrations increased by 48-72 hr in 4 dogs. Of the 32 dogs, 4 were dead or were euthanized prior to the 48-72 hr time point. No significant difference between initial CRP concentration and outcome was found (P = 0.054). Initial and 48-72 hr CRP values taken together were significantly different between outcome groups (P < 0.001). Serum CRP concentrations that were elevated at both time points were associated with a poor prognosis. No correlation was found between CRP concentrations and WBC counts at presentation (P = 0.83); however, a significant correlation was noted at 48-72 hr (P = 0.03). Evaluation of sequential CRP concentrations in dogs with acute abdomen syndrome may be helpful in assessing clinical response to treatment and predicting outcome. Also, serum CRP may be better in detecting tissue injury and/or inflammation at presentation than WBC counts in select cases.

Cardiovascular and metabolic syndrome risk among men with and without erectile dysfunction: case-control study.

Erectile dysfunction has been associated with cardiovascular diseases. The aim here was to evaluate cardiovascular risk through the Framingham Risk Score (FRS) criteria, C-reactive protein (CRP) assays and presence of metabolic syndrome (MS) in men with and without erectile dysfunction diagnosed within a healthcare program. A retrospective case-control study was conducted. The patients were selected from a healthcare program at the Hospital Israelita Albert Einstein, between January and December 2007. 222 men were retrospectively selected, and they were divided into two groups: men with erectile dysfunction (n = 111) and men without erectile dysfunction (n = 111). The patients were stratified according to the International Index of Erectile Function-Erectile Function domain (IIEF-EF domain). CRP and FRS were analyzed and the two groups were compared. The CRP levels were significantly higher among men with erectile dysfunction (P = 0.04). Patients with erectile dysfunction also had high FRS (P = 0.0015). CRP and FRS did not correlate with the severity of erectile dysfunction. The presence of metabolic syndrome was greater among men with erectile dysfunction (P < 0.05). The severity of erectile dysfunction was directly associated with metabolic syndrome. Men with erectile dysfunction presented higher cardiovascular risk according to the FRS criteria and CRP measurements. Severe erectile dysfunction seemed to have a correlation with metabolic syndrome.

Highly sensitive immunoassay based on E. coli with autodisplayed Z-domain

The Z-domain of protein A has been known to bind specifically to the F c region of antibodies (IgGs). In this work, the Z-domain of protein A was expressed on the outer membrane of Escherichia coli by using “Autodisplay” technology as a fusion protein of autotransport domain. The E. coli with autodisplayed Z-domain was applied to the sandwich-type immunoassay as a solid-support of detection-antibodies against a target analyte. For the feasibility demonstration of the E. coli based immunoassay, C-reactive protein (CRP) assay was carried out by using E. coli with autodisplayed Z-domain. The limit of detection (LOD) and binding capacity of the E. coli based immunoassay were estimated to be far more sensitive than the conventional ELISA. Such a far higher sensitivity of E. coli based immunoassay than conventional ELISA was explained by the orientation control of immobilized antibodies and the mobility of E. coli in assay matrix. From the test results of 45 rheumatoid arthritis (RA) patients’ serum and 15 healthy samples, a cut-off value was established to have optimal sensitivity and selectivity values for RA. The CRP test result of each individual sample was compared with ELISA which is the reference method for RA diagnosis. From this work, the E. coli with Z-domain was proved to be feasible for the medical diagnosis based on sandwich-type immunoassay.

Evaluation of the Clinical Performance of an Automated Procalcitonin Assay for the Quantitative Detection of Bloodstream Infection

Bloodstream infection (BSI) is associated with a high mortality rate. Since the origin of infection is demonstrated in approximately 2/3rds of cases, early and established biomarkers are warranted. We evaluated the clinical performances of automated procalcitonin (PCT) and C-reactive protein (CRP) assays for the quantitative detection of BSI. Analytical performance of the VIDAS(R) BRAHMS PCT assay (bioMérieux, France) was assessed and also compared with the semi-quantitative PCT-Q test (BRAHMS Aktiengesellschaft, Germany). We prospectively included consecutive patients divided into 3 groups at the Dong-A University Medical Center. Patients were categorized according to the criteria of the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference (ACCP/SCCM), and also on the basis of catheter-associated bacteremia. A total 77 patients were enrolled. All mean values of PCT and PCT-Q were consistent with the reference value. Measured PCT concentrations showed good linearity (r=0.983). The between-run, within-run, and total imprecisions were below 5%. The PCT levels in gram-negative bacteremia were significantly higher than those in gram-positive bacteremia. Furthermore, the PCT concentrations were significantly different among non-infection, bacteremia, sepsis, severe sepsis, and septic shock groups. Our study showed that PCT >0.3 ng/mL had 95.0% sensitivity and 97.3% specificity, whereas CRP >5.46 mg/dL had 85.0% sensitivity and 86.5% specificity for diagnosing sepsis. We suggest that, compared with CRP, PCT is a better diagnostic and discriminative biomarker of sepsis categorized according to the ACCP/SCCM. Moreover, catheter-associated bacteremia could be discriminated from sepsis using PCT concentration.

Magnetic bead based assay for C-reactive protein using quantum-dot fluorescence labeling and immunoaffinity separation

A magnetic bead based sensitive sandwich assay for C-reactive protein (CRP) has been developed. In this assay, magnetic microbeads conjugated with monoclonal anti-CRP are used to capture CRP in human serum, and then sequentially incubated with biotinylated monoclonal anti-CRP and streptavidin coated quantum dots (QDs) to form sandwich immunocomplexes. The immunocomplexes are further mixed with an immunoaffinity separation buffer to release QDs from the magnetic bead surface by dissociating antibody-antigen pairs. After magnetic bead separation, the fluorescence signal of QDs released in the immunoaffinity separation buffer is measured to quantify CRP. This proposed approach takes advantages of magnetic beads for fast magnetic separation, sandwich binding of two monoclonal antibodies for high specificity, and QD fluorescence labeling for high detection sensitivity. Moreover, it adopts immunoaffinity separation to avoid the interference of magnetic bead autofluorescence in signal transduction and thus enhances the detection resolution of the assay. The detection limit of CRP is 0.5 fM, corresponding to 10 pM CRP in 50 microL of sample volume, and the detection range is of around 3 orders of magnitude.

Immuno-pillar chip: a new platform for rapid and easy-to-use immunoassay

We present a new rapid and easy-to-use immunoassay chip which we have named the immuno-pillar chip. It has hydrogel pillars, fabricated inside a microchannel, with many antibody molecules immobilized onto 1 µm diameter polystyrene beads. To evaluate the chip performance, we applied it to the sandwich assay of C-reactive protein (CRP), α-fetoprotein (AFP) and prostate-specific antigen (PSA), a cardiac and inflammation marker, tumors and prostate cancer markers, respectively. For detection of disease markers, we confirmed the chip provides rapid analysis (total assay time of about 4 min) with high sensitivity, it is easy-to-use (no special skills are needed), and it uses small volumes of the sample and reagent (0.25 µL each). Moreover, multiplex assay for three biomarkers was also possible. Additionally, the immuno-pillar chip has a big advantage of having hardly any influence on the assay results even if the introduction quantities of the sample or reagents are different.

Effect of menopause and use of contraceptives/hormone therapy on association of C-reactive protein and depression: A population-based study

Objective Unipolar depression has been found to associate with elevated C-reactive protein (CRP) levels in men, but findings among women have been conflicting. It has been hypothesized that this would be explained by a different hormonal environment (compared with men) and its changes throughout the lifecycle in women, but until now, the corresponding evidence has been lacking. We investigated the association between CRP levels and depressive symptoms in a population-based study in pre-, peri-, and postmenopausal women and, also, whether this association is affected by the use of exogenous hormones (contraceptives and postmenopausal hormone therapy). Methods The entire age classes of those born in 1942, 1947, 1952, 1957, and 1962 and living in Pieksämäki, Finland, were invited ( n=1294), and out of 730 women, 512 (70.1%) participated in this cross-sectional study in 1997 to 1998. Depressive symptoms were assessed by Beck's Depression Inventory-21 (BDI-21), and CRP was measured with a high-sensitivity CRP (hs-CRP) assay. Results We found a positive correlation between hs-CRP levels and depressive symptoms in peri- and postmenopausal women not using exogenous hormones (Pearson correlation coefficient, r=.248, P<.001; and r=.343, P=.059, respectively). After multivariate adjustment, a statistically significant interaction was noted between hs-CRP levels and the exogenous hormone use on total score of BDI-21 ( P=.022) among “peri- and postmenopausal women.” Conclusions Our novel findings suggest that female hormones may have moderating effect at peri- and postmenopausal women on the association between elevated CRP levels and depressive symptoms. Further studies are, however, needed to confirm our findings.

No relationship between lung function and high‐sensitive C‐reactive protein in adolescence

Several studies on adults have indicated that lower spirometric lung function may be associated with increased systemic inflammation, but no studies have investigated if this association is already present in adolescence. We explored the temporal relationship between changes in lung function and concentrations of plasma C-reactive protein (CRP) in a population-based cohort study at ages 14 and 20 years using a high-sensitivity CRP assay. CRP measurements were performed in a total of 420 subjects at mean age of 13.9 years. Of these, 262 subjects (62%) participated in the follow-up investigation at mean age of 20.1 years. Levels of log-CRP at age 14 were not significantly associated with forced expiratory volume (FEV(1) ) or FEV(1) / forced vital capacity (FVC) ratio at age 20, nor with the change in FEV(1) , FVC or FEV(1) /FVC ratio between 14 and 20 years after controlling for body mass index (BMI), airway hyperresponsiveness (AHR), eosinophil cationic protein (ECP), asthma, smoking, sex, and height at 14 years, and change in height between 14 and 20 years. Sex, BMI, AHR, ECP and change in height between 14 and 20 years were identified as independent factors associated with the change in FEV(1) , FVC and FEV(1) /FVC ratio in adolescence. We did not find an association between CRP levels at age 14 and change in lung function by age 20; whereas, sex, change in height, BMI, AHR and ECP were associated with lung function change in adolescence. Our findings indicate that systemic inflammation is of less importance for change in lung function in adolescence. Please cite this paper as: Nybo M, Hansen HS, Siersted HC and Rasmussen F. No relationship between lung function and high-sensitive C-reactive protein in adolescence.

High sensitivity C-reactive protein: Its correlation with sputum cell counts in bronchial asthma

Two major acute-phase proteins were identified in human, C-reactive protein and serum amyloid A. There are 3 types of C-reactive protein assays: conventional C-reactive protein, high sensitivity C-reactive protein and cardiac C-reactive protein. High sensitivity C-reactive protein assays can detect minor inflammatory changes that could be missed by other indices of inflammation. Induced sputum cell counts are relatively non-invasive, safe and reliable method for identifying the presence and type of airway inflammation in asthmatic patients. This study was designed to detect the role of serum levels of high sensitivity C-reactive protein in asthmatic patients with or without inhaled corticosteroids treatment. Also to determine the relationship of serum high sensitivity C-reactive protein levels to clinical indices of asthma and inflammatory cell counts in induced sputum. Serum high sensitivity C-reactive protein level, pulmonary function tests, body mass index and induced sputum cell counts were estimated in 50 asthmatic patients (26 steroid inhaled and 24 steroid naïve). Fifteen healthy volunteers, who matched in age and sex with the other groups, were used as a control group. There was an increase of high sensitivity C-reactive protein in asthmatic patients among both steroid inhaled and steroid naïve patients compared to the healthy controls. Serum high sensitivity C-reactive protein correlated negatively with pulmonary function tests and positively with sputum eosinophil % in both inhaled steroid and steroid naïve groups. High sensitivity C-reactive protein is one of the markers of systemic inflammation that can be indirectly reflecting the degree of severity of airway inflammation in bronchial asthma.

Low-grade inflammation in individuals with the hypertriglyceridemic waist phenotype: Another feature of the atherogenic dysmetabolism

The purpose of this study was to explore the possibility that the recently described “hypertriglyceridemic waist” (HTGW) phenotype, a risk for future coronary artery disease, is associated with the presence of low-grade inflammation. This is a cross-sectional study in a cohort of apparently healthy nondiabetic employed individuals in whom the presence of low-grade inflammation was determined by using the Dade Behring high-sensitivity C-reactive protein (hs-CRP) assay. We have presently analyzed the results obtained in 9842 apparently healthy individuals, at a mean (SD) age of 44 (11) years. We identified 1249 individuals (70.0% men) with HTGW phenotype according to the cutoff points of waist girth of at least 90 cm for men and at least 85 cm for women and triglycerides levels of at least 177 mg/dL for men and at least 133 mg/dL for women. In addition, we identified 1164 individuals (69.3% men) with the metabolic syndrome (MetS) according to the updated Adult Treatment Panel III criteria. The mean (SD) of hs-CRP was 1.3 (2.9) mg/L for the 8055 individuals who had neither the HTGW phenotype nor the MetS, 2.1 (2.7) mg/L for those who had the HTGW phenotype and no MetS, and 2.5 (2.7) for 538 individuals with the MetS and no HTGW phenotype, whereas those who had both atherogenic disorders presented an hs-CRP concentration of 2.9 (2.3) mg/L. In this cohort of apparently healthy nondiabetic employed individuals, the HTGW phenotype had a similar prevalence as the MetS and was associated with the presence of low-grade inflammation. This inflammation could be a pathophysiologic link between this dysmetabolism and atherothrombosis. In addition, the HTGW phenotype is relatively prevalent and could be a simple and inexpensive way to single out individuals at risk for future coronary artery disease.

A Meta Analysis of Relationship between C - Reactive Protein and Respiratory Tract Infection in Children (134.64)

Abstract BACKGROUND: Although several studies have evaluated serum concentrations of C-reactive protein (CRP) as a predictor of bacterial respiratory tract infections or pneumonia in this patient population, the utility of this test remains unclear. OBJECTIVE: The purpose of this meta-analysis was to quantitatively define the utility of serum CRP as a predictor of bacterial respiratory tract infections or pneumonia in acutely ill children. METHODS: Multiple databases were searched, bibliographies reviewed,and 13 authorities in the field were queried.The quality of each included study was determined have 6 metrics: diagnostic criteria; study author; CRP agent; patient age; CRP assay of method; and CRP results before patients who received antibiotics. Data was extracted from each article; the primary outcome measure was the means of patients with bacterial or not bacterial infection and serum CRP concentrations exceeding 8 mg/L. RESULTS: Thirteen studies fulfilled inclusion criteria. Combining all of the studies demonstrated a pooled study population of 2760 patients.The level of serum CRP in the children with bacterial infection were higher 3.13 times than viral infection(Z=7.61,p£1/40.00001,95% confidence interval=2.33-3.94),and were higher 3.02 times than control group(Z=10.26,p£1/40.00001,95% confidence interval =2.44-3.60).The level of serum CRP in children with viral infection were higher 0.68 times than control group(Z=4.74,p£¼ 0.00001,95% confidence interval=0.40-0.96). Children with bacterial infection were significantly serum CRP concentrations than children with nonbacterial infections.CONCLUSIONS:The serum CRP level has value for early recognition of bacterial infections could guide treatments,reduce misuse of antibiotics.