Serum hs-CRP Levels Research Articles

Correlation between HS-CRP in Serum with Neurological Deficit Measured by Nihss in Acute Ischemic Stroke

Background: CRP can increase the regulation of adhesion receptors on endothelial cells which can lead toinfiltration of neutrophil and monocyte cells to endothelial cells. This causes endothelial cell damage andblood brain barrier dysfunction eventually leading to brain cell death. This brain cell death will result inimpaired brain function and affect the severity of the stroke. The problem that arises is whether there is acorrelation between CRP levels in serum and the severity of acute ischemic stroke as measured by NIHSS.Method: Sixty patients with acute thrombotic stroke who were treated at the neurology ward of Dr.SoetomoGeneral Hospital (a Teaching Hospital of Faculty of Medicine, Universitas Airlangga) during June-September2019 had serum levels of CRP measured with sandwich ELISA method using high sensitivity CRP (hs-CRP)and neurological deficit was assessed using the NIHSS.Result: Mean age of subjects was 57,45±8,89 years. The study subjects consisted of 37 male and 23 female.The median serum levels of hs-CRP is 0,4 mg/dL with a range of 0,1-15,1 mg/dL. Median NIHSS is 5 witha range of 2-15. There is a positive correlation with moderate correlation strength between serum levels ofhs-CRP and the NIHSS value in patients with acute thrombotic stroke and statistically significant (p=0.000,r=0.454).Conclusion: There is a moderate positive correlation between serum levels of hs-CRP and neurologicaldeficit measured by NIHSS.

High Sensitivity C-Reactive Protein and Cholesterol Level as Risk Markers for Both Periodontitis and Coronary Artery Disease

Objectives: The association between periodontal disease and cardiovascular disease (CVD) has received considerable attention, although it is unclear whether there is a causal component. Therefore, this study aimed to determine the Correlation between high sensitivity C reactive protein (hs-CRP) and total blood cholesterol levels in periodontitis (PD) and coronary artery disease (CAD). 
 Methods: Eighty subjects (40 males and 40 females) divided into four equal groups: Group 1: control group, healthy without CAD or PD, group 2: PD without CAD (n=20). group 3: PD with CAD, and group 4: CAD without PD. Periodontitis was defined according to the 2017 periodontal disease classification. Periodontal probing depth (PPD) and clinical attachment level (CAL) were recorded. All participants were assessed for CAD by angiography (coronary computed tomography angiography or coronary angiography). Finally, serum hs-CRP and total cholesterol levels were determined by using the particle enhanced immunoturbidimetric assay method. 
 Results: The median of serum cholesterol and hs-CRP levels was significantly lower in the control group than the patients’ groups (P<0.05). There were no statistically significant differences in gender and age among the studied groups (P>0.05). Furthermore, significant, positive, and strong correlations of PPD and CAL with the hs-CRP and Cholesterol. 
 Conclusions: Serum levels of hs-CRP and Cholesterol were positively proportionate to the measurements of CAL and PPD by increasing the severity of PD parameters (PPD and CAL), serum level of CAD biomarkers (hs-CRP and Cholesterol) were increased.

Serum High-sensitivity C-reactive Protein Level and Corrected QT Interval in Agricultural Workers in Myanmar Exposed to Chronic Occupational Organophosphate Pesticides.

Although acute organophosphate (OP) pesticide poisoning is associated with the risk cardiovascular diseases (CVD), the association between chronic occupational OP pesticide exposure and CVD risk is limited. We investigated serum high-sensitivity C-reactive protein (hs-CRP) levels and QTc intervals in 45 agricultural workers who were chronically exposed to OP pesticides and 45 non-exposed subjects. Serum hs-CRP level was determined by enzyme-linked immunosorbent assay (ELISA) and a level >1.0 mg/l was regarded as CVD risk. The QT interval was measured by routine 12-lead Electrocardiogram (ECG) with Lead II rhythm, and QTc was calculated. The median value of the serum hs-CRP level [1.20 (0.67-2.38) vs 0.74 (0.41-1.17) mg/l, P <0.05] and the mean QTc interval (422.71 ± 23.73 vs 396.27 ± 18.48 ms, P <0.0001) was significantly higher in the OP pesticide exposed subjects. Pesticide exposure was significantly associated with CVD risk (Chi-Square χ2 = 6.480, P = 0.011) and QTc interval prolongation (χ2 = 13.846, P <0.001). A higher risk of CVD (odds ratio = 3.030; 95% confidence interval = 1.276 - 7.197) was observed in the OP pesticide exposed subjects. This study suggested that OP pesticide exposure should be considered as one of the significant risk factors for CVDs.

Association between high-sensitivity C-reactive protein levels and depression: Moderation by age, sex, obesity, and aerobic physical activity

Background: Low-grade systemic inflammation evidenced by elevated serum high-sensitivity C-reactive protein (hsCRP) levels can be a biomarker for depression. This study aimed to investigate the association between serum hsCRP levels and depressive symptoms and to explore the potential moderating effects of age, sex, body mass index (BMI), and aerobic physical activity on the association.Methods: Data of 10,702 adults (≥ 19 years) were obtained from the nationwide cross-sectional Korea National Health and Nutrition Examination Surveys of 2016 and 2018. Significant depressive symptoms were defined as ≥ 10 on the Patient Health Questionnaire-9, and high hsCRP level was defined as > 3.0 mg/L.Results: Adults with high hsCRP levels were more likely to have depressive symptoms (odds ratio [OR]: 1.41, 95% confidence interval [CI]: 1.07–1.84) and suicidal ideation (OR: 1.39, 95% CI: 1.07–1.80) than those with low hsCRP levels. In the age- and sex-stratified analysis, high hsCRP levels were associated with depressive symptoms in the non-geriatric population (age ≤ 64 years) alone, with a higher OR in males than females. In subgroup analyses, the association between them was observed only among obese adults and adults without aerobic physical activity.Limitations: Causal interpretation is limited due to the cross-sectional design.Conclusions: Our results replicate previous findings of an association between high hsCRP levels and depressive symptoms in adults using a large nationally representative sample. The association between them was more prominent in the non-geriatric population, males, obese adults, and those without aerobic physical activity.

Effects of Antioxidant Vitamins, Curry Consumption, and Heavy Metal Levels on Metabolic Syndrome with Comorbidities: A Korean Community-Based Cross-Sectional Study.

The burden of metabolic syndrome (MetS) has increased worldwide, especially during the COVID-19 pandemic, and this phenomenon is related to environmental, dietary, and lifestyle risk factors. We aimed to determine the association between the levels of serum heavy metals, hs-CRP, vitamins, and curry intake and to predict risks of MetS based on marginal effects. A data set of 60,256 Koreans aged ≥ 15 years between 2009 and 2017 was used to obtain information on sociodemographic, lifestyle, family history characteristics, MetS, food intake survey, and serum heavy metals. Daily intake of vitamins was measured by a one-day 24 h recall, and curry consumption was calculated using a food frequency questionnaire. Serum heavy metal levels were quantified by graphite furnace atomic absorption spectrometry and using a mercury analyzer. We found that vitamin B1, B2, B3, C, and A intakes were significantly lower in subjects with than without MetS. In contrast, serum levels of Pb, Hg, Cd, vitamin A, E, and hs-CRP were significantly higher in subjects with MetS. The risk of MetS was significantly lower for high curry consumers than low curry consumers (adjusted odds ratio 0.85, 95%CI 0.74–0.98). The risks of MetS were reduced by 12% and 1%, when vitamin B1 and C intakes increased by one mg, respectively, but were increased by 14%, 3%, and 9%, when serum levels of Pb, Hg, and hs-CRP increased by one unit. These results show that the potential health benefits resulting from vitamin and curry intakes could protect the public against the dual burden of communicable and non-communicable diseases. Further studies are required to reduce risk factors associated with serum heavy metal levels and to determine whether interactions between vitamin and curry consumption influence the presence of MetS.

POS0115 RISK FACTORS FOR CORONARY HEART DISEASE AND ATHEROSCLEROSIS IN PATIENTS WITH BECHET’S DISEASE

Background:Objectives:To evaluate traditional risk factors for clinically manifest and asymptomatic atherosclerosis in pts with BD.Methods:Traditional risk factors for atherosclerosis were evaluated in 95 pts with Bechet’s disease (BD) and 40 healthy age and gender matched controls. The male-to-female ratio was 3,7:1, pts’ mean age was 29.7 (23-35) y, the mean age at the disease onset - 19,9 (14-25) y, and mean disease duration - 9,6 (4-15) y. The common carotid artery intima-media thickness (IMT) was evaluated by high resolution B-mode ultrasonography. A plaque was defined as a local intima-media thickening ≥1,2 mm, with reference IMT thickness &lt;0,9 mm. Serum concentration of high-sensitivity C-reactive protein (hs CRP) was measured by immunonephelometric assay (BN-100 Analyzer; Dade Behring). Lipid profile evaluation included total cholesterol, TGs, HDL, LDL and atherogenic index.Results:Traditional risk factors for atherosclerosis (one or more) were found in 85,3% of BD pts, dyslipidemia was the most common risk factor and was present in 76,84% of pts, mostly due to increased total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels. 22,1% had arterial hypertension (AH), 29,5% were current smokers, 27,4% had excess body weight, 3,1% had family history of cardiovascular diseases (CVD). Traditional risk factors for atherosclerosis were found in 80% out of 40 gender and age matching subjects from the control group, i.e., showing practically the same prevalence as in BD pts.Table 1.The incidence-rate of traditional risk factors in BD patients and controlsVariablesBD pts (n=95)Controls (n=40)рAge, years29,0 [23,0;35,0]29,0 [25,0;32,0]NSBMI, kg/m223,1 [21,1;25,5]23,8 [22,0;26,0]NSBMI ≥ 25 kg/m2, n (%)26 (27,4)15 (37,5)NSArterial hypertension, n (%)21 (22,1)4 (10)NSFamily history of CVD3 (3,1)5 (12,5)0,05Cigarette smoking, n (%)28 (29,5)12 (30,0)NSDyslipidemia, n (%)73 (76,8)27 (67,5)NSTotal cholesterol, mml/l5,0 [4,3;6,1]5,1 [4,5;5,7]NSCholesterol &gt; 5,0 mml/l, n (%)47 (49,5)25 (62,5)NSTGs, mml/l0,92 [0,7;1,3]0,89 [0,60;1,08]NSTGs &gt; 1,7 mml/l, n (%)8 (8,4)3 (7,5)NSLDL, mml/l3,36 (2,8;4,0)3,3 [2,7;3,7]NSLDL &gt; 3 mml/l, n (%)63 (66,3)25 (62,5)NSHDL, mml/l1,19 [1,0;1,5]1,35 [1,2;1,6]0,06HDL ≤1 mml/l (male), ≤ 1,2 mml/l (female) n (%)30 (31,6)5 (12,5)0,03Reduced HDL levels were more common in BD pts vs the controls - 30 (31,6%) vs 5 (12,5), р=0,03 as shown in table 1. Other traditional risk factors were similarly present in both groups with no significant difference between BD pts and the controls.Analysis showed similar incidence of CV events (nonfatal myocardial infarction, angina pectoris and stroke) in both groups. There were no differences between BD pts and healthy people in terms of lifetime risk for CVD. High lifetime risk ≥ 20% was found in 4 BD pts vs 0 in the control group; moderate lifetime risk &gt;10% &lt; 20% - in 6,3% of BD pts vs 2,5% in the control group, and low lifetime risk &lt; 10% -was found in 89,5% of BD pts vs 97,5% of the controls.Average IMT values were significantly higher in BD pts - 0.68 [0.60;0.73] vs 0.63 [0.56;0.65], p=0.008, but at the same time, IMT thinning (up to &lt; 0.5 mm) was significantly more common in BD pts - 32.6% vs 12.5% in the control group (p=0.01). HsCRP serum levels were significantly higher in BD pts (2.42 [0.5;8.8] mg / l) than in the control group (0.37 [0.15;0.75]), p=0.001. There was a correlation between hs-CRP and BMI in BD pts (r=0.2, p&lt;0.05), but no correlation was found between hsCRP and BD activity/BD clinical manifestations.Conclusion:Decreased HDL cholesterol levels were more common in BD patients than in the control group, just as thinning of IMT, most likely because of vasculitis.Disclosure of Interests:None declared

Expression levels of plasma exosomal miR-124, miR-125b, miR-133b, miR-130a and miR-125b-1-3p in severe asthma patients and normal individuals with emphasis on inflammatory factors

BackgroundIdentification of molecular markers, such as miRNAs is promising for the diagnosis of asthma and its clinical phenotypes. The aim of this study was to examine the changes in the expression of selected microRNAs in plasma exosomal fractions of severe asthma patients. The expression of miRNAs was determined in relation to the changes in inflammatory markers.MethodSevere asthma patients (n = 30) and healthy subjects (n = 30) were selected among the individuals referred to asthma and allergy clinic. Blood was collected from each participant to determine the serum high-sensitive C-reactive protein (hs-CRP) and total IgE. The exosomal fraction of plasma was isolated and processed for quantitation of miR-124, miR-125b, miR-133b, miR-130a and miR-125b-1-3p expression using quantitative real time-PCR (qRT-PCR).ResultsSerum hs-CRP and total IgE were significantly higher in asthma patients compared to controls. Expression of miR-124, miR-133b, and miR-130a was down-regulated in asthma patients as compared to controls (p < 0.0001). However, the expression of miR-125b was substantially higher in patients compared to controls (p < 0.0001). There was no significant difference in the expression of miR-125b-1-3p in the patients and controls. Data analysis revealed that among the miRNAs, changes in miR-125b in severe asthma patients were highly correlated with the serum levels of hs-CRP and IgE.ConclusionOverexpression of miR-125b in severe asthma which was associated with serum IgE and hs-CRP may suggest that this molecule is linked to inflammatory reactions. Up-regulation of miR-125b together with decreased expression of miR-124, miR-133b, and miR-130a may suggest that this miRNA profile is useful for diagnosis and discrimination of clinical phenotypes of asthma.

The Effect of Atorvastatin in Knee Osteoarthritis

The aim of this, randomized, double-blind, placebo-controlled study is to evaluate the effect of using 40mg atorvastatin on the progression of joint structural changes and symptoms over 3months in Iraqi patients with symptomatic knee osteoarthritis.This study was performed at Department of Rheumatology, Baghdad Teaching Hospital during the period from September 2020 to January 2021.A total of 44 patients with knee osteoarthritis were assigned to the placebo group (n=21) and atorvastatin group (n=23)that was received atorvastatin 40mg once daily. Both groups received etoricoxib tablets 60mg as a rescue medicine on need. Both groups were treated continuously for 12 weeks.Serum levels of C-terminal telopeptide of type II collagen CTXII, high sensitive c-reactive protein HS-CRP and Western Ontario and McMaster Universities Osteoarthritis Index WOMAC was measured before and after three months of treatment.Resultsshowed that after three months of treatment, the atorvastatin group showeda significant symptomatic improvement in total WOMAC scoring (P&lt;0.0001) associated with a significant reduction (P&lt;0.001) in serum CTXII, HS-CRP level.These results confirmed that the atorvastatin treatment in patients with knee osteoarthritis has clinical efficacy in reducing symptoms through the improvement of WOMAC index and reduction of serum level of CTXII and HS-CRP. In conclusions: Atorvastatin in a dose of 40mg daily can reduce the symptoms of OA.

The effect of Cornus mas extract consumption on bone biomarkers and inflammation in postmenopausal women: A randomized clinical trial.

The drastic decrease in estrogen levels in menopausal women can elevate bone resorption and osteoporosis. Cornus mas extract (C. mas extract) is a potential candidate for treating menopausal-related bone complications because of its phytoestrogen and anti-inflammatory contents. It was an interventional double-blind placebo-controlled randomized study. Eighty-four women aged 45-60 years old were randomly allocated to either the extract group receiving 3 capsules of 300 mg C. mas extract or the placebo group receiving 3 capsules of 300 mg of starch powder per day for 8 weeks. Then, venous blood was used to measure bone-specific alkaline phosphatase (BAP), osteocalcin (OC), C-terminal telopeptide (TC) as well as serum levels of PTH and hsCRP. Our results indicated the decrease in alkaline phosphatase, PTH, and as an inflammation biomarker, hsCRP, between two groups at the end of the study. No statistically significant difference was observed in telopeptide C, osteocalcin, and calcium between the placebo and extract groups after 8 weeks of intervention. In conclusion, the results indicate that the C. mas extract supplement of 900 mg/day may decrease levels of BAP, PTH, and hsCRP. However, this intervention had no beneficial effect on OC and TC in healthy postmenopausal women.

Increased Serum High-Sensitivity C-Reactive Protein in Growth Hormone-Deficient Patients With Non-Functioning Pituitary Tumors

Introduction: Growth hormone (GH) deficiency, the most common hormone deficit complicated with pituitary tumors, is associated with higher mortality and cardiovascular events. Inflammation, as measured by high-sensitivity C-reactive protein (hs-CRP), has been reported to be associated with cardiovascular events. However, the association between hs-CRP and GH deficiency is still unknown. We retrospectively evaluated the association between serum hs-CRP levels and GH secretion in patients with non-functioning pituitary tumors (NFPTs). Methods: In this retrospective study, adult patients with non-functioning pituitary adenoma (NFPA) and Rathke’s cyst who received a GH-releasing pepitide-2 (GHRP-2) test from 2013 until 2016 were included. Patients with a history of pituitary surgery or radiation, or estimated GFR lower than 30 mL/min/1.73m2 were excluded. Results: Of 81 patients (70 NFPA and 11 Rathke’s cyst), 44% were diagnosed as severe GH deficiency by GHRP-2 test. Serum hs-CRP level was significantly higher in the male patients (P = 0.001) and the patients with regularly alcohol intake (P = 0.011) and was significantly correlated with BMI (r = 0.35, P = 0.002), creatinine (r = 0.41, P < 0.001), eGFR (r = -0.29, P = 0.009), peak GH response to GHRP-2 (r = -0.48, P < 0.001), AST (r = 0.32, P = 0.004), ALT (r = 0.34, P = 0.002), γGTP (r = 0.41, P < 0.001), HDL-cholesterol (r = -0.33, P = 0.003) and triglyceride (r = 0.25, P = 0.02). Smoking habit (P = 0.084), age (r = 0.18, P = 0.10), LDL-cholesterol (r = 0.16, P = 0.15), IGF-1 (r = -0.14, P = 0.23) and IGF-1 SD score (r = -0.11, P = 0.32) were not significantly correlated with serum hs-CRP level. Peak GH response to GHRP-2 (β = -0.24, P = 0.024) was a significant variable to determine serum hs-CRP level after adjustment for age, sex, BMI, regularly alcohol intake and serum creatinine, γGTP and HDL-cholesterol levels. Conclusion: Increased serum hs-CRP levels in the GH-deficient patients with NFPTs suggested the contribution of GH deficiency to pathogenesis of inflammation associated with cardiovascular diseases.

Effects of Transcutaneous Electrical Acupoint Stimulation on Postoperative Cognitive Decline in Elderly Patients: A Pilot Study.

BackgroundPostoperative cognitive decline (POCD) in the old ages seriously delays the rapid recovery. Here, we aimed to investigate the effects of transcutaneous electrical acupoint stimulation (TEAS) against POCD in elderly patients undergoing laparoscopic radical colon cancer surgery, as well as the potential mechanism.MethodsA prospective, single-center, parallel-group, randomized trial was designed. A total of 100 patients (age ≥65 years) undergoing laparoscopic radical resection of colon cancer were involved and randomly divided into TEAS (Group T) and control (Group C) groups. The patients in Group T were performed with percutaneous acupoint electrical stimulation in bilateral Hegu, Neiguan and Zusanli points from 30 minutes before anesthesia induction to the end of surgery. A Z-score based on Mini-Mental State Exam (MMSE) was used to assess the incidence of POCD. The levels of serum IL-6, hs-CRP, CGRP at 0 min before TEAS (T0), 1 h after beginning of surgery (T1) and the end of surgery (T2) were evaluated.ResultsOur data showed that the cumulative duration of POCD on postoperative day 2 and 3 in Group T was significantly decreased compared to Group C (P < 0.05). Compared with T0, the levels of serum IL-6, hs-CRP, and CGRP in both Group T and C were statistically elevated at T1 and T2 (P < 0.05). Moreover, the levels of serum IL-6 and hs-CRP were decreased, but the level of CGRP was increased in Group T compared to Group C at T1 and T2 (P < 0.05).ConclusionTEAS is associated with a lower cumulative duration of POCD in elderly patients undergoing laparoscopic radical colon cancer surgery, which may be related to the regulation of inflammatory factors and neuropeptides interacted with gut–brain axis.

Low-grade inflammation as a potential mediator between depressive symptoms and temporomandibular pain: an 11-year follow-up study on Finnish adults

Background Low-grade inflammation and depressiveness have been associated with chronic pain conditions. Objective To examine whether low-grade inflammation mediates the association between depressive symptoms and temporomandibular (TM) pain in Finnish adults based on the Health 2000/2011 Surveys (BRIF8901). Methods The sample comprised subjects who underwent clinical TM pain examination (pain on palpation of the masticatory muscles and temporomandibular joints) in 2000 and 2011 and responded to questions on TM pain symptoms in 2011. The serum level of hs-CRP was obtained in both years, and depressiveness was assessed using the Beck Depression Inventory-21 (BDI-21) in 2000 and BDI-13 in 2011. Four subgroups were formed based on the presence of TM pain: No pain, pain in 2000-only, pain in the 2011-only, and pain in both-years. Analyses included Rao Scott’s chi-square test cross-sectionally, and multinomial logistic regression longitudinally with the level of hs-CRP and BDI-21 score in 2000 as predictors. Mediation was tested using Hayes A. Processv3.5. Results Higher BDI-21/-13 and hs-CRP levels corresponded to higher prevalences of TM pain in both years. Longitudinally, in men, higher hs-CRP level predicted TM pain in 2000-only and TM pain in both-years. Higher BDI-21 score predicted having TM pain in 2011-only. In women, higher BDI-21 score predicted TM pain in 2000-only and having TM pain in both-years. Both BDI-21 and hs-CRP had a direct effect on TM pain outcome with no mediation detected. Conclusion While depressiveness may increase the risk of chronic TM pain in women, the risk in men is increased by low-grade inflammation.

Changes of Serum Sex Hormone-Binding Globulin, Homocysteine, and Hypersensitive CRP Levels during Pregnancy and Their Relationship with Gestational Diabetes Mellitus

Background: Inflammatory response state is related to the pathogenesis of gestational diabetes mellitus (GDM). Objective: To investigate the changes of serum sex hormone-binding globulin (SHBG), homocysteine (Hcy), and hypersensitive CRP (hs-CRP) levels during pregnancy and their relationship with GDM. Methods: The nested case-control study method was used. Sixty nonobese single pregnant women diagnosed with GDM were divided into the GDM group (GDM, n = 60), together with another 60 pregnant women with normal glucose tolerance who were matched in the same period and divided into the control group (control, n = 60). The serum Hcy, hs-CRP, and SHBG levels were measured. Results: The serum levels of Hcy and hs-CRP were significantly higher in the GDM group compared with the control group, and serum levels of SHBG was significantly lower in the GDM group compared with the control group at different stages of pregnancy. The serum levels of Hcy and hs-CRP in pregnant women increased with the increase of gestational age, and serum levels of SHBG decreased with the increase of gestational age. Increased Hcy and hs-CRP levels in the second trimester and decreased SHBG levels in the first trimester were related to GDM. The odds ratio (OR) and 95% confidence interval (CI) were as follows: OR: 4.5, 95% CI: 1.5–13.0; OR: 4.2, 95% CI: 1.5–10.1; and OR: 0.4, 95% CI: 0.3–0.7, respectively. Conclusion: Increased Hcy and hs-CRP in the second trimester and decreased SHBG in the first trimester were independent predictors of GDM, which provides a new idea for early prevention and treatment of GDM.

Elevated circulating Selenoprotein P levels in patients with polycystic ovary syndrome

Selenoprotein P (SeP), an hepatokine that is primarily produced by liver, has been reported to affect glucose metabolism. In this study, we aimed to measure and compare serum SeP values in patients with polycystic ovary syndrome (PCOS) and a healthy control group, and to investigate whether there was a relationship between SeP values and insulin resistance in patients with PCOS. This prospective case-control study included 40 patients with PCOS and 39 healthy women (non-PCOS) matched for age and body mass index. SeP levels were significantly higher in the PCOS group compared with the healthy controls (7.48 ± 3.80 vs. 5.17 ± 3.20 mg/ml, p = .005). Serum insulin, hs-CRP, HOMA-IR, FBG, total-testosterone, and free-testosterone levels were higher in women with PCOS than in controls. In an unadjusted model and after adjusting for potential confounders, SeP had increased odds for PCOS (p = .007). ROC curve analysis showed that the area under the ROC curves were 0.691 (95% CI: 0.576–0.806, p < .003) for SeP levels. The optimal cut-off value of SeP for detecting PCOS was ≥5.87 mgl/ml. We showed, for the first time, that serum SeP levels were increased significantly in PCOS, Our results suggest that there is a potential link between PCOS and SeP levels IMPACT STATEMENT What is already known on this subject? Selenoprotein deficiency causes various dysfunctions associated with oxidative stress, but recent studies found that increased SeP levels were associated with insulin resistance. Circulating SeP levels have been found to be increased in patients with type 2 diabetes mellitus (T2DM). What the results of this study add? Our study is the first in the literature to examine the relationship between SeP levels and the presence of PCOS. Serum SeP levels were increased significantly in PCOS. What the implications are of these findings for clinical practice and/or further research? SeP seemed to have a role in PCOS. SeP can be used to predict metabolic disorders associated with PCOS and to determine treatment methods.

Severe periodontitis is associated with the serum levels of hypersensitive C reactive protein and lipoprotein-associated phospholipase A2 in the patients of acute ischemic stroke

BackgroundPeriodontitis is associated with the pathogenesis of atherosclerotic plaque, and hypersensitive C reactive protein (hs-CRP) and lipoprotein-associated phospholipase A2 (Lp-PLA2) are the serum biomarkers of the stability of atherosclerotic plaque. Whether periodontitis is associated with the serum level of hs-CRP and Lp-PLA2 of acute ischemic stroke remains unclear. Material and MethodsWe recruited 103 cases with acute ischemic stroke within 7 days after stroke onset. Pocket depth and clinical attachment loss were assessed by oral examination to define the severe periodontitis. Demographic information including gender, age and body weight index, income level, education level, past medical history include smoking history, drinking history, ischemic stroke history, coronary heart disease, hypertension, diabetes and hyperlipidemia were collected, and serum biomarkers including white blood cell (WBC), fibrinogen, total cholesterol (TC), triglyceride (TG), lower density lipoprotein (LDL-C), high density lipoprotein (HDL-C), hs-CRP, HemoglobinA1c (HbAlc), Homocysteine (HCY) and Lp-PLA2 were tested. Results65 (63.1%) cases were diagnosed as severe periodontitis. Severe periodontitis group showed more male, age, drinking history, higher levels of hs-CRP and Lp-PLA2. Multivariate logistic regression showed that severe periodontitis was were significantly associated with hs-CRP (OR = 2.367, 95%CI: 1.182–4.738; P = .015) and Lp-PLA2 (OR = 2.577, 95% CI: 1.010–6.574; P = .048). ConclusionsSevere periodontitis is independently associated with the serum Level of hs-CRP and Lp-PLA2 in patients with acute ischemic stroke. Whether the improvement of periodontitis could decrease the occurrence and re-occurrence of ischemic stroke by stablizating atherosclerotic plaque need be further studied in future.

The impact of L-citrulline supplementation on glucose homeostasis, lipid profile, and some inflammatory factors in overweight and obese patients with type 2 diabetes: A double-blind randomized placebo-controlled trial.

This study investigated the impact of L-citrulline on glucose homeostasis, lipid profile, and inflammatory factors in overweight and obese patients with type 2 diabetes (T2D). In total, 54 participants with T2D were assigned to L-citrulline (3g/day L-citrulline) or placebo groups and tested for 8 weeks. Serum levels of insulin, fasting glucose, hemoglobin A1c (HbA1c), lipid profile, tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), and L-citrulline were measured pre- and post-intervention. Totally, 45 patients were enrolled in the research. L-citrulline supplementation decreased serum levels of insulin (p= .025), glucose (p= .032), HbA1c (p= .001), HOMA-IR (p= .037), TNF-α (p= .036), and hs-CRP (p= .027) significantly. At the end of the study, despite the significant decrease in serum levels of triglyceride (p= .027) and the increase in high-density lipoprotein cholesterol levels (p< .001) in the L-citrulline group, no significant differences were found for these parameters between the groups. Moreover, no significant inter- and intra-group changes were observed for dietary intakes, anthropometric indices, total and low-density lipoprotein cholesterol levels (p> .05). In conclusion, L-citrulline supplementation might improve glucose homeostasis, some lipid factors and inflammatory markers in overweight and obese patients with T2D.

Evaluation of Blood Levels of C-Reactive Protein Marker in Obstructive Sleep Apnea: A Systematic Review, Meta-Analysis and Meta-Regression.

(1) Introduction: High sensitivity C-reactive protein (hs-CRP) and CRP are inflammatory biomarkers associated with several inflammatory diseases. In both pediatric and adult individuals with Obstructive Sleep Apnea (OSA) higher hs-CRP and CRP were observed, compared to controls. With the present systematic review, meta-analysis and meta-regression we expand upon previous meta-analyses in four ways: (1) We included 109 studies (96 in adults and 13 in children); (2) we reported subgroup and meta-regression analyses in adults with OSA compared to controls on the serum and plasma levels of hs-CRP; (3) we reported subgroup and meta-regression analyses in adults with OSA compared to controls on the serum and plasma levels of CRP; (4) we reported serum and plasma levels of both hs-CRP and CRP in children with OSA, always compared to controls. (2) Materials and Methods: The PubMed/Medline, Scopus, Cochrane Library, and Web of Science databases were searched to retrieve articles published until 31 May 2020, with no restrictions. The data included basic information involving the first author, publication year, country of study, ethnicity of participants in each study, age, BMI, and AHI of both groups, and mean and standard deviation (SD) of plasma and serum levels of CRP and hs-CRP. (3) Results: A total of 1046 records were retrieved from the databases, and 109 studies were selected for the analysis (96 studies reporting the blood levels of hs-CRP/CRP in adults and 13 studies in children). For adults, 11 studies reported plasma hs-CRP, 44 serum hs-CRP, 9 plasma CRP, and 32 serum CRP levels. For children, 6 studies reported plasma hs-CRP, 4 serum hs-CRP, 1 plasma CRP, and 2 serum CRP levels. Compared to controls, the pooled MD of plasma hs-CRP levels in adults with OSA was 0.11 mg/dL (p < 0.00001). Compared to controls, the pooled MD of serum hs-CRP levels in adults with OSA was 0.09 mg/dL (p < 0.00001). Compared to controls, the pooled MD of plasma CRP levels in adults with OSA was 0.06 mg/dL (p = 0.72). Compared to controls, the pooled MD of serum CRP levels in adults with OSA was 0.36 mg/dL (p < 0.00001). Compared to controls, the pooled MD of plasma hs-CRP, serum hs-CRP, plasma hs-CRP, and serum hs-CRP in children with OSA was 1.17 mg/dL (p = 0.005), 0.18 mg/dL (p = 0.05), 0.08 mg/dL (p = 0.10), and 0.04 mg/dL (p = 0.33), respectively. The meta-regression showed that with a greater apnea-hypapnea index (AHI), serum hs-CRP levels were significantly higher. (4) Conclusions: The results of the present systematic review, meta-analysis and meta-regression showed that compared to healthy controls plasma and serum levels of hs-CRP and serum CRP level were higher in adults with OSA; for children, and compared to controls, just plasma hs-CRP levels in children with OSA were higher.

Prognostic value of lymphocyte cell ratios in peritoneal dialysis

Background: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been introduced as useful inflammatory markers to predict the outcome of a wide spectrum of diseases, such as malignancies and cardiovascular pathologies. Limited evidence is available for their role in end-stage renal disease and dialysis patients. The aim of this study was to evaluate NLR and PLR as predictors of mortality in peritoneal dialysis (PD) patients. Methods: In this retrospective study 122 incident PD patients between 2004 and 2019 were included. Demographic, clinical and laboratory data were collected. Relationships between NLR, PLR and high-sensitivity C-reactive protein (hs-CRP) were evaluated by Spearman correlation test. Univariable and multivariable Cox regression analysis were performed to determine the association of NLR and PLR with all-cause mortality. Results: Mean levels of NLR and PLR were 3.99±2.6 and 195.5±101.7, respectively. Both NLR and PLR were significantly and positively correlated with serum hs-CRP levels (r=0.340, p&lt;0.001 and r=0.360, p&lt;0.001, respectively). The overall mortality rate was 18.9% after a mean follow-up of 30.2±24.0 months. On multivariable modeling, we found that higher NLR (HR=1.662, 95%CI 1.117-2.472) and higher PLR (HR=1.010, 95%CI 1.004-1.015), in addition to lower residual renal function and higher Charlson comorbidity index were significant independent predictors of poor survival, when adjusted for nutritional status. Discussion: In this study, NLR and PLR were validated as inflammatory markers and predicted survival in our PD patients. Our results suggest that NLR might be a better indicator of mortality than PLR.

Associations between Pre-Bariatric High-Sensitivity C-Reactive Protein and Post-Surgery Outcomes.

Background: Obesity is a chronic inflammatory condition associated with increased circulating levels of C-reactive protein (CRP). Bariatric surgery has been reported to be effective in improving both inflammatory and liver status. Our aims were to elucidate the relationships between pre-surgery high sensitivity-CRP (hs-CRP) values and post-surgery weight loss and liver steatosis and fibrosis in patients with severe obesity undergoing Roux-en-Y gastric bypass. Methods: We conducted an observational prospective study on 90 individuals with morbid obesity, who underwent gastric bypass. Anthropometric indices, laboratory assessment (lipid panel, glycemic status, liver enzymes, and hs-CRP), liver stiffness and steatosis were evaluated at baseline and 6-months after surgery. Results: There was a significant post-surgery reduction in all the anthropometric variables, with an average weight loss of 33.93 ± 11.79 kg; the mean percentage of total weight loss (TWL) was 27.96 ± 6.43%. Liver elasticity was significantly reduced (from 6.1 ± 1.25 to 5.42 ± 1.52 kPa; p = 0.002), as well as liver aminotransferases, nonalcoholic fatty liver disease fibrosis score (NFS) and the grade of steatosis. Serum hs-CRP levels significantly reduced (from 9.26 ± 8.45 to 3.29 ± 4.41 mg/L; p < 0.001). The correlations between hs-CRP levels and liver fibrosis (elastography), steatosis (ultrasonography), fibrosis-4 index, NFS, and surgery success rate were not significant. Regression analyses showed that serum hs-CRP levels were not predictive of liver status and success rate after surgery in both unadjusted and adjusted models. Conclusions: In patients with morbid obesity, bariatric surgery caused a significant decrease in hs-CRP levels, liver stiffness and steatosis. Baseline hs-CRP values did not predict the weight-loss success rate and post-surgery liver status.

Raised high-sensitivity C-reactive protein and cognitive impairment among African stroke survivors within the first three months following stroke

Stroke remains a major factor causing death and disabilities such as cognitive impairment. There is conflicting evidence on the role and dynamics of high sensitivity C-reactive protein (hsCRP), an acute phase pro-inflammatory protein, in post-stroke cognitive impairment. This study evaluated cognitive impairment and examined its relationship with serum hsCRP in the first three months following stroke. Cognition was assessed using Montreal Cognitive Assessment test, while serum hsCRP concentrations were assessed using enzyme link immunosorbent assay kit. Data were processed using SPSS Statistics version 20.0. Sixty subjects, comprising of 30 stroke patients and 30 healthy subjects, matched for age, sex and level of education were studied. Cognitive impairment was observed among the stroke patients, while the healthy subjects showed normal cognitive function; and the difference in the cognitive scores of the two groups was highly significant (P = 0.001). There was higher prevalence of cognitive impairment among the stroke survivors compared to the non-stroke subjects. Serum hsCRP was significantly higher among the stroke survivors compared to the healthy subjects (P = 0.001). The high hsCRP level correlates well with duration of stroke and working memory domain of cognition. The data revealed a high prevalence of cognitive impairment and concurrent high serum hsCRP levels among stroke survivors in the first three months following stroke, in contrast with normal subjects. The high hsCRP level correlates with duration of stroke and working memory domain of cognition. The data suggest a role for serum hsCRP and inflammation in the development of post-stroke cognitive impairment.