Serum High Sensitivity Research Articles

Impact of metabolic disturbances and malnutrition-inflammation on 6-year mortality in Japanese patients undergoing hemodialysis.

Metabolic syndrome confers an increased risk of cardiovascular disease (CVD) in the general population. The relationship between adiponectins, and clinical outcomes in patients undergoing hemodialysis remains controversial. We investigated whether adiponectins, biomarkers of inflammation, nutrition status and clinical features predict the mortality of patients undergoing hemodialysis for 6 years. We measured baseline plasma total and high-molecular-weight (HMW) adiponectins, tumor necrosis factor (TNF)-α, serum high sensitivity C-reactive protein (hsCRP), and clinical characteristics including visceral fat area (VFA) and the Geriatric Nutritional Risk Index (GNRI) in 133 patients undergoing chronic hemodialysis. Forty-one of the 133 patients died during follow-up. The deceased patients were significantly older, had more prior CVD and diabetes, higher TNF-α and hsCRP levels but lower GNRI. VFA, and total and HMW adiponectin did not significantly differ between the two groups. TNF-α and hsCRP levels and GNRI score were significant for predicting all-cause and cardiovascular mortality in receiver operating curve analyses. When stratified by a GNRI score of 96, Cox proportional hazards analyses identified TNF-α as a significant predictor of all-cause mortality (hazard ratio [HR] 1.23; P = 0.038) and hsCRP as a significant predictor of all-cause and cardiovascular mortality (HR, 2.32, P = 0.003; HR 2.30, P = 0.012, respectively) after adjusting for age, sex, diabetes mellitus, and prior CVD, only in malnourished patients. These results demonstrate that malnutrition and the inflammatory markers TNF-α and hsCRP, but not metabolic markers, including VFA and adiponectins have a significant impact on 6-year all-cause and cardiovascular mortality in Japanese patients undergoing hemodialysis.

Tumor necrosis factor beta NcoI polymorphism (rs909253) is associated with inflammatory and metabolic markers in acute ischemic stroke.

Polymorphisms in genes coding for pro-inflammatory molecules represent important factors for the pathogenesis and outcome of stroke. The aim of this study was to evaluate the relationship between the tumor necrosis factor beta (TNF-β) NcoI (rs909253) polymorphism with inflammatory and metabolic markers in acute ischemic stroke. Ninety-three patients and 134 controls were included. The TNF-β polymorphism was determined using PCR-RFLP with NcoI restriction enzyme. Stroke subtypes and neurological deficit score were evaluated. White blood cell counts, erythrocyte sedimentation rate (ESR), plasma levels of IL-6 and TNF-α, serum high sensitivity C-reactive Protein (hsCRP), serum lipid profile, plasma levels of glucose and insulin, and homeostatic model assessment of insulin resistance (HOMA-IR) were determined. Stroke patients presented higher white blood cell counts, hsCRP, ESR, glucose, insulin, and HOMA-IR, and lower HDL cholesterol than controls (p < 0.01). There was no difference in genotypic and allelic frequency of TNF-β NcoI polymorphism among patients and controls (p > 0.05). However, stroke patients carrying the TNFB2/B2 genotype presented higher levels of TNF-α, white blood cell counts, total cholesterol, LDL cholesterol, glucose, insulin, and HOMA-IR than those with other genotypes (p < 0.05). White blood cells, IL-6, hsCRP, and ESR were positively correlated with the neurological deficit of the patients (p < 0.05). Taken together, TNF-β NcoI polymorphism, by itself, was not associated with increased susceptibility for stroke development. However, the homozygous genotype for the allele TNFB2 was associated with higher expression of classical inflammatory and metabolic markers of development and outcome of stroke than other genotypes. The identification of variant alleles might allow both better prediction of susceptibility for stroke as well the identification of novel stroke mechanisms that could be target to new therapeutic approaches. Stroke patients carrying the TNFB2 variant allele could have a beneficial effect with the anti-inflammatory therapies in the early inflammatory phase of stroke.

Diagnostic performance of serum high-sensitivity procalcitonin and serum C-reactive protein tests for detecting bacterial infection in febrile neutropenia

Although a few prospective studies have addressed the question as to which biomarker of infection in adult patients with febrile neutropenia (FN) is superior, procalcitonin (PCT) or C-reactive protein (CRP), the results have been inconsistent and inconclusive. This was possibly due to the poor sensitivity of previous PCT tests that have a functional sensitivity of 0.5 ng/ml. Between November 2010 and February 2012, we prospectively compared the diagnostic utility of serum high-sensitivity (hs) PCT (lower limit of detection, 0.02 ng/ml) and CRP levels for detecting bacterial infection in patients with FN. Serum was collected within 72 h after the onset of FN in patients with hematological disorders. Seventy-five febrile episodes were evaluable. The areas under the receiver operating characteristic curves for life-threatening infection defined as septic shock and bacteremia caused by non-coagulase negative staphylococcus were 0.824 (95% CI 0.711-0.937; P = 0.001) for hsPCT and 0.673 (0.505-0.842; P = 0.068) for CRP, respectively. In contrast, CRP, but not hsPCT, tended to increase significantly with the clinical severity, as indicated by the diagnostic classification (P = 0.002 for trend). The serum hsPCT test may be more useful than the serum CRP test in the detection of life-threatening infection at an early phase after the onset of FN. In contrast, the serum CRP test may be more useful in diagnosing the severity of infection. However, neither of these tests was able to differentiate the cause of FN with a low probability of fatal outcome.

High sensitive c-reactive protein and serum amyloid a are inversely related to serum bilirubin: effect-modification by metabolic syndrome

Objectives: Bilirubin has been implicated in cardiovascular protection by virtue of its anti-inflammatory and anti-oxidative properties. The metabolic syndrome is featured by enhanced low-grade systemic inflammation and increased oxidative stress. Serum amyloid A (SAA) impairs anti-oxidative properties of high-density lipoprotein (HDL). We determined relationships of high sensitive C-reactive protein (hs-CRP) and SAA with bilirubin in subjects with and without metabolic syndrome (MetS).

Biological variation of cardiac troponin T in patients with end-stage renal disease and in healthy individuals

Serum cardiac troponin T concentrations are important predictors of cardiovascular and all-cause mortality in end-stage renal disease. In patients with end-stage renal disease, assessment of serial results is essential to distinguish between a cardiovascular event and chronic elevation. We employed a high-sensitivity serum cardiac troponin T assay to evaluate the long-term biological variation in end-stage renal disease patients and in healthy individuals; these biological variation data were used to define the reference change value and the analytical goals. Serum samples were collected from 18 end-stage renal disease patients in steady-state conditions, one per month for 6 months, and from 11 healthy volunteers at weekly intervals over 5 weeks. Biological variation data were derived using analysis of variance. Baseline serum cardiac troponin T concentrations in end-stage renal disease patients were above the 99th percentile of the healthy population and increased with duration of haemodialysis. For end-stage renal disease patients, within-subject (CVI) and between-subject (CVG) coefficients of variation were 14.7 and 77.8%, respectively, whereas these were 5.9 and 30.4%, respectively, for healthy individuals. The derived two-tailed and one-tailed reference change values were 44.1 and 37.1%, respectively, for end-stage renal disease patients, and 21.6 and 18.2% for healthy subjects. For appropriate clinical management of end-stage renal disease patients in the context of a cardiovascular event, regular monitoring of serum cardiac troponin T concentrations could be important in order to allow future comparison through reference change value. Biological variation data in end-stage renal disease patients were significantly higher than for healthy individuals; therefore, the use of proper reference change value data is recommended. Moreover, the observed CVI values provide demanding imprecision goals for current technology.

Serum leukotrienes, circulating neutrophils, and high sensitivity C-reactive protein in Chinese children with sleep-disordered breathing.

A number of previous works have shown that leukotriene (LT) concentration emerged disease severity-dependent increases in both exhaled breath condensate and urine of sleep-disordered breathing (SDB) patients. However, few studies have investigated how circulating level of LTs contributes to systemic inflammation of SDB, and the relationship between LT production, leukocyte count and high sensitivity C-reactive protein (hsCRP) level in SDB disease remains controversial. Prospective, observational study that included standard questionnaires, physical examinations and polysomnography. Serum leukotriene B4 (LTB(4)) and cysteinyl leukotrienes (cysLTs) were determined by means of enzyme-linked immunosorbent assays. A total of 166 children with SDB and 45 control subjects were recruited. SDB children had increased serum levels for both LTB(4) and cysLTs as well as neutrophil (Neu) count and hsCRP than the control group, and all the inflammatory parameters emerged disease severity-dependent increases. LT production correlated significantly with Neu count and hsCRP level. In the regression model, both apnea-hypopnea index and body mass index z-score were significant predictors of LTB(4) and cysLTs (p < 0.001). The activated systemic inflammatory response as reflected by serum elevations of LTs, Neu counts and hsCRP is present in children with SDB, and the magnitude of inflammation emerged disease severity-dependent. The level of LTs is significantly associated with circulating Neu counts and hsCRP values in SDB.

Effects of omega-3 fatty acid supplementation on insulin metabolism and lipid profiles in gestational diabetes: Randomized, double-blind, placebo-controlled trial

We are aware of no study that examined the effects of omega-3 fatty acid supplementation on insulin metabolism and lipid profiles in gestational diabetes (GDM). This study was designed to assess the effects of omega-3 fatty acid supplementation on insulin concentrations and lipid profiles among pregnant women with GDM. This randomized, double-blind, placebo-controlled clinical trial was performed among 56 women with GDM. Subjects were randomly assigned to receive either 1000 mg omega-3 fatty acid supplements containing 180 mg eicosapentaenoic acid and 120 mg docosahexanoic acid (n = 28) or placebo (n = 28) for 6 weeks. Fasting blood samples were taken at study baseline and after 6 weeks of intervention to quantify biochemical variables. Although omega-3 fatty acid supplementation did not led to a significant change in serum insulin levels and HOMA-IR in omega-3 fatty acid group, we found a significant difference in changes in serum insulin levels (change from baseline: -1.5 ± 7.5 vs. +3.5 ± 8.5 μIU/mL, P = 0.02) and HOMA-IR (-0.4 ± 2.1 vs. +1.1 ± 2.4, P = 0.02) comparing the two groups. Furthermore, a significant reduction in serum high sensitivity C-reactive protein (hs-CRP) levels was seen after omega-3 fatty acid supplementation compared with placebo (-236.3 ± 1541.9 vs. 898.6 ± 2292.7 ng/mL, P = 0.03). Omega-3 fatty acid supplementation did not influence fasting plasma glucose, homeostatic model assessment-Beta cell function (HOMA-B), quantitative insulin sensitivity check index (QUICKI) and lipid profiles. Omega-3 fatty acid supplementation in GDM women had beneficial effects on insulin resistance, however, it did not affect plasma glucose, HOMA-B, QUICKI and lipid profiles. Clinical registration number: www.irct.ir as IRCT201312265623N16.

Cardiovascular risk factors in children with long-standing untreated idiopathic subclinical hypothyroidism.

Subclinical hypothyroidism (SH), defined as increased TSH serum levels and normal serum free T4 concentrations, has been associated with an increased risk of coronary heart disease in adults. Data in children and adolescents are scanty. The objective of the study was to investigate the clinical and biochemical cardiovascular risk factors in children with mild SH (serum TSH concentrations 4.5-10 mU/L). This is a cross-sectional and controlled study conducted at a tertiary referral center on patients with persistent idiopathic long-standing (3.2 ± 0.4 y) mild SH. At study entry patients and controls underwent a clinical and biochemical assessment for cardiovascular risk. Forty-nine children aged 8.5 ± 0.5 years with SH and 49 controls were enrolled in the study. Systolic and diastolic blood pressure, body mass index (BMI), waist to height ratio, lipid profile, homocysteine, high-sensitivity serum C-reactive protein, fibrinogen, adiponectin, insulin, and homeostasis model assessment index were measured. Waist to height ratio (P < .0001), atherogenic index (P = .001), triglycerides to high-density lipoprotein-cholesterol ratio (P = .01), and homocysteine levels (P = .002) were significantly higher and high-density lipoprotein-cholesterol significantly lower (P = .003) in SH subjects compared with controls. No significant differences were found in the other clinical and biochemical cardiovascular risk factors analyzed. Multivariate regression model revealed that BMI and thyroid status were the main independent factors affecting dependent variables. Even after an adjustment for BMI, most of the variables still remained significantly associated with mean TSH levels or SH duration. Mild long-lasting untreated idiopathic SH may be associated with subtle proatherogenic abnormalities. Although it is difficult to establish whether these mild abnormalities represent the early steps in the initiation of atherogenesis, these children need to be carefully monitored for metabolic complications.

The Effects of Wet Cupping on Serum High-Sensitivity C- Reactive Protein and Heat Shock Protein 27 Antibody Titers in Patients with Metabolic Syndrome

Summary Introduction: It has previously been reported that increased level of serum heat shock proteins (Hsps) antibody in patients with metabolic syndrome. It is possible that the expression of Hsp and inflammatory markers can be affected by cupping and traditional Chinese medicine. There is a little data investigating the effects of cupping on markers of inflammation and Hsp proteins,

High – Sensitivity C - Reactive Protein: An Independent Proinflammatory Cardiac Marker in Healthy Overweight and Obese Individuals

In Asian countries, Indians are at high risk of premature CVD and T2DM due to abdominal obesity. Adipose tissue over the abdomen is a major source of inflammatory mediators. Numerous studies have demonstrated role of serum high sensitivity C reactive protein (hsCRP) as independent predictor of metabolic syndrome, T2DM and atherosclerotic diseases among healthy individuals. We postulated that in spite of normal glucose tolerance and normal lipid profile, obese persons are at high cardiac risk due to chronic low grade systemic inflammation. In present cross sectional study we enrolled 50 metabolically healthy overweight and obese individuals and 50 age and sex matched lean controls. We recorded history, anthropometric measures of adiposity BMI, waist and hip circumference, in study group. After overnight fast blood samples were assayed for blood glucose, lipid profile and hsCRP levels. Serum hsCRP levels were raised significantly in cases compared to control (mean 3.8+/-1.8 Vs 1.2+/-0.7 p< 0.001). We found significant positive association of hsCRP with anthropometric indices BMI and waist: hip ratio. In obese group there was evidence of significant family history of obesity, T2DM and CVD in first degree relatives compared to control.

Serum procalcitonin and high sensitivity C-reactive protein in distinguishing ADHF and CAP

BackgroundRapid and accurate diagnosis and management can be lifesaving for patients with acute dyspnea. However, making a differential diagnosis and selecting early treatment for patients with acute dyspnea in the emergency setting are a clinical challenge that requires complex decision-making in order to achieve hemodynamic balance, decrease unnecessary usage of antibiotic therapy, and decrease mortality. AimTo study the efficacy of measuring high sensitivity C-reactive protein (Hs-CRP) and procalcitonin (PCT) levels on admission in differentiating acute decompensated heart failure (ADHF) from community acquired pneumonia (CAP) in patients with acute dyspnea in the emergency setting. MethodsA comparative analytical study of ADHF included CAP patients admitted to the emergency room for acute dyspnea. Patients who qualified the criteria for both pneumonia and heart failure were excluded. Efficacy for Hs-CRP and PCT as a diagnostic markers was evaluated by using receiver operator curves (ROC). ResultsThirty patients with ADHF and 30 patients with CAP were studied. Patients with pneumonia had increased Hs-CRP and PCT levels on admission (mean values were 76.6±41.8mg/L, and 0.95±0.54ng/ml, respectively), compared with those with heart failure (18.53±18.49mg/L, and 0.09±0.03ng/ml, respectively). For differentiating pneumonia from HF, the cutoff value of Hs-CRP was 15mg/L, with sensitivity 96.7% and specificity 70%, while the cutoff value of PCT was 0.2ng/ml with sensitivity 93.3% and specificity 100%. ConclusionProcalcitonin and Hs-CRP levels can both independently distinguish CAP from ADHF in the emergency setting.

IMPACT OF GRANZYME B GENE EXPRESSION ON INFLAMMATION AND INSULIN RESISTANCE IN ATHEROSCLEROSIS

Background/Aim: Atherosclerosis is an inflammatory disease in which many immune cells are accumulated. Cytotoxic T lymphocytes, the dominant immune cells in advanced atherosclerotic lesions, exert their activity via proapoptotic protease granzyme B (GZB). However, increased GZB was detected in atherosclerotic lesions, its exact role and contribution toward atherosclerosis-related key regulatory processes yet unclear. Method: GZB mRNA expression was quantified in peripheral blood of 15 apparently healthy controls and 58 atherosclerotic patients divided into 23 non-diabetic and 35 diabetic patients by Taqman RT-PCR. Serum high sensitivity C-reactive protein and insulin levels were estimated by ELISA. Results: There is a significant 3-fold increase in GZB mRNA in atherosclerotic patients compared to control (P<0.001). Moreover, GZB mRNA levels were positively correlated with cardiovascular risk ratios, markers of inflammation and insulin resistance. Multiple regression analysis revealed that DM and current smoking were significant predictors for GZB gene expression. Conclusions: GZB might have a role in inflammation and insulin resistance processes associated with atherosclerosis development and progression.

Adhesion Molecule CD146 and its Soluble Form Correlate Well with Carotid Atherosclerosis and Plaque Instability

Intraplaque neovascularization and foam cell infiltration contribute to the development of unstable plaque, leading to thromboembolism and stroke. Cell adhesion molecules (CAMs) have been reported to be involved in the progression of atherosclerosis and plaque vulnerability. The aim of this study was to assess the association of adhesion molecule CD146 with carotid plaque instability. We collected forty atherosclerotic plaques from 40 patients undergoing carotid endarterectomy. The clinical information of each patient was obtained, and the plaque morphology and characteristics were examined by the ultrasound. The CD146 expressions of the plaques were graded by using semiquantitative scales. The serum level of soluble form of CD146 was detected by enzyme-linked immunosorbent assay (ELISA). CD146 expression was mainly on the intraplaque blood vessels and infiltrated macrophages. The CD146 expression was strongly correlated with the matrix metalloproteinase-9(MMP-9)expressions (P < 0.001) in the plaques. Soluble CD146 (sCD146) was also elevated in patients with atherosclerotic plaques. There was significant correlation between the increased CD146 expression and sCD146 level (P = 0.0057). sCD146 correlated well with serum MMP-9 (P < 0.0044), IL-6 (P = 0.0044) and high sensitivity C-reactive protein (hsCRP) (P = 0.005). Adhesion molecules CD146 and its soluble form strongly correlated with the development of inflammation of atherosclerosis and plaque instability. CD146 may be a promising biomarker for monitoring the development and instability of atherosclerotic plaque in patients with carotid diseases.

Effect of Tongxinluo capsule combined with irbesartan on hypertension serum high sensitivity C reactive protein and blood lipid level

目的 探讨通心络胶囊对高血压患者血脂和血清超敏C反应蛋白(CRP)水平的影响.方法 收集2010年11月至2012年11月河北省华北油田总医院收治的92例高血压患者,采用随机数字表法将患者随机分为两组各46例,对照组采用厄贝沙坦治疗,治疗组在对照组治疗基础上配合通心络胶囊治疗,治疗结束后比较两组患者的CRP和相关血脂指标的改善程度,以及血压的控制情况.结果 ①血压控制情况比较:治疗后对照组高血压控制有效率为74.0%,治疗组为91.3%,两组高血压控制有效率比较,差异有统计学意义(χ2＝6.28,P＜0.05).② CRP水平变化比较:两组患者治疗后CRP水平[治疗组为(1.03±0.46)mg/L,对照组为(1.94±0.58)mg/L]均较同组治疗前[分别为(2.37±0.79)mg/L,(2.56±0.92)mg/L]明显改善(P＜0.05),且治疗组疗效优于对照组.③血脂水平变化比较:两组患者治疗后血清总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白(LDL)水平[治疗组分别为(4.03±0.51)mmol/L、(1.69±0.36)mmol/L、(3.17±0.48)mmol/L,对照组分别为(4.86±0.47)mmol/L、(2.03±0.47)mmol/L、(3.45±0.66)mmol/L]均较同组治疗前[治疗组分别为(5.14±0.63)mmol/L、(2.28±0.62)mmol/L、(3.76±0.83)mmol/L,对照组分别为(5.08±0.86)mmol/L、(2.31±0.54)mmol/L、(3.81±0.75)mmol/L]明显改善(P＜0.05),且治疗组疗效优于对照组.结论 通心络胶囊可改善高血压患者C反应蛋白和血脂水平。

The Relationship Between Specific Fatty Acids of Serum Lipids and Serum High Sensitivity C- Reactive Protein Levels in Morbidly Obese Women

Background/Aims: The fatty acid profile in plasma lipids contributes to the increase of plasma high sensitivity C-reactive protein (hsCRP), a marker of inflammation and predictor of cardiovascular risk. The aim of this study was to examine the relationship between specific fatty acids (FA) of serum lipids and serum hsCRP in morbidly obese woman. Methods: The study included 16 morbidly obese (mean BMI= 43 ± 2.2 kg/m²) non-diabetic woman awaiting bariatric surgery. FA extracted from serum lipids were methylated and analyzed on GC-MS. Commercially available ELISA kits were used to determine the serum inflammatory markers. Results: We demonstrated that total saturated FA (SFA) and total monounsaturated FA (MUFA) of serum lipids were positively correlated with serum hsCRP, whereas both n-3 and n-6 total polyunsaturated FA (PUFA) were negatively correlated with serum hsCRP. Serum interleukin-6 correlated positively with some SFA and MUFA, whereas negatively with some of PUFA. Positive correlation between serum hsCRP and specific SFA and MUFA or negative correlation with PUFA decreased with the increased FA chain length. The number and localization of double bonds also had impact on these correlations. Conclusion: Our findings suggest that individual serum lipid FA levels, depending on the length of FA chain, number and the localization of double bonds are distinctly associated with hsCRP in morbidly obese subjects.

The Changes of Biomarkers by Telmisartan and their Significance in Cardiovascular Outcomes: Design of a Trial of Telmisartan Prevention of Cardiovascular Diseases (ATTEMPT-CVD)

Objective: Angiotensin II receptor blocker (ARB) has become first-line agent for the treatment of hypertensive patients because they are associated with an excellent effect for blood pressure control and a lower rate of occurrence of adverse reactions. To our knowledge, there is no report of the large-scale study that measures biomarkers in 1000 or more patients for long follow-up period. To compare the effects of ARB therapy and that of standard therapy except ARB on the changes of biomarker levels and the incidence of cardiovascular events, a trial of telmisartan prevention of cardiovascular diseases (ATTEMPT-CVD) was planned. Urinary albumin creatinine rates, plasma brain natriuretic peptide, serum high sensitivity c-reactive protein, urinary 8-hydroxy-deoxy-guanosine, serum adiponectin, and high-molecular weight adiponectin were selected as biomarkers. These biomarkers are known to be predictive factors for cardiovascular event, renal dysfunction, or atherosclerosis. Methods: ATTEMPT-CVD is a multicenter, prospective, randomized open-label, controlled trial with blinded endpoint assessment. High-risk patients with heart, peripheral, renal, or cerebrovascular disease or diabetes are being recruited and followed for 3 years. The randomization is performed as stratified randomization after age, gender, past history of disease and usage of angiotensin converting enzyme inhibitor are adjusted for. The biomarker assessment is performed at the start of the study (at registration), after 6, 12, 24 and 36 months from the start of the study. Furthermore, survey of general laboratory tests, cardiovascular events, adverse events, and drug compliance is also performed at the same point of biomarker assessment and after 3 months from the start of the study. Conclusions: The ATTEMPT-CVD is the first large clinical trial focusing of the efficacy of ARB therapy on the relationship between prevention of cardiovascular event and the changes of biomarkers. This study will provide a novel insight into the significance of biomarkers considering the therapy on high-risk hypertensive patients.

Assessment of ischaemia modified albumin in unstable angina and its correlation with selected acute phase reactants

Abstract: Objective: There is evidence that ischaemia modified albumin increases (IMA) in acute coronary syndrome but enough work has not been done in assessing the correlation between IMA and inflammatory markers in unstable angina. The aim of study was to observe whether ischaemia modified albumin would significantly be altered in unstable angina patients and also whether the same would be correlated with selected acute phase reactants. Method: The present hospital based, non interventional, cross sectional study was undertaken in Medical College and Hospital, Kolkata. Forty seven cases of unstable angina (UA) and fifty suitable controls were enrolled for the study. Serum ischaemia modified albumin (IMA), serum albumin, serum total cholesterol, serum high-sensitivity C-reactive protein (hsCRP), serum ceruloplasmin and serum transferrin were measured in blood from the study population. Results: Serum ischaemia modified albumin and hsCRP (P < 0.001) were significantly higher in UA cases whereas serum transferrin (P < 0.001) and albumin (P < 0.001) were significantly lower in cases as compared to controls. IMA was not correlated with acute phase reactants. Serum IMA (P-0.06) was not considered as an important inflammatory marker in UA. However, serum hsCRP and serum transferrin play significant role (P

Systemic Inflammation in Older Adults With Asthma-COPD Overlap Syndrome.

PurposeThe role of systemic inflammation on asthma-COPD overlap syndrome is unknown. This study aimed to examine systemic inflammation in asthma-COPD overlap syndrome, and to identify associations between clinical characteristics and inflammatory mediators in asthma-COPD overlap syndrome.MethodsIn 108 adults older than 55 years comprising healthy controls (n=29), asthma (n=16), COPD (n=21) and asthma-COPD overlap syndrome (n=42), serum high sensitivity C-reactive protein and Interleukin 6 (IL-6) were assayed. Spirometry, induced sputum, quality of life, comorbidities and medications were assessed, and their associations with asthma-COPD overlap syndrome were analyzed using logistic regression. Associations between systemic inflammatory mediators and clinical characteristics were tested in multivariate linear regression models.ResultsPatients with asthma-COPD overlap syndrome had significantly elevated IL-6 levels compared with healthy controls and asthmatics. Age, comorbidity index and IL-6 level were independently associated with asthma-COPD overlap syndrome. FEV1% predicted was inversely associated with IL-6 level, and cardiovascular disease was associated with an increased IL-6 level. Systemic markers were not associated with airway inflammation.ConclusionsSystemic inflammation is commonly present in asthma-COPD overlap syndrome, and asthma-COPD overlap syndrome resembled COPD in terms of systemic inflammation. IL-6 is a pivotal inflammatory mediator that may be involved in airflow obstruction and cardiovascular disease and may be an independent treatment target.

Effect of inhaled corticosteroids on systemic inflammation in asthma.

Background:Recent research using serum high sensitivity C-reactive protein (hs-CRP) has evidenced existence of low grade systemic inflammation in asthmatics whose correlation with various clinical indices is not fully studied.Objective:To investigate the relationship between systemic inflammation and various clinical and treatment characteristics of asthma.Materials and Methods:Forty asthmatics (22 steroid inhaling and 18 steroid naïve) and 40 healthy subjects matched for age and sex were examined cross-sectionally. Along with clinical assessment, serum hs-CRP levels were measured for all subjects using latex enhanced immunoturbidometry method.Results:Serum hs CRP levels were significantly higher in steroid naïve asthmatics when compared to normal subjects (0.93 ± 1.18 vs 0.24 ± 0.31 mg/dL, respectively; Mann-Whitney U test, P < 0.001). This association persisted after adjusting for age, gender, body mass index (BMI), and socioeconomic status (adjusted odds ratio 10.47; 95% CI 1.88-58.3; P < 0.01). Steroid inhaling asthmatics had serum hs-CRP levels comparable with control group (0.17 ± 0.18 vs 0.24 ± 0.31 mg/dL respectively, P > 0.05). Among the clinical and treatment related variables, duration of inhaled steroids usage alone correlated significantly with serum hs-CRP levels (Pearson correlation coefficient r = 0.449, P < 0.05), which was independent of age, BMI, duration of illness, and frequency of emergency visits.Conclusion:This study confirms the existence of low grade systemic inflammation in asthma which is effectively controlled by inhaled steroids. Such an effect of inhaled steroids appears to be more pronounced in recent users than that of long-term users, possibly due to lower adherence rate among the latter.

Effects of Short-term Chlorella Supplementation on Fatigue Recovery after Exercise

The purpose of this study was to investigate the metabolic deterioration and joint problems in retired elite female basketball players. In order to determine the associations between metabolic deterioration and joint health status, 19 retired and 12 current elite female basketball players were recruited for this study. After an overnight fasting, we performed an oral glucose tolerance test (OGTT) for all participants, and measured their fasting blood glucose, glycated hemoglobin (HbA1c) and serum high sensitivity C-reactive protein (hs-CRP) levels. The joint health status of hip and knee in both current and retired basketball players were determined by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) joint health questionnaire. Results showed that retired players have significantly greater body mass index (BMI), glucose area under the curve (GAUC), fasting blood glucose, hs-CRP and HbA1c levels, along with higher WOMAC joint function aspect scores compared to current players. Moreover, WOMAC joint stiffness was positively associated with fasting blood glucose level. However, the WOMAC overall score and individual aspects showed no association with serum hs-CRP levels. We conclude that retired female basketball players with impaired glycemic control, hyperglycemia and obesity were associated with declined joint health status. Our results therefore suggest that metabolic deterioration in retired female basketball players may be associated with impairments in joint health and functions.