Mean hsCRP Levels Research Articles

Early Detection of Arteriovenous Fistula Problems among Pediatric Hemodialysis Patients

Abstract Background End stage Kidney disease (ESKD) is a major problem that is related to development of inflammation. Establishment of vascular access (VA) in the form of arteriovenous fistula (AVF) is mandatory to conduct efficient hemodialysis (HD). VA complications are one of the main causes of increase in morbidity and mortality in ESKD patients, which needs to be monitored regularly. Objective to evaluate the value of duplex ultrasound (DUS) and inflammatory markers (high sensitivity (hs) CRP, IL10, TNF) in early detection of vascular access complications in pediatric ESKD patients on regular HD. Methods This observational and interventional study was carried on 59 pediatric patients on regular HD at the PediatricDialysis Unit, Children’s Hospital, Ain Shams University, where DUS and serum level of inflammatory markers (hs-CRP, IL10, and TNF) were assessed once at time of enrollment (1) and the second at the time of early clinical suspicion of VA complication (2) which was detected by any abnormalities in physical examination. Results The study comprised 59 pediatric patients on regular HD, their mean (± SD) age was 13.97 (±2.65) years, 39 (56.5%) of them were males. The most common etiology of CKD was congenital anomalies of kidney and urinary track (CAKUT). Complications of the VA were reported in 55.9% of our studied patients, which include thrombosis, aneurysm, stenosis, early VA failure, pseudoaneurysm and perivascular hematoma, where thrombosis was the most frequent (28.8%), and was confirmed by DUS. AVF diameter (2), and flow volume (2) were significantly lower among patients with AVF thrombosis. The mean serum level of hs CRP was significantly elevated at the time of early clinical suspicion of AVF stenosis, and was confirmed by DUS, in comparison to its baseline level at time of enrollment of the study (0.08±0.08, 0.16±0.28 ng/mL, respectively, p = 0.04), serum IL10(1&2) and TNF (2) were higher in this group. Early VA failure were reported in patients who had lower AVF diameter (1), PSV (1), EDV(1&2),flow volume (1&2), and higher AVF diameter (2), PSV (2). Conclusion DUS and hs-CRP are useful tools for early detection and, hence the management of AVF complications.

10-year trajectory of Life’s Essential 8 and incident hypertension: a community-based cohort study

BackgroundThe health effects of Life’s Essential 8 (LE8) on chronic diseases have been disclosed, but its association with hypertension remains unknown. The current study aimed to explore the potential link between 10-year LE8 trajectory and the incidence of hypertension.MethodsLE8 was constructed from four behaviors and four metabolic factors, ranging from 0 to 100. Latent mixture models were used to identify trajectories of LE8 scores during 2006 to 2016. Incident hypertension was diagnosed based on self-reported clinical diagnoses and physical examinations from 2016 to 2020. Cox models were employed to assess the association of LE8 trajectories with hypertension. In addition to incorporating the mean hs-CRP levels from 2006 to 2016, age, sex, monthly income, educational level, and occupation at recruitment were adjusted for as confounding factors.Results7500 participants aged 40.28 ± 10.35 years were included in the study, of whom 2907 (38.76%) were women. Five LE8 trajectory patterns were identified. After around four-year follow-up, 667 hypertension events were observed. Compared to the Low-Stable trajectory, the hazard ratios and 95% confidence intervals for the Moderate-Increasing, Moderate-Decreasing, Moderate-Stable, and High-Stable trajectories were 0.51 (0.40, 0.65), 0.81 (0.64, 1.02), 0.45 (0.36, 0.58), 0.23 (0.16, 0.33), respectively. The risk of incident hypertension decreased as participants improved their LE8 status. The robustness of the primary results was confirmed through several sensitivity analyses.ConclusionsLE8 trajectories were associated with the incident hypertension. People who improved their LE8 scores over time experienced a decreased risk of hypertension, even if they started with lower LE8 scores initially.

A Comparative Study on Levels of hs-CRP and Lipid Profile in Prediabetic and Normal Population.

This study aimed to compare high-sensitivity C-reactive protein (hs-CRP) and lipid profile levels between prediabetic and normal populations and explore correlations between hs-CRP and lipid profile in prediabetic individuals. The study was conducted among Group A comprising 75 prediabetic individuals, and Group B, which included 75 non-diabetic controls from the general population. Results showed that the mean hs-CRP level in Group A (1.717) significantly exceeded that of Group B (0.917) (p = 0.001). Pearson correlation analysis revealed significant positive linear relationships between hs-CRP and lipid profile parameters, indicating that as total cholesterol, triglycerides (TGs), high-density lipoprotein (HDL), and very low-density lipoprotein (VLDL) increased, hs-CRP also increased. A significant negative linear relationship was observed between hs-CRP and HDL. Moreover, a positive linear relationship existed between hs-CRP and glycemic parameters (fasting blood sugar (FBS), postprandial blood sugar (PPBS), and Glycated haemoglobin (HbA1c)). It is concluded that elevated hs-CRP, an inflammatory marker, correlated with dysregulated lipid profiles, and glycemic parameters, indicating its potential role in assessing inflammation in prediabetic individuals and its association with dyslipidemia and glucose metabolism.

#336 Early detection of vascular access complication in pediatric CKD hemodialysis patients

Abstract Background and Aims Vascular access (VA) dysfunction is a major clinical complication in the hemodialysis (HD) population and has a direct effect on dialysis outcome. Where in patients undergoing HD, neointimal hyperplasia results in vascular stenosis and subsequent thrombosis, which lead to vascular access failure. Interleukin-10 (IL-10), hs CRP, and tumor necrosis factor- (TNF–α) are inflammatory markers which are proved to be involved in the process neointimal hyperplasia & subsequent complications. We aimed to evaluate the value of these inflammatory markers in early detection of arterio-venous fistula (AVF) failure, in pediatric patients on regular HD, together with the clinical & radiological diagnoses, for proper intervention for correcting AVF failure according to guidelines. Method It was an prospective cohort study, where we included 59 pediatric chronic kidney disease patients’ stage 5, on regular HD (CKD5d), who were following up regularly with us for 1 year. Patients with nonfunctioning AVFs due to complications as thrombus occluding fistula, infections, or large aneurysm, were excluded from the beginning of the study. Monitoring of VA by pre-cannulation physical examination was performed to detect the physical signs of dysfunction, at least once per month according to KDOQI guidelines. Venous pressure (VP) and trans-membrane pressure (TMP) were recorded at each HD session, to detect any abnormalities and to record the pressure changes with the appearance of any AVF complications. Doppler ultrasound (DUS) was performed routinely every 3 months for all HD patients, & at the time of development AVF complications. Blood samples for measuring IL10, TNF, hs CRP were collected from the patients every 2 weeks for 12 months, prior to HD sessions, where we included the most recent samples prior to, and at the time of development complications, which were clinically and radiologically confirmed. Results The mean (±SD) age of our patients was 13.97 (±2.65) years, where we had 39 (56.5%) males, and 30 (43.5%) females, with a median (IQR) HD duration of 4.0 (5.0) years. On assessing the AVF complications, 33 patients (55.9%) had experienced complications, where thrombosis was the most common reported one (17 patients, 28.8%), followed by aneurysm formation in 14 patients (23.7%), while 6 patients (10%) had stenosed AVF, early VA failure in 2 patients (3.4%),1 patient (1.7%) had pseudoaneurysm, and another patient (1.7%) had perivascular hematoma. Mean serum levels of Hs-CRP, TNF-α, IL-10 were elevated at timing of early development of complication, in comparison to their baseline levels, meanwhile serum IL10, and TNF alpha were significantly higher among patients who developed AVF stenosis. The baseline hs-CRP had related positively with AVF diameter at the time of the development of the complications. Conclusion The inflammatory markers have no clinically applied role in early detection of AVF abnormalities, therefore, physical examination and DUS are deemed sufficient.

CLINICAL RELEVANCE OF HIGH SENSITIVITY C-REACTIVE PROTEIN IN ACUTE MYOCARDIAL INFARCTION PATIENTS

Objectives: Poor cardiovascular outcomes have been linked to high-sensitivity C-reaction protein (hs-CRP), a biomarker of residual inflammatory risk. Whether or not a patient has diabetes mellitus, evaluate the relationship among hs-CRP levels estimated at hospital admission and in-hospital consequences and death. Methods: This prospective cohort study included 100 acute myocardial infarction (AMI) patients with both non-ST elevation myocardial infarction (STEMI) and STEMI who were admitted to the cardiac care critical care unit intensive therapy unit. Results: Diabetics had a considerably higher incidence of hypertension (p=0.001) and dyslipidemia (p=0.001) compared to non-diabetics. Diabetics exhibited a significantly higher mean hs-CRP level (6.76±1.12 vs. 3.65±0.98 mg/dL; p=0.01) than non-diabetics. Meanwhile, compared to non-diabetics, diabetics utilized significantly more aspirin (p=0.001), beta-blockers (p=0.001), angiotensin receptor blockers (ARBs) (p=0.01), and statins (p=0.001). Furthermore, compared to those with hs-CRP <3 mg/L, those with hs-CRP ≥3 mg/dL had a significantly higher incidence of dyslipidemia (p=0.001) and hypertension (p=0.001). Conclusion: The results of the current study demonstrated that hs-CRP upon admission is a valid predictor of hospital morbidity and death in patients with AMI who are diabetic or non-diabetic. Individuals with diabetes showed greater CRP levels than non-diabetic AMI patients did.

Changes in High-Sensitivity C-Reactive Protein Levels After Two-Weeks of Moderate-Intensity Endurance Exercise in Obese Women

Study purpose. The study purpose was to analyze the effect of moderate-intensity endurance exercise on reducing inflammation in obese women. Materials and methods. Twenty obese women selected according to the established criteria were used as subjects. Then the subjects were divided into two groups: the control group (G1) and the endurance exercise group (G2). Moderate-intensity endurance exercise was performed by running on a treadmill for 40 minutes, with a frequency of 5 times/week for 2 weeks. Moderate-intensity was performed with 60%-70% HRmax (HRmax formula: 220-age). Blood sampling for inflammation measurement using the biomarker High-sensitivity C-reactive protein (hs-CRP) was performed before and after the intervention for 2 weeks. hs-CRP was measured using the enzyme-linked immunosorbent assay (ELISA) method. A paired sample t-test with a significant level (p ≤ 0.05) was used for data analysis. Results. The results showed the mean hs-CRP levels between before and after the intervention in G1 (6.76±4.40 vs. 6.43±4.89 ng/mL, (p=0.641)) and G2 (6.56±3.34 vs. 2.12±1.14 ng/mL, (p=0.004)). Conclusions. The study indicates that moderate-intensity endurance exercise has been shown to be effective in reducing inflammation levels in obese women, so individuals with obesity are advised to reduce inflammation levels through moderate-intensity endurance exercise.

The association between depressive symptoms and high-sensitivity C-reactive protein: Is body mass index a moderator?

ObjectiveDepression and obesity are highly comorbid conditions with shared biological mechanisms. It remains unclear how depressive symptoms and body mass index (BMI) interact in relation to inflammation. This cross-sectional study investigated the independent associations of depressive symptoms and BMI with high sensitivity C-reactive protein (hs-CRP), as well as the moderating role of BMI on the depressive symptoms-hs-CRP association. MethodsParticipants (n = 8827) from the 2015–2018 National Health and Nutrition Examination Surveys were aged ≥20 with a BMI ≥18.5 kg/m2, completed the Depression Screener, and had hs-CRP data. Multivariable linear regression was used to analyze hs-CRP in relation to depressive symptoms and BMI. An interaction term was included to examine whether the depressive symptoms-hs-CRP relationship differs depending on BMI. ResultsThere was a slight, albeit non-significant, increase in hs-CRP levels with each one-point increase in depressive symptoms (aCoef.Estm. = 0.01, 95% CI = −0.05, 0.06, p = 0.754). Participants with overweight (aCoef.Estm. = 1.07, 95% CI = 0.61, 1.53, p < 0.001) or obese (aCoef.Estm. = 3.51, 95% CI = 3.04, 3.98, p < 0.001) BMIs had higher mean hs-CRP levels than those with a healthy BMI. There were no significant interactions between depressive symptoms and overweight (aCoef.Estm. = 0.04, 95% CI = −0.04, 0.13, p = 0.278) or obese (aCoef.Estm. = 0.11, 95% CI = −0.01, 0.22, p = 0.066) BMI indicating a lack of difference in the depressive symptoms-hs-CRP association across participants in the healthy versus overweight and obese ranges. ConclusionsThis study suggests that BMI might not act as a moderator in the association between depressive symptoms and hs-CRP. Results should be replicated in larger samples. Further research is warranted to understand underlying mechanisms.

The influence of chronic inflammation on the illnesscourse of bipolar disorder: A longitudinal study

IntroductionC-reactive protein (CRP) is a systemic inflammatory marker, which indicates systemic inflammatory processes It is involved in different inflammatory processes of the body and is a reliable marker for the general inflammatory state of the body. High sensitive CRP seems to play a key role as a state and trait marker of bipolar disorder (BD). In the current study, we tried to determine the long-term effect of CRP levels on clinical symptoms and illness course of bipolar disorder. MethodsFor the current study, we examined 106 patients with BD for a period of four years. Participants underwent a clinical screening for depressive and manic episodes with the Hamilton Depression Scale (HAMD) and the Young Mania Rating Score (YMRS) and a serological diagnostic for inflammatory parameters every six months, thus leading to 8 measurement times in total. Patients with the presence of severe medical or neurological comorbidities such as active cancer, chronic obstructive lung disease, rheumatoid arthritis, systemic lupus erythematosus, Alzheimer's disease, Parkinson's disease, Huntington's disease or multiple sclerosis and acute infections were not included in the study. ResultsIn our sample, 26% showed a mean hsCRP above 5 mg/dl. Those patients showed a significantly higher mean YMRS score than those with a mean hsCRP under 5 mg/dl during our observation period. Regarding HAMD there was no significant difference in hsCRP values. The existence of lithium treatment showed no significant influence on mean hsCRP levels between the start and endpoint. ConclusionIndividuals who were exposed to a higher level of inflammation over time suffered from more manic symptoms in this period. These findings underline the hypothesis that inflammatory processes have an accumulative influence on the illness course of BD, especially concerning manic symptoms and episodes.

Association of High Sensitivity C-reactive Protein with Type II Diabetic Retinopathy

Objective: The objective of this study is to find out the association of diabetic retinopathy with serum homocysteine and high sensitivity (hs) CRP levels.&#x0D; Methods: The research was conducted out at the Army Medical College's Department of Physiology and Centre for Research in Experimental and Applied Medicine (CREAM), Rawalpindi, in partnership with the Armed Forces Institute of Ophthalmology, Rawalpindi for a tenure of 12 months. Ninety subjects, were included in the study, thirty in each group: controls, diabetic subjects, and the patients suffering from diabetic retinopathy (DR).&#x0D; Results: Healthy controls, diabetic subjects, and patients with DR were found to have mean Fasting Blood Glucose (FBG) values of 5.51 0.34 (mmol/l), 8.11 0.67 (mmol/l), and 8.73 0.90 (mmol/l), respectively (p=0.001). The mean HbA1c level in normal subjects was noted as 5.08 ± 0.27 in healthy controls as compared to 7.70 + 0.89 (mmol/l)) in diabetic subjects and 9.02 + 1.76 (mmol/l) in patients with DR (p=0.001 by ANOVA). &#x0D; In normal subjects, the mean hs CRP levels were noted to be 3.74 + 1.97 (mg/l) in healthy controls as compared to 15.32 + 2.93 (mg/l) in diabetic subjects and 26.71 + 4.88 (mg/l) in patients with diabetic retinopathy (p=0.001 by ANOVA).&#x0D; Conclusion: During the study, it was found that elevated levels of these inflammatory biomarkers can accurately predict the onset of diabetic retinopathy and that hs CRP levels are strongly related with the development of diabetic retinopathy. Monitoring these inflammatory signs in the serum can therefore help prevent diabetic microangiopathic consequences, including DR.

Longitudinal changes in high sensitivity C-reactive protein associated with serum uric acid in the Korean Genome and Epidemiology Study

Cross-sectional studies support the role of serum uric acid (SUA) in inflammation, but evidence from cohort studies is scarce. Longitudinal associations between SUA and high-sensitivity C-reactive protein (hs-CRP) were examined in the general population. Data for participants from the Health Examinees-Gem cohort (n = 50,028; 40–69 years; 67% women) who were examined between 2004 and 2013 and followed up until 2016 were analyzed. SUA and hs-CRP were measured at baseline and during follow-up. SUA was evaluated as a continuous variable and was also divided into sex-specific quartiles. Mean hs-CRP levels at follow-up were evaluated using multivariable proportional odds regression, with non-linear smoothed baseline hs-CRP levels serving as a covariate. Selected pathological markers were also examined in relation to hs-CRP. Increased levels of SUA at baseline were related to increased levels of hs-CRP at follow-up [regression coefficient per mg/dL increase in baseline SUA (β) = 0.08, 95% confidence interval (CI), 0.040–0.128]. A dose–response relationship was observed, (P for linear trend = 0.0015). The mean values of hs-CRP were highest among participants with the highest follow-up but lowest baseline SUA levels. Elevated hs-CRP levels at follow up (> 3 mg/L) were positively related to fasting blood glucose levels, triglycerides levels, liver enzymes, and blood pressure, but negatively related to high density lipoprotein cholesterol levels per unit increase in baseline hs-CRP. High SUA levels were associated with high hs-CRP levels, suggesting a potential role of SUA in inflammation. However, additional research is needed to confirm these findings.

Relationship of Adiponectin and High-Sensitivity CReactive Protein with Left Ventricular Dysfunction among Patients Undergoing Coronary Angiography

Background: Decreased levels of adiponectin (APN) and elevated levels of high-sensitivity C-reactive protein (hs-CRP) have been found as predictors of left ventricular dysfunction and cardiovascular events. Therefore, this study aimed to assess the relationship of APN and hs-CRP with the severity of left ventricular dysfunction among Egyptian patients undergoing coronary angiography (CAG).&#x0D; Methods: A cross-sectional study was conducted among 100 Egyptian patients who underwent clinically indicated CAG at Suez Canal University Hospital in Ismailia - Egypt, from May 2009 to December 2010. The left ventricular ejection fraction (LVEF) scoring system was used to assess left ventricular function based on echocardiographic findings. Pearson correlation was used to determine the relationship of APN and hs-CRP levels with echocardiographic LVEF score, and analysis of variance (ANOVA) was used to compare clinical and biochemical parameters among patients according to left ventricular function at P-value &lt;0.05.&#x0D; Results: The mean hs-CRP level had a significant weak negative correlation with the mean HDL-cholesterol level (r = -0.222; P = 0.048), while the mean APN level had a significant weak negative correlation with BMI (r = -0.269; P = 0.007) but a significant weak positive correlation with the mean hs-CRP level (r = 0.215; P = 0.031) and a significant moderate positive correlation with the mean HDL-cholesterol level (r = 0.302; P = 0.002). Left ventricular function in patients undergoing CAG was normal in 34 (34%), mildly impaired in 41 (41%) patients and moderately impaired in 25 (25%), with significantly different mean hs-CRP levels among the three groups (P = 0.025) that increased from normal to moderately impaired left ventricular function. However, there was no statistically significant difference in left ventricular function according to the mean level of APN.&#x0D; Conclusion: The hs-CRP level is negatively correlated with HDL-cholesterol, while APN is negatively correlated with BMI and hs-CRP but positively correlated with HDL-cholesterol in Egyptian patients undergoing CAG. The hs- CRP level correlates with the severity of left ventricular dysfunction. However, left ventricular function does not appear to correlate with APN levels.

Association of anxiety and depressive symptoms with C-reactive protein in diverse Latinos: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

High sensitivity C-reactive protein (hsCRP) is a marker of systemic inflammation that has been associated with persistent depressive symptoms. Depression and anxiety are frequently associated with a chronic inflammatory state, yet the nature of this relationship has not been rigorously examined in diverse Hispanic/Latino populations. We aimed to study the association of anxiety and depressive symptoms as well as comorbid presentations, with circulating high sensitivity C-reactive protein (hsCRP) levels in a large Latino cohort of diverse heritages. We hypothesized a significant positive associations of both anxiety and depressive symptoms and hsCRP levels and potential variations among the heritage groups. Depressive symptoms and anxiety were measured by the Center for Epidemiological Studies Depression Scale (CES-D) and State-Trait Anxiety Inventory (STAI), respectively. Serum hsCRP (hsCRP) levels of 15,448 participants (age 18 to 75 years; 52.3% women) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) were measured and categorized based on the established cardiovascular disease (CVD) risk reference values (< 1mg/L, low; 1-<3 mg/L, intermediate; ≥ 3mg/L, high). Mean CES-D, STAI scores, and hsCRP levels were 7.0 (SD = 5.9), 17.0 (SD = 5.7), and 3.84 (SD = 7.85), respectively. Generalized linear modeling, adjusted for sociodemographic characteristics revealed significant associations between depression (exp(β) = 1.12; p<0.01) and anxiety symptoms (exp(β) = 1.10; p<0.05) with continuous hsCRP levels. For categorical values of hsCRP, one SD increase in CES-D and STAI scores was associated with a 10% and 8% increase in the RRRs of high vs. low hsCRP, respectively. However, these relationships between CES-D or STAI and hsCRP were no longer statistically significant after adjustment for CVD risk factors and medications. We found modest associations between anxiety and depressive symptoms and systemic inflammation measured by hsCRP among diverse Hispanics/Latinos that did not appreciably differ between heritage groups.

Association of Circulating Matrix Metalloproteinase-9 and the Risk of Coronary Heart Disease in Young Smokers

Introduction: Smoking causes cardiovascular risk which may alter the stability between the production and degradation of the extracellular matrix. Matrix metalloproteinase-9 (MMP-9) is a zinc-containing endopeptidase that degrades the extracellular matrix and plays a vital role in tissue remodeling. As a result, elevated serum MMP-9 levels produced by smoking, particularly at young age, raise the risk of future CHD. So this study aims to find out the possible relationship between circulating MMP-9 and the risk of cardiovascular disease in young smokers. Methods: The study was conducted on smokers with CHD subjects attending cardiology and medicine OP of the SRM Medical College Hospital and research center Tamil Nadu, India. The study group was divided into three groups. Group 1 includes 120 healthy controls as nonsmokers, Group 2 includes 120 smokers with Coronary heart disease (CHD), and Group 3 includes 120 smokers with diabetes and CHD subjects in the age group of 20-55 years. Serum MMP-9, hs-CRP, and APO-E levels were measured using the ELISA method and the lipid level was measured enzymatically using AU480 automatic analyzer (back man coulter). Results: The mean serum MMP-9, hs-CRP, and APO-E levels were significantly higher in both groups (p&lt;0.05) when compared to controls. The study also shows a significant positive association between MMP-9 with hs-CRP, APO-E, smoking burden, and smoking intensity. Conclusion: The study concludes a significant association exists between cigarette smoking with MMP-9 and also relative exposure to circulating inflammation markers plays a potential role in the pathogenesis of CHD.

J-shaped association between LDL cholesterol and cardiovascular events: A longitudinal primary prevention cohort of over 2.4 million people nationwide

IntroductionLow-density lipoprotein (LDL) cholesterol-lowering treatment is beneficial for the secondary or primary prevention of high-risk atherosclerotic cardiovascular disease (ASCVD). However, the prognostic implications of low LDL cholesterol levels in patients without previous ASCVD and without statin use remain elusive. MethodsFrom a nationwide cohort, 2,432,471 participants without previous ASCVD or statin use were included. For myocardial infarction (MI) and ischemic stroke (IS), participants were followed-up from 2009 to 2018. They were stratified according to 10-year ASCVD risk (<5 %, 5 %–<7.5 %, 7.5 %–<20 %, and ≥20 %) and LDL cholesterol level (<70, 70–99, 100–129, 130–159, 160–189, and ≥190 mg/dL). ResultsThe relationship between LDL cholesterol levels and ASCVD events exhibited a J-shaped curve for both MI and IS. After classification according to the ASCVD risk, this J-shaped relationship was consistently observed for the composite of MI and IS. Participants with an LDL cholesterol level <70 mg/dL showed a higher MI risk than those with a level of 70–99 mg/dL or 100–129 mg/dL in the low-ASCVD risk group. The J-shaped curve between LDL cholesterol levels and MI risk was attenuated across ASCVD risk groups. For IS, participants with an LDL cholesterol level <70 mg/dL demonstrated increased risks compared with those with a level of 70–99 mg/dL, 100–129 mg/dL, or 130–159 mg/dL in the borderline, intermediate, and high ASCVD risk groups, respectively. In contrast, a linear association was observed in participants taking statins. Interestingly, a J-shaped association was observed between LDL cholesterol and high-sensitivity C-reactive protein (hs-CRP) levels; the mean hs-CRP level and the proportion of individuals with increased hs-CRP levels were relatively high among individuals with an LDL cholesterol level <70 mg/dL. ConclusionsAlthough high LDL cholesterol levels increase the risk of ASCVD, low LDL cholesterol levels do not warrant safety from ASCVD. Therefore, individuals with low LDL cholesterol levels should be carefully monitored.

Electronic Cigarettes Versus Tobacco Poly Use: Reduced Oxidative Stress but Similar Inflammatory Effect

Background: Smoking in any form is a significant risk factor for developing cardiovascular diseases, chronic obstructive pulmonary disease, lung cancer, and other oxidative damage-induced diseases. The increasing global trend of E-cigarettes has led traditional smokers to perceive them as a safer option. Objectives: This study aimed to compare the levels of malondialdehyde (MDA) as a marker of oxidative damage and high-sensitivity C-reactive protein (hs-CRP) as a marker of inflammation between pure E-cigarette users and tobacco poly-users (smoking combinations of traditional products). Moreover, it also evaluated the influence of Body Mass Index, frequency, and duration of vaping/smoking on these biomarkers. Materials and Methods: This analytical cross-sectional pilot study included 40 males aged 18-25 (20 pure E-cigarette users and 20 tobacco poly-users). MDA and hs-CRP were estimated on serum, and SPSS-Version 28.0.1.1 was used for data analysis. Mean hs-CRP and MDA levels for the two groups were compared using the Mann-Whitney-U test. Results: Mean level of hs-CRP between the two groups was not significantly different. However, MDA levels were lower in pure E-cigarette users than in tobacco poly-users, especially among those with normal BMI and those who vaped/smoked more frequently and for a longer duration Conclusion: Oxidative damage was lesser for pure E-cigarette users and could potentially be the less harmful option than tobacco poly-use. However, E-cigarettes are not the safest substitute for conventional smoking as it causes a similar extent of risk for inflammation-related CVD. Findings need further exploration to study the long-term effects on a larger population group to draw definitive conclusions.

Smoking Induces the Circulating Levels of Matrix Metalloproteinase-9 and Its Association with Cardiovascular Risk in Young Smokers

Smoking causes cardiovascular risk, which may alter the stability between the production and degradation of the extracellular matrix. Matrix metalloproteinase-9 (MMP-9) is a zinc-containing endopeptidase that degrades the extracellular matrix and is involved in tissue remodelling and several physiological processes. As a result, smoking-induced elevated serum MMP-9 levels, particularly at a younger age, raise the risk of coronary heart disease (CHD). Thus, this study aimed to determine the possible relationship between smoking-induced circulating MMP-9 and the risk of cardiovascular disease in young smokers. In this cross-sectional study, the patients were divided into three groups. Each group contains 120 study participants. Group one consisted of 120 healthy individuals with no physical and mental illness, group two consisted of 120 active smokers with a heart disease, and group three consisted of 120 active smokers with a heart disease and diabetes, who attended Sri Ramaswamy Memorial Hospital for cardiology checkup at the age of 20-55 years. The serum MMP-9, high-sensitivity C-reactive protein (hs-CRP), and apolipoprotein-E (APO-E) levels were analyzed using the ELISA method, and the lipid levels were measured enzymatically using AU480 automatic analyzer (Beckman Coulter). Compared with non-smokers, the study shows that the mean serum MMP-9, hs-CRP, and APO-E levels were significantly higher in smokers (p<0.001). A strong relationship was also found between MMP-9 and hs-CRP, APO-E, smoking load, and smoking intensity. A significant association was found between cigarette smoking with MMP-9, and relative exposure to circulating inflammation markers plays a potential role in the pathogenesis of CHD.

Fasting Serum Lipid Profile and Its Association with Serum High Sensitivity C-Reactive Protein in Type II Diabetes Mellitus

Background: Patients with type II diabetes mellitus frequently have altered lipid profiles. Detection of serum high sensitivity C-reactive protein is associated with cardiovascular events in type II DM as the presence of subclinical inflammation. The study was undertaken to observe the fasting serum lipid profile level and its association with serum hs-CRP in type II DM.&#x0D; Materials and methods: A hospital-based observational study was carried out in the Outpatient Department of Endocrinology, Chittagong Medical College Hospital and Department of Biochemistry, Chittagong Medical College. By using non-probability consecutive sampling, a total of 176 participants were enrolled, with 126 type II DM and 50 in the control group. Plasma glucose and serum hs-CRP, fasting serum lipid profile was estimated.&#x0D; Results: The mean serum hs-CRP level in patients with type II DM (9.1 ± 0.36 mg/L) was significantly (p 0.0001) elevated as compared to control (4.3 ± 0.09 mg/L). The result showed an increase in serum total cholesterol, serum triglycerides, serum HDLC and serum LDL-C among the diabetic patients when compared with the healthy control group. Serum hs-CRP was significantly associated with serum TG and serum LDL-C in type II diabetics. Moreover, serum hs-CRP was found to have a significant positive correlation with serum LDL-C and serum TG. Only 77.78% of patients had increased LDL-C but altogether 85.71% of patients had increased serum hs-CRP levels.&#x0D; Conclusion: According to the findings of this study,increased serum hs-CRP was well associated and positively correlated with components of the fasting lipid profile, indicating early identification of cardiovascular risk among type II diabetics.&#x0D; Chatt Maa Shi Hosp Med Coll J; Vol.21 (2); July 2022; Page 35-39

A Case-Control Study on the Changes in High-Sensitivity C-Reactive Protein and Tumor Necrosis Factor-Alpha Levels with Surgical Treatment of OSAS.

Obstructive sleep apnea syndrome (OSAS) is a common but underdiagnosed condition with significant health and economic implications for society. Inflammatory mediators are proposed to be associated with the presence and severity of OSAS and contribute to morbidity and mortality. This paper details a prospective non-randomized case control study of a cohort of subjects, who underwent surgical treatment of OSAS and were enrolled to assess the sleep parameters and blood levels of selected inflammatory markers at pre-operative and post-operative time points, also comparing them to the levels in a control group. A total of 25 study subjects and 18 control subjects were enrolled. Median values and interquartile range (IQR) of the apnea-hypopnea index (AHI) in the study group pre-operatively and post-operatively were 34 (18.5-45.5) and 13.3 (7.5-27.3), while in the control group 1.4 (1.0-2.1) per hour. The mean (IQR) hs-CRP levels (mg/L) were 1.782 (0.941-5.594) and 1.980 (0.990-5.445) in the study group, pre-operatively and post-operatively, respectively, while 0.891 (0.767-1.436) in the control group. The mean (IQR) TNF-α levels (pg/mL) were 7.999 (6.137-9.216) and 6.614 (5.534-7.460) pre-and post-operatively, respectively, and were 6.000 (5.026-6.823) in the control group. Results demonstrated that both inflammatory markers, hs-CRP and TNF-α, are higher in subjects with OSAS compared to the controls, and their levels decrease, but are still higher than the controls, after successful surgical treatment. Further analysis including the body mass index and age demonstrated that these changes were significant for TNF-α, but not hs-CRP.

A study of effect of alcohol consumption on cardiovascular biomarkers in a tertiary care centre in the Kumaon Region

An important mechanism responsible for increased cardiovascular risks in chronic excessive alcohol use is the pro-oxidant effects of alcohol. There are some emerging risk factors like :- (i) lipoprotein(a) {Lp[a]}, (ii) High‑sensitivity C‑reactive protein (hs‑CRP), (iii) Lipid profile, (iv) Prothrombotic and proinflammatory factors that play an important role in the pathogenesis of atherosclerosis. So we investigated the relation between the levels of cardiovascular biomarkers &amp; the degree of alcohol intake in alcoholic subjects. The present study was carried out in the Department of Biochemistry, in association with the Department of Medicine, Government Medical College, Haldwani. Estimation of Serum Level of hs-CRP &amp; Lp (a) byturbidimetric immunoassay. Serum Cholesterol by CHOD-POD &amp; Triglycerides by enzymatic colorimetric method. LDL cholesterol was calculated by Friedwald equation.The mean total cholesterol, TG, LDLc, hs-CRP, Lp(a) &amp; including HDLc levels were significantly raised (p &amp;#60; 0.05) in cases as compared to controls. The mean serum total cholesterol &amp; Lp (a) levels showed no significant association across different alcohol drinking groups (p&amp;#62;0.05). The mean TG &amp; LDLc levels were significantly (p&amp;#60;0.05) higher in occasional drinkers and heavy drinkers than that of low-moderate &amp; moderate drinkers. The mean serum HDL cholesterol levels in the occasional drinkers were significantly elevated in comparison to the low-moderate drinkers, moderate drinkers and heavy drinkers. The mean serum hs-CRP level in the mediocre and heavy drinkers was significantly low (p&amp;#60;0.05) as compared occasional drinkers and low-moderate drinkers. Our study suggests heavy drinking (&amp;#62;30drinks/week) must be strongly discouraged as it may lead to changes in cardiovascular markers and dyslipidemia. Our study also showed a beneficial effect of occasional drinking on HDLc and moderate drinking on hs-CRP.

Association of Serum High Sensitivity C-Reactive Protein with Insulin Resistance in Patients with Type-ΙΙ Diabetes Mellitus

Background: Insulin resistance (IR) is the major event in type-ΙΙ diabetes mellitus followed by an increasing degree of β-cell dysfunction. Chronic inflammation is the driving force for IR and type-ΙΙ DM. The process of inflammation induces hepatic synthesis of high sensitivity C-reactive protein (an acute-phase protein) which plays a role in IR. The study was undertaken to find out the association of serum hs-CRP with insulin resistance in patients with type-ΙΙ diabetes mellitus.&#x0D; Methodology: A hospital-based observational study was carried out in the Outpatient Department of Endocrinology, Chittagong Medical College Hospital and Department of Biochemistry, Chittagong Medical College. A total of 126 patients with type-II diabetes mellitus aged 40-64 years were included by non-probability consecutive sampling technique. Serum hs-CRP, fasting serum insulin was estimated. IR was calculated by using the Homeostasis Model Assessment of Insulin Resistance index (HOMA-IR).&#x0D; Results: The mean serum hs-CRP level was 9.1 ± 0.36 mg/L in patients with type-II DM. Serum hs-CRP was significantly associated with insulin resistance and positively correlated with HOMA-IR in type-II diabetics. Body mass index (BMI) as one of the key indicators of insulin resistance was also associated with serum hs-CRP in this study population. Additionally serum hs-CRP was correlated positively with BMI and fasting serum insulin in patients with type-II DM.&#x0D; Conclusion: The results of this study concluded that increased serum hs-CRP was well associated and positively correlated with insulin resistance and its parameters signifying a possible role of subclinical inflammation in IR among patients with type-II diabetes mellitus.&#x0D; EMCJ. January 2022; 7(1): 15-20