Serum hs-CRP Levels Research Articles

A Hot Water Extract of Curcuma longa L. Improves Fasting Serum Glucose Levels in Participants with Low-Grade Inflammation: Reanalysis of Data from Two Randomized, Double-Blind, Placebo-Controlled Trials.

The dietary spice Curcuma longa L. (C. longa), also known as turmeric, has various biological effects. A hot water extract of C. longa was shown to have anti-inflammatory activities in preclinical and clinical studies. Chronic low-grade inflammation is associated with the disruption of glucose homeostasis, but the effect of C. longa extract on glucose metabolism in humans is poorly understood. Therefore, we investigated the effect of C. longa extracts on serum glucose levels in the presence of low-grade inflammation. We reanalyzed our published data from two randomized, double-blind, placebo-controlled trials in overweight participants aged 50 to 69 years and performed a stratified analysis using the inflammatory marker high-sensitivity C-reactive protein (hsCRP). In both studies, participants took a test food with a hot water extract of C. longa (C. longa extract group, n = 45 per study) or without C. longa extract (placebo group, n = 45 per study) daily for 12 weeks, and we measured the levels of serum hsCRP and fasting serum glucose. The mean baseline hsCRP value was used to stratify participants into two subgroups: a low-hsCRP subgroup (baseline mean hsCRP < 0.098 mg/dL) and a high-hsCRP subgroup (baseline mean hsCRP ≥ 0.098 mg/dL). In the low-hsCRP subgroup, we found no significant difference in fasting serum glucose levels between the two groups in either study, but in the high-hsCRP subgroup, the C. longa extract group had significantly lower levels of serum hsCRP (p < 0.05) and fasting serum glucose (p < 0.05) than the placebo group in both studies. In conclusion, a hot water extract of C. longa may help to improve systemic glucose metabolism in people with chronic low-grade inflammation.

The Effect of High-Intensity Interval Training and Sleep Regulation on Some Inflammatory Markers, Anaerobic Capacity, and Body Composition in Teenage Girls with Sleep Disorders

Introduction: The present study aimed to compare the effect of high-intensity interval training (HIIT), sleep regulation, and the combined method on interleukin-6 (IL-6), high-sensitivity reactive protein (hs-CRP), anaerobic capacity, and body mass index (BMI) of adolescent girls with sleep disorders. Method: Eighty teenage girls with sleep disorders were randomly assigned to HIIT, sleep regulation, a combination of the two (HIIT+ sleep regulation), and control groups. All girls participated in pre-test and post-test sessions for the measurements two days before and after the research process. The participants in the HIIT and combined groups underwent a HIIT training program for four weeks, three sessions per week, and the subjects in the sleep regulation and combined groups performed the sleep regulation program by extending the sleep time duration by five minutes every night. Results: The findings showed a significant difference between groups for the serum levels of IL-6 and hs-CRP, BMI, and anaerobic power (P&lt;0.001). Bonferroni's post hoc test showed a significant decrease in BMI and serum levels of IL-6 and hs-CRP and a significant increase in the minimum power in the combined group compared to the other three groups (P&lt;0.001). In addition, a significant increase in anaerobic power (peak and average power) was respectively observed in the combined and HIIT groups, compared to the sleep regulation and control groups (P&lt;0.001). Conclusion: The HIIT+ sleep regulation combined intervention can be a valuable interventional treatment to improve the care of sleep disorders in adolescent girls and, consequently, reduce the problems and costs of treatment for these individuals and their families

Association of Duration of Smoking Cessation or Cumulative Smoking Amount with Serum hs-CRP Level in Korean Adults: A Nationwide Population-Based Cross-Sectional Study.

This study investigates the association between the duration of smoking cessation or cumulative smoking amount with serum high-sensitivity C-reactive protein (hs-CRP) levels. We assessed the decreasing risk for cardiovascular disease (CVD) and cancer following smoking cessation in Korean adults who were former smokers compared with current smokers. This study used data from the 2016–2018 Korea National Health and Nutrition Examination Survey. A total of 5411 participants were included. The duration of smoking cessation and cumulative smoking amount were classified into cut-offs for 6 and 17 months, and 5 and 20 pack-years, respectively, using tertile values. Elevated serum hs-CRP level was defined as ≥1 mg/L. Multivariate logistic regression analysis was performed. The odds ratio (OR) for elevated serum hs-CRP level was 0.73 times lower in the group whose duration of smoking cessation was 17 months or more than that in the group who were current smokers after adjusting for confounding variables (95% confidence interval (CI): 0.57–0.92; p < 0.01). The OR for elevated serum hs-CRP level was 0.71 and 0.67 times lower in the groups whose cumulative smoking amounts were less than 5 and 5–20 pack-years than that in the group who were current smokers (95% CI: 0.50–0.99 and 0.50–0.92, respectively; both p < 0.05). This study reveals that a duration of smoking cessation of more than 17 months and a cumulative smoking amount of less than 20 pack-years were significantly associated with a decreased risk of elevated serum hs-CRP levels in Korean adults who were former smokers. Therefore, quitting smoking early and a low cumulative smoking amount are a potential preventive strategy for CVD and cancer that can be easily accessible using serum hs-CRP.

C-reactive protein and uric acid roles in distinguishing ST-segment elevation myocardial infarction from non-ST-elevation acute coronary syndrome

ABSTRACT Acute coronary syndrome (ACS) is defined as a range of conditions which the blood flow to the heart was reduced or stopped. This disorder is correlated to a systemic inflammatory response and some biochemical factors. Therefore, the aim of this study was investigations of serum C-reactive protein (CRP) and uric acid levels in ST-segment elevation myocardial infarction (STEMI) and non-ST-elevation ACS (NSTE ACS), as common subtypes of ACS. Patients with ACS (n = 140) were assessed with coronary arteriography and divided into STEMI and NSTE ACS groups. The serum levels of hs-CRP and uric acid were investigated using a routine clinical chemistry analyzer. Patients with STEMI showed a significant increase in uric acid level compared to those with NSTE ACS (P < .0001). Other data indicated that hs-CRP level in patients with STEMI was significantly higher than individuals with NSTE ACS (P < .0001). Modeling analysis revealed that the increased levels of acid uric and hs-CRP in patients with STEMI were independent of the effects of age, gender, background diseases, and familial history (P < .001). The current study provides further evidence to indicate that hs-CRP and uric acid may be considered as biofactors for comparing STEMI from NSTE ACS and determining disease outcome.

The Clinical Effect and Mechanism of Prostant on Urinary Retention and Anal Pain.

Anal pain and urinary retention are the two most outstanding complications of the procedure for prolapse and hemorrhoids (PPH) surgery. This study intended to assess the clinical effect and mechanism of Prostant on urinary retention and anal pain after the PPH. Here, 30 patients received PPH surgery. The role and mechanism of Prostant in patients and mice with urinary retention and anal pain were evaluated. ANOVA tests were executed and differences between groups were regarded as statistically significant when p < 0.05. Prostant effectively improved the urination status, lower abdomen symptoms, time to urinate and score of VAS, and the reduction of TNF-α and IL-6. Similarly, Prostant can ameliorate the outcome of urodynamics in urinary retention mice. Mechanically, Prostant reversed the urinary retention-elevated the serum level of hs-CRP and TNF-α, reduction of IL-2, imbalance of Treg/Th17, and level of JAK2 and phosphorylated STAT3. Besides, Prostant ameliorated the pain as shown by the reduction of writhing response, and the elevation of threshold of pain and degree of swelling. Moreover, Prostant antagonized the pain-induced dysregulation of Treg/Th17. Therefore, Prostant can treat patients and mice with anal pain and urinary retention by modulating the balance of Th17/Treg to regulate the secretion and production of inflammatory factors. We hope our results can establish a scientific treatment approach for solving anal pain and urinary retention after PPH surgery of mixed hemorrhoids.

Oral microbiome and serological analyses on association of Alzheimer's disease and periodontitis.

To investigate the association between Alzheimer's disease (AD) and periodontitis in the aspects of periodontal status, serological markers, and oral microbiome. Twenty AD and 20 healthy subjects were enrolled in this age- and gender-matched case-control study. Clinical periodontal parameters and serum biomarkers, including amyloid β42 (Aβ42 ), Tau, phosphorylated Tau (pTau), triglyceride, pro-inflammatory cytokines, and anti-Porphyromonas gingivalis lipopolysaccharide (LPS) antibody were examined. The saliva samples were analyzed for oral microbiome composition. Alzheimer's disease patients with Clinical Dementia Rating (CDR) ≥1 exhibited significantly more clinical attachment loss (CAL) than those with lower CDR. The levels of serum Tau protein, hsCRP and anti-P.gingivalis LPS antibody were markedly elevated in the AD group compared with the control group. Serum pTau protein level was positively correlated with anti-P.gingivalis LPS antibody titer. Moreover, the increased abundances of Capnocytophaga sp ora clone DZ074, Eubacterium infirmum, Prevotella buccae, and Selenomonas artemidis were detected in the AD group. Interestingly, serum levels of Aβ42, pTau, and anti-P.gingivalis LPS antibody were strongly related to the gene upregulation in human pathogen septicemia. Our study suggested the association of periodontal infection and oral microbiome with AD. Further large-scale studies with longitudinal follow-up are warranted.

Protective Role of Amiodarone on Reperfusion Arrhythmia in Patients of Acute Myocardial Infarction with Percutaneous Coronary Intervention Treatment.

With the development and popularity of percutaneous coronary intervention (PCI), ischemia-reperfusion injury (IRI) has attracted more and more clinical attention. Reperfusion arrhythmia (RA), one of the common manifestations during and after PCI, can affect the postoperative cardiac function of patients with acute myocardial infarction (AMI). Therefore, effective intervention on RA has important clinical significance. This study observed the effect of amiodarone on reperfusion arrhythmia (RA) after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) and explored its possible mechanism. The results showed that amiodarone had good clinical efficacy in the prevention of RA in patients with AMI after PCI, and it could reduce the levels of serum IL-6, hs-CRP, CK-MB, and cTnI in patients and reduce the damage caused by reperfusion, thereby reducing the occurrence of RA.

The effect of statin therapy in combination with ezetimibe on circulating C-reactive protein levels: a systematic review and meta-analysis of randomized controlled trials.

Previous studies have reported that statin or ezetimibe therapy has an anti-inflammatory effect. However, the results of individual studies on the effect of statin therapy in combination with ezetimibe on C-reactive protein (CRP) and high-sensitivity CRP (hs-CRP) levels have not been clear. Therefore, the present systematic review and meta-analysis were conducted on randomized clinical trials (RCTs) to evaluate the effect of statin therapy in combination with ezetimibe on CRP and hs-CRP levels. A literature search was carried out on the MEDLINE, SciVerse Scopus, and Clarivate Analytics Web of Science databases up to February 2022 to find eligible studies. The pooled effect sizes were considered for weighted mean difference (WMD) and 95% confidence intervals (CI) for CRP and hs-CRP, and it was also determined as standardized weighted mean difference (SMD) for overall CRP. For all variables, a random-effects model was used. Of the 57 studies included in the systematic review, 53 were used for meta-analysis. Statin therapy in combination with ezetimibe significantly reduced the serum levels of hs-CRP (WMD - 0.2mg/l; 95% CI - 0.4, - 0.1, P ˂ 0.001) and overall CRP (SMD - 0.16mg/l; 95% CI - 0.2, - 0.07, P ˂ 0.001). Nevertheless, CRP levels were not significantly changed by combination therapy. A significant association was observed between the serum low-density lipoprotein cholesterol (LDL-C) changes and hs-CRP levels, which can justify the source of heterogeneity. The current study showed that statin therapy in combination with ezetimibe could be effective in reducing the levels of hs-CRP and overall CRP.

Correlation between Abdominal Circumference and Serum High-Sensitivity C-Reactive Protein Concentration at Age 35–64 Years

The prevalence of central obesity in Indonesia is increasing every year. Based on data released by Riskesdas in 2018, there were 31% of the population aged 15 years and over suffer from central obesity, where the highest was found in the 45–54 years group (42.3%), followed by 44 years (39.2%) and 55–64 years group (39.1%). Central obesity can be measured by waist circumference or abdominal circumference, and it plays an important role in the occurrence of cardiovascular disease. Examining C-reactive protein (CRP) at low levels using high-sensitivity CRP (hs-CRP) methods will help to predict the risk of coronary heart disease. This study aimed to find the correlation between waist circumference and hs-CRP serum levels between the ages of 35 and 64. The study was an analytical observational with a cross-sectional approach attended by 25 respondents at Bhayangkara Hospital Tingkat I Raden Said Sukanto, Kramat Jati, East Jakarta, from October to November 2019. The waist circumference was measured with a metlin roll, and Prodia Laboratory took the blood to measure hs-CRP serum levels using ELISA methods. The data were analyzed using the Pearson correlation test. The results showed a correlation between waist circumference and hs-CRP serum levels with Sig. (2-tailed)=0.000 (p&lt;0.05). There was a correlation between waist circumference and hs-CRP serum levels, which indicated that the greater the waist circumference, the higher levels of serum hsCRP would be.

The role of some inflammatory markers, cytokins and tumor markers in diagnosis of endometriosis

Endometriosis is a multifactorial disease which etiopathogenesis has not been elucidated. One of the theories of etiopathogenesis is the inflammatory theory. Aims of the study: To develop a practical non-invasive test for the diagnosis of endometriosis by examining some inflammatory markers and cytokines; to compare the highly sensitive C-reactive protein (hsCRP), cytokines (interleukin-6-IL-6 and tumor necrotizing factor alpha) and the tumor marker cancer antigen 125 (CA-125) among healthy patients and patients with endometriosis; to determine the sensitivity and specificity of each biomarker separately in the diagnosis of endometriosis and to determine their role in the diagnosis of endometriosis. Materials and methods: In a prospective study conducted at the University Clinic for Gynecology and Obstetrics, Ss. Cyril and Methodius University in Skopje, North Macedonia 138 patients were included of a reproductive age between 18-50 years (83 with diagnosis endometriosis operated laparoscopically or with laparotomy) and a control group of 55 healthy women, in a period between 01.09.2018 to 01.05.2021. Serum levels of IL-6, TNF-α, hs-CRP and tumor marker CA-125 were evaluated in both groups. Results: Serum levels of CA-125, IL-6 and TNF-α and hs-CRP were significantly higher in patients with endometriosis compared to the control group. The surface under the ROC curve (AUC) for IL-6, CA-125, hs-CRP, and TNF-α has shown that as individual markers they all have a discriminatory capacity to diagnose patients with endometriosis. Conclusions: Results obtained in our study showed statistically significantly higher serum concentrations of CA-125, IL-6 and TNF-α and hs-CRP in patients with endometriosis compared to the control group of patients. However, none of these biomarkers showed a high sensitivity for diagnosis of endometriosis. It is necessary to find a panel combination of biomarkers with a high sensitivity of about 100% that will enable early diagnosis of endometriosis.

Naochang Tongtiao acupuncture based on brain-gut axis for acute ischemic stroke and its effect on levels of IL-17, hs-CRP and TMAO

To compare the clinical therapeutic effect on acute ischemic stroke between Naochang Tongtiao acupuncture (acupuncture for brain-gut homology) and conventional acupuncture, and to explore the possible mechanism. A total of 64 patients with acute ischemic stroke were randomized into an observation group and a control group, 32 cases in each one. Basic western medical therapy was adopted in both groups. In the observation group, Naochang Tongtiao acupuncture was applied at anterior oblique line of vertex-temporal, Zhongwan (CV 12), Guanyuan (CV 4), Tianshu (ST 25), Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39). In the control group, conventional acupuncture was applied. The treatment was given once a day, 6 days a week for 3 weeks in both groups. Before and after treatment, National Institution of Health stroke scale (NIHSS) score, serum levels of interleukin-17 (IL-17) and hypersensitive C reactive protein (hs-CRP), and plasma level of trimethylamine oxide (TMAO) were compared in the two groups. After treatment, NIHSS scores, serum levels of IL-17 and hs-CRP, and plasma levels of TMAO were decreased compared before treatment in both groups (P<0.01), and those in the observation group were lower than the control group (P<0.05). Naochang Tongtiao acupuncture can improve the nerve function in patients with acute ischemic stroke, its therapeutic effect is superior to conventional acupuncture, the mechanism may relate to the regulation on inflammatory reaction and the level of intestinal flora metabolite.

Diagnostic Value and Prognostic Significance of Procalcitonin Combined with C-Reactive Protein in Patients with Bacterial Bloodstream Infection.

Objective To study the clinical values and implications for the prognosis of procalcitonin (PCT) combined with C-reactive protein (hs-CRP) in patients with bacterial bloodstream infection. Methods One hundred and twenty patients with infection hospitalized from Mar. 2020 to Jun. 2021 were chosen as subjects. All participants were tested for serum PCT, hs-CRP, and blood culture. According to the types of pathogenic bacteria, they were divided into the gram-negative bacteria bloodstream infection group (n = 53) and the gram-positive bacteria bloodstream infection group (n = 31). Depending on the prognostic outcome of the participants after 28 days, they were categorized into survival and fatality cohorts. The PCT and hs-CRP levels were compared to explore diagnostic value implications for the prognosis of the cases with bacterial bloodstream infection. Results Serum PCT and hs-CRP values in the positive cohort were higher than those in the negative cohort. The levels of serum PCT and hs-CRP in pulmonary infection were higher than those in the group with negative cases, and the difference was statistically significant (P < 0.05). There were 27 gram-positive participants and 9 gram-negative cases in the positive cohort. The serum PCT value of gram-negative bacterial infection was greater than that of gram-positive bacterial infection. The value of serum PCT in the gram-negative bacterial infection group was higher than that in the gram-positive bacterial infection group, and the difference was statistically significant (P < 0.05). The areas under the curve (AUCs) of PCT, combination of hs-CRP and PCT, and hs-CRP were 0.946, 0.783, and 0.991, respectively. The combined examination of PCT and hs-CRP was the largest, PCT was the second, and hs-CRP was the lowest. These results indicated that the accuracy of combined detection of PCT and hs-CRP in the diagnostic bloodstream infection was the highest (0.991), followed by PCT (0.946) and the lowest (0.783). The PCT and hs-CRP levels of the survival cohort were lower than those in the death cohort. AUCs of PCT, hs-CRP and PCT, and hs-CRP were 0.848, 0.826, and 0.934, respectively. The combined examination of PCT and hs-CRP was the largest, followed by PCT and hs-CRP. The accuracy of the combination of PCT and hs-CRP was the highest (0.934), followed by PCT (0.848), and the diagnostic accuracy of hs-CRP was the lowest (0.826). Conclusion There were significant differences in the levels of PCT and CRP between the gram-positive bacteria group and the gram-positive bacteria group. PCT and CRP have high diagnostic values in predicting the short-term prognosis of patients. PCT and CRP assist clinical diagnosis and guide treatment and play a positive role in early treatment and prognosis evaluation of patients.

Role of Cigarette Smoking on Serum Angiotensin-Converting Enzyme and Its Association With Inflammation and Lipid Peroxidation.

IntroductionCigarette smoking promotes angiotensin-converting enzyme (ACE) production and causes a substantial change in inflammation and oxidative stress, resulting in an increase in antioxidant activity and lipid peroxidation.ObjectiveThe study's goal is to determine the role of cigarette smoking on serum ACE and its relation with inflammatory markers and lipid peroxidation.MethodsThe cross-sectional study consists of three groups. The study participants are all men between the age group of 20 to 55 years. Group 1 includes 120 healthy controls as nonsmokers, Group 2 consists of 120 active smokers with coronary heart disease (CHD) and Group 3 includes 120 active smokers with diabetic CHD patients attending the SRM Medical College Hospital in Tamil Nadu for cardiology and medical Outpatient. Measurements of serum ACE, oxidized low-density lipoprotein (oxLDL), high-sensitivity C-reactive protein (hsCRP), and matrix metalloprotease-9 (MMP-9) were performed using the ELISA method (enzyme-linked immunosorbent assay). Using a spectrophotometric approach, the total antioxidant capacity and lipid peroxidation, particularly Malondialdehyde (MDA), were assessed.ResultsThe mean serum ACE (92.35±10.28), oxLDL (48.59±8.56), hs-CRP (5.87±1.62), MMP-9 (89.20±30.19), and MDA (1.146±0.198) levels were significantly (p-value <0.0001) higher in smokers with CHD and diabetes (group 3) when compared to group 1 and group 2. On the other hand, the total antioxidant capacity (0.413±0.097) of smokers of group 3 was found to be (p<0.0001) significantly lower than those of group 1 and group 2. The study also demonstrated a significant correlation between ACE with MDA, ox-LDL, total antioxidant capacity, hs-CRP, MMP-9, smoking load, and smoking intensity in smokers.ConclusionThe study concludes a substantial correlation exists in smokers owing to ACE modification, which results in inflammation and lipid peroxidation activation. This is strongly associated with an increased risk of major cardiovascular events.

Effects of Dapagliflozin in Combination with Metoprolol Sustained-Release Tablets on Prognosis and Cardiac Function in Patients with Acute Myocardial Infarction after PCI.

Objective To find the effects of dapagliflozin in combination with metoprolol sustained-release tablets on cardiac function and prognosis in acute myocardial infarction patients after PCI. Methods A total of 84 patients with myocardial infarction who experienced PCI from February 2020 to February 2022 were included and allocated into 3 groups: groups A, B, and C (n = 28/per group). Group A was given dapagliflozin combined with metoprolol sustained-release tablets, group B was given dapagliflozin, and group C was given the placebo. Left ventricular end diastolic diameter (EDD), left ventricular ejection fraction (LVEF), and end systolic diameter (ESD) were measured before and after treatment in all groups; myocardial infarction areas were matched among all three groups at 3 months posttreatment. The serum concentrations of interleukin-6 (IL-6), hypersensitive C-reactive protein (hs-CRP), superoxide dismutase (SOD), and malondialdehyde (MDA) were detected in all three groups before and after treatment. The levels of N-terminal probrain natriuretic peptide (NT-pro BNP), lipoprotein (a) (Lp(a)), ischemia-modified albumin (IMA), and secreted frizzled-related protein 5 (SFRP5) were also detected in the serum of all groups. Adverse reactions and cardiovascular adverse events were matched between all groups. Results The levels of LVEF in groups A and B were increased after treatment, while the levels of EDD and ESD were decreased. The improvement degree of LVEF and EDD levels in groups A and B was found greater compared to group C (P < 0.05). No significant difference was found in myocardial infarction area among the three groups at 3 months postoperation (P > 0.05). Serum concentrations of MDA, hs-CRP, IL-6, IMA, NT-proBNP, and Lp(a) were found to decrease in all three groups after treatment, while the levels of SOD and SFRP5 were increased. The improvement degree of serum hs-CRP, IL-6, SOD, MDA, IMA, NT-proBNP, Lp(a), and SFRP5 levels was greater in both groups A and B compared to group C. The improvement degree of serum hS-CRP, SOD, MDA, IMA, Nt-probNP, Lp(a), and SFRP5 levels was significantly greater in group A compared to group B (P < 0.05). No adverse effect was observed in all three groups (P > 0.05). Total occurrence of cardiovascular adverse effects such as stent thrombosis, heart failure, ventricular fibrillation, and death was 10.71% in group A, 25.00% in group B, and 53.75% in group C. There was statistical significance in the onset of cardiovascular adverse effects 3 months postoperation among all three groups (P < 0.05). Conclusion Dapagliflozin with metoprolol sustained-release tablets can be effective in improving the heart function, inflammatory response, oxidative stress response, and prognosis in patients after PCI.

Association Between High-Sensitivity C-Reactive Protein and Prognosis of Patients with Acute Cerebral Infarction.

PurposeTo investigate the association of serum high-sensitivity C-reactive protein (hs-CRP) with the severity of neurological deficits and prognosis in patients with acute cerebral infarction (ACI).Patients and MethodsIn this retrospective analysis, 119 patients with ACI were recruited from January to December 2020. The serum hs-CRP level was measured by a latex-enhanced immunoturbidimetric assay. The severity of neurological deficits and prognosis of ACI patients were assessed using the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS). Multivariate logistic analysis was performed and receiver operating characteristic (ROC) curves were plotted to evaluate the value of hs-CRP in predicting the prognosis of ACI.ResultsThe patients with a more favorable prognosis (mRS score 0–2) had a lower median serum hs-CRP level than those with a worse prognosis (mRS score 3–6) (3.32 IQR: 1.51, 8.04 to 17.93 IQR:16.02, 19.01; P<0.001). After adjusting for potential confounders, multivariable linear regression showed that serum hs-CRP level was independently associated with NIHSS score (Beta = 0.952, P<0.001) and mRS score (Beta=0.878, P<0.001). Multivariate logistic analysis revealed that high hs-CRP level was an independent predictor of the poor prognosis in patients with ACI (adjusted1 OR = 1.995; 95% CI = 1.499–2.655; adjusted2 OR = 2.75; 95% CI = 1.015–7.457). ROC curve analysis indicated that the area under the curve for hs-CRP to predict poor prognosis was 0.986. The cutoff value, sensitivity, and specificity were 11.835 mg/L, 95%, and 92.5%, respectively. In terms of ischemic stroke subtypes, the serum hs-CRP level was higher in large-artery atherosclerosis (LAA) patients than in those with small-artery occlusion (SAO) and cardioembolism (CE). In addition, the patients with LAA had higher scores of NIHSS and mRS than those with SAO and CE.ConclusionSerum hs-CRP level is an independent predictor of prognosis, and an efficient index to discriminate patients with ACI, especially for those with LAA.

Effects of Ramipril on Biomarkers of Endothelial Dysfunction and Inflammation in Hypertensive Children on Maintenance Hemodialysis: the SEARCH Randomized Placebo-Controlled Trial.

Hypertension, endothelial dysfunction, and inflammation are associated with increased cardiovascular mortality in end-stage kidney disease. We evaluated the effects of ACE (angiotensin-converting enzyme) inhibition on biomarkers of endothelial dysfunction and inflammation in hypertensive children with end-stage kidney disease on maintenance hemodialysis. In a randomized, double-blind, placebo-controlled trial, 135 (72 males/63 females) children and adolescents (age 7-15 years) were randomly assigned to treatment with either 2.5 mg once daily ramipril (n=68) or placebo (n=67) for 16 weeks. Primary outcome were the serum concentrations of asymmetrical dimethylarginine, a marker of endothelial dysfunction and hs-CRP (high-sensitivity C-reactive protein), a marker of inflammation. Changes in IL-6 (interleukin-6), TNF-α (tumor necrosis factor-alpha), systolic (S), and diastolic (D) blood pressure were secondary outcomes. Change in potassium levels and incidence of hyperkalemia were among the safety parameters. Ramipril, but not placebo, significantly reduced serum levels of asymmetrical dimethylarginine (-79.6%; P<0.001), hs-CRP (-46.5%; P<0.001), IL-6 (-27.1%; P<0.001), and TNF-α (-51.7%; P<0.001). Systolic blood pressure and diastolic blood pressure were significantly lowered in both groups with a greater reduction in children receiving ramipril (median between-group differences -12.0 [95% CI -18.0 to -9.5] and -9.0 [95% CI -12.0 to -4.5]; P<0.001, respectively). Changes in asymmetrical dimethylarginine, hs-CRP, IL-6, or TNF-α in the ramipril group did not significantly correlate with blood pressure reductions. No severe cases of hyperkalemia or other serious treatment-associated adverse events were observed. Ramipril improves biomarkers of endothelial dysfunction and inflammation in hypertensive children on maintenance hemodialysis in addition to its efficacious and safe potential to lower blood pressure. URL: https://www. gov; Unique identifier: NCT04582097.

Value of procalcitonin as a potential biomarker in predicting acute kidney injury in patients with bee stings

To investigate the predictive value of procalcitonin (PCT) in the development of acute kidney injury (AKI) in patients after bee stings. A total of 105 bee stings patients admitted to Mianyang Central Hospital from May 2019 to August 2021 were enrolled and were divided into AKI group (37 cases) and non-AKI group (68 cases) according to the occurrence of AKI. Baseline demographic information [gender, age, body mass index (BMI), sting season, sting site, number of stings, underlying disease, clinical manifestations, and inflammatory factor levels] were collected and compared between the two groups. Logistic regression model was used to analyze the risk factors associated with the occurrence of AKI in bee stings patients. Pearson model was used to analyze the correlation between PCT and other indicators; the receiver operator characteristic curve (ROC curve) were drawn to analyze the predictive value of each indicator on the occurrence of AKI in bee stings patients. There were significant differences in age, number of bee stings, and vomiting after admission between the two groups of patients. The levels of serum creatinine (SCr), PCT, interleukin-6 (IL-6) and hypersensitive C-reactive protein (hs-CRP) were significantly higher in the AKI group than those in the non-AKI patients [SCr (μmol/L): 122.36±32.45 vs. 76.74±28.52, PCT (μg/L): 1.42±1.05 vs. 0.34±0.21, IL-6 (ng/L): 277.52±120.25 vs. 112.14±73.34, hs-CRP (mg/L): 7.64±3.26 vs. 3.01±2.13, all P < 0.05]. Serum PCT levels were positively correlated with serum SCr, IL-6, and hs-CRP levels in patients with AKI after bee stings (r values of 0.486, 0.393, and 0.425, respectively; P = 0.002, 0.016, and 0.009, respectively). Multivariate Logistic analysis showed that age, SCr, PCT, IL-6, and hs-CRP were independent risk factors for AKI in patients with bee stings. The ROC curve analysis showed that the area under the ROC curve (AUC) of age, SCr, PCT, IL-6 and hs-CRP for predicting AKI in patients with bee stings were 0.622 [95% confidence interval (95%CI) was 0.516 to 0.727], 0.722 (95%CI was 0.601 to 0.843), 0.869 (95%CI was 0.781 to 0.958), 0.739 (95%CI was 0.627 to 0.851) and 0.799 (95%CI was 0.700 to 0.900), respectively. The best cut-off value of PCT was 0.742 μg/L, the sensitivity was 75.70% and the specificity was 90.50%. The serum PCT level was significantly elevated in patients with AKI after bee stings, which is an independent risk factor for AKI after bee stings. Serum PCT level has better predictive efficacy for AKI after bee stings and can be used as a valid biomarker for clinical prediction.

An evaluation of the efficacy and safety of thrombolysis in patients with wake-up stroke using the combination of inflammatory factors Interleukin-6 and C-reactive protein with multi-mode magnetic resonance imaging

ObjectiveTo explore the efficacy and safety of using thrombolysis in patients with wake-up stroke (WUS). MethodsThe serum IL-6 and hs-CRP levels of the patients in both the experimental group and the standard group were measured before thrombolysis and at 1 and 24 h afterwards. National Institute of Health Stroke Scale (NIHHS) scores were also recorded at the same time points as well as at 10 and 90 d after thrombolysis, and modified Rankin Scale (mRS) scores were calculated before thrombolysis and at 10 and 90 d afterwards. The differences in all these observations before and after thrombolysis were then investigated. Results(1) The levels of serum IL-6 and hs-CRP in the experimental group and the standard group were higher than those in the healthy control group before thrombolysis (P < 0.05), indicating that higher levels of hs-CRP and IL-6 are risk factors for WUS (P < 0.05). (2) There were no significant differences in the serum hs-CRP and IL-6 levels of the patients in the experimental and standard groups before thrombolysis (P > 0.05). (3) The serum IL-6 and hs-CRP levels were positively correlated with the NIHHS scores in both the experimental group and the standard group (P < 0.05), and they correlated with the mRS scores at 90 d. ConclusionsInterleukin-6 and hs-CRP can be used as biological indicators of inflammatory injury and diagnosis of stroke, and the combined detection of IL-6 and hs-CRP is of importance in predicting a deterioration in stroke patients.

Association of circulating miRNA-21-5p and miRNA-146a-5p expression level with disease activity of ankylosing spondylitis

BackgroundThe etiopathogenesis of ankylosing spondylitis (AS) involve interaction between genetic and environmental factors which exert an effect on epigenetic mechanisms including non-coding miRNAs causing immune dysfunction and inflammation. This study is designed to find if there is an association in the expression levels of miRNA- 21-5 (miR-21-5p) and miR- 146a-5p with the disease activity, also to assess their role in the follow up of patients. MethodSixty individuals enrolled in this case-control study; 30 individual (28 males and 2 females) as patients group, and the healthy controls group include 30 individuals (27 males and 3 female). Twenty four patients were human leukocyte antigen (HLA B-27) positive, while the other 6 patients were negative. Reverse transcription polymerase chain reactions (RT- PCR) was used for determination of the expression levels of miRNA-21-5p and miRNA-146a-5p in serum of patients and controls, while concentration of high sensitivity C- reactive protein (HS- CRP) was estimated using enzyme linked immune-sorbent assay (ELISA). These tests were done two times for each patient; the first is before starting biologic treatment and the second after two months from taking the first dose. ResultsThere are significant elevations (p < 0.001) in the expression of miR- 21-5p and miR- 146a-5p also in the serum level of Hs-CRP in patients compared with controls. In patient group, miR-21-5p expression is significantly reduced at end of the study (p value <0.05), while there is no significant difference (p > 0.05) of miR-146-5p expression between baseline and end of the study. At base line of the study; it is found that the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) scores and Hs-CRP were positively correlated with both of miR- 146a-5p and miR- 21-5p and the correlation remain positive at in the end of study. In conclusion, expression level of circulating miR-21-5p and miR-146a-5p could be serve as non invasive biomarkers for the diagnosis of AS. Micro-RNA-21-5p associated with the activity and severity of the disease and it could be used for follow up patients with AS and for assessment the response to biological treatments.

Serum Endocan Levels and Subclinical Atherosclerosis in Patients with Chronic Kidney and End-Stage Renal Diseases.

Background and AimChronic kidney disease (CKD) and its final stage: end-stage renal disease (ESRD), are common clinical conditions. Endocan is a human endothelial cell-specific molecule produced by endothelial cells. Its production is related to activation of endothelium and angiogenesis. In this study, we assessed the relation between serum endocan levels and subclinical atherosclerosis (SCA) in CKD and hemodialysis (HD) patients.Subjects and MethodsThe present case control study enrolled 30 patients on regular HD for at least 6 months, 30 patients with CKD, and 30 age and sex-matched healthy controls. All participants were subjected to careful history taking and thorough clinical examination. Laboratory investigations included complete blood count, kidney functions, and serum cholesterol, triglycerides, calcium, phosphorus, albumin, PTH, hsCRP, and endocan levels.Results HD and CKD groups had significantly higher endocan levels when compared with control group (median (IQR): 519.0 (202.3–742.0) versus 409.0 (245.3–505.3) and 273.0 (168.0–395.5) ng/L, respectively). Also, HD patients had significantly higher endocan levels when compared with CKD levels. HD patients had significantly higher carotid intima-media thickness (CIMT) when compared with CKD patients (median (IQR): 0.80 (0.80–0.90) versus 0.75 (0.73–0.75) mm, p < 0.001). HD patients had significantly higher frequency of SCA when compared with CKD patients (46.7% versus 13.3%, p=0.005). Patients with SCA had significantly higher hsCRP (median (IQR): 36.5 (26.8–43.5) versus 24.0 (15.8–29.0) mg/dl) and endocan levels (697.0 (528.3–974.8) versus 222.5 (158.8–565.8) ng/L) when compared with patients without SCA. ROC curve analysis of endocan for identification of SCA in HD patients showed that at a cutoff of 380.5 ng/L, endocan has an AUC of 0.862 with a sensitivity and specificity of 92.9% and 68.7%, respectively. Conclusions Serum endocan levels are related to SCA in HD patients. In addition, it is associated with the hyperinflammatory state in those patients.