Changes In hs-CRP Research Articles

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.

The Association Between S100A8/A9 and the Development of Very Late Stent Thrombosis in Patients With Acute Myocardial Infarction

Very late stent thrombosis (VLST) is a rare but serious complication following percutaneous coronary intervention (PCI). S100A8/A9 plays an important role in thrombosis through modulating the inflammatory response. This observational study aimed to reveal the association between S100A8/A9 and VLST. Continuous blood samples were collected from patients at both the time of index PCI for acute myocardial infarction (AMI) and the time of PCI for VLST (VLST group) or follow-up coronary angiography (AMI group). In all, 56 patients were selected in each group from a cohort of 8476 patients and other 112 individuals who underwent health checkups (normal control [NC] group) were selected as controls. Serum levels of S100A8/A9 and high sensitivity C-reactive protein (hs-CRP) were tested and compared. The mean level of S100A8/A9 was 3754.4 ± 1688.9 ng/mL during index PCI and increased to 5517.8 ± 2650.9 ng/mL at the time of VLST; in the AMI group, S100A8/A9 level was 2434.9 ± 1243.4 ng/mL during index PCI and decreased to 1568.2 ± 772.1 ng/mL during follow-up, similar to that detected in the NC group (1618.2 ± 641.4 ng/mL). Of note, S100A8/A9 levels showed significant increases during VLST when compared to its own levels during index PCI, which was different from the changes of hs-CRP. Higher serum levels of S100A8/A9 are associated with the development of VLST.

Активность системного ювенильного идиопатического артрита у детей, иммунизированных 13-валентной конъюгированной пневмококковой вакциной: проспективное когортное исследование

Evaluation of the safety profile of vaccines in patients with rheumatic diseases requires an assessment of their impact on disease activity. The effect of antipneumococcal vaccination on the activity of systemic juvenile idiopathic arthritis (sJIA) has not been studied so far. Objective. To evaluate the dynamics of sJIA activity after immunization with pneumococcal 13-valent conjugate vaccine (PCV13) of patients receiving biologicals. Patients and methods. This study included patients with sJIA in remission or active disease receiving biologicals during inpatient treatment and vaccinated with PCV13. To evaluate the effect of immunization on sJIA activity, we measured serum levels of high-sensitivity C-reactive protein (hs-CRP) and calprotectin. In addition to that, we assessed the number of new cases, when concentration of these markers was above the upper limit (UL) 4 weeks after PCV13 administration. Results. In 18 out of 53 patients in remission (34%) and 3 out of 25 patients with active sJIA (12%), hs-CRP levels were undetectable (0.1 mg/L) at both time-points (baseline and after 4 weeks). Among those with detectable hs-CRP levels in at least one time-point 4 weeks after vaccination, patients in remission (n = 35) had no significant changes in hs-CRP (median -0.17 mg/mL; 95% CI -0.84…0.41), whereas patients with active sJIA (n = 22) demonstrated a 3-fold decrease in hs-CRP level (median -0.94 mg/mL (95% CI -3.93…0.05). We observed no significant difference in calprotectin levels in the groups. Concentration of hs-CRP above the UL 4 weeks after vaccination was detected in 2 out of 53 sJIA patients in remission (4%) and none of the patients with active sJIA. Сoncentration of calprotectin above the UL 4 weeks after vaccination was detected in 8 out 53 (15%) and 5 out 25 (20%) sJIA patients in remission and with active disease, respectively. Conclusion. Vaccination against pneumococcal infection in patients with sJIA led to an increase in the level of highly sensitive laboratory markers of sJIA activity in 4–20% of patients. Key words: disease activity, safety, high-sensitivity C-reactive protein, biological drugs, calprotectin, juvenile idiopathic arthritis, pneumococcal 13-valent conjugate vaccine

Prospective Study of Long-Term Interrelationships Among Adiposity-Associated Biomarkers in Women.

This study aimed to investigate the prospective interrelationships among biomarkers that may provide mechanistic insights into obesity-related diseases. A total of 850 women in the Nurses' Health Study II with two fasting blood measurements (1996-1999 and 2010-2011) of adiponectin, leptin, soluble leptin receptor, insulin, retinol-binding protein4, high-sensitivity C-reactive protein (hsCRP), and interleukin-6 were included. Biomarker interrelationships were examined in the following three ways: (1) cross-sectional associations at baseline and follow-up, (2) longitudinal associations of concurrent biomarker changes, and (3) prospective associations of each baseline biomarker with other biomarker changes. In cross-sectional analyses, most biomarkers were correlated after multivariable adjustment including BMI, with the strongest correlations observed between leptin and insulin and between hsCRP and interleukin-6. In longitudinal analyses, similar results were observed after multivariable adjustment including weight change. However, in prospective analyses, only three associations observed in cross-sectional and longitudinal analyses were consistently significant (P < 0.05). Every doubling in baseline adiponectin was associated with -9.0% insulin change. The corresponding estimate was 9.3% for baseline leptin and hsCRP change and 3.1% for baseline hsCRP and leptin change. Baseline adiponectin concentrations were inversely associated with subsequent insulin change, whereas baseline leptin concentrations were positively associated with hsCRP change and vice versa.

The effect of lanthanum carbonate on calciprotein particles in hemodialysis patients

BackgroundAggregation of solid-phase calcium–phosphate and fetuin-A form nanoparticles called calciprotein particles (CPP). Serum CPP levels are increased in CKD patients and correlated with vascular stiffness and calcification. In this study, we evaluated effects of lanthanum carbonate (LC) and calcium carbonate (CC) on serum CPP levels in hemodialysis (HD) patients.MethodsTwenty-four (24) HD patients (50% men, age; 68 ± 12 years, dialysis period; 6.2 ± 4.8 years, Kt/v; 1.74 ± 0.34) were treated with CC during 0–8 weeks and then switched to LC during 9–16 weeks. Blood samples were obtained at 0, 8, 16 weeks. Serum CPP levels (TCPP) were measured by the gel-filtration method. Low-density CPP (LCPP) levels were determined by centrifuging the serum samples at 16,000 g for 2 h and measuring CPP levels in the supernatant. The difference between TCPP and LCPP was defined as the high-density CPP (HCPP) level. We evaluated association of TCPP, LCPP, and HCPP with serum calcium (Ca), phosphorus (P), intact PTH, FGF23, Klotho, fetuin-A, aortic calcification index (ACI), LDL cholesterol, and hs-CRP.ResultsTCPP and LCPP levels were significantly decreased after switching CC to LC, whereas Ca and P levels were not changed. HCPP levels were below the lower limit quantification in all patients. The changes in P, Ca × P, LDL cholesterol, but not ACI and the changes in hs-CRP, were correlated with the change in TCPP levels.ConclusionThe TCPP levels were significantly decreased after switching CC to LC. Non-calcium-containing phosphate binders may be preferable for lowering CPP levels.

An add-on training program involving breathing exercises, cold exposure, and meditation attenuates inflammation and disease activity in axial spondyloarthritis - A proof of concept trial.

ObjectivesThe primary objective of this trial was to assess safety and anti-inflammatory effects of an add-on training program involving breathing exercises, cold exposure, and meditation in patients with axial spondyloarthritisMethodsThis study was an open-label, randomised, one-way crossover clinical proof-of-concept trial. Twenty-four patients with moderately active axial spondyloarthritis(ASDAS >2.1) and hs-CRP ≥5mg/L were included and randomised to an intervention (n = 13) and control group (n = 11) group that additionally received the intervention after the control period. The intervention period lasted for 8 weeks. The primary endpoint was safety, secondary endpoints were change in hs-CRP, serum calprotectin levels and ESR over the 8-week period. Exploratory endpoints included disease activity measured by ASDAS-CRP and BASDAI, quality of life (SF-36, EQ-5D, EQ-5D VAS), and hospital anxiety and depression (HADS).ResultsWe found no significant differences in adverse events between groups, with one serious adverse event occurring 8 weeks after end of the intervention and judged ‘unrelated’. During the 8-week intervention period, there was a significant decline of ESR from (median [interquartile range] to 16 [9–26.5] to 9 [5–23] mm/hr, p = 0.040, whereas no effect was found in the control group (from 14 [8.3–27.3] to 16 [5–37] m/hr, p = 0.406). ASDAS-CRP declined from 3.1 [2.5–3.6] to 2.3 [1.9–3.2] in the intervention group (p = 0.044). A similar trend was observed for serum calprotectin (p = 0.064 in the intervention group versus p = 0.182 in the control group), but not for hs-CRP.ConclusionsThis proof-of-concept study in axial spondyloarthritis met its primary endpoint with no safety signals during the intervention. There was a significant decrease in ESR levels and ASDAS-CRP upon the add-on training program in the intervention group. These findings warrant full-scale randomised controlled trials of this novel therapeutic approach in patients with inflammatory conditions.Trial registrationClinicalTrials.gov; NCT02744014

Inflammatory serum markers and risk and severity of prostate cancer: The PROCA-life study.

Whether chronic inflammation mirrored by high levels of systemic inflammatory markers such as high sensitive-CRP (hs-CRP) and white blood cell count (WBC) are associated with prostate cancer development remains unclear. In the Prostate Cancer Study throughout Life (PROCA-life), a prospective population-based cohort study, 7,356 men were included. Prediagnostic WBC and hs-CRP were assessed from blood collected at study entry; 2,210 participants also had a second CRP measure during follow-up. During a mean 11.8 years follow-up, 509 men developed prostate cancer (mean age at diagnosis 71.7 years). Multivariable Cox proportional hazard regression models were used to study whether individual biomarkers (WBC, hs-CRP), a combined score based on analyte tertiles (score range 2-6), or change in CRP were associated with risk and severity of prostate cancer. We observed a positive dose-response relationship between hs-CRP and prostate cancer risk with a Hazard Ratio (HR) per mg/l of 1.3, 95% CI 1.00-1.07. Men with an increase in hs-CRP between two measurements (Δhs-CRP) of ≥1.00 mg/l had a 36% increased risk of prostate cancer (HR 1.36, 95% CI 1.02-1.82), compared to men with no change or decrease in hs-CRP. Men with a systemic inflammatory score of 5 or 6 had a 68% higher risk of being diagnosed with metastatic disease (HR 1.68, 95% CI, 1.04-2.73) compared to men with lower scores. Our study supports that hs-CRP including repeated measurements alone or in combination with WBC may be a useful inflammation-related biomarker for prostate cancer risk and prognosis.

Real-World Clinical Effectiveness and Tolerability of Hydroxychloroquine 400 Mg in Uncontrolled Type 2 Diabetes Subjects who are not Willing to Initiate Insulin Therapy (HYQ-Real-World Study).

The epidemic of T2DM is rising across the globe. Systemic inflammation plays a pivotal role in the pathogenesis and complications of T2DM. Combination of two or more oral hypoglycemic agents (OHA) is widely prescribed in patients with T2DM, however many patients have poor glycemic control despite receiving combination therapy. The new antidiabetic drugs are relatively costly or many patients have anxiety over the use of injectable insulin. The objective of this observational study was to investigate the effectiveness and tolerability of hydroxychloroquine (HCQ) in T2DM patients uncontrolled on multiple OHA and despite high sugar level not willing to initiate insulin therapy in a real-world clinical setting. A prospective, investigator-initiated, observational, single-centred study was conducted where 250 patients (18-65 years) with T2DM for more than 5 years, with uncontrolled glycemia despite on a combination of multiple OHA, HbA1c between ≥7% and <10.5%, FPG >130 mg/dL or PPG >180 mg/dL and BMI between >25 and <39 kg/m2, were prescribed hydroxychloroquine sulphate 400 mg once daily for 48 weeks. Percentage of drugs used at the baseline were as follows: metformin 2000 mg (100%), glimepiride 4 mg (100%), pioglitazone 30 mg (100%), sitagliptin 100 mg (100%), canagliflozin 300 mg (52.4%), empagliflozin 25 mg (22.8%), dapagliflozin 10 mg (17.6%) and voglibose 0.3 mg (62%). Mean change in HbA1c, blood glucose and hs-CRP at baseline, week 12, 24 and 48 were assessed using the paired t-test. After 48 weeks of add-on treatment with HCQ, almost all SGLT-2 inhibitors were withdrawn; metformin dose was reduced to 1000 mg, glimepiride reduced to 1 mg and sitagliptin reduced to 50 mg OD. Patients continued to have good glycemic control. HbA1c was reduced from 8.83% to 6.44%. Reduction in FPG was 40.78% (baseline 177.30 mg/dL) and PPG was reduced by 58.95% (baseline 329.86 mg/dL). Change in mean body weight was -4.66 Kg. The reduction in glycemic parameters and mean body weight was significant (p < 0.0001). Hs-CRP was significantly reduced from 2.70±1.98 mg/L to 0.71±0.30 mg/L 9 (p < 0.0001). More reduction in glycemic parameters and body weight was observed among the patients with higher hs-CRP (> 3 mg/L) as compared to patients with baseline hs- CRP ≤ 3 mg/L. Most common adverse events reported with the drug therapy were GI irritation (3.6%) and hypoglycemia (2%). None of the patients required medical assistance for hypoglycemia. Add-on treatment of HCQ effectively improved glycemic control in T2DM patients uncontrolled on multiple antidiabetic drugs. By virtue of its antidiabetic and anti-inflammatory properties, it may emerge as a valuable therapeutic intervention for the patients with T2DM.

P3539Comparative efficacy of renin-angiotensin aldosteron system modulators and angiotensin receptor neprilyzin inhibitor in chronic heart failure with reduced, mid-ranged and preserved ejection fraction

Abstract The aim of study was to compare efficacy of therapy with ramipril (R, 10 mg) + spironolacton (S, 25 mg), valsartatan (V, 320 mg) + S, sacubitril/valsartan (S/V, 97/103 mg), and S/V+S on prognosis, left (LV) and right ventricular (RV) and atrial (LA) and (RA) functional parameters, NT-pro-BNP (pg/ml), transforming growth factor-beta (TGF-β) and hsCRP (ng/ml) levels in patients (pts) with III NYHA FC heart failure in relation to reduced (HFrEF), mid-ranged (HFmEF) or preserved (HFpEF) ejection fraction (EF). Methods 122 pts (age 58.4) with HFrEF (EF&lt;50), 108 pts (age 59.9) with HFmEF (40≤EF&lt;50) and 104 pts (age 63.1) with HFpEF (EF≥50) in sinus rhythm were randomly assigned to groups, receiving R+S (n=32; 28; 27), V+S (n=30; 27; 26) and S/V (n=31; 27; 26) and S/V+S (n=29; 26; 25) in addition to diuretics and beta-blockers. Results 1-year mor-tality and hospitalization (%) were, 40.6 and 73.3; 39.3 and 57.1; 33.3 and 55.5 in R+S; 43.3 and 76.7; 40.7 and 59.3; 38.5 and 57.7 in V+S; 32.3 and 58.1; 29.6 and 48.1 and 30.1 and 42.3 in S/V and 31 and 55.2; 30.8 and 42.3 and 32 and 40 in S/V+S receiving groups with HFrEF, HFmEF and HFpEF, respectively. Survival analysis revealed RR reduction of 1-year mortality at 20.7 and 23.6; 25.4 and 28.4 and hospitalization at 20.7 and 24.3; 24.7 and 29.3 in HFrEF pts, treated by S/V and S/V+S, compared to R+S and V+S, respectively (p&lt;0.05). Similarly, 1-year mortality and hospitalization were reduced at 24.7 and 21.6; 27.3 and 24.3 in HFmEF pts. Significant reduction of 1-year hospitalization at 23.8 and 23.7; 27.9 and 30.7 (p&lt;0.05), but not mortality was revealed in V/S and V/S+S treatment group with HFpEF. 1-year S/V and S/V+S treatment significantly (at % from baseline, p&lt;0.01) decreased levels of TGF-β at 32.3 and 34.5; 31.3 and 33.3, NT-pro-BNP at 40.3 and 42.3 and 38.9 and 40.1, e' at 30.6 and 31.5; 30.2 and 30.6,Ar-A at 56.6 and 58.8; 55.1 and 57.2, RAFI at 34.3 and 35.1; 32.9 and 33.6, LAFI at 35.7 and 36.6; 34.9 and 35.2, LV EF at 23.1 and 24.2; 22.1 and 23.4 in pts with HFrEF and HFmEF, and significant changes of hsCRP at 34.6 and 35.2, levels of TGF-β at 30.2 and 31.2, TAPSE at 42.2 and 43.4, e' at 26.2 and 28.2, PA ET at 19.8 and 20.3 in pts with HFpEF, compared to R+S and V+S, respectively. Conclusions 1) S/V and S/V+S treatment associated with significant reduction of morbidity and mortality in pts with HFrEF and HFmEF, and hospitalization in HFpEF compared to use of R+S and V+S. 2) Changes of NT-pro-BNP, Ar-A, RAFI and LAFI, e' ≥40%, TGF-β ≥30% identified pts with cardiovascular risk reduction in HFrEF and HFmEF groups, while changes of TGF-β, hsCRP≥30%; PAET ≥30% revealed pts with improvement of morbidity in pts with HFpEF. 3) Prognostic improvement in pts treated by S/V and S/V+S has related to improvement of TGF-β, LV systolic and diastolic functional parameters, LA and RA functional parameters in HFrEF and HFmEF and to TGF-β, hsCRP, LV diastolic and RV functional parameters changes in HFpEF.

Changes in pulse pressure × heart rate, hs-CRP, and arterial stiffness progression in the Chinese general population: a cohort study involving 3978 employees of the Kailuan Company.

BackgroundPulse wave velocity (PWV) is a marker of arterial stiffness, which represents sub-clinical atherosclerosis. Pulsatile stress and high-sensitivity C-reactive protein (hs-CRP) are associated with arteriosclerosis. However, there is no prospective data confirming whether changes in pulsatile stress and inflammatory markers affect the progression of arterial stiffness. The aim of this study was to investigate the relationships over time between the effects of changes in pulsatile stress and hs-CRP, and arterial stiffness progression during a 2-year follow-up.MethodsWe performed a longitudinal study involving 3978 participants. All participants underwent a physical examination in 2010–2011 and 2012–2013, during which we measured participants' hs-CRP levels, brachial–ankle pulse wave velocity (baPWV), and pulsatile stress.ResultsBaseline hs-CRP was correlated with baPWV (r = 0.18, P = 0.000); however the correlation was weaker than that with systolic blood pressure (r = 0.65), pulsatile stress (r = 0.57), and rate-pressure product (r = 0.58). Multiple linear regression analysis demonstrated that changes in pulsatile stress, mean arterial pressure, and low-density lipoprotein-C (LDL-C) were positively correlated with changes in baPWV, with correlation coefficients of 0.27, 0.25, and 0.07, respectively, but not with changes in hs-CRP. Moreover, each 100-aU increase in pulsatile stress, 1 mmHg increase in mean blood pressure, and 1 mmol/L increase in LDL-C was associated with a 3 cm/s, 4.78 cm/s, and 17.37 cm/s increase in baPWV, respectively.ConclusionsPulsatile stress increases are associated with arterial stiffness progression, but that changes in hs-CRP had no effect on arterial stiffness progression. Hs-CRP may simply be a marker of inflammation in arterial stiffness and has no association with arterial stiffness progression.

Macroprolactinaemia modulates cardiometabolic effects of fenofibrate in men with atherogenic dyslipidaemia: A pilot study.

Cardiometabolic effects of hypolipidaemic agents depend on plasma levels of monomeric prolactin. Although macroprolactinaemia seems to be associated with increased cardiometabolic risk, no previous study has investigated whether macroprolactinaemia modulates pleiotropic effects of hypolipidaemic agents. The study population included two age-, weight-, blood pressure- and lipid-matched groups of men: 12 men with elevated levels of big-big prolactin and 16 men with prolactin levels within the reference range. Because of atherogenic dyslipidaemia, all subjects were treated for 6months with fenofibrate (200mg daily). Glucose homeostasis markers and plasma lipids, as well as plasma levels of uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen, homocysteine and 25-hydroxyvitamin D, were determined in patients at the beginning and at the end of the study. Men with elevated levels of big-big prolactin were characterized by higher levels of hsCRP and fibrinogen and lower levels of 25-hydroxyvitamin D as well as decreased insulin sensitivity than subjects with prolactin levels within the reference range. In men without macroprolactinaemia, fenofibrate decreased circulating levels of total and LDL cholesterol, triglycerides, uric acid, hsCRP and fibrinogen, and increased concentrations of HDL cholesterol, homocysteine and 25-hydroxyvitamin D, as well as improved insulin sensitivity. In subjects with macroprolactinaemia, fenofibrate action was limited to the changes in HDL cholesterol, triglycerides, hsCRP and homocysteine. With the exception of homocysteine, cardiometabolic effects of fenofibrate were stronger in subjects without than in subjects with elevated levels of big-big prolactin. The results of the study indicate that macroprolactinaemia exerts a negative impact on cardiometabolic effects of fenofibrate.

POSITIVE EFFECTS OF RENAL DENERVATION ON MARKER OF CARDIOVASCULAR INFLAMMATION AND LEFT VENTRICULAR MASS. 24-MONTH FOLLOW-UP

Objective: The C-reactive protein (hsCRP) as biomarker of vascular inflammation and remodeling is proven involved in development of left ventricular hypertrophy and determined as predictive factor of cardiovascular complications. Our objective was to study the influence of renal denervation (RDN) on left ventricular mass (LVM) and hsCRP at 24 month after the treatment and their relationship. Design and method: 20 patients with resistant hypertension aged 59.5 ± 6.1 years and 24-h blood pressure (BP) 154.8 ± 13.4/83.8 ± 13.8 mm Hg, giving inform consent, were enrolled in the study. RDN was done to all patients. Initially and at 24 months after treatment patients were measured 24-h BP, high-sensitive hsCRP by enzyme-linked immunosorbent assay (ELISA) and LVM by the cardiac magnetic resonance (CMR). Results: Based on changes of LVM at 24 month after RDN all patients retrospectively were divided into 2 groups: the 1st with changes in LVM < 0 g (n = 7) and the 2nd group with changes > 0 g (n = 13) Groups were comparable in baseline 24-h BP (158.3 ± 19.6/88.3 ± 16.2 vs 152.8 ± 8.9/81.4 ± 12.3 mm Hg, p > 0.05), LVM (214.1 ± 61.7 vs 250.3 ± 68.4 g, p = 0.26) and hsCRP (4.6 ± 3.3 vs 3.3 ± 2.8 mg/l, p = 0.41). Despite of comparable changes of SBP at 24 month after RDN (-11/-4.0 vs -15.5/-7.5 mm Hg, p = 0.19 for SBP, p = 0.87 for DBP) hsCRP decreased significantly by 33.3% (p = 0.046) in the 2nd group without significant changes in value of hsCRP in the 1st group (by 19.6%, p = 0.35). There was no correlation between changes of LVM and hsCRP at 24 month after RDN in both groups. Conclusions: The regression of hsCRP was detected in patients with decreased LVM as one of possible ways of realization cardioprotective efficacy of RDN.

Effects of ginseng supplementation on selected markers of inflammation: A systematic review and meta-analysis.

The present meta-analysis was performed to evaluate the efficacy of ginseng administration on serum level of inflammatory biomarkers. We performed a systematic search of all available randomized controlled trials (RCTs) conducted up to June 2018 in the following electronic databases: PubMed, Scopus, Cochrane, and Google Scholar. RCTs that investigated the effect ginseng supplementation on high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were included for final analysis. A total of seven RCTs were included in the meta-analysis. Results indicated significant reduction in IL-6 (mean difference [MD]: -0.265pg/ml, 95% CI [-0.396, -0.135], p<.001) and TNF-α (MD: -2.471pg/ml, 95% CI [-2.904, -2.039], p<.001) and no significant change in hs-CRP (MD: -0.125mg/L, 95% CI [-0.597, 0.347], p=.604). Although there was publication bias across studies, trim and fill analysis showed that results from unpublished studies could not change the results for CRP. However, removing one study in sensitivity analysis did reveal a significant reduction in CRP. We conclude that ginseng supplementation significantly lowered IL-6 and TNF-α but did not significantly lower CRP. However, these findings were not robust, because they showed sensitivity for CRP and IL-6, and future long-term well-designed dose-escalating trials are required.

Determination of Serum Homocysteine and Hypersensitive C-reactive Protein and Their Correlation with Premature Coronary Heart Disease.

This study aims to investigate the correlation between premature coronary heart disease (pCHD) and both serum homocysteine (Hcy) and hypersensitive C-reactive protein (hs-CRP). A total of 170 patients with pCHD were enrolled in this study from June 2014 to April 2016 (including 52 patients with stable angina pectoris [SAP], 70 patients with unstable angina pectoris [UAP], and 48 patients with acute myocardial infarction [AMI]), together with 105 healthy controls (CON) selected at the same period, to observe the changes of Hcy and hs-CRP in CHD patients and those with different types of CHD. The levels of serum Hcy and hs-CRP in group pCHD were significantly higher than in group CON (P < .05). The levels of Hcy and hs-CRP in group AMI were significantly higher than in group UAP and group SAP (P < .05). The changes of serum Hcy and hs-CRP were significantly higher in patients with multi-vascular lesions and dual-vascular lesions than in those with single-vascular lesion (P < .05). The levels of serum Hcy and hs-CRP in CHD patients are positively correlated with the severity of CHD, which increase with the increase of lesion count. The combined detection of Hcy and hs-CRP can initially reflect the severity of coronary artery, thus better guiding treatment and predicting prognosis.

Sesame oil and vitamin E co-administration may improve cardiometabolic risk factors in patients with metabolic syndrome: a randomized clinical trial.

Metabolic syndrome (MetS) represents a clustering of metabolic abnormalities that are associated with an increased risk of type 2 diabetes and cardiovascular disease. We aimed to evaluate the effects of sesame oil enriched with vitamin E (vit E), sesame oil alone and sunflower oil on lipid profile, fasting blood glucose (FBG), malondialdehyde (MDA), high-sensitivity C-reactive protein (Hs-CRP), homeostatic model assessment (HOMA-IR), and blood pressure (BP) in patients with MetS. Overall, 75 individuals with MetS (aged 30-70 years) participated in this randomized, single-blind controlled trial. Patients were randomly allocated to: (1) Group A (n = 25): sesame oil (30 ml/day) enriched with vit E (400 mg/day), (2) Group B (n = 25): sesame oil (30 ml/day), (3) Group C (n = 25): sunflower oil (30 ml/day). Anthropometric data, dietary intake, blood pressure, and biochemical markers, including fasting serum lipids, FBG, serum insulin, MDA, and hs-CRP were measured at baseline and at week 8. In individuals in the sesame oil enriched with vit E group (Group A), there were significant reductions in serum total cholesterol (TC), triglycerides (TG), FBG, HOMA-IR, MDA, hs-CRP, high-density lipoprotein (HDL-C) systolic and diastolic BP (for all the comparison p < 0.02). Similarly, in Group B (taking sesame oil alone), TC, TG, FBG, HOMA-IR, MDA, systolic and diastolic BP were significantly improved (for all the comparison p < 0.025), while there were no significant changes in serum HDL (baseline = 35.9 ± 7.2 mg/dL vs. 36.4 ± 6.2 mg/dL, p = 0.432) and hs-CRP (baseline = 4.38 ± 1.34 mg/dL vs. week 8 = 3.96 ± 1.7 mg/dL, p = 0.057) in second group. No significant changes in any of the studied clinical and anthropometric data were found in Group C (on sunflower oil). Sesame oil (±vit E) was shown to beneficially affect several cardiometabolic indices (including lipids, FBG, BP, HOMA-IR, and MDA) in patients with MetS.

Epicardial fat thickness and biomarkers of inflammation in patients with stable coronary artery disease: correlation with the severity of coronary atherosclerosis

Aim. To study the relationship between the epicardial fat thickness (EFT), biomarkers of inflammation and metabolic dysfunction in patients with coronary artery disease (CAD) and various severity of coronary atherosclerosis.Material and methods. The study consisted of 89 patients (47 men and 42 women) with stable CAD at the age of 62,2±6,5 years, who assessed the presence and severity of coronary atherosclerosis according to angiography with the calculation of the Gensini Score (GS). We conducted an ultrasonic evaluation of the EFT. We determined the content of glucose, lipid fractions, apoproteins, pro-inflammatory cytokines and adipokines, C-reactive protein by a highly sensitive method (hsCRP).Results. In the total sample of patients, the median GS index was 13,5 (3,5; 43) points, the median EFT was 4,93 (3,95; 6,0) mm, the median hsCRP was 2,1 (1,02; 3,65) mg/l. There were no correlation relationships between the GS index and the body mass index, waist circumference, EFT, hsCRP, lipid and carbohydrate metabolism in the general group of patients. In the course of linear regression analysis, an independent contribution of hsCRP &gt;2,1 mg/l to the formation of the first two tertiles of a sample of GS values was established (0≤ GS ≤28, paired linear regression hsCRP at GS β=0,55, p=0,0221), whereas in patients with GS values from the third tertile (GS &gt;28 points), the growth of this parameter had an independent association with an increase in the EFT (estimation of the coefficient of paired linear regression of the EFT on GS β=0,56, p=0,0015). The range of hsCRP changes did not affect the value of the β coefficient in paired linear regression models in patients with GS &gt;28 points (n=29) and in the subgroup of patients with GS &gt;28 and hsCRP &gt;2,1 mg/l (n=18).Conclusion. The absence of an independent association between EFT and minor or moderate severity of atherosclerotic lesions of the coronary arteries (for GS ≤28 points) in patients with CAD, while an independent marker of GS index increase is higher than 2,1 mg/l. An independent contribution to the formation of a severe coronary atherosclerosis (with a GS value of &gt;28 points) is equally made by thickening of EFT, and a moderately elevated level of hsCRP.

Change in Plant-Based Diet Quality Is Associated with Changes in Plasma Adiposity-Associated Biomarker Concentrations in Women

ABSTRACTBackgroundA healthful plant-based diet is associated with lower risk of cardiometabolic diseases. However, it is still unclear whether such benefits are due to its favorable effects on adiposity-associated biomarkers.ObjectiveWe investigated the associations between biomarkers and 3 plant-based diet indices: an overall plant-based diet index (PDI); a healthful plant-based diet index (hPDI); and an unhealthful plant-based diet index (uPDI).MethodsIn the Nurses’ Health Study II, 831 women [baseline mean age: 45 y; body mass index (BMI, kg/m2): 24.6] were randomly selected from those who provided 2 blood samples in 1996–1999 and 2010–2011 to measure plasma concentrations of adiponectin, leptin, soluble leptin receptor (sOB-R), insulin, retinol-binding protein-4, high-sensitivity C-reactive protein (hsCRP), and interleukin-6 (IL-6). Plant-based diet indices were derived from semiquantitative food frequency questionnaires assessed at each blood collection. Linear mixed models were used to evaluate cross-sectional associations, and general linear models were used to evaluate longitudinal associations.ResultsIn cross-sectional analyses with multivariable adjustment including BMI, higher hPDI was associated with lower concentrations of leptin, insulin, and hsCRP, and higher adiponectin and sOB-R concentrations (biomarker differences per 10-point higher hPDI: −7.2%, −10.0%, −13.6%, 3.0%, and 1.9%, respectively; P ≤ 0.025). A higher uPDI was associated with higher concentrations of leptin and insulin (4.4% and 4.8%, respectively; P ≤ 0.048). In longitudinal analyses with multivariable adjustment including weight change, an increase in hPDI (improved plant-based diet quality) was inversely associated with changes in leptin and hsCRP (biomarker changes per 10-point hPDI increase: −7.7% and −17.8%, respectively; P ≤ 0.005), whereas an increase in uPDI (worsened plant-based diet quality) was positively associated with changes in leptin, hsCRP, and IL-6 (10.1%, 13.5%, and 12.4%, respectively; P ≤ 0.021).ConclusionsAdherence to a healthful plant-based diet is associated with favorable long-term changes in adiposity-associated biomarker concentrations in women.

How does empagliflozin improve arterial stiffness in patients with type 2 diabetes mellitus? Sub analysis of a clinical trial

BackgroundEmpagliflozin has been shown to reduce cardiovascular mortality, but the underlying pathogenetic mechanisms are poorly understood. It was previously demonstrated that empagliflozin improved arterial stiffness.MethodsOur analysis comprising 58 patients with type 2 diabetes mellitus identifies factors triggering the improvement of arterial stiffness. All patients participated in an investigator-initiated, prospective, double-blind, randomized, placebo-controlled, interventional clinical trial (http://www.ClinicalTrials.gov: NCT02471963, registered 15th June 2015, retrospectively registered) and received either 6-weeks treatment with 25 mg empagliflozin orally once daily or placebo (crossover). Central systolic pressure and central pulse pressure were recorded by the SphygmoCor System (AtCor Medical). Now, we investigated the impact of parameters of glucose metabolism, volume status, sympathetic activation, lipids, uric acid, blood pressure and inflammation on vascular parameters of arterial stiffness using multivariate regression analysis.ResultsAs previously reported, therapy with empagliflozin improved arterial stiffness as indicated by reduced central systolic blood pressure (113.6 ± 12.1 vs 118.6 ± 12.9 mmHg, p < 0.001), central pulse pressure (39.1 ± 10.2 vs 41.9 ± 10.7 mmHg, p = 0.027) forward (27.1 ± 5.69 vs 28.7 ± 6.23 mmHg, p = 0.031) as well as reflected wave amplitude (18.9 ± 5.98 vs 20.3 ± 5.97 mmHg, p = 0.045) compared to placebo. The multivariate regression analysis included age, sex and change between empagliflozin and placebo therapy of the following parameters: HbA1c, copeptin, hematocrit, heart rate, LDL-cholesterol, uric acid, systolic 24-h ambulatory blood pressure and high sensitive CRP (hsCRP). Besides the influence of age (beta = − 0.259, p = 0.054), sex (beta = 0.292, p = 0.040) and change in systolic 24-h ambulatory blood pressure (beta = 0.364, p = 0.019), the change of hsCRP (beta = 0.305, p = 0.033) emerged as a significant determinant of the empagliflozin induced reduction in arterial stiffness (placebo corrected). When replacing HbA1c with fasting plasma glucose in the multivariate regression analysis, a similar effect of the change in hsCRP (beta = 0.347, p = 0.017) on arterial stiffness parameters was found.ConclusionBesides age and sex, change in systolic 24-h ambulatory blood pressure and change in hsCRP were determinants of the empagliflozin induced improvement of vascular parameters of arterial stiffness, whereas parameters of change in glucose metabolism and volume status had no significant influence. Our analysis suggests that empagliflozin exerts, at least to some extent, its beneficial vascular effects via anti-inflammatory mechanisms.Trial registrationhttp://www.ClinicalTrials.gov: NCT02471963, registered 15th June 2015, retrospectively registered

Vitamin D supplementation has no effect on matrix metalloproteinases-2, -9, and tissue inhibitor matrix metalloproteinase-1 in subjects with metabolic syndrome: A pilot study.

The present randomized, double-blind, placebo controlled study aimed to evaluate the effect of vitamin D supplementation on matrix metalloproteinases-2, -9 (MMP-2 and MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in subjects with metabolic syndrome. Forty-six eligible subjects were randomly assigned to either vitamin D or placebo groups for 16 weeks. The participants were asked to take 50,000IU vitamin D or matching placebo every week. Metabolic and anthropometric indices, serum MMP-2, MMP-9, TIMP-1 and high-sensitivity C-reactive protein (hsCRP) were assessed before and after intervention. Moreover, dietary intake, sun exposure and physical activity were also determined. The trial was registered at http://www.irct.ir (No. IRCT201409033140N14). Participants were 40.20±4.60 y and 45.50% males. Compared to the baseline values, MMP-9 and TIMP-1 concentrations were decreased after 16 weeks in the intervention group (p=0.03 and p=0.04, respectively). However, the changes of MMP-2, MMP-9, TIMP-1 and hsCRP in the intervention group were not significant compared to the placebo group (p>0.05). Furthermore, the metabolic or anthropometric indices between two study groups remained unchanged (p>0.05). The findings of the present study demonstrated no effect of vitamin D supplementation on MMP-2, MMP-9 and TIMP-1 concentrations in subjects with metabolic syndrome. However, there is a need for more longitudinal trials to investigate the role of vitamin D on atherosclerosis and cardiovascular diseases in subjects with metabolic syndrome.