Elevated High-sensitivity C-reactive Protein Research Articles

Association between high-sensitivity C-reactive protein levels and depression: Moderation by age, sex, obesity, and aerobic physical activity

Background: Low-grade systemic inflammation evidenced by elevated serum high-sensitivity C-reactive protein (hsCRP) levels can be a biomarker for depression. This study aimed to investigate the association between serum hsCRP levels and depressive symptoms and to explore the potential moderating effects of age, sex, body mass index (BMI), and aerobic physical activity on the association.Methods: Data of 10,702 adults (≥ 19 years) were obtained from the nationwide cross-sectional Korea National Health and Nutrition Examination Surveys of 2016 and 2018. Significant depressive symptoms were defined as ≥ 10 on the Patient Health Questionnaire-9, and high hsCRP level was defined as > 3.0 mg/L.Results: Adults with high hsCRP levels were more likely to have depressive symptoms (odds ratio [OR]: 1.41, 95% confidence interval [CI]: 1.07–1.84) and suicidal ideation (OR: 1.39, 95% CI: 1.07–1.80) than those with low hsCRP levels. In the age- and sex-stratified analysis, high hsCRP levels were associated with depressive symptoms in the non-geriatric population (age ≤ 64 years) alone, with a higher OR in males than females. In subgroup analyses, the association between them was observed only among obese adults and adults without aerobic physical activity.Limitations: Causal interpretation is limited due to the cross-sectional design.Conclusions: Our results replicate previous findings of an association between high hsCRP levels and depressive symptoms in adults using a large nationally representative sample. The association between them was more prominent in the non-geriatric population, males, obese adults, and those without aerobic physical activity.

Abstract P022: Self-reported Polycystic Ovary Syndrome Is Associated With Higher Odds Of Metabolic Syndrome In Women Aged 18-76 Years From The Hispanic Community Health Study/Study Of Latinos

Introduction: Polycystic Ovary Syndrome (PCOS) is associated with increased Metabolic Syndrome (MetS), however, these findings have not been characterized in Hispanic/Latina women who are disproportionately burdened by obesity and cardiovascular disease risk compared to non-Hispanic whites. It is also unclear if this association is moderated by elevated high-sensitivity C-Reactive Protein (hs-CRP) levels, a marker for inflammation and a predictor of cardiovascular disease. Hypothesis: In Hispanic/Latina women, we hypothesized that 1) PCOS (self-reported diagnosis and signs) is associated with a higher prevalence of MetS compared to those not reporting PCOS 2) elevated hs-CRP is associated with MetS, and 3) the PCOS-MetS association is moderated by elevated hs-CRP. Methods: We used information from reproductive and economic questionnaires and venous blood measurements collected in Hispanic Community Health Study/Study of Latinos (2008-2017), a U.S. community-based cohort study of Hispanic/Latino adults. PCOS was operationalized as either 1) signs of PCOS (e.g., menstrual cycles >35 days, irregular cycles (at age 20 to 40 years old when not using birth control pills or other hormone medications and not pregnant or breastfeeding) or 2) having answered “yes” to a self-reported question on PCOS. MetS was operationalized as ≥3 elevated subcomponents of MetS (i.e., waist circumference, hypertension, insulin resistance, lipid profile, and triglycerides). A hs-CRP value ≥3.0 mg/L was considered elevated. We adjusted for the complex survey study design, age, study center, Hispanic/Latina background, and age at immigration in all models. Results: The overall (unweighted N=9582) age ranged from 18 to 76 years (mean=41.74, SD=14.18). The prevalence of PCOS (self-reported diagnosis and signs) was 12% (1008/7366), prevalence of MetS was 40% (2380/3495), prevalence of elevated-hsCRP was 44% (3704/4667). PCOS was associated with a significantly higher odds of MetS before (OR 1.35, 95% CI: 1.06-1.71) and after adjusting for elevated-hsCRP (OR 1.29, 95%CI: 1.02-1.65). Elevated hs-CRP is significantly associated with MetS (OR 2.31, 95%CI: 1.95-2.76). There was no significant interaction effect of hs-CRP in the PCOS-MetS association. Conclusions: Prevalence of PCOS (self-reported and signs) was 12% in our sample of Hispanic/Latina women, which is consistent with the previous findings in non-Hispanic whites. Both PCOS (self-reported diagnosis and signs) and elevated hs-CRP were significantly associated with higher prevalence of MetS and could indicate women at metabolic disease risk.

The role of maternal preconception vitamin D status in human offspring sex ratio

Evolutionary theory suggests that some animal species may experience shifts in their offspring sex ratio in response to maternal health and environmental conditions, and in some unfavorable conditions, females may be less likely to bear sons. Experimental data in both animals and humans indicate that maternal inflammation may disproportionately impact the viability of male conceptuses; however, it is unknown whether other factors associated with both pregnancy and inflammation, such as vitamin D status, are associated with the offspring sex ratio. Here, we show that among 1,228 women attempting pregnancy, preconception 25-hydroxyvitamin D concentrations are positively associated with the live birth of a male infant, with notably stronger associations among women with elevated high sensitivity C-reactive protein, a marker of systemic low-grade inflammation. Our findings suggest that vitamin D may mitigate maternal inflammation that would otherwise be detrimental to the implantation or survival of male conceptuses in utero.

Risk Factors for Progression from Subclinical to Clinical Phase of Psoriatic Arthritis: A Case-Control Study.

IntroductionThe objective of this study is to identify the potential risk factors for progression from subclinical to clinical psoriatic arthritis (PsA).MethodsA retrospective, longitudinal, case–control study was conducted at a single hospital, including 25 patients with clinically confirmed PsA in the case group and 137 controls without confirmed PsA. All patients in both groups had a medical history of subclinical PsA. Various baseline covariates were collected from all patients when they had a status of subclinical PsA. Univariate, multivariate, stratified, and interaction analyses were employed to identify potential risk factors of transiting to clinical PsA from subclinical PsA.ResultsIn multivariate logistic regression analysis, older age (OR 10.15, 95% CI 2.79–36.91, p = 0.00), alcohol drinking (OR 3.43, 95% CI 1.17–10.12, p = 0.03), elevated high-sensitivity C-reactive protein (hs-CRP) (OR 1.05, 95% CI 1.01–1.09, p = 0.03) were identified as risk factors for transition from subclinical to clinical PsA. Stratified and logistic regression analyses suggest a significant interaction between age and fatty liver. For patients aged less than 45 years old, the association between fatty liver and clinical PsA was statistically significant.ConclusionsOlder age, alcohol drinking, elevated hs-CRP, and the presence of fatty liver at less than 45 years old appear to increase the risk of transition from subclinical to clinical PsA. These findings call for a need to manage these risk factors.

Elevated high-sensitivity C-reactive protein levels predict poor outcomes among patients with acute cardioembolic stroke.

High-sensitivity C-reactive protein (hs-CRP) as a prognostic factor of stroke has been proposed and studied. However, the relationship between hs-CRP levels and outcomes among patients with cardioembolic stroke (CES) remains unclear. This study aimed to evaluate the association between hs-CRP levels in the acute phase of CES and poor patient outcomes. We recruited 478 patients with first-onset CES. Hs-CRP and other biochemical markers were measured within 24 h after admission. Hs-CRP levels were grouped into quartiles (<2.31, 2.31 to <6.09, 6.09 to <22.30, and ≥22.30 mg/L). Stroke severity was assessed using the modified Rankin scale (mRS), with mRS scores of 0 to 2 classified as a good outcome, and scores of 3 to 6 as a poor outcome. Composite endpoints included poor outcomes, vascular death, myocardial infarction (MI), and recurrent stroke (ischemic or hemorrhagic). At 3-month and 1-year follow-ups, we used multivariate logistic regression analysis to assess the relationship between baseline hs-CRP levels, mRS scores, and composite endpoints. Among 478 patients with CES, the median hs-CRP level was 6.09 mg/L. Regarding the primary outcome, we found that hs-CRP levels ≥22.30 mg/L were positively correlated with poor outcomes at the 3-month and 1-year follow-ups [odds ratio (OR): 3.862, 95% confidence interval (CI): (1.675-8.904), P=0.002; and OR: 5.479, 95% CI: (1.692-17.744), P=0.005, respectively]. The secondary outcomes paralleled the results of the primary outcomes at the 3-month and 1-year follow-ups [OR: 3.381, 95% CI: (1.620-7.058), P=0.001; and OR: 3.181, 95% CI: (1.475-6.860), P=0.003, respectively]. Elevated hs-CRP in patients with CES is an independent predictor of poor outcomes; however, this association is particularly evident when hs-CRP ≥22.30 mg/L.

High-sensitivity C-reactive protein in HIV care: Tuberculosis diagnosis and short-term mortality in a cohort of Kenyan HIV patients in the DREAM programme

ObjectiveTuberculosis (TB) is the leading cause of death in HIV-positive people. In Kenya, 140 000 new TB cases occurred in 2019, and 13 000 HIV-positive patients died due to TB. The objective of this study was to investigate the role of high-sensitivity C-reactive protein (HS-CRP) in TB diagnosis and the prediction of mortality in HIV-positive patients. MethodsThe IDEA-TB Study enrolled HIV-positive adult patients attending three DREAM centres in Kenya who were suspected of having TB. A lateral flow urine lipoarabinomannan assay (LF-LAM), serum HS-CRP, and GeneXpert MTB/RIF assay (Xpert MTB/RIF) were performed. Six-month survival was evaluated. ResultsA total of 574 patients were enrolled. The median (interquartile range) age, body mass index, and CD4 count were 45 years (37–54 years), 20.5 kg/m2 (18.5–23.69 kg/m2), and 477 cells/mL (290–700 cells/mL), respectively. TB was confirmed in 87 (15.2%) patients. Concordance between the Xpert MTB/RIF and LF-LAM tests was 87.1%. HS-CRP was higher in TB patients (35.39 mg/l vs 9.21 mg/l). Malnutrition and elevated HS-CRP were associated with TB: odds ratio (OR) 2.5 (95% confidence interval (CI) 1.14–5.72) and OR 6.6 (95% CI 3.87–11.52), respectively. Nine (1.6%) patients died during follow-up. No single factor was associated with mortality. Only the combination of malnutrition and elevated HS-CRP was highly predictive of death (odds ratio (OR) 9.8, 95% CI 1.88–50.95); the association was stronger in TB patients (33.3% vs 1.0%; OR 47.6, 95% CI 7.03–322.23). ConclusionTB diagnosis in HIV-positive patients remains challenging. HS-CRP could play a role in predicting early mortality in symptomatic patients.

Elevated high-sensitivity C-reactive protein concentrations may be associated with increased postdischarge mortality in patients with myocardial injury after noncardiac surgery: A retrospective observational study.

Myocardial injury after noncardiac surgery (MINS) is one of the most common cardiovascular complications associated with mortality and morbidity during the first 2 years after surgery. However, the relevant variables associated with mortality after discharge in patients with MINS have not been fully investigated. This study aimed to evaluate the association between persistent inflammation detected by high-sensitivity C-reactive protein (hsCRP) at discharge and postdischarge mortality after MINS. Retrospective observational analysis of acquired data from Samsung Medical Center Troponin in Noncardiac Operation (SMC-TINCO) registry. A tertiary hospital from January 2010 to June 2019. Patients who were discharged alive after a diagnosis of MINS. The primary endpoint was postdischarge 1-year mortality, and 30-day mortality and the mortality from 30 days to 1 year was also compared. Data from a total of 4545 adult patients were divided into two groups according to hsCRP concentration at discharge. There were 757 (16.7%) patients in the normal hsCRP group and 3788 (83.3%) patients in the elevated hsCRP group. After inverse probability weighting, 1-year mortality was significantly higher in the elevated group than the normal group (hazard ratio 1.93, 95% CI 1.45 to 2.57, P < 0.001). Thirty-day mortality and the mortality from 30 days to 1 year were also increased in the elevated group. In patients with MINS, an elevated hsCRP concentration at discharge appeared to be associated with increased mortality. Further research is needed to determine whether controlling inflammation can be helpful in reducing mortality.

Severity of COVID-19 in Cancer patients versus patients without Cancer: A Propensity Score Matching Analysis.

Purpose: Data are extremely limited with regards to the impact of COVID-19 on cancer patients. Our study explored the distinct clinical features of COVID-19 patients with cancer.Experimental Design: 189 COVID-19 patients, including 16 cancer patients and 173 patients without cancer, were recruited. Propensity score 1:4 matching (PSM) was performed between cancer patients and patients without cancer based on age, gender and comorbidities. Survival was calculated by the Kaplan-Meier method and the difference was compared by the log-rank test.Results: PSM analysis yielded 16 cancer patients and 64 propensity score-matched patients without cancer. Compared to patients without cancer, cancer patients tended to have leukopenia and elevated high-sensitivity C-reactive protein (hs-CRP) and procalcitonin. For those with critical COVID-19, cancer patients had an inferior survival than those without cancer. Also, cancer patients with severe/critical COVID-19 tended to be male and present with low SPO2 and albumin, and high hs-CRP, lactate dehydrogenase and blood urea nitrogen on admission compared to those with mild COVID-19. In terms of risk factors, recent cancer diagnosis (within 1 year of onset of COVID-19) and anti-tumor treatment within 3 months of COVID-19 diagnosis were associated with inferior survival.Conclusions: We found COVID-19 patients with cancer have distinct clinical features as compared to patients without cancer. Importantly, cancer patients with critical COVID-19 were found to have poorer outcomes compared to those without cancer. In the cancer cohort, patients with severe/critical COVID-19 presented with a distinct clinical profile from those with mild COVID-19; short cancer history and recent anti-cancer treatment were associated with inferior survival.

Association of High Levels of High-Sensitive C-Reactive Protein with Metabolic Syndrome- A Cross-sectional Study

Introduction: Elevated high-sensitivity C-Reactive Protein (hsCRP) might be associated with prolonged low inflammation stage like Metabolic Syndrome (MetS) and also predicts onset of Cardiovascular Disease (CVD) and Diabetes Mellitus (DM). Precise association of hsCRP with occurrence of MetS among Western part of India is less clear. Aim: To evaluate serum hsCRP level in MetS patients and its association with occurrence of MetS, components of MetS and demographic variables. Materials and Methods: This was a hospital based cross- sectional study, carried out on 86 cases of MetS and 86 age and sex matched apparently healthy controls for a duration of 20 months in Grant Government Medical College and Associated Hospital, Mumbai. The detailed history including alcohol consumption and smoking, Waist Circumference (WC), Systolic and Diastolic Blood Pressures (SBP, DBP) were taken from all the study participants. Diagnosis of MetS was done according to revised National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. About 5 mL venous blood was collected by venepuncture for measurement of hsCRP, Fasting Blood Glucose (FBG), Triglyceride (TAG) and HDL-C. Chi-square test, unpaired t-test, one-way ANOVA and multivariate linear regression model were used for statistical analysis by using SPSS 16.0 software. The p-value of &lt;0.05 was taken as statistically significant. Results: Mean value of hsCRP was 4.97±1.48 mg/L and 2.99±1.20 mg/L in MetS cases and controls, respectively. The mean difference of hsCRP was statistically highly significant (p&lt;0.001). The hsCRP level of &gt;3.0 mg/L (OR= 5.8, CI=2.68- 13.5, p&lt;0.001) and 1-3 mg/L (OR= 2.6, CI=1.24-6.19, p&lt;0.01) were significantly associated with MetS. The hsCRP was significantly higher in older age groups (p&lt;0.001), heavy alcohol use (p&lt;0.01), WC (p&lt;0.003) and FBG (p&lt;0.03) in MetS cases. Serum hsCRP level was independently positively associated with age (β=0.26, p=0.01), WC (β=0.33, p=0.001) and FBG (β=0.25, p=0.02) in MetS cases. Conclusion: The hsCRP was significantly associated with MetS syndrome particularly in cases with high WC and fasting blood sugar.

Risk factors for mortality in patients undergoing peritoneal dialysis: a systematic review and meta-analysis

Aim Inconsistent investigations of the risk factors for all-cause mortality in patients undergoing peritoneal dialysis (PD) were reported. The present meta-analysis aimed to assess the impact of some clinical characteristics on the risk of mortality in PD patients. Methods PubMed and Embase were systematically searched for studies evaluating the risk factors for all-cause mortality in PD patients. Hazard ratio (HR) and 95% confidence interval (CI) were derived using a random-effect or fixed-effect model considering the heterogeneity across studies. Result A total of 26 studies were included in this meta-analysis in accordance with the inclusion and exclusion criteria. Age, primary cardiovascular diseases, diabetes mellitus, and high level of alkaline phosphatase showed significant positive associations with elevated risk of all-cause and cardiovascular mortality in PD patients, while hemoglobin acted as a benefit factor. Furthermore, early onset of peritonitis, high peritoneal transport status, elevated body mass index and high-sensitivity C-reactive protein could also considerably increase the risk of all-cause mortality. The absolute serum level of magnesium, potassium, and uric acid required to improve survival in PD patients should be verified further. Conclusions Multiple factors could affect the risk of mortality in PD patients.

The Relationship between Serum Leukotriene B4 and High-Sensitivity C-Reactive Protein Expression Levels and Adverse Reactions in Patients with Colon Cancer During Perioperative Blood Transfusion

To explore the predictive value of serum high-sensitivity C-reactive protein and leukotriene B4 in perioperative blood transfusion patients with colon cancer in patients with adverse blood transfusion reactions. 168 patients undergoing colon cancer surgery in a hospital from March 2018 to March 2020 were selected as the research objects and checked the levels of high-sensitivity C-reactive protein and leukotriene B4 in the venous blood of all patients. There were 73 cases in the adverse blood transfusion group (experimental group) and 95 cases in the non-transfusion reaction group (control group). The serum levels of high-sensitivity C-reactive protein and leukotriene B4 in the two groups were compared. Based on the analysis of the basic data of the two groups of patients, serum high-sensitivity C-reactive protein and leukotriene B4 are independent risk factors for perioperative adverse reactions in colon cancer patients. The levels of serum high-sensitivity C-reactive protein and leukotriene B4 in the experimental group are higher than those in the normal group and there are differences, both were statistically significant (p<0.05); receiver operating characteristic curve results showed that the area under the curve of high-sensitivity C-reactive protein and leukotriene B4 alone and in combination to predict adverse transfusion reactions were 0.733, 0.819 and 0.877, respectively. The area under the curve of combined factor diagnosis was greater than single diagnosis; serum high-sensitivity C-reactive protein≥14.64 mg/l and leukotriene B4≥18.86 pg/l are risk factors for adverse reactions in patients with colon cancer perioperative blood transfusion. Elevated serum high-sensitivity C-reactive protein and leukotriene B4 in patients with colon cancer during perioperative blood transfusion are risk factors for adverse blood transfusion reactions. High-sensitivity C-reactive protein≥14.64 mg/l and leukotriene B4≥18.86 pg/l suggest that adverse blood transfusion reactions may occur. The combination of the two can increase the incidence of adverse blood transfusion reactions.

Association Between Peripheral Blood Cell Count Abnormalities and Health-Related Quality of Life in the General Population

Complete blood cell counts, including differentials, are widely available and change on aging. Peripheral blood cell counts outside the normal range have previously been associated with increased mortality rates and a number of comorbid conditions. However, data about the association between blood cell count abnormalities, other than anemia, and health-related quality of life (HRQoL) are scarce. We investigated the association between abnormalities in (differential) blood cell counts and HRQoL in 143 191 community-dwelling individuals from the prospective population-based Lifelines cohort. HRQoL was measured using the RAND 36-Item Health Survey. Logistic regression analyses were used to determine the effect of blood cell count abnormalities on the odds of having a lower score than an age- and sex-specific reference value for each domain. Leukocytosis, neutrophilia, and a high neutrophil to lymphocyte ratio were associated with impaired HRQoL across multiple domains, both for younger and older (≥60 years) individuals. Using multivariable models, we confirmed that these associations were independent of the potential confounding factors obesity, smoking, alcohol use, number of medications (as a measure of comorbidity), anemia, and mean corpuscular volume. The impact on HRQoL was most pronounced for high neutrophil levels. Further, high white blood cell counts proved to be a better marker for inferior HRQoL as compared to elevated high-sensitivity C-reactive protein levels. Decreased HRQoL in several domains was also observed for individuals with monocytosis, lymphocytosis, and thrombocytosis. Taken together, the present study demonstrates an association between inflammatory and myeloid-skewed blood cell counts and inferior HRQoL in community-dwelling individuals.

Observational Cross-Sectional Study of Inflammatory Markers After Transient Ischemic Attacks, Acute Coronary Syndromes, and Vascular Stroke Events

We identified the prevalence of elevated high-sensitivity C-reactive protein and interleukin-6 in patients with recent cardiovascular (CV) events with or without prediabetes/diabetes, and in a control group of patients with remote CV events. Interleukin-6 was elevated in patients with prediabetes/diabetes and recent CV events (median, 4.84 pg/mL; interquartile range, 3.27-7.45) compared with patients with remote events (2.36 pg/mL; interquartile range, 1.09-4.00). There was a trend for elevated high-sensitivity C-reactive protein in patients with acute events and prediabetes/diabetes (P = 0.147). This supports the notion that patients with prediabetes/diabetes and recent CV events have higher inflammatory burdens than patients without recent CV events or dysglycemia.

Parents' use of extreme physical violence is associated with elevated high-sensitivity C-reactive protein in children

BackgroundChildren who grow in settings where parenting is harsh tend to develop a response tendency that may give rise to a chronic pro-inflammatory state. Thus, we aimed to identify if experiencing abuse triggers an increase in the child high sensitivity C-reactive protein (hs-CRP) in a population birth cohort, Generation XXI. MethodsAt cohort participants age of 7 years, information on parents’ disciplinary practices was collected by trained interviewers using the Conflict Tactics Scale Parent-Child version. Venous blood samples were obtained after overnight fast and hs-CRP was quantified. ResultsOf 4175 participants, 44.0% of children reported low frequency of physical violence, 50.1% reported frequent but not severe physical violence, 5.3% reported frequent and severe physical violence, and 0.6% children reported parental extreme physical violence. Higher levels of hs-CRP were observed among children who reported the highest grade of violence severity (58.3%). After adjustment for child's sex, age and parental education, the increasing grade of violence severity increased the odds of higher hs-CRP levels. LimitationsNo significant increase in the levels of hs-CRP was found in children exposed to less severe violence. However that does not mean that those forms of violence have no impact on health in the long-term period. Also, the cross-sectional nature of the study prevents us from concluding the directionality of the effects, although we provided theoretical arguments for the proposed pathway. ConclusionsChildren physically abused by their parent(s) present heightened inflammation levels. Thus, our results show that stressful events may impact inflammatory processes even at very early ages.

Association of neutrophil-to-lymphocyte ratio with non-calcified coronary artery burden in psoriasis: Findings from an observational cohort study

BackgroundInflammation in the form of elevated high-sensitivity c-reactive protein (hs-CRP) has been shown to be critical in the development of atherothrombosis. Psoriasis, a chronic inflammatory skin disease, is associated with high systemic-inflammation, elevated neutrophil-to-lymphocyte ratio (NLR) and accelerated non-calcified coronary artery burden (NCB) by coronary computed tomography angiography (CCTA). We hypothesized that NLR would associate with early, rupture-prone atherosclerosis assessed as NCB independent of hs-CRP. Methods316 consecutive psoriasis participants were recruited with 233 having one-year follow-up as part of a prospective, observational cohort study design. CCTA scans were performed to assess NCB in all three major epicardial coronary arteries. ResultsPatients with above average NLR (>mean: 2.29 ​± ​1.21) were older (mean ​± ​SD; 52.0 ​± ​12.8 vs. 47.9 ​± ​12.6, p ​= ​0.002), had higher hs-CRP (med. IQR: 2.3 (0.9–7.3) vs. 1.4 (0.7–3.2), p ​= ​0.001) and had higher NCB (mean ​± ​SD; 1.21 ​± ​0.58 vs. 1.13 ​± ​0.49, p ​= ​0.018) when compared to patients with below average NLR. NLR associated with psoriasis area severity index score (β ​= ​0.14, p ​= ​0.017), hs-CRP (β ​= ​0.16, p ​= ​0.005), as well as NCB independent of traditional risk factors, body mass index, statin use and hs-CRP (β ​= ​0.08, p ​= ​0.009). One year of biologic therapy for psoriasis was associated with a reduction in NLR (−14.5%, p ​< ​0.001), and this change in NLR associated with change in NCB in fully adjusted models and beyond hs-CRP (β ​= ​0.17, p ​= ​0.002). ConclusionNLR associated with psoriasis severity, hs-CRP and NCB at baseline. Biologic therapy reduced NLR over time and this change in NLR associated with the change in NCB at one-year. Taken together, these findings suggest that NLR may capture psoriasis patients at higher risk of NCB due to residual inflammation not fully captured by hs-CRP.

Association between Dietary Macronutrient Intake and High-Sensitivity C-Reactive Protein Levels among Obese Women in Kuantan, Malaysia

Elevated high-sensitivity C-reactive protein (hs-CRP) levels may be associated with an increased risk of cardiovascular disease (CVD). In general, an individual’s dietary intake may influence the hs-CRP level. However, evidence on the influence of dietary macronutrient intake on hs-CRP levels among obese Malaysian women remains fragmented. Therefore, this study aims to investigate the association between the hs-CRP level and dietary macronutrient intake of obese adults living in Kuantan. The assessment of 24-hour dietary recall and venous hs-CRP levels were investigated in 67 women with a body mass index of 27.5 to 39.9 kg/m². The findings revealed that obese women living in Kuantan had elevated hs-CRP levels (median = 7.95 mg/L, IQR = 7.90) and a significant negative correlation between the hs-CRP level and total dietary fiber intake (r = 0.205, p =.014). In conclusion, this study suggests that certain macronutrients, particularly dietary fiber, seem to be associated with elevated hs-CRP in obese women. Hence, this information could help assess and manage low-grade chronic inflammation and underlying obesity-related conditions.

Study of high-sensitivity C-Reactive protein levels in subjects with type 2 diabetes mellitus

Introduction: The Diabetes mellitus was characterized by chronic hyperglycemia with disturbances of carbohydrate, fat, and protein metabolism resulting from defects in insulin secretion, insulin action, or both. The two broad categories of diabetes are type 1 and type 2. Type 2 Diabetes Mellitus (T2DM) is the most common form of diabetes. The role of elevated high sensitivity C-reactive protein (hs-CRP) as a risk marker for cardiovascular diseases, including coronary heart disease, stroke and peripheral arterial disease is well established through consistent results from a number of prospective studies. More recent data suggest that hs-CRP is superior to other markers of inflammation for risk evaluation. Materials and Methods: The present study was conducted over a period of one year on outpatients attending the General Medicine Department at Narayana General Hospital, Nellore. The study was undertaken on 50 type 2 Diabetes mellitus and 50 normal healthy controls. Both male and females in the age group of 35 – 70 years were included. Results: Fasting blood glucose, post prandial blood glucose, and hs-CRP levels was measured in 50 T2DM cases and 50 age matched healthy controls. The mean and standard deviation were calculated for all the Biochemical parameters. The significance between the groups were determined using Student t- test for Equality of means. The p-value of < 0.05 was considered significant. Conclusion: This study concludes that there is increase in hs-CRP levels in T2DM cases compared with controls. hs-CRP is an inflammatory marker and has role in atherosclerosis. From this study it is observed that there is moderate correlation between hs-CRP levels and it increases the risk of atherosclerosis. Keywords: Diabetes Mellitus, hs-CRP, Hyperglycemia, Inflammation.

Prognostic Impact of High-Sensitivity C-Reactive Protein in Patients Undergoing Percutaneous Coronary Intervention According to BMI.

The aim of this study was to determine the prevalence and prognostic implications of elevated high-sensitivity C-reactive protein (hsCRP) in patients undergoing percutaneous coronary intervention (PCI) according to body mass index (BMI). Whereas elevated hsCRP predicts adverse clinical outcome after PCI in the general population, the impact of BMI on its prognostic utility remains unclear. Data from 14,140 patients who underwent PCI between January 2009 and June 2017 at a large tertiary care center were analyzed. Patients were divided into 4 BMI categories: normal (BMI 18.5 to<25kg/m2, n=2,808), overweight (BMI 25 to<30kg/m2, n=6,015), obese (BMI 30 to<35kg/m2, n=3,490), and severely obese (BMI≥35kg/m2, n=1,827). Elevated hsCRP was defined as >3mg/l. The primary endpoint of interest was the occurrence of major adverse cardiac events (MACE; defined as death, myocardial infarction, or target vessel revascularization) within 1 year after PCI. Elevated hsCRP was present in 18.9%, 23.6%, 33.3%, and 47.7% of the normal, overweight, obese, and severely obese groups, respectively. MACE rates were consistently higher in patients with elevated hsCRP across all BMI categories (normal, 13.4% vs. 8.3%; overweight, 11.2% vs. 7.2%; obese, 10.6% vs. 7.5%; severely obese, 11.9% vs. 6.5%; p<0.01 for all). After multivariate adjustment, hsCRP elevation remained significantly associated with MACE independent of BMI (hazard ratios: normal, 1.43 [95% confidence interval: 1.04 to 1.95]; overweight, 1.56 [95% confidence interval: 1.21 to 1.88]; obese, 1.40 [95% confidence interval: 1.06 to 1.84]; severely obese, 1.92 [95% confidence interval: 1.35 to 2.75]; p<0.05 for all). Among patients undergoing PCI, the prevalence of hsCRP elevation progressively increased with higher BMI. Measurement of hsCRP facilitates prognostic risk assessment for adverse outcome after PCI across a broad range of BMI.

The Finnish Diabetes Risk Score (FINDRISC), incident diabetes and low-grade inflammation

AimsThe FINDRISC was created to predict the development of type 2 diabetes mellitus (T2DM). Since T2DM associates with inflammation we evaluated if the FINDRISC could predict either current or incident T2DM, and elevated high sensitivity C-reactive protein (hs-CRP). Methods41,880 people (age 41.9 ± 9.7 years; 31% female) evaluated between 2008 and 2016 were included. First, the cross-sectional association between the FINDRISC with presence of either T2DM or hs-CRP ≥ 2.0 mg/L was tested. After a 5 ± 3 years follow-up we tested the score predictive value for incident T2DM and inflammation in respectively 10,559 individuals without diabetes and in a subset of 2,816 individuals having no elevated hs-CRP at baseline. ResultsIn the cross sectional analysis the FINDRISC was associated with both T2DM (OR 1.24, 95% CI: 1.23–1.26, P < 0.001) and inflammation (OR 1.10, 95% CI: 1.09–1.11, P < 0.001) per FINDRISC unit, as well as in longitudinal analyses (OR 1.17, 95% CI: 1.14–1.20, P < 0.001; and OR 1.04, 95% CI: 1.02–1.07, P < 0.001; respectively, per FINDRISC unit). The C-statistic for incident T2DM and inflammation was 0.79 (95% CI 0.77–0.82) and 0.55 (95% CI 0.53–0.58), respectively. ConclusionThe FINDRISC shows good discrimination for incident T2DM but less for inflammation.

Abstract 14093: High-Sensitivity C-reactive Protein Modifies the Effect of Lipoprotein (a) on Cardiovascular Risk: The Multi-Ethnic Study of Atherosclerosis (MESA)

Introduction: Lipoprotein (a) (Lp(a)) and inflammation, as represented by elevated high-sensitivity C-reactive protein (hsCRP) concentration, are both considered as risk-enhancers in the 2018 AHA/ACC Cholesterol guidelines. However, little is known as to whether the association of Lp(a) with atherosclerotic cardiovascular disease (ASCVD) risk is modified by inflammation. Objective: We assessed whether hsCRP modifies the association of Lp(a) with ASCVD risk. Methods: MESA participants with baseline hsCRP and Lp(a) levels were included. Incident ASCVD events were ascertained from baseline through 2017. Time to incident ASCVD was analyzed using Kaplan Meir curves. Cox proportional hazards models were used to assess the association between Lp(a), hsCRP, and time to ASCVD events adjusting for covariates. Results: The study included 4,654 participants with mean age of 62 and 52.5% females (1,702 Caucasians, 557 Chinese Americans, 1,336 African Americans and 1,059 Hispanics). With a mean 13.6-year follow-up, 676 ASCVD events occurred among 4,609 participants (Figure 1). In participants with hsCRP &lt;2mg/L, the association of Lp(a) (per 1 Log unit increase) and risk for ASCVD as represented by hazard ratio (HR) and 95%CI was 1.01 (0.79, 1.28). In subjects with hsCRP ≥2mg/L, the risk increased to 1.26 (1.01, 1.58). When compared to the reference group with Lp(a) &lt;50mg/dL and hsCRP &lt;2mg/L, the risk for ASCVD in participants with Lp(a) ≥50mg/dL and hsCRP &lt;2mg/L was 1.13 (0.85, 1.50) and in those with Lp(a) &lt;50mg/dL and hsCRP ≥2mg/L was 1.09 (0.92, 1.31). The risk increased significantly to 1.62 (1.26, 2.07) in participants with Lp(a) ≥50mg/dL and hsCRP ≥2mg/L. Conclusions: Lp(a)-related ASCVD risk is modified by hsCRP levels. The findings of this analysis suggest that Lp(a) may serve as a risk enhancing factor in individuals with hsCRP level ≥2mg/L. Future studies are needed to determine whether Lp(a) is associated with risk of ASCVD in the absence of subclinical inflammation.