Ultrasensitive C-reactive Protein Research Articles

Elevated tau and interleukin-6 concentrations in adults with obstructive sleep apnea

Obstructive sleep apnea (OSA) is characterized by apneas and hypopneas that result in hypoxia, cerebral hypoperfusion, endothelial dysfunction, inflammation, and oxidative stress. These pathophysiologic processes likely contribute to neuronal damage. Tau is a protein that stabilizes microtubules and, along with amyloid beta (Aβ), is associated with neurodegenerative processes. We sought to determine if tau and other biomarkers of inflammation were related to OSA severity.Concentrations of tau, Aβ40, Aβ42, c-reactive protein (CRP), TNF-α, interleukin (IL)-6, and IL-10 were measured in blood and compared between participants with moderate-severe OSA (n = 28), those with mild OSA (n = 22), and healthy controls (n = 24). The cohort included relatively young, primarily male active duty military personnel without a history of traumatic brain injury or neurodegenerative disease. Total biomarker concentrations were determined from plasma samples using an ultra-sensitive detection method, Simoa™, and CRP was assayed by ELISA. Total tau and IL-6 concentrations were elevated in participants with moderate-severe OSA, with a mean apnea-hypopnea index (AHI) of 26.1/h, compared to those with mild OSA (mean AHI 8.6/h) and healthy controls (mean AHI 2.1/h). Tau concentrations were also significantly correlated with the AHI (r = 0.342, p = 0.004). Our findings show that tau is elevated in the blood of young patients with moderate-severe OSA, suggesting that this degree of sleep-disordered breathing is a contributing factor in the development of neurodegenerative disorders. The finding of increased IL-6 further suggests that inflammatory biomarkers are present early in the course of this chronic disease.

Metabolic syndrome and concentrations of uric acid and ultrasensitive C-reactive protein

To establish the prevalence of metabolic syndrome (MS) according to ATP III and its correlation with the concentration of uric acid and C-reactive protein (CRP) in people aged between 45 and 60, living in the Getsemaní neighborhood of Cartagena. Observational, descriptive-correlational study on a population of 802 inhabitants of the Getsemaní neighborhood of Cartagena, Colombia. A random sample of 302 inhabitants was analyzed with a 95% confidence interval and 5% margin of error. ATP III diagnostic criteria were applied, and the instrument used included basic data about the general context of the patient (social, demographic and economic aspects, family history, work activity and physical characteristics such as weight, waist circumference, blood pressure, and BMI), as well as diagnostic tests such as glycemia, total cholesterol, triglycerides, HDLc, LDLc, uric acid and ultra-sensitive C-reactive protein. The prevalence of metabolic syndrome in the susceptible population is 18 %. The most common metabolic syndrome factor is abdominal obesity with 85 %, followed by increase of triglycerides by 76 %. The prevalence of metabolic syndrome was considered high when applying ATP III criteria. No significant association was observed regarding CRP values and the chances of developing metabolic syndrome in both men and women. However, uric acid levels were correlated to the disease in the group of women susceptible to suffering from MS with a value of p=0.0022.

Thalidomide is Associated With Increased T Cell Activation and Inflammation in Antiretroviral-naive HIV-infected Individuals in a Randomised Clinical Trial of Efficacy and Safety

Trial DesignOpen-label, randomised, controlled, pilot proof-of-concept clinical trial. MethodsParticipants: Antiretroviral naïve adult males with CD4 count ≥350cells/mm3.Interventions: Patients were randomised to receive thalidomide 200mg QD for 3weeks (Thalidomide group) or not (Control group) and followed for 48weeks.Objective: We hypothesized that short-term Thalidomide use would reduce HIV related inflammation and HIV replication among antiretroviral naïve HIV infected individuals.Outcome: Viral loads, CD4/CD8 counts, ultra-sensitive C-reactive protein (US-CRP), cell activation markers, and plasma lipopolysaccharide (LPS) were analyzed.Randomisation: Unrestricted randomisation.Blinding: No blinding was used. ResultsNumbers randomised: Thirty recruited individuals were randomised to Thalidomide (16 patients) or Control (14 patients) groups.Recruitment: Patients were recruited from April 2011 to January 2013.Outcome: Viral loads remained stable in both groups. During thalidomide treatment, a decrease in CD4/CD8 ratio (p=0.04), a decrease in CD4 count (p=0.04), an increase in cell activation calculated by the percentage of CD38 +/HLA-DR+ CD8 cells (p<0.05) and an increase in US-CRP (p<0.01) were observed in the Thalidomide group, with all parameters returning to baseline levels after thalidomide interruption. We confirmed that thalidomide increased HIV replication in vitro of 6 of 7 samples from long-term antiretroviral suppressed individuals.Harms: No class 3/4 adverse events occurred. ConclusionsShort-term use of thalidomide led to an intense transient increase in T cell activation and inflammation, with a decrease in the CD4+ cell count without changes to the CD8+ cell count. We confirmed that thalidomide acts in vitro as a latency reversal agent and speculate that the in vivo results obtained were due to an increase in HIV replication.

The relationship between hyperthyrotropinemia and metabolic and cardiovascular risk factors in a large group of overweight and obese children and adolescents.

Mild TSH elevations are frequently observed in obese patients, in the absence of any detectable thyroid disease. Our objective is to evaluate the relationship between the raised TSH levels and the biochemical and clinical consequences of obesity. This is a retrospective cross-sectional study of a large population of obese children and adolescents. We evaluated 833 subjects (340 m, 493 f), aged 14.4±2.5 (range 5.2-18.5) years, height SDS 0.27±1.04 (-3.49-4.35), and BMI SDS 2.94±0.59 (1.60-4.68). Body composition, free T4, TSH, anti-TPO antibodies, anti-TG antibodies, inflammation markers (total WBC and the subtypes, ultrasensitive C-reactive protein), and metabolic parameters [AST, ALT, γGT, ALP, glycaemia, insulin, total cholesterol (TC), HDL-cholesterol (HDL-C), and LDL-cholesterol (LDL-C), triglycerides (TG)] were measured, and oral disposition index (ODI) and cardiovascular risk factors (TC/HDL-C and TG/HDL-C) were calculated. After exclusion of the subjects showing anti-thyroid antibodies, the remaining 779 (325 m, 454 f) were then subdivided into two subgroups according to a TSH value below (group A) or above (group B) 4.5mU/L. Clinical characteristics and hematological markers of patients with and without positive anti-thyroid antibodies were similar, with the exception of higher TSH levels in the latter group. Using analysis of covariance, the subjects of group B had significantly higher values of TC (170.3±28.7 vs 163.3±32.9mg/dL; p<0.05), systolic (125.8±13.5 vs 124.5±13.1mm/Hg), and diastolic blood pressure (79.2±8.0 vs 77.9±8.2mm/Hg) than subjects of group A. No difference was observed in body composition, ODI, and the cardiovascular risk factors between these two groups. TSH elevation in overweight and obese children and adolescents, being associated with a higher TC and blood pressure, might negatively influence the cardiac status. Longitudinal studies are requested, however, to confirm this hypothesis and, therefore, to conclude whether a substitutive treatment with l-thyroxine is really needed in these patients.

Unsaturated Fatty Acids Improve Atherosclerosis Markers in Obese and Overweight Non-diabetic Elderly Patients.

Several studies have demonstrated the benefits of replacing trans and saturated fats with unsaturated fatty acids on cardiovascular diseases. We aimed to demonstrate the effect of polyunsaturated and monounsaturated fat supplementation on the biochemical and endothelial markers of atherosclerotic disease in obese or overweight non-diabetic elderly patients. Seventy-nine patients were randomly divided into three groups: flaxseed oil, olive oil, and sunflower oil; patients in each group received 30mL of oil for 90days. Patients were subjected to anthropometric and bioimpedance assessments; biochemical and endothelial evaluations were performed through ultrasonography of the brachial artery and carotid artery for endothelium-dependent dilation and intima-media thickness assessment, respectively, before and after the intervention. The participants' usual diet remained unchanged. The flaxseed oil group had improved ultra-sensitive C-reactive protein levels (p=0.074) and reduced carotid intima-media thickness (CIMT) (p=0.028); the olive oil group exhibited an improved apolipoprotein (Apo)B/ApoA ratio (p=0.021), reduced CIMT (p=0.028), and improved flow-mediated vasodilation (FMV) (p=0.054); and similarly, the sunflower oil group showed an improved ApoB/ApoA ratio (p=0.024), reduced CIMT (p=0.048), and improved FMV (p=0.001). Unsaturated fatty acid supplementation using the three vegetable oils attenuated pro-inflammatory properties and improved prothrombotic conditions. Therefore, introducing or replacing saturated and trans fat with unsaturated fatty acids is beneficial for cardiovascular risk reduction in obese or overweight non-diabetic elderly people. Further studies are needed to determine which unsaturated fat best prevents cardiovascular disease in elderly patients.

Cardiovascular risk profile in patients with myelopathy associated with HTLV-1

HAM/TSP (HTLV-1-associated myelopathy/tropical spastic paraparesis) is a slowly progressive disease, characterized by a chronic spastic paraparesis. It is not known if the disease carries an independent risk for cardiovascular disease. The objective of this study was to evaluate the cardiovascular risk profile related to HAM/TSP and compare it with the general population. MethodsThis was a cross-sectional study, with a control group. HAM/TSP patients were evaluated using cardiovascular risk scores (ASCVD RISK, SCORE and Framingham) and inflammatory markers (ultrasensitive CRP and IL-6), and compared with a control group of healthy individuals. We also evaluated the correlation between cardiovascular risk and the functional status of patients with HAM/TSP evaluated by the FIM scale. ResultsEighty percent of patients in this study were females, mean age of 51 years (11.3). The control group showed an increased cardiovascular event risk in 10 years when ASCVD was analyzed (cardiovascular risk ≥7.5% in 10 years seen in 43% of patients in the control group vs. 23% of patients with HAM/TSP; p=0.037). There was no difference in ultrasensitive CRP or IL-6 values between the groups, even when groups were stratified into low and high risk. There was no correlation between the functional status of HAM/TSP patients and the cardiovascular risk. ConclusionsIn this study, the cardiovascular risk profile of patients with HAM/TSP was better than the risk of the control group.

Effects of depressive symptoms on clinical outcomes, inflammatory markers and quality of life after a significant weight loss in a bariatric surgery sample.

Obesity is linked to a low-grade chronic systemic inflammation that improves after weight loss. Depressive disorder has been suggested to be associated with systemic inflammation up regulation. We aimed to explore whether, after a significant weight loss, the presence of depressive symptoms was associated with differences in terms of inflammatory markers and quality of life. Sixty patients (78.3%♀, age 46.4 ± 9.9) who underwent bariatric surgery, with a minimum follow up of 18 months, were evaluated. For the screening of depression, the Beck Depression Inventory (BDI) was administered. Ten subjects (16.6%) had a positive screening for depressive disorder. The percentage of patients with weight regain was greater among subjects with symptoms of depression (70% vs. 32%; p = 0.024), although no differences were seen regarding BMI prior to surgery and current BMI. Acute phase reactants were higher among subjects with symptoms of depression: platelets (319 ± 15 x 10^12/L vs. 232 ± 47 x 10 ^ 12/L; p = 0.001), erythrocyte sedimentation rate (24.7 ± 11.3 mm vs.17 ± 10 mm; p = 0.03), fibrinogen (486 ± 107 mg/dL vs. 406 ± 66 mg/dL; p = 0.003), ferritin (106 ± 180 ng/ml vs. 34 ± 44 ng/ml; p = 0.014) and ultrasensitive C-reactive protein (0.96 ± 1.84 mg/dL vs. 0.24 ± 0.26 mg/dL; p = 0.008). All domains of quality of life were significantly lower in the depressive group. Despite a significant weight loss, inflammatory markers are greater and quality of life lower when associated with depressive symptoms.

Insulin resistance and associated factors: a cross-sectional study of bank employees

OBJECTIVE:Insulin resistance is characterized by the failure of target cells to respond to normal levels of circulating insulin, and this condition is related to cardiovascular disease. This study sought to evaluate the prevalence of insulin resistance and its association with markers of metabolic abnormalities and metabolic syndrome in bank employees.METHODS:A cross-sectional study was performed on 498 working men and women aged ≥20 years old. The Homeostasis Model Assessment (HOMA-IR) was used to determine the presence of insulin resistance based on cut-off values of ≤2.71 for normal insulin levels and >2.71 for insulin resistance, as established for the adult Brazilian population.RESULTS:It was observed that the 52 (10.4%) overweight individuals with insulin resistance were 4.97 times (95%CI 1.31-18.83) more likely to have high HOMA-IR values than the normal-weight participants; among those who were obese, the likelihood increased to 17.87 (95%CI 4.36-73.21). Individuals with large waist circumferences were 3.27 times (95%CI 1.03-10.38) more likely to develop insulin resistance than those who were within normal parameters. The HOMA-IR values differed between subjects with and without metabolic syndrome, with values of 2.83±2.5 and 1.10±0.81 (p=0.001), respectively. The levels of insulin, ultrasensitive C-reactive protein and uric acid were also associated with insulin resistance.CONCLUSION:The prevalence of insulin resistance among bank employees is high, and insulin resistance is associated with and serves as a marker of metabolic syndrome. Cardiovascular disease and metabolic syndrome-associated metabolic abnormalities were observed, and insulin resistance may be a risk factor in this group of professionals.

Genotypic carriers of the obesity-associated FTO polymorphism exhibit different cardiometabolic profiles after an intervention.

Children and adolescents with at-risk genotypes (AA/AT) of the rs9939609 polymorphism in FTO, a fat mass and obesity-associated gene, may exhibit different cardiometabolic profile responses than subjects with the TT genotype after an interdisciplinary intervention. The sample consisted of 36 school children from southern Brazil. We used DNA quantitation and real-time polymerase chain reaction (PCR) for polymorphism genotyping. We measured anthropometric parameters (body mass index (BMI), waist circumference, hip circumference, waist-hip ratio, body fat percentage and skinfold sum), biochemical parameters (glucose, lipid profile, ultra-sensitive C-reactive protein, uric acid, alanine aminotransferase, aspartate aminotransferase, insulin and adiponectin) and blood pressure. The 4-month intervention consisted of physical education classes, nutritional counseling, and postural and oral health counseling. We observed no significant differences among the groups (AA, AT and TT) after the intervention. However, we observed improvements in three parameters (waist circumference, hip circumference and C-reactive protein) in the AT/AA genotype group and in two parameters (hip circumference and uric acid) in the TT genotype group. After an intervention program, carriers of at-risk genotypes for obesity (AA/AT) do not exhibit differences in biochemical parameters, blood pressure and anthropometric parameters compared with carriers of the TT genotype.

Association of C reactive protein levels with metabolic syndrome in adults: a population-based study

Metabolic syndrome is highly prevalent among adults in Chile and represents a health risk. To determine the relationship between metabolic syndrome (MetS) and its components, with C reactive protein levels (CRP) as an inflammation marker. The population studied consisted of 736 individuals born in a hospital from Valparaíso Region, aged between 32-38 years at the time of the study. MetS was identified according to the Adult Treatment Panel (ATP) III guidelines and inflammation was measured using ultra-sensitive CRP. This parameter was classified as normal for values from 0 to 3 mg/L, high for values from 3.01 to 10 mg/L and very high for values > 10 mg/L. Median CRP was in the normal range (1.9 mg/L, interquartile range 0.7-5.2) and was higher among women than men (2.2 and 1.4 mg/L respectively, p < 0.01). Twenty seven percent of participants had MetS. One-fourth had high blood glucose values, one-third had high triglyceride levels and 28% had blood pressure values over those established as normal in MetS. Elevated waist circumference (WC) and low HDL cholesterol were found among almost 50% of participants. A relationship between MetS and high CRP was only found among men with an Odds ratio (OR) of 2.04 (95% confidence intervals (CI): 1.11-3.73). The same association was observed for high triglyceride levels with an OR of 2.02 (CI: 1.17-3.49) and high WC with an OR of 3.89 (CI: 2.06-7.36). Among women, the only relationship observed was between abdominal obesity and very high CRP with an OR of 2. 65 (CI: 1.20-5.84). Metabolic syndrome, high triglyceride levels, and abdominal obesity were associated with inflammation only in men.

Increased ultrasensitive C-reactive protein is not associated with obesity in hospitalized heart failure patients.

ABSTRACTObjective:To evaluate the association between obesity and levels of high-sensitivity C-reactive protein (hs-CRP) in patients with heart failure admitted to a tertiary hospital.Methods:Cross-sectional study with a consecutive sampling of hospitalized patients with heart failure. Sociodemographic and clinical data were collected, and the nutritional status was assessed through indicators such as body mass index (in kg/m2), waist circumference (in cm), waist-hip ratio, triceps skinfold (in mm) and subscapularis skinfold (in mm). Neck circumference (in cm) was measured as well as serum levels of hs-CRP, in mg/L.Results:Among 123 patients, the mean age was 61.9±12.3 years and 60.2% were male. The median of hs-CRP was 8.87mg/L (3.34 to 20.01). A tendency to an inverse correlation between neck circumference and hs-CRP was detected (r=-0.167; p=0.069). In the multiple linear regression analysis, after adjustment for age, disease severity (NYHA classification III and IV, low ejection fraction, left ventricular dysfunction during diastole), and infectious conditions there was an inverse association between hs-CRP and neck circumference (ß=-0.196; p=0.03) and subscapularis skinfold (ß=-0.005; p=0.01) in the total sample, which was not maintained after the stratification by sex.Conclusion:Increased levels of hs-CRP in patients hospitalized for heart failure were not associated with obesity.

Lipoxin A4 Is Increased in the Plasma of Preeclamptic Women.

Excessive inflammation is involved in preeclampsia (PE) pathogenesis. Lipoxin A4 (LXA4) is an eicosanoid that counter-regulates inflammation. The main objective of this study was to determine LXA4 plasma levels in PE women. The correlations among LXA4 levels, ultrasensitive C-reactive protein (us-CRP) levels, and clinical/laboratory parameters of the studied participants were also investigated. LXA4 plasma levels were determined by ELISA in 23 nonpregnant, 26 normotensive pregnant, and 27 PE women (early PE (N = 10) and late PE (N = 17)), according to gestational age (GA) at clinical symptoms onset). The clinical/laboratory parameters included in Spearman's correlation analysis were: systolic and diastolic blood pressure (SBP and DBP, respectively), lactate dehydrogenase (LDH) activity, platelet count, proteinuria, and white blood cell count (WBC). LXA4 levels were higher in PE women than in nonpregnant and normotensive pregnant women, and similar between nonpregnant and normotensive pregnant women. LXA4 plasma levels were higher in early PE vs. normotensive pregnancy (GA < 34 weeks) and in late PE vs. normotensive pregnancy (GA ≥ 34 weeks). No significant differences were detected between early and late PE. LXA4 levels were positively correlated with us-CRP levels, SBP, DBP, and WBC. No significant correlation was detected between LXA4 levels and the other laboratory parameters. Chronic inflammation in PE, in spite of increased levels of LXA4, points to a possible failure in this regulatory pathway. Further studies are necessary to clarify this issue and to evaluate the role of LXA4 and other proresolving mediators of inflammation in the pathogenesis of PE.

Metabolic syndrome and C-reactive protein in bank employees.

BackgroundThe ultrasensitive C-reactive protein (us-CRP) is used for the diagnosis of cardiovascular disease, but it is not well described as a marker for the diagnosis of metabolic syndrome (MS).MethodsAn observational and transversal study of bank employees evaluated anthropometric, hemodynamic, and biochemical data. CRP values were determined using commercial kits from Roche Diagnostics Ltd, and MS criteria were analyzed according to National Cholesterol Education Program’s – Adult Treatment Panel III (NCEP/ATP III).ResultsA total of 88 individuals had MS, and 77.3% (n=68) of these showed alterations of us-CRP (P=0.0001, confidence interval [CI] 0.11–0.34). Individuals with MS had higher mean values of us-CRP in global measures (P=0.0001) and stratified by sex (P=0.004) than individuals without the syndrome. This marker exhibited significant differences with varying criteria for MS, such as waist circumference (P=0.0001), triglycerides (P=0.002), and diastolic blood pressure (P=0.007), and the highest levels of us-CRP were found in individuals with more MS criteria.Conclusionus-CRP was strongly associated with the presence of MS and MS criteria in this group of workers. us-CRP is a useful and effective marker for identifying the development of MS and may be used as a reference in routine care.

One night of partial sleep deprivation increased biomarkers of muscle and cardiac injuries during acute intermittent exercise

The aim of this study was to evaluate the effect of two types of partial sleep deprivation (PSD) on biomarkers of muscle and cardiac injuries in response to acute intermittent exercise in professional athletes. In a counterbalanced order, ten healthy male Taekwondo athletes were asked to perform the Yo-Yo Intermittent Recovery Test (YYIRT) in three conditions, allowing a 36 h recovery period in between: 1) following a full night of habitual sleep known as a reference sleep night (RN); 2) following PSD in the beginning of the night (PSDBN); and 3) following PSD in the end of the night (PSDEN). Heart rate (HR) and arterial oxygen saturation (SaO2) were measured during exercise. Blood samples were taken just before and 3 min after the YYIRT to measure biomarkers related to muscle and cardiac injuries (BRMCI). No significant effect of PSD was observed for physiological parameters (i.e., HR and SaO2). However, a significant alteration of resting ultra-sensitive C-reactive protein (us-CRP) (P<0.05) and myoglobin (MYO) (P<0.01) levels was detected after PSDEN. Furthermore, all BRMCI were altered by exercise. Likewise, compared to RN, PSD affected creatine phosphokinase (CPK) and MYO levels in response to exercise (P<0.05). The present study indicates that PSDEN increase the resting us-CRP and MYO levels, and that the two types of PSD increase the CPK and MYO levels in response to acute intermittent exercise, among Taekwondo athletes, in the evening of the following day. However, no rise of the physiological responses has been observed after the two types of PSD, at rest and in response to the exercise.

Early Markers of Atherosclerotic Disease in Individuals with Excess Weight and Dyslipidemia.

BackgroundExcessive weight is a cardiovascular risk factor since it generates a chronic inflammatory process that aggravates the endothelial function.ObjectiveTo evaluate the endothelial function in individuals with excess weight and mild dyslipidemia using brachial artery flow-mediated dilation (BAFMD), and the association of endothelial function with anthropometric and biochemical variables.MethodsCross-sectional study that included 74 individuals and evaluated anthropometric variables (body mass index [BMI], waist-hip ratio [WHR], waist circumference [AC], and percentage of body fat [PBF]), biochemical (blood glucose, insulinemia, ultrasensitive C-reactive protein, fibrinogen, total cholesterol, HDL-cholesterol, triglycerides, and LDL-cholesterol) and endothelial function (BAFMD, evaluated by ultrasound). The statistical analysis was performed with SPSS, version 16.0. To study the association between the variables, we used chi-square, Student's t and Mann-Whitney tests, and Pearson's correlation. Logistic regression analyzed the independent influence of the factors. Values of p < 0.05 were considered significant.ResultsThe participants had a mean age of 50.8 years, and 57% were female. BMI, WC, WHR, and PBF showed no significant association with BAFMD. The male gender (p = 0.02) and higher serum levels of fibrinogen (p = 0.02) were significantly and independently associated with a BAFMD below 8%.ConclusionsIn individuals with excess weight and mild untreated dyslipidemia, male gender and higher levels of fibrinogen were independently associated with worse BAFMD.

Comparison of conservative and surgical treatment methods in patients with meniscopathy

Objective: Arthroscopic surgery is currently a well-known treatment method for meniscal pathologies. This study aims to compare conservative and surgical methods in patients with meniscopathy. Materials and Methods: The retrospective analyses of 68 patients with meniscal tear were included in this study. Patients were divided into two groups: a medical treatment group (MTG) and a surgical treatment group (STG). Diagnosis was perfomed by physical examination and magnetic resonance imaging (MRI). All patients were evaluated before and after treatment with main pain score (MPS), International Knee Documentation Committee (IKDC) score, body mass index (BMI), and Ultrasensitive C-reactive protein (US-CRP). In the MTG group, 31 patients underwent medical treatment with naproxen sodium for three days, ice application, activity modification, and muscle exercises. In the STG group, 37 patients underwent arthroscopic partial menisectomy and naproxen sodium for three days. Parameters characterizing pretreatment and posttreatment states were compared statistically. The MPS, IKDC, BMI, and US-CRP values of both groups were recorded at baseline and three months after treatment. Results: Surgical treatment group (STG): In this group, after three months of treatment, MPS decreased and IKDC scores increased significantly when compared with baseline (P 0.1799, respectively). Medical treatment group (MTG): In this group, MPS decreased and BMI increased significantly after three months compared with preoperative scores (P 0.05, respectively). Conclusion: IKDC and pain scores of patients with meniscal tear improved by arthroscopic knee surgery.

MULTIFACTOR PREDICTION OF LONG-TERM OUTCOMES OF ACUTE CORONARY SYNDROME WITH SUSTAINED ST SEGMENT ELEVATION

Aim. Prediction of long-term (annual) adverse and benefit outcomes of acute coronary syndrome with sustained ST elevation (STEMI) for the improvement of rehabilitation, secondary prevention and personified approach to treatment. Material and methods. Totally 145 patients included with STEMI (106 men, 39 women), hospitalized to the CCH №1 of Novosibirsk during the year 2010. Mean age of the patients was 59,1±6,1 y. Diagnosis of ACS was set by a collection of criteria developed by European Society of Cardiology and American Heart Association (2000). All patients underwent clinical and instrumental investigation as following: clinical examination, electrocardiography, echocardiography, Holter monitoring, measurement of the inflammatory cytokines and molecular-genetic test. By the methods of factor and correlation analysis, the study made it to define the influence of the each of the factors studied on probability of adverse annual prognosis. Results. As the result of the study, we invented a brand new method of multifactor prediction of long-term (annual) adverse and positive outcomes of the acute coronary syndrome with sustained ST elevation. The model includes the check for the absence or existence in the patient of diabetes mellitus (DM), ejection fraction of the left ventricle (EF LV), ultrasensitive C-reactive protein concentration (hsCRP), and genotype for polymorphism rs1376251 of the gene TAS2R50. Sensitivity of the proposed method of prediction for adverse outcomes was 82%, positive outcomes — 80%. Conclusion. The model proposed was created on the basis of the parameters measured in Russian patients and includes the activity of atherosclerotic inflammation and the patient’s genotype. An equation for the probability calculation of an adverse outcome shows, what is the weight multiplier of one or another factor to influence the probability of adverse outcome. The model is simple in use and makes it possible to individualize secondary prevention for this type of patients.

Lipid profile among girls with systemic lupus erythematosus.

The aim of the study was to describe biomarkers of lipid metabolism associated with increased cardiovascular risk and their correlation with disease variables and markers of inflammation in adolescent females with systemic lupus erythematosus (SLE). This cross-sectional controlled study evaluated 33 adolescent females with juvenile SLE and 33 healthy controls. Anthropometric data, SLE disease activity index (SLEDAI), medications, proteinuria, ultra-sensitive C-reactive protein (us-CRP), lipid profile (total cholesterol, LDL-c, HDL-c and triglycerides), apolipoproteins A and B (Apo A-I and B), paraoxonase, and myeloperoxidase were evaluated. Median age of the patients and the median disease duration were 16.7years and 54months, respectively. SLEDAI scores above 4 were observed in 11 (33.3%) patients. Moreover, 12 (36.4%) patients were overweight, and 5 (15.2%) had low height for age ratios. Dyslipidemia was observed in 13 (39.4%) patients and in 7 (21.2%) controls with a decrease in HDL-c concentrations in SLE patients even after adjustment for their nutritional status. In the group with SLE, us-CRP concentrations were inversely correlated with LDL-c/ApoB ratio (p=0.031). After multivariate regression analysis, the SLE group showed lower concentration of Apo A-I and a decreased LDL-c/ApoB ratio. SLE adolescent females with low disease activity, with preserved kidney function and on low dose of corticosteroids, regardless of nutritional status and food intake, have proatherogenic lipid biomarkers, which may contribute to an increased atherosclerotic risk.

CHANGES IN C-REACTIVE PROTEIN AND BIOCHEMICAL PROFILE IN PRESCHOOL CHILDREN WITH OBESITY.

the childhood obesity is a serious public health problem because if weight gain continues, complications such as insulin resistance, dyslipidemia, orthopedic disorders, sleep apnea, and metabolic syndrome may occur in other stages of child development. the objective of this study was to evaluate C-reactive protein (CRP) concentrations, lipid profiles, and glucose levels in obese children three to five years of age and compare them to eutrophic children. in this study, 100 children aged three to five years were selected and divided into two groups (n = 50 per group): a group of eutrophic children (< 84th percentile) and a group of obese children (> 95th percentile). An anthropometric evaluation and quantification of plasma levels of ultrasensitive CRP, triglycerides, cholesterol, LDL-C, HDL-C, and glucose were performed. the data showed a significant increase in obese children with regard to height (p < 0.005), weight (p < 0.0001), body mass index (p < 0.0001), ultrasensitive CRP (p < 0.0001), triglycerides (p < 0.0001), LDL (p < 0.0001), and glucose levels (p < 0.0001) as well as decreased levels of HDL (p < 0.0001) compared to eutrophic children. metabolic changes that occur in obese preschool children are characterized by increases in inflammatory markers and lipid profiles. Considering that during preschool age the programming and number of adipocytes that will remain with the individual for the rest of their life are determined, this stage is crucial in the development of complications associated with obesity.

The ZONE Diet and Metabolic Control in Type 2 Diabetes

Obesity is associated with chronic inflammation of the adipose tissue, which contributes to obesity-associated complications such as insulin resistance and type 2 diabetes. The increased inflammatory response seems to be directly related to modern nutrition, particularly aspects of fat quality and macronutrient composition. We have recently published an observational study investigating the practicability and effects of a combined dietary intervention with increased relative protein content and low-glycemic-index carbohydrates, supplemented with omega-3 polyunsaturated fatty acids (PUFAs), on metabolic control and inflammatory parameters in real-life situations in patients with type 2 diabetes. The primary efficacy parameter was the change in HbA1c, and secondary parameters included change in systemic inflammation (measured by ultrasensitive C-reactive protein), body weight, waist circumference, fat mass, and homeostasis model assessment–insulin resistance. Counseling a protein-enriched and low-glycemic-index diet supplemented with long-chain omega-3 PUFAs in a real-life clinical setting improved glycemic control, waist circumference, and silent inflammation in overweight or obese patients with type 2 diabetes.