Inflammatory Factors C-reactive Protein Research Articles

Gut microbiota and inflammatory factor characteristics in major depressive disorder patients with anorexia

BackgroundThis study aimed to explore the gut microbiota and inflammatory factor characteristics in major depressive disorder (MDD) patients with anorexia and to analyze the correlation between gut microbiota and inflammatory factors, anorexia, and HAMD scores.Methods46 MDD patients and 46 healthy controls (HC) were included in the study. The 46 MDD patients were divided into two groups according to whether they had anorexia:20 MDD without anorexia (MDA0 group) and 26 MDD with anorexia (MDA1 group). We used the Hamilton Depression Scale-24 (HAMD-24) to evaluate the depression status of all participants and 16 S ribosomal RNA (16 S rRNA)sequencing to evaluate the composition of the gut microbiota. Inflammatory factors in peripheral blood such as C-reactive protein (CRP) were detected using enzyme-linked immunosorbent assay (ELISA). Spearman’s correlation analysis was used to evaluate the correlation between gut microbiota and inflammatory factors, HAMD scores, and anorexia.Results1). CRP was significantly higher in the MDA0, MDA1, than HC. 2). An analysis of α-diversity shows: the Simpson and Pielou indices of the HC group are higher than the MDA1 group (P < 0.05). 3). The β-diversity analysis shows differences in the composition of microbial communities between the MDA0, MDA1, and HC group. 4). A correlation analysis showed that Blautia positively correlated with anorexia, HAMD scores, and CRP level, whereas Faecalibacterium, Bacteroides, Roseburia, and Parabacteroides negatively correlated with anorexia, HAMD scores, and CRP level. 5). The receiver operating characteristic (ROC) curve was drawn using the differential bacterial genera between MDD patients with or without anorexia as biomarkers to identify whether MDD patients were accompanied with anorexia, and its area under curve (AUC) was 0.85. The ROC curve was drawn using the differential bacterial genera between MDD patients with anorexia and healthy controls as biomarkers to diagnose MDD patients with anorexia, with its AUC was 0.97.ConclusionThis study suggested that MDD patients with anorexia had a distinct gut microbiota compared to healthy individuals, with higher level of CRP. Blautia was more abundant in MDD patients with anorexia and positively correlated with CRP, HAMD scores, and anorexia. The gut microbiota might have influenced MDD and anorexia through the inflammatory factor CRP.

Effects of omega-3 fatty acid supplementation on nutritional status and inflammatory response in patients with stage II-III NSCLC undergoing postoperative chemotherapy: a double-blind randomized controlled trial.

The primary objective of this study was to investigate the effects of oral omega-3 fatty acids in lowering the risk of malnutrition and improving the inflammatory response in patients with stage II-III lung cancer receiving postoperative chemotherapy. One hundred and three lung cancer patients identified as being at risk for malnutrition according to the 2002 nutritional risk screening criteria were randomized into either the omega-3 fatty acid supplementation group or the placebo group during postoperative chemotherapy. Data on anthropometric parameters, laboratory nutritional indicators, and inflammatory markers were collected, and changes and differences between the two groups were compared and analyzed. Sixty three patients were included in the final analysis. The baseline information of the two groups of patients was comparable (p > 0.05). After 12 weeks, patients in the treatment group exhibited significantly higher levels of hemoglobin (11.26 ± 1.25 vs.10.60 ± 0.94, p = 0.021) and serum albumin (45.38 ± 5.06 vs.42.66 ± 5.06, p = 0.036) compared with those in the placebo group. Meanwhile, the levels of inflammatory factors C-reactive protein (2.16 ± 1.06 vs. 4.11 ± 1.72, p < 0.001), interleukin-1 (6.61 ± 2.19 vs.10.85 ± 3.61, p < 0.001), interleukin-6 (2.48 ± 1.20 vs. 4.53 ± 0.98, p < 0.001), interleukin-8 (9.26 ± 2.69 vs. 39.01 ± 6.53, p < 0.001), and tumor necrosis factor-α (1.88 ± 0.60 vs. 4.07 ± 0.97, p < 0.001) were significantly decreased in the treatment group. In contrast, differences in weight, BMI, upper arm circumference, triceps skinfold thickness, triglycerides, cholesterol, and IFN-γ between the two groups were not statistically significant (p > 0.05). Finally, in the treatment group, the levels of hemoglobin (10.89 ± 1.15 vs. 11.82 ± 1.21, p = 0.042), triglyceride (0.92 ± 0.29 vs. 1.03 ± 0.22, p = 0.043), and cholesterol (3.56 ± 0.82 vs. 4.23 ± 0.88, p = 0.045) were higher in stage II patients after the intervention compared with stage III patients. Supplementation with omega-3 fatty acids improved nutritional status and reduced chronic inflammatory responses in patients with stage II-III non-small cell lung cancer undergoing postoperative chemotherapy. AEA RCT Registry, identifier AEARCTR-0007165.

Early Enteral Nutrition Facilitates Postoperative Recovery and Diminishes Complications in Patients Undergoing Laparoscopic Rectal Cancer Surgery

We have examined the effect of early enteral nutrition on postoperative recovery as well as the incidence of complications in patients undergoing laparoscopic rectal cancer surgery. The control group received traditional nursing care for postoperative nutrition, whereas the treatment group received early postoperative enteral nutrition. Relative to the control group, the postoperative anal exhaust time, first defecation time, first eating of solid food time, bowel sound recovery time, and hospital stay in the treatment group were shorter (P &lt; 0.05), nutrition-related indexes including serum total protein, albumin, and prealbumin were elevated (P &lt; 0.05), levels of serum inflammatory factors C-reactive protein, interleukin-6, and tumor necrosis factor-α were lower (P &lt; 0.05), peripheral blood CD3+, CD4+, and CD4+/CD8+ cells were elevated, while CD8+ cells were decreased (P &lt; 0.05). The incidence of postoperative complications in the treatment groups was lower relative to the control group (P &lt; 0.05). To sum up, early postoperative enteral nutrition can not only promote the immune function and nutritional status of patients undergoing laparoscopic rectal cancer surgery but also help reduce the postoperative inflammatory response and promote recovery.

Effect of statins on pulmonary function in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized controlled trials.

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease, and its treatment is still controversial. Statins have been proven to have anti-inflammatory and immunomodulatory effects, but their effectiveness in the treatment of COPD is still unclear. We conducted this meta-analysis to more accurately evaluate the therapeutic effect of statins on COPD patients. Randomized controlled studies published in PubMed, Cochrane Library, Embase, Wiley Online Library, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases from inception to July 2022 were retrieved to evaluate the effect of statins on COPD patients. Two evaluators conducted literature screening based on inclusion and exclusion criteria, and conducted a bias risk assessment on them. Meta analysis was conducted using Stata17.0 statistical software. A total of 1,463 patients from 10 studies were included. After statin treatment, the percentage of predicted forced expiratory volume in the first second (FEV1%pred) of COPD patients was improved [weighted mean difference (WMD): 7.89; 95% confidence interval (CI): 7.19-8.60; P<0.05], and the level of the inflammatory factor C-reactive protein (CRP) decreased (WMD: -0.63; 95% CI: -1.84, 0.58; P<0.05). The 6-minute walking distance (6MWD) of patients in the statin treatment group demonstrated a significant benefit (WMD: 26.27; 95% CI: 24.02-28.51; P<0.05). Compared to the placebo control group, statins significantly reduced COPD Assessment Test (CAT) (WMD: -2.45; 95% CI: -3.62, -1.27). Preliminary evidence suggests that statins may have a certain effect on improving lung function, reducing inflammatory factor levels, and improving clinical symptoms in COPD patients. However, due to the quality and quantity limitations of the included studies, these results need to be further verified through a larger, higher quality randomized controlled trial (RCT).

炎症因子C-反应蛋白和白介素-6在缺血性脑卒中的研究进展

炎症因子C-反应蛋白和白介素-6在缺血性脑卒中的研究进展

An ionic silver coating prevents implant-associated infection by anaerobic bacteria in vitro and in vivo in mice

Currently, implants are utilized clinically for bone transplant procedures. However, if infectious osteomyelitis occurs at implant sites, removal of bacteria can be challenging. Moreover, altered blood flow at peri-implant infectious sites can create an anaerobic environment, making it more difficult to treat infection with antibiotics. Thus, it would be beneficial if implants could be modified to exhibit antibacterial activity, even in anaerobic conditions. Here, we show antibacterial activity of silver ions coated on titanium rods, even against the anaerobic bacteria Porphyromonas gingivalis (P. gingivalis), both in vitro and in vivo. Specifically, we implanted silver-coated or control uncoated titanium rods along with P. gingivalis in mouse femoral bone BM cavities and observed significantly inhibited P. gingivalis infection with silver-coated compared with non-coated rods, based on in vivo bio-imaging. Osteonecrosis by infectious osteomyelitis and elevation of the inflammatory factors C-reactive protein and IL-6 promoted by P. gingivalis s were also significantly reduced in the presence of silver-coated rods. Overall, our study indicates that silver ion coating of an implant represents a therapeutic option to prevent associated infection, even in anaerobic conditions or against anaerobic bacteria.

Research on the Association Between Obstructive Sleep Apnea Hypopnea Syndrome Complicated With Coronary Heart Disease and Inflammatory Factors, Glycolipid Metabolism, Obesity, and Insulin Resistance

The aim of this study is to explore the association between obstructive sleep apnea hypopnea syndrome (OSAHS) complicated with coronary heart disease (CHD) and inflammatory factors, glycolipid metabolism, obesity, and insulin resistance. A total of 400 patients diagnosed with OSAHS who underwent polysomnography (PSG) monitoring in the Sleep Diagnosis and Treatment Center of Beijing Luhe Hospital from March 2015 to September 2018 were selected and divided into the OSAHS group (n = 200) and the OSAHS + CHD group (n = 200) according to disease condition. The questionnaire survey was conducted, the somatology indexes were measured, and the PSG, insulin, glycolipid metabolism parameters, and serum inflammatory factors were detected. Body weight, body mass index, waist circumference, and Epworth sleepiness scale (ESS) score were all significantly increased in the OSAHS + CHD group compared with those in the OSAHS group (p < 0.05). The microarousal index (MAI), apnea hypopnea index (AHI), cumulative percentage of time spent at oxygen saturation below 90% (CT90%), oxygen desaturation index (ODI), lowest oxygen saturation (LSaO2), total apnea time (TAT), and mean oxygen saturation (MSaO2) had statistically significant differences between the OSAHS + CHD group and the OSAHS group (p < 0.05). According to the Spearman correlation analysis of AHI, LSaO2, MSaO2, CT90%, ODI, and MAI with HOMA-IR in both groups, MAI, AHI, CT90%, and ODI were positively correlated with HOMA-IR (r > 0), while LSaO2 and MSaO2 were negatively correlated with HOMA-IR (r < 0). Compared with the OSAHS group, the OSAHS + CHD group had an obviously increased level of triglyceride (TG) (p < 0.05), and obviously increased levels of serum inflammatory factors C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interferon-γ (IFN-γ) (p < 0.05). The occurrence of OSAHS complicated with CHD is related to inflammatory factors, glycolipid metabolism, obesity rate, and HOMA-IR.

The Role of Slit-2 in Gestational Diabetes Mellitus and Its Effect on Pregnancy Outcome

BackgroundSlit guidance ligand 2 (Slit-2), as a member of the Slit family, can regulate the inflammatory response and glucose metabolism. The purpose of this study was to explore the expression of Slit-2 in maternal peripheral blood and neonatal cord blood of gestational diabetes mellitus (GDM) patients and its potential importance in disease progression.MethodsThis study included 57 healthy pregnant women and 61 GDM patients. The levels of Slit-2, C-reactive protein (CRP), monocyte chemoattractant protein-1 (MCP-1), C-peptide (C-P), galectin-3(Gal-3), HbA1c, fasting blood glucose (FBG) and fasting insulin (FINS) in maternal peripheral blood and neonatal cord blood were detected by ELISA. Spearman’s rank correlation test was used to assess the association between peripheral Slit-2 and inflammatory indicators, insulin resistance, and pregnancy outcomes. Logistic regression analysis was used to analyze the risk factors of GDM.ResultsSlit-2 levels in maternal peripheral blood and neonatal cord blood of the GDM patients were higher than those of the HC. Slit-2 levels in maternal peripheral blood and neonatal cord blood of the GDM patients were positively correlated with inflammatory factors CRP and MCP-1 levels. The level of Slit-2 in the maternal peripheral blood of the GDM patients was positively correlated with the level of homeostasis model assessment insulin resistance (HOMA-IR) and HbA1c in maternal peripheral blood, but was negatively correlated with the level of homeostasis model assessment –β (HOMA-β). We also found that the Slit-2 level in the maternal peripheral blood of the GDM patients was negatively correlated with neonatal blood glucose, positively correlated with neonatal weight and independent of neonatal total bilirubin.ConclusionOur study suggests that the abnormal increase in Slit-2 in GDM may be related to its pathogenesis, and it was correlated with neonatal blood glucose and weight in patients with GDM, suggesting that Slit-2 may be a potential biomarker of GDM.

Analysis of the Effect of Trastuzumab Combined with Docetaxel on Serum Tumor Markers in the Treatment of HER-2 Positive Breast Cancer and Factors Influencing Therapeutic Efficacy.

ObjectiveTo explore the influence of trastuzumab (TZ) combined with docetaxel (DTX) on serum tumor markers (TMs) in the treatment of human epidermal growth factor receptor 2-positive (HER-2+) breast cancer (BC) and to analyze the factors influencing therapeutic efficacy.MethodsNinety-six patients with HER-2+ BC treated in the First Affiliated Hospital of Anhui University Of Science and Technology from January 2019 to December 2020 were selected. According to different treatment plans, the patients were divided into two arms with 48 cases each. The control group (CG) was treated with DTX, and the research group (RG) was given TZ combined with DTX (TZ+DTX). The two arms were compared regarding the following aspects: curative effects, adverse reaction, alterations of TMs and inflammatory factors (IFs), and quality of life. Logistic regression analysis was performed to analyze the factors affecting the efficacy of patients.ResultsAfter treatment, the TMs carcinoembryonic antigen (CEA), carbohydrate antigen (CA)125 and CA15-3 were significantly lower in RG compared with CG. The levels of IFs C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) were also lower in CG. The overall response rate and the Karnofsky performance status (KPS) score were significantly higher in RG. No evident difference was observed in the total incidence of adverse reactions between the two arms. The high expression of CEA, CA125 and CA15-3 as well as DTX monotherapy increased the risk of adverse prognosis.ConclusionTZ+DTX can effectively improve the clinical efficacy of HER-2+ BC patients and reduce their levels of serum TMs and IFs.

Continuous renal replacement therapy in sepsis-associated acute kidney injury: Effects on inflammatory mediators and coagulation function

BackgroundTo explore the effect of continuous renal replacement therapy (CRRT) in patients with sepsis-associated acute kidney injury (SA-AKI) with the Acute Kidney Injury Network Classification III and its effect on inflammatory mediators and coagulation function. MethodsWe evaluated 90 patients who were diagnosed with sepsis and treated at our hospital. Forty patients received CRRT (group A) and the remainder received routine therapy (group B). We compared the renal function indices, represented by blood urea nitrogen (BUN) and serum creatinine (Scr), the urinary levels of kidney injury molecule 1, and the curative effect indices between the two groups. The incidence of major adverse cardiovascular events was compared between both groups. Further, the therapeutic effect (total effective rate) was evaluated and compared. ResultsAfter treatment, the levels of BUN and Scr in group A were significantly lower than those in group B (p < 0.05). Intensive care unit stay time was shorter in group A than in group B (p < 0.05). Further, the levels of the inflammatory factors C-reactive protein, tumor necrosis factor-α, interleukin 9, and interferon γ were lower in group A than in group B (p < 0.05). Lastly, the incidence of major adverse cardiovascular events was lower in group A than in group B, and the total effective rate was higher in group A than in group B (p < 0.05). Conclusion: In patients with SA-AKI, CRRT has a better therapeutic effect than routine therapy, which is worthy of clinical promotion.

Clinical Application of Serum Inflammatory Factors Combined with Dynamic Detection in the Diagnosis and Treatment of Neonatal Sepsis.

Background:To investigate the clinical application value of the combination of the inflammatory factors and dynamic detection in the diagnosis and treatment of neonatal sepsis by detecting serum inflammatory factor C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) levels before and after treatment of neonatal infection.Methods:A total of 138 neonates with different degrees of infection were randomly enrolled, including 88 cases in the sepsis group and 50 cases in the virus infection group. Another 50 non-infected newborns in the same period were enrolled as the normal control group. Venous blood of all subjects for CRP, PCT, IL-6 detection, and send bacterial blood culture for sepsis and virus infection groups were collected at the same time. In the recovery period, venous blood of children in sepsis group was collected again to review CRP, PCT, IL-6, and differences in each test index of each group were compared.Results:The serum CRP, PCT, IL-6 levels in the sepsis group were significantly higher than those in the virus infection group (all P <0.05); serum CRP, PCT, IL-6 levels in the sepsis group were significantly lower than before treatment (P <0.05); the sensitivity and accuracy of the combined detection of indicators for the diagnosis of neonatal sepsis were significantly improved.Conclusion:The inflammatory factors CRP, PCT, and IL-6 are closely related to the occurrence and development of neonatal sepsis. Combined detection can effectively improve the diagnostic accordance rate, which is beneficial to the early diagnosis and early clinical intervention of neonatal sepsis.

Clinical manifestations of blood cell parameters and inflammatory factors in 92 patients with COVID-19.

BackgroundAlthough there are many COVID-19 case series studies, few studies report the relationship between variations in blood cell parameters and inflammatory factors and disease severity. This study aims to describe the dynamic trends in COVID-19 blood cell parameters and inflammatory factors.MethodsNinety-two patients with confirmed COVID-19 at Jingzhou Central Hospital, Hubei Province, China, between January 23, 2020, and April 10, 2020, were enrolled. Epidemiological data, clinical information, and laboratory test results were collected and analyzed.ResultsAs patient age increased, disease severity increased (P<0.0001). The inflammatory factor C-reactive protein (CRP) showed a gradual increasing trend with disease aggravation. Based on dynamic change graphs, CRP in all patients with severe and critical COVID-19 initially increased and then decreased; however, CRP in patients with a good prognosis did not increase again after the initial decline (<20 mg/L). CRP in patients with a poor prognosis returned to a high level (>50 mg/L) 1 week after the initial decrease and continued to fluctuate at a high level. Lymphocyte count (LYM#) in patients with severe and critical disease was significantly lower (<1×109/L) than that in patients with moderate disease; LYM# was significantly increased 3 weeks after disease onset in patients with a good prognosis (>1×109/L), but patients with a poor prognosis continued to have a low LYM#.ConclusionsCRP and LYM# showed strong correlation with disease progression, suggesting that these parameters could be used to monitor changes in patient condition.

Atherosclerosis, inflammatory factor changes, cognitive disorder and vascular endothelial functions in patients with different grades of leukoaraiosis.

To study the atherosclerosis (AS), inflammatory factor level, cognitive disorder and vascular endothelial functions in patients with different grades of leukoaraiosis (LA), and to explore the correlations of different grades of LA with cognitive disorder. A total of 180 patients with cerebral infarction admitted and treated in the Department of Neurology of our hospital were selected, and they were graded according to the Tarvonen-shcolder standard, with 45 patients in each group. The atherosclerotic plaques of the patients were detected via a color Doppler ultrasound system and magnetic resonance imaging (MRI). Their inflammatory factor levels were determined using enzyme-linked immunosorbent assay (ELISA). The cognitive function was scored based on the mini-mental state examination (MMSE), and the levels of malondialdehyde (MDA), superoxide dismutase (SOD), endothelin (ET) and nitric oxide (NO) were measured to evaluate vascular endothelial functions. According to the comparisons among four groups of the patients, the incidence rate of AS was gradually increased among patients with different grades of LA (p < 0.05). With the aggravation of LA, the levels of inflammatory factors in patients were obviously increased (p < 0.05). LA patients had evidently lowered MMSE scores and levels of SOD and NO, but notably raised inflammatory factors C-reactive protein (CRP) and matrix metalloproteinase-9 (MMP-9) and vascular endothelial function indices MDA and ET (p < 0.05). The occurrence of LA is implicated with the increasing levels of inflammatory factors in the patients, aggregation of cognitive dysfunction and impairment vascular endothelial functions.

Correlations of Changes in Brain Natriuretic Peptide (BNP) and Cardiac Troponin I (cTnI) with Levels of C-Reactive Protein (CRP) and TNF-α in Pediatric Patients with Sepsis.

BackgroundThis study investigated the changes in plasma brain natriuretic peptide (BNP) and cardiac troponin I (cTnI) levels in pediatric patients with sepsis, and explored their relationships with serum inflammatory factors in pediatric patients.Material/MethodsA total of 120 pediatric patients with sepsis admitted to and treated at our hospital from 2013 to 2017 were divided into 4 groups: a systemic inflammatory response syndrome (SIRS) group (n=28), a sepsis group (n=35), a severe sepsis group (n=27), and a septic shock group (n=30). Plasma BNP, cTnI, and creatine kinase-MB (CK-MB) levels in pediatric patients in the 4 groups were measured, and the correlations of BNP and cTnI with plasma inflammatory factors C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-α) were investigated.ResultsThe plasma BNP and cTnI levels in pediatric patients with sepsis were significantly higher than those in the SIRS group (p<0.05). After hospitalization and treatment, levels of BNP and cTnI in pediatric patients were decreased. The concentrations of BNP and cTnI were correlated with CRP level (r=0.88 and 0.88, respectively). The associations (r value) of BNP and cTnI with TNF-α levels were 0.35 and 0.48, respectively.ConclusionsThe levels of plasma BNP and cTnI are associated with the severity of sepsis in pediatric patients, and were positively correlated with CRP and TNF-α levels, which provides a novel strategy for the early diagnosis and evaluation of sepsis in pediatric patients.

A Nomogram based on Inflammatory Factors C-Reactive Protein and Fibrinogen to Predict the Prognostic Value in Patients with Resected Non-Small Cell Lung Cancer.

Purpose: This study aimed to develop an effective nomogram for predicting survival in surgically treated non-small cell lung cancer patients.Methods: We retrospectively evaluated 856 NSCLC in this study. Cox regression analyses were performed to identify significant prognostic factors for developing a nomogram to predict overall survival (OS). The discriminative ability was assessed with the concordance index (C-index).Results: On multivariate analysis of the 856 cohort, independent factors for survival were CRP, fibrinogen, tumor status, nodal status, distant metastasis and clinical stage, which were entered into the nomogram. The C-index of the established nomogram 0.720 (95% CI: 0.671-0.769) was higher than that of the seventh edition TNM staging system 0.689 (95% CI: 0.668-0.709) for predicting OS (P < 0.05). Compared with patients with low CRP levels (< 8.6 g/L) and low fibrinogen levels (< 3.7 g/L), patients with high CRP and fibrinogen levels had shorter OS. Subgroup analyses revealed that the nomogram was a favorable prognostic parameter in stage I-IV NSCLC (P < 0.05).Conclusion: A nomogram integrating CRP and fibrinogen, which could be convenient and feasible to obtain from the serum preoperatively, may assist in risk stratification for individual patient with resected NSCLC.

Association of dietary fatty acids intake with pro-coagulation and inflammation in Saudi Adults.

The aim of the study was to understand whether dietary fatty acids such as saturated, polyunsaturated, and monounsaturated fatty acids act as inflammatory mediators or influence pro-coagulation in Saudi adults. The study sought to examine inflammatory factors such as C-reactive protein, tumor necrosis factor-alpha and activated plasminogen activator inhibitor 1. A total number of 232 consenting Saudi adults, aged 18-60 years were randomly selected in this cross-sectional study. Independent Student t-test was done to compare means of normally distributed data. Spearman correlation between the variables was determined. The values of different fatty acids and adipokines were transformed logarithmically/square root to normalize data before correlations were determined and statistical analyses performed. Statistical significance was set at p<0.05. The results show a significant positive correlation of dietary intake of poly and monounsaturated fatty acids, but not saturated fatty acids, with activated plasminogen activator inhibitor 1 (r=0.31, p=0.02, r=0.32 p=0.04). On the other hand, dietary intake of saturated fatty acids showed a negative correlation with serum C-reactive protein levels (p=0.001) in males. Dietary unsaturated fatty acids is possibly associated with the production of a pro-coagulation factor without enhancing the secretion of pro-inflammatory molecules, while saturated fatty acids have no effect on activated plasminogen activator inhibitor 1, but their level is negatively associated with the inflammatory factor C-reactive protein. We conclude that dietary intake may exert a gender-specific effect in inflammatory processes among adults. Further studies are warranted to confirm present findings.

Obesity Is a Major Determinant of the Association of C-Reactive Protein Levels and the Metabolic Syndrome in Type 2 Diabetes

The inflammatory factor C-reactive protein (CRP) and the fibrinolytic variables fibrinogen and plasminogen activator-1 (PAI-1) are associated with long-term cardiovascular morbidity. To determine the contribution of body adiposity (BMI), insulin sensitivity (homeostasis model assessment of insulin resistance [HOMA-IR], and glycemia (HbA(1c) [A1C]) to the levels of these inflammatory and fibrinolytic variables in recently diagnosed (<or=3 years), drug-naive, type 2 diabetic subjects (fasting plasma glucose <or=10 mmol/l), we examined a representative subgroup (n = 921) of the U.S. cohort in ADOPT (A Diabetes Outcome Progression Trial). The relationship between levels of CRP, fibrinogen, PAI-1 antigen and PAI-1 activity, and baseline variables including National Cholesterol Education Program Adult Treatment Panel III metabolic syndrome phenotype were explored. All four factors increased significantly with increasing numbers of metabolic syndrome components (P = 0.0136 to P < 0.0001). BMI (P < 0.0001) and HOMA-IR (P < 0.0001) but not A1C (P = 0.65) increased with increasing numbers of metabolic syndrome components. Adjustment of CRP levels for BMI eliminated the association between CRP and the number of metabolic syndrome components, while adjusting for HOMA-IR did not (P = 0.0028). The relationships of PAI-1 antigen and PAI-1 activity with the number of metabolic syndrome components were maintained after adjusting for BMI (P = 0.0002 and P = <0.0001, respectively) or HOMA-IR (P = 0.0008 and P = <0.0001, respectively), whereas that with fibrinogen was eliminated after adjusting for BMI but not after adjusting for HOMA-IR (P = 0.013). Adjustment for A1C had no effect on any of the relationships between the inflammatory and fibrinolytic factors and the metabolic syndrome. We conclude that in recently diagnosed, drug-naive type 2 diabetic subjects, markers of inflammation and fibrinolysis are strongly related to the number of metabolic syndrome components. Further, for CRP and fibrinogen this relationship is determined by body adiposity and not by insulin sensitivity or glucose control.