hs-CRP Values Research Articles

Comparison Between Inflammatory Biomarkers (High-Sensitivity C-Reactive Protein and Neutrophil-Lymphocyte Ratio) and Psychological Morbidity in Suicide Attempt Survivors Brought to Medicine Emergency.

Objectives: This study aimed to compare inflammatory biomarkers (high-sensitivity {hs} C-reactive protein, neutrophil-lymphocyte ratio) and psychological morbidity in suicide attempt survivors.Methods: One hundred ninety-eight poisoning cases screened, 40 age-matched suicide attempt survivors (SAS), 40 healthy controls (HC) between the age of 18 years and 60 years were included. Complete hemogram, neutrophil-lymphocyte ratio (NLR), hsCRP values obtained, compared with Hospital Anxiety and Depression Scale (HADS), suicide intent scale, presumptive stressful life events scale (PSLES), general health questionnaire 12-item (GHQ-12) (Hindi version), and Hindi Mental State Examination (HMSE).Results: A statistically significant difference was observed in hsCRP (p=0.016) and NLR (p=0.029) of depressed-suicidal participants vs healthy controls. hsCRP values of anxious-suicidal subjects vs healthy controls showed a statistically significant difference (p=0.001). There was a statistically significant difference between patients, healthy controls in HADS anxiety and HADS depression mean scores (p<0.001). The PSLES items were ranked according to the mean stress scores of all the items (mean±SD), highest four were excessive alcohol use by the family member 47.50 (±27.03), conflicts with in-laws 50 (±27.73), family conflict 50 (±29.42), marital conflict 50.63 (±32.76). There was a statistically significant difference in hemoglobin (p<0.001), red blood cells count (p<0.001), hematocrit (p<0.001) between suicide attempt survivors and healthy controls.Conclusion: Both hsCRP and NLR have emerged as potential inflammatory biomarkers for depressive patients with suicidal attempts. Additionally, there may be a link between anemia and suicide risk in patients with depression.

Comparative characteristics of the level of highly sensitive C-reactive protein in patients with systemic lupus erythematosus and rheumatoid arthritis

The aim of this work was to study the dependence of the concentration of C-reactive protein in the blood of patients on the severity of systemic lupus erythematosus (SLE). Material and methods. We examined 26 patients with SLE, the comparison group consisted of patients with rheumatoid arthritis (RA) (n = 88). Results. The hsCRP level was significantly higher in patients with a high degree of activity than in patients with minimal and moderate SLE activity (F = 4.409, p = 0.023). In addition, in patients with SLE, a significant direct correlation was found between hsCRP and ESR values (r = 0.409, p = 0.047), antinuclear factor (r = 0.389, p = 0.021), antibodies to double-stranded DNA (r = 0.226, p = 0.033), leukocytes in urine (r = 0.571, p = 0.002), microalbuminuria (r = 0.727, p = 0.017) AsAT (r = 0.428, p = 0.046), and inverse correlation – with the value of blood leukocytes (r = –0.662, p &lt; 0.001). Conclusion. It was found that an increase in the levels of hsCRP in the sera of SLE patients is accompanied by an increase in the degree of disease activity, which indicates a direct correlation between the level of hsCRP and SLE activity. Consequently, the concentration of hsCRP reflects the acute phase response and the intensity of the inflammatory process in SLE.

Iron Deficiency in Vegetarian and Omnivorous Individuals: Analysis of 1340 Individuals

The objective of this study was to evaluate the serum levels of ferritin and the prevalence of iron deficiency in vegan and omnivorous individuals by taking into account the presence of elements that cause an elevation of ferritin levels, such as increased homeostatic model assessment of insulin resistance (HOMA-IR), body mass index (BMI), and high-sensitivity C-reactive protein (hs-CRP) values. The parameters were evaluated in 1340 individuals, i.e., 422 men and 225 women who do not menstruate and 693 women who do menstruate, based on omnivorous or vegetarian eating habits. The progressive increase in BMI, HOMA-IR, and inflammation caused an elevation in ferritin concentration, regardless of the eating habits in the groups studied. In the overall sample, omnivores had a higher prevalence of obesity, higher ferritin levels, and a lower prevalence of iron deficiency (ferritin < 30 ng/mL). However, after the exclusion of individuals with inflammation (with overweight/obesity and elevated hs-CRP levels), the actual iron deficiency was assessed and was not higher among vegetarians, except in women with regular menstrual cycles. Our data show that nutritional status and inflammation levels affect ferritin levels and may interfere with the correct diagnosis of iron deficiency in both vegetarian and omnivorous individuals. Compared to vegetarians, women who do not menstruate and men had the same prevalence of iron deficiency when following an omnivorous diet.

HIGH SENSITIVITY- C REACTIVE PROTEIN AS CARDIOVASCULAR RISK MARKER IN METABOLIC SYNDROME PATIENTS.

Background &amp; Objectives: 20-25% of the world's adult population have metabolic syndrome (MetS); mortality of these people is double, and the morbidity of heart attack or stroke is three times higher than in the healthy population. Recent research has focused on the use of high-sensitivity C-reactive protein (hs-CRP), a marker of inammation, in the detection of patients at increased risk for cardiovascular disease. The study was conducted to evaluate for the evidence of the association between baseline hs-CRP levels and the metabolic syndrome. Methods: It was a cross-sectional study of 200 adults, 18–50 years of age, both the sexes randomly selected from diabetes &amp; obesity OPD at tertiary care hospital &amp; compared with 200 age &amp; sex-matched controls. Diagnosis of Metabolic syndrome was done according to Modied National Cholesterol Education Program ATP III criteria (2004). High Sensitivity -C Reactive Proteins -hs-CRP was done by ELISA method (CAL BIOTECH). Statistical Analysis was done by Pearson correlation coefcient to study the correlation between hs-CRP &amp; various components of metabolic syndrome. Results: We found signicantly increased hs-CRP levels (P&lt;0.001) in metabolic syndrome, 60% of patients with metabolic syndrome belonged to the high-risk group with a mean hs-CRP value &gt;3 mg/L &amp; a positive correlation of hs-CRP with abdominal circumference &amp; triglyceride &amp; HDL levels Conclusion: increased hs- CRP levels in metabolic syndrome may increase the risk of having cardiovascular mortality. These prospective data suggest that measurement of hs-CRP adds clinically important prognostic information to the metabolic syndrome.

Association of triglyceride-glucose index and high-sensitivity C-reactive protein with asymptomatic intracranial arterial stenosis: A cross-sectional study

Background and aimsTriglyceride-glucose index (TyG) and high-sensitivity C-reactive protein (hsCRP) have been shown to play important roles in the pathophysiological mechanisms of atherogenesis. However, the cumulative value of TyG and hsCRP in identifying asymptomatic intracranial arterial stenosis (aICAS), as well as its severity and numerical burden, is uncertain. This study seeks to fill this knowledge gap. Methods and resultsThis study included 1938 participants aged ≥40 years who were free of stroke or transient ischemic attack. All participants were classified into four groups based on the participants’ TyG and hsCRP levels, including low-TyG and low-hsCRP, low-TyG and high-hsCRP, high-TyG and low-hsCRP, and high-TyG and high-hsCRP groups. The presence of aICAS was screened via transcranial Doppler ultrasound and confirmed by magnetic resonance angiography. The TyG was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. We used multinomial logistic regression analysis to investigate the cumulative value of TyG and hsCRP on identifying the severity of aICAS or its numerical burden. After adjustment for conventional confounders, isolated high-hsCRP, isolated high-TyG, and high-TyG combined with high-hsCRP were independently associated with moderate-to-severe aICAS. Compared with the low-TyG and low-hsCRP group, participants with high-TyG and high-hsCRP had a 2.6 times higher odds ratio (OR) of having a single moderate-to-severe aICAS and a 3.3 times higher OR of having multiple moderate-to-severe aICASs. ConclusionThe cumulative value of TyG and hsCRP may better identify moderate-to-severe aICAS as well as its numerical burden.

Interleukin 6 (rs1800795) and pentraxin 3 (rs2305619) polymorphisms-association with inflammation and all-cause mortality in end-stage-renal disease patients on dialysis

Chronic inflammation plays an important role in the progression and outcome of chronic kidney disease (CKD). The circulating levels of the inflammatory biomarkers interleukin 6 (IL6) and pentraxin 3 (PTX3) are enhanced in CKD patients, and are associated with the progression of the disease and with higher risk for cardiovascular events, the major cause of death in CKD patients. Our aim was to study how specific polymorphisms of IL6 and PTX3 encoding genes affect the inflammatory response and outcome of end-stage renal disease (ESRD) patients on dialysis. Methodology included the analysis of two single nucleotide polymorphisms (SNP), namely the IL6 (rs1800795) polymorphism in the promoter region (-174G > C), and the PTX3 (rs2305619) polymorphism in the intron 1 (+ 281A > G), which were analyzed in ESRD patients on dialysis and in a group of heathy individuals. The allelic frequencies, genotype distribution and their association with circulating levels of the inflammatory markers C-reactive protein (CRP), IL6, growth differentiation factor 15 (GDF15) and PTX3, were determined in ESRD patients. Events of death were recorded along one year, to assess the association of the studied SNPs with all-cause mortality and the inflammatory biomarkers, in ESRD patients. Results showed that the allelic frequencies and genotype distribution for IL6 and PTX3 SNPs in the control group and ESRD patients were similar and in agreement with other European reports. For the IL6 polymorphism, we found a trend towards higher levels of high-sensitivity (hs) CRP, IL6 and PTX3 in the homozygous genotypes; the CC genotype also showed the highest levels of GDF15. The mortality rate after the 1-year follow-up was 10.4%. The CC genotype (IL6 SNP) was associated to a higher risk of mortality and deceased patients carrying this genotype also showed the highest levels of hsCRP. Regarding the studied PTX3 SNP, the AA genotype was linked to an enhanced inflammatory response, showing the highest values of hsCRP and IL6. Nevertheless, this genotype had no significant impact on the mortality rate. In conclusion, both studied SNPs seem to modulate the inflammatory response in ESRD and may, therefore, be determinant on disease progression and patients’ outcome. Our data also highlights the importance of research on genetic variants that, although less frequent, may have significant biological value.

Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Nondialysis Chronic Kidney Patients.

Background The Neutrophil-to-Lymphocyte Ratio (NLR) and the Platelet-to-Lymphocyte Ratio (PLR) are inflammatory biomarkers for several diseases, such as cancer and cardiovascular morbidities; however, there are currently few studies on kidney diseases. We aimed to evaluate nondialysis patients and determine the association of NLR and PLR with inflammation in these patients. Methods A prospective cross-sectional study was conducted with 85 patients at different stages of chronic kidney disease (CKD), treated at the Kidney Disease Prevention Center of the University Hospital of the Federal University of Maranhão. This study included adult nondialysis patients diagnosed with CKD. The participants' blood samples were collected for a high-sensitivity C-reactive protein (hs-CRP) test and blood count. They were divided into two groups according to the presence or absence of inflammation based on the hs-CRP value (<0.5 mg/dL). NLR and PLR were calculated based on the absolute number of neutrophils, lymphocytes, and platelets and were compared between them and with hs-CRP. Statistical analysis was performed using the Stata software, with the Shapiro–Wilk, Mann–Whitney, Spearman's Correlation, and receiver operating characteristic curve tests. This study was approved by the local ethics committee. Results The participants were categorized into two groups: with inflammation (n = 64) and without inflammation (n = 21). The mean age was 61.43 ± 14.63 y. The NLR and PLR values were significantly different between the groups with and without inflammation (p=0.045and p=0.004, respectively). However, only PLR showed a significant positive correlation with hs-CRP (p=0.015). The best cutoff point for NLR to detect inflammation was 1.98, with 76.19% sensitivity and 48.44% specificity. For PLR, it was 116.07, with 85.71% sensitivity and 51.56% specificity. There was no significant difference between the area under the NLR and PLR curve (0.71 vs. 0.64; p=0.186) for this population. Conclusions This study showed that PLR was positively correlated with hs-CRP in nondialysis CKD patients and can be used to identify inflammation in this population.

A high-sensitivity C-reactive protein in assessing severity of asthma: A case control study

Asthma is often believed to be a disorder localized to the lungs, current evidence indicates that it may represent a component of systemic airway disease involving the entire respiratory tract. Despite significant improvements in the diagnosis and management of asthma over the past decade, as well as the availability of comprehensive and widely-accepted national and international clinical practice guidelines for the disease.This is prospective and descriptive study patients were derived among patients with asthma presented for follow -up examination in outpatient Department of pulmonary Medicine of Government Hospital. The patients were on maintenance treatment including inhaled corticosteroids and bronchodilators according to the guideline treatment of asthma. In our present study, a total of 65 patients were included out of which 36(55.3%) were males. In our study, most of the patients were 51-70 years i.e., 36 out of 65(55.4%), followed by 31-50. The mean hsCRP in case group patients are 3.62±0.84 and in control group patients 0.83±0.15. Pulmonary lung function test using Spirometer was done in all the patients (case &amp; control). The FEV1 values are compared against hsCRP values. Statistical significance is assessed using Spearmann’s correlation. Case group patients showing highly significant negative correlation of hsCRP with FEV1.The results of this study indicate increased serum hsCRP concentration in asthma compared to controls. Increased serum hs-CRP correlates positively with severity of asthma and thus can be considered as a tool in predicting asthma status.

EVALUATION OF SERUM URIC ACID, SERUM MAGNESIUM AND LIPID PROFILES IN TYPE 2 DIABETES MELLITUS PATIENTS FOR THE RISK FACTOR OF CARDIOVASCULAR DISEASE.

Background &amp; Objective: Dyslipidemia is one of the common disorders which are seen in most of the diabetes patients, which causes cardio vascular diseases.However, serum uric acid and lipid profiles are considered as the potential risk factor for developing diabetes, hypertension, stroke and cardiovascular diseases. Also the direct association of trace elements such as serum magnesium and hs-CRP in type 2 diabetes has been observed.The aim of the present study is to evaluate serum uric acid, serum magnesium and lipid profiles in type 2 diabetes mellitus patients for the risk factor of cardiovascular disease and its comparison with non diabetic subjects. Material &amp; Methods: This case-control study was conducted in the Department of Biochemistry,PIMS,Udaipur.The study included 100 patients with type 2 Diabetes Mellitus (both males and females) who were recruited from the institute's medicine OPD and wards and 100 healthy controls (both males and females) with normal plasma glucose and with no symptoms suggestive of DM were included in the study. All the Biochemical parameters analysis was done on fully automated analyzer-ERBA 360 EM. Results: The mean values of serum lipid profile (serum cholesterol,serum triglycerides,VLDL,LDL) were compared between healthy controls and patients with type 2 DM, showed highly significant difference in patients with type 2 DM as compared with healthy controls (p&lt;0.001). However, on comparing HDL between healthy controls and patients with type 2 DM, the difference seems to be significant (p&lt;0.05).The mean values of RBS,HbA1c,uric acid and hs-CRP were highly significant in patients with type 2 DM as compared with healthy controls (p&lt;0.001).The mean values of serum magnesium showed significant difference between healthy controls and patients with type 2 DM p&lt;0.05). Interpretation And Conclusion: The common lipid abnormalities seen during diabetes induce dyslipidemia causing the development of CVD's among diabetic patients. Also elevated levels of hs-CRP, hyperuricemia, hypomagnesium suggest that it could be a better prognosis for CVD's and stroke in diabetic patients.

Inflammation and microbial translocation measured prior to combination antiretroviral therapy (cART) and long-term probability of clinical progression in people living with HIV

BackgroundDespite the effectiveness of cART, people living with HIV still experience an increased risk of serious non-AIDS events, as compared to the HIV negative population. Whether pre-cART microbial translocation (MT) and systemic inflammation might predict morbidity/mortality during suppressive cART, independently of other known risk factors, is still unclear. Thus, we aimed to investigate the role of pre-cART inflammation and MT as predictors of clinical progression in HIV+ patients enrolled in the Icona Foundation Study Cohort.MethodsWe included Icona patients with ≥2 vials of plasma stored within 6 months before cART initiation and at least one CD4 count after therapy available. Circulating biomarker: LPS, sCD14, EndoCab, hs-CRP. Kaplan-Meier curves and Cox regression models were used. We defined the endpoint of clinical progression as the occurrence of a new AIDS-defining condition, severe non-AIDS condition (SNAEs) or death whichever occurred first. Follow-up accrued from the data of starting cART and was censored at the time of last available clinical visit. Biomarkers were evaluated as both binary (above/below median) and continuous variables (logescale).ResultsWe studied 486 patients with 125 clinical events: 39 (31%) AIDS, 66 (53%) SNAEs and 20 (16%) deaths. Among the analyzed MT and pro-inflammatory markers, hs-CRP seemed to be the only biomarker retaining some association with the endpoint of clinical progression (i.e. AIDS/SNAEs/death) after adjustment for confounders, both when the study population was stratified according to the median of the distribution (1.51 mg/L) and when the study population was stratified according to the 33% percentiles of the distribution (low 0.0–1.1 mg/L; intermediate 1.2–5.3 mg/L; high > 5.3 mg/L). In particular, the higher the hs-CRP values, the higher the risk of clinical progression (p = 0.056 for median-based model; p = 0.002 for 33% percentile-based model).ConclusionsOur data carries evidence for an association between the risk of disease progression after cART initiation and circulating pre-cART hs-CRP levels but not with levels of MT. These results suggest that pre-therapy HIV-driven pro-inflammatory milieu might overweight MT and its downstream immune-activation.

COMPARISON OF HIGH SENSITIVITY C-REACTIVE PROTEIN VALUE FOR STEROID SENSITIVE NEPHROTIC SYNDROME PATIENTS WITH STEROID RESISTANT

Backgroud : Nephrotic syndrome (NS) is the most common glomerulopathy in childhood. The incidence of NS in the United States and United Kingdom is 2-7 new cases per 100,000 children per year, with a prevalence ranging from 16 cases per 100,000 children, and is found to be higher in developing countries. Nephrotic syndrome is a chronic disease that requires long-term monitoring because one of the complications that can be caused is cardiovascular complications caused by hyperlipidemia. High Sensitivity C-Reactive Protein (hs-CRP) can be used as a cardiovascular predictor in NS patients. Objective : To determine the differences in the value of hs-CRP in steroid sensitive nephrotic syndrome patients with steroid resistance. Methods : Case control design in 36 pediatric patients with nephrotic syndrome who came to the outpatient and inpatient unit of H. Adam Malik Hospital Medan from August 2020 to December 2020. Sampling using consecutive sampling technique, conducted interviews with parents, physical and laboratory examinations to confirm the diagnosis of steroid sensitive and steroid resistant nephrotic syndrome. An unpaired t-test and Mann-Whitney test were analyzed to assess the comparison between variables. Result : All NS patients were 36 subjects, 25 subjects (69.4%) were male and 11 subjects (30.5%) were female. The mean age of the study subjects for steroid sensitive NS patients was 8.4 (SD 4.8) years, whereas for steroid-resistant NS patients was 10.4 (SD 4.7) years. There was no significant difference between the hs-CRP value of steroid sensitive nephrotic syndrome patients with steroid resistance. Conclusion : There is no significant difference between the hs-CRP value of steroid sensitive nephrotic syndrome patients with steroid resistance.

MO799IS COMBINATION OF MAINTENANCE HEMODIALYSIS WITH HEMOPERFUSION AN EFFECTIVE METHOD IN MANAGEMENT OF RENAL OSTEODYSTROPHY AND INFLAMMATION IN HEMODIALYSIS PATIENTS?

Abstract Background and Aims Some of the conditions which occur in maintenance hemodialysis (MHD) patients with a high incidence resulting in a decline in their quality of life, include malnutrition, renal osteodystrophy, refractory hypertension and chronic systemic inflammation. In developing countries, due to the low level of economic development, low-flux dialysis is the main means of extracorporeal blood purification therapy. But it can hardly remove the middle and large molecule uremic toxins and protein-bound toxins; as a result, the patients suffer from long-term complications and poor quality of life. In this study, we attempted to investigate whether the combination of maintenance hemodialysis (MHD) with hemoperfusion (HP) could improve the clearance rate of middle and large molecule uremic toxins so as to improve their uremic complications. Method A total of 54 patients, who underwent routine hemodialysis, were assessed in this study. Those patients were randomly divided into two groups: Group 1 (27 patients) received combined treatment of HD with hemoperfusion (HP) in this regimen: HD 2 times a week with HD+HP once a week two times in a row, then after two weeks, and afterwards once a month as a maintenance treatment. Group 2 (27 patients) was only undergoing maintenance HD 3 times a week. The clinical and laboratory properties of both groups were followed up for 18 months, whereas the primary outcomes included normal clinical data, high sensitive C-reactive protein (hsCRP), immunoreactive parathyroid hormone (iPTH), phosphorus (P04), calcium (Ca), albumin, iron (Fe), total iron binding capacity (TIBC), hemoglobin, Epo doses and types of hypertensive drugs. Results At the end of the 18-month observation, the serum concentration of albumin, P04, hsCRP, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were lower with Group 1 than with Group 2 (p&amp;lt;0.05). Whereas, higher levels of iPTH were noticed in group 1, but when the laboratory and clinical data are analysed of the group 1 alone a statistically significant lower values after the observational period are noticed especially in the serum values of iPTH (p&amp;lt;0.05), P04 (p&amp;lt;0.001), CRP (p&amp;lt;0.011), SBP and DBP (p&amp;lt;0.05). Conclusion HD+HP was superior to HD in regularly eliminating middle and large molecule uremic toxins accumulated in the body which is mostly shown through reducing the values of iPTH and hsCRP. These findings suggest a potential role for HD+HP in the treatment of inflammation and renal osteodystrophy as well, because lowering these values of iPTH leads to a normalization of other minerals which is expected and therefore leads to a stabilization of this long-term uremic complications, which can improve the overall general condition of the MHD patient.

Mathematical model under E-health context for diagnosis of head and neck space Gram infection through CT imaging

The study aimed to investigate the head and neck space infection by Gram bacteria using mathematical model-based CT (computer tomography) under e-health (electronic health). Specifically, a total of 180 clinical patients with head and neck space infection were collected as the research subjects. CT/MRI examination was adopted to diagnose the disease. A mathematical model was then established to be applied in CT imaging. The cause and treatment effect were analyzed by summarizing the data, including basic information, bacterial culture, source and extent of infection, serious complications, and other factors. The results showed that the CT/MRI imaging based on the mathematical model can effectively diagnose the disease and assess the disease progress. There were more male patients than female patients with head and neck space infection, and more elderly patients than younger patients. A total of 42 patients had serious complications, accounting for 23.3% of the total patients. The most common one was descending mediastinitis, followed by respiratory obstruction, pneumonia, pericarditis, orbital infection, and multiple organ failure. There were many sources of infection in the head and neck space. The main cause was dental infection, and there were 137 cases, accounting for 76.1% of the total. Among them, odontogenic infections included tooth apical periodontitis, wisdom tooth pericoronitis, and periodontal disease. Other sources of infection included glandular infections, iatrogenic infections, and traumatic foreign bodies. The most common part affected by head and neck space infection was the submandibular space, and other parts included the masseter space, the cheek space, and the sublingual space. Severe complications of head and neck space infection were mainly inferior mediastinitis and respiratory obstruction. In the bacterial culture experiment, a total of 75 bacterial cultures of 180 patients were positive, and 62 strains of bacteria were cultured, including 11 kinds of gram-positive bacteria and 4 kinds of gram-negative bacteria. The main pathogens cultivated were Streptococcus viridans, Staphylococcus aureus, and Klebsiella pneumoniae. In laboratory tests, the values of WBC and hs-CRP in patients with severe complications were significantly higher than those in patients with common head and neck space infection. Imipenem and ornidazole were the most commonly used antibiotics in the clinical treatment of patients with severe complications. In conclusion, head and neck space infection is a serious infectious disease that may be life-threatening and requires timely and effective treatment.

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 &gt;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.

Prognostic Role of High Sensitivity C-Reactive Protein in Patients With Acute Myocardial Infarction.

Background: High sensitivity CRP (hs-CRP) has attracted intense interest in risk assessment. We aimed to explore its prognostic value in patients with acute myocardial infarction (AMI).Methods and Results: We enrolled 4,504 consecutive AMI patients in this prospective cohort study. The associations between hs-CRP levels with the incidence of in-hospital HF was evaluated by logistic regression analysis. The association between hs-CRP levels and the cumulative incidence of HF after hospitalization were evaluated by Fine-Gray proportional sub-distribution hazards models, accounting for death without HF as competing risk. Cox proportional hazards regression models were constructed to estimate the association between hs-CRP levels and the risk of all-cause mortality. Over a median follow-up of 1 year, 1,112 (24.7%) patients developed in-hospital HF, 571 (18.9%) patients developed HF post-discharge and 262 (8.2%) patients died. In the fully adjusted model, the risk of in-hospital heart failure (HF) [95% confidence intervals (CI)] among those patients with hs-CRP values in quartile 3 (Q3) and Q4 were 1.36 (1.05–1.77) and 1.41 (1.07–1.85) times as high as the risk among patients in Q1 (p trend < 0.001). Patients with hs-CRP values in Q3 and Q4 had 1.33 (1.00–1.76) and 1.80 times (1.37–2.36) as high as the risk of HF post-discharge compared with patients in Q1 respectively (p trend < 0.001). Patients with hs-CRP values in Q3 and Q4 had 1.74 (1.08–2.82) and 2.42 times (1.52–3.87) as high as the risk of death compared with patients in Q1 respectively (p trend < 0.001).Conclusions: Hs-CRP was found to be associated with the incidence of in-hospital HF, HF post-discharge and all-cause mortality in patients with AMI.

Long-term impact of high-sensitivity C-reactive protein in patients with intermittent claudication due to peripheral artery disease following endovascular treatment.

Little is known about the prognostic impact of high-sensitivity C-reactive protein (hs-CRP) levels on causes of death during long-term follow-up. We, therefore, investigated the associations between hs-CRP and clinical outcomes in the patients with intermittent claudication. Three hundred thirty-five consecutive patients (mean age, 72 ± 8years, 82% men) undergoing first intervention for de novo iliac and/or femoropopliteal artery lesions from 2009 to 2020 were studied. Patients were divided into 2 groups based on the optimal cutoff value of hs-CRP (> or ≤ 0.15mg/dL). The median follow-up duration was 3.6years (interquartile range, 1.0-6.2years). Although the cumulative incidence rate of major adverse cardiovascular limb events was not significantly different between the higher and lower hs-CRP groups (29.0 and 22.1%, respectively; log-rank test, p = 0.410), that of all-cause death was significantly higher in the higher hs-CRP group than in the lower hs-CRP group (18.7 vs. 5.8%, log-rank test, p = 0.007), even in cardiovascular-related death and malignancy-related death (log-rank test, p = 0.030 and 0.046, respectively). Higher hs-CRP levels at the time of intervention were significantly associated with higher frequency of all-cause death, even after adjusting for other risk factors (hazard ratio 2.79; 95% confidence interval 1.66-7.17, p = 0.024). In addition, malignancy-related death was most frequent as high as 60% (21/35 deaths), and elevated hs-CRP levels and the Brinkman index were strongly independent predictors of malignancy-related death. In conclusion, elevated hs-CRP levels were significantly associated with cardiovascular-related and malignancy-related deaths in patients with intermittent claudication. Furthermore, the result that cancer mortality exceeds cardiovascular mortality is different from previous reports, so the present findings warrant further investigation.

Comparative Evaluation of the Diagnostic Value of Procalcitonin and hsCRP for the Presence of Mild-to-Moderate Diabetic Foot Infections.

The aim of this study is to compare the efficacy of procalcitonin (PCT) and high-sensitive C-reactive protein (hsCRP) as diagnostic biomarkers in patients with diabetes and mild-to-moderate diabetic foot infections. A total of 119 patients (102 with type 2 diabetes and 17 with type 1 diabetes), of mean age 60.29 ± 10.05 years, divided into 3 groups-diabetic foot ulcer (DFU) with active infection (IDFU group, n = 41), DFU without clinical signs of infection (non-IDFU group, n = 35), and a control group with diabetes without DFU (n = 43). Infection severity was graded according to the International Working Group on the Diabetic Foot guideline-non-IDFU group as Grade 1, IDFU group as Grade 2 (n = 22), and Grade 3 (n = 19). Serum hsCRP was assessed by the immunoturbidimetric method and PCT by the enzyme chemiluminescence immunoassay (ECLIA) method. Levels of white blood cells (WBC) were assessed using the Medonic hematology analyzer and erythrocyte sedimentation rate (ESR) by the Westergren method. Serum hsCRP, WBC count, and ESR were significantly higher in the IDFU group as compared to non-IDFU and control groups, whereas PCT levels did not differ between the groups. hsCRP presented with higher sensitivity (80%), specificity (79%), area under the curve (AUC) 0.856, in comparison to PCT (sensitivity 63%, specificity 62%, AUC 0.617) for the presence of IDFU, as well as in the Grade 3 subgroup (84% sensitivity and specificity, AUC 0.911). The combined model of both markers did not present with better accuracy than using hsCRP alone. In conclusion, hsCRP appears to be a better diagnostic biomarker than PCT in the diagnosis of moderate foot ulcer infection. Both markers fail to distinguish mild infection.

Associations between Pre-Bariatric High-Sensitivity C-Reactive Protein and Post-Surgery Outcomes.

Background: Obesity is a chronic inflammatory condition associated with increased circulating levels of C-reactive protein (CRP). Bariatric surgery has been reported to be effective in improving both inflammatory and liver status. Our aims were to elucidate the relationships between pre-surgery high sensitivity-CRP (hs-CRP) values and post-surgery weight loss and liver steatosis and fibrosis in patients with severe obesity undergoing Roux-en-Y gastric bypass. Methods: We conducted an observational prospective study on 90 individuals with morbid obesity, who underwent gastric bypass. Anthropometric indices, laboratory assessment (lipid panel, glycemic status, liver enzymes, and hs-CRP), liver stiffness and steatosis were evaluated at baseline and 6-months after surgery. Results: There was a significant post-surgery reduction in all the anthropometric variables, with an average weight loss of 33.93 ± 11.79 kg; the mean percentage of total weight loss (TWL) was 27.96 ± 6.43%. Liver elasticity was significantly reduced (from 6.1 ± 1.25 to 5.42 ± 1.52 kPa; p = 0.002), as well as liver aminotransferases, nonalcoholic fatty liver disease fibrosis score (NFS) and the grade of steatosis. Serum hs-CRP levels significantly reduced (from 9.26 ± 8.45 to 3.29 ± 4.41 mg/L; p < 0.001). The correlations between hs-CRP levels and liver fibrosis (elastography), steatosis (ultrasonography), fibrosis-4 index, NFS, and surgery success rate were not significant. Regression analyses showed that serum hs-CRP levels were not predictive of liver status and success rate after surgery in both unadjusted and adjusted models. Conclusions: In patients with morbid obesity, bariatric surgery caused a significant decrease in hs-CRP levels, liver stiffness and steatosis. Baseline hs-CRP values did not predict the weight-loss success rate and post-surgery liver status.

Prognostic value of suPAR and hsCRP on acute kidney injury after cardiac surgery

BackgroundAcute kidney injury (AKI) represents a serious complication following cardiac surgery. Adverse outcome after cardiac surgery has been observed in the presence of elevated levels of soluble urokinase-type plasminogen activator receptor (suPAR) and high-sensitivity C-Reactive Protein (hsCRP). The aim of study was (i) to investigate the relationship between preoperative elevated levels of suPAR and hsCRP and postoperative AKI in unselected cardiac surgery patients and (ii) to assess whether the concentration of the biomarkers reflected severity of AKI.MethodsIn a retrospective observational study, biobank blood plasma samples (n = 924) from patients admitted for elective on-pump cardiac surgery were analysed for suPAR and hsCRP levels. The relation between suPAR and hsCRP-values and AKI (any stage), defined by the KDIGO (Kidney Disease: Improving Global Outcomes) criteria, was assessed using adjusted logistic regression. Further, the association between biomarkers and severity (KDIGO 1, KDIGO 2–3 and renal replacement therapy (RRT)) was assessed using adjusted logistic regression.ResultsPostoperative AKI (any stage) was observed in 327 patients (35.4 %). A doubling of preoperative suPAR corresponded to an adjusted odds ratio (OR) for postoperative AKI (any stage) of 1.62 (95 % CI 1.26–2.09, p < 0.001). Furthermore, a doubling of suPAR had an adjusted OR of 1.50 (95 % CI 1.16–1.93, p = 0.002), 2.44 (95 % CI 1.56–3.82, p < 0.001) and 1.92 (95 % CI 1.15–3.23, p = 0.002), for KDIGO 1, KDIGO 2–3 and need for RRT, respectively. No significant association was found between elevated levels of hsCRP and any degree of AKI.ConclusionsIncreasing levels of suPAR, but not hsCRP, were associated with development and severity of AKI following on-pump cardiac surgery.

POS-256 ROXADUSTAT INCREASES HEMOGLOBIN IN ANEMIC NON-DIALYSIS-DEPENDENT (NDD) AND DIALYSIS-DEPENDENT (DD) CHRONIC KIDNEY DISEASE (CKD) PATIENTS INDEPENDENT OF INFLAMMATION

Inflammation is a common cause of decreased responsiveness to erythropoiesis-stimulating agents. Roxadustat, an oral hypoxia-inducible factor prolyl hydroxylase inhibitor, treats anemia by inducing endogenous erythropoietin production and increasing iron utilization via reducing hepcidin. Roxadustat efficacy has been shown in those with inflammation, as defined by baseline (BL) elevation of high sensitivity C-reactive protein (hsCRP). This pooled analysis explored the efficacy of roxadustat in correcting Hb in NDD-CKD and DD-CKD patients across the spectrum of BL hsCRP values.