Blood Fibrinogen Levels Research Articles

Characterization of Flowing Blood Optical Property Under Various Fibrinogen Levels Using Optical Coherence Tomography

The feasibility of characterization of human blood fibrinogen levels using optical coherence tomography (OCT) was investigated. Three groups of blood samples were reconstituted of red blood cells: 1) phosphate-buffered saline; 2) plasma with its intrinsic fibrinogen removed and commercial fibrinogen added; and 3) native plasma with various fibrinogen levels (0-12 g/L). OCT signal slope (OCTSS) of blood was extracted from OCT depth-reflectivity profiles. Effects of hematocrit (HCT) and blood flow on OCTSS of the blood under various fibrinogen concentrations were also studied. The results of blood flowing at 5 mm/s showed that OCTSS of all the three groups at HCT of 40% decreases with the increasing fibrinogen concentration up to a certain level, i. e., >8, 6, and 4 g/L for groups 1, 2, and 3, respectively. The blood of group 2 at HCTs of 30%, 40%, and 50% had a rapid decrease in OCTSS in the range of fibrinogen concentration of 0-2, 0-6, and 0-10 g/L, respectively. OCTSS value of blood flowing at 2.5 mm/s was lower than that at 5 mm/s at each fibrinogen concentration. In conclusion, OCTSS has a strong correlation with plasma fibrinogen concentration, and has the potential to identify the abnormal level of human blood fibrinogen.

Preliminary evidence for obesity-associated insulin resistance in adolescents without elevations of inflammatory cytokines

BackgroundTo ascertain whether the associations between obesity, inflammation, and insulin resistance established in human adult studies are found among adolescents.MethodsWe contrasted 36 obese and 24 lean youth on fasting glucose, insulin levels, lipid profile, hemoglobin A1C, markers of hepatic function, white blood cell count, C-reactive protein (CRP) and fibrinogen levels. The cytokines IL-6, TNF-α, IFN-γ, IL-10 and IL-4 and the adipokines leptin, resistin, and adiponectin were also compared between the two groups. The fasting glucose and insulin values were used to estimate the degree of insulin resistance with the homeostatic model assessment of insulin resistance (HOMA-IR). T-tests and correlations were run to examine group differences and associations between groups. In addition, regression analyses were used to ascertain whether the markers of inflammation were predictive of the degree of insulin resistance.ResultsAlthough obese adolescents had clear evidence of insulin resistance, only CRP, fibrinogen and leptin were elevated; there were no group differences in pro- or anti-inflammatory cytokines nor adiponectin and resistin. Anthropometric measures of obesity and level of insulin resistance were highly correlated to the acute phase reactants CRP and fibrinogen; however, the degree of insulin resistance was not predicted by the pro- or anti-inflammatory cytokine markers. Obese adolescents had higher white blood cell counts. In addition they had higher circulating alanine aminotransferase concentrations and lower circulating albumin and total protein than lean adolescents, possibly as a result of hepatocyte damage from fatty liver.ConclusionUnlike rodent or adult studies, we found that wide-spread systemic inflammation is not necessarily associated with insulin resistance among adolescents. This finding does not support the current paradigm that the associations between obesity and insulin resistance are, to a significant degree, mediated by low grade systemic inflammation. These data support the need for further adolescent studies to explore these associations.

Abstract 346: Change in Alcohol Consumption Status Associated with Changes in Fibrinogen Levels over 13 Years of Follow-up: The Coronary Artery Risk Development in Young Adults Study

Introduction: Moderate alcohol consumption is inversely related to coronary/cardiovascular disease (CVD) risk and mortality. Conversely, fibrinogen has been positively associated with atherosclerosis and thrombosis. No studies to date have examined longitudinal associations between alcohol consumption and blood fibrinogen levels. Methods: We included 2548 CARDIA participants (55% women, 43% black) with fibrinogen and alcohol use data at year 7 (1992-93; ages 25-37) and year 20 examinations (2005-06). Fibrinogen was measured using automated nephelometry. Alcohol use was self-reported and categorized as current, former or never drinkers at each exam. ANCOVA models were used to relate changes in alcohol use to changes in mean fibrinogen levels stratified by sex and race, after controlling for year 7 fibrinogen. Subsequent models also adjusted for conventional cardiovascular risk factors (Figure). Results: Over 13 years, mean fibrinogen increased by 71mg/dL vs. 70mg/dL (p-difference=NS) in black men (BM) vs. white men (WM), and 78mg/dL vs. 68mg/dL (p-difference<0.05) in black women (BW) vs. white women (WW), respectively. The Pearson’s correlation coefficients between years 7 and 20 fibrinogen were 0.60 (BM), 0.47 (WM), 0.54 (BW) and 0.53 (WW) (each p<0.001). Compared with never-drinkers, becoming or staying a drinker was associated with a smaller longitudinal increase in fibrinogen for BM, BW and WW after multivariable adjustment (Figure). Conversely, WM who stayed drinkers had a larger increase in fibrinogen (p<0.01). Relative to never-drinkers, fibrinogen increased more among BM (p<0.05), WM (p<0.001) and WW (p=NS) who were no longer alcohol users by year 20. Conclusions: In this young cohort, we observed an inverse longitudinal relationship between alcohol consumption and fibrinogen in BM, BW and WW. These results provide a novel insight into the mechanism for established protective effect of moderate alcohol intake on CVD outcomes.

Relationship of blood glucose, blood lipids, blood uric acid and fibrinogen level, and prognosis of acute lacunar cerebral infarction patients

Objective To investigate the relationship of blood glucose,blood lipids,serum uric acid,fibrinogen level and prognosis of patients with acute lacunar cerebral infarction.Methods Clirical data of 127 cases with acute lacunar cerebral infarction were retrospectively analyed.Patients with normal blood glucose,blood lipid,uric acid and fibrinogen level were enrolled into A group of 64 cases,63 cases with abnormal levels were selected as group B,an average of 2 years of follow-up,observing the two groups of neurologic,re-infarction incidence and prevalence of vascular dementia were obsenved in two groups.Results After 4 weeks of treatment,A group of neural function defect score(9.6 ±7.3) was significantly lower than group B( 14.3 ±7.4) (t =3.8696,P ＜0.05) ;95.4％ total effective rate in A group was significantly higher than B group of 82.0％ ( x2 =5.8623,P ＜ 0.05 ).After an average follow-up of 2 years,A group of recurrent cerebral infarction rate( 18.8％ ),vascular dementia rates(7.8％ ),were significantly lower than group B(28.6％),17.5％(11/63)(x2 =6.5421,5.9623,P＜0.05).Conclusion A number of abnormal serum biochemical indexes had a significant impact on short and long-term prognosis of acute lacunar cerebral infarction. Key words: Cerebral infarction; Apolipoproteins; Blood glucose; Uric acid; Fibrinogen

The effect of compulsory schooling on health—evidence from biomarkers

Using data from the Health Survey for England and the English Longitudinal Study on Ageing, we estimate causal effects of schooling on health. Our study complements earlier studies exploiting two nationwide increases in British compulsory school leaving age in 1947 and 1973, respectively, by using biological stress markers as measures of health outcomes in addition to self-reported measures. We find a strong positive correlation between education and health, both self-rated and measured by blood fibrinogen and C-reactive protein levels. However, causal effects estimates based on compulsory schooling changes are ambiguous and remain statistically insignificant.

Síndrome metabólica em adolescentes do sexo feminino com sobrepeso e obesidade

OBJETIVO: Avaliar parâmetros bioquímicos e fisiológicos em adolescentes do sexo feminino com sobrepeso/obesidade ou com peso corporal normal e avaliar se fatores de risco cardiovascular, postulados como componentes da síndrome metabólica, já estão presentes nessa faixa etária. MÉTODOS: Estudo transversal, tendo-se comparado a totalidade de meninas com idades entre 12 e 18 anos de um colégio de Ribeirão Preto, divididas em dois grupos: sobrepeso/obesidade (n=30) e controle (n=39). De cada menina, foram avaliados parâmetros antropométricos (peso, estatura, dobras cutâneas, circunferências do abdome e do quadril) e bioquímicos (glicose, insulina, lipidograma, ureia, creatinina, fibrinogênio, PAI-1, ferritina, sódio e microalbuminúria). RESULTADOS: As adolescentes com sobrepeso/obesidade apresentaram níveis maiores de pressão arterial, glicose, triglicérides, ácido úrico, PAI-1, fibrinogênio e insulina e níveis menores de colesterol-HDL em relação ao grupo controle. A análise de alterações e formação de clusters de fatores de risco demonstrou que 76,7% das adolescentes do grupo sobrepeso apresentaram dois ou mais fatores de risco relacionados à síndrome metabólica, enquanto 79,5% das adolescentes do grupo controle apresentaram nenhuma ou apenas uma alteração. Os parâmetros microalbuminúria e ferritina sérica não apresentaram alterações e diferenças entre os grupos. CONCLUSÕES: Adolescentes do sexo feminino com sobrepeso/obesidade já apresentam hipertensão, dislipidemias, disfibrinólise, hiperinsulinemia e clusters de fatores de risco cardiovascular.

The value of serum fibrinogen level in the diagnosis of acute appendicitis

The aim of this study was to investigate the importance of serum fibrinogen level in the diagnosis of acute appendicitis. This study was performed on 201 patients who admitted to our clinic. Symptoms, signs, duration of symptoms, and laboratory indicators of appendicitis were recorded, in keeping with the Alvarado score for acute appendicitis. The ultimate diagnosis was based on histopathological results. Serum fibrinogen levels were detected before surgery. The sensitivity, specificity, and predictive values of single test and test combinations were calculated at different cut-off levels. During the study period, 201 patients underwent surgery for suspected acute appendicitis. Appendicitis was confirmed in 179 (89%) patients. The mean age was 24.8±7.7 (range, 20-57) years, and 154 (76.6%) patients were male and 47 (23.4%) female. The best diagnostic cut-off point for fibrinogen was found at 245.5 mg/dl, for white blood cells (WBC) at 11,900x109/L and for Alvarado score at 7. The use of fibrinogen blood level may be a new diagnostic acute-phase reactant in the diagnosis of acute appendicitis. The formulation of a triple test is recommended as criteria in deciding emergency surgery or observation.

Elevated circulating levels of the serum acute-phase protein YKL-40 (chitinase 3-like protein 1) are a marker of obesity and insulin resistance in prepubertal children

YKL-40 (chitinase 3-like protein 1) is a newly recognized protein that is secreted by activated macrophages and neutrophils and expressed in a broad spectrum of inflammatory conditions and cancers. It has also been associated with endothelial dysfunction and diabetes in adults. Its role in childhood obesity has not been evaluated yet. Our aim was to evaluate the associations of serum YKL-40 levels with markers of obesity, inflammation, and insulin resistance in children. Forty-one obese prepubertal children and 41 age- and sex-matched lean controls were included, and serum YKL-40 levels were determined. Body mass index (BMI), blood pressure (BP), body fat percentage, fasting glucose, insulin, homeostasis model assessment for insulin resistance (HOMA-IR) index, whole-body insulin sensitivity index, lipids, white blood cell (WBC) count, C-reactive protein, and fibrinogen levels were also assessed. Obese children had higher YKL-40 levels compared with controls (P = .003). Insulin-resistant individuals showed higher YKL-40 compared with non–insulin-resistant individuals after adjusting for age and BMI (adjusted P = .039). Serum YKL-40 levels were positively correlated with age, BMI, body fat percentage, fasting glucose and insulin, HOMA-IR index, whole-body insulin sensitivity index, systolic BP, mean BP, and WBC count (P < .05). After adjustment for age, sex, BMI, WBC count, and systolic BP, HOMA-IR index remained significantly associated with YKL-40 levels (P < .001). The study suggests that YKL-40 levels are elevated in obese youth and represent a marker of insulin resistance even in childhood. Prospective studies are needed to determine whether children with elevated YKL-40 levels are at higher risk for future cardiovascular disease.

Acute hyperhomocysteinemia alters the coagulation system and oxidative status in the blood of rats

In the present study, we investigated the effect of the acute administration of homocysteine (Hcy) on parameters of the coagulation system, as well as fibrinogen and nitrite levels in the blood of rats. In addition, we evaluated the effect of acute hyperhomocysteinemia on thiobarbituric acid-reactive substances in plasma and on antioxidant enzymes activities (superoxide dismutase, catalase, and gluthatione peroxidase) in the erythrocytes of rats. Wistar rats, aged 29 days, received a single subcutaneous dorsal injection of saline (control) or Hcy (0.6 μmol/g body weight). Fifteen minutes, 1 h, 6 h or 12 h after the injection, the rats were euthanized and the blood, plasma, and erythrocytes were collected. Results showed that Hcy significantly increased platelet count in the blood and plasma fibrinogen levels of rats at 15 min and 1 h, but not at 6 h and 12 h, when compared with the control group. Prothrombin time, activated partial thromboplastin time, and nitrite levels significantly decreased in plasma at 15 min and 1 h, but not at 6 h and 12 h after Hcy administration. In addition, hyperhomocysteinemia increased thiobarbituric acid-reactive, an index of lipid peroxidation, in plasma at 15 min and 1 h; decreased the superoxide dismutase and gluthatione peroxidase activity, and increased the catalase activity at 15 min in erythrocytes of rats, suggesting that acute Hcy administration may alter the oxidative status in the blood of rats. Our findings suggest that hypercoagulability and oxidative stress can occur after acute hyperhomocysteinemia, possibly in association, at least in part, with the vascular dysfunction and thromboembolic complications observed in homocystinuric patients.

Synthetic peptide fragment (65–76) of monocyte chemotactic protein-1 (MCP-1) inhibits MCP-1 binding to heparin and possesses anti-inflammatory activity in stable angina patients after coronary stenting

The peptide from C-terminal domain of MCP-1 (Ingramon) has been shown to inhibit monocyte migration and possess anti-inflammatory activity in animal models of inflammation and post-angioplasty restenosis. Here, we investigate the effect of Ingramon treatment on blood levels of acute-phase reactants and chemokines in patients after coronary stenting and the mechanisms of Ingramon anti-inflammatory activity. Eighty-seven patients with ischemic heart disease (IHD) who faced the necessity of coronary angiography (CA) were enrolled. In 67 patients, one-stage coronary stenting was performed; 33 of them were treated with Ingramon in addition to standard therapy. Twenty patients underwent CA only. High-sensitivity C-reactive protein (hsCRP) and fibrinogen blood levels were detected routinely. The chemokine concentration in plasma was measured by enzyme-linked immunosorbent assay (ELISA) or cytometric bead array-based immunoassay. Intracellular Ca(2+) levels and cell surface integrin exposure were assayed by flow cytometry. MCP-1 dimerization was studied by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). MCP-1-heparin binding was assessed with a biosensor and ELISA. Ingramon treatment was accompanied by less pronounced elevation of hsCRP and fibrinogen levels and decreased MCP-1 concentration in plasma in patients after coronary stenting. Ingramon had no effect on MCP-1 interaction with cell receptors or MCP-1 dimerization, but inhibited MCP-1 binding to heparin. The anti-inflammatory activity of the peptide may be mediated by an impaired chemokine interaction with glycosaminoglycans.

Castration methods do not affect weight gain and have diverse impacts on the welfare of water buffalo males

Castration is used to improve the management of water buffalo beef males raised under extensive conditions. However, as buffalo are considered robust animals, their welfare is often neglected, which, among other implications, may compromise their productivity. The aim of this study was to determine the effects of different castration methods on the stress level and weight gain of water buffalo males. Two experiments were performed with three treatments each. In experiment 1, serum cortisol concentrations were used as stress indicators for non-castrated (control group) or castrated males, either surgically or by burdizzo clamp. In experiment 2, blood levels of fibrinogen were used as stress indicators for males in the control group compared to those castrated by either burdizzo clamp or intratesticular injection of calcium chloride (chemical castration). In both experiments, clinical parameters and the mean daily weight gain were measured for all males. Surgical castration and chemical castration caused higher stress than castration with burdizzo, with no differences observed in weight gain among castration methods. In conclusion, for water buffalo males, castration with burdizzo clamp is preferable to surgical and chemical methods because it causes the lowest stress level in the animals.

Konjenital Kalp Hastalığı Olan Hastalarda Anormal Koagülasyon Test Sonuçlarının Oranı

Introduction: Coagluation abnormalities are expected in patients with congenital heart disease. We searched the rate of abnormal coagulation test in children with both cyanotic and non-cyanotic heart disease and investigated the clinical relevance of these abnormal tests. Material and Method: 49 children who have congenital heart disease and needed surgical intervention were prospectively enrolled to this study. Demographic data, primary diagnosis, bleeding complication during and after the intervention and prognosis of the patients were recorded. Platelet counts, prothrombin time, activated partial thromboplastine time and blood fibrinogen levels were measured prior to intervention. Results: 16 patients had prolonged PT, 13 patients had low fibrinogen level, 10 patients had prolonged aPTT and 5 patients had low platelet count. Conclusion: There was no increased complication risk in patients with abnormal test results, but caution must be taken during operation of these patients.Key words:

Atorvastatin Given prior to Electrical Cardioversion Does Not Affect the Recurrence of Atrial Fibrillation in Patients with Persistent Atrial Fibrillation Who Are on Antiarrhythmic Therapy

Objective: In this study, our aim was to evaluate the effect of a higher dose of atorvastatin on the recurrence rate of atrial fibrillation (AF) after electrical cardioversion (EC) in addition to antiarrhythmic therapy. Subjects and Methods: 48 patients with persistent AF were included in this study. The patients were randomized to an atorvastatin 40-mg treatment group and a control group. Atorvastatin was started 3 weeks before EC and was continued for 2 months after EC. EC was performed using biphasic shocks after 3 weeks of treatment with the orally administered anticoagulant warfarin. Lipid and inflammatory parameters (high-sensitivity C-reactive protein, white blood cell count and fibrinogen level) were evaluated at the baseline and before EC. The endpoint of this study was electrocardiographically confirmed recurrence of AF of >10 min. Results: There were no significant differences in baseline characteristics and lipid and inflammatory marker levels between the treatment and control groups. Total cholesterol and low-density lipoprotein levels were significantly decreased in patients taking atorvastatin for 2 months compared with baseline values (174 ± 31 vs. 129 ± 25 mg/dl, p = 0.001, and 112 ± 23 vs. 62 ± 20 mg/dl, p = 0.001, respectively), while no significant change occurred in control patients (168 ± 26 vs. 182 ± 29 mg/dl, p = 0.07, and 99 ± 18 vs. 108 ± 26 mg/dl, p = 0.1, respectively). At the end of the 2-month follow-up period, 9 patients (20.5%) experienced AF recurrence, and there was no significant difference in AF recurrence rate between the treatment and control groups (26 vs. 13%; p = 0.2). Conclusion: Atorvastatin therapy prior to EC does not prevent the recurrence of arrhythmia in patients with persistent AF who are receiving antiarrhythmic therapy.

Comparison of Growth Factor and Platelet Concentration From Commercial Platelet-Rich Plasma Separation Systems

Background: Clinical studies claim that platelet-rich plasma (PRP) shortens recovery times because of its high concentration of growth factors that may enhance the tissue repair process. Most of these studies obtained PRP using different separation systems, and few analyzed the content of the PRP used as treatment. Purpose: This study characterized the composition of single-donor PRP produced by 3 commercially available PRP separation systems. Study Design: Controlled laboratory study. Methods: Five healthy humans donated 100 mL of blood, which was processed to produce PRP using 3 PRP concentration systems (MTF Cascade, Arteriocyte Magellan, Biomet GPS III). Platelet, white blood cell (WBC), red blood cell, and fibrinogen concentrations were analyzed by automated systems in a clinical laboratory, whereas ELISA determined the concentrations of platelet-derived growth factor αβ and ββ (PDGF-αβ, PDGF-ββ), transforming growth factor β1 (TGF-β1), and vascular endothelial growth factor (VEGF). Results: There was no significant difference in mean PRP platelet, red blood cell, active TGF-β1, or fibrinogen concentrations among PRP separation systems. There was a significant difference in platelet capture efficiency. The highest platelet capture efficiency was obtained with Cascade, which was comparable with Magellan but significantly higher than GPS III. There was a significant difference among all systems in the concentrations of WBC, PDGF-αβ, PDGF-ββ, and VEGF. The Cascade system concentrated leukocyte-poor PRP, compared with leukocyte-rich PRP from the GPS III and Magellan systems. Conclusion: The GPS III and Magellan concentrate leukocyte-rich PRP, which results in increased concentrations of WBCs, PDGF-αβ, PDGF-ββ, and VEGF as compared with the leukocyte-poor PRP from Cascade. Overall, there was no significant difference among systems in the platelet concentration, red blood cell, active TGF-β1, or fibrinogen levels. Clinical Relevance: Products from commercially available PRP separation systems produce differing concentrations of growth factors and WBCs. Further research is necessary to determine the clinical relevance of these findings.

A Study of blood soluble P-selectin, fibrinogen, and von Willebrand factor levels in idiopathic and lone atrial fibrillation

A prothrombotic state with elevated levels of soluble P-selectin (sP-sel), fibrinogen, von Willebrand factor (vWf), and other haemostatic indices has been reported in some patients with atrial fibrillation (AF). Whether these changes are due to AF itself or coexistent cardiovascular diseases remains a matter of debate. Therefore, in the present study, the differences in plasma levels of sP-sel, fibrinogen, and vWf between patients with idiopathic/lone AF and sex-, age-, and risk factor-matched controls were investigated to determine whether AF itself might be associated with a hypercoagulable state. Ninety consecutive patients (63 males, 54.1 ± 10.1 years) with idiopathic AF were studied, 60 (43 males, 48.8 ± 7.5 years) of whom were diagnosed as lone AF. Plasma sP-sel and vWf were measured by enzyme-linked immunosorbent assay. Plasma fibrinogen was measured by chromometry. These indices in AF patients were compared with those in sex-, age- and risk factor-matched controls. Compared with the controls, patients with idiopathic AF had higher levels of sP-sel (AF vs. control: 33.4 ± 7.4 vs. 29.2 ± 6.5 ng/mL, P < 0.001) and fibrinogen (AF vs. control: 3.3 ± 0.9 vs. 3.0 ± 0.6 g/L, P = 0.02), but not vWf, whether with the adjustment of covariates or not. As for those < 60 years, between lone AF and age-matched controls, significant difference existed in the levels of sP-sel (AF vs. control: 34.5 ± 7.3 vs. 30.2 ± 7.3 ng/mL, P = 0.002), but not in those of fibrinogen and vWf, whether with the adjustment of covariates or not. Both platelet activation and abnormal changes in coagulation were suggested in idiopathic AF and a platelet activation state in lone AF. This supports the notion that AF per se contributes to a state of hypercoagulation.

Renal Failure and Posterior Reversible Encephalopathy Syndrome in Patients With Thrombotic Thrombocytopenic Purpura

Little is known of the nature of the neurologic manifestations in thrombotic thrombocytopenic purpura (TTP). We have recently reported posterior reversible encephalopathy syndrome (PRES) as the predominant brain abnormality in patients with TTP. Posterior reversible encephalopathy syndrome has been associated with a variety of medications and pathologic states including increased arterial blood pressure and renal failure. The factors that predispose patients with TTP to PRES are not known. To ascertain whether the presence and degree of hypertension and typical laboratory abnormalities seen in hospitalized patients with TTP are predictors of PRES. Design, Setting, and Patients We performed a retrospective analysis of brain imaging in 46 hospitalized patients with acute TTP seen at St Mary's and Rochester Methodist hospitals in Rochester, Minnesota, from January 1997 to June 2007. Head computed tomographic scans and brain magnetic resonance images were evaluated independently by 2 investigators. We then performed statistical analysis to determine whether the presence of PRES was associated with the presence of hypertension or abnormal laboratory data, including renal function. Forty-seven incidences of patients having TTP and neuroimaging were evaluated over a 10-year period. Thirty-three patients (70%) had brain magnetic resonance imaging performed. Of the patients who had acute abnormalities on brain magnetic resonance imaging, 13 (48%) were found to have PRES. Degree of hypertension was not associated with PRES on brain magnetic resonance imaging (P = .55). There was no association between hematocrit or platelet nadir, maximum blood urea nitrogen, D dimer, fibrinogen, lactate dehydrogenase, or total bilirubin levels and occurrence of PRES. The only variable highly associated with PRES on neuroimaging was the glomerular filtration rate (P = .02). The occurrence of PRES in patients with acute TTP is associated with worse renal function.

Sleep apnea is common in patients with coronary artery disease

Sleep-disordered breathing (SDB) has a prognostic impact in patients with cardiac diseases. We included 257 patients with preserved left ventricular function and angiographically proven coronary artery disease (CAD). All patients underwent cardiorespiratory polygraphy. In 251 patients high-sensitive C-reactive protein and fibrinogen were measured. SDB was documented in 188 patients (apnea-hypopnea-index [AHI] 16.4+/- 1.9/h): 58 patients presented central sleep apnea (CSA) and 130 patients obstructive sleep apnea (OSA). All patients (73%) with SDB had higher blood fibrinogen levels than those without SDB (p = 0.01). We found 197 patients with CRP-values below the cut-off of 0.5 mg/dl (group 1) and 54 patients with no active infection but CRP>0.5 mg/dl (group 2). Severity of SDB was significantly higher in group 2 (p = 0.01). SDB has a high prevalence in CAD patients and seems to be associated with chronic inflammation, which may be linked to CAD progression and/or acute coronary events.

Metabolic and hemostatic characteristics of patients with type 2 diabetes mellitus differing in the severity of angiopathy

The objective of the present study was to identify risk factors of developing vascular disorders in patients at different stages of type 2 diabetes mellitus (DM2) by comprehensive analysis of metabolic parameters, hemograms, thrombocytic and plasma hemostasis. The study involved 75 patients (22 men and 53 women of mean age 57,3±9,7 years) having angiopathies of different severity. The data obtained confirmed the presence of risk factors of vascular pathology in different phases of DM2. All the examined patients including those without angiopathies in the early period of diabetes showed triglyceridemia, cholesterolemia, enhanced platelet aggregation activity, and shortened activated partial thromboplastin time. Patients with diabetic nephropathy at the stage of microalbuminuria and with non-proliferative retinopathy were distinct from the remaining ones in that they had significantly higher blood alpha-2 globulin and fibrinogen levels. Diabetic patients with micro- and macrovascular problems were characterized by marked dysproteinemia and abnormal platelet disaggregation.

Chronic low-grade inflammation, lipid risk factors and mortality in functionally dependent elderly

It has been proved that a highly sensitive C-reactive protein (hsCRP) can be used as an established marker of chronic inflammation for cardiovascular risk assessment. Since mean values of both low-density cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) decrease during aging, the knowledge that increased hsCRP concentration predicts mortality (Mt) would influence therapy and treatment outcome. The aim of this study was to examine importance of chronic low grade inflammation and its association with lipid risk factors for all-cause Mt in functionally dependent elderly. The participants of this longitudinal prospective study were 257 functionally dependent elderly aged 65-99 years. Baseline measurements: anthropometric measurements, blood pressure, fasting plasma total cholesterol (TC), triglyceride (TG), HDL-C, LDL-C, non-HDL-C, hemoglobin Alc (HbA1c) were recorded and different lipid ratios were calculated. Inflammation was assessed by the levels of white blood cells, fibrinogen and hsCRP. The participants with hsCRP grater than 10 mg/L were excluded from the study. The residual participants (77.4% women) were divided into three groups according to their hsCRP levels: a low (< 1 mg/L, n=70), average (1 to 3 mg/L, n=69), and high (3-10 mg/L, n=69) hsCRP group. Associations of all-cause Mt with different risk factors were examined using logistic regression analysis. The hsCRP level showed a significant positive correlation with waist (r = 0.199, p = 0.004) and hip (r = 0.187, p = 0.007) circumferences, body mass index (r = 0.143, p = 0.040) and serum triglyceride level (r = 0.139, p = 0.045) and significant negative correlation with HDL-C (r = -0.164, p = 0.018). Ratios TC/HDL-C and TG/HDL-C were significantly smaller in the low hsCRP group compared to the average hsCRP group (p = 0.019,p = 0.045, respectively) and without significant differences compared with the high hsCRP group. Two years after the baseline examination 22.1% participants died from all-cause Mt. After adjustment for other risk factors, a TC was significantly associated with all-cause Mt only in high hsCRP group: Odds ratio (OR) = 3.71 (95% confidence interval-CI: 1.09-12.63). In this study a high hsCRP was an important factor to identify functionally dependent elderly at high risk who may have more benefit from agressive lipid lowering treatment.

The Effect of Compulsory Schooling on Health - Evidence from Biomarkers

Using data from the Health Survey for England and the English Longitudinal Study on Ageing, we estimate the causal effect of schooling on health. Identification comes from two nation wide increases in British compulsory school leaving age in 1947 and 1973, respectively. Our study complements earlier studies exploiting compulsory schooling laws as source of exogenous variation in schooling by using biomarkers as measures of health outcomes in addition to self-reported measures. We find a strong positive correlation between education and health, both self-rated and measured by blood fibrinogen and C-reactive protein levels. However, we find ambiguous causal effects of schooling on women's self-rated health and insignificant causal effects of schooling on men's self-rated health and biomarker levels in both sexes.