Serum hs-CRP Concentrations Research Articles

Changes and Roles of IL-6, hsCRP, and proCT in Patients with Chronic Periodontitis in Head and Neck Cancer Pre/Post Radiotherapy

Background: Head and neck cancer (HNC) patients frequently undergo radiotherapy as a standalone treatment or in combination with chemotherapy. Radiotherapy is associated with adverse effects, including detrimental impacts on periodontal health, which increase the risk of periodontitis. Objective: To investigate the clinical significance of interleukin-6 (IL-6), high-sensitive C-reactive protein (hsCRP), and procalcitonin (proCT) as prognostic indicators. Methods: 150 participants were divided into three groups: (n=50, HNC post-RT) patients with head and neck cancer who had radiation treatment six months ago (n=50, HNC pre-RT), and individuals with periodontal health as the control group (n=50). Probing pocket depth (PPD), clinical attachment loss (CAL), gingival bleeding index (GBI), plaque index (PI), and hyposalivation were meticulously recorded. To quantify serum concentrations of IL-6, hs-CRP, and proCT, an electrochemiluminescence immunoassay (eCLIA) was used. Results: Serum levels of IL-6, hsCRP, and proCT were significantly elevated in two groups of patients with chronic periodontitis with head and neck cancer post-radiotherapy (CP+HNC post-RT) and patients with chronic periodontitis with HNC pre-radiotherapy (CP+HNC pre-RT) compared to a control group. ROC analysis demonstrated the diagnostic accuracy of IL-6, hsCRP, and proCT for both clinical cases. Furthermore, all clinical periodontal index scores (CAL, PPD, PI, and GBI) were significantly elevated compared to a control group. Conclusions: HNC post-RT patients presented significantly higher serum IL-6, hs-CRP, proCT, and periodontal score levels than HNC pre-RT.

Protective effects of fructose-1,6-bisphosphate postconditioning on myocardial ischemia-reperfusion injury in patients undergoing valve replacement：a randomized, double-blind, placebo-controlled clinical trial.

Pharmacological postconditioning can protect against myocardial ischaemia-reperfusion injury during cardiac surgery with extracorporeal circulation. The aim of this study was to observe the protective effects of fructose-1, 6-bisphosphate (FDP) postconditioning on myocardial ischaemia-reperfusion injury in patients undergoing cardiac valve replacement with extracorporeal circulation. Patients undergoing elective mitral valve replacement and/or aortic valve replacement were divided into normal saline postconditioning group (NS group) and FDP postconditioning group (FDP group). The primary outcome was the plasma concentration of creatine kinase-MB (CK-MB). The secondary outcomes were the plasma concentrations of lactate dehydrogenase (LDH), creatine kinase (CK), high-sensitivity C-reactive protein (hs-CRP), alpha-hydroxybutyrate dehydrogenase (α-HBDH) and cardiac troponin I (cTnI), the spontaneous cardiac rhythm recovery profile, the extracorporeal circulation time and duration of surgery, ICU and postoperative hospitalization. Forty patients were randomly assigned to receive intervention and included in the analysis. The serum concentrations of CK-MB, LDH, CK, cTnI, α-HBDH and hs-CRP at T1∼4 were lower in the FDP group than in the NS group (P < 0.001). Compared with the NS group, the dosage of dopamine administered 1∼90min after cardiac resuscitation, the spontaneous cardiac rhythm recovery time and the incidence of ventricular fibrillation were lower in the FDP group (P < 0.001, P < 0.001 and P = 0.040, respectively). The values of ST- changes were increased more significantly in the NS group than in the FDP group （median [standard deviation] 1.3 [0.3] mm vs 0.7 [0.2] mm）(P < 0.001). Compared with the NS group, the time of recovery of ST-segment deviations was shorter in the FDP group（50.3 [12.3] min vs 34.6 [6.9] min） (P < 0.001). The fructose-1, 6-bisphosphate postconditioning could improve both myocardial ischaemia-reperfusion injury and the spontaneous cardiac rhythm recovery during cardiac valve surgery with extracorporeal circulation.

IL-6 inhibition with clazakizumab in patients receiving maintenance dialysis: a randomized phase 2b trial

Inflammation mediated by interleukin-6 (IL-6) is strongly associated with cardiovascular risk. Here we evaluated clazakizumab, a monoclonal antibody targeting the IL-6 ligand, in a phase 2b dose-finding study. Adults with cardiovascular disease and/or diabetes receiving maintenance dialysis with high-sensitivity C-reactive protein (hs-CRP) ≥ 2 mg l−1 at baseline were randomized to receive clazakizumab (2.5 mg, 5 mg or 10 mg, n = 32 per dose group) or placebo (n = 31) every 4 weeks. The primary endpoint was the change from baseline in hs-CRP to week 12, expressed as the geometric mean ratio. Clazakizumab treatment signficantly reduced serum hs-CRP concentrations at week 12 by 86%, 90% and 92% relative to placebo in patients randomized to 2.5 mg, 5 mg or 10 mg clazakizumab, respectively (all P < 0.0001), meeting the primary outcome. With regard to secondary endpoints, clazakizumab treatment reduced serum fibrinogen, amyloid A, secretory phospholipase A2, and lipoprotein(a) concentrations, as well as increased mean serum albumin concentrations at 12 weeks, relative to placebo. The proportion of patients who achieved hs-CRP < 2.0 mg l−1 was 79%, 82% and 79% in the 2.5 mg, 5 mg and 10 mg clazakizumab groups, respectively, compared with 0% of placebo-treated patients. With regard to safety, no cases of sustained grade 3 or 4 thrombocytopenia or neutropenia were observed. Serious infections were seen with similar frequency in the placebo, clazakizumab 2.5 mg and clazakizumab 5 mg groups, but were numerically more frequent in the clazakizumab 10 mg group. The results of this trial indicate that in patients receiving maintenance dialysis, clazakizumab reduced inflammatory biomarkers associated with cardiovascular events. ClinicalTrials.gov registration: NCT05485961.

Genomic and epigenomic changes by low force electrically induced exercise of human paralyzed muscle

Musculoskeletal deterioration following complete paralysis, such as after a spinal cord injury, results in osteoporotic bone and atrophic, glycolytic, and insulin-resistant skeletal muscle. Decreased bone integrity can be overloaded with very little force; therefore, high force contractions should be avoided in people with long-term spinal cord injury. Together, these changes compromise systemic metabolism for people with SCI and contribute to the development of secondary non-communicable diseases. Electrically induced exercise training offers a unique strategy to ensure full muscle recruitment without high force levels by using high current intensity and a low stimulation frequency (&lt;5Hz) to prevent force summation of stimulus pulses. While acute epigenomic and genomic changes have been found with this low force exercise method; how long-term training affects skeletal muscle and systemic biomarkers of health remains unknown. Purpose: We seek to determine the long-term genomic and epigenomic response of low-force electrically induced exercise in paralyzed skeletal muscle. Methods: 10 males with a complete SCI completed at least 6-months of unilateral electrically induced exercise training using low-force (3Hz) stimulation. Participants completed at least 5 exercise training sessions per week for at least 6-months. A muscle fatigue assessment and fasting venous blood draw were performed before and after training. Percutaneous muscle biopsies were obtained from a trained and untrained vastus lateralis. Gene expression was measured using the Affymetrix HTA 2.0 array and epigenomic expression was measured using Illumina’s MethylEPIC array. Parametric tests were used to compare pre and post training. All participants provided written consent approved by the University of Iowa Institutional Review Board in compliance with the Declaration of Helsinki. Results: Participants maintained a high compliance by completing 119±19% of the training sessions for 7.2±1.2 months. There was a 115±34% change improvement of the fatigue index after training (p=0.002). Serum concentrations of insulin, hsCRP, and myostatin were decreased by 43±8% (p=0.155), 26±8%(p=0.047), 35±9%(p=0.098) after exercise training, respectively. Serum BDNF increased by 68±14%(p=0.093) after exercise training. There was a strong correlation between the primary principal component and the trained limb (R2=0.20, p=0.046). There were 693 and 671 genes to be significantly up or down regulated after exercise training (FDR &lt; 0.05). Of the genes most responsive to exercise training, MYH6, MYH7, and MYL3 were increased in expression and decreased in median methylation. MSTN and ACTN3 were decreased in genomic expression with an increase in median methylation after exercise training. Conclusions: Low-force electrically induced exercise training improved fatigability, a muscle oxidative phenotype transition, and improved serum biomarkers associated with metabolism and inflammation. Together, these data highlight the impact low-force electrically induced exercise can have on paralyzed muscle and is suggestive that this rehabilitation strategy may provide benefits for people living with paralysis. Research Support: This study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development: R01HD084645, R01HD082109. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

The associations of oxidative stress and inflammatory markers with obesity in Iranian population: MASHAD cohort study

BackgroundLow-grade inflammation and stress oxidative condition play a role in the pathogenesis of obesity, and the serum levels of these markers, such as pro-oxidant-antioxidant balance (PAB), high-sensitivity C-reactive protein (hs-CRP), and uric acid may indicate obesity progression. In this study, we aimed to investigate the relationship between obesity with PAB, hs-CRP, and uric acid in the Iranian population.MethodsThis study was derived from the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) study. A total of 7985 subjects aged 35 to 65 years were divided into three groups according to body mass index (BMI) as: normal, overweight and obese groups. Anthropometric indices and biochemical parameters such as PAB, superoxide dismutase type 1 (SOD1), hs-CRP, and uric acid were measured in all the participants. We evaluated the association of obesity with inflammatory factors by using multivariate regression analysis. Also, those participants with hypertension, an endocrine disorder, history of cardiovascular diseases and diabetes mellitus were excluded from the study.ResultsThere was a positive significant correlation between BMI and serum PAB, hs-CRP and uric acid (p < 0.001). While no statistically significant relation was observed between BMI and SOD1 (p = 0.85). Multivariate regression analysis showed that the risk of overweight and obesity increased 1.02 and 1.03-fold according to increase 10 units of PAB raise in comparison to reference group (normal weight) [(odds ratio (OR): 1.02, 95% CI (1.01–1.03)] and [OR: 1.03, 95% CI (1.01–1.04)], respectively). In addition, hs-CRP serum concentration was significantly associated with a high risk of obesity [(OR: 1.02; 95% CI (1.01–1.03)]. While the high levels of serum uric acid were associated with increased odds of overweight and obesity risk [OR: 1.4; CI (1.39–1.58) and OR: 1.76; CI (1.63–1.89), respectively].ConclusionsGenerally, we showed a significant association between BMI and serum PAB, hs-CRP values and uric acid levels, suggesting the role of these factors as risk stratification factors for obesity.

Estimation of NLRP3 Inflammasome Role and some Biochemical Parameters in Patients with Chronic Kidney Diseases (CKD)

Chronic kidney disease (CKD) is a widespread condition that poses a major threat to human health. With substantial public health costs, severe morbidity, and mortality, CKD prevalence is increasing. The study aimed to look at NLRP3 inflammasome , hsCRP , Urea , Creatinine, Uric acid and GFR levels. Serum NLRP3 inflammasome , hsCRP , Urea , Creatinine, Uric acid and GFR levels were determined in 90 patients with Chronic Kidney Diseases (CKD) , and 85 healthy subjects, an age range (30-75). The results of current study show a significant increase in the concentration of serum NLRP3 inflammasome, hs-CRP, urea , creatinine and uric acid in (CKD) patients group in comparison with controls group (p&lt;0.05). While shows a significant decrease in GRF in (CKD) patients group in comparison with controls group (p&lt;0.05). The aim of this study is estimated the NLRP3 inflammasome , Inflammation marker , kidney function tests and Glomerular filtration rate (GFR) in patients with Chronic Kidney Disease.

Added γ-oryzanol boosted anti-inflammatory effects of canola oil in adult subjects with type 2 diabetes: a randomized controlled clinical trial.

This study was conducted to examine the effects of daily intake of γ-oryzanol (ORZ)-fortified canola oil, as compared with plain canola and sunflower oils, on certain inflammatory and oxidative stress biomarkers in adult subjects with Type 2 Diabetes (T2D). We randomly allocated 92 adult subjects with T2D from both sexes to one of the following groups to receive: (a) ORZ-fortified canola oil (ORZO; n1 = 30); (b) unfortified canola oil (CANO; n2 = 32); or (c) sunflower oil (SUFO; n3 = 30) for 12weeks. Dietary and laboratory evaluations were performed initially and finally. Serum hs-CRP concentrations significantly decreased in ORZO group (from 3.1 ± 0.2 to 1.2 ± 0.2 mg/L), as compared with CANO (p = 0.003) and SUFO (p < 0.001) groups. Serum IL-6 significantly decreased just in ORZO (-22.8%, p = 0.042) and CANO groups (-19.8%, p = 0.038). However, the between-group differences were not significant. Serum IL-1β slightly decreased in ORZO (-28.1%, p = 0.11) and increased in SUFO (+ 20.6%, p = 0.079) but between-group difference was statistically significant (p = 0.017). Serum IFN-γ concentrations decreased significantly only in ORZO (from 3.3 ± 0.08 to 2.9 ± 0.21 IU/mL, p = 0.044). Salivary IgA concentrations increased significantly in all three intervention groups. Notwithstanding, only the difference between ORZO and CANO groups was statistically significant (p = 0.042). Similarly, circulating malondialdehyde concentrations significantly decreased in all three groups but with no between-group significant difference. Daily consumption of ORZ-fortified canola oil, compared with unfortified canola and sunflower oils, for 12 weeks resulted in boosting of certain anti-inflammatory effects of canola oil. These findings may have preventive implications for both clinicians and policy makers. This clinical trial was registered at clinicaltrials.gov (03.08.2022; NCT05271045).

Obesity and sarcopenic obesity characterized by low-grade inflammation are associated with increased risk for major depression in women.

We aimed to determine women's risk of major depressive disorder (MDD) in relation to obesity phenotypes characterized by levels of circulating high-sensitivity C-reactive protein (hsCRP). This population-based retrospective cohort study comprised 808 women (ages 20-84 y) recruited 1994-1997 and followed for a median 16.1 y (IQR 11.9-16.8). At baseline, body fat and lean tissue mass were measured by whole body dual-energy x-ray absorptiometry (DXA). Obesity was identified as high fat mass index (>12.9 kg/m2), body fat percentage (≥35%) and body mass index (≥30 kg/m2); sarcopenic obesity referred to a high ratio fat mass/fat-free mass (≥0.80). Systemic inflammation was operationalized as serum hsCRP concentration in the upper tertile (>2.99 mg/L). Obesity phenotypes were: non-obese + lowCRP, non-obese + highCRP, obese + lowCRP, and obese + highCRP. During follow-up, the Structured Clinical Interview for DSM-IV-TR (SCID-I/NP) was used to identify lifetime history of MDD and age of onset. Poisson regression models were used to estimate the MDD rate for each obesity phenotype during follow-up. Demographic, health and lifestyle factors were tested as potential confounders. During 11,869 p-y of follow-up, 161 (19.9%) women experienced an MDD episode. For obesity phenotypes based on fat mass index, models adjusted for baseline age and prior MDD, and non-obese + lowCRP as reference, RR for non-obese + highCRP was 1.21 (95% CI 0.80, 1.82), obese + lowCRP 1.46 (0.86, 2.47) and obese + highCRP 1.56 (1.03, 2.37). Patterns were similar for obesity by body fat percentage, body mass index and sarcopenic obesity. Consistently across different obesity definitions, this longitudinal study reports that women with both obesity and systemic inflammation are at increased risk of subsequent MDD. Future research should examine whether tackling this metabolically unhealthy obesity type - through, for example, lifestyle or medication approaches - can reduce depression risk.

C-reactive protein: perioperative changes and prognostic significance in assessing the risk of atrial fibrillation in patients after coronary bypass surgery

Aim. To study the level of high-sensitivity C-reactive protein (hsCRP) before coronary artery bypass surgery (CABG) and on days 7-10, as well as to assess the association of perioperative changes in hsCRP with the risk of postoperative atrial fibrillation (POAF).Material and methods. The study included 80 patients (71 (88,75%) men) who underwent an elective CABG in Cardiac Surgery Department of Sklifosovsky Research Institute of Emergency Medicine. The first episode of POAF was considered an episode of arrhythmia, registered by electrocardiography (ECG), Holter monitoring (HM) or bedside cardiac monitor in the intensive care unit. Depending on the development of atrial fibrillation in the postoperative period, patients were divided into 2 following groups: patients with POAF (n=20), patients without POAF (n=60). The serum level of hsCRP was studied twice: before surgery and 7-10 after CABG in patients of both groups.Results. Both groups did not differ significantly in the initial concentration of hsCRP (p=0,802). In the postoperative period, patients in both groups showed a significant increase in hsCRP compared with the initial concentration — up to 39,1 [19,6; 64,0] mg/l in the POAF group (p&lt;0,001) and up to 29,3 [19,7; 45,6] mg/l in the group without POAF (p=0,001), but the difference between the groups was not significant (p=0,338). Serum hsCRP concentration at 7-10 days after CABG in patients of both groups was significantly higher than the baseline (p&lt;0,001). However, no association between POAF risk and hsCRP concentration was found (p&gt;0,05).Conclusion. In patients after CABG, on days 7-10, there is a significantly higher level of hsCRP compared with the initial concentration. There were no significant differences in the level of hsCRP between patients with and without POAF. The POAF of is not associated with an initially elevated level of hsCRP and hsCRP level on days 7-10 after CABG.

Association of hsCRP with Serum Creatinine in Type 2 Diabetic Patients at Tertiary Care Hospital

Background: High-sensitive C-reactive protein (hs-CRP) is a marker of inflammation. CRP may play a significant role as a predictor of inflammation in nephropathy and chronic kidney disease. Objective: The aim of the present study was to estimate hs-CRP levels and serum creatinine levels among type 2 diabetes mellitus patients and to determine association between them. Methodology: This was an analytical, quantitative, hospital-based study performed on type 2 diabetic patients and was conducted at the Department of Biochemistry of BIRDEM General Hospital, Dhaka, Bangladesh. It was analyzed serum concentrations of hs-CRP, serum creatinine, serum glucose and family history of the patients. Results: This observational study showed that a greater number of diabetics had high serum creatinine level (41% vs 59%). 67.6% of study population had moderate to high level of hsCRP. hs-CRP was found significantly higher in diabetics with renal impairment (1.66±0.86 vs. 7.01±3.44, p&lt;0.001). Serum creatinine had positive (r=0.88, p&lt;0.001) correlation with hs-CRP. Glycated hemoglobin and serum creatinine were linearly related with inflammatory marker. When creatinine increased by 1 unit, hs-CRP increased by 0.84 units (β=0.84, p=&lt;0.001). Conclusion: This study concludes that the increase in serum hs-CRP value type 2 diabetic patients increase the risk of diabetic nephropathy and thus increase the value of serum creatinine level. Journal of Current and Advance Medical Research, July 2022;9(2):59-62

Systemic Lupus, Metabolic Syndrome, Cardiac Disease, and Peripheral Artery Disease

Systemic Lupus, Metabolic Syndrome, Cardiac Disease, and Peripheral Artery Disease

The Association between Inflammation, Testosterone and SHBG in men: A cross-sectional Multi-Ethnic Study of Atherosclerosis.

Earlier studies have investigated the role of obesity-related inflammation and endogenous sex hormones in men. The role of interleukin-6 (IL-6) and C-reactive protein (CRP) with testosterone and sex hormone binding globulin (SHBG) levels in men is still debated. To investigate the independent association between levels of high sensitivity CRP (hsCRP) and IL-6 with endogenous sex hormones in men. Cross-sectional observational study using data from the Multi-Ethnic Study of Atherosclerosis. A community-based sample of 3212 men aged 45-84 years was included. After exclusions, 3041 men remained for the analyses. Serum concentrations of testosterone, SHBG, hsCRP, IL-6, and sTNFR were measured from the baseline exam. Multivariable linear regressions were used to examine the association of inflammatory markers with sex hormones. An inverse association was found between levels of hsCRP and levels of testosterone and SHBG, even after adjustment for confounders and IL-6 (Total Testosterone; B = -0.14, Bioavailable Testosterone; B = -0.06, and SHBG; B = -0.66). Similar results were found for IL-6, although a positive association was found for SHBG (B = 0.95). Notably, an inverse association was found for IL-6 with bioavailable testosterone in African Americans and Hispanic Americans aged 45-54 years. No associations were found for sTNFR and endogenous sex hormones. Our results indicate that inflammatory markers have independent associations with levels of testosterone (total and bioavailable) and furthermore, appear to associate differently with SHBG levels.

Determination of high-sensitivity C-reactive protein reference intervals for apparently healthy children in Addis Ababa, Ethiopia

Objective: Since then, the reference intervals of serum hsCRP in apparently healthy Ethiopian children are unknown. Therefore, this study aimed to determine the reference intervals of serum hsCRP for apparently healthy children. Methods: In this cross-sectional study, a total of 492 apparently healthy children aged 5–17 years were recruited from residents of Addis Ababa. Well-trained professionals took anthropometric measurements. The biochemical analysis was performed with the automatic biochemical analyzer Cobas Integra 400 Plus from Roche. The 2.5th and 97.5th percentile limits were calculated using a non-parametric method as per the Clinical Laboratory Standard Institute (CLSI) guide. A box plot was used to show the distribution of hsCRP by age and gender. Furthermore, bivariate and multivariable logistic regression analyses were carried out to evaluate factors associated with elevated hsCRP levels. Percentiles were displayed by age subgroup and sex. p-values &lt;0.05 were considered statistically significant. Results: The study included 245 boys and 247 girls. For the age group of 5–11 years, the combined 2.5th and 97.5th percentiles, which can be used as a reference interval for children in Addis Ababa, were 0.15–6.78 mg/L, while for the older age group (12–17 years), the determined percentile was 0.14–4.40 mg/L. Likewise, the current study shows that never or occasionally eating vegetables and/or fruits (AOR = 2.28, 95% CI, 0.84–4.97), and being obese (AOR = 3.63, 95% CI, 1.14–11.53) were independent risk factors for elevated serum hsCRP concentrations. Conclusion: This study is the first to determine the reference intervals of hsCRP concentrations among apparently healthy Ethiopian children. Notable differences were observed in the established percentiles of hsCRP in comparison with published literature.

Evaluation of Certain Inflammatory Markers in Transfusion Dependent β-Thalassemic Patients

To determine the serum concentration of certain inflammatory markers including TNF-α and hs-CRPβ-thalassemic patients on different types of treatmentand to investigate the possible correlation between these inflammatory markers and iron overload referred to by serum ferritin concentration, moreoverto assesswhether inflammation in β-thalassemia could be controlled by deferasirox or deferoxamine as compared to transfusion dependent patients without iron chelator. Ninety transfusion dependent β-thalassemic children with age range 13–75 months were included in this study, and 30 age and sex matched healthy subjects served as control,thepatients were divided into three groups according to the type of the treatment,each group included 30 patients Group1 comprised β-thalassemic patients without iron chelator, Group2 comprisedβ-thalassemic patients on deferasirox iron chelator while Group3 comprisedβ-thalassemic patients on deferoxamine iron chelator. Serum ferritin, hs-CRP, and TNF-α was measured for all participants by ELISA method. Compared with the control, the serum level of ferritin and hs-CRP were significantly elevated in all patients groups while the serum level of TNF-α were only significantly elevated in Group1 and Group3. Further analysis of the results revealed positive correlation between serum ferritin withTNF-α and with hs-CRP.A comparison among the patients groups show that patients on deferasirox (Group2) had significantly low level of TNF-α as compared to Group1 and Group3. On the other hand serum ferritin and hs-CRP concentration in Group3 were significantly higher than the other two groups, furthermore when Group3 patients are subdivided according to their compliance on deferoxaminethe result show that the serum level of ferritin, hs-CRP and TNF-α are significantly higher in poor compliance subgroup as compared to good compliancepatients and when good compliance subgroup are compared with Group2 no significant deference in the measured parameter was found. Chronic inflammatory state is present in these patients withincreased levels of inflammatory markers such as TNF-α andCRP. The observed correlations of ferritin with inflammatory markers imply that iron overload may play a key role in release of these markers. Chelation Therapy with deferasirox can attenuate inflammation and reduces inflammatory markers level while deferoxamine appear to be less effective as most patients suffer from poor compliance on this type of iron chelator.

Association of mercury exposure with the serum high-sensitivity C-reactive protein level in Korean adults.

Although there is evidence that mercury (Hg) exposure may be a potential risk factor for cardiovascular disease (CVD), few nationwide epidemiological researches have analyzed the association between blood Hg concentration and serum high-sensitivity C-reactive protein (hs-CRP) level as a biomarker of CVD. The present population-based national study was performed with data from the 2016-2017 National Health and Nutrition Examination Survey. In the total sample of 3,773 adults aged ≥20 years, the serum hs-CRP concentrations were 1.03 mg/L among participants in the lowest quartile of blood Hg level and 1.18 mg/L among those in highest quartile. The trend for the prevalence of a risky (>1.0 mg/L) hs-CRP level (moderate risk and high risk) was significantly related to an increased quartile blood Hg concentration. After adjustment for confounders, participants with the highest quartiles of blood Hg had increased odds of a risky (>1.0 mg/L) hs-CRP level (adjusted odds ratio = 1.34; 95% confidence interval, 1.02-1.77) compared with those with the lowest quartile of blood Hg. These findings demonstrate that a high blood Hg level increases the concentration of serum hs-CRP, a sensitive marker of chronic low-grade inflammation, and imply that the increased body burden associated with high blood Hg is a potential risk factor in the development of many inflammatory diseases, including CVD.

Serum calcium and magnesium were inversely associated with high sensitivity C-reactive protein in Chinese adults with coronary artery disease

Objective Scarce data examined the associations of circulating calcium (Ca) and magnesium (Mg) with high-sensitivity C-reactive protein (hsCRP) in humans. We conducted a hospital-based cross-sectional study to evaluate the associations of serum Ca, Mg, and Ca/Mg ratio with hsCRP and examine the mediating roles of body mass index (BMI). Methods A total of 7203 patients with coronary artery disease (CAD) (average age: 61.0 years) were included. Serum concentrations of Ca, Mg, and hsCRP were measured. Results The multivariate analysis of covariance was used to determine Ca- and Mg-hsCRP associations. Serum Ca and Mg were inversely associated with hsCRP, while no significant association between Ca/Mg ratio and hsCRP was detected. After adjustment for age and sex, higher Ca and Mg concentrations were associated with lower hsCRP (quintile5 [Q5] vs. Q1: 6.35 vs. 11.88 mmol/L for Ca; Q4 vs. Q1: 4.61 vs. 6.44 mmol/L for Mg). The multivariate-adjusted analysis found that serum Ca and Mg were inversely associated with hsCRP levels (Q5 vs. Q1: 6.69 vs. 11.33 mmol/L for Ca; Q4 vs. Q1: 4.65 vs. 6.32 mmol/L for Mg). Similar findings were observed in the stratified analyses by sex (men and women) and BMI (< 28 and ≥ 28 kg/m2). In path analysis, BMI had no mediating effects on the Ca- or Mg-hsCRP associations. Conclusion Generally, our study showed significant inverse associations of serum Ca and Mg with hsCRP in CAD patients. Our findings provided further support for the anti-inflammatory effects of Ca and Mg in CAD patients.

Serum visfatin, resistin levels and inflammation markers in psoriasis patients

Psoriasis is a common chronic inflammatory skin condition that varies in severity. Psoriasis is associated with complex disorders, which incorporate metabolic syndrome, obesity and impaired glucose tolerance. Adipose tissue secretes several hormones and cytokines, in particular visfatin and resistin that could be involved in the development of psoriasis by acting as pro-inflammatory or immunoregulatory factors. The aim of this work was to evaluate the serum level of visfatin and resistin as well as of high-sensitivity C-reactive protein (hs-CRP) and erythrocyte sedimentation rate (ESR) in psoriatic patients. The study included 43 healthy individuals and 45 patients divided into three groups with mild, moderate and severe clinical degrees of disease assessed by the Psoriasis Area Severity Index (PASI). The results showed a significant increase in the concentration of serum visfatin, resistin, ESR and hs-CRP in patient groups in comparison with a control group. The highest increase in indicators was observed in the group of patients with severe disease compared with the mild and moderate patients groups. The significance of studied indicators as biomarkers of psoriasis disease severity is analyzed. Keywords: erythrocyte sedimentation rate, high sensitivity C-reactive protein, psoriasis, resistin, visfatin

Markers of malnutrition, inflammation, and tissue remodeling are associated with 1-year outcomes in patients with advanced heart failure.

A number of predictive models and biomarkers are used to assess outcomes in patients with advanced heart failure (HF). We sought to evaluate whether markers of malnutrition, inflammation, and tissue remodeling are associated with 1‑year mortality in patients with advanced HF. We analyzed 200 consecutive patients with advanced HF. We assessed markers of inflammation and malnutrition, such as the neutrophil percentage‑to-albumin ratio (NPAR), the advanced lung cancer inflammation index (ALI), and the level of high‑sensitivity C-reactive protein (hsCRP). We also evaluated the level of tenascin‑C (TNC), as well as known markers of HF, such as N‑terminal pro-B-type natriuretic peptide (NT-proBNP), creatinine, and bilirubin. Receiver operating characteristic (ROC) and Kaplan-Meier survival analyses were performed to evaluate the association of each parameter with 1‑year mortality. The median (interquartile range) age of the patients was 58 (51-64) years. The independent predictors of death were ALI (odds ratio [OR], 0.966; 95% CI, 0.941-0.992; P = 0.01) and NPAR (OR, 1.373; 95% CI, 1.126-1.674; P = 0.002), as well as serum levels of TNC (OR, 1.04; 95% CI, 1.020-1.050; P <0.001), hsCRP (OR, 1.187; 95% CI, 1.037-1.360; P = 0.01), NT‑ proBNP (OR, 1.110; 95% CI, 1.100-1.200; P = 0.02), creatinine (OR, 1.034; 95% CI, 1.013-1.055; P = 0.001), and bilirubin (OR, 1.079; 95% CI, 1.014-1.149; P = 0.02). The ROC analysis indicated a good discriminatory power of TNC (area under the curve [AUC] = 0.807), NT‑ proBNP (AUC = 0.760), hsCRP (AUC = 0.706), ALI (AUC = 0.749), and NPAR (AUC = 0.785) in predicting mortality during the 1‑year follow up. Our study demonstrated that a decreased ALI value, increased NPAR value, as well as elevated serum concentrations of TNC, NT‑proBNP, hsCRP, creatinine, and bilirubin are associated with 1‑year mortality in patients with advanced HF.

The effects of omega 3 fatty acids on the serum concentrations of pro inflammatory cytokines anddepression status in patients with bipolar disorder: A randomized double-blind controlled clinical trial.

The inflammation accelerates the progression of bipolar disorder. Supplementation of anti-inflammatory supplements in adjuvant with medications may alleviate disorder signs. This study aimed to investigate the effects of omega-3 fatty acid supplementation on the serum concentrations of pro-inflammatory cytokines and depression status in patients with bipolar disorder. This randomized clinical trial study was conducted in Zahedan city in 2021. Patients with bipolar disorder (n = 60) were grouped into two groups: omega-3 fatty acid supplement group (n = 30, 15 men and 15 women) and placebo one using a permuted block stratified randomization. The patients in the omega-3 group received 2 g of omega-3 fatty acids daily for 2 months while patients in the placebo group received 2 g soft gels daily in the same form. Depression score and the serum concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) were assessed before and after the study. Depression score and the serum concentrations of TNF-α, IL-6, and hs-CRP were decreased after intervention in the omega-3 fatty acid group also compared with the placebo group (P < 0.001). The results also show a positive correlation between the serum concentrations of TNF-α, IL-6, and hs-CRP with depression scores (P < 0.001). Prescription of omega-3 fatty acids can decrease inflammatory parameters and help to decrease depression in patients with bipolar disorder. This supplement can be used along with medications for decreasing the inflammatory markers in these patients.

N-terminal pro-B-type natriuretic peptide, high-sensitivity C-reactive protein and ferritin in predicting the functional outcome in stroke patients

Abstract Background: Biomarkers that predict the outcome of stroke are critical for treatment, considering them to be a valuable adjunct to routine clinical examination and imaging data. Methods: Thirty-one patients admitted with stroke along with 30 controls were included in the study. Patients were divided into ischaemic and haemorrhagic stroke groups based on radiological findings. The study group was evaluated within 48 h of symptom onset for clinical stroke severity (Scandinavian Stroke Scale [SSS] and National Institute of Health Stroke Scale). Functional status before the stroke (modified Rankin Scale [mRS]) and at discharge was evaluated. The association of N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hsCRP) and serum ferritin concentrations with stroke severity and functional outcomes at discharge in acute ischaemic and haemorrhagic stroke patients. Results: The median NT-proBNP, hsCRP and ferritin serum concentrations were significantly high for cases when compared to controls (P &lt; 0.05). However, serum concentrations of NT-proBNP, hsCRP and ferritin were not significantly different when ischaemic and haemorrhagic stroke patients were compared. HsCRP showed a negative correlation with SSS score on admission and showed a positive correlation with mRS at discharge. In multivariate adjusted regression models, hsCRP remained associated with worse functional outcomes at discharge. Conclusions: In acute stroke patients, elevated concentration of hsCRP is associated with greater clinical stroke severity and worse functional outcomes at discharge. Hence, it can be used along with computed tomography scan/magnetic resonance imaging for assessment of stroke severity.