Changes In hs-CRP Research Articles

Randomized Study of the Effects of Vitamin D and Magnesium Co-Supplementation on Muscle Strength and Function, Body Composition, and Inflammation in Vitamin D-Deficient Middle-Aged Women

This study aimed to investigate the effects of vitamin D and magnesium co-supplementation on muscle strength and function, body composition, and inflammation in vitamin D-deficient middle-aged women. In this study, 83 healthy middle-aged women (40-55 years) with vitamin D deficiency were randomly assigned into two groups: (1) intervention: receiving a 50,000-IU vitamin D soft gel (weekly) plus a 250-mg magnesium tablet (daily); (2) control: receiving a vitamin D placebo (weekly) plus a magnesium placebo (daily), for 8 weeks. Before and after the intervention, anthropometric indices, muscle strength, muscle function, and some inflammatory markers were measured. After 8 weeks of supplementation, significant difference was observed in handgrip strength and time for Time Get Up and Go (TGUG) test between the intervention and placebo groups (P < 0.05). Regarding percentage of fat mass (FM%) and fat free mass (FFM%), and knee extension strength, there was no significant difference between the two groups at the end of intervention (P > .05). Serum 25(OH)-D levels increased significantly (P < 0.001) and its change was significantly different between the two groups, at the end of the intervention (P < 0.001). Serum level of hs-CRP decreased significantly in the intervention group compared to baseline (P < 0.001), and the change in hs-CRP was significant between the two groups at the end of the intervention (P < 0.01). Furthermore, serum level of TNF-α declined significantly in the intervention group compared to baseline (P < 0.001) but, no significant differences were seen between the two groups in regard of serum levels of TNF-α and IL-6 after the intervention (P > 0.05). Our findings show that vitamin D and magnesium co-supplementation, for 8 weeks, in healthy middle-aged women with vitamin D deficiency have beneficial impacts on muscle strength, muscle function, and probably inflammation.

Effects of nimodipine combined with betahistine on CRP and other inflammatory cytokines and vascular endothelial function in patients with hypertensive cerebral vasospasm.

This study aims to investigate the effect of nimodipine combined with betahistine on the levels of CRP and other inflammatory cytokines, as well as vascular endothelial function in patients with hypertensive cerebral vasospasm. A total of 80 patients with hypertensive cerebral vasospasm from March 2016 to September 2018 were enrolled and randomly equally divided into two groups. At 1 week before enrollment, the application of all antihypertensive drugs was stopped. Then amlodipine tablets were used in control group, based on which nimodipine tablets were applied in observation group. All the patients included were followed up for 1 month. The changes in the cerebral vasospasm index in the course of treatment as well as inflammatory cytokines and indicators related to vascular endothelial function at 1 month after treatment were measured and compared between the two groups. The correlations of the cerebral vasospasm index with the changes in inflammatory cytokines and vascular endothelial function-related factors in the body were analyzed. Finally, the effective rates of blood pressure regulation and cerebral vasospasm treatment were compared, while the adverse reactions and the overall clinical treatment effect of the two groups were evaluated. The cerebral vasospasm indexes in observation group were significantly lower than those in control group at 3 d, 1 week and 1 month after treatment (p < 0.05). At 1 month after treatment, the levels of inflammatory cytokines such as high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in observation group were significantly reduced compared to those in control group (p < 0.05). As for vascular endothelial function-related indicators, the endothelin-1 (ET-1) level in observation group was markedly lower than that in control group, whereas the level of nitric oxide (NO) was statistically higher than that in control group (p < 0.05). The cerebral vasospasm index was statistically positively correlated with changes in hs-CRP, IL-6, TNF-α and ET-1 (p < 0.05), but negatively correlated with changes in NO (p < 0.05). Besides, the effective rates of blood pressure regulation and cerebral vasospasm treatment in observation group were significantly higher than those in control group (p < 0.05). The overall treatment effective rate in observation group was markedly higher than that in control group (p < 0.05), and there were no significant differences of adverse reactions between the two groups (p > 0.05). For the treatment of hypertensive cerebral vasospasm, combined application of betahistine on the basis of nimodipine can effectively reduce the body's aseptic inflammatory responses, improve vascular endothelial function and increase the cerebral circulation blood flow, which offers a favorable strategy for clinical therapy.

Correlations of inflammatory factors, CCCK-18, MMP-9 and D-Dimer with APACHE II Score and prognosis of patients with acute cerebral hemorrhage.

The aim of this study was to explore the correlations of inflammatory factors, caspase-cleaved cytokeratin-18 (CCCK-18), matrix metalloproteinase-9 (MMP-9) and D-Dimer (DD) with the acute physiology and chronic health evaluation (APACHE) II Score and prognosis of patients with acute cerebral hemorrhage (ACH). A total of 40 ACH patients receiving conservative treatment in our hospital from March 2017 to January 2019 were enrolled as control group, and 40 patients undergoing craniotomy evacuation of hematoma were selected as observation group. All patients enrolled were followed-up via outpatient service for 1 year, and the levels of inflammatory factors, CCCK-18, MMP-9 and DD were compared between the two groups at enrollment. The change tendency in the National Institute of Health Stroke Scale (NIHSS) Score for neurological function in the two groups was recorded during intervention (at enrollment, at 1 week after enrollment, at discharge and at 1 year of follow-up), and the correlations of APACHE II Score with the changes in high-sensitivity C-reactive protein (hs-CRP), CCCK-18, MMP-9 and DD were analyzed. Additionally, relevant factors affecting the neurologic outcomes of ACH patients were subjected to univariate and multivariate analyses. At enrollment, the levels of inflammatory factors (hs-CRP and interleukin-6 [IL-6]), CCCK-18, MMP-9, and DD were significantly higher in observation group than those in control group (P<0.05). The NIHSS Score was overtly higher in observation group than that in control group at 1 week after enrollment, at discharge, and at 1 year of follow-up (P<0.05), and it was positively correlated with changes in hs-CRP, CCCK-18, MMP-9, and DD (P<0.05). Univariate analysis at 1 year of follow-up showed that the levels of hs-CRP, CCCK-18, MMP-9 and DD were relevant risk factors affecting the neurologic outcomes of ACH patients. Increased hs-CRP, CCCK-18, MMP-9 and DD levels were independent risk factors for poor neurologic outcomes of ACH patients. ACH patients receiving emergency operation have a poorer prognosis and a higher APACHE II Score than those undergoing conservative treatment. The APACHE II Score has positive associations with the levels of inflammatory factors, CCCK-18, MMP-9 and DD. In addition, raised levels of hs-CRP, CCCK-18, MMP-9 and DD are considered as independent risk factors for poor neurologic outcomes of ACH patients.

P1375ORAL VITAMIN C EFFECT ON HEPCIDIN LEVEL IN HAEMODIALYSIS PATIENTS WITH FUNCTIONAL IRON DEFICIENCY ANAEMIA

Abstract Background and Aims Hepcidin is a key regulatory peptide in iron homeostasis, inhibiting iron absorption by binding to ferroportin. Inflammatory mediated increase in hepcidin levels and reduced clearance in hemodialysis (HD) patients lead to functional iron deficiency ( FID) and Erythropoiesis-stimulating agent (ESA) resistance. Ascorbic acid (Vitamin C) may be used as adjuvant therapy in FID anemia through its anti-inflammatory and anti-oxidant nature, but there was limited studies investigating the direct relation between vitamin C and hepcidin level in HD patients. We Aimed to test the reducing therapeutic effect of oral vitamin C supplement on hepcidin level among hemodialysis patients with functional iron deficiency anaemia. Method This study is an open label randomized controlled clinical trial that was conducted in hemodialysis units of Ain Shams University hospitals, 48 prevalent HD patients with mean age of 46.48 ± 15.57 years were included ,Group 1 (study group) :31 patients [13(41.9%) males &amp; 18(58.1%) females] who received the conventional treatment of erythropoietin stimulating agents together with oral supplementation of vitamin C 500 mg every other day dose for 3 months. Group 2 (control group): included 17 patients [8(47.1%) males and 9 (52.9%) females] who received only the conventional therapy of erythropoietin stimulating agents according to their Hb levels. The patients enrolled in the study were patients on regular conventional HD for more than 6 months with functional iron deficiency anemia, defined as: hemoglobin level &amp;lt;11 gm/dl, ferritin level &amp;gt;200 ng/ml and TSAT &amp;gt;20 %. Patients with history of non-renal causes of anemia including malignancy, end-stage liver disease, or chronic hypoxia, patients with evidence of active or occult bleeding, patients who received blood transfusion within the last 4 months, history of recent hospitalization or infection requiring antibiotics within the last 4 weeks and patients with evidenced iron deficiency anemia were all excluded from the study .Laboratory parameters including serum hepcidin level, highly sensitive CRP (hsCRP) titer, CBC, kidney function tests and iron indices were measured at baseline and after 3 months . Results Oral vitamin C supplementation in Group 1(study group) resulted in statistically significant reduction in Hepcidin levels in the study group [mean 2506.45± 1320.53 pg/ml to 1748.39 ±1432.28 pg/ml ](P=0.03), and highly significant reduction in hsCRP level [mean 8603.23 ±2547.77 ng/ml to 5611.29 ±2829.27 ng/ml](P=0.001) after 3months of treatment. On comparing the two groups regarding changes in Hepcidin levels during follow up, illustrates that vitamin C together with time resulted in significant reduction of hepcidin levels in the study group (P&amp;lt;0.05) by repeated measure ANOVA test (Figure 1). Comparison between the two groups regarding change in hsCRP levels during follow up showed there was a highly significant change in the mean hsCRP over time, and the mean hsCRP differed significantly between the two groups (Figure 2). A significant reduction in serum iron and ferritin levels was observed in study group after treatment vitamin C but the change of the mean of S. ferritin level didn’t differ significantly in comparison to control group . Decreased EPO requirements and elevation of hemoglobin level were observed in the study group but without a statistical significance compared to the control group, this might be attributed to the short period of vit C supplementation. There was a highly significant correlation between serum hepcidin and hsCRP (r=0.46, P&amp;lt;0.01) . Conclusion : Oral Vitamin C may be promising therapy in decreasing serum hepcidin and hsCRP in prevalent hemodialysis patients with functional iron deficiency anemia.

Depression and the Effect of Sertraline on Inflammatory Biomarkers in Patients with Nondialysis CKD.

Inflammatory biomarkers are elevated in patients with CKD and associated with poor outcomes. Major depressive disorder (MDD) is prevalent in CKD and associated with inflammation. No studies investigated the effect of MDD treatment on plasma inflammatory biomarkers in patients with nondialysis CKD. In a prespecified analysis of the randomized, double-blind CKD Antidepressant Sertraline Trial, we investigated whether treatment with sertraline versus placebo or response to treatment would affect plasma levels of albumin, prealbumin, IL-6, and high-sensitivity C-reactive protein (hsCRP), measured at baseline and after 12 weeks of treatment. We also explored whether somatic versus nonsomatic depressive symptoms, measured using the Quick Inventory of Depressive Symptomatology, and quality-of-life subscales, measured using the Kidney Disease Quality of Life Short Form, were associated with baseline levels of these inflammatory biomarkers. Of the 193 participants, mean age was 58.4 (SD 13) years and 58% were black, 42% were white, and 18% were Hispanic. Higher baseline hsCRP correlated with somatic depressive symptoms (r=0.21; P=0.01), fatigue (r=0.22; P=0.005), and poorer physical functioning (r=-0.26; P=0.001). There was no change in hsCRP in the sertraline group. hsCRP increased in placebo nonresponders from baseline (median, 3.7 mg/L; interquartile range [IQR], 1.7-10.0 mg/L) to exit (median, 4.9 mg/L; IQR, 1.8-8.8 mg/L; P=0.01). The change from baseline to exit differed between placebo responders (median, -0.4 mg/L; IQR, -9.3 to 0.2 mg/L) and nonresponders (median, 0.8 mg/L; IQR, -0.1 to 3.9 mg/L; P=0.008). There were no differences in changes in albumin, prealbumin, or IL-6 from baseline in any group. Among patients with CKD and MDD, hsCRP correlated with somatic symptoms of depression and fatigue, but not with nonsomatic symptoms. Sertraline treatment was not associated with a longitudinal change in hsCRP from baseline regardless of treatment effect on depressive symptoms, but those who failed to respond to placebo had an increase in hsCRP over time. This area deserves further investigation. CKD Antidepressant Sertraline Trial (CAST), NCT00946998.

1061-P: Effects of Long-Term Vitamin D and Omega-3 Fatty Acid Supplementation on Inflammatory and Cardiac Biomarkers in Patients with Type 2 Diabetes

Background: Immune system activation contributes to the development of microvascular and macrovascular complications in diabetes. Identifying interventions that reduce inflammation may delay progression of diabetes complications. Methods: This study reports pre-specified secondary outcomes of the Vitamin D and Omega-3 Trial to Prevent and Treat Diabetic Kidney Disease, in which 1,312 adults with type 2 diabetes were randomized to vitamin D3 (2000 IU/d) versus placebo and omega-3 fatty acids (EPA+DHA;1g/d) versus placebo in a 2x2 factorial design. We measured serum interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) at baseline and after two and five years, then used linear mixed models to test treatment effects. Results: Participants were on average 67.6 years old (46% women). Overall, baseline geometric means of IL-6, hsCRP, and NT-proBNP were 1.2 pg/mL, 1.9 mg/L, and 262 pg/mL, respectively. After five years, mean IL-6 and hsCRP remained within 5% of their baseline values while mean NT-proBNP increased by 56% in the full population. Compared with placebo, participants assigned to vitamin D3 had a larger increase in NT-proBNP over time (ratio of change compared with placebo at five years 1.25; 95%CI 1.09-1.43; p=0.005), while there was no significant difference in change in IL-6 (ratio 0.97; 95%CI 0.80-1.18) or hsCRP (ratio 0.90; 95%CI 0.79-1.02). Comparing omega-3 fatty acids to placebo, there was no significant difference in change in IL-6 (ratio 1.11; 95%CI 0.92-1.34), hsCRP (ratio 0.88; 95%CI 0.77-1.00), or NT-proBNP (ratio 1.03; 95%CI 0.90-1.17) at five years. No heterogeneity was observed in subgroup analyses accounting for pre-specified clinical and demographic features. Conclusions: Among adults with type 2 diabetes, supplementation with vitamin D3 or omega-3 fatty acids did not reduce IL-6, hsCRP, or NT-proBNP long-term. Disclosure C. Limonte: None. L. Zelnick: None. A. Hoofnagle: None. R. Thadhani: None. M. Melamed: Other Relationship; Self; American Board of Internal Medicine, ICON plc. J. Ruzinski: None. I. Lee: None. H. Sesso: None. J.E. Buring: Advisory Panel; Spouse/Partner; Pharmavite. J.E. Manson: None. I. de Boer: Advisory Panel; Self; Boehringer Ingelheim International GmbH. Consultant; Self; George Clinical, Goldfinch Bio, Ironwood Pharmaceuticals. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R01DK088762); National Institutes of Health (U01CA138962, R01CA138962)

FRI0575 BIOMARKER ANALYSIS FROM THE RISE-SSC STUDY OF RIOCIGUAT IN EARLY DIFFUSE CUTANEOUS SYSTEMIC SCLEROSIS (DCSSC)

FRI0575 BIOMARKER ANALYSIS FROM THE RISE-SSC STUDY OF RIOCIGUAT IN EARLY DIFFUSE CUTANEOUS SYSTEMIC SCLEROSIS (DCSSC)

The Effect of the Ultra-Marathon Run at a Distance of 100 Kilometers on the Concentration of Selected Adipokines in Adult Men

Pro-inflammatory adipokines have a multifunctional role in adipogenesis, angiogenesis, glucose homeostasis, and inflammation. The aim of the present study is to evaluate the effect of running a 100 km ultra-marathon on serum levels of two adipokines: resistin and chemerin. Fifteen male participants complete a medical questionnaire and their body composition is assessed. Serum resistin, chemerin, high sensitivity C-reactive protein (hs-CRP), glucose, and lactate levels are measured at baseline and post-race. During-race data on fluid and food consumption and energy expenditure are calculated. There is a higher (p < 0.001) post-race concentration of resistin and hs-CRP compared with resting values, with no change in chemerin levels. There is an inverse correlation of the change in resistin levels with post-run glucose values (r = 0.742, p < 0.001) and a positive correlation between changes in hs-CRP and energy expenditure (r = 0.782, p < 0.001). The present results show the impact of running an ultra-marathon on serum levels of pro-inflammatory markers released by adipose tissue. It is difficult to establish whether these results may be due to the stress of exercise, high energy expenditure or caloric deficit. However, we suggest that an addition of resistin to traditional pro-inflammatory markers (including CRP) may improve the assessment of inflammation in conditions of high-energy expenditure.

A comparative study of PF‐06438179/GP1111 (an infliximab biosimilar) and reference infliximab in patients with moderate to severe active rheumatoid arthritis: A subgroup analysis

AimPF‐06438179/GP1111 (PF‐SZ‐IFX) is a biosimilar of reference infliximab (Remicade®). This analysis compared the efficacy of PF‐SZ‐IFX and reference infliximab sourced from the European Union (IFX‐EU) in patient subgroups from a randomized, comparative study of PF‐SZ‐IFX versus IFX‐EU.MethodsPatients with rheumatoid arthritis were randomized 1:1 to PF‐SZ‐IFX (n = 324) or IFX‐EU (n = 326); study drug (3 mg/kg) was administered intravenously at weeks 0, 2, and 6, then every 8 weeks thereafter. Subgroup analyses of efficacy endpoints such as American College of Rheumatology criteria for ≥20% clinical improvement (ACR20), change in high‐sensitivity C‐reactive protein (hs‐CRP), and change in Disease Activity Score in 28 joints, four components based on hs‐CRP (DAS28‐CRP) at weeks 14 and 30 were performed by age, gender, race, region, immunogenicity status, and treatment history.ResultsOverall, ACR20 response rates as well as changes in DAS28‐CRP and hs‐CRP at week 14 were similar between PF‐SZ‐IFX and IFX‐EU within the subgroups of age, gender, race, region, treatment history, and immunogenicity status. Results to week 30 support overall similarity in efficacy between the two treatment arms in all subgroups.ConclusionOverall, PF‐SZ‐IFX and IFX‐EU were similar in efficacy within the analyzed subgroups of age, gender, race, region, treatment history, and immunogenicity status. The efficacy results from these subgroup analyses were aligned with the previously described results for the overall population up to week 30.

Effects of chromium supplementation on inflammatory biomarkers: A systematic review and dose-response meta-analysis of randomized controlled trials

IntroductionAccumulating evidence suggests that chromium (Cr) supplementation may prevent inflammation, however, the results have been inconsistent. To derive a more precise estimation of the efficacy of Cr supplementation on inflammatory mediators such as tumor necrosis factor‐alpha (TNF‐α), high-sensitivity C‐reactive protein (hs-CRP), and interleukin‐6 (IL‐6), this systematic review and meta-analysis was performed. MethodsAn advanced search of PubMed and Scopus was conducted from inception to 14 April 2020 to find randomized controlled trials that assessed the effect of Cr supplementation on inflammation among the adult population. ResultsThe search resulted in identifying 10 articles which met the inclusion criteria for the systematic review. Our results indicated that Cr supplementation significantly decreased serum levels of hs-CRP (weighted mean differences (WMD): -0.95 mg/l; 95 % CI, -1.54 to -0.36, P = 0.002). Greater effects on hs-CRP were detected in trials using Cr picolinate and Cr chloride, dosage <300 μg with duration ≤12 weeks. Also, 12 weeks supplementation with Cr dinicocysteinate led to a significant reduction in the level of TNF-α but Cr picolinate did not show significant changes in serum levels of TNF-α. Moreover, both Cr picolinate and Cr dinicocysteinate had no significant differences in the level of serum IL-6 and IL-8. Although, a significant non-linear association was found between serum hs-CRP changes and study duration (Pnon-linearity = 0.03), we did not find any significant association between serum hs-CRP changes and dosage (Pnon-linearity = 0.86) with Cr picolinate supplementation. ConclusionSupplementation with Cr picolinate and Cr chloride at dose <300 μg for ≤12 weeks could significantly decrease serum hs-CRP levels.

Effects of soy isoflavones on serum systemic and vascular inflammation markers and oxidative stress in peritoneal dialysis patients: A randomized controlled trial.

Cardiovascular disease (CVD) is common in peritoneal dialysis (PD) patients. This study was designed to investigate the effects of isoflavones on systemic and vascular inflammation markers and oxidative stress in PD patients. In this randomized clinical trial, 40 PD patients were randomly assigned to either the isoflavone or the placebo group. The isoflavone group received 100 mg soy isoflavones daily for 8 weeks, whereas the placebo group received corresponding placebos. At baseline and the end of eighth week, serum high sensitive C-reactive protein (hs-CRP), intercellular adhesion molecule type 1 (ICAM-1), vascular cell adhesion molecule type 1 (VCAM-1), E-selectin, and malondialdehyde were measured. Serum VCAM-1 decreased significantly in the isoflavone group at the end of Week 8 compared to baseline (p = .01), whereas no significant change was observed in the placebo group. Serum ICAM-1 decreased significantly in the isoflavone (p = .01) and placebo (p = .01) group compared to baseline. However, the reduction of ICAM-1 was significantly higher in the isoflavone group than in the placebo group (p = .02). There were no significant differences between the two groups in mean changes of serum E-selectin, malondialdehyde, and hs-CRP. This study indicates that isoflavones reduce serum VCAM-1 and ICAM-1, which are two CVD risk factors, in PD patients.

Tribulus Terrestris may decrease muscle damage markers following a high-intensity resistance exercise: A pilot study.

The purpose of this study was to investigate the effect of two weeks of Tribulus Terrestris (TT) on the responses of Interleukin-6 (IL-6), high sensitivity C-reactive protein (hs-CRP), and enzymes creatine phosphokinase (CPK) and lactate dehydrogenase (LDH) following a single session of resistance exercise (RE). Eighteen healthy non-athlete males (age: 22.44 ± 2.54 years, BMI: 26.15 ± 1.62 kg/m2) participated in this study and were divided randomly into two 9-person groups of supplementation or placebo. The participants consumed two 250-mg capsules of TT or placebo (maltodextrin) per day and performed six REs with the intensity 80, 85, and 90% of 1RM in three circles at the day after the end of supplementation period. Blood samples were collected before the initiation of supplementation, and before and after the RE session. Total changes of IL-6 (p<0.001) and LDH (p=0.005) were significant in both groups. Bonferroni post hoc test showed that increased values of IL-6 and CPK in both groups were significant after exercise compared with pre-exercise and baseline (p<0.001). There were no significant differences in relation to within- and between-group changes in hs-CRP (p>0.05). Moreover, differences between the groups regarding post-exercise IL-6 and CPK were not significant (p>0.05). However, post-exercise LDH in supplementation group were lower than placebo group (p=0.015). In conclusion, short-term supplementation with TT has no effect on IL-6 and hs-CRP, but may be effective on the reduction of muscle damage enzymes CPK and LDH following high-intensity circuit RE.

Impact of Vitamin E supplementation on vascular function in haptoglobin genotype stratified diabetes patients (EVAS Trial): a randomised controlled trial

AimsVitamin E (Vit-E) may preferentially improve cardiovascular risk in haptoglobin 2-2 (Hp2-2) genotype diabetes individuals. We studied the impact of Vit-E supplementation on vascular function in diabetes individuals stratified by haptoglobin genotype in Singapore.MethodsIn this 24-week, double blind, placebo-controlled RCT, we recruited 187 subjects (101 Hp2-2, 86 non-Hp2-2). Intervention: alpha-tocopherol-400 IU. Primary Outcome: Change in EndoPAT-derived reactive-hyperaemia index (RHI) and augmentation index (AIx); Secondary Outcomes: Pulse-Wave velocity (Sphygmocor-PWV), carotid intima media thickness (CIMT), inflammation (hsCRP), derivatives of reactive-oxygen metabolites (dROMs), biological antioxidant-potential (BAPs), HbA1c, LDL-C, HDL-C and oxidised LDL-C (ox-LDL).ResultsOverall, with Vit-E supplementation no significant change in RHI, PWV, CIMT, hsCRP, dROMS, BAPs, HDL-C and HbA1c was observed (p > 0.05); an increase in LDL-C with concomitant decrease in ox-LDL, and incidentally increase in eGFR was observed (p < 0.05). No interaction effect with haptoglobin genotype was seen for all outcomes (p > 0.05). Subgroup analysis: In the non-Hp-2-2 group, Vit-E supplementation led to a higher EndoPAT-derived AIx, accompanied by higher LDL and ox-LDL concentrations (p < 0.05); Hp2-2 group: Vit-E supplementation led to higher eGFR when compared to the non-Hp2-2 group (exploratory) (p < 0.05). We observed an interaction effect for baseline haptoglobin concentration (threshold > 119 mg/dl) with intervention in terms of increased EndoPAT-derived AIx in the Hp > 119 mg/dl group whereas no change in the group with Hp ≤ 119 mg/dl.ConclusionVit-E supplementation did not show any preferential benefit or deleterious effect on vascular function in Hp2-2 diabetes subjects in Singapore. A possible deleterious effect of an increase in arterial stiffness in individuals with Hp > 119 mg/dl was observed. Future studies should consider personalisation based on baseline Hp concentrations in patients with T2DM rather than just Hp2-2 genotype to evaluate impact on the detailed lipid pathways, cardiac and renal physiology. The impact of ethnic differences needs to be explored in greater details.

Vitamin C supplementation and C-reactive protein levels: Findings from a systematic review and meta-analysis of clinical trials.

Background and purpose C-reactive protein (CRP) is an inflammatory biomarker which prognosticates cardiovascular disease. Previous studies have reached mixed conclusions regarding the effect of vitamin C on reducing CRP or hs-CRP level. The present systematic review and meta-analysis was conducted to resolve these inconsistencies. Materials and methods: Related articles published up to August 2018 were searched through PubMed, Scopus, Ovid, ISI web of science, Embase, and Cochrane databases by relevant keywords. Clinical trials which examined the effect of either vitamin C supplementation or vitamin C-enriched foods on CRP and hs-CRP levels were included. A total of 11 studies with 14 data sets involving 818 subjects were included. Results Overall, the pooled analysis revealed that vitamin C could decrease CRP level relative to placebo group (Weighted mean difference [WMD]=-0.73 mg/L: 95% CI: -1.30 to -0.15, p=0.013) with a considerable heterogeneity (I2=98%, p<0.001). Moreover, subgroup analyses revealed that the beneficial effect of vitamin C on CRP level alternation only was found in male (p=0.003), non-smoker (p=0.041), healthy (p=0.029) and younger participants (p=0.010). Vitamin C could improve CRP level only at doses of less than 500 mg/day (p=0.009). Regarding hs-CRP changes, the pooled analysis did not show any significant effect of vitamin C (WMD=-0.65 mg/L: 95% CI: -2.03 to 0.72, p=0.35). This finding was confirmed by all subgroup analyses expect for high quality articles in which hs-CRP level was elevated after vitamin C supplementation (p=0.026). Conclusion In conclusion, supplementation with vitamin C might have a significant effect only on CRP reduction. Further studies are needed to confirm this effect.

Evaluation of high-sensitivity C-reactive protein and uric acid in vericiguat-treated patients with heart failure with reduced ejection fraction.

AimsThe effects of vericiguat vs. placebo on high‐sensitivity C‐reactive protein (hsCRP) and serum uric acid (SUA) were assessed in patients with heart failure with reduced ejection fraction (HFrEF) in the Phase 2 SOCRATES‐REDUCED study (NCT01951625).Methods and resultsChanges from baseline hsCRP and SUA values at 12 weeks with placebo and vericiguat (1.25 mg, 2.5 mg, 5.0 mg and 10.0 mg, respectively) were assessed. The probability of achieving an hsCRP value of ≤3.0 mg/L or SUA value of <7.0 mg/dL at week 12 was tested. Median baseline hsCRP and SUA levels were 3.68 mg/L [interquartile range (IQR) 1.41–8.41; n = 335] and 7.80 mg/dL (IQR 6.40–9.33; n = 348), respectively. Baseline‐adjusted mean percentage changes in hsCRP were 0.2%, −19.5%, −24.3%, −25.7% and −31.9% in the placebo and vericiguat 1.25 mg, 2.5 mg, 5.0 mg and 10.0 mg groups, respectively; significance vs. placebo was observed in the vericiguat 10.0 mg group (P = 0.035). Baseline‐adjusted mean percentage changes in SUA were 5.0%, −1.3%, −1.1%, −3.5% and −5.3% in the placebo, and vericiguat 1.25 mg, 2.5 mg, 5.0 mg and 10.0 mg groups, respectively; significance vs. placebo was observed in the 5.0 mg and 10.0 mg groups (P = 0.0202 and P = 0.004, respectively). Estimated probability for an end‐of‐treatment hsCRP value of ≤3.0 mg/L and SUA value of <7.0 mg/dL was higher with vericiguat compared with placebo. The effect was dose‐dependent, with the greatest effect observed in the 10.0 mg group.ConclusionsVericiguat treatment for 12 weeks was associated with reductions in hsCRP and SUA, and a higher likelihood of achieving an hsCRP value of ≤3.0 mg/L and SUA value of <7.0 mg/dL.

Factors Related to Cardiac Troponin T Increase after Participation in a 100 Km Ultra-Marathon.

Background: Intensive and prolonged exercise leads to a rise of troponin concentration in blood. The mechanism responsible for troponin release during exercise remains ill-defined. The study aim was to search for risk factors of troponin increase after a prolonged endurance competition. Methods: The study included a group of 18 amateurs, healthy volunteers (median age 41.5 years, interquartile range – IQR 36–53 years, 83% male) who participated in a 100 km running ultra-marathon. Information on demographic characteristics, pre- and post-race heart rate, blood pressure, body composition and glucose, lactate (L), troponin T (hs-TnT) and C reactive protein (hs-CRP) concentration were obtained. Additionally, data on L and glucose levels every 9.2 km and fluid/food intakes during the race were collected. Results: There was a significant hs-TnT increase after the race exceeding upper reference values in 66% of runners (from 5 IQR 3–7 ng/L to 14 IQR 12–26 ng/L, p < 0.0001). None of the baseline parameters predicted a post-race hs-TnT increase. The only factors, correlating with changes of hs-TnT were mean L concentration during the race (rho = 0.52, p = 0.03) and change of hs-CRP concentration (rho = 0.59, p = 0.01). Conclusions: Participation in a 100 km ultra-marathon leads to a modest, but significant hs-TnT increase in the majority of runners. Among analysed parameters only mean lactate concentration during the race and change in hs-CRP correlated with troponin change.

The Effects of Synbiotic Supplementation on Glycemic Status, Lipid Profile, and Biomarkers of Oxidative Stress in Type 1 Diabetic Patients. A Placebo-Controlled, Double-Blind, Randomized Clinical Trial.

Background and ObjectiveThe aim of the present study was to evaluate the effects of synbiotic on glycemic status, lipid profile, and biomarkers of oxidative stress in type 1 diabetes mellitus (T1DM) patients.Materials and MethodsIn this double-blind clinical trial, 50 T1DM patients were randomly allocated to intervention (n = 25) and control (n = 25) groups and received either synbiotic powder (Lactobacillus sporogenes GBI-30 (probiotic), maltodextrin and fructooligosaccharide (prebiotic)) or placebo 2 g per day for 8 weeks. Fasting blood samples were collected before and after the intervention to measure fasting blood glucose (FBG), insulin concentration, hemoglobin A1c (HbA1c), lipid profile, and biomarkers of oxidative stress such as total antioxidant capacity (TAC) and hs-C-reactive protein (hs-CRP).ResultsSupplementation with synbiotic resulted in a significant decrease in the mean serum levels of HbA1c and hs-CRP (p = 0.01 and p = 0.004, respectively), and marginally significant decrease in FBG (p = 0.05) in the intervention group post- intervention. Also, the mean changes of FBG and hs-CRP were significantly lower in the intervention group compared with the control group (p = 0.03 and p = 0.005, respectively). There were no significant changes found in lipid profile in intervention group post-intervention (p≥ 0.05). The mean serum levels of insulin and TAC were significantly increased in the intervention group post-intervention (p = 0.001). There was a significant increase in the mean changes of TAC (p = 0.005) in the intervention group compared with the control group.ConclusionThe 8-week synbiotic supplementation in T1DM patients may be effective in improvement of FBG, HbA1c, insulin, hs-CRP, and TAC.

Correlation Between Oral Health and Systemic Inflammation (COHESION): A Randomized Pilot Follow-Up Trial of a Plaque-Identifying Toothpaste

BackgroundInflammation is intimately involved in the pathogenesis of atherosclerosis and is accurately measured by high-sensitivity C-reactive protein (hs-CRP), a sensitive marker for future risk of cardiovascular disease. The Correlation between Oral Health and Systemic Inflammation (COHESION) trial was designed to test the hypothesis that PlaqueHD, a plaque-identifying toothpaste, reduces hs-CRP. MethodsThe trial was designed initially to include 132 subjects with hs-CRP between 2.0 and 10.0 mg/L but instead randomized 112 between 0.5 and 10.0, of which 103 had baseline and follow-up data and comprised the intention-to-treat sample. Of these, a prespecified subgroup analysis included 40 with baseline hs-CRP >2.0 and all hs-CRP <10. Because the distribution of hs-CRP was skewed toward higher values, to achieve normality assumptions, the significance of changes in hs-CRP between groups over time was tested on log-transformed data using a mixed effects analysis of variance. ResultsThe intention-to-treat analysis showed no significant differences between the PlaqueHD and placebo group (P = .615). The prespecified subgroup analysis showed a significant difference between the PlaqueHD and placebo group (P = .047). Results of the analysis showed a reduction in hs-CRP at follow-up of 0.58 in the PlaqueHD and an increase of 0.55 in the placebo group. ConclusionsThese findings are compatible with those of a prior pilot trial that also suggested benefits only in subjects with baseline elevations. Future trials targeting reductions of hs-CRP levels should randomize subjects with baseline hs-CRP between 2.0 and 10.0 mg/L.

Analysis of correlation between serum NSE, hs-CRP levels and NIHSS score in patients with cerebral infarction

Objective To investigate the correlation between the changes of serum neuron specific enolase (NSE) and hypersensitive C-reactive protein (hs-CRP) levels and the degree of neurological deficit (NIHSS) score in patients with cerebral infarction. Methods From January 2017 to January 2019, 63 patients with cerebral infarction admitted to Lishui Central Hospital were selected.According to NIHSS score, they were divided into 13 mild cases, 30 moderate cases and 20 severe cases.According to infarction area, they were divided into large area group (16 cases), small area group (27 cases) and lacunar infarction group (20 cases). Another 60 cases underwent health examination in our hospital from January 2017 to January 2019 were selected as the control group.Enzyme-linked immunosorbent assay (ELISA) was used to determine the content of NSE, and immunoturbidimetric assay was used to determine the content of hs-CRP.The changes of serum NSE and hs-CRP levels in the cerebral infarction group and control group, serum NSE, hs-CRP levels and NIHSS scores in different severity and infarction area, and the correlation between serum NSE and hs-CRP changes and NIHSS scores were compared. Results The serum levels of NSE [(21.34±3.27)ng/mL] and hs-CRP [(10.48±2.14)mg/L] in the cerebral infarction group were significantly higher than those in the control group [(6.23±1.08)ng/mL, (2.83±0.46)mg/L] (t=34.061, 27.095, all P<0.05). The serum levels of NSE [(26.98±3.64) ng/mL], hs-CRP [(15.36±2.57)mg/L] and NIHSS score[(38.49±3.25)points] in the severe group were higher than those in the moderate group and mild group, which in the moderate group [(20.98±3.21)ng/mL, (10.25±2.09)mg/L and (22.18±3.48)points] were higher than those in the mild group [(12.64±2.78)ng/mL, (5.47±1.40)mg/L and (7.38±2.56)], the differences were statistically significant (F=14.975, 9.132, 15.873, all P<0.05). The serum levels of NSE [(25.43±3.35)ng/mL], hs-CRP [(16.54±2.71)mg/L] and NIHSS score[(37.34±3.75)points] in the large area group were higher than those in the small area group and lacunar infarction group, which in the small area group [(21.67±3.12)ng/mL, (10.86±2.21)mg/L and (21.25±3.26)points] were higher than those in the lacunar infarction group [(13.45±2.97)ng/mL, (4.79±1.35)mg/L and (8.49±2.15)points], the differences were statistically significant (F=13.241, 9.893, 17.482, all P<0.05). The serum levels of NSE and hs-CRP were positively correlated with NIHSS score (r=0.829, 0.713, all P<0.05). Conclusion The levels of serum NSE and hs-CRP in patients with cerebral infarction increase with the progression of the disease, and there is a linear positive correlation between NSE and hs-CRP and NIHSS score.It is considered that NSE and hs-CRP are of great value in evaluating the degree of neurological impairment, the severity of the disease and the size of the infarct. Key words: Infarction, middle cerebral artery; Neuron-specific enolase; C-reactive protein; Neurological deficit score

Does green tea extract enhance the anti-inflammatory effects of exercise on fat loss?

Green tea extract (GTE) can exert antiobesity and anti-inflammatory effects. Our study determined whether the benefits of GTE are summative with exercise-induced changes in anthropometric indices, and the levels of inflammatory cytokines, adiponectin and irisin in inactive overweight women. Thirty overweight female participants were randomized to 3 groups: endurance training + placebo (ET + P); endurance training + GTE (ET + GTE); and Control (no exercise) + placebo (Control, n = 10). The exercise intervention consisted of an 8-week endurance-training programme of 3 sessions per week (aerobics, aerobic circuit training, and fast walking or jogging at a moderate intensity of 40-59% of the heart rate reserve). The dose of GTE used was 500 mg/day in the form of a green tea capsule. Body weight, body mass index, waist to hip ratio and body fat percentage were decreased in both ET + P and ET + GTE interventions (P < .001 for both interventions). The reduction of anthropometric values in the ET + GTE group was significantly higher than ET + P interventions (P < .001). Both exercise interventions also significantly (P < .001) increased adiponectin (ET + GTE = 5.28 mg/mL [95% confidence interval {CI}, 4.48 to 6.08] and ET + P = 3.34 mg/mL [95% CI, 2.76 to 3.92]) and decreased high-sensitivity C-reactive protein (hs-CRP; ET + GTE = -0.95 mg/L [95% CI, -1.15 to -0.75] and ET + P = -0.35 mg/L [95% CI, -0.46 to -0.24]). Changes in adiponectin and hs-CRP were greater (P < .05) in ET + GTE compared to ET + P. There were no significant differences in irisin, interleukin-6 or tumour necrosis factor-α between the 3 groups (P > .05). GTE improves exercise-induced body composition by further decreasing exercise-induced changes in weight, body mass index, waist to hip ratio and body fat percentage. The combination of GTE and exercise also produced greater changes in anti-inflammatory (increases in adiponectin) and metabolic (decreases in hs-CRP) markers than exercise alone.