Log hsCRP Research Articles

Increased plasma serotonin metabolite 5-hydroxyindole acetic acid concentrations are associated with impaired systolic and late diastolic forward flows during cardiac cycle and elevated resistive index at popliteal artery and renal insufficiency in type 2 diabetic patients with microalbuminuria.

Although lower extremity arterial disease is frequently accompanied by diabetes mellitus, the association of circulating biomarkers with flow components during the cardiac cycle in lower-leg arteries has yet to be fully elucidated. We enrolled 165 type 2 diabetic patients with normal ankle-brachial index (ABI 1.0-1.4), comprising 106 normoalbuminuric and 59 microalbuminuric patients, and 40 age-matched nondiabetic subjects consecutively admitted to our hospital. Serum high sensitivity C-reactive protein (hsCRP) level and plasma von Willebrand factor ristocetin cofactor activity (VWF) and vasoconstrictor serotonin metabolite 5-hydroxyindole acetic acid (5-HIAA) concentrations were measured. An automatic device was used to measure ABI and brachial-ankle pulse wave velocity (baPWV). Flow components during the cardiac cycle, total flow volume, and resistive index at popliteal artery were evaluated using gated magnetic resonance imaging. Although estimated glomerular filtration rate (eGFR), early diastolic flow reversal, heart rate, and ABI were similar between the groups, diabetic patients had higher log hsCRP (p<0.001), VWF (p<0.001), 5-HIAA (p=0.002), resistive index (p<0.001) and baPWV (p<0.001) and lower systolic (p=0.026) and late diastolic (p<0.001) forward flows and total flow volume (p<0.001) than nondiabetic subjects. Multivariate analyses demonstrated that 5-HIAA in microalbuminuric patients showed higher associations with systolic and late diastolic forward flows during the cardiac cycle, total flow volume and resistive index at popliteal artery, and eGFR compared to normoalbuminuric patients. In microalbuminuric patients, 5-HIAA was a significant independent determinant among these factors. Thus, increased plasma 5-HIAA levels are involved in the pathogenesis of impaired blood flow in lower extremities and renal insufficiency in diabetic patients with microalbuminuria.

Abstract 14086: Investigation of Inflammatory Markers and Cardiac Events Following Discontinuation of Interleukin-1 Receptor Antagonist in NSTE-ACS Patients

Background: The ILA HEART study demonstrated that administration of IL-1 receptor antagonist (IL-1ra) for 14 days after onset of NSTE-ACS reduced high sensitivity C-reactive protein (hsCRP) at 7 and 14 days, however day 30 hsCRP and 1 year MACE were both increased. Objectives: To analyze the inflammatory effect of withdrawal of IL-1ra following effective suppression of hsCRP in the context of NSTE-ACS. Methods and Results: Mixed-model analysis was performed with log hsCRP as dependent variable, day 1 hsCRP as covariate, treatment, day, and treatment/day interaction as fixed effects, and patient as random effect. Mixed-model analysis (Table 1) demonstrates increased hsCRP in the IL-1ra group at day 30 (vrs day 14 IL-1ra, p&lt;0.0001 and vrs day 30 placebo, p=0.0196). Analysis of achieved hsCRP at day 14 demonstrates suppression of hsCRP with IL-1ra in each tertile (Fig 1A). In contrast to the placebo group, withdrawal of IL-1ra results in loss of hsCRP suppression. Within the IL-1ra group hsCRP was higher in patients suffering MACE events (Fig 1B). Conclusions: Inhibition of IL-1 for 14 days after NSTE-ACS temporarily suppresses CRP. It seems likely that anti-IL-1 therapy will need to be continued for longer after NSTE-ACS.

Serum neutrophil gelatinase-associated lipocalin is associated with cardiovascular events in patients with chronic kidney disease.

Neutrophil gelatinase-associated lipocalin (NGAL) is a member of the lipocalin family best known as a novel and early marker of acute kidney injury (AKI). Recent data suggest that NGQueryAL is not only a marker of AKI, but also an important player in the vascular remodeling, atherosclerotic plaque stability and thrombus formation. We conducted this study to investigate the association of serum NGAL levels with fatal and composite (fatal and non-fatal) cardiovascular events (CVE) in a cohort of patients with stage 1-5 CKD. This was an observational cohort study in which serum NGAL was obtained from 298 CKD (stages 1-5) patients. Fatal and composite CVE were recorded for a median 41 months. We examined alteration of serum NGAL through CKD groups as well as association with inflammatory markers. We also performed a Cox regression analysis to determine the association of NGAL with predefined clinical outcomes. The median value of NGAL was 50.5 ng/mL (IR 47.6-54.9 ng/mL), and higher NGAL values were recorded in diabetic patients. In a multiple linear regression model, including all univariate associates of NGAL, only log eGFR, log hs-CRP and log HDL cholesterol maintained an independent association with log NGAL. During the observational period, 30 patients died due to cardiovascular causes and 69 non-fatal CVE were registered. In the fully adjusted model, we observed a 2.08-fold increase in the risk of fatal CVE and a 1.50-fold increase in the risk of fatal and non-fatal CVE for each increment of 1 SD in log NGAL values. This is the first study that shows that serum NGAL is associated with cardiovascular events (fatal and non-fatal) in patients with CKD, independently of traditional risk factors, renal function and inflammation.

High-sensitivity C-reactive protein, but not white blood cell count, independently predicted incident diabetes in a Japanese health screening population.

To compare high-sensitivity C-reactive protein (hs-CRP) and white blood cell count (WBC) as a predictor of incident diabetes in a population where obesity is not prevalent. This is a retrospective 6-year follow-up study in a Japanese health screening population including 1874 men and 1094 women. Using Cox regression methods, hazard ratios (HRs) of incident diabetes for hs-CRP and WBC adjusting for fasting plasma glucose (FPG), hemoglobin A1c (HbA1c) and other confounders were calculated, and using areas under receiver operating characteristic curve (AUCs), diabetes-predicting abilities of hs-CRP and WBC were compared. Diabetes was defined as FPG ≥ 126 mg/dL and HbA1c ≥ 6.5 % or use of antidiabetic medication. During the 6-year follow-up period (mean ± SD, 4.8 ± 1.7 years), 71 men (3.8 %) and 19 women (1.7 %) developed incident diabetes. The fully adjusted HRs [95 % confidence intervals (CIs)] of incident diabetes for each 1 SD increase in log hs-CRP and WBC were 1.20 (0.92-1.56) (p = 0.174) and 1.01 (0.78-1.30) (p = 0.946), respectively. The fully adjusted HRs (95 % CIs) of incident diabetes for the highest tertile of hs-CRP and WBC compared with the lowest tertile were 2.57 (1.05-6.27) (p = 0.039) and 1.20 (0.53-2.70) (p = 0.665), respectively. The AUCs (95 % CIs) of hs-CRP and WBC for the discrimination of incident diabetes were 0.73 (0.68-0.77) and 0.67 (0.62-0.72), respectively. Hs-CRP, but not WBC, was independently associated with incident diabetes in a Japanese health screening population where obesity is not prevalent.

Increased Plasma S100A12 Levels Are Associated With Diabetic Retinopathy and Prognostic Biomarkers of Macrovascular Events in Type 2 Diabetic Patients.

To explore the association between plasma S100A12 levels and the presence of diabetic retinopathy (DR) and disease outcomes. Fasting venous blood samples were collected from 372 subjects (264 relatively healthy subjects with type 2 diabetes and 108 nondiabetic subjects). The plasma CRP, pentosidine, soluble form of the receptor for advanced glycation end products (sRAGE), and S100A12 levels were analyzed in all of the patients and controls. In total, 264 patients with diabetes were followed through office visits and medical records for an average of 17.6 ± 1.5 months to determine the occurrence of major adverse disease end points. An increase in the plasma levels of S100A12, pentosidine, sRAGE, and hs-CRP from healthy to T2DM to T2DM with DR was observed. Multivariate logistic regression revealed that plasma S100A12 levels were independently associated with the presence of DR in the patients with T2DM (odds ratio, 1.421; 95% confidence interval [CI], 1.036-2.531; P = 0.033). The receiver operating characteristic (ROC) curves for developing DR using the Log S100A12, Log pentosidine, Log sRAGE, and Log hs-CRP values revealed that the area under the receiver operating characteristic curves (AUC) were 0.822 (P < 0.001), 0.561 (P = 0.092), 0.572 (P = 0.051), and 0.566 (P = 0.068), respectively. Increased plasma S100A12 levels might be predictive of future major adverse disease end points in DR patients without a previous diagnosis of macrovascular disease. The plasma levels of S100A12 are closely associated with the presence of DR and might be a better biomarker for DR and the prediction of future macrovascular events.

High-sensitivity C-reactive protein predicts adverse cardiovascular events in patients with Takayasu arteritis with coronary artery involvement.

The study aimed to assess the association of high-sensitivity C-reactive protein (hsCRP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) to major adverse cardiovascular events (MACE) in Takayasu arteritis (TA) patients with coronary artery disease (CAD). Data on 60 TA patients with CAD and 60 age- and severity-matched patients with CAD hospitalized in Fuwai Hospital from 2005 to August 2014 were assessed. The clinical features, laboratory data, coronary angiographic findings, treatment, and follow-up outcomes were summarized retrospectively. MACE were defined as death from cardiac causes, myocardial infarction, nonfatal target vessel revascularization, or rehospitalization due to unstable or progressive angina. CAD patients had more atherogenic lipid and lipoprotein profiles such as lower levels of high-density lipoprotein cholesterol (HDL-C) (1.0 ± 0.2 vs. 1.3 ± 0.3 mmol/L, p = 0.01) and higher levels of low-density lipoprotein cholesterol (LDL-C) (2.5 ± 0.9 vs. 2.2 ± 1.1 mmol/L, p = 0.04) in contrast with TA-CAD patients. During a mean follow-up period of 3.2 years, 31 patients with Takayasu coronary arteritis reached the endpoint. Multivariate Cox proportional hazards model demonstrated that log(hsCRP) (HR = 5.3, 95 % CI = 1.1-27.8, p = 0.04) was a significant and independent predictor of MACE in patients with Takayasu coronary arteritis. Elevated baseline levels of hsCRP predict cardiovascular events, independent of other prognostic markers in TA-related CAD patients.

Associations of decreased serum transthyretin with elevated high-sensitivity CRP, serum copper and decreased hemoglobin in ambulatory elderly women.

Transthyretin (TTR), a sensitive indicator of malnutrition and inflammation, has been shown to be associated with mortality in elderly population. We examined relationships between serum TTR and a range of risk factors for mortality in 185 free-living elderly women. Blood was drawn between breakfast and lunch. TTR was correlated negatively with age (r=-0.30, p<0.001). After controlling for age, TTR was negatively associated with log high-sensitivity CRP (hsCRP) and serum copper. It was positively associated with albumin, serum iron and hemoglobin. In addition, TTR was positively correlated with systolic and diastolic blood pressure and postprandial triglyceride (TG). In multiple regression analysis for TTR as a dependent variable, hemoglobin (standardized β, 0.244), serum copper (standardized β, -0.134), postprandial TG (standardized β, 0.223) and log hsCRP (standardized β, -0.190) emerged as determinants of TTR independently of age, albumin, serum iron, systolic and diastolic blood pressure, and explained 22.8% of TTR variability. Subclinical low-grade inflammation, elevated serum copper and decreased hemoglobin were associated with decreased serum TTR in community-living elderly Japanese women and may represent important confounders of the relationship between low TTR and mortality in the elderly. The positive association of TTR with postprandial TG warrants further investigation.

First-trimester maternal serum C-reactive protein as a predictor of third-trimester impaired glucose tolerance.

We evaluated whether first-trimester high-sensitivity C-reactive protein (hsCRP), a suggested marker of pregnancy-associated hyperglycemia, predicts third-trimester impaired glucose tolerance (IGT) in a secondary analysis of a prospective cohort of nondiabetic singletons enrolled at <26 weeks gestation. We measured the association between hsCRP collected at <14 weeks among women classified as IGT (gestational diabetes screening results, 135 to <200 mg/dL) and those among normoglycemic women. Multivariable modeling estimated the association between log hsCRP and IGT, adjusted for maternal body mass index (BMI). Among 300 women, 13% (39 of 300) had IGT. The hsCRP was positively associated with glucose (P = .005). Compared with normoglycemic women, women with IGT had higher log hsCRP (0.87 ± 0.66 vs 0.67 ± 0.60, P = .04), but the association was not significant in adjusted models (adjusted odds ratio 1.20, 95% confidence interval 0.65-2.21). The hsCRP did not predict third-trimester IGT in this analysis when BMI is considered. Early identification of women at risk of IGT remains a priority, but the contribution of maternal BMI appears greater than hsCRP.

Abstract 11600: Long Sleep Duration and Low-Grade Inflammation: New Indicators of Arterial Stiffness in the Japanese at High-risk of Cardiovascular Disease

Background: Recently, several studies have reported that long sleep duration was independently associated with increased aortic stiffness. On the other hand, high-sensitive C-reactive protein (hs-CRP) was associated with increased aortic stiffness. In this study, the relationships among self-reported sleep duration, hs-CRP and pulse wave velocity (PWV) were investigated in the Japanese at high-risk of cardiovascular disease. In addition, we investigated whether antihypertensive treatment moderated these relationships or not. Methods: Among 4310 patients with one or more cardiovascular risks recruited for the Japan Morning Surge-Home Blood Pressure Study, brachial-ankle PWV and hs-CRP measurement were performed in the 2304 patients (64.7 years old, male 49.6%). A self-administered questionnaire included items on daily sleep duration was used. Results: According to the sleep duration (6h or less,6h to 8h,8h or more per night), significant associations of sleep duration were observed with PWV (1594 vs 1644 vs 1763 cm/s, p&lt;0.0001).In the multiple regression analysis adjustment for confounders including age body mass index, total cholesterol, HbA1c and clinic systolic blood pressure (SBP), long sleep duration (8h or more per night) (B: 29, 95%CI: 1.0-56, p&lt;0.05) and log hs-CRP (B: 25, 95%CI: 3.1-48, p&lt;0.05) were significantly positively associated with PWV. A significant interaction was found between long sleep duration and antihypertensive agent non-use for PWV (p&lt;0.05). Especially, in the group without calcium channel blockers (CCBs), long sleep duration was significantly associated with PWV (p&lt;0.01), while a marginal significant synergetic relationship was observed between long sleep duration and log hs-CRP for PWV (p=0.07). On the other hand, there were no significant interactions between long sleep duration and angiotensin receptor blockers non-use. Conclusions: Long sleep duration and hs-CRP were significant indicators of increased PVW in the high-risk Japanese population. In those without CCBs, long sleep duration served as a strong determinant for arterial stiffness, marginally interacted by low-grade inflammation. CCBs use might be important not to aggravate artery remodeling caused by long sleep duration.

Elevated plasma pentraxin 3 levels are associated with development and progression of diabetic retinopathy in Korean patients with type 2 diabetes mellitus.

To evaluate the association between elevated levels of plasma pentraxin 3 (PTX3) and the development and/or progression of diabetic retinopathy (DR). In this case-control study, 92 diabetic patients with DR (group 3), 30 diabetic patients without DR (group 2), and 41 normal subjects (group 1) were enrolled. Log-transformed values of plasma PTX3 and high-sensitivity C-reactive protein (hsCRP) concentrations were measured and used in our analysis. For subgroup analysis, group 3 was divided into four subgroups: mild, moderate, severe nonproliferative, and proliferative DR. In our 163 participants, average plasma PTX3 levels were 916.1 ± 532.2, 1093.7 ± 1034.2, and 1817.9 ± 1776.9 pg/mL for groups 1, 2, and 3, respectively. The duration of diabetic mellitus (DM), glycated hemoglobin (HbA1c), log hsCRP, and log PTX3 were significantly different between the three groups (P = 0.008, P < 0.001, P = 0.046, and P < 0.001, respectively). In subgroup analysis, plasma log PTX3 levels increased in correlation with the severity of DR (R = 0.372, P < 0.001). Multivariate logistic analysis showed that the correlation between DR development and duration of DM and log PTX3 values was significant (P = 0.014 and P = 0.025, respectively), whereas correlation with log hsCRP values was not significant in univariate analysis (P = 0.129). The receiver operating characteristic curves of DR development were plotted using log PTX3 and log hsCRP values, and the area under the curves was found to be 0.721 (P = 0.001) and 0.614 (P = 0.087), respectively. Plasma PTX3 is positively associated with DR development and progression, and may be a more accurate predictor of DR development than hsCRP.

C-reactive protein levels and risk of disabling dementia with and without stroke in Japanese: The Circulatory Risk in Communities Study (CIRCS)

ObjectiveStudies have shown that elevated high-sensitivity C-reactive protein (hs-CRP) predicts stroke, which is a risk factor for dementia. It remains, however, unclear whether hs-CRP increases risk of dementia. MethodsA prospective nested case–control study of Japanese 40–69 years of age was conducted using frozen serum samples collected from approximately 7531men and women who participated in cardiovascular risk surveys from 1984 to 1994 in one community and 1989–1995 in another community under the Circulatory Risk in Communities Study (CIRCS). Two control subjects per case were matched by sex, age, community, and year of serum storage. The hs-CRP was measured using a latex particle-enhanced immunonephelometric assay. ResultsBetween 1999 and 2013, we identified 275 disabling dementia cases (96 cases with history of stroke and 179 without it). There was a positive association between hs-CRP levels and risk of dementia with history of stroke. No significant association was observed between hs-CRP levels and risk of dementia without history of stroke. After adjustment for hypertension, diabetes and other confounding variables, the positive association remained statistically significant. The multivariable odds ratios associated with 1-SD increment of log hs-CRP were 1.02 (0.87–1.20) for total dementia, 1.35 (1.02–1.79) for dementia with history of stroke, and 0.89 (0.72–1.10) for dementia without history of stroke. ConclusionElevated hs-CRP levels were associated with increased risk of disabling dementia in individuals with history of stroke but not in those without it.

Relationship between vitamin D and inflammatory markers in older individuals.

In older persons, vitamin D insufficiency and a subclinical chronic inflammatory status frequently coexist. Vitamin D has immune-modulatory and in vitro anti-inflammatory properties. However, there is inconclusive evidence about the anti-inflammatory role of vitamin D in older subjects. Thus, we investigated the hypothesis of an inverse relationship between 25-hydroxyvitamin D (25(OH)D) and inflammatory markers in a population-based study of older individuals. After excluding participants with high-sensitivity C-reactive protein (hsCRP) ≥ 10 mg/dl and those who were on chronic anti-inflammatory treatment, we evaluated 867 older adults ≥65 years from the InCHIANTI Study. Participants had complete data on serum concentrations of 25(OH)D, hsCRP, tumor necrosis factor (TNF)-α, soluble TNF-α receptors 1 and 2, interleukin (IL)-1β, IL-1 receptor antagonist, IL-10, IL-18, IL-6, and soluble IL-6 receptors (sIL6r and sgp130). Two general linear models were fit (model 1-adjusted for age, sex, and parathyroid hormone (PTH); model 2-including covariates of model 1 plus dietary and smoking habits, physical activity, ADL disability, season, osteoporosis, depressive status, and comorbidities). The mean age was 75.1 ± 17.1 years ± SD. In model 1, log(25OH-D) was significantly and inversely associated with log(IL-6) (β ± SE = -0.11 ± 0.03, p = <0.0001) and log (hsCRP) (β ± SE = -0.04 ± 0.02, p = 0.04) and positively associated with log(sIL6r) (β ± SE = 0.11 ± 0.04, p = 0.003) but not with other inflammatory markers. In model 2, log (25OH-D) remained negatively associated with log (IL-6) (β ± SE = -0.10 ± 0.03, p = 0.0001) and positively associated with log(sIL6r) (β ± SE = 0.11 ± 0.03, p = 0.004) but not with log(hsCRP) (β ± SE = -0.01 ± 0.03, p = 0.07). 25(OH)D is independently and inversely associated with IL-6 and positively with sIL6r, suggesting a potential anti-inflammatory role for vitamin D in older individuals.

Serum copper, zinc and risk factors for cardiovascular disease in community-living Japanese elderly women.

Associations of copper (Cu) and zinc (Zn) serum levels with risk factors for cardiovascular disease (CVD) have not been extensively studied in elderly Asian people. Relationships to CVD risk factors were examined in 202 freely-living elderly Japanese women. By univariate analysis, log high-sensitivity C-reactive protein (hsCRP) and non-HDL cholesterol were associated with serum Cu concentrations. An independent predictor of Cu was log hsCRP. Serum Zn concentrations decreased with age. After adjustment for age, serum albumin, HDL cholesterol and red blood cell (RBC) were positively and serum insulin and log hsCRP were inversely associated with serum Zn. In stepwise multiple regression analysis (model 1), serum albumin and HDL cholesterol were associated with serum Zn. In analysis excluding albumin from model 1 (model 2), independent determinants were log hsCRP (inverse) and the total number of RBC. In analysis including serum creatinine in model 2, creatinine has emerged as a determinant in addition to log hsCRP and RBC number. In analysis including estimated glomerular filtration rate (eGFR) instead of creatinine and excluding age in model 2, eGFR has emerged as a determinant of serum Zn in addition to log hsCRP and RBC number. Systemic low-grade inflammation may contribute to elevated serum Cu and decreased serum Zn concentrations in the elderly, and may represent an important confounder of the relationship between the serum trace elements and mortality in this population.

Amino-Terminal Pro-B-Type Natriuretic Peptide and High-Sensitivity C-Reactive Protein but Not Cystatin C Predict Cardiovascular Events in Male Patients with Peripheral Artery Disease Independently of Ambulatory Pulse Pressure

Patients with peripheral arterial disease (PAD) are at high risk for cardiovascular (CV) events. We have previously shown that ambulatory pulse pressure (APP) predicts CV events in PAD patients. The biomarkers amino-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), and cystatin C are related to a worse outcome in patients with CV disease, but their predictive values have not been studied in relation to APP. Blood samples and 24-hour measurements of ambulatory blood pressure were examined in 98 men referred for PAD evaluation during 1998-2001. Patients were followed for a median of 71 months. The outcome variable was CV events defined as either CV mortality or any hospitalization for myocardial infarction, stroke, or coronary revascularization. The predictive values of log(NT-proBNP), log(hs-CRP), and log(cystatin C) alone and together with APP were assessed by multivariable Cox regression. Area under the curve (AUC) and net reclassification improvement (NRI) were calculated compared with a model containing other significant risk factors. During follow-up, 36 patients had at least 1 CV event. APP, log(NT-proBNP), and log(hs-CRP) all predicted CV events in univariable analysis, whereas log(cystatin C) did not. In multivariable analysis log(NT-proBNP) (hazard ratio (HR) = 1.62; 95% confidence interval (CI) = 1.05-2.51) and log(hs-CRP) (HR = 1.63; 95% CI = 1.19-2.24) predicted events independently of 24-hour PP. The combination of log(NT-proBNP), log(hs-CRP), and average day PP improved risk discrimination (AUC = 0.833 vs. 0.736; P < 0.05) and NRI (37%; P < 0.01) when added to other significant risk factors. NT-proBNP and hs-CRP predict CV events independently of APP and the combination of hs-CRP, NT-proBNP, and day PP improves risk discrimination in PAD patients.

Inverse Association of Serum Leptin with Flow-Mediated Dilatation Independent of Body Fat Distribution, Insulin Resistance, Oxidative Stress and Inflammation in Young Women

Chronic hyperleptinemia found in obesity has been shown to be associated with endothelial dysfunction, an early and fundamental event in the development of atherosclerosis. We examined whether elevated leptin levels are associated with decreased endothelial function in young women. Flow-mediated dilatation (FMD) in the brachial artery, fat mass by dual-energy absorptiometry, Matsuda index, an insulin sensitivity index derived from an oral glucose tolerance test, serum leptin, adiponectin, hepatic enzymes, lipid profile, high-sensitivity C-reactive protein (hsCRP) and urinary 8-epi-prostaglandin F- 2α (8-epi-PGF 2α ), a marker of oxidative stress, were measured in 44 young women. After adjustment for age, FMD was associated inversely with percentage of body fat, trunk fat and leg fat. In addition, FMD showed inverse associations with serum leptin, log hsCRP and log alanine aminotransferase (all p<0.05 or less). In multiple regression analysis only leptin emerged as an independent determinant of FMD (standardized beta、-0.325) and explained 11% of FMD variability. In conclusion, leptin serum levels had an impact on arterial distensibility in young women, a finding that raises the possibility that leptin levels in the general population during early adulthood may already be relevant to the development of vascular dysfunction.

Measurement of antioxidant capacity using the biological antioxidant potential test and its role as a predictive marker of metabolic syndrome

Background/AimsOxidative stress increases the risk of cardiovascular complications of metabolic syndrome (MetS). This study was conducted to examine the difference in antioxidant capacity according to the presence of MetS, and to characterize the association between antioxidant capacity and MetS-related factors.MethodsWe used the biological antioxidant potential (BAP) test to estimate antioxidant capacity. The BAP test has recently been used as an indicator of antioxidant capacity. We measured BAP levels in 45 patients with MetS (mean age, 44.6 ± 1.1 years) and 47 age- and sex-matched controls (mean age, 42.7 ± 1.1 years). To evaluate the association between antioxidant capacity and MetS, adiponectin, high-sensitivity C-reactive protein (hs-CRP), interleukin-6, tumor necrosis factor-α, and homeostatic model assessment for insulin resistance (HOMA-IR), linear regression and logistic analyses were performed.ResultsThe mean BAP of the MetS group (1,937.3 ± 36.5 µmol/L) was significantly lower than that of the non-MetS group (2,101.7 ± 29.5 µmol/L). Also, the mean BAP was low in persons having low high density lipoprotein and high triglyceride. Reduced antioxidant capacity was significantly associated with adiponectin, HOMA-IR and hs-CRP after adjusting for age and sex. The odds ratios for MetS with BAP, log adiponectin, log HOMA-IR, and log hs-CRP were 0.63 (95% confidence interval [CI], 0.49 to 0.82), 0.22 (0.10 to 0.51), 14.24 (4.35 to 46.58), and 1.93 (1.36 to 2.75), respectively.ConclusionsPersons with MetS showed reduced antioxidant capacity. We identified relationships between antioxidant capacity measured by BAP test and MetS, as well as MetS-related factors, such as insulin resistance, hs-CRP, and adiponectin.

Low vital capacity was found to be associated with incident diabetes in health screening population of Japanese women.

There have been no previous studies regarding the relationship between the respiratory function and incident diabetes in East Asian women in whom obesity is not prevalent. Using Cox regression models, hazard ratios (HRs) for incident diabetes for each one SD increase in the percent vital capacity (%VC), a parameter of restrictive pulmonary dysfunction, forced expiratory volume in one second over forced vital capacity (FEV1/FVC), a parameter of obstructive pulmonary dysfunction, and log high-sensitivity C-reactive protein (hs-CRP) were calculated in 1,704 men and 1,016 women among a Japanese health screening population. Over the four-year study period (mean of 3.4 years), 54 men (3.2%) and 19 women (1.9%) developed diabetes. The HRs [95% confidence intervals (CIs); p values] for incident diabetes for each one SD increase in %VC and log hs-CRP were 0.81 (0.61-1.06; 0.127) and 1.29 (0.97-1.73; 0.085), respectively in men, and 0.55 (0.35-0.88) 0.012 and 2.50 (1.37-4.57; 0.003), respectively in women adjusted for age, fasting glucose and body mass index. The FEV1/FVC was not found to be significantly associated with incident diabetes in any regression models. The Spearman's correlation coefficients between %VC and hs-CRP was -0.11 (p<0.001) in men and -0.08 (p=0.007) in women. The HRs (95% CIs; p values) for each one SD increase in %VC and hs-CRP were 0.86 (0.65-1.13; 0.278) and 1.26 (0.94-1.70; 0.125), respectively in men, and 0.56 (0.34-0.94; 0.028) and 2.95 (1.49-5.81; 0.002), respectively in women, further adjusted for each other, systolic blood pressure, triglycerides and HDL cholesterol. A low %VC was found to be associated with incident diabetes, independent of hs-CRP in women among a Japanese health screening population.

Everolimus-eluting stent suppresses chronic inflammatory reaction compared with bare metal stent in off-label patients

Background: Drug-eluting stents (DES) have been shown to be very effective in reducing target vessel revascularization to prevent restenosis as compared with bare metal stents (BMS). DES have been increasingly used in indications, but their safety and efficacy have not been clarified. Therefore, MULTI-LINK VISION® cobalt chromium stent (CCS) and the XIENCE V® everolimus eluting stent (EES) which have the same CCS platform were compared to examine systemic inflammation markers, outcomes, and complications in patients with indications. Methods: Consecutive 365 patients (445 lesions) in off-label indications, who were treated with EES (201 patients, 255 lesions) and CCS (164 patients, 190 lesions) were evaluated. Off-label indications included ostial, left main, long, bifurcation, and in-stent restenotic lesions, chronic total occlusions (CTO), small vessels, and ST-segment elevation myocardial infarction (STEMI). One year outcomes and 9-month angiographic follow-up results were analyzed. Logarithm high-sensitivity CRP (Log hs-CRP) and IL-6 were also measured before and 9-months after PCI. Results: Age, prevalence of diabetes, and the lesions of restenosis, CTO, small vessel, diffuse long and bifurcation were significantly higher in the EES than in the CCS group. In contrast, presence of thrombus in the culprit lesion and STEMI were significantly lower in the EES than in the CCS group. Lesion length (p=0.008) and stent length (p=0.006) were longer in the EES than in the CCS group, while reference diameter was smaller in the EES than in the CCS group (p=0.008). Initial success rate was similar in both groups. The incidence of MACE (4.4% vs. 17.7%, p<0.05), TLR (2.4% vs. 12.6%, p<0.05), ST (1.2% vs. 3.7%, p<0.05) and MI (1.2% vs. 4.9%, p<0.05) were significantly lower in the EES than in the CCS group, respectively, while the incidence of cardiac death did not differ. Log hs-CRP and IL-6 significantly decreased in the EES group 9-months after PCI as compared with before PCI (Log hs-CRP: 3.98±0.25→2.99±0.38, IL-6; 6.66±3.27→3.80±2.44, p<0.01), but not the CCS group. Conclusion: Patients with EES in off label indications including STEMI were associated with favorable reduction of repeat revascularization with prevention of restenosis and outcomes which might be induced by the stronger continuous anti-inflammatory effect of EES compared to CCS.

Waist circumference and menopausal status are independent predictors of endothelial low-grade inflammation.

Background: The high-sensitivity C-reactive protein (hs-CRP) seems to be associated with the presence of atherosclerosis. The association between menopause-related changes in endogenous sex hormones and hs-CRP levels remains controversial. Objective: To compare the levels of hs-CRP in pre- and postmenopausal women and to evaluate the association of endogenous sex hormones, waist circumference (WC) and insulin resistance with the levels of hs-CRP. Methods: This cross-sectional study included 145 women (age range: 45–65 years), 56 premenopausal and 89 postmenopausal. Patients were evaluated for hormonal and lipid profile, HOMA-IR, hs-CRP and WC. Each variable was first assessed for correlation with log hs-CRP using a univariate model, and significant variables were then added to the multivariate regression model. A p value <0.05 was considered statistically significant. Results: The hs-CRP is higher in postmenopausal patients (3.6 ± 4.9 versus 2.6 ± 3.7, p = 0.004). The log hs-CRP was positively correlated with WC (r = 0.13, p = 0.005), HOMA-IR (r = 0.29, p = 0.001), and triglycerides (r = 0.50, p = 0.01). The menopausal status (p = 0.02) and WC (p = 0.00003) behaved as independent predictors of hs-CRP levels. No correlation was found between hs-CRP and the time since menopause (r = −0.1, p = 0.58). Conclusions: The hs-CRP is higher in postmenopausal patients. The menopausal status and WC were independently associated with hs-CRP levels in this sample of pre and postmenopausal women.

OP0005 Effect of Biologic Agents on Lipids and Cardiovascular Risk in Rheumatoid Arthritis Patients

BackgroundCardiovascular disease (CVD) risk scores incorporating measures of inflammation such as the Reynolds risk score (RRS) may be more appropriate to predict CVD risk in patients (pts) with rheumatoid arthritis...