Markers Of Inflammation In Adults Research Articles

Blueberry Consumption and Exercise: Gap Analysis Using Evidence Mapping.

Objective: Strenuous muscular workouts can increase markers of inflammation that can potentially damage components of skeletal muscles. Blueberries contain a variety of nutrients and phytochemicals that have individually been related to reduction in oxidative stress and inflammation. The objective was to conduct a systematic overview using evidence mapping to identify research-dense and evidence gap areas that examine the impact of blueberry consumption on exercise performance and inflammatory markers in adults. Design: The authors searched Medline, Cochrane Central, and Commonwealth Agricultural Bureau for literature published between 1946 and September 2019. Abstracts and full-text publications were screened in duplicate for studies that evaluated outcomes related to metabolism, lipoprotein, muscle damage, markers of oxidative stress, inflammatory markers, or gait after participants consumed blueberries and were subjected to some form of exercise. Results: The authors found nine randomized controlled trials, one single-arm study, and one observational study that met the eligibility criteria. Inflammatory markers, F2-isoprostanes, and gait speed were the most frequently reported outcomes, with each one reported by at least three studies. Outcomes related to metabolism, lipoproteins, muscle damage, and most markers of oxidative stress and most gait-related outcomes were each reported by one study. Intervention trials were generally conducted with a small number of participants and the majority included mostly younger individuals. Using multivariate analysis, the sole observational study examined physical ability among participants who consumed higher doses of blueberries compared with participants who consumed a half cup of blueberries less than once a month. Conclusions: Evidence mapping found that further research in both randomized controlled trials and cohort studies examining the impact of blueberry consumption on exercise performance and inflammatory markers is needed to establish an association.

Antiretroviral therapy reduces but does not normalize immune and vascular inflammatory markers in adults with chronic HIV infection in Kenya.

Markers of monocyte/macrophage activation and vascular inflammation are associated with HIV-related cardiovascular diseases (CVD) and mortality. We compared these markers among African people living with HIV (PLWH) and HIV-negative adults, and examined risk factors associated with elevated biomarkers (>75th percentile) in PLWH on antiretroviral therapy (ART). Cross-sectional study. We measured serum concentrations of a gut integrity biomarker (intestinal-fatty acid binding protein), monocyte/macrophage activation biomarkers (soluble CD14 and CD163), and vascular inflammation biomarkers [soluble intercellular adhesion molecule 1 (sICAM-1) and soluble vascular adhesion molecule 1 (sVCAM-1)]. We assessed the relationship of these inflammatory parameters with HIV, using logistic regression adjusting for traditional CVD risk factors. Among the 541 participants, median age was 43 years and half were female. Among 275 PLWH, median CD4 T-cell count and duration of ART use was 509 cells/μl and 8 years, respectively. PLWH had significantly higher prevalence of elevated inflammatory biomarkers compared with HIV-negative individuals even after adjustment for traditional CVD risk factors. Compared with individuals without HIV, the prevalence of elevated biomarkers was highest among persons with detectable viral load and CD4 T-cell counts 200 cells/μl or less. In a subanalysis among PLWH, nadir CD4 T-cell count 200 cells/μl or less was associated with elevated soluble CD14 (sCD14); dyslipidemia with elevated sCD14, sICAM-1, and sVCAM-1; and overweight/obesity with reduced sCD14. Longer ART exposure (>4 years) was associated with reduced sVCAM-1 and sICAM-1. HIV and not traditional CVD risk factors is a primary contributor of monocyte/macrophage activation and inflammation despite ART. Anti-inflammatory therapies in addition to ART may be necessary to reduce these immune dysregulations and improve health outcomes of African PLWH.

Protocol for systematic review and meta-analysis: impact of statins as immune-modulatory agents on inflammatory markers in adults with chronic diseases

IntroductionStatins, also known as 3-hydroxy-3-methylglutaryl coenzyme-A (HMG-CoA) reductase inhibitors, are lipid-lowering agents that are central in preventing or reducing the complications of atherosclerotic cardiovascular disease. Because statins have anti-inflammatory properties,...

How do early socioeconomic circumstances impact inflammatory trajectories? Findings from Generation XXI

BackgroundThe association between socioeconomic position and markers of inflammation in adults, including C-reactive protein (CRP), is well-established. We hypothesized that children from families of less-advantaged socioeconomic circumstances may be at higher inflammatory risk during childhood and, consequently, throughout their life course. Thus, we aimed to investigate whether early socioeconomic circumstances impact CRP trajectories using repeated measures of data from a population-based birth cohort. MethodsData from 2510 participants of Generation XXI, a prospective Portuguese population-based birth cohort, were included in this study. Early socioeconomic circumstances comprised maternal education and occupation, paternal education and occupation, and household income at the child’s birth. Venous blood samples were collected from the children at ages four, seven, and ten years, and high-sensitivity CRP (Hs-CRP) was quantified. Hs-CRP trajectories were computed using a linear mixed-model approach. ResultsParticipants from less-advantaged socioeconomic circumstances presented higher levels of Hs-CRP by age of ten years. The higher the mother´s education and disposable household income, the lower the minimum value of the log Hs-CRP observed throughout childhood. Further, the age at which that minimum log Hs-CRP value was reached occurs later, meaning that children born in more-advantaged socioeconomic circumstances had lower levels of log Hs-CRP compared with children from less-advantaged families. ConclusionsPoor socioeconomic circumstances early in life are associated with increased inflammation levels throughout the first decade of life. This study demonstrates that social inequalities may impact population health beginning at very early ages.

Trends of Fecal Calprotectin and Lactoferrin Results for Infants

Abstract Calprotectin and lactoferrin can be measured in stool to test for inflammation in the gastrointestinal tract associated with inflammatory bowel disease (IBD) versus irritable bowel syndrome (IBS). The clinical specificity of these markers decreases in children versus adults because of the broader differential diagnosis for intestinal inflammation in children. Surprisingly, these tests are frequently ordered for infants (age = 0 years). Therefore, we wanted to assess our historical data in order to understand how infant calprotectin and lactoferrin concentrations change over time and review literature for the potential differential diagnosis for intestinal inflammation in infants. Data were analyzed on 19,543 infants/toddlers ages 0 to 2 years who had a stool test result of either the quantitative ELISA calprotectin PhiCal assay (Eurospital) or qualitative ELISA Lactoferrin Chek assay (Techlab). For the quantitative calprotectin test, the averages and medians were graphed over time in infants. And for the qualitative lactoferrin test, the positivity rate was graphed over time in infants. Both were compared to toddlers of ages 1 to 2 years old. The average level of calprotectin in neonates (0-1 months old) was 336 ± 348 μg/g with a median of 192 μg/g. While these values were dramatically above the adult normal reference range of 0 to 50 μg/g, the average level decreased over time to 119 ± 218 μg/g with a median of 39 μg/g for toddlers 2 years old. The presence of elevated lactoferrin was detected in 89% of neonates versus 34% of toddlers age 2 years. These trends demonstrate that both calprotectin and lactoferrin may be elevated early in life for many infants, but rapidly decline with time. Ordering trends show that, for infants/toddlers age 0 to 2 years, fecal calprotectin ordering has grown rapidly, whereas fecal lactoferrin has remained stable. In conclusion, while fecal calprotectin and lactoferrin are widely used markers of pathologic intestinal inflammation in adults, results in infants must be interpreted with great care. An elevated calprotectin or lactoferrin concentration in infant stool may be pathological, perhaps due to necrotizing enterocolitis or food-associated enteropathy, but is also associated with nonpathological reasons such as intestinal exposure to food antigens or commensal bacteria. Literature studies have shown associations of elevated calprotectin or lactoferrin with diet, gestational age at birth, and even mode of delivery. Thus, it is essential that clinicians interpret calprotectin levels or the presence of elevated lactoferrin in the context of the entire clinical picture and understand the lack of specificity of these markers for pathological conditions in infants.

Relationship between serum alkaline phosphatase level, C-reactive protein and leukocyte counts in adults aged 60 years or older

Serum alkaline phosphatase (ALP), a useful marker of hepatobiliary or bone disorders, has been known to be associated with cardiovascular disease (CVD), which is increasingly being viewed as an inflammatory disease. C-reactive protein level and leukocyte count have also been highlighted as independent risk markers of CVD. Thus, the mechanism underlying the link between elevated ALP and CVD could be subclinical low-grade inflammation. This study aimed to examine associations of serum ALP level with inflammatory markers. This cross-sectional study included 2403 participants (1324 men and 1079 women) aged ≥60 years who participated in a health examination program. Serum ALP quartiles were categorized as follows: Q1: ≤51, Q2: 52–61, Q3: 62–74 and Q4: ≥75 U/L. The odds ratios (ORs) and 95% confidence intervals (CIs) for high CRP and leukocyte count (≥75th percentiles) were calculated after adjusting for confounding variables across serum ALP quartiles using multiple logistic regression analysis. Median CRP level and mean leukocyte count increased in accordance with serum ALP quartiles. Compared to the lowest quartile, the ORs (95% CI) of the highest quartile for high CRP and leukocyte count were 2.03 (1.50–2.76) and 1.54 (1.13–2.10) after adjusting for age, sex, body mass index, smoking status, alcohol intake, fasting plasma glucose, log-transformed triglyceride and HDL-cholesterol levels. Serum ALP level was positively and independently associated with inflammatory markers in adults aged 60 years or older.

Systemic inflammatory markers associated with cardiovascular disease and acute and chronic exposure to fine particulate matter air pollution (PM2.5) among US NHANES adults with metabolic syndrome

BackgroundThere has been no investigation to date of adults with metabolic syndrome examining the association of short and long-term exposure to fine particulate matter (PM2.5) air pollution with cardiovascular-disease related inflammatory marker (WBC and CRP) levels in a nationally representative sample. The goal of this study is to assess the susceptibility of adults with metabolic syndrome to PM2.5 exposure as suggested by increased cardiovascular-disease related inflammatory marker levels. MethodsA cross sectional analysis of adult National Health and Nutrition Examination Survey (NHANES) participants (2000–2008) was carried out with linkage of CDC WONDER meteorological data and downscaler modeled USEPA air pollution data for census tracts in the continental United States.Participants were non-pregnant NHANES adults (2000–2008) with complete data for evaluating presence of metabolic syndrome and laboratory data on WBC and CRP. Exposures studied included short (lags 0–3 days and their averages), long-term (30 and 60 day moving and annual averages) PM2.5 exposure levels at the census tract level in the continental United States. The main outcomes included CRP and WBC levels the day of NHANES study visit analyzed using multiple linear regression, adjusting for age, gender, race, education, smoking status, history of any cardiovascular disease, maximum apparent temperature and ozone level, for participants with and without metabolic syndrome. ResultsA total of 7134 NHANES participants (35% with metabolic syndrome) met the inclusion criteria. After adjusting for confounders, we observed a significant effect of PM2.5 acutely at lag day 0 on CRP level; a 10µg/m3 rise in lag day 0 PM2.5 level was associated with a 10.1% increase (95% CI: 2.2–18.6%) in CRP levels for participants with metabolic syndrome. For those without metabolic syndrome, the change in CRP was −1.3% (95% CI −8.8%, 6.8%). There were no significant associations for WBC count.In this first national study of the effect of PM2.5 air pollution on levels of cardiovascular-disease related inflammatory markers in adults with metabolic syndrome, CRP levels were found to be significantly increased in those with this condition with increased fine particulate matter levels at lag day 0. With one third of US adults with metabolic syndrome, the health impact of PM2.5 in this sensitive population may be significant.

Antioxidants from diet or supplements do not alter inflammatory markers in adults with cardiovascular disease risk. A pilot randomized controlled trial

Antioxidants have been reported to have anti-inflammatory effects, but there is a lack of research comparing food to supplement antioxidant sources. The aim of this study was to determine if increases in intake of foods naturally rich in antioxidants would lower blood levels of inflammatory markers more than consuming antioxidant supplements among adults with cardiovascular disease risk factors. Eighty-eight generally healthy adults with ≥1 elevated risk factor for cardiovascular disease were randomized in a single-blind (diets)/double-blind (supplements), parallel-group study for 8 weeks. Participants consumed (1) usual diet and placebo pills (n = 29), (2) usual diet and antioxidant supplements (n = 29), or (3) antioxidant-rich foods closely matched to antioxidant content of supplements and placebo (n = 30). Usual diet combined with antioxidant supplements or increased antioxidant-rich food intake was designed to approximately double daily habitual antioxidant intake. Antioxidant pills included carotenoids, mixed tocopherols, vitamin C, and selenium. Fasting blood samples were analyzed for inflammatory marker concentrations of interleukin-6, monocyte chemotactic protein-1, and soluble intercellular adhesion molecule-1. Participants in the intervention groups successfully doubled most antioxidants as verified by diet records and elevated blood concentrations in treatment groups. Baseline levels of inflammatory markers for the entire study group were 110 ± 65 pg/mL for monocyte chemotactic protein-1, 0.9 ± 0.7 pg/mL for interleukin-6, and 217 ± 56 ng/mL for soluble intercellular adhesion molecule-1 (means ± standard deviation) and did not differ by treatment arm. After 8 weeks, there were no significant within-group changes or between-group 8-week change differences in inflammatory marker concentrations. In conclusion, no beneficial effects were detected on the inflammatory markers investigated in response to antioxidants from foods or supplements.

Impact of vitamin D supplementation on endothelial and inflammatory markers in adults: A systematic review

This systematic review aims to evaluate randomised controlled trials (RCTs) investigating the effect of vitamin D supplementation on endothelial function and inflammation in adults. An electronic search of published randomised controlled trials, using Cochrane, Pubmed and Medline databases was conducted, with the search terms related to vitamin D and endothelial function. Inclusion criteria were RCTs in adult humans with a measure of vitamin D status using serum/plasma 25(OH)D and studies which administered the intervention through the oral route. Among the 1107 studies retrieved, 29 studies met the full inclusion criteria for this systematic review. Overall, 8 studies reported significant improvements in the endothelial/inflammatory biomarkers/parameters measured. However, in 2 out of the 8 studies, improvements were reported at interim time points, but improvements were absent post-intervention. The remaining 21 trial studies did not show significant improvements in the markers of interest measured. Evidence from the studies included in this systematic review did not demonstrate that vitamin D supplementation in adults, results in an improvement in circulating inflammatory and endothelial function biomarkers/parameters. This systematic review does not therefore support the use of vitamin D supplementation as a therapeutic or preventative measure for CVD in this respect.

Effect of topical beclomethasone on inflammatory markers in adults with eosinophilic esophagitis: A pilot study.

Background:Topical corticosteroids have proven efficacy in the treatment of eosinophilic esophagitis (EoE) and are considered the cornerstone of therapy.Objective:To evaluate the effect of topical beclomethasone dipropionate (BDP) therapy on clinical outcomes, esophageal eosinophilia, and other markers of inflammation in patients with EoE.Methods:Nine subjects with a biopsy-proven diagnosis of EoE were enrolled. In a cross-over design, the subjects were randomly assigned to a sequence of BDP and placebo. Treatment periods were 8 weeks, with a 4-week washout period. The subjects had endoscopic biopsies and blood tests at baseline and after each treatment period. They were instructed to maintain a diary of symptoms. Immuno-histochemical studies were performed for interleukins IL-4, IL-5, IL-13, granulocyte-macrophage colony-stimulating factor (GM-CSF), and transforming growth factor (TGF) beta. Reverse transcription polymerase chain reaction was performed for IL-3, IL-4, IL-5, IL-10, IL-13, IL-17F, IL-25, IL-33, chemokine ligands (CCL)2, CCL5, CCL11, GM-CSF, and TGF-beta levels. The mast cell tryptase (MCT) level was measured in esophageal tissues.Results:BDP led to a significantly larger decrease in esophageal eosinophilia compared with placebo, but there was no significant change in peripheral eosinophilia and high-sensitivity C-reactive protein between the two groups. The study was not powered enough for us to report a significant improvement in clinical symptoms. There was a significant decrease in tissue IL-13 and MCT levels from baseline to the end of treatment between the treatment and placebo groups. Mean fold decreases in cytokine expression between the baseline and treatment groups were observed for IL-17F, IL-25, CCL2, and CCL5.Conclusion:Treatment with topical BDP was associated with significant decrease in esophageal eosinophilia, MCT and IL-13. BDP is a potential alternative to fluticasone propionate and budesonide for treatment of EoE. Larger studies are needed to validate these findings.

Sedentary time and markers of inflammation in people with newly diagnosed type 2 diabetes

Background and aimsWe investigated whether objectively measured sedentary time was associated with markers of inflammation in adults with newly diagnosed type 2 diabetes. Methods and resultsWe studied 285 adults (184 men, 101 women, mean age 59.0 ± 9.7) who had been recruited to the Early ACTivity in Diabetes (Early ACTID) randomised controlled trial. C-reactive protein (CRP), adiponectin, soluble intracellular adhesion molecule-1 (sICAM-1), interleukin-6 (IL-6), and accelerometer-determined sedentary time and moderate-vigorous physical activity (MVPA) were measured at baseline and after six-months. Linear regression analysis was used to investigate the independent cross-sectional and longitudinal associations of sedentary time with markers of inflammation.At baseline, associations between sedentary time and IL-6 were observed in men and women, an association that was attenuated following adjustment for waist circumference. After 6 months of follow-up, sedentary time was reduced by 0.4 ± 1.2 h per day in women, with the change in sedentary time predicting CRP at follow-up. Every hour decrease in sedentary time between baseline and six-months was associated with 24% (1, 48) lower CRP. No changes in sedentary time between baseline and 6 months were seen in men. ConclusionsHigher sedentary time is associated with IL-6 in men and women with type 2 diabetes, and reducing sedentary time is associated with improved levels of CRP in women. Interventions to reduce sedentary time may help to reduce inflammation in women with type 2 diabetes.

Associations between urinary soy isoflavonoids and two inflammatory markers in adults in the United States in 2005–2008

The aim of this study was to determine the association between urinary isoflavonoid (genistein, daidzein, and the daidzein metabolites O-desmethylangolensin (O-DMA) and equol) excretion and markers of inflammation in adults in the United States in National Health and Nutrition Examination Survey (NHANES) 2005-2008. The NHANES is a cross-sectional study conducted by the National Center for Health Statistics to study the health and nutritional status of people living in the United States. The analysis included 1,683 participants from study years 2005-2008 for whom urinary isoflavonoids were measured and who met inclusion criteria. Urinary isoflavonoids were measured by HPLC-APPI-MS/MS. Serum C-reactive protein (CRP) was measured by latex-based nephelometry. White blood cell (WBC) count was measured by Coulter counting. Multivariable linear regression was used to calculate the geometric mean values of the markers, and multivariable logistic regression was used to estimate the odds of high CRP (≥3 mg/L) and of high WBC count (≥7,900/μL) by quartile of urinary isoflavonoid (nmol/mg creatinine). The highest quartile of genistein (OR = 0.62; 95 % CI 0.39-0.99) was associated with significantly decreased odds of high CRP compared with the lowest quartile. The sum of daidzein and its metabolites was significantly inversely associated with serum CRP concentration (p-trend = 0.017). Equol was inversely associated with WBC count (p-trend < 0.0001). O-DMA was the only isoflavonoid whose excretion was significantly associated with a decrease in both CRP (p-trend = 0.024) and WBC count (p-trend < 0.0001). Though no clear pattern emerged, higher excretion of certain soy isoflavonoids was associated with decreased CRP concentration and WBC counts, suggesting a possible inverse association between soy intake and inflammation.

Associations between urinary soy isoflavones and inflammatory markers in adults in the United States in 2005–2008

We aimed to determine the association between urinary isoflavones and blood markers of inflammation in US adults using NHANES 2005–2008 (n=1683). Multivariable logistic regression was used to calculate geometric mean serum C‐reactive protein (CRP) concentrations and white blood cell counts (WBC) and to estimate the odds of high CRP (≥3mg/L) and of high WBC (≥7,900/μL) by quartile of urinary genistein (GEN), daidzein (DAZ), Odesmethylangolensin (O‐DMA), and equol. The highest quartile of GEN and third quartile of DAZ were associated with significantly decreased odds of high CRP compared to the lowest quartile (OR GEN: 0.62; 95% CI: 0.39–0.99 and OR DAZ: 0.59; 95% CI: 0.35– 0.98). The sum of DAZ, O‐DMA and equol was significantly associated with decreased CRP concentrations (p‐trend = 0.017). Increasing equol was associated with decreased WBC (p‐trend &lt;0.0001). O‐DMA was the only isoflavone whose excretion was significantly associated with a decrease in both inflammation markers (p‐trend CRP = 0.024, p‐trend WBC &lt;0.0001). These results suggest a possible inverse association between soy isoflavones and inflammation.Support: NIH/JHSPH

Impact of vitamin D supplementation on markers of inflammation in adults with cystic fibrosis hospitalized for a pulmonary exacerbation

Patients with cystic fibrosis (CF) suffer from chronic lung infection and inflammation leading to respiratory failure. Vitamin D deficiency is common in patients with CF, and correction of vitamin D deficiency may improve innate immunity and reduce inflammation in patients with CF. We conducted a double-blinded, placebo-controlled, randomized clinical trial of high-dose vitamin D to assess the impact of vitamin D therapy on antimicrobial peptide concentrations and markers of inflammation. We randomized 30 adults with CF hospitalized with a pulmonary exacerbation to 250,000 IU of cholecalciferol or placebo, and evaluated changes in plasma concentrations of inflammatory markers and the antimicrobial peptide LL-37 at baseline and 12 weeks post intervention. In the vitamin D group, there was a 50.4% reduction in tumor necrosis factor-α (TNF-α) at 12 weeks (P<0.01), and there was a trend for a 64.5% reduction in interleukin-6 (IL-6) (P=0.09). There were no significant changes in IL-1β, IL-8, IL-10, IL-18BP and NGAL (neutrophil gelatinase-associated lipocalin). We conclude that a large bolus dose of vitamin D is associated with reductions in two inflammatory cytokines, IL-6 and TNF-α. This study supports the concept that vitamin D may help regulate inflammation in CF, and that further research is needed to elucidate the potential mechanisms involved and the impact on clinical outcomes.

Low- and High-Dose Plant and Marine (n-3) Fatty Acids Do Not Affect Plasma Inflammatory Markers in Adults with Metabolic Syndrome

Chronic inflammation is considered to play a role in the development of cardiovascular disease. Various (n-3) fatty acids (FA) have been reported to have antiinflammatory effects, but there is a lack of consensus in this area, particularly in regard to optimal source(s) and dose(s). This study aimed to determine the effects of high and low doses of (n-3) FA from plant and marine sources on plasma inflammatory marker concentrations. One-hundred adults with metabolic syndrome were randomly assigned to a low or high dose of plant- (2.2 or 6.6 g/d a-linolenic acid) or marine- (1.2 or 3.6 g/d EPA and DHA) derived (n-3) FA or placebo for 8 wk, using a parallel arm design (n= 20/arm). Fasting blood samples collected at 0, 4, and 8 wk were analyzed for concentrations of monocyte chemotactic protein-1 (MCP-1), IL-6, and soluble intercellular adhesion molecule-1 (sICAM-1) and for cardiovascular risk factors. Baseline concentrations across all 5 groups combined were (mean ± SD) 103 ± 32 ng/L for MCP-1, 1.06 ± 0.56 ng/L for IL-6, and 0.197 ± 0.041 ng/L for sICAM-1. There were no significant differences in 8-wk changes in plasma inflammatory marker concentrations among the 5 groups. Plasma TG and blood pressure decreased significantly more and the LDL cholesterol concentration increased more in the high-dose fish oil group compared to the 8-wk changes in some of the other 4 groups (P= 0.04). In conclusion, no beneficial effects were detected for any of the 3 inflammatory markers investigated in response to (n-) FA in adults with metabolic syndrome regardless of dose or source.

Inflammatory markers and secondhand tobacco smoke exposure among U.S. workers.

Self-reported exposure to secondhand smoke (SHS) has been associated with elevated inflammatory markers in adults. The association between SHS indicated by serum cotinine and markers of inflammation has not been investigated in adult workers. Using the subpopulation of employed participants (20 years and older) who were non-smokers and denied home SHS exposure from the National Health and Nutrition Examination Survey (NHANES) 1999-2002, the association between serum cotinine and inflammatory markers (C-reactive protein, fibrinogen, homocysteine, and white blood cells) was analyzed. Inflammatory marker values were log-transformed and expressed as geometric means with 95% confidence intervals (CI). Serum cotinine was categorized as either no cotinine (below the detection limit), low cotinine (above the detection limit and <0.2 ng/ml), or high cotinine (>or=0.2 and <15.0 ng/ml). The association between serum cotinine and inflammatory markers was analyzed using univariate and multivariate-adjusted linear regression. Geometric mean serum cotinine was significantly higher among non-smokers reporting SHS exposure in the workplace (0.17 vs. 0.10 ng/ml, P < 0.01). Workers exposed to low and high levels of cotinine had significantly higher homocysteine levels relative to non-exposed workers; mean homocysteine differences remained significant in the multivariable model (i.e., 0.363 and 0.491 mg/dl increase, respectively). Exposure to SHS as measured by serum cotinine may result in increased homocysteine levels among adult workers. These results provide further evidence in support of universal workplace smoking restrictions in order to protect worker health. Further research is required to determine the adverse effects of workplace SHS exposure on cardiovascular risk.

Association between cigarette smoking and C-reactive protein in a representative, population-based sample of adolescents

Although related to inflammatory markers in adults, little is known about the association between cigarette smoking and C-reactive protein (CRP) in adolescent smokers. We examined the association between high-sensitivity CRP (hs-CRP) concentrations and smoking in youth. We used data from a cross-sectional, province-wide survey of a representative sample of youth conducted in Quebec, Canada, in 1999. Data were collected in self-report questionnaires completed by participants and their parents. Participants provided a fasting blood sample, and anthropometric measures were undertaken by trained technicians. The present analysis pertains to 1,501 adolescents aged 13 and 16 years who completed questionnaires and for whom blood samples were available. The independent association between a six-category indicator of smoking status and elevated hs-CRP, defined as a value at least in the 90th percentile of the age- and sex-specific CRP distribution, was assessed in multiple logistic regression analyses controlling for potential confounders. Relative to never-smokers, the odds ratios (95% confidence intervals) for puffers (i.e., never smoked a whole cigarette), those who smoked but not in the past month, light past-month smokers, moderate past-month smokers, and heavy past-month smokers were 1.04 (0.55-1.98), 1.76 (1.06-2.94), 1.39 (0.70-2.76), 2.07 (0.96-4.42), and 2.40 (1.18-4.88), respectively. Our data suggest a positive association between smoking status and elevated CRP in adolescents, and in particular among heavier past-month smokers. Damage related to cigarette smoking may begin soon after tobacco use initiation, reinforcing the preventive message that no level of smoking is safe in youth.

Inflammatory Markers in Adults with Prader-Willi Syndrome before and during 12 Months Growth Hormone Treatment

Background: In Prader-Willi syndrome (PWS) obesity and partial growth hormone (GH) deficiency are frequently observed. The risks of cardiovascular diseases and early death are increased. We examined inflammatory markers in adult PWS, before and during 12 months of GH treatment. Method: Twelve PWS adults, median age 23.5 years (17–37) and median BMI 33.8 kg/m² (21.2–50.4), participated. Serum interleukin-6, tumour necrosis factor α, high sensitive protein C-reactive protein (HCRP), cholesterol, triglycerides, leptin, adiponectin, glucose, insulin, insulin-like growth factor I and body composition were measured at baseline and after 6 and 12 months of GH treatment. Results: Median and range at baseline for interleukin-6 was 9.87 ng/l (1.76–10.72), for tumour necrosis factor α 2.39 ng/l (1.00–3.26) and for HCRP 7.64 mg/l (0.41–41.1) (normal values < 5 ng/l, < 8 ng/l and<5 mg/l, respectively). At baseline correlations between inflammatory markers and age, anthropometry, body composition and the metabolic parameters were non-significant; only positive associations were found between tumour necrosis factor α and body weight (r = 0.617, p = 0.033) and between HCRP and BMI (r = 0.594, p = 0.041). GH treatment non-significantly decreased the levels of the inflammatory markers. Conclusion: In this pilot study, levels of interleukin-6 and HCRP were increased, and GH intervention did not significantly reduce the levels. Chronic inflammation might contribute to the increased cardiovascular morbidity and mortality in PWS.