Serum High Sensitivity Research Articles

The association of markers of oxidative-inflammatory status with malnutrition in hemodialysis patients with serum ferritin lower than 500 ng/mL

Enhanced inflammatory-oxidative status is well established in chronic kidney disease. The objective of this study was to evaluate the oxidative- inflammatory status and iron indices in patients undergoing maintenance hemodialysis (HD) with serum ferritin lower than 500 ng/mL, and to correlate them with nutritional status. In a cross-sectional survey 35 HD patients (23 with normal nutritional status, 12 with Protein-Energy-Wasting syndrome, PEW), and healthy volunteers (n = 35) were studied. Serum concentration of iron, ferritin, transferrin saturation, malondialdehyde (MDA), protein carbonyl (PC), high-sensitive serum C -reactive protein (hs-CRP) and blood counts were determined. The nutritional status was determined by anthropometric and biochemical criteria. HD patients showed low values of hemoglobin and higher values of ferritin, MDA and PC when compared with healthy volunteers. HD subjects with PEW had higher values of PC and hs-PCR as compared to HD patients with normal nutritional status. A multiple logistic regression analysis showed that the independent variables PC (Wald Statistic 4.25, p = 0.039) and hs-CRP (Wald Statistic 4.83, p = 0.028) where related with the patients' nutritional condition. In HD patients with serum ferritin below 500 ng/mL was observed one association of the markers of oxidative stress and inflammation with poor nutritional status independently of serum ferritin, gender and age.

Effect of omega-3 and ascorbic acid on inflammation markers in depressed shift workers in Shahid Tondgoyan Oil Refinery, Iran: a randomized double-blind placebo-controlled study

The present study aimed to assess the effect of supplementation of omega-3 and/or vitamin C on serum interleukin-6 and high sensitivity C-reactive protein concentration and depression scores among shift workers in Shahid Tondgoyan oil refinery. The study design was randomized, double-blind, placebo-controlled, parallel trial. Totally 136 shift workers with a depression score ≥10 in 21-item Beck Depression Rating Scale were randomly assigned to receive omega-3 (180 mg eicosapentaenoate acid and 120 mg docosahexaenoic acid) or/and vitamin C 250 mg or placebo twice daily (with the same taste and shape as omega-3 and vitamin C) for 60 days in four groups. Depression score, interleukin-6 and high sensitivity C-reactive protein were measured at baseline and after 60 days. This study showed that supplementation of omega-3 plus vitamin C is associated with a decrease in depression score (p<0.05). Supplementation of omega-3 without vitamin C, is associated with a reduction in depression score (p<0.0001) and high sensitivity C-reactive protein concentration (p<0.01). Therefore omega-3 supplementation showed a better effect on reducing depression score and high sensitivity C-reactive protein, but supplementation of vitamin C along with omega-3 did not have significant effect on change in C-reactive protein level compared to omega-3 alone. (Registration number: IRCT201202189056N1)

Serum lipoprotein(a) and high sensitivity C reactive protein levels in Saudi patients with type 2 diabetes mellitus and their relationship with glycemic control

To study serum lipoprotein(a) [Lp(a)] and high sensitivity C reactive protein (hsCRP) levels in Saudi patients with type 2 diabetes mellitus (DM) and their relationship with glycemic control. Materials and methods: A total of 201 subjects were selected for the study. The final selection included 103 patients with type 2 DM (64 males and 39 females) and 98 healthy control subjects (58 males and 40 females). Fasting venous blood samples were analyzed for glucose, glycosylated hemoglobin (HbA1c), lipids, Lp(a), and hsCRP levels. Results: Subjects with poor glycemic control showed significantly higher levels of fasting blood glucose levels (10.29 ± 3.56 vs. 7.05 ± 1.64, P = 0.0001) and HbA1c (9.72 ± 2.54 vs. 6.56 ± 0.51, P = 0.0001). Moreover, subjects with poor glycemic control were more obese than those with good glycemic control (BMI 30.63 ± 5.32 vs. 28.52 ± 4.93 P = 0.04010). It was observed that the diabetics with poor glycemic control had significantly higher levels of serum triglycerides (2.32 ± 1.26 vs. 1.67 ± 1.37, P = 0.0426), and hsCRP (5.16 ± 3.29 vs. 3.97 ± 2.5, P = 0.0423) compared with the good glycemic control group. While the difference for TC, LDL, HDL, and Lp(a) was nonsignificant, significant positive correlations were observed between HbA1c, BMI (r = 0.247, P = 0.038), TG (r = 0.247, P = 0.044), and hsCRP (r = 0.326, P = 0.006). Conclusion: Diabetic patients have higher levels of hsCRP and Lp(a) than healthy individuals. Diabetic patients with poor glycemic control have significantly higher hsCRP levels compared to those with good glycemic control. However, there is no effect of glycemic control on Lp(a) levels.

Correlation between Serum Adiponectin and Risk Factors in Patients with Coronary Artery Disease

To investigate the correlation between serum adiponectin (ADP) and high sensitivity C-reactive protein (hsCRP) as well as risk factors in patients with coronary artery disease (CAD). 90 patients with coronary artery disease (CAD) who were subjected to coronary angiography were involved. Among the patients, 41 had acute myocardial infarction (AMI), 27 had unstable angina pectoris (UAP), and 22 had stable angina pectoris (SAP). 20 healthy people comprised the control group (NC). Serum ADP was measured using an enzyme linked immunosorbent assay (ELISA). hsCRP was measured using immunoturbidimetry. Cardiovascular risk factors were also investigated. The serum ADP concentrations in the AMI group and the UAP group were significantly lower than those in the SAP group (p < 0.05) and the NC group (p < 0.01). The hsCRP concentrations in the AMI group and the UAP group were significantly higher than those in the SAP group (p < 0.05) and the NC group (p < 0.05). The ADP concentration was negatively correlated with the hsCRP concentration in the acute coronary syndrome group (r = -0.33, p < 0.05). Moreover, the more risk factors there were, the lower the serum ADP concentration in the CAD patients was. Serum ADP is associated with CAD and cardiovascular risk factors. ADP has anti-inflammatory and anti-atherogenic properties, which may have a predictive value for the genesis and development of ACS.

The influence of fasudil on the serum hs-CRP and SAA in the treatments of patients with acute cerebral infarction

Objective To study the effectiveness of fasudil on the serum high sensitive C-reactive protein (hs-CRP) and serum amyloid A (SAA) in the patients with acute cerebral infarction.Methods 100 patients with acute cerebral infarction were randomly divided into two groups,the control group (n =50 cases) and the treatment group(n =50 cases).The patients in the control group were treated through salvia injection,while the patients in the treatment group were treated through fasudil.They were treated for forteen days.The hs-CRP and SAA in the serum were detected before and after treatment.Results The total efficienties were 92％ in the treatment group and 84％ in the control group.There was a significant difference between two groups(x2 =1.5152,P ＜ 0.05).The treatment group before and after treament with hs-CRP were (11.3 ± 3.7) mg/L,(3.6 ± 1.1) mg/L.The control group before and after treatment with hs-CRP were (10.9 ± 3.5) mg/L,(7.2 ± 2.8) mg/L.Before and after treatment two groups had significant difference (t =14.1053,P ＜ 0.01) ; after the treatment in the two groups had significant diffecence (t =8.4618,P ＜ 0.05).The treatment group before and after treatment with SAA were (17.6 ± 5.2) mg/L,(2.7 ± 0.9)mg/L,control group before and after SAA treatment were (17.1 ± 4.9) mg/L,(5.2 ± 1.8) mg/L.Before and after treatment,two groups had significant difference (t =2.0096,2.0096,all P ＜ 0.01) ; after the treatment in the two groups had significant difference(t =8.7841,P ＜ 0.05).Conclusion Fasudil can improve acute cerebral infarction throughmitigating inflammation. Key words: Brain infarction; C-Reactive protein; Amyloid protein A; Fasudil

The Fractional Exhaled Nitric Oxide and Serum High Sensitivity C-Reactive Protein Levels in Cough Variant Asthma and Typical Bronchial Asthma

Fractional exhaled nitric oxide (FeNO) is known to be a good marker of airway eosinophilic inflammation in bronchial asthma. Recently, serum high sensitivity C-reactive protein (hs-CRP) has been shown to be also useful to detect the airway inflammation. Newly diagnosed 90 cough variant asthma and 92 bronchial asthma patients were enrolled. FeNO, serum hs-CRP, pulmonary function tests, bronchial hyperresponsiveness, IgE and sputum eosinophils ratio were compared. Ninety healthy control subjects were set for FeNO and serum hs-CRP normal range reference. We have compared the clinical utilities of FeNO and serum hs-CRP to differentiate bronchial asthma and cough variant asthma. FeNO was significantly higher in bronchial asthma (92.6 ± 85.5ppb) than in cough variant asthma (35.6 ± 43.3; p < 0.001) and both were significantly higher than normal range (18.0 ± 6.4, p < 0.001, respectively), and in differentiating between the two groups showed a sensitivity of 0.69 and a specificity of 0.73 at the cutoff value of 28 ppb. Serum hs-CRP did not differ significantly between bronchial asthma (723 ± 1162ng/ml) and cough variant asthma (558 ± 758) even if both were significantly higher than normal range (345 ± 401, p < 0.01 and p < 0.05 respectively). FeNO is more useful than serum hs-CRP in differentiating patients with bronchial asthma from those with cough variant asthma, and healthy persons.

Effect of typical and atypical antipsychotic drugs on serum C-reactive protein and lipid profile in schizophrenic patients

Objectives: To assess the effect of quetiapine and fluphenazine on serum high sensitivity C-reactive protein (hs-CRP) and serum lipid profile in schizophrenic patients. Patients and methods: The subjects comprised two groups of twenty seven newly diagnosed schizophrenic patients for each group. The first group was treated orally with quetiapine at a dose 200-500 mg/day. The second group was treated with fluphenazine intramuscularly at a dose 25 mg every 4 weeks. Twenty seven healthy volunteers were also included as a control group. The patient and the control groups were age and sex matched. The patients were diagnosed by a psychiatrist on the basis of semi-structured interview to determine DMS-IV diagnosis. Clinical symptoms were assessed in 14 of the 18 Brief individual Psychiatry Rating Scale (BPRS) items in order to measure the severity of schizophrenia. Fasting blood samples from the patients were taken for analysis before the beginning of quetiapine or fluphenazine treatment and after 8 weeks of the study. Other blood samples were taken from healthy subjects as a control group. Results: Serum hs-CRP was significantly (p  0.01) higher in the schizophrenic patients before treated by quetiapine or fluphenazine (difference = 382.9% and 395.1% of control, respectively) than controls. The measurement of hs-CRP decreased significantly (p  0.01) after quetiapine treatment by 19.1%, while it was increased significantly (p  0.01) after fluphenazine by 12.3% compared with before treatment values. In the schizophrenic patients, serum total cholesterol (TC) and triglycerides (TG) were significantly higher (p  0.01) than controls, while high density lipoprotein cholesterol (HDL-C) was lower than controls. Quetiapine caused significant increase (p  0.01) in serum TC and TG, while serum HDL-C decreased significantly (p  0.01) compared with the results before treatment. Fluphenazine did not cause any significant change in the lipid parameters. Quetiapine treatment significantly increased (p  0.05) body mass index (BMI), whereas fluphenazine did not change BMI compared with before treatment values. Base time and after 8 weeks of quetiapine or fluphenazine treatment showed significant decrease in the score of BPRS by quetiapine and fluphenazine. Conclusion: Quetiapine depressed CRP and caused dyslipidemia. Fluphenazine raised CRP but it had no effect on lipid profile.

The correlation between serum high sensitivity C-reactive protein and leptin in reproductive age overweight/obese women in Erbil city

Background and objectives:&nbsp;Leptin could be a key regulator of C-reactive protein (CRP) levels, which serve as a marker of systemic inflammation. Both leptin and CRP are predictors of cardiovascular disease (CVD). This study, attempted to characterize the association between inflammatory marker hs-CRP and serum leptin in overweight/obese women in reproductive age in comparison with normal body mass index women (BMI) as a control group. Methods: Eighty reproductive age women were divided into two groups: first group of 50 overweight / obese women; with mean age 27.7 years and BMI mean (31.4 Kg/m2). The second group of 30 age-matched women with mean age 28.8 years and BMI mean (22.5 Kg/m2)&nbsp;which served as control group. Any subject with other diseases or on medication that might affect the study was excluded. Fasting blood samples for both groups were collected and serum hs-CRP, leptin, lipid profile and glucose were measured Results: In the overweight / obese group hs-CRP concentrations were significantly associated with BMI and leptin (r =0.3, r =0.284, with p &lt;0.05) respectively. This association remained significant, even after adjusting BMI, for each one unit increase in serum leptin the serum hs-CRP escalated by a mean of 0.05 (mg/L). Serum Leptin notably has a more significant role than BMI in explaining changes of serum hs-CRP since its standardized coefficient was higher (ß =0.384 with p=0.001) versus (ß =0.266 with p=0.016) for BMI in overweight and obese women. Conclusion: Leptin is a stronger predictor of hs-CRP than BMI in overweight and obese women in reproductive age.

Soluble CD163 in young sickle cell disease patients and their trait siblings

CD163 is expressed on cells of monocyte-macrophage lineage and is the main hemoglobin-haptoglobin receptor. Inflammation and monocyte activation are predisposing factors to vaso-occlusion and pulmonary hypertension, which are serious complications in sickle cell disease (SCD). Siblings of SCD patients may have the same pathophysiology without displaying symptoms. We assessed soluble CD163 (sCD163) levels in 60 children with SCD and 30 sickle cell trait (SCT) siblings compared with 30 healthy controls as a potential marker for disease severity and treatment response. Patients were studied stressing on the presence of pulmonary hypertension by Dopplar-Echocardiography, sickling crisis, transfusion requirements, hydroxyurea response, hematological profile, high sensitivity C-reactive protein (hs-CRP) and serum sCD163. sCD163 was significantly elevated in SCD patients and SCT siblings compared with controls and the highest levels were in untreated SCD patients (P < 0.001). sCD163 was higher in patients with pulmonary hypertension, acute chest syndrome or stroke as well as in patients who developed sickling crisis during the study period (P < 0.05). Hydroxyurea-treated patients had lower sCD163 compared with untreated patients (P < 0.001). sCD163 was positively correlated to leukocyte count, HbS, hs-CRP, pulmonary artery pressure and tricuspid regurgitant velocity whereas inversely correlated to hemoglobin and HbF levels. The cut-off value of sCD163 at 1400 ng/ml could be considered a predictor for vaso-occlusive crisis in SCD with a sensitivity of 92.3% and specificity of 94.1%. sCD163 can be considered a biomarker for pulmonary hypertension, early crisis prediction and monitoring hydroxyurea response in SCD patients. Elevated sCD163 in trait siblings could reflect increased risk of sickling in challenging situations.

Brain-stem auditory evoked responses in COPD patients

BackgroundCOPD is a multi-system disorder. It appears to be associated with the presence of systemic inflammatory markers as C reactive protein. Aim of the workThe present study aimed to evaluate the brain-stem auditory evoked potentials (BAEP) abnormalities in stable COPD patient and its correlation with high sensitivity C reactive protein (hs-CRP) as a part of multi-system disorder. Subjects and methodsThis case control study was carried out at Mansoura University Hospital Egypt from October 2009 to February 2010. The study comprised 40 stable COPD patients and 15 healthy controls with no risk that may lead to neuropathy. All the patients and controls were subjected to the following: I-Thorough history taking and clinical examination. II-Pulmonary function tests including: 1-Spirometry 2-Body plethsymography 3-Arterial blood gases analysis. III- Record of brain-stem auditory evoked potentials (BAEP) including: latencies of waves I, II, III, IV and V together with interpeak latencies (IPLs) of I–III, I–V and III–V and amplitudes of waves I–Ia and V–Va. IV–Measurement of serum high sensitivity C reactive protein (hs-CRP) by ELISA technique. V–Statistical analysis. ResultsThe level of hs-CRP reactive protein in COPD was significantly elevated and correlated with spirometric, blood gases parameters and GOLD stage. The BAEP latencies of waves I, II, III, IV and V, together with interpeak latencies and amplitudes of waves I–Ia and V–Va measured on both ears were significantly different in COPD patients than controls. The prevalence of brain-stem auditory evoked potentials abnormalities was higher among very severe group of COPD. Most of BAEP wave latencies together with interpeak latencies and wave amplitudes on both ears were significantly correlated with the spirometric and blood gases parameters. The level of hs-CRP was correlated significantly with abnormalities of BAEP variables. ConclusionThis study showed significant subclinical BAEP abnormalities in studied stable COPD male patients. This indicates conductive defect of auditory nerve, cochlea and even hearing pathway in the brain as a part of systemic inflammation.Theses BAEP abnormalities were significantly correlated with GOLD classification, hs-CRP and PaO2.

EFFECTS OF INFLAMMATION, OXIDATIVE STRESS AND PLATELET ACTIVATION ON CORONARY HEART DISEASE AND THEIR INTERACTIONS

ObjectivesTo investigate changes in inflammation, oxidative stress and platelets in patients with coronary heart disease (CHD) and the relationship among them by determining the levels of inflammatory markers, product of...

CORRELATION STUDY OF CAROTID ATHEROSCLEROSIS AND SERUM HIGH SENSITIVITY C-REACTIVE PROTEIN LEVELS IN ELDERLY HYPERTENSIVE PATIENTS

ObjectivesTo investigate the correlation of carotid atherosclerosis and serum high sensitivity C-reactive protein levels in elderly hypertensive patientsMethods102 cases of elderly patients with hypertension were selected according to the WHO/ISH...

Resistance training decreases serum inflammatory markers in diabetic rats

Inflammation plays an important role in the genesis and progression of diabetes. The purpose of this study was to investigate the effect of resistance training on serum levels of some inflammatory markers associated with diabetes mellitus. Twenty-four male Wistar rats (290 ± 19 g) were randomly divided into three groups: non-diabetic control (non-DC), diabetic control (DC), and diabetic trained (DT). Animals in DT group were subjected to a resistance training program with the use of a ladder (3 days/week, for 4 weeks). Body weight, serum high sensitivity C-reactive protein (hs-CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-α, fasting glucose, and insulin were measured. Four weeks of resistance training decreased serum levels of TNF-α, hs-CRP, and IL-6 in diabetic rats when compared with DC animals. We conclude that resistance training with appropriate intensity, duration, and recovery between exercise bouts has marked anti-inflammatory effects on diabetic rats. This may be an efficient strategy to protect against some diabetic complications.

Anti-inflammatory effect of purified dietary anthocyanin in adults with hypercholesterolemia: A randomized controlled trial

Background and aimAtherosclerosis is a chronic inflammatory disease and previous studies have demonstrated that anthocyanin inhibits atherosclerosis. In the present study, we explored the effects of anthocyanins on inflammatory cytokines in hypercholesterolemic adults and cell lines. Methods and resultsA total of 150 subjects with hypercholesterolemia consumed a purified anthocyanin mixture (320 mg/d) or a placebo twice a day for 24 weeks in a randomized, double-blind trial. Anthocyanin consumption significantly decreased the levels of serum high sensitivity C-reactive protein (hsCRP) (−21.6% vs. −2.5%, P = 0.001), soluble vascular cell adhesion molecule-1 (sVCAM-1) (−12.3% vs. 0.4%, P = 0.005) and plasma IL-1β (−12.8% vs. −1.3%, P = 0.019) compared to the placebo. We also found a significant difference in the LDL-cholesterol (−10.4% vs. 0.3%, P = 0.030) and HDL-cholesterol level changes (14.0% vs. −0.9%, P = 0.036) between the two groups. In cell culture assays in vitro, purified anthocyanin mixture, delphinidin-3-Ο-β-glucoside (Dp-3g) and cyanidin-3-Ο-β-glucoside (Cy-3g) inhibited IL-6 and IL-1β-induced CRP production (P < 0.05) in HepG2 cell line and LPS-induced VCAM-1 secretion (P < 0.05) in porcine iliac artery endothelial cell line respectively in a dose-dependent manner. In addition, the reduction of inflammatory cytokines associated with anthocyanin mixture was stronger when compared with the effects of Dp-3g and Cy-3g separately (P < 0.05). ConclusionsAnthocyanin mixture reduced the inflammatory response in hypercholesterolemic subjects. In addition, different anthocyanin compounds were found to have additive or synergistic effects in mediating anti-inflammatory responses in vitro cell culture assays.

Serum nitric oxide metabolites and high sensitivity C-reactive protein are important biomarkers in non obese, Indian type 2 diabetic males

Inflammation, endothelial dysfunction, and oxidative stress are postulated to be the principal events in the pathogenesis of type 2 diabetes mellitus and its vascular complications. Serum Nitric Oxide metabolites (NOX) and high sensitivity C-reactive protein (hs-CRP) were measured in eighty non-obese, type 2 diabetic males (40 to 65 years) without (group B, N = 40) and with vascular disease [16 retinopathy (group C), 24 hypertension (group D)]; and compared with forty healthy, age and sex matched control subjects (group A). The mean age of diabetic patients and healthy controls was 49.5 ± 5.80 vs. 51.0 ± 7.15 years, respectively (P = 0.212). Diabetic group had higher Fasting Plasma Glucose (FPG), hs-CRP, and NOX levels than control group (135.3 ± 28.69 vs. 96.7 ± 10.46; 5.1 ± 2.59 vs. 1.7 ± 0.54; 61.1 ± 15.67 vs. 37.1 ± 3.69, respectively, P = 0.001). When compared with diabetics without complication (53.7 ± 10.37), levels of NOX were significantly higher (P = 0.001) both in retinopathy (74.5 ± 19.39) and hypertension (64.4 ± 13.60) group, whereas that of hs-CRP (4.4 ± 2.85 vs.6.5 ± 2.93, P = 0.015) differed only in retinopathy group. There was no difference between retinopathy and hypertension group. There was significant (P < 0.05) positive correlation between age, duration of diabetes, hs-CRP, and NOX; hs-CRP and NOX among group B and C. A negative correlation was noted between hs-CRP and NOX (r = −0.068, P = 0.752) among hypertensives. By multivariate regression analysis, FPG, hs-CRP and NOX were found to be independent indicators of complications after adjustment for age and duration of diabetes. This study reveals that NOX and hs-CRP are important biomarkers in type 2 diabetes mellitus and its associated vascular complications.

Obesity and Serum High Sensitivity C-Reactive Protein Levels Among Elderly Turkish Immigrants in the Netherlands with Type 2 Diabetes

The study examined the associations of anthropometric measures of obesity with high sensitivity C-reactive protein (hs-CRP) levels in Turkish immigrants with type 2 diabetes (T2D) living in the Netherlands. A total of 110 participants, physician-diagnosed with T2D, aged 30 years and older were recruited from multiple sources from The Hague, Netherlands. Serum hs-CRP levels were measured with immunoturbidimetric assay. Glycated hemoglobin (A1C) was determined by high-pressure liquid chromatography. Measures of obesity: body weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were determined. Statistical analysis included descriptive statistics, Pearson’s correlations and multiple linear regressions (MLR) stratified by gender. Hs-CRP was log transformed to achieve normality. Subjects with hs-CRP levels >10 mg/L (n = 17) were excluded from the analysis. Females had a higher BMI (p = 0.007), HC (p < 0.001), and WHtR (p = 0.011) as compared to males. Conversely, males had a higher weight (p = 0.007), and WHR (p < 0.001) than females. MLR showed that after controlling for covariates, log hs-CRP was positively associated with BMI (B = 0.039, SE = 0.019, β = 0.287, p < 0.05), WC (B = 0.025, SE = 0.011, β = 0.332, p < 0.05) and WHtR (B = 4.015, SE = 1.464, β = 0.376, p < 0.01) in females only. Gender-specific associations between obesity measures and hs-CRP level need to be further investigated in the Turkish immigrant population. Hs-CRP assessment may be added as a standard of care for T2D treatment within this population.

Efficacy and safety of secukinumab in patients with rheumatoid arthritis: a phase II, dose-finding, double-blind, randomised, placebo controlled study

ObjectiveTo assess the safety and efficacy of secukinumab, a fully human monoclonal anti-interleukin-17A antibody, in patients with rheumatoid arthritis (RA).MethodsPatients (n=237) with inadequate response to methotrexate were randomly assigned to...

Obesity indices and metabolic markers are related to hs-CRP and adiponectin levels in overweight and obese females

Obese subjects had increased serum high sensitivity C-reactive protein (hs-CRP), decreased adiponectin levels, and impaired microvascular endothelial function compared to lean subjects. We investigated the relationships of serum hs-CRP, adiponectin and microvascular endothelial function with obesity indices and metabolic markers in overweight and obese female subjects. Anthropometric profile, body fat composition, biochemical analysis, serum hs-CRP and adiponectin levels, and microvascular endothelial function were measured in 91 female subjects. Microvascular endothelial function was determined using laser Doppler fluximetry and the process of iontophoresis. Mean age and body mass index (BMI) of subjects were 34.88 (7.87) years and 32.93 (4.82) kg/m(2). hs-CRP levels were positively correlated with weight, BMI, waist circumference, hip circumference, body fat and visceral fat. Adiponectin levels were positively correlated with insulin sensitivity index (HOMA-%S), and inversely correlated with waist hip ratio, triglyceride, fasting insulin and insulin resistance index (HOMA-IR). No relationship was seen between microvascular endothelial function and obesity indices, and metabolic markers. In overweight and obese female subjects, hs-CRP levels were correlated with obesity indices while adiponectin levels were inversely correlated with obesity indices and metabolic markers. No significant relationship was seen between microvascular endothelial function with obesity indices and metabolic markers including hs-CRP and adiponectin in female overweight and obese subjects.

RR21. Inflammatory Mediators and Cerebral Embolism in Carotid Stenting: New Markers of Risk

Cerebral embolism is a feared complication of carotid artery stenting (CAS) and might be associated with specific morphological patterns, however serological predictors of risk have been scarcely investigated. Consecutive patients with carotid artery stenosis undergoing filter-protected CAS were preoperatively evaluated to identify unstable plaque at duplex ultrasound, complicated aortic plaque at trans-esophageal echocardiography and inflammatory status with high sensitivity C-reactive proteins (hs-CRP) and serum amyloid-A protein (SSA) serum levels. Aortic arch type, carotid tortuosity, and complexity of the procedure were considered. Cerebral embolism was evaluated by comparing number, volume and side of preoperative and postoperative cerebral lesions at diffusion weight resonance magnetic imaging (DW-RMI) and through light and scanning electron microscopy analysis of cerebral protection filters obtained from CAS. Twenty consecutive patients were submitted to CAS with no complications. At least 1 asymptomatic cerebral lesion on DW-MRI was present in 18 (90%) patients. Female gender was associated with a higher number of cerebral lesions (18.2±10.9 vs. 8.3±8.8 P = .03). Plaque morphology, supraaortic vessels anatomy and procedure complexity did not correlate with number or volume of new cerebral lesions at DW-RMI. The presence of complicated aortic plaque was associated with higher volume of contralateral cerebral lesions (2350±2593 vs. 636±632 mm3 P = .02). Hs-CRP >5mg/l and SAA >10 mg/l were significantly associated with a higher number of cerebral lesions (16.2 ± 10.7 vs. 4.3±3.4 P = .02, and 14.8 ± 10.3 vs. 2.8 ± 3.4 P = .006, respectively). Hs-CRP>5 and SAA>10 mg/l also correlated with greater surface involvement by embolic materials in the protection filters at microscopic analysis (37.0 ± 5.7 vs. 26.9 ± 2.5 P = .004). Inflammatory status is associated with higher embolic risk during CAS independent from morphological and technical aspects of the procedure.

Abstract 114: Pomegranate Regressed Atheroma in Carotid and Coronary Arteries: Fiction or Fact?

Background: Atherosclerosis is a disease of large and medium-sized muscular arteries and is characterized by endothelial dysfunction, vascular inflammation, and the buildup of lipids, cholesterol, calcium, and cellular debris within the intima of the vessel wall, oxidized low-density lipoprotein (LDL) can reduce the expression of nitric oxide synthase, the enzyme that produces nitric oxide. Nitric oxide reduces injury to the vessel walls, which also helps prevent the development of atherosclerosis Recently, they discovered that pomegranate juice enhances the bioactivity of nitric oxide synthase in endothelial cells. Furthermore, pomegranate’s antioxidant properties protect nitric oxide from oxidative destruction, thus augmenting its biological actions. Therefore the objective of present study was to assess the effect of pomegranateon atherosclerosis regression via interfering with inflammatory and oxidative pathways. Methods: 60 local domestic rabbits were assigned to three groups: Group I (n = 30) fed normal diet,Group II ( n = 30) Rabbit fed high cholesterol-diet (induced untreated group), Group III ( n = 30) high cholesterol-diet for 12 weeks but adding oral pomegranate juice at 6 weeks .Blood samples were collected at (0 time ), after 6 and 12 weeks for measurement of serum triglycerides (TG), total cholesterol (TC), HDL-C and serum high sensitive C-Reactive Protein (hsCRP), serum IL-6 and serum TNF-a. At the end of 12 weeks,both carotid and right coronary arteries was removed, part of it for histopathology to assess the atherosclerotic change according to AmericanHeart Association classification of atherosclerosis phases and for aortic intema-media thickness also part of it homogenized for malondialdehyde (MDA) and reduced glutathione (GSH). Results: Compared with the control, levels of TC, TG, LDL-C, VLDL-C, atherogenic index, hsCRP, IL-6, TNF-a and arterial MDA were increased and arterial GSH and serum HDL-C were decreased in the animals with a high-choleterole diet ( P &lt; 0.01). Histologically all induced-untreated rabbit showed significant atherosclerosis lesions in both arteries ( P &lt; 0.01) all occurred at 6 and 12 weeks. While in pomegranate treated group at 12 weeks, levels of TC, TG, LDL-C, VLDL-C, atherogenic index, hsCRP, IL-6, TNF-a and arterial tissue of MDA were decreased and coronary and carotid GSH and serum HDL-C were increased relatively ( P &lt; 0.01).Low power microscopic morphologic analysis revealed that pomegranate treated group markedly regressed ( P &lt; 0.01) the atherosclerotic lesion in form of decrease intima-media thickness in histomorphometric measurements in the studied arteries at 12 weeks compared with rabbits on a high-fat diet at same period. In conclusion pomegranate juiceregressed atherosclerosis in carotid and coronary arteries in hypercholesterolemic rabbit via inhibition of inflammatory, oxidative pathways, reduced level of lipid parameters and decreased aortic intima-media thickness.