Serum hs-CRP Levels Research Articles

The Correlation of Inflammation, Oxidative Stress, and Hippocampal Perfusion in Patients with Atrial Fibrillation.

Atrial fibrillation (AF) is closely related to abnormal cerebral blood flow. Inflammation and oxidative stress have always been important factors in the pathophysiology of AF. It remains unknown whether inflammation and oxidative stress are correlated to hippocampal perfusion in patients with AF.Sixty-three patients with AF with normal hippocampal blood perfusion (NHBP) were compared to 71 patients with AF with abnormal hippocampal blood perfusion (AHBP) using a case-control study design. The serum levels of inflammation and oxidative stress were measured. The hippocampal perfusion was detected. (1) The serum levels of high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and oxidized low-density lipoprotein (ox-LDL) were statistically higher in the AHBP group than in the NHBP group. In the AHBP subgroup analysis, the serum levels of hs-CRP and IL-6 were statistically higher in patients with persistent AF than those with paroxysmal AF. (2) The relative cerebral blood volume (rCBV), mean transit time (MTT), and the time-to-peak (TTP) were statistically higher in the AHBP group than in the NHBP group. Moreover, cerebral blood flow (rCBF) was statistically lower in the AHBP group than in the NHBP group. (3) relative cerebral blood volume (rCBV), rCBF, MTT, and TTP were passively associated with serum hs-CRP and IL-6; rCBV, rCBF, and MTT were positively associated with ox-LDL. The serum levels of hs-CRP, IL-6, and ox-LDL were associated with AHBP in patients with AF after multivariate logistic regression analysis.Oxidative stress and inflammatory biomarkers were increased in patients with AF with AHBP, in which the serum levels of hs-CRP and IL-6 in the persistent AF group were statistically higher than those in the paroxysmal AF group. The serum levels of hs-CRP, IL-6, and ox-LDL were associated with AHBP in patients with AF.

Platelet-to-lymphocyte ratio and serum hsCRP levels in third trimester and adverse pregnancy outcomes in women with gestational diabetes mellitus

Gestational diabetes mellitus (GDM) is a major complication of pregnancy. GDM is associated with a higher risk of adverse pregnancy outcomes (APO). The purpose of this study was to assess the association between third-trimester platelet to lymphocyte ratio (PLR) and high-sensitivity C-reactive protein (hsCRP) concentration and the risk of APO in GDM pregnant women. This study selected 406 non-elderly gestational diabetes patients diagnosed in the Renmin Hospital of Wuhan University from May 2021 to February 2023 as the research objects. According to the presence or absence of APO, they were divided into an APO group (n = 171) and a non-APO group (n = 235). Logistic regression model to evaluate the correlation between PLR and hsCRP and APO in women with GDM; Restricted cubic spline analyses was used to explore nonlinear correlations between PLR or hsCRP and the risk of APO; ROC curve analysis of the diagnostic performance of PLR and hsCRP for APO in women with GDM. APO occurred in 171 of the 406 included participants. Compared with the non-APO group, patients in the APO group had higher PLR and hsCRP levels. The incidence of APO was positively associated with PLR and the hsCRP level in each logistic regression model (P < 0.05). After adjusting for all the risk factors included in this study, restricted cubic spline analyses found that the PLR and the hsCRP level were positively associated with the risk of APO. The levels of PLR and hsCRP in the third trimester are related to the occurrence of APO in women with GDM, and high levels of PLR and hsCRP may indicate the occurrence of APO.

A Cross-sectional Study to Correlate the Levels of High Sensitivity C-Reactive Protein and Size of Infarct in Ischemic Stroke

Background: Inflammation plays a major role in the pathophysiology of acute cerebrovascular accidents and nowadays, a newer and more sensitive method to test for lower circulating levels of C-reactive protein (CRP), highly sensitive CRP (hsCRP), is being used in apparently healthy individuals for risk assessment. Previous studies show that CRP strongly correlates with stroke severity and independently predicts mortality and recurrence in patients with acute ischemic stroke. The aim of this study was to evaluate the relationship between inflammatory marker-hsCRP and stroke severity by means of volumetric measurement of infarct size. Methods: In this cross-sectional study, 60 patients with acute ischemic stroke were included who were diagnosed using the National Institute of Health Stroke Scale (NIHSS) and magnetic resonance imaging (MRI) scans. Serum levels of hsCRP were measured. Lesion volumes (in ml) were calculated by multiplying slice thickness (4–5 mm) by the total lesion area and divided into quartiles. The relationship between hsCRP levels and diffusion-weighted imaging infarct volume quartiles was examined. Results: Ischemic stroke was predominantly seen in the male population (n = 36, 60%) and the sixth decade of life. The mean NIHSS score of the study population was 10.68 ± 1.068. The mean (± standard deviation [SD]) level of serum hsCRP was 6.69 ± 7.072 mg/L. The mean (± SD) stroke volume was 8.64 ± 14.21 ml. The correlation between hsCRP and the size of infarct on three-dimensional MRI brain scan was statistically highly significant (P &lt; 0.001, r = 0.667). Conclusions: Higher hsCRP levels were associated with larger infarct volumes in acute ischemic stroke suggesting that elevated hsCRP levels, may serve as a helpful serologic marker in the evaluation of the severity of acute ischemic stroke.

Evaluating the effect of the antiPCSK9 vaccine on systemic inflammation and oxidative stress in CFA-challenged albino mice

Abstract Background Besides effective lipid lowering therapy aimed to reduce LDL-C, one should always look at other risk factors that may essentially increase the risk of residual cardiovascular disease risk, including diabetes, thrombotic factors and inflammation. Purpose To find whether the antiPCSK9 vaccine can affect the serum C-reactive protein (CRP) and oxidative stress during acute systemic inflammation. Methods Male albino mice were randomly divided into three groups, including non-treated mice (the sham group), mice treated with Freund's complete adjuvant (CFA) (the CFA group), and vaccinated mice treated with CFA (the vaccine group). The vaccine group was subcutaneously immunized with the antiPCSK9 formulation, four times in bi-weekly intervals. To induce inflammation, all mice were subjected to the CFA challenge after the vaccination plan. To determine the efficacy of the antiPCSK9 vaccine in albino mice, plasma antiPCSK9 antibody titer, plasma PCSK9 concentration, and PCSK9/LDLR interaction were assayed. The serum level of high-sensitive CRP (hs-CRP) and oxidative stress status were evaluated by a mouse CRP ELISA kit and the pro-oxidant antioxidant balance (PAB) assay, respectively. Results Upon three boosters, the vaccine induced a high-titer IgG antiPCSK9 antibody in albino mice, which was accompanied with a significant reduction in the plasma level of the free PCSK9 (-24.7% and -28.5% compared with the sham and CFA group, respectively), and the inhibition of PCSK9/LDLR interaction (-27.8% and -29.4% compared with the sham and CFA group, respectively). In addition, the serum level of hs-CRP was significantly increased in the vaccine and CFA groups by 225% and 274%, respectively, when compared with the sham group; however, it was non-significantly decreased (-18%) in the vaccine group in comparison with the CFA group (Figure 1A). Moreover, the PAB values indicated that oxidative stress was significantly increased in the CFA group (by 72.7%) and the vaccine group (by 76%) when compared to the sham group; however, there was no significant difference in the PAB values between the vaccine and CFA groups (Figure 1B). Conclusion Our results indicate that, despite inducing the production of the functional antiPCSK9 antibodies, the antiPCSK9 vaccine failed to significantly reduce the serum hs-CRP and oxidative stress induced in the CFA-challenged albino mice. Figure 1. The effect of the antiPCSK9 vaccine on (A) the serum level of hs-CRP in albino mice and (B) the serum PAB in albino mice. The sham group involved non-treated mice, the CFA group involved the CFA-treated mice, and the vaccine group involved mice who after vaccination were treated with the CFA. Pooling of samples was performed to obtain sufficient sample volume for assay, when needed. The PAB values were expressed in an arbitrary HK (Hamidi-Koliakos). Data are expressed as mean ±SD (10 mice per group). Statistical differences at a p-value &amp;lt;0.05 were considered as significant.Figure 1.

Association of selected inflammatory markers and risk factors with pain in patients undergoing cervical or lumbar disc herniation

Introduction&#x0D; Studies have suggested that radicular pain following disc herniation may be associated with local or systemic inflammatory responses produced in the vicinity of the herniated disc rather than compression of the nerve. Present study assessed the association of serum interleukin-6 (IL-6) levels, high-sensitivity C-reactive protein (hs-CRP) and related risk factors in patients undergoing discectomy following cervical disc herniation (CDH) or lumbar disc herniation (LDH).&#x0D; Methods&#x0D; Study recruited 77 patients undergoing discectomy for LDH and CDH. An interviewer administered questionnaire was used to obtain sociodemographic, behavioral and occupational data. IL-6 and hs-CRP levels were measured in each individual. IL-6 was analyzed by ELISA method and hs-CRP was determined using auto analyzer. Results were analyzed by using SPSS version 25.0.&#x0D; &#x0D; Results&#x0D; Significant correlation was not found with serum IL-6 and hs-CRP levels (r=0.02, p˃0.05) for acute and chronic CDH and LDH. Patients with chronic neck or back pain showed significantly (p=0.043) higher IL-6 level compared to patients with acute neck or back pain. Serum hs-CRP level was significantly higher (p=0.048) in patients with acute neck or back pain compared to patients with chronic neck or back pain. Significant association was not observed between; level of physically demanding nature of occupation (p=0.542), duration of occupation (p=0.446), type of exercise (p=0.371), type of sports (p=0.339) and CDH or LDH.&#x0D; Conclusion&#x0D; Though significant correlation was not observed between inflammatory markers IL-6, hs-CRP and CDH or LDH. The mean IL-6 was higher in chronic back pain and neck pain patients with LDH and CDH whereas mean hs-CRP mean was higher in acute back pain and neck pain patients. Significant association was not reported between selected known risk factors (behavioral, occupational) and CDH or LDH.

Expression and clinical association of MFG-E8 and TAM receptors in diabetic patients with different stages of microvascular complication: An experimental study.

Diabetic nephropathy (DN) is a major microvascular complication of diabetes mellitus that leads to end-stage renal disease. Hyperglycemia triggers apoptosis and kidney damage. Milk fat globule-epidermal growth factor 8 (MFG-E8) and TAM receptor tyrosine kinases, Tyro3, Axl, and Mer, are phagocytic receptors that mediate the clearance of apoptotic cells. This study aimed to identify the role of MFG-E8 and TAM receptors in the development of DN. A total of 146 patients with type 2 diabetes mellitus (T2DM), early stage DN, clinical DN and 48 healthy controls were employed to analyze the serum levels of MFG-E8, soluble Tyro3, Axl, Mer, and RAGE by enzyme-linked immunosorbent assay. The serum levels of CREA, hsCRP, CysC, and β2-microglobulin were measured by spectrophotometric analysis using a biochemical analyzer (AU5800). Our results showed that the serum levels of MFG-E8 were elevated in patients with T2DM compared with healthy controls; however, it decreased gradually in patients with DN with the severity of kidney injury, especially in the clinical DN group. Moreover, the levels of sTyro3, sAxl, and sMer were reduced in patients with T2DM and DN compared to healthy controls, particularly in patients with DN. The levels of MFG-E8, sTyro3, sAxl, and sMer were negatively correlated with UAER at 24 hours, CREA, hsCRP, CysC, β2-microglobulin, and RAGE, respectively. In addition, TAM receptors had significantly higher predictive and diagnostic values for early stage DN from T2DM than hsCRP, β2-microglobulin, and CysC, which are also predictive biomarkers of early stage DN from clinical DN. Decreased MFG-E8 and TAM receptor expression is associated with an increased risk of microvascular complications in patients with T2DM, which plays a critical role in the diagnosis of diabetic patients with microvascular complications, especially early stage DN, and in monitoring the development of DN.

Effect of GH Deficiency Caused by Nonfunctioning Pituitary Masses on Serum C-reactive Protein Levels.

GH supplementation for GH deficiency (GHD) has been reported to decrease high-sensitivity C-reactive protein (hs-CRP), an inflammatory marker; however, the association between GHD and hs-CRP remains unclear. We aimed to clarify the impact of impaired GH secretion due to pituitary masses on hs-CRP levels. We retrospectively examined the association between GH secretion, assessed using GH-releasing peptide-2, and serum hs-CRP levels before and a year after the pituitary surgery in patients with nonfunctioning pituitary neuroendocrine tumor or Rathke cleft cyst. Among 171 patients, 55 (32%) presented with severe GHD (peak GH response to GH-releasing peptide-2 < 9 ng/mL). Serum hs-CRP levels were significantly higher in patients with severe GHD than in those without (P < .001) and significantly correlated with the peak GH (r = -0.50, P < .001). Multiple regression analyses showed that the peak GH significantly and negatively predicted hs-CRP levels (β = -0.345; 95% CI, -0.533 to -0.158) and the lowest quartile of the peak GH (<5.04 ng/mL) were significantly associated with increase in hs-CRP levels (exp [β] = 1.840; 95% CI, 1.209 to 2.801), after controlling for other anterior hormones and metabolic parameters. Postoperative change in the peak GH (N = 60) significantly predicted change in hs-CRP levels (β = -0.391; 95% CI, -0.675 to -0.108), independent of alterations in other anterior hormones and metabolic parameters. The inverse association between GH secretion and hs-CRP levels highlights the protective role of GH in the increase in hs-CRP.

Circulating levels of miR125a, miR126, and miR146a-5p in patients with obstructive sleep apnea and their relation with markers of endothelial dysfunction.

obstructive sleep apnea (OSA) is a prevalent sleep disorder that is associated with increased risk factors for cardiovascular diseases (CVDs). Oxidative stress, insulin resistance, inflammation, and endothelial dysfunction are increased in OSA patients and microRNAs (miRs) are regulatory elements that influence these pathological mechanisms. miR125a, miR126, and miR146a-5p play a role in these pathological mechanisms and have not been evaluated in patients with OSA. This case-control study was performed on 90 OSA patients and 34 controls. Circulating levels of miR125a, miR126, and miR146a-5 were determined using real-time PCR, and serum levels of hsCRP, ICAM-1, and VCAM-1 were evaluated using ELISA kits. miR125a and miR146a were elevated in patients with OSA compared to controls while miR126 decreased significantly. All three miRs indicated a remarkable difference between the mild-OSA group compared to the severe-OSA group. Furthermore, patients with OSA showed elevated levels of hsCRP, ICAM-1, and VCAM-1. Multiple linear regression indicated an independent association of miR125a with ICAM-1 and hsCRP, miR126 associated with VCAM-1 and total cholesterol, and miR146a-5p represented an association with apnea-hypopnea index and ICAM-1. Furthermore, miR146a-5p illustrated a good diagnostic ability to differentiate between OSA and controls. Circulating miR125a, miR126, and miR146a-5p fluctuations in patients with OSA and their relations with markers of endothelial dysfunction provide in vivo evidence and suggest a potential role for these miRs with endothelial dysfunction in patients with OSA.

Association between serum omega-3 PUFAs levels and cognitive impairment in never medically treated first-episode patients with geriatric depression: A cross-sectional study

BackgroundGeriatric depression increases the public health burden and health care costs, reduces quality of life. Studies have shown the association between ω-3 PUFAs levels and inflammatory markers levels and depression, but few have explored the relationship between omega-3 PUFAs, inflammatory markers, and cognitive function in geriatric depression. This study aimed to compare the differences in ω-3 PUFAs levels and inflammatory markers between geriatric depression with cognitive impairment (CI) and those without CI. MethodsA total of three hundred and five elderly patients were recruited. In addition to collecting basic information, their blood specimens were collected to detect serum EPA, DHA, AA, TC, LDL-C, IL-6, TNF-α, and hs-CRP levels. The Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), and The Montreal cognitive assessment (MoCA) were used to assess their depression, anxiety, and cognitive function, respectively. ResultsCompared to those without CI, geriatric depression patients with CI had higher serum TC, LDL-C levels, lower EPA, DHA, and AA levels, and more elevated IL-6, TNF-α, and hs-CRP levels (all P < 0.05). Further linear regression analysis showed that EPA, DHA, and TNF-α, hs-CRP levels were significantly associated with the occurrence and the severity of CI. LimitationsNo causal relationship could be drawn due to the cross-sectional design. ConclusionsOmega-3 PUFAs and inflammatory factors levels may predict CI in elderly patients with MDD in the future. Our findings suggest that ω-3 PUFAs (EPA and DHA) and inflammatory factors (TNF-α and CRP) may predict the occurrence and the severity of CI among elderly MDD patients.

Adjunctive canakinumab reduces peripheral inflammation markers and improves positive symptoms in people with schizophrenia and inflammation: A randomized control trial

BackgroundClinical trials of anti-inflammatories in schizophrenia do not show clear and replicable benefits, possibly because patients were not recruited based on elevated inflammation status. Interleukin 1-beta (IL-1β) mRNA and protein levels are increased in serum, plasma, cerebrospinal fluid, and brain of some chronically ill patients with schizophrenia, first episode psychosis, and clinical high-risk individuals. Canakinumab, an approved anti-IL-1β monoclonal antibody, interferes with the bioactivity of IL-1β and interrupts downstream signaling. However, the extent to which canakinumab reduces peripheral inflammation markers, such as, high sensitivity C-reactive protein (hsCRP) and symptom severity in schizophrenia patients with inflammation is unknown. Trial designWe conducted a randomized, placebo-controlled, double-blind, parallel groups, 8-week trial of canakinumab in chronically ill patients with schizophrenia who had elevated peripheral inflammation. MethodsTwenty-seven patients with schizophrenia or schizoaffective disorder and elevated peripheral inflammation markers (IL-1β, IL-6, hsCRP and/or neutrophil to lymphocyte ratio: NLR) were randomized to a one-time, subcutaneous injection of canakinumab (150 mg) or placebo (normal saline) as an adjunctive antipsychotic treatment. Peripheral blood hsCRP, NLR, IL-1β, IL-6, IL-8 levels were measured at baseline (pre injection) and at 1-, 4- and 8-weeks post injection. Symptom severity was assessed at baseline and 4- and 8-weeks post injection. ResultsCanakinumab significantly reduced peripheral hsCRP over time, F(3, 75) = 5.16, p = 0.003. Significant hsCRP reductions relative to baseline were detected only in the canakinumab group at weeks 1, 4 and 8 (p’s = 0.0003, 0.000002, and 0.004, respectively). There were no significant hsCRP changes in the placebo group. Positive symptom severity scores were significantly reduced at week 8 (p = 0.02) in the canakinumab group and week 4 (p = 0.02) in the placebo group. The change in CRP between week 8 and baseline (b = 1.9, p = 0.0002) and between week 4 and baseline (b = 6.0, p = 0.001) were highly significant predictors of week 8 change in PANSS Positive Symptom severity scores. There were no significant changes in negative symptoms, general psychopathology or cognition in either group. Canakinumab was well tolerated and only 7 % discontinued. ConclusionsCanakinumab quickly reduces peripheral hsCRP serum levels in patients with schizophrenia and inflammation; after 8 weeks of canakinumab treatment, the reductions in hsCRP are related to reduced positive symptom severity. Future studies should consider increased doses or longer-term treatment to confirm the potential benefits of adjunctive canakinumab in schizophrenia.Australian and New Zealand Clinical Trials Registry number: ACTRN12615000635561.

Grape seed extract in combination with deferasirox ameliorates iron overload, oxidative stress, inflammation, and liver dysfunction in beta thalassemia children

Background and purposeIron overload in the body is associated with serious and irreversible tissue damage. This study aimed to investigate the iron‐chelating, antioxidant, anti-inflammatory, and hepatoprotective activities of grape seed extract (GSE) supplement as well as its safety in β‐thalassemia major (β‐TM) pediatric patients receiving deferasirox as a standard iron‐chelation therapy. Materials and methodsThe children were randomly allocated to either GSE group (n = 30) or control group (n = 30) to receive GSE (100 mg/day) or placebo capsules, respectively, for 4 weeks. The serum levels of iron, ferritin, total iron-binding capacity (TIBC), alanine transaminase (ALT), aspartate aminotransferase (AST), tumor necrosis factor alpha (TNF-α), high-sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA), and glutathione (GSH) as well as superoxide dismutase (SOD) activity and hemoglobin (Hb) concentration were measured pre-and post-intervention. ResultsGSE supplement significantly attenuated the serum levels of iron (p = 0.030), ferritin (p = 0.017), ALT (p = 0.000), AST (p = 0.000), TNF-α (p = 0.000), and hs-CRP (p = 0.001). The TIBC level (p = 0.020) significantly enhanced in the GSE group compared with the placebo group. Moreover, GSE supplement remarkably improved the oxidative stress markers, MDA (p = 0.000) and GSH (p = 0.001). The changes in the SOD activity (p = 0.590) and Hb concentration (p = 0.670) were not statistically different between the groups. ConclusionGSE supplement possesses several health beneficial influences on children with β‐TM by alleviating iron burden, oxidative stress, inflammation, and liver dysfunction.

The efficacy of Nigella sativa L. oil on serum biomarkers of inflammation and oxidative stress and quality of life in patients with knee osteoarthritis: A parallel triple-arm double-blind randomized controlled trial.

The aim of this double-blind clinical trial was to investigate the effects of Nigella sativa oil on serum inflammatory and oxidative stress biomarkers and quality of life in patients with knee osteoarthritis (OA). Forty-five patients who met the eligibility criteria were randomly divided into three groups with a ratio of 1:1:1. The first group received 2.5 mL oral N. sativa oil twice/day plus placebo topical oil, the second group received 2.5 mL topical N. sativa oil three times/day plus placebo oral oil, and the third group received oral and topical oil placebos. There were no intergroup differences in baseline characteristics. After 6 weeks of supplementation, oral N. sativa caused a significant improvement in the serum levels of hs-CRP (p = .003), MDA (p = .003), and TAC (p = .001). Oral N. sativa oil compared to placebo (aMD (95% CI): -0.81 (-1.45 to -0.19); p = .012) and topical N. sativa oil [aMD (95% CI): -0.76 (-1.38 to -0.15); p = .016] significantly reduced hs-CRP serum levels. Significant improvements were observed in the general, physical, and mental health subscales in the oral and topical N. sativa oil compared to the placebo group (p < .05). The six-week oral N. sativa oil supplementation was effective in improving inflammatory biomarkers in knee OA. Both oral and topical N. sativa oil increased the quality of life.

THU069 Growth Hormone Secretion And Serum High-sensitivity C-reactive Protein Levels In Adult Patients With Non-functioning Pituitary Tumors

Abstract Disclosure: Y. Seki: None. S. Morimoto: None. K. Bokuda: None. D. Watanabe: None. S. Watanabe: None. K. Yamashita: None. N. Takano: None. A. Ichihara: None. Background: Growth hormone (GH) deficiency, which causes visceral obesity and non-alcohol fatty liver disease, increases cardiovascular event risks. Serum high-sensitivity C-reactive protein (hs-CRP) levels has been reported to estimate those risks. GH supplementation therapy was reported to decrease the serum hs-CRP levels in GH deficient patients, however, the association between GH secretion and serum hs-CRP levels have been unclear. Patients and Methods: We retrospectively reviewed charts of the patients with non-functioning pituitary adenoma and Rathke’s cysts who underwent preoperative GH-releasing peptide-2 (GHRP-2) tests to assess GH secretion, and investigated the association between GH secretion and background characteristics. Patients who had a history of pituitary surgery, severe renal insufficiency or active inflammatory diseases, or received GH supplementation therapy were excluded. Results: Among 171 patients (100 NFPA and 71 Rathke’s cysts), 55 (32%) presented severe GH deficiency, as diagnosed using GHRP-2 tests. Serum hs-CRP levels were significantly higher in the patients with severe GH deficiency than in those without severe GH deficiency (754 [393—1330] vs 249 [113—537] ng/mL, P &amp;lt; 0.001). Serum hs-CRP levels were significantly correlated with logarithm of peak GH response to GHRP-2 (r = -0.50, P &amp;lt; 0.001), but not with IGF-1 SD score (r = -0.10, P = 0.21). In the multiple regression analysis, peak GH response to GHRP-2 was a significant variable for determining serum hs-CRP levels (β = -0.340, P = 0.001) after adjustment with age, sex, BMI, smoking habit, alcohol consumption, hypertension, diabetes mellitus, dyslipidemia, abnormal liver function, and other pituitary hormone deficiencies. Severe GH deficiency were significantly associated with for serum hs-CRP levels higher than 1000 ng/mL (Odds ratio, 2.58 ;95% Confidence interval 1.15-5.78) when adjusted for obesity and abnormal liver function. Conclusion: GH secretion was significantly and negatively associated with serum hs-CRP levels independent of atherosclerotic risk factors, metabolic complications of GH deficiency, and other anterior pituitary hormone secretions. Presentation: Thursday, June 15, 2023

Assessment of serum and salivary visfatin levels in newly diagnosed patients of type-II DM.

Type II diabetes mellitus (T2DM) is a metabolic disorder. It is thought to be an autoinflammatory disease, as inflammatory mediators are associated with the progression of the disease. Visfatin, an adipokine, is linked to insulin resistance. We aimed to study serum and salivary visfatin levels, at the time of diagnosis of T2DM, in middle-aged individuals, in the context of other diagnostic parameters like fasting blood sugar (FBS), postprandial blood sugar (PPBS), and glycated haemoglobin A1c (HbA1c). Thirty newly diagnosed T2DM (Group-I, T2DM) patients and 30 healthy nondiabetic individuals (Group-II, health controls [HC]) matched for age and sex were studied. In both the groups, we assessed serum and salivary visfatin levels, and serum high-sensitivity C-reactive protein (hs-CRP) levels. We also compared serum and salivary visfatin levels and serum hs-CRP levels between Group-I and Group-II individuals. The correlation between the groups was tested using Pearson's correlation. A P- value < 0.001 was considered to be statistically significant. The data was tabulated using software MS Excel and analysed using IBM Statistical Package for the Social Sciences (SPSS) Version 22.0. A positive correlation with a value of 0.8836 and a P value of 0.001 was noted between serum and salivary visfatin of Group-I. This is the first study in the Indian scenario to study the serum and salivary visfatin in newly diagnosed T2DM individuals. Serum visfatin and hs-CRP levels increased in T2DM, thus defining the link between visfatin, inflammation and T2DM, but we failed to notice a positive correlation.

Long-term effects of vitamin D supplementation and maintaining sufficient vitamin D on knee osteoarthritis over 5 years

ObjectivesThis study aimed to investigate the long-term effect of vitamin D supplementation compared to placebo over 5 years in participants with knee osteoarthritis (OA). We also aimed to describe the effect of maintaining sufficient serum vitamin D levels over five years in knee OA.MethodsParticipants (n = 173) from the Hobart centre of the Vitamin D Effects on Osteoarthritis (VIDEO) trial were extensively followed up 3 years after the cessation of 2-year investigational treatment. Participants were classified as maintaining sufficient vitamin D (n = 79) and not maintaining sufficient vitamin D (n = 61) groups.ResultsThere was no significant difference in change in the knee symptoms, depression, and serum levels of IL6 and hs-CRP between both comparisons after 3 years of cessation of the clinical trial. However, among participants who reported no knee surgery (KS), there was a significant improvement in WOMAC function (β: − 83.7, 95% CI: − 167.3, 0) and depression scores (β: − 1.3, 95% CI: − 2.3, − 0.2) in vitamin D group compared to the placebo group. Similarly, those who maintained adequate vitamin D levels over 5 years had significantly less WOMAC knee pain (β: − 33.9, 95% CI: − 65.7, − 2) and physical dysfunction (β: − 105.5, 95% CI: − 198.2, − 12.8) than participants with vitamin D deficiency over 5 years.ConclusionVitamin D supplementation over 2 years or maintaining vitamin D sufficiency for 5 years was not associated with statistically significant differences in change in knee symptom scores over 5 years. However, among participants who did not report KS, 2-year vitamin D supplementation and maintaining sufficient vitamin D was linked to modest improvements in knee symptoms and depression scores in knee OA.

Imbalanced serum levels of resolvin E1 (RvE1) and leukotriene B4 (LTB4) may contribute to the pathogenesis of atherosclerosis

Persistent and chronic unresolved inflammation exerts a critical role in developing atherosclerosis; however, mechanisms that prevent the resolution of inflammation in atherosclerosis are poorly delineated. This study aims to evaluate the serum levels of inflammatory high-sensitivity C-reactive protein (hsCRP), pro-inflammatory leukotriene B4 (LTB4), besides anti-inflammatory compounds, including eicosapentaenoic acid (EPA) and its derivative resolvin E1 (RvE1) in patients with atherosclerosis. Thirty-four atherosclerosis patients and thirty-two age- and sex-matched healthy individuals were included in this study. The serum levels of hsCRP, LTB4, EPA, and RvE1 were measured using the enzyme-linked immunosorbent assay (ELISA) technique. Our results showed that the hsCRP serum levels in the three-vessel disease (3VD) subgroup of patients are significantly lower than those in the mild and single-vessel disease (SVD) subgroups (P < 0.05). Besides, the serum levels of LTB4 were meaningfully greater in patients with atherosclerosis compared to healthy controls (P < 0.05). Also, the serum EPA and RvE1 levels were significantly higher in patients than in controls (P < 0.01 and P < 0.05, respectively). However, the ratio of RvE1 to LTB4 (RvE1:LTB4) in patients was significantly reduced to that in controls (P < 0.0001). These findings illustrate that imbalanced pro-resolving RvE1 and pro-inflammatory LTB4 might contribute to failing vascular inflammation resolution and subsequent progression toward chronic inflammation in atherosclerosis.

Analysis of Serum Markers of Perioperative Brain Injury and Inflammation Associated with Endovascular Treatment of Intracranial Aneurysms: A Preliminary Study.

Embolization is the preferred method for treating intracranial aneurysms due to its less invasive nature. However, recent findings suggest that even uncomplicated embolization may cause structural damage to the brain through ischemic or inflammatory mechanisms. This study aimed to find possible biomarkers of brain injury and inflammation in patients suffering from intracranial aneurysms who underwent endovascular treatment by measuring serological markers indicating brain damage. The study involved 26 patients who underwent uncomplicated intravascular stenting for unruptured intracranial aneurysms between January 2020 and December 2021. Blood samples were collected before the procedure, at 6-12 h, and at 24 h after the procedure. The following protein biomarkers levels were tested with ELISA: S100B, hNSE, TNF, hsCRP, FABP7, NFL, and GP39. Statistical analysis of the results revealed significant increases in serum levels for the four biomarkers: FABP7-before 0.25 (ng/mL) vs. 6-12 h 0.26 (p = 0.012) and vs. 24 h 0.27 (p < 0.001); GP39-before 0.03 (pg/mL) vs. 6-12 h 0.64 (p = 0.011) and vs. 24 h 0.57 (p = 0.001); hsCRP-before 1.65 (μg/mL) vs. 24 h 4.17 (p = 0.037); NFL-before 0.01 (pg/mL) vs. 6-12 h 3.99 (p = 0.004) and vs. 24 h 1.86 (p = 0.033). These biomarkers are recognized as potential indicators of neurovascular damage and should be monitored in clinical settings. Consequently, serum levels of NFL, GP39, hsCRP, and FABP7 measured before and 24 h after endovascular procedures can serve as important markers for assessing brain damage and indicate avenues for further research on biomarkers of neurovascular injury.

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.

Assessment of Serum C-reactive Protein Level in Patients with Radiographically Diagnosed Apical Periodontitis Pre- and Post-root Canal Treatment – An In vivo Study

Abstract Aim: Apical periodontitis (AP) is a sequel to endodontic infection. AP may contribute to low-grade systemic inflammation associated with a generalised increase in systemic inflammatory mediators such as C-reactive protein (CRP), interleukin (IL)-1, IL-2, IL-6 and immunoglobulin (IgA, IgG and IgM) levels. This study aimed to assess the changes that may occur in the relative serum high-sensitivity CRP (hs-CRP) levels in patients with AP, before and after root canal therapy. Methodology: Twenty-six healthy individuals aged 20–50 years with radiographically diagnosed AP took part in this prospective observational study. Patients with moderate-to-severe periodontitis, systemic diseases and cardiac risk factors (hypertension, diabetes, dyslipidaemia and smoking) were excluded from the study. The serum hs-CRP of these patients was assessed before root canal treatment (RCT). The RCT was completed in two appointments with an inter-appointment calcium hydroxide intracanal medicament. After 3 months, the healing of AP was evaluated clinically and radiographically, and serum hs-CRP levels were recorded. The values obtained were statistically analysed. Results: The data obtained from patients were statistically analysed. Reduction in serum hs-CRP values was noted after 3 months following RCT. However, it was not statistically significant. Conclusion: The results of the present study indicate that RCT reduced the levels of hs-CRP in the serum of patients with radiographically diagnosed AP.

Effects of Tocotrienol-Rich Fraction Supplementation in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

There are a large number of studies that have reported benefits of tocotrienol-rich fraction (TRF) in various populations with different health status. To date, no systematic reviews have examined randomized controlled trials (RCTs) on the effect of TRF supplementations specifically in patients with type 2 diabetes mellitus (T2DM). This systematic review and meta-analysis aim to examine the changes in HbA1c (glycated hemoglobin), blood pressure, and serum Hs-CRP (C-reactive protein high sensitivity) levels at post-TRF supplementation. Online databases including PubMed, Scopus, OVID Medline, and Cochrane Central Register of Controlled Trials were searched from inception until March 2023 for RCTs supplementing TRF in patients with T2DM. A total of 10 studies were included in the meta-analysis to estimate the pooled effect size. The Cochrane Risk-of-Bias (RoB) Assessment Tool was utilized to evaluate the RoB in individual studies. The meta-analysis revealed that TRF supplementation at a dosage of 250-400 mg significantly decreased HbA1c (-0.23, 95% CI: -0.44, -0.02, P < 0.05, n = 754), particularly where the intervention duration is less than 6 mo (-0.47%, 95% CI: -0.90, -0.05, P < 0.05, n = 126) and where duration of diabetes is less than 10 y (-0.37, 95% CI: -0.68, -0.07, P < 0.05, n = 83). There was no significant reduction in systolic and diastolic blood pressure and serum Hs-CRP (P > 0.05). The present meta-analysis demonstrated that supplementing with TRF in patients with T2DM decreased HbA1c but does not decrease systolic and diastolic blood pressure and serum Hs-CRP.