Ultrasensitive C-reactive Protein Research Articles

Impact of Ramadan fasting on lipid profile and cardiovascular risk factors in patients with stable coronary artery disease

BackgroundThe effects of Ramadan fasting (RF) on cardiometabolic risk factors in patients with stable ischemic heart disease are not well known. AimThe aim of this study was to evaluate the impact of RF on lipid profile and cardiovascular risk factors in patients with a stable coronary heart disease. MethodsA prospective observational study carried out in the Cardiology department of Charles Nicolle Hospital (Tunisia). Eighty-four patients with a stable ischemic heart disease who intended to fast were enrolled during May 2020. Detailed clinical and biochemical assessments were performed before and after the holy month. Parameters of glycemic control, lipid profile, ultrasensitive C-reactive protein concentration (us-CRP) and homocysteine were performed before- and after- Ramadan (BR and AR, respectively). ResultsEighty-four patients including 79 males and 5 females, with a mean age of 57±7 years completed the study. Levels of cholesterol, triglycerides, low-density lipoprotein-cholesterol and apoprotein A were significantly improved AR fasting in comparison with their BR values. There was a significant decrease in blood fasting glucose, insulin level, Homeostasis model assessment of insulin resistance index and in us-CRP level. ConclusionIn patients with stable ischemic heart disease, RF may be accompanied by an improvement of lipid profile and glycemic parameters without increase in coronary events.

Early Antiandrogen Therapy With Dutasteride Reduces Viral Shedding, Inflammatory Responses, and Time-to-Remission in Males With COVID-19: A Randomized, Double-Blind, Placebo-Controlled Interventional Trial (EAT-DUTA AndroCoV Trial - Biochemical).

Background and objectiveSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cell entry and subsequent infectivity are mediated by androgens and the androgen receptors through the regulation of transmembrane protease, serine 2 (TMPRSS2). Androgenetic alopecia (AGA) predisposes males to severe coronavirus disease 2019 (COVID-19) disease, while the use of 5-alpha-reductase inhibitors (5ARis) and androgen receptor antagonists reduce COVID-19 disease severity. In this study, we aimed to determine the potential benefit of dutasteride, a commonly used broad and potent 5ARi, as a treatment for COVID-19.Design, setting, and participantsThe study was conducted at outpatient clinics. Subjects presented to the clinics with a positive reverse transcription-polymerase chain reaction (RT-PCR) test taken within 24 hours of recruitment. All subjects presented with mild to moderate symptoms.InterventionsSubjects were given either dutasteride 0.5 mg/day or placebo for 30 days or until full COVID-19 remission. All subjects received standard therapy with nitazoxanide 500 mg twice a day for six days and azithromycin 500 mg/day for five days.Main outcome(s) and measure(s)The main outcome(s) and measure(s) were as follows: time to remission, oxygen saturation (%), positivity rates of RT-PCR-SARS-CoV-2, and biochemical analysis [ultrasensitive C-reactive protein (usCRP), D-dimer, lactate, lactate dehydrogenase (LDH), erythrocyte sedimentation rate (ESR), ultrasensitive troponin, and ferritin].ResultsSubjects taking dutasteride (n=43) demonstrated reduced fatigue, anosmia, and overall disease duration compared to subjects taking a placebo (n=44) (p<.0001 for all). Compared to the placebo group, on Day seven, subjects taking dutasteride had a higher virologic remission rate (64.3% versus 11.8%; p=.0094), higher clinical recovery rate (84.7% versus 57.5%; p=.03), higher mean [standard deviation: SD] oxygen saturation (97.0% [1.4%] versus 95.7% [2.0%]; p=.02), lower median [Interquartile range: IQR] usCRP (0.34 mg/L [0.23 mg/L-0.66 mg/L] versus 1.47 mg/L [0.70 mg/L-3.37 mg/L]; p<.0001), lower median [IQR] lactate (2.01 mmol/L [1.12 mmol/L-2.43 mmol/L] versus 2.66 mmol/L [2.05 mmol/L-3.55 mmol/L]; p=.0049), lower median [IQR] ESR (5.0 mm/1h [3.0 mm/1h-11.0 mm/1h] versus 14.0 mm/1h [7.25 mm/1h-18.5 mm/1h]; p=.0007), lower median [IQR] LDH (165 U/L [144 U/L-198 U/L] versus 210 U/L [179 U/L-249 U/L]; p=.0013) and lower median [IQR] troponin levels (0.005 ng/mL [0.003 ng/mL-0.009 ng/mL] versus 0.007 ng/mL [0.006 ng/mL-0.010 ng/mL]; p=.048).Conclusions and relevanceThe findings from this study suggest that in males with mild COVID-19 symptoms undergoing early therapy with nitazoxanide and azithromycin, treatment with dutasteride reduces viral shedding and inflammatory markers compared to males treated with a placebo.

Analysis of inflammatory markers in patients with abnormal circadian rhythm of blood pressure

IntroductionInflammatory status could play a role in alterations of blood pressure (BP) circadian rhythm. The aim of our study is to compare levels of usual inflammatory markers in patients with and without circadian BP abnormalities.Material and methodsThis is a cross-sectional design study with retrospective data analysis which included patients from an Internal Medicine Department with normal and high BP levels older than 18 years who were separated into two groups according to the circadian profile of BP (dipper and non-dipper) based on the results of 24-hour ambulatory BP monitoring. Patients were assessed for demographic characteristics and cardiovascular risk factors. We considered as inflammatory markers the platelet count (PTC), erythrocyte sedimentation rate (ESR), ultra-sensitive C-reactive protein, ferritin, fibrinogen, and uric acid.ResultsThe study included 551 patients (mean age of 54 years, 47% women). The non-dipper group had a higher percentage of individuals with higher ESR (OR = 1.77, 95% CI: 1.23–1.55, p = 0.001), uric acid (OR = 1.50, 95% CI: 1.04–2.16, p = 0.028) and fibrinogen (OR = 1.72, 95% CI: 1.18–2.51, p = 0.001) and a higher percentage of patients with higher PTC (OR = 0.54, 95% CI: 0.37–0.78, p = 0.005). These results were independent of age, waist circumference, presence of arterial hypertension, diabetes or hyperlipidemia, and use of antihypertensive drugs including renin angiotensin aldosterone system blockers.ConclusionsPatients with impaired circadian BP rhythm were associated with an unfavorable inflammatory status independently of BP levels. This fact could play a role in the prognostic differences observed between dipper and non-dipper patients.

Pain in women with knee and/or hip osteoarthritis is related to systemic inflammation and to adipose tissue dysfunction: Cross-sectional results of the KHOALA cohort

BackgroundConsidering the role of metabolic diseases in osteoarthritis (OA), we investigated whether biomarkers of adipose tissue dysfunction could be associated with OA-related pain. DesignWe cross-sectionally analyzed patients with knee and/or hip OA at inclusion in the KHOALA cohort. We used visual analogic scale (VAS) for pain, the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Osteoarthritis Knee and Hip Quality of Life (OAKHQOL) pain subscores. At inclusion, we measured ultra-sensitive CRP (usCRP), leptin and adiponectin for calculation of leptin:adiponectin ratio (LAR), a marker of adipose tissue dysfunction associated with central adiposity, high-molecular-weight adiponectin, visfatin and apolipoproteins. Univariate and multivariable analyses using stepwise linear regression models were performed to search for correlation between pain assessments and these biomarkers, with systematic adjustment on age. ResultsIn 596 women with hip and/or knee OA, multivariable analyses indicated that higher pain intensity was associated with higher LAR (VAS pain: β=0.49; p = 0.0001, OAKHQOL pain: β=-0.46; p = 0.0002, WOMAC pain: β=0.30; p = 0.001) in the whole group as well as in hip or knee OA patients considered separately. Pain intensity correlated also with usCRP level (VAS pain: β= 0.27; p = 0.02, OAKHQOL pain: β =-0.30; p = 0.01) and Kellgren-Lawrence score. In 267 men, no correlation between biomarkers and pain was found. ConclusionSerum LAR and usCRP level are associated with pain level, independently of radiographic structural severity in women with hip and/or knee OA, emphasizing the role of adipose tissue dysfunction and of meta-inflammation in pain experience in the female population.

The direct correlation between oxidative stress and LDL-C levels in adults is maintained by the Friedewald and Martin equations, but the methylation levels in the MTHFR and ADRB3 genes differ

Low-density lipoprotein (LDL-C) concentrations are a standard of care in the prevention of cardiovascular disease and are influenced by different factors. This study compared the LDL-C concentrations estimated by two different equations and determined their associations with inflammatory status, oxidative stress, anthropometric variables, food intake and DNA methylation levels in the LPL, ADRB3 and MTHFR genes. A cross-sectional population-based study was conducted with 236 adults (median age 37.5 years) of both sexes from the municipality of João Pessoa, Paraíba, Brazil. The LDL-C concentrations were estimated according to the Friedewald and Martin equations. LPL, ADRB3 and MTHFR gene methylation levels; malondialdehyde levels; total antioxidant capacity; ultra-sensitive C-reactive protein, alpha-1-acid glycoprotein, homocysteine, cobalamin, and folic acid levels; usual dietary intake; and epidemiological variables were also determined. For each unit increase in malondialdehyde concentration there was an increase in the LDL-C concentration from 6.25 to 10.29 mg/dL (p <0.000). Based on the Martin equation (≥70 mg/dL), there was a decrease in the DNA methylation levels in the ADRB3 gene and an increase in the DNA methylation levels in the MTHFR gene (p <0.05). There was a positive relation of homocysteine and cholesterol intake on LDL-C concentrations estimated according to the Friedewald equation and of waist circumference and age based on the two estimates. It is concluded the LDL-C concentrations estimated by the Friedewald and Martin equations were different, and the Friedewald equation values were significantly lower than those obtained by the Martin equation. MDA was the variable that was most positively associated with the estimated LDL-C levels in all multivariate models. Significant relationships were observed based on the two estimates and occurred for most variables. The methylation levels of the ADRB3 and MTHFR genes were different according to the Martin equation at low LDL-C concentrations (70 mg/dL).

Long-term natural history of transient constrictive pericarditis

Abstract Background In recent years, there has been increasing recognition of a potentially-reversible, transient/ subacute form of constrictive pericarditis (CP). To date, studies have been small with lack of long-term longitudinal follow-up. Purpose We aimed to elucidate the causes and natural history of subacute CP. Methods Patients were included if (1) they had a diagnosis of CP, (2) had cardiac magnetic resonance (CMR) within 12 months of symptom onset with evidence of pericardial delayed enhancement/ inflammation (Figure) (3) received anti-inflammatory medications. Results A total of 78 individuals were included, comprising 61 men (78%) with a mean age of 59±14 years. Causes of subacute CP included idiopathic/ viral pericarditis (58%), post-pericardiotomy (29%), autoimmune (6%), radiation therapy (3%) and others (4%). After median follow-up of 4.4 years, 31 (40%) required pericardiectomy. There were no deaths. Patients who underwent pericardiectomy had longer duration of symptoms at presentation [6 (4–9) vs. 3 (2–5) months, P&amp;lt;0.01], were more likely to be on diuretic therapy (87 vs. 45%, P&amp;lt;0.001), had lower ultra-sensitive C-reactive protein [4.4 (2.6–13.1) vs. 11.95 (1.8–61.55) mg/dl, P&amp;lt;0.001] and lower erythrocyte sedimentation rate [5 (2–10) vs. 25 (6–43 mm/hr), P=0.031] compared to those who were managed medically. There were no other significant differences in clinical characteristics or baseline anti-inflammatory therapy. The presence of elevated inflammatory markers (HR: 0.18; 95% CI: 0.06–0.58, P&amp;lt;0.01) was an independent predictor of freedom from pericardiectomy after adjustment for relevant clinical and imaging parameters. Conclusions We present the original observations of the largest cohort of patients with transient CP to date and demonstrate that increased inflammatory markers were independently associated with long-term freedom from pericardiectomy. Our results suggest that a trial of anti-inflammatory therapy in the setting of elevated inflammatory markers may be appropriate prior to referral for surgery given the possible reversibility. Pericardial delayed enhancement Funding Acknowledgement Type of funding source: None

Descripción de un servicio de telerreumatología en una institución colombiana

IntroductionModels in health care have been static for a long time, but recently there has been a change in recognising that technology in the area of information and communication could lead to a change in improving health services. Telemedicine has been increasing and its use now extends to the entire process of health care. It is beginning to be implemented in the rheumatology area, in Colombia. The characteristics of a tele-rheumatology service are described, as well as a more detailed observation of a cohort of patients with rheumatoid arthritis (RA), in order to identify strengths and improvements. MethodsA descriptive observational cross-sectional study was conducted on the total population of patients who were treated by the tele-rheumatology service in the synchronous modality for a period of 30 months. As regards the follow-up of patients with RA, all patients were included who were treated exclusively by means of synchronous telemedicine for a minimum period of 6 months with at least three follow-ups, in which it was possible to calculate the clinimetry by Das28 with the use of C reactive protein (CRP). Measures of frequency, central tendency and dispersion according to type of variable will be used for the descriptive analysis. ResultsData was collected from 1905 patients during the period between August 2017 and March 2020. A total of 4864 consultations were made. Non-attendance of 368 (7.85%) consultations was registered. There were 1784 (83%) patients with a definitive diagnosis by the rheumatologist. A total of 284 patients (14.9%) were discharged by the rheumatology service, and 85 (4.46%) were referred for an exclusively face-to-face evaluation. Auxiliary medical care at the place of origin was provided by a general practitioner in 1,749 (91%) cases. There was no security during the care process as regards the physical examination in 46 (2.4%) cases. Of the total number of patients, 184 (9.6%) cases came from rural areas or municipalities far from the place of care. Biological therapies were prescribed in 139 patients, 56 new prescription during the 30 months. Of 479 RA patients, 200 met the criteria for follow-up. Of these, according to the activity measured by DAS28 with the use of ultrasensitive CRP, 54 patients (27%) were found on admission to the program in remission, 23 (11.5%) patients had low activity, 81 (40.5%) patients had moderate activity, and high activity was found in 42 (21%) patients. Regarding the start of follow-up, there was a 47% increase in the number of patients in remission, and low activity to 19.5%, in contrast to a reduction of 25% in patients with moderate activity and in 9% increase high activity in their last measurement, possible during monitoring. In the group of 200 patients from long-term follow-up, biological therapies were used 61 times. Of the 166 patients during follow-up without biological therapies on admission, these were required in 16%. DiscussionA detailed follow-up of the patients was carried out in the telemedicine service in a synchronous way for a period of two and a half years. The low percentage of absences shows a good adherence to the program. Physical examination, the main reason for medical care at the remission site, was not without difficulties, in this minority it was necessary to carry out diagnostic images. It would be important to assess this group of patients where there are doubts regarding the physical examination, those who have a certain number of appointments without a definitive diagnosis, or in whom biological or high-cost therapies would be used should necessarily be referred to face-to-face consultation. In the group of patients with RA, the percentage of biological use is considered high in relation to the expected standards. This may be for several reasons, such as the high number of patients with prior use of biological agents, the majority of patients with long-term disease, and difficulties in accessing follow-up due to rheumatology, as well as the small number of sero-negative patients in the study population, and practices related to non-presential medical practice may overestimate the activity of the disease. In conclusion, telemedicine has great advantages in the care of rheumatology patients, although it requires modifications to improve these services in favour of patients.

Clinical-epidemiological analysis of HDL2 and HDL3 subfractions in adults from Maracaibo city, Venezuela.

To carry out a clinical-epidemiological analysis of high-density lipoprotein cholesterol subfractions (HDL-C) in adults from Maracaibo, Venezuela. A descriptive and cross-sectional study of the database from the Metbolic Syndrome Prevalence in Maracaibo Study was carried out. HDL3 and HDL2 serum concentration, as well as the HDL2/HDL3 ratio, were determined in 359 individuals of both sexes, over 18 years of age. Values obtained were evaluated according to sociodemographic, clinical and biochemical characteristics. Mean population age was 39.4 ± 15.2 years, and 51.5% were female. Differences in HDL-C subfraction levels were only observed in those subjects with low HDL-C levels. Women with hypertriglyceridemia showed significantly lower serum HDL3 and HDL2 concentrations than those with normal triglycerides (p=0.033), as well as a lower HDL3 level and HDL2 / HDL3 ratio in those with higher levels of ultra-sensitive C-reactive protein (us-CRP) (p<0.001). A significantly lower concentration of HDL2 was observed in men with some degree of hypertension (p=0.031), insulin resistance (p=0.050) and metabolic syndrome (p=0.003); while those with elevated us-CRP showed a lower concentration of HDL3 (p=0.011). HDL-C subfractions show varying clinical-epidemiological behavior in adults from Maracaibo. Lower serum levels are observed in men, differences only in those with low HDL-C; and no predominance of any subclass was observed according to sociodemographic, clinical and biochemical characteristics.

Increased ultra sensitive CRP: Abiomarker of microvascular risk in men with type 2 diabetes

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Effects of resistance training on kidney morphology of aged ovariectomized rats

With the advancing age, there is an increase of the incidence of chronic renal diseases. However, it is suggested that exercise, as resistance training, is a key factor in positively modulate the kidney structure and function. Thus, this study aimed to analyze the effects of estrogen deprivation and a moderate resistance protocol on the right kidney structure of rats. A total of 32 animals were randomly divided in four groups (n = 8/per group): control group (CG); resistance trained animals (RT); control ovariectomized animals (OvxC); and trained ovariectomized animals (OvxT). Sections of the right kidney were stained with hematoxylin and eosin for morphometry and blood was collected for biochemical analysis. Our results showed that the group submitted to both ovariectomy and resistance training had significant impact on renal corpuscle components (Bowman’s space, renal corpuscle area, and visceral layer), and proximal and distal tubules. Additionally, resistance training, with or without estrogen deprivation, increases creatine phosphokinase and decreases ultrasensitive C-reactive protein. In summary, we suggested that moderate resistance training may be a key factor to maintain the kidney structure and function across age. However, future studies are need to corroborate with our findings.

Association of Lifestyle and Body Composition on Risk Factors of Cardiometabolic Diseases and Biomarkers in Female Adolescents.

Background Female adolescents are considered a risk group for cardiometabolic disease due to their lifestyle (LS). Objective To evaluate the association between LS classes and body composition groups with cardiometabolic disease risk factors and pro- and anti-inflammatory biomarkers in female adolescents. Methods This cross-sectional study was carried out with female adolescents aged 14 to 19 years, from Viçosa-MG, Brazil. Latent class analysis assessed LS classes. Kinanthropometric measurements were taken together with the body fat percentage (BF%), being analyzed by the Dual Energy X-ray Absorptiometry (DEXA) equipment. Blood pressure and biochemical parameters were analyzed in the Health Division of the Federal University of Viçosa. The pro- and anti-inflammatory biomarkers were analyzed using Luminex technology. Associations with biomarkers were estimated by multiple linear regression. Results 405 female adolescents were evaluated. The majority, 82.57%, 72.90%, and 65.31%, were classified as inactive by the number of steps, with high screen and cell phone time, respectively. Furthermore, 41.55% did meet the minimum of 60 minutes of moderate-to-vigorous physical activity (MVPA) and 54.69% had high values of BF% (DEXA). The “Sedentary & Inactive LS” class together with the high levels of weight and BF% were associated with increased levels of blood pressure, lipid profile, and uric acid. It was also found that “Inactive & Sedentary LS”, high BF%, insulin resistance, and ultra-sensitive C-reactive protein were associated with the concentrations of proinflammatory biomarkers of tumor necrosis factor-α, interleukin-6, and leptin. Conclusion We concluded that female adolescents with overweight/obese and high BF% presented higher values of anthropometric indicators, levels of blood pressure, concentration of uric acid and hs-CRP, and lower concentration of HDL. Inactive and Sedentary lifestyle of these girls, along with excess body fat, insulin resistance, and higher concentrations of hs-CRP were associated with the higher concentration proinflammatory markers.

Proteina C reactiva ultrasensible y riesgo cardiovascular en pacientes con diabetes mellitus tipo 2

Propósito: Describir el riesgo cardiovascular de los pacientes con diabetes mellitus tipo 2 (DM2), según los valores de proteína C reactiva ultrasensible (PCR-us) del Patronato del Diabético zona 1, en el año 2019.&#x0D; Material y métodos: Estudio descriptivo transversal, realizado en el Patronato del Diabético de zona 1 donde se tomaron a 196 pacientes mayores de 50 años, obteniéndose características sociodemográficas, medidas antropométricas mediante pesa Rosthal®, flexometro y tallimetro SECA 213; además se tomaron muestras de sangre todo lo anterior previo al consentimiento informado, las cuales fueron procesadas en iCroma ll donde se conocieron los valores de Proteína C reactiva ultrasensible (PCR-us).&#x0D; Resultados: Los pacientes que aceparon formar parte del estudio tuvieron una media de edad de 62±8.62 DE, 74.4 % (146) del sexo femenino, 54 % (106) eran católicos y el 82.1 % (161) residen en Guatemala. El estado nutricional fue de 26 % (50) encontrándose en normal, el 11 % (21) con sobrepeso y 63% (125) con obesidad. Para índice cintura cadera con respecto al sexo femenino se obtuvo una media de 0.89±0.05 DE y una media 0.97±0.05 DE del sexo masculino. Respecto a riesgo cardiovascular se obtuvo una media de 2.9±2.8 DE y 76 % (148) se encontraban en riesgo cardiovascular moderado/alto.&#x0D; Conclusiones: De los pacientes estudiados 7 de cada 10 fueron mujeres, con una media para la edad de 62 años. Se encontraron 7 de cada 10 con sobrepeso u obesidad con una media para índice cintura cadera con respecto al sexo elevado. El riesgo cardiovascular presentó una media de 2.9±2.8 DE y 8 de cada 10 están en riesgo moderado/alto.&#x0D;

Effects of baru almond oil (Dipteryx alata Vog.) supplementation on body composition, inflammation, oxidative stress, lipid profile, and plasma fatty acids of hemodialysis patients: A randomized, double-blind, placebo-controlled clinical trial

BackgroundThe consumption of nuts and edible seeds is associated with the improvement of the metabolic profile and reduction of cardiovascular diseases. However, the effects of its subproducts, such as oil, are still poorly studied. This study aimed to evaluate the effect of the baru almond oil supplementation on inflammation, oxidative stress, body composition, lipid profile, and plasma fatty acids of hemodialysis patients. MethodsIn a randomized, double-blind, 12-week placebo-controlled clinical study, hemodialysis patients were supplemented with 5 g of baru oil (BG, n = 17) or 5 g of mineral oil (placebo, BP, n = 12). Body composition, renal function, ultra-sensitive C-reactive protein (us-CRP), oxidative stress, plasma fatty acids, and lipid profile were analysed before and after the intervention. ResultsPatients were aged 50.5 ± 2.2 years and the average time of dialyses was 52,1 ± 42,6 months. The BG decreased us-CRP concentration compared to PG (-1.2 ± 0.2 vs. + 0.8 ± 0.2 mg / L,d = 0.88; p = 0.01). Baru almond oil supplementation was not effective in improving body composition, lipid profile, and oxidative stress. ConclusionBaru almond oil supplementation decreased us-CRP concentration in patients with chronic kidney disease under hemodialysis treatment.

P1190OXIDATIVE STRESS AND INFLAMMATION IN PERITONEAL DIALYSIS: DANGEROUS AND TO BE SOLVED

Abstract Background and Aims Cardiovascular disease is the leading cause of excess mortality in chronic kidney disease (CKD) and dialysis patients with oxidative stress (OxSt) and inflammation playing a pivotal role, as non-traditional risk factors and OxSt and inflammation have been shown to increase in peritoneal dialysis. Rho kinase (ROCK) activation is deeply involved in the induction of OxSt and inflammation and is closely linked to cardiovascular-renal remodeling. We aimed to evaluate in peritoneal dialysis patients with a molecular biology approach OxSt, in terms of phosphorylation state of MYPT-1 (marker of ROCK activity), the protein expression of p22phox (subunit of NADPH oxidase, essential for the generation of ROS), and inflammation state, in terms of acute-phase proteins level (Interleukin 6 (IL-6), ultra-sensitive C-reactive protein (US-CRP), Ferritin, Albumin and Transferrin). Method 9 male ESRD patients (39-81 years old) were enrolled and analyzed before (baseline) and after three and six months of peritoneal dialysis treatment (CAPD 7 patients, APD 2 patients). Mononuclear cells (PBMCs) MYPT-1 phosphorylation state and p22phox protein expression were determined by Western Blot. Specific acute-phase proteins as IL-6, US-CRP, Ferritin, Albumin and Transferrin were assessed through blood chemistry tests. Results MYPT-1 phosphorylation was increased after six months of treatment with peritoneal dialysis compared with three months and predialysis (1.03±0.07 vs 1.02±0.04 vs 1.57±0.16 d.u., p&amp;lt;0.0001). p22phox protein expression (0.72±0.05 vs 0.73±0.10 vs 1.28±0.12 d.u., p&amp;lt;0.0001) and ferritin level (101.4±15.3 vs 173.6±11.5 vs 189.0±20.3 µg/l, p=0.002) increased as well. Albumin was decreased after six months of peritoneal dialysis treatment compared with three months and predialysis (43.38±0.10 vs 40.00±1.59 vs 36.46±1.43 g/l, p=0.007). IL-6 and US-CRP remained unchanged at a high level. Conclusion The increase of OxSt and inflammation during peritoneal dialysis is confirmed also at molecular biology level and may lead in the medium-long term to dangerous consequences. The necessary improvement of OxSt status in peritoneal dialysis needs a multitarget approach. It might include the use of neutral pH, low glucose degradation products, low lactate and iso-osmolar peritoneal dialysis solutions, strict glycemic control, optimal volume management and, likely, a supplementation with antioxidants as N-acetylcysteine.

M204. ULTRA-RESISTANT SCHIZOPHRENIA IS ASSOCIATED WITH A DELAY TO INITIATE CLOZAPINE AND WITH LESS ABDOMINAL OBESITY. SEX DIFFERENCES IN INSULINEMIA AND LEPTIN LEVELS ARE OBSERVED BETWEEN RESPONDERS AND NOT RESPONDERS

Background30% patients suffering from schizophrenia fail to obtain therapeutic benefit even after two appropriate antipsychotic trials and are considered resistant. The recommended treatment in these cases is clozapine (CLZ), but only 40% of patients with resistant schizophrenia show clinical response, a condition called ultra-resistance (UR) and defined as the lack of antipsychotic response after 8 to 12 weeks of treatment with at least 400 mg/day of clozapine or plasma levels ≥ 350 ng/ml. The objective of the present study is to identify factors associated with UR in in a group of patients from Argentina.MethodsA paired case-control study was conducted, being cases those patients with UR schizophrenia and controls those who responded to CLZ; both groups were matched by age and sex. The response to CLZ was measured using the PANSS (UR was defined with a total score ≥ 80). The following parameters were compared between groups: months of untreated psychosis, months until the introduction of clozapine, body mass index (BMI), waist circumference, fasting blood glucose, insulinemia, triglyceridemia, HDL cholesterol, ultrasensitive C-reactive protein (CRP) and plasma leptin levels. Clozapine and nor-clozapine plasma trough levels were measured by HPLC-MS/MS.Results9 men (M) and 7 women (W) with the diagnosis of UR schizophrenia were matched with the same number of responders (R) to clozapine. Total PANSS scores (mean ± SD) for each group were as follows: W-R 48.9 ± 11; W-UR 88.4 ± 6 (p < 0.0001); M-R 60.5 ± 7; M-UR 112.8 ± 23 (p < 0.0001). CLZ dose was significantly higher both in W-UR and in M-UR than in paired controls (p < 0.05). Nonsignificant differences were observed for nor-CLZ plasma concentration among groups. Clozapinemia was not different among men but it was significantly higher in W-UR in comparison with W-R (p < 0.05).Significant differences were detected in the amount of months that passed before initiation of CLZ both for women (W-R 140.9 ± 124, W-UR 255.6 ± 153, p < 0.005) and men (M-R 104.0 ± 51. 6 versus M-UR 174.6± 65; p < 0.05). Body mass index (kg/m2) was significantly lower in UR patients: W-R 35.3 ± 6 versus W-UR 26.9 ± 3 (p < 0.05) and M-R 30.6 ± 5 versus M-UR 22.7 ± 4 (p <.005). Waist circumference (cm) was also significantly lower in UR independently of sex: W-R 110.6 ± 12 versus W-UR 98.5 ± 8 (p < 0.05); M-R 113.9 ± 15 versus M-UR 87.4 ± 9 (p <0 .005). Insulinemia (UI/ml) was significantly lower in M-UR than in M-R (16.1± 8 versus 9.4 ± 7, p<0.005) but not in women. Also significant differences were found in leptin levels (pg/ml) in men but not in women (M-R 1824.0 ± 1139 versus M-UR 477.6 ± 692; p < 0.05). No differences were observed in the number of antipsychotics received before CLZ, months of untreated psychosis, fasting glycemia, trygliceridemia, HDL cholesterol, CRP, HbA1c and diastolic or systolic arterial blood pressure.DiscussionTime to CLZ initiation could be a critical factor predisposing to UR. The absence of clozapine-induced abdominal obesity and changes in BMI are also to be associated with poor clinical response, independently of plasma drug levels. Differences between ultra-resistant men and women concerning insulin and leptin plasma levels should be further investigated. As far as we know, this is the first paired case-control study aimed to investigate factors associated with CLZ resistance in schizophrenia.

MON-LB108 Measurement Of Carotid Intima,hepatic Steatosis And Inflammatory Markers In Obese Children

Measurement of carotid intima,hepatic steatosis and inflammatory markers in obese children. Elevated levels of inflammatory factors and increased mean intimal carotid thickness (IMT) would increase the risk of atherothrombotic events and contribute to the progression of cardiovascular disease in obese children. Objectives: Evaluate inflammatory factors, metabolic syndrome and non-alcoholic liver steatosis and carotid IMT as an early cardiovascular risk marker. Patients and methods: Descriptive cross-sectional exploratory study. Consider 41 obese children both sexes between 6- 12 years old. Evaluated: anthropometry and determinations of lipid and liver profile, blood glucose, insulin, HOMA, ultrasensitive CRP, fibrinogen. Hepatic ultrasound and measurement of carotid IMT with ESAOTE Mylab 50 Exdicion equipment. . Results: From 41 studied patients, 57% were female. 51% presented MS and 68% elevated triglycerides. CRP> 1 was found in 71% of cases. Hepatic steatosis was observed in 60%, which only 10% had altered transaminases. 12% presented high fibrinogen. Patients with MS had a significant positive difference in the IMTCC (X = 0.41 ± 0.12; p 0.024), HDL (X 37.89 ± 1.72; p 0.004) triglycerides (X 149.42 ± 10.69; p 0.002) in relation to patients without MS. Conclusion: CRP is an inflammatory risk factor associated with elevated BMI and MS. There was a higher prevalence of MS in our study. The increase in the average intimal thickness is significantly related to the presence of MS and RCP>1. The determination of marker molecules of an inflammatory state and measurement of carotid IMT would contribute to the implementation of strategies to prevent cardiovascular, hepatic and metabolic risk since childhood.

Effects of Vitamin D Status on Inflammatory Markers in Obese Subjects: A Systematic Review

Background: Recent studies have demonstrated the role of micronutrients in the manifestation of comorbidities associated with obesity. Vitamin D deficiency, in particular, appears to be associated with increased levels of inflammatory markers, which may lead to chronic low-grade inflammation, elevating the risk of chronic diseases such as diabetes, metabolic syndrome, and cardiovascular disease. The objective of this study was to perform a systematic review of observational studies conducted to investigate the effect of vitamin D deficiency on inflammatory markers in obese subjects. Methodology: This systematic review was conducted in accordance with the “STROBE” and PRISMA recommendations. Observational studies that evaluated the effect of vitamin D status on inflammatory markers in obese subjects were selected and reviewed. Searches were conducted in the PubMed, SciVerse Scopus, and Web of Science databases from February 21 to 22, 2018. Results: After the selection and removal of duplicate articles, 10 eligible articles were identified. Results from eight observational studies showed an association between vitamin D deficiency or insufficiency in the body and increased concentrations of inflammatory markers in obese individuals. On the other hand, two of the studies did not demonstrate any correlation. With regard to the inflammatory markers evaluated, eight studies showed high concentrations of ultra-sensitive C-reactive protein, five studies found an increase in interleukin-6 concentrations, and two studies noted increased levels of tumor necrosis factor. Conclusion: The data presented in this systematic review provide evidence of the association between vitamin D deficiency and increased inflammation in obesity.

Effect of dietary intervention with a legume-based food product on malondialdehyde levels, HOMA index, and lipid profile

BackgroundPrevalence of overweight and obesity, a condition that promotes development of chronic degenerative diseases, has increased in Mexico in recent years. Implementation of strategies to increase daily consumption of vegetables, legumes, whole grain cereals, and fruits by the population will result in an adequate intake of soluble fiber, antioxidants, protein of vegetable origin, and vitamins. ObjectiveTo assess the effect of a commercial food product prepared using 6 legumes on some anthropometric and biochemical parameters in apparently healthy subjects. MethodsA randomised dietary intervention trial where subjects in the study group received for three months 15 g of the product, administered daily in periods of five days with two days of rest. Before and after intervention, anthropometric and dietary assessments were performed, and serum glucose, lipid profile, insulin, ultrasensitive C-reactive protein, malondialdehyde (MDA) and insulin resistance (HOMA index) were measured. A Mann-Whitney U test was used and values of P < .05 were considered statistically significant. ResultsSixty university students were included in the study (53% males). At the end of the intervention, decreases were seen in serum glucose levels (P = .001), MDA (P = .001) and HOMA index (P = .017), but there were no significant changes in all other parameters. ConclusionsDaily intake of 15 g of the legume-based food product improved serum glucose and malondialdehyde levels in the study group, as well as insulin resistance; which could be attributed to the presence of polyphenols and isoflavones such as genistein in legumes.

Vitamin D and laboratory indicators of cardiovascular risk in the elderly.

The aim of this work was to study the availability of vitamin D in the population of free living elderly people in St. Petersburg and its relationship with laboratory indicators of the risk of cardiovascular complications. In winter were surveyed 209 volunteers who did not take vitamin D during the previous 6 months, with 152 women and 57 men aged 71 to 91 years. In all the examined patients the concentration of D(OH) in serum was below 30 ng/ml (analyzer and reagents «Architect i1000SR, Abbott»). No significant mutual effects were found between level 25(OH)D and lipid spectrum, hemoglobin A1C, testosterone, ultra-sensitive C-reactive protein. The close relationship between vitamin D(OH) concentration and brain natriuretic peptide (BNP) levels was characterized by rs=0.187 (p=0.007). In older people with severe vitamin deficiency (less than 10 ng/ml), the risk of elevated BNP levels was 2.6 times higher than in those with reduced vitamin levels (20-30 ng/ml).

Polydopamine-based molecular imprinted optic microfiber sensor enhanced by template-mediated molecular rearrangement for ultra-sensitive C-reactive protein detection

Conventional molecular imprinting technique is utilized for the construction of three dimensional binding cavities just providing complementary shape and size of the specific template molecule for the recognition of the same. Although molecular imprinting is able to largely improve the selectivity of detection, it lowers the limit of detection (LOD) a little. In this study, a microfiber interference sensor decorated with the polydopamine (PDA)-based molecularly imprinted with C-reactive protein (CMIP-PDA) was developed for C-reactive protein (CRP) detection, in which template molecule induced dopamine2/5,6-dihydroxyindole (DHI) trimer rearrangement in the dopamine self-polymerization process and further forms complementary hydrophobic/hydrophilic and charge distribution other than shape and size in the imprinting cavity corresponding to template. The combination of optical fiber interferometer with enhancement effect from template-mediated rearrangement remarkably boosts the recognition sensitivity. Therefore, our sensor sensitivity reaches 0.881 nm/ (lg ng/mL) and the LOD is found to be 5.813 × 10−10 ng/mL, which is about 8 orders of magnitude lower than the commercial sandwich-type ELISA kit. Moreover, the CMIP-PDA microfiber sensor has excellent repeatability and high selectivity for the target molecule. These findings confirm that the proposed PDA-based molecular imprinting can provide an ultrasensitive, rapid, low cost and label-free CRP diagnosis as well as can be varied to meet any specific biomarkers. This work also opens up new opportunity to quantitatively monitor biological molecules with extremely low concentration.