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Rittmannsberger H, Barth M, Lamprecht B, Malik P, Yazdi-Zorn K. [Interaction of somatic findings and psychiatric symptoms in COVID-19. A scoping review]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2024; 38:1-23. [PMID: 38055146 DOI: 10.1007/s40211-023-00487-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/24/2023] [Indexed: 12/07/2023]
Abstract
An infection with SARS-CoV‑2 can affect the central nervous system, leading to neurological as well as psychiatric symptoms. In this respect, mechanisms of inflammation seem to be of much greater importance than the virus itself. This paper deals with the possible contributions of organic changes to psychiatric symptomatology and deals especially with delirium, cognitive symptoms, depression, anxiety, posttraumatic stress disorder and psychosis. Processes of neuroinflammation with infection of capillary endothelial cells and activation of microglia and astrocytes releasing high amounts of cytokines seem to be of key importance in all kinds of disturbances. They can lead to damage in grey and white matter, impairment of cerebral metabolism and loss of connectivity. Such neuroimmunological processes have been described as a organic basis for many psychiatric disorders, as affective disorders, psychoses and dementia. As the activation of the glia cells can persist for a long time after the offending agent has been cleared, this can contribute to long term sequalae of the infection.
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Affiliation(s)
- Hans Rittmannsberger
- Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Österreich.
| | - Martin Barth
- Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Österreich
| | - Bernd Lamprecht
- Med Campus III, Universitätsklinik für Innere Medizin mit Schwerpunkt Pneumologie, Kepler Universitätsklinikum GmbH, Linz, Österreich
- Medizinische Fakultät, Johannes Kepler Universität Linz, Linz, Österreich
| | - Peter Malik
- Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Österreich
| | - Kurosch Yazdi-Zorn
- Neuromed Campus, Klinik für Psychiatrie mit Schwerpunkt Suchtmedizin, Kepler Universitätsklinikum GmbH, Linz, Österreich
- Medizinische Fakultät, Johannes Kepler Universität Linz, Linz, Österreich
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Shi W, Jiang Y, Wang Y, Zhang C, Yu T, Li T. The Diagnostic Value of Various Inflammatory Biomarkers for Diagnosing Periprosthetic Joint Infection is Gender-Specific. J Inflamm Res 2022; 15:3975-3982. [PMID: 35860231 PMCID: PMC9291658 DOI: 10.2147/jir.s364309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Previous studies have suggested that the diagnostic biomarkers of periprosthetic joint infection (PJI) are largely influenced by gender. In the present study, we aimed to evaluate the diagnostic value of traditional inflammatory biomarkers, fibrinolytic biomarkers (fibrinogen and D-dimer), and C-reactive protein (CRP)/albumin for PJI in different genders. Methods A single-center retrospective analysis was performed on revision total hip or knee arthroplasty between June 2013 to June 2021, and the study included 80 patients in the PJI group and 136 patients in the non-PJI group. PJI was diagnosed based on the International Consensus Meeting (ICM) in 2018. The levels of CRP, fibrinogen, erythrocyte sedimentation rate (ESR), D-dimer, and albumin count were determined. Receiver operating characteristic (ROC) curves and Youden's index were used to evaluate the diagnostic ability of various biomarkers. Results The levels of CRP, fibrinogen, D-dimer, ESR, and CRP/albumin were significantly higher in the PJI group (P < 0.001). In PJI of females, the predictive value of CRP was the highest among the five biomarkers, with the area under the curve (AUC) of 0.98. The optimal predictive cut-off for CRP was 8.86 mg/L, with a sensitivity and specificity of 90.2% and 95.7%, respectively. When combined with the other four biomarkers, the AUC of CRP was 0.98, 0.99, 0.98, and 0.99, respectively. In PJI of males, the predictive value of ESR was the highest among the five biomarkers, with an AUC of 0.92. The optimal predictive cut-off for ESR was 14.50 mm/h, with a sensitivity and specificity of 84.6% and 86.6%, respectively. When combined with the other four biomarkers, the AUC of ESR was 0.95, 0.94, 0.93, and 0.97, respectively. Conclusion CRP and ESR were excellent biomarkers for diagnosing PJI in female and male patients, respectively, and their combined use with CPR/albumin could provide higher diagnostic value in different genders.
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Affiliation(s)
- Weipeng Shi
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China.,Medical Department of Qingdao University, Qingdao, Shandong, People's Republic of China
| | - Yaping Jiang
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Yingzhen Wang
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Cailong Zhang
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Tengbo Yu
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Tao Li
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
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3
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Horst-Bruinsma IEVD. Does gender modify outcome in rheumatic diseases? Joint Bone Spine 2022; 89:105365. [DOI: 10.1016/j.jbspin.2022.105365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/04/2022] [Accepted: 02/14/2022] [Indexed: 11/16/2022]
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Furuta M, Takeuchi K, Takeshita T, Shibata Y, Suma S, Kageyama S, Asakawa M, Shimazaki Y, Hata J, Ninomiya T, Yamashita Y. Baseline periodontal status and modifiable risk factors are associated with tooth loss over a 10-year period: estimates of population attributable risk in a Japanese community. J Periodontol 2021; 93:526-536. [PMID: 34435683 PMCID: PMC9305417 DOI: 10.1002/jper.21-0191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 07/14/2021] [Accepted: 07/25/2021] [Indexed: 11/06/2022]
Abstract
Background This study aimed to examine whether modifiable risk factors can predict tooth loss over 10 years and estimate population attributable risk (PAR) for a combination of modifiable factors. Methods This longitudinal study included 1466 participants who underwent dental examinations in 2007 and 2017 and were aged 40 to 79 years at baseline. Periodontal conditions were assessed using the 2018 periodontal classification. Incident tooth loss was defined as ≥4 teeth lost over a 10‐year period. We calculated the partial PAR (pPAR%) for tooth loss to estimate the combined effect of modifiable risk factors. Results Incidence of tooth loss was 17.5%. Directed acyclic graphs were used to identify risk factors for tooth loss. A logistic regression model showed that baseline periodontitis, dental caries experience, no regular dental visit, periodontal treatment, smoking, and obesity were associated with tooth loss after adjusting for covariates; pPAR% was 55.5% (95% confidence interval: 31.1% to 73.0%) in periodontitis Stage III to IV and 87.6% (50.4% to 97.4%) in the combination of all factors, respectively. The sex‐stratified analysis showed that smoking and no regular dental visit in men and obesity in women were identified as potential risk factors for tooth loss. Conclusions Modifiable factors accounted for most cases of incident tooth loss. Risk factors for tooth loss might differ by sex, suggesting that the appropriate approach for preventing tooth loss base on sex.
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Affiliation(s)
- Michiko Furuta
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Kenji Takeuchi
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toru Takeshita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,OBT Research Center, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Yukie Shibata
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Shino Suma
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Shinya Kageyama
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Mikari Asakawa
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Yoshihiro Shimazaki
- Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihisa Yamashita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
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Variation in Inflammatory Biomarkers Among Demographic Groups Significantly Affects Their Accuracy in Diagnosing Periprosthetic Joint Infection. J Arthroplasty 2021; 36:1420-1428. [PMID: 33190995 DOI: 10.1016/j.arth.2020.10.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/08/2020] [Accepted: 10/20/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Diagnosis of periprosthetic joint infection (PJI) is a multistep process that involves performing various tests including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). The latter two tests, despite being used at all times for PJI diagnosis, are known to be nonspecific and substantially affected by demographic characteristics, including age, gender, race, and body mass index. It is unknown how these variations affect the diagnostic utility of serological markers for PJI. METHODS Institutional databases were queried to identify patients undergoing revision arthroplasty between 2010 and 2018, in whom preoperative serum ESR and CRP was performed. Patient demographics were collected, and patients were cross-referenced with an internal database to determine their infection status. Analyses were performed to determine how ESR and CRP varied with respect to demographic factors, including age, gender, race, and infection status. Given that patient infection status was known at the time of revision, conclusions were drawn about the effect of these variations in inflammatory markers on the diagnostic utility of ESR and CRP. RESULTS The value of ESR increased by age was higher in females and African American race. No significant differences were observed in the value of CRP among the demographic factors, although a slight positive trend was observed with respect to age. The variation in inflammatory markers significantly affected the sensitivity, specificity, and accuracy of ESR and CRP for PJI diagnosis. CONCLUSION Understanding how the accuracy of diagnostic tests varies with respect to demographic factors can help physicians avoid subjecting patients to unnecessary additional testing and reach more accurate diagnoses of PJI.
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Probasco WV, Cefalu C, Lee R, Lee D, Gu A, Dasa V. Prevalence of idiopathically elevated ESR and CRP in patients undergoing primary total knee arthroplasty as a function of body mass index. J Clin Orthop Trauma 2020; 11:S722-S728. [PMID: 32999546 PMCID: PMC7503783 DOI: 10.1016/j.jcot.2020.05.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are commonly used inflammatory markers utilized to aid in the diagnosis of periprosthetic infection (PJI). Patients with obesity, however, are known to have elevated baseline levels of these inflammatory markers. Therefore, this retrospective study aimed to determine the relationship between elevated ESR and CRP and body mass index (BMI) in patients undergoing total knee arthroplasty (TKA). In doing so, physicians can better determine whether BMI should be taken into account when evaluating the prognostic value of elevated preoperative ESR and CRP levels for risk of PJI in primary TKA patients. METHODS This is a retrospective case series of 181 patients who had undergone primary TKA at a single institution. Patients undergoing primary unilateral TKA were eligible unless they had undergone previous TKA, contralateral knee symptoms, or elevated white blood cell (WBC) count. A linear regression model was utilized to demonstrate the relationship between proportions of patients with elevated biomarker values and categories of BMI. Analysis of variance and independent two-sample t-tests were utilized to assess differences in mean ESR, CRP, and WBC levels between the "healthy patients" and "patients with comorbidities" subgroups within each BMI category. RESULTS Eligible patients (n = 181) were stratified by BMI category. Elevated ESR was associated significantly with BMI (ESR: r2 = 0.89, P < 0.001) unlike elevated CRP (r2 = 0.82, P = 0.133) and WBC count (r2 = .01; P = .626). No statistically significant differences in ESR values and WBC count between the "healthy patients" versus "patients with comorbidities" were demonstrated within any BMI category. In patients of normal weight (BMI 20-25 kg/m2), "healthy patients" had a statistically significantly higher mean CRP level than "patients with comorbidities" (1.73 mg/L vs. 0.70 mg/L, P < 0.001). There were no other statistically significant differences in mean CRP levels by health status. CONCLUSION Caution is advised when utilizing ESR and CRP to diagnose periprosthetic joint infection without considering BMI given that increasing preoperative levels of ESR and CRP are correlated with higher BMI.
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Affiliation(s)
- William V. Probasco
- Department of Orthopedic Surgery, George Washington University, 2300 M Street NW, Washington DC, 20037, USA
- Department of Orthopedic Surgery, Louisiana State University Health Sciences Center, 1542 Tulane Avenue, New Orleans, LA, 70112, USA
| | - Charles Cefalu
- Department of Orthopedic Surgery, Harvard University, 55 Fruit Street, Boston, MA, 02114, USA
- Department of Orthopedic Surgery, Louisiana State University Health Sciences Center, 1542 Tulane Avenue, New Orleans, LA, 70112, USA
| | - Ryan Lee
- Department of Orthopedic Surgery, George Washington University, 2300 M Street NW, Washington DC, 20037, USA
| | - Danny Lee
- Department of Orthopedic Surgery, George Washington University, 2300 M Street NW, Washington DC, 20037, USA
| | - Alex Gu
- Department of Orthopedic Surgery, George Washington University, 2300 M Street NW, Washington DC, 20037, USA
| | - Vinod Dasa
- Department of Orthopedic Surgery, Louisiana State University Health Sciences Center, 1542 Tulane Avenue, New Orleans, LA, 70112, USA
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7
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Ng QX, Yeo WS, Lim DY, Chee KT. Re-examining the Association Between COVID-19 and Psychosis. PSYCHOSOMATICS 2020; 61:853-855. [PMID: 32682504 PMCID: PMC7308742 DOI: 10.1016/j.psym.2020.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 06/17/2020] [Indexed: 11/23/2022]
Affiliation(s)
- Qin Xiang Ng
- MOH Holdings Pte Ltd., Singapore, Singapore; Institute of Mental Health, Buangkok Green Medical Park, Singapore, Singapore.
| | | | - Donovan Yutong Lim
- Institute of Mental Health, Buangkok Green Medical Park, Singapore, Singapore
| | - Kuan Tsee Chee
- Institute of Mental Health, Buangkok Green Medical Park, Singapore, Singapore
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Higgins V, Omidi A, Tahmasebi H, Asgari S, Gordanifar K, Nieuwesteeg M, Adeli K. Marked Influence of Adiposity on Laboratory Biomarkers in a Healthy Cohort of Children and Adolescents. J Clin Endocrinol Metab 2020; 105:5675353. [PMID: 31845996 PMCID: PMC7077953 DOI: 10.1210/clinem/dgz161] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/26/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND The prevalence of pediatric obesity is increasing worldwide and strongly associates with metabolic abnormalities, including inflammation, insulin resistance, and dyslipidemia. This study assessed the influence of 3 measures of adiposity on levels of routinely assessed biochemical markers in apparently healthy children and adolescents. METHODS The influence of adiposity on 35 biochemical markers was examined in the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) cohort of healthy children and adolescents by comparing serum biomarker levels between subjects with a normal weight, overweight, and obese body mass index (BMI). The cohort comprised 1332 subjects 5.1 to 19.0 years of age with a BMI ranging from 13.4 to 65.0 kg/m2. The association between each biochemical marker and BMI, waist circumference, and waist-to-height ratio z-scores was assessed, while adjusting for age and sex. Reference intervals were established for all biochemical markers before and after removing overweight/obese subjects. RESULTS In children and adolescents, levels of 13 routinely assessed biochemical markers, including alanine aminotransferase, apolipoprotein B, complement components 3 and 4, cholinesterase, high sensitivity C-reactive protein, gamma-glutamyl transferase, haptoglobin, high-density lipoprotein cholesterol, iron, transferrin, triglycerides, and uric acid, were significantly different between BMI categories. BMI, waist circumference, and/or waist-to-height ratio were significantly associated with the serum concentration of 24 of the 35 markers examined, after adjusting for age and sex. CONCLUSIONS Excess adiposity significantly influences circulating levels of routinely assessed laboratory markers, most notably liver enzymes, lipids/lipoproteins, inflammatory markers, and uric acid in children and adolescents. Although it is unknown whether altered biochemical marker levels in subjects with overweight/obesity reflect health or indolent disease, clinicians should be aware of the effect of weight status on several laboratory tests.
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Affiliation(s)
- Victoria Higgins
- CALIPER Program, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Arghavan Omidi
- CALIPER Program, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Houman Tahmasebi
- CALIPER Program, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Shervin Asgari
- CALIPER Program, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Kian Gordanifar
- CALIPER Program, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Michelle Nieuwesteeg
- CALIPER Program, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Khosrow Adeli
- CALIPER Program, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada
- Correspondence and Reprint Requests: Khosrow Adeli, Clinical Biochemistry, DPLM, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8 Canada. E-mail:
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Van der Touw T, Andronicos NM, Smart N. Is C-reactive protein elevated in obstructive sleep apnea? a systematic review and meta-analysis. Biomarkers 2019; 24:429-435. [PMID: 30908094 DOI: 10.1080/1354750x.2019.1600025] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Purpose: This study examined whether circulating C-reactive protein (CRP) is elevated in obstructive sleep apnoea (OSA) independent of the confounding effects of comorbidities, smoking, body mass index (BMI), age and gender. Methods: A systematic review of the literature was performed using PubMed, Embase and Cochrane databases from 1 January 1997 to 1 November 2017 using the key words obstructive sleep apnoea and C-Reactive protein to identify full text English language studies that compared CRP in adult non-smoking OSA participants without comorbidities and adult healthy non-smoking control participants matched for BMI, age and gender. Data from eligible studies were subjected to meta-analysis using RevMan version 5.3. Results: Five studies (219 OSA participants, 116 controls) met the selection criteria. The total standard mean difference for circulating high sensitivity CRP was 0.61 mg/dL higher in OSA participants than in control participants (confidence interval: 0.38 to 0.84, p < 0.00001), with low between-studies heterogeneity (df = 7, p = 0.16, I2 = 33%) and minimal evidence of publication bias. Conclusions: CRP levels in non-smoking OSA participants without comorbidities were increased relative to levels in healthy matched non-smoking control participants, suggesting that pharyngeal or systemic inflammatory effects attributable to OSA may elevate CRP.
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Affiliation(s)
- Tom Van der Touw
- a School of Science and Technology , University of New England , Armidale , Australia
| | | | - Neil Smart
- a School of Science and Technology , University of New England , Armidale , Australia
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Cominetti O, Núñez Galindo A, Corthésy J, Valsesia A, Irincheeva I, Kussmann M, Saris WHM, Astrup A, McPherson R, Harper ME, Dent R, Hager J, Dayon L. Obesity shows preserved plasma proteome in large independent clinical cohorts. Sci Rep 2018; 8:16981. [PMID: 30451909 PMCID: PMC6242904 DOI: 10.1038/s41598-018-35321-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 11/02/2018] [Indexed: 12/21/2022] Open
Abstract
Holistic human proteome maps are expected to complement comprehensive profile assessment of health and disease phenotypes. However, methodologies to analyze proteomes in human tissue or body fluid samples at relevant scale and performance are still limited in clinical research. Their deployment and demonstration in large enough human populations are even sparser. In the present study, we have characterized and compared the plasma proteomes of two large independent cohorts of obese and overweight individuals using shotgun mass spectrometry (MS)-based proteomics. Herein, we showed, in both populations from different continents of about 500 individuals each, the concordance of plasma protein MS measurements in terms of variability, gender-specificity, and age-relationship. Additionally, we replicated several known and new associations between proteins, clinical and molecular variables, such as insulin and glucose concentrations. In conclusion, our MS-based analyses of plasma samples from independent human cohorts proved the practical feasibility and efficiency of a large and unified discovery/replication approach in proteomics, which was also recently coined “rectangular” design.
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Affiliation(s)
- Ornella Cominetti
- Proteomics, Nestlé Institute of Health Sciences, Lausanne, Switzerland
| | | | - John Corthésy
- Proteomics, Nestlé Institute of Health Sciences, Lausanne, Switzerland.,Nutrition Analytics, Nestlé Institute of Health Sciences, Lausanne, Switzerland
| | - Armand Valsesia
- Nutrition and Metabolic Health, Nestlé Institute of Health Sciences, Lausanne, Switzerland
| | - Irina Irincheeva
- Nutrition and Metabolic Health, Nestlé Institute of Health Sciences, Lausanne, Switzerland.,Clinical Trial Unit, University of Bern, Bern, Switzerland
| | - Martin Kussmann
- Proteomics, Nestlé Institute of Health Sciences, Lausanne, Switzerland.,The Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Wim H M Saris
- NUTRIM, School for Nutrition, Toxicology and Metabolism, Department of Human Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Ruth McPherson
- Ruddy Canadian Cardiovascular Genetics Centre, University of Ottawa Heart Institute, Ottawa, Canada
| | - Mary-Ellen Harper
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Robert Dent
- Ottawa Hospital Weight Management Clinic, The Ottawa Hospital, Ottawa, Canada
| | - Jörg Hager
- Nutrition and Metabolic Health, Nestlé Institute of Health Sciences, Lausanne, Switzerland
| | - Loïc Dayon
- Proteomics, Nestlé Institute of Health Sciences, Lausanne, Switzerland.
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Jiang H, Wang W, Wang C, Xie X, Hou Y. Association of pre-ablation level of potential blood markers with atrial fibrillation recurrence after catheter ablation: a meta-analysis. Europace 2017; 19:392-400. [PMID: 27386883 DOI: 10.1093/europace/euw088] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 03/09/2016] [Indexed: 11/13/2022] Open
Abstract
Aims The meta-analysis was aimed to search for candidate blood markers whose pre-ablation level was associated with atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA). Methods and results A systematic literature search of PubMed, EMBASE, Springer Link, Web of Science, Wiley-Cochrane library, and supplemented with Google scholar search engine was performed. Thirty-six studies covering 11 blood markers were qualified for this meta-analysis. Compared with the nonrecurrence group, the recurrence group had increased pre-ablation level of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), N-terminal pro-brain natriuretic peptide (NT-pro-BNP), interleukin-6 (IL-6), C-reactive protein, low density lipoprotein (LDL), and tissue inhibitor of metal loproteinase-2 (TIMP-2) [standardized mean difference (95% confidence interval): 0.37 (0.13-0.61), 0.77 (0.40-1.14), 1.25 (0.64-1.87), 0.37 (0.21-0.52), 0.35 (0.10-0.60), 0.24 (0.07-0.42), 0.17 (0.00-0.34), respectively], while no statistical difference of pre-ablation level of white blood cell, total cholesterol, triglyceride, and transforming growth factor-β1 was found. Subgroup analysis demonstrated that ANP was associated with AF recurrence in participants who had no concomitant structural heart diseases (SHD); however, not in participants who had SHD, C-reactive protein was associated with AF recurrence in Asian studies, whereas not in European studies. Conclusion Increased pre-ablation level of ANP, BNP, NT-pro-BNP, IL-6, C-reactive protein, LDL, and TIMP-2 was associated with greater risk of AF recurrence after RFCA.
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Affiliation(s)
- Hui Jiang
- Department of Clinical Medicine, School of Medicine, Shandong University, Jinan, Shandong Province, China.,Department of Cardiology, Shandong Provincial Qianfoshan Hospital, Shandong University, No. 16766 Jingshi Road, Jinan, Shandong Province 250014, China
| | - Weizong Wang
- Department of Clinical Medicine, School of Medicine, Shandong University, Jinan, Shandong Province, China.,Department of Cardiology, Shandong Provincial Qianfoshan Hospital, Shandong University, No. 16766 Jingshi Road, Jinan, Shandong Province 250014, China
| | - Cong Wang
- Department of Cardiology, Shandong Provincial Qianfoshan Hospital, Shandong University, No. 16766 Jingshi Road, Jinan, Shandong Province 250014, China
| | - Xinxing Xie
- Department of Cardiology, Shandong Provincial Qianfoshan Hospital, Shandong University, No. 16766 Jingshi Road, Jinan, Shandong Province 250014, China
| | - Yinglong Hou
- Department of Cardiology, Shandong Provincial Qianfoshan Hospital, Shandong University, No. 16766 Jingshi Road, Jinan, Shandong Province 250014, China
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Barosi G, Massa M, Campanelli R, Fois G, Catarsi P, Viarengo G, Villani L, Poletto V, Bosoni T, Magrini U, Gale RP, Rosti V. Primary myelofibrosis: Older age and high JAK2 V617F allele burden are associated with elevated plasma high-sensitivity C-reactive protein levels and a phenotype of progressive disease. Leuk Res 2017. [DOI: 10.1016/j.leukres.2017.06.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Correlation between erythrocyte sedimentation rate and C-reactive protein level in patients with rheumatic diseases. Reumatologia 2015; 53:243-6. [PMID: 27407254 PMCID: PMC4847318 DOI: 10.5114/reum.2015.55825] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 09/19/2015] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Erythrocyte sedimentation rate (ESR) and serum level of C-reactive protein (CRP) are the acute phase reactants most commonly determined in patients with rheumatic diseases. The indices are affected by different factors, but both of them are applied for evaluation of the disease activity in patients with inflammatory disorders of the musculoskeletal system. MATERIAL AND METHODS The authors compared the results of ESR and CRP, which were carried out during routine diagnosis in 200 patients admitted to the Department of Rheumatology. RESULTS A significant correlation between ESR and CRP was found (ESR after 1 h/CRP: correlation coefficient 0.6944, ESR after 2 h/CRP: correlation coefficient 0.6126). There was no difference in ESR or CRP between male and female patients, and patients older than 40 years had higher ESR and CRP. CONCLUSIONS The obtained results support the usefulness of both indices in the clinical practice of rheumatologists.
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Oksuzyan A, Shkolnikova M, Vaupel JW, Christensen K, Shkolnikov VM. Sex Differences in Biological Markers of Health in the Study of Stress, Aging and Health in Russia. PLoS One 2015; 10:e0131691. [PMID: 26121035 PMCID: PMC4484801 DOI: 10.1371/journal.pone.0131691] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 06/05/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The apparent contradiction that women live longer but have worse health than men, the so called male-female health-survival paradox, is very pronounced in Russia. The present study investigates whether men in Moscow are healthier than women at the level of biomarkers, and whether the associations between biomarkers and subjective health have sex-specific patterns. MATERIALS Previously collected data in the study of Stress, Aging, and Health in Russia (SAHR, n = 1800) were used to examine sex differences in biomarkers and their associations with physical functioning and self-rated health. RESULTS The present study found mixed directions and magnitudes for sex differences in biomarkers. Women were significantly disadvantaged with regard to obesity and waist circumference, whereas men had a tendency toward higher prevalence of electrocardiographic abnormalities. No sex differences were indicated in the prevalence of immunological biomarkers, and mixed patterns were found for lipid profiles. Many biomarkers were associated with physical functioning and general health. Obesity and waist circumference were related to lower physical functioning among females only, while major Q-wave abnormalities with high probabilities of myocardial infarction and atrial fibrillation or atrial flutter were associated with physical functioning and self-rated health among males only. CONCLUSION No clear patterns of sex differences in prevalence of high-risk levels of biomarkers suggest that the male-female health-survival paradox is weaker at the level of health biomarkers. We found some evidence that certain biomarkers reflecting pathophysiological changes in the organism that do not possess acute health risks, but over many years may lead to physical disability, are associated with physical functioning and self-rated health in women, whereas others reflecting more serious life-threatening pathophysiological changes are associated with physical functioning and self-rated health in men.
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Affiliation(s)
- Anna Oksuzyan
- Max Planck Institute for Demographic Research, Rostock, Germany
- Department of Epidemiology, Biostatistics, and Biodemography, University of Southern Denmark, Odense, Denmark
- * E-mail:
| | - Maria Shkolnikova
- Scientific and Clinical Institute of Pediatry at the Pirogov Moscow Medical University, Moscow, Russian Federation
| | - James W. Vaupel
- Max Planck Institute for Demographic Research, Rostock, Germany
- Max-Planck Odense Center on the Biodemography of Aging, Odense, Denmark
| | - Kaare Christensen
- Department of Epidemiology, Biostatistics, and Biodemography, University of Southern Denmark, Odense, Denmark
- Max-Planck Odense Center on the Biodemography of Aging, Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Vladimir M. Shkolnikov
- Max Planck Institute for Demographic Research, Rostock, Germany
- New Economic School, Moscow, Russian Federation
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Ormseth MJ, Chung CP, Oeser AM, Connelly MA, Sokka T, Raggi P, Solus JF, Otvos JD, Stein CM. Utility of a novel inflammatory marker, GlycA, for assessment of rheumatoid arthritis disease activity and coronary atherosclerosis. Arthritis Res Ther 2015; 17:117. [PMID: 25956924 PMCID: PMC4445500 DOI: 10.1186/s13075-015-0646-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 05/01/2015] [Indexed: 01/05/2023] Open
Abstract
Introduction GlycA is a novel inflammatory biomarker measured using nuclear magnetic resonance (NMR). Its NMR signal primarily represents glycosylated acute phase proteins. GlycA was associated with inflammation and development of cardiovascular disease in initially healthy women. We hypothesized that GlycA is a biomarker of disease activity and is associated with coronary artery atherosclerosis in patients with rheumatoid arthritis (RA). Methods We conducted a cross-sectional study of 166 patients with RA and 90 control subjects. GlycA was measured from an NMR signal originating from N-acetylglucosamine residues on circulating glycoproteins. The relationship between GlycA and RA disease activity (Disease Activity Score based on 28 joints (DAS28)) and coronary artery calcium score was determined. Results GlycA concentrations were higher in patients with RA (median (interquartile range): 398 μmol/L (348 to 473 μmol/L)) than control subjects (344 μmol/L (314 to 403 μmol/L) (P < 0.001). In RA, GlycA was strongly correlated with DAS28 based on erythrocyte sedimentation rate (DAS28-ESR) and DAS28 based on C-reactive protein (DAS28-CRP) and their components, including tender and swollen joint counts, global health score, ESR and CRP (all P < 0.001). The area under the receiver operating characteristic curve for GlycA’s ability to differentiate between patients with low versus moderate to high disease activity based on DAS28-CRP was 0.75 (95 % confidence interval (CI): 0.68, 0.83). For each quartile increase in GlycA, the odds of having coronary artery calcium increased by 48 % (95 % CI: 4 %, 111 %), independent of age, race and sex (P = 0.03). Conclusion GlycA is a novel inflammatory marker that may be useful for assessment of disease activity and is associated with coronary artery atherosclerosis in patients with RA.
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Affiliation(s)
- Michelle J Ormseth
- Department of Medicine, Vanderbilt University Medical Center, 1161 21st Avenue South, T-3113 MCN, Nashville, TN, 37212, USA.
| | - Cecilia P Chung
- Department of Medicine, Vanderbilt University Medical Center, 1161 21st Avenue South, T-3113 MCN, Nashville, TN, 37212, USA.
| | - Annette M Oeser
- Department of Medicine, Vanderbilt University Medical Center, 1161 21st Avenue South, T-3113 MCN, Nashville, TN, 37212, USA.
| | | | - Tuulikki Sokka
- Department of Rheumatology, University of Eastern Finland, Jyvaskyla Central Hospital, 40620, Jyvaskyla, Finland.
| | - Paolo Raggi
- Department of Medicine, University of Alberta, 4A7.050, 8440 - 112 Street, Edmonton, AB, T6G 2B7, Canada.
| | - Joseph F Solus
- Department of Medicine, Vanderbilt University Medical Center, 1161 21st Avenue South, T-3113 MCN, Nashville, TN, 37212, USA.
| | | | - C Michael Stein
- Department of Medicine, Vanderbilt University Medical Center, 1161 21st Avenue South, T-3113 MCN, Nashville, TN, 37212, USA.
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Siemons L, ten Klooster PM, Vonkeman HE, van Riel PLCM, Glas CAW, van de Laar MAFJ. How age and sex affect the erythrocyte sedimentation rate and C-reactive protein in early rheumatoid arthritis. BMC Musculoskelet Disord 2014; 15:368. [PMID: 25373740 PMCID: PMC4228188 DOI: 10.1186/1471-2474-15-368] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 10/27/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are two commonly used measures of inflammation in rheumatoid arthritis (RA). As current RA treatment guidelines strongly emphasize early and aggressive treatment aiming at fast remission, optimal measurement of inflammation becomes increasingly important. Dependencies with age, sex, and body mass index have been shown for both inflammatory markers, yet it remains unclear which inflammatory marker is affected least by these effects in patients with early RA. METHODS Baseline data from 589 patients from the DREAM registry were used for analyses. Associations between the inflammatory markers and age, sex, and BMI were evaluated first using univariate linear regression analyses. Next, it was tested whether these associations were independent of a patient's current disease activity as well as of each other using multiple linear regression analyses with backward elimination. The strengths of the associations were compared using standardized beta (β) coefficients. The multivariate analyses were repeated after 1 year. RESULTS At baseline, both the ESR and CRP were univariately associated with age, sex, and BMI, although the association with BMI disappeared in multivariate analyses. ESR and CRP levels significantly increased with age (β-ESR=0.017, p<0.001 and β-CRP=0.009, p=0.006), independent of the number of tender and swollen joints, general health, and sex. For each decade of aging, ESR and CRP levels became 1.19 and 1.09 times higher, respectively. Furthermore, women demonstrated average ESR levels that were 1.22 times higher than that of men (β=0.198, p=0.007), whereas men had 1.20 times higher CRP levels (β=-0.182, p=0.048). Effects were strongest on the ESR. BMI became significantly associated with both inflammatory markers after 1 year, showing higher levels with increasing weight. Age continued to be significantly associated, whereas sex remained only associated with the ESR level. CONCLUSIONS Age and sex are independently associated with the levels of both acute phase reactants in early RA, emphasizing the need to take these external factors into account when interpreting disease activity measures. BMI appears to become more relevant at later stages of the disease.
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Affiliation(s)
- Liseth Siemons
- />Arthritis Center Twente, Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherlands
- />Department of Psychology, Health & Technology, Faculty of Behavioural Sciences, University of Twente, PO Box 217, 7500 AE Enschede, The Netherlands
| | - Peter M ten Klooster
- />Arthritis Center Twente, Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherlands
| | - Harald E Vonkeman
- />Arthritis Center Twente, Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherlands
- />Arthritis Center Twente, Department of Rheumatology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Piet LCM van Riel
- />Scientific Institute for Quality of Healthcare, Radboud University, Nijmegen, The Netherlands
| | - Cees AW Glas
- />Department of Research Methodology, Measurement and Data Analysis, University of Twente, Enschede, The Netherlands
| | - Mart AFJ van de Laar
- />Arthritis Center Twente, Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherlands
- />Arthritis Center Twente, Department of Rheumatology, Medisch Spectrum Twente, Enschede, The Netherlands
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Flock MR, Skulas-Ray AC, Harris WS, Gaugler TL, Fleming JA, Kris-Etherton PM. Effects of supplemental long-chain omega-3 fatty acids and erythrocyte membrane fatty acid content on circulating inflammatory markers in a randomized controlled trial of healthy adults. Prostaglandins Leukot Essent Fatty Acids 2014; 91:161-8. [PMID: 25091379 PMCID: PMC4156902 DOI: 10.1016/j.plefa.2014.07.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 07/04/2014] [Accepted: 07/07/2014] [Indexed: 02/08/2023]
Abstract
The long-chain omega-3 polyunsaturated (n-3 PUFA), eicosapentaenoic (EPA) and docosahexaenoic acid (DHA), may have anti-inflammatory effects. We evaluated the dose-response effect of EPA+DHA supplementation on circulating TNF-α, IL-6, and CRP and explored associations between red blood cell (RBC) membrane PUFA content and TNF-α, IL-6, and CRP. Young adults with low fish intake (n=116) received one of five doses (0, 300, 600, 900, or 1,800 mg/d EPA+DHA) for 5 months. There were no significant effects of supplemental EPA+DHA on IL-6 or CRP; however, there was a marginal treatment effect for TNF-α (p<0.08). At baseline, higher quartiles of RBC DHA were associated with lower TNF-α (p=0.001); higher quartiles of arachidonic acid were associated with higher TNF-α (p=0.005). EPA+DHA supplementation had no dose-response effect on TNF-α, IL-6, or CRP in healthy young adults; however, associations between inflammatory markers and RBC PUFA warrant further investigation.
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Affiliation(s)
- Michael R Flock
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, 16802, United States
| | - Ann C Skulas-Ray
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, 16802, United States.
| | - William S Harris
- Health Diagnostic Laboratory, Inc., Richmond, VA, United States; Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, United States
| | - Trent L Gaugler
- Department of Mathematics, Lafayette College, Easton, PA 18042, United States
| | - Jennifer A Fleming
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, 16802, United States
| | - Penny M Kris-Etherton
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, 16802, United States
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Xiao S, Zhao L. Gut microbiota-based translational biomarkers to prevent metabolic syndrome via nutritional modulation. FEMS Microbiol Ecol 2013; 87:303-14. [PMID: 24219358 PMCID: PMC4262049 DOI: 10.1111/1574-6941.12250] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 09/20/2013] [Accepted: 11/04/2013] [Indexed: 12/14/2022] Open
Abstract
In the face of the global epidemic of metabolic syndrome (MetS) and its strong association with the increasing rate of cardiovascular morbidity and mortality, it is critical to detect MetS at an early stage in the clinical setting to implement preventive intervention long before the complications arise. Lipopolysaccharide, the cell wall component of Gram-negative bacteria produced from diet-disrupted gut microbiota, has been shown to induce metabolic endotoxemia, chronic low-grade inflammation, and ultimately insulin resistance. Therefore, ameliorating the inflammation and insulin resistance underlying MetS by gut microbiota-targeted, dietary intervention has gained increasing attention. In this review, we propose using dynamic monitoring of a set of translational biomarkers related with the etiological role of gut microbiota, including lipopolysaccharide binding protein (LBP), C-reactive protein (CRP), fasting insulin, and homeostasis model assessment of insulin resistance (HOMA-IR), for early detection and prevention of MetS via nutritional modulation. LBP initiates the recognition and monomerization of lipopolysaccharide and amplifies host immune responses, linking the gut-derived antigen load and inflammation indicated by the plasma levels of CRP. Fasting plasma insulin and HOMA-IR are measured to evaluate insulin sensitivity that is damaged by pro-inflammatory cytokines. The dynamic monitoring of these biomarkers in high-risk populations may provide translational methods for the quantitative and dynamic evaluation of dysbiosis-induced insulin resistance and the effectiveness of dietary treatment for MetS.
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Affiliation(s)
- Shuiming Xiao
- State Key Laboratory of Microbial Metabolism, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
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19
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Li YJ, Li ZM, Xia Y, Huang JJ, Huang HQ, Xia ZJ, Lin TY, Li S, Cai XY, Wu-Xiao ZJ, Jiang WQ. Serum C-reactive protein (CRP) as a simple and independent prognostic factor in extranodal natural killer/T-cell lymphoma, nasal type. PLoS One 2013; 8:e64158. [PMID: 23724031 PMCID: PMC3665788 DOI: 10.1371/journal.pone.0064158] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 04/09/2013] [Indexed: 12/22/2022] Open
Abstract
Background C-reactive protein (CRP) is a biomarker of the inflammatory response, and it shows significant prognostic value for several types of solid tumors. The prognostic significance of CRP for lymphoma has not been fully examined. We evaluated the prognostic role of baseline serum CRP levels in patients with extranodal natural killer (NK)/T-cell lymphoma (ENKTL). Methods We retrospectively analyzed 185 patients with newly diagnosed ENKTL. The prognostic value of the serum CRP level was evaluated for the low-CRP group (CRP≤10 mg/L) versus the high-CRP group (CRP>10 mg/L). The prognostic value of the International Prognostic Index (IPI) and the Korean Prognostic Index (KPI) were evaluated and compared with the newly developed prognostic model. Results Patients in the high-CRP group tended to display increased adverse clinical characteristics, lower rates of complete remission (P<0.001), inferior progression-free survival (PFS, P = 0.001), and inferior overall survival (OS, P<0.001). Multivariate analysis demonstrated that elevated serum CRP levels, age >60 years, hypoalbuminemia, and elevated lactate dehydrogenase levels were independent adverse predictors of OS. Based on these four independent predictors, we constructed a new prognostic model that identified 4 groups with varying OS: group 1, no adverse factors; group 2, 1 factor; group 3, 2 factors; and group 4, 3 or 4 factors (P<0.001). The novel prognostic model was found to be superior to both the IPI in discriminating patients with different outcomes in the IPI low-risk group and the KPI in distinguishing between the low- and intermediate-low-risk groups, the intermediate-low- and high-intermediate-risk groups, and the high-intermediate- and high-risk groups. Conclusions Our results suggest that pretreatment serum CRP levels represent an independent predictor of clinical outcome for patients with ENKTL. The prognostic value of the new prognostic model is superior to both IPI and KPI.
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Affiliation(s)
- Ya-Jun Li
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhi-Ming Li
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yi Xia
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jia-Jia Huang
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Hui-Qiang Huang
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhong-Jun Xia
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Department of Hematological Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Tong-Yu Lin
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Su Li
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xiu-Yu Cai
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhi-Jun Wu-Xiao
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Wen-Qi Jiang
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
- * E-mail:
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Sutherland JP, McKinley B, Eckel RH. The metabolic syndrome and inflammation. Metab Syndr Relat Disord 2012; 2:82-104. [PMID: 18370640 DOI: 10.1089/met.2004.2.82] [Citation(s) in RCA: 145] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The metabolic syndrome (MS) is a clustering of cardiovascular risk factors, with insulin resistance as a major feature. This syndrome has been variously defined, but generally consists of 3 or more of the following components: hyperglycemia, hypertension, hypertriglyceridemia, low HDL, and increased abdominal circumference and/or BMI at >30 kg/m(2). The WHO criteria require the presence of insulin resistance to make the diagnosis. The current review focuses particularly on the association of the MS and the proinflammatory state as well as treatment options to prevent the development of coronary heart disease (CHD). Chronic inflammation is frequently associated with the MS. Inflammatory markers that have been associated with MS include hs-CRP, TNF-alpha, fibrinogen, and IL-6, among others. The link between inflammation and the MS is not fully understood. One postulated mechanism is that these cytokines are released into the circulation by adipose tissue, stimulating hepatic CRP production. The prothrombotic molecule PAI-1 is also increased in the MS. Adiponectin, produced exclusively by adipocytes, is decreased in obesity. The association of these proinflammatory and prothrombotic markers with the MS is discussed in detail. The general goals of treatment of the MS are prevention of CHD events and diabetes if not already present. The approach to treatment of those with the MS should include lifestyle changes, including weight loss and exercise as well as appropriate pharmacological therapies. Certain medications, which may be used in persons with MS, have been shown to have beneficial effects on clinical outcome and/or anti-inflammatory effects.
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Hornbuckle LM, Liu PY, Ilich JZ, Kim JS, Arjmandi BH, Panton LB. Effects of resistance training and walking on cardiovascular disease risk in African-American women. Med Sci Sports Exerc 2012; 44:525-33. [PMID: 21778912 DOI: 10.1249/mss.0b013e31822e5a12] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE The study's purpose was to evaluate the effects of walking (W) and walking plus resistance training (WRT) on cardiovascular disease risk factors in inactive middle-aged (49.0 ± 5.5 yr) African-American women (body mass index = 34.7 ± 6.4 kg·m(-2)). METHODS Body composition, blood pressure, HDL cholesterol, triglycerides, glycosylated hemoglobin (HbA1c), C-reactive protein, and fibrinogen were measured before and after a 12-wk exercise intervention. Subjects were randomly assigned to one of two training groups. The W group (n = 25) was instructed to increase daily pedometer-measured walking to ≥10,000 steps per day, whereas the WRT group (n = 19) was given the same walking prescription plus supervised resistance training 2 d·wk(-1). A two-way repeated-measures ANOVA with an intention-to-treat analysis was performed to examine changes between groups. Significance was accepted at P ≤ 0.05. RESULTS Both groups significantly (P < 0.001) increased walking (W = 5453 ± 2119 to 6845 ± 2279 steps per day, WRT = 4823 ± 1758 to 6859 ± 2012 steps per day). WRT significantly (P < 0.001) increased both upper (100 ± 15 to 113 ± 18 kg) and lower (102 ± 20 to 116 ± 25 kg) body strength compared with W. WRT significantly decreased waist circumference (94.8 ± 12.3 to 92.9 ± 12.0 cm, P = 0.021) and total fat mass (42.6 ± 11.1 to 41.8 ± 10.8 kg, P = 0.036) compared with W. WRT also significantly decreased pre- to postintervention body fat (45.8% ± 6.2% to 45.3% ± 6.2%, P = 0.018), HbA1c (5.9% ± 1.2% to 5.6% ± 1.0%, P = 0.028), and mean glucose calculated from HbA1c (122 ± 39 to 114 ± 32 mg·dL(-1), P = 0.028), whereas W showed no changes. Blood pressure, HDL cholesterol, triglycerides, and C-reactive protein were not affected by either intervention. CONCLUSIONS Although both interventions increased steps per day, WRT was more effective in improving several body composition measures and glucose control in 12 wk. WRT may be an important addition to a lifestyle intervention aiming to facilitate reductions in cardiovascular disease risk factors in overweight and obese African-American women.
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Affiliation(s)
- Lyndsey M Hornbuckle
- Department of Health, Physical Education, and Sport Science, Kennesaw State University, Kennesaw, GA 30144-5591, USA.
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Lee S, Kim IT, Park HB, Hyun YK, Kim YJ, Song SO, Kim H. High-sensitivity C-reactive protein can predict major adverse cardiovascular events in Korean patients with type 2 diabetes. J Korean Med Sci 2011; 26:1322-7. [PMID: 22022185 PMCID: PMC3192344 DOI: 10.3346/jkms.2011.26.10.1322] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Accepted: 08/29/2011] [Indexed: 11/20/2022] Open
Abstract
Inflammation is thought to play a role in the pathogenesis of major adverse cardiovascular events (MACE). It has been suggested that the measurement of markers of inflammation may aid in predicting the risk of such events. Here, the relationship between high-sensitivity C-reactive protein (hs-CRP) levels and MACE in Korean patients with type 2 diabetes is assessed. A retrospective cohort study was conducted as a follow-up among 1,558 patients with type 2 diabetes and without cardiovascular diseases over a mean period of 55.5 months. A Cox proportional-hazards model was used to determine whether increased hs-CRP levels are useful as a predictor for future MACE. The hazard ratio of MACE was 1.77 (95% CI; 1.16-2.71) in subjects who had the highest hs-CRP levels (> 0.21 mg/dL) compared to subjects who had the lowest hs-CRP levels (< 0.08 mg/dL), after adjusting for age, regular physical activity, current smoking, and duration of diabetes. The present results indicate that high hs-CRP levels can act as a predictor for the MACE occurrence in Korean patients with type 2 diabetes.
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Affiliation(s)
- Sangheun Lee
- Department of Internal Medicine, College of Medicine, Kwandong University, Goyang, Korea
| | - In Tae Kim
- Department of Internal Medicine, College of Medicine, Kwandong University, Goyang, Korea
| | - Hyung Bok Park
- Department of Internal Medicine, College of Medicine, Kwandong University, Goyang, Korea
| | - Yu Kyung Hyun
- Department of Internal Medicine, College of Medicine, Kwandong University, Goyang, Korea
| | - Yoon Ji Kim
- Department of Internal Medicine, College of Medicine, Kwandong University, Goyang, Korea
| | - Sun Ok Song
- Department of Internal Medicine, College of Medicine, Kwandong University, Goyang, Korea
| | - Hyeongjin Kim
- Department of Endocrinology, College of Medicine, Kwandong University, Goyang, Korea
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Mermigkis C, Bouloukaki I, Mermigkis D, Kallergis E, Mavroudi E, Varouchakis G, Tzortzaki E, Siafakas N, Schiza SE. CRP evolution pattern in CPAP-treated obstructive sleep apnea patients. Does gender play a role? Sleep Breath 2011; 16:813-9. [PMID: 21881894 DOI: 10.1007/s11325-011-0580-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 07/25/2011] [Accepted: 08/19/2011] [Indexed: 02/08/2023]
Abstract
BACKGROUND-AIM C-reactive protein (CRP) is directly implicated in atherogenesis and associated cardiovascular morbidity in patients with obstructive sleep apnea (OSA). Effective continuous positive airway pressure (CPAP) treatment has been shown to gradually decrease CRP levels and thus consequently improve disease-related cardiovascular morbidity. However, the influence of gender on the CRP evolution pattern has never been assessed before. The aim of our study was to investigate possible gender differences in CRP evolution in OSA patients 3 and 6 months after the start of effective CPAP treatment. METHODS The study population consisted of 436 patients (252 males/184 females) with newly diagnosed moderate to severe OSA and good CPAP compliance assessed by a thorough follow up. High-sensitivity C-reactive protein (hs-CRP) was assessed before CPAP initiation and at the third and sixth month of the follow-up period. RESULTS C-reactive protein values showed a statistically significant decrease at the third and sixth month of CPAP therapy [initial values 0.79 ± 0.65 mg/dL versus 0.70 ± 0.52 mg/dL (p < 0.05) after 3 months and 0.30 ± 0.33 mg/dL (p < 0.001) after 6 months of CPAP therapy]. When patients were divided into males and females, the above evolution pattern was changed. At the third month time point, the CRP values showed a statistically significant decrease only in males (from 0.74 ± 0.53 mg/dL to 0.61 ± 0.5 mg/dL, p < 0.01) while females showed only minimal and insignificant changes (from 0.87 ± 0.79 mg/dL to 0.83 ± 0.51 mg/dL, p > 0.05). After 6 months' treatment, CRP decreased significantly in both genders (males from 0.74 ± 0.53 mg/dL to 0.28 ± 0.32 mg/dL, p < 0.001 and females from 0.87 ± 0.79 mg/dL to 0.34 ± 0.36 mg/dL, p < 0.001). CONCLUSION Our results suggest a delay in the normalization of CRP levels in females despite effective CPAP treatment. A time period of at least 6 months appeared to be required in women in order to reduce CRP levels and consequent cardiovascular risk. In contrast, CPAP's protective role in males is achieved at an earlier time point. Gender-related hormonal and genetic factors may influence the above CRP evolution pattern.
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Affiliation(s)
- Charalampos Mermigkis
- Sleep Disorders Center, Pulmonary Department, 401 General Army Hospital, Athens, Greece.
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Abstract
Systemic and local inflammation in relation to the resident microbiota of the human gastro-intestinal (GI) tract and administration of probiotics are the main themes of the present review. The dominating taxa of the human GI tract and their potential for aggravating or suppressing inflammation are described. The review focuses on human trials with probiotics and does not include in vitro studies and animal experimental models. The applications of probiotics considered are systemic immune-modulation, the metabolic syndrome, liver injury, inflammatory bowel disease, colorectal cancer and radiation-induced enteritis. When the major genomic differences between different types of probiotics are taken into account, it is to be expected that the human body can respond differently to the different species and strains of probiotics. This fact is often neglected in discussions of the outcome of clinical trials with probiotics.
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Lao XQ, Neil Thomas G, Jiang CQ, Zhang WS, Adab P, Lam TH, Cheng KK. Obesity, high-sensitive C-reactive protein and snoring in older Chinese: The Guangzhou Biobank Cohort Study. Respir Med 2010; 104:1750-6. [DOI: 10.1016/j.rmed.2010.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2009] [Revised: 06/03/2010] [Accepted: 06/07/2010] [Indexed: 11/16/2022]
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Unek IT, Bayraktar F, Solmaz D, Ellidokuz H, Sisman AR, Yuksel F, Yesil S. The levels of soluble CD40 ligand and C-reactive protein in normal weight, overweight and obese people. Clin Med Res 2010; 8:89-95. [PMID: 20660932 PMCID: PMC2910107 DOI: 10.3121/cmr.2010.889] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Obesity has been suggested as an independent risk factor for cardiovascular disease. Increasing evidence shows that engagement of soluble CD40 ligand (sCD40L) with its receptor plays a crucial role in the pathogenesis of atherosclerosis. The aim of the present study was to test whether obesity is associated with low-grade systemic inflammation as measured by serum high-sensitive C-reactive protein (hsCRP) and sCD40L concentration. METHODS Serum hsCRP and sCD40L concentrations were measured in 148 nondiabetic people. The participants were divided into three groups depending upon their body mass index (BMI) levels: Group 1 (normal weight), BMI<25 kg/m(2); Group 2 (overweight), BMI 25 kg/m(2) to 29.9 kg/m(2); and Group 3 (obese), BMI>or=30 kg/m(2). RESULTS Obese people had more elevated hsCRP levels than both their normal weight and overweight counterparts (P=0.000 and P=0.000, respectively). Similarly, serum concentrations of sCD40L were significantly higher, statistically, in obese subjects compared with normal weight subjects (P=0.003). In addition, obese subjects had higher values of sCD40L than overweight subjects, but the difference did not reach statistical significance (P=0.063). The levels of high-density lipoprotein cholesterol were significantly lower in obese subjects compared to normal weight subjects (P=0.048). The analysis of platelet count disclosed a statistically significant difference between obese subjects and normal weight subjects (P=0.028). The levels of BMI were positively correlated with the serum levels of hsCRP and sCD40L in all subjects (r=0.514, P=0.000 and r=0.283, P=0.000, respectively). Levels of hsCRP were positively correlated with waist circumference, fasting glucose, total cholesterol, triglyceride, low-density lipoprotein cholesterol, leukocytes, platelets, systolic and diastolic blood pressure. Similarly, soluble CD40L levels were positively correlated with waist circumference, fasting glucose and leukocytes. CONCLUSION Obese patients showed a significant increase of hsCRP and sCD40L levels compared with normal weight subjects, which might contribute to the known proinflammatory milieu found in these patients.
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Affiliation(s)
- Ilkay Tugba Unek
- Dokuz Eylul University School of Medicine, Department of Internal Medicine, 35340, Inciralti, Izmir, Turkey.
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Pelletier P, Lapointe A, Laflamme N, Piché ME, Weisnagel SJ, Nadeau A, Lemieux S, Bergeron J. Discordances among different tools used to estimate cardiovascular risk in postmenopausal women. Can J Cardiol 2009; 25:e413-6. [PMID: 19960135 PMCID: PMC2807837 DOI: 10.1016/s0828-282x(09)70535-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2007] [Accepted: 11/30/2008] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND New cardiovascular disease (CVD) risk factors are being recognized and suggested to be included in CVD risk stratification. High-sensitivity C-reactive protein (hs-CRP) and the metabolic syndrome (MetS) are among these risk factors. However, CVD risk classification may be divergent when using different approaches. OBJECTIVES To compare differences in CVD risk estimation using the Framingham risk score (FRS), hs-CRP and the presence of the MetS in a group of 109 postmenopausal women in primary CVD prevention. METHODS The FRS and presence of the MetS were determined. CVD risk was evaluated with a cardiovascular point scoring system based on Framingham covariables and hs-CRP values (Women's Health Study [WHS] model). The estimated CVD risks based on hs-CRP levels and the WHS model were compared with the FRS. RESULTS Using the FRS, 99% of women (n=108) were determined to have a low CVD risk. The MetS was identified in 39.4% (n=43) of the women. When hs-CRP was used alone to estimate CVD risk, 37.6% (n=41) of women were classified as being at low, 33.9% (n=37) at moderate and 28.4% (n=31) at high CVD risk. With the WHS model, 83.5% (n=91), 14.7% (n=16) and 1.8 % (n=2) of women were classified as being at low, moderate and high CVD risk, respectively. CONCLUSIONS A substantial number of postmenopausal women showing evidence of the MetS were not identified by the FRS, even though women with the MetS are at higher risk of CVD. Estimation of risk by hs-CRP is significantly divergent when using conventional hs-CRP cutoff values compared with an integrated use in the WHS model.
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Affiliation(s)
- Pascal Pelletier
- Lipid Research Centre, Centre Hospitalier Universitaire de Québec Research Centre
| | - Annie Lapointe
- Institute of Nutraceuticals and Functional Foods, Laval University
| | - Nathalie Laflamme
- Lipid Research Centre, Centre Hospitalier Universitaire de Québec Research Centre
| | - Marie-Eve Piché
- Institute of Nutraceuticals and Functional Foods, Laval University
| | - Stanley John Weisnagel
- Lipid Research Centre, Centre Hospitalier Universitaire de Québec Research Centre
- Diabetes Research Unit, Centre Hospitalier Universitaire de Québec Research Centre, Quebec City, Quebec
| | | | - Simone Lemieux
- Institute of Nutraceuticals and Functional Foods, Laval University
| | - Jean Bergeron
- Lipid Research Centre, Centre Hospitalier Universitaire de Québec Research Centre
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Oh JY, Lee JA, Lee H, Oh JY, Sung YA, Chung H. Serum C-reactive protein levels in normal-weight polycystic ovary syndrome. Korean J Intern Med 2009; 24:350-5. [PMID: 19949734 PMCID: PMC2784979 DOI: 10.3904/kjim.2009.24.4.350] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2008] [Accepted: 03/03/2009] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Serum levels of highly sensitive C-reactive protein (hsCRP), a vascular inflammatory marker, may predict the development of cardiovascular disease (CVD) and type 2 diabetes. Women with polycystic ovary syndrome (PCOS) are at greater risk for type 2 diabetes and CVD. The aim of this study was to compare hsCRP levels between normal weight women with PCOS and controls with a normal menstrual cycle and to determine the factors associated with serum hsCRP levels. METHODS Thirty-nine lean PCOS patients and 24 healthy, regular cycling women were enrolled in this study. We performed anthropometric measurements, fat computed tomography (CT), and blood sampling to determine blood chemistry and levels of hsCRP, gonadotropins, testosterone, and sex-hormone binding globulin. We also conducted 75-g oral glucose-tolerance test and euglycemic hyperinsulinemic clamp to assess insulin sensitivity. RESULTS Serum hsCRP concentrations were higher in women with PCOS than in women with regular mensturation. However, this difference was no longer significant after adjusting for body mass index (BMI). hsCRP levels were correlated with waist circumference (r=0.46, p<0.01), BMI (r=0.46, p<0.01), visceral fat area (r=0.45, p<0.01), and systolic (r=0.42, p<0.05) and diastolic blood pressure (r=0.39, p<0.05). hsCRP also tended to be negatively associated with insulin-mediated glucose uptake (IMGU) (r=-0.31, p=0.07). A multiple regression analysis revealed that BMI (beta=0.29, p<0.05), systolic blood pressure (beta=0.39, p<0.01), and IMGU (beta=-0.31, p<0.05) predicted serum hsCRP levels in women with PCOS. CONCLUSIONS PCOS by itself does not seem to be associated with increased hsCRP levels, whereas known CVD risk factors affect serum hsCRP levels in PCOS.
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Affiliation(s)
- Ji Young Oh
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Ji-Ah Lee
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyejin Lee
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jee-Young Oh
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Yeon-Ah Sung
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyewon Chung
- Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul, Korea
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Evrin PE, Nilsson SE, Oberg T, Malmberg B. Serum C‐reactive protein in elderly men and women: Association with mortality, morbidity and various biochemical values. Scandinavian Journal of Clinical and Laboratory Investigation 2009; 65:23-31. [PMID: 15859024 DOI: 10.1080/00365510510013505] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The primary aim of this study was to define the distribution and the prognostic value of serum C-reactive protein (s-CRP) measured by a high-sensitivity method in elderly subjects of both genders with special reference to the distribution below 10 mg/l. As a secondary aim, a possible gender difference of s-CRP was examined. MATERIAL AND METHODS Baseline s-CRP was described in a population-based sample of opposite-sex, twin-pairs (197 F, 189 M available for blood-sampling) aged 71-80 years (mean age 74.5 years), considering mortality through the next 4 years, morbidity (myocardial infarction, angina pectoris, congestive heart failure, arterial hypertension, venous thromboembolism, stroke, diabetes, gout, psoriasis, rheumatoid arthritis) before and after blood sampling, biochemical values (serum levels of urate, urea, ApoA1, ApoB, folate, FSH, LH, oestradiol, progesterone, testosterone, cortisol) and anthropometric measurements (body mass index (BMI), circumference of waist, buttocks and hips). RESULTS The level of s-CRP did not deviate substantially from what has been reported for younger subjects. Higher values indicated an increased risk of cardiovascular morbidity and diabetes in women but not in men. The s-CRP level was associated with serum levels of urate, progesterone, folate, ApoA1, ApoB and the quotient ApoB/ApoA1 as well as with BMI and waist circumference. CONCLUSIONS For the 71-80 years age group, s-CRP below the 80th percentile (4.3 mg/l) seems to have prognostic capacity mainly in women. The highest association with mortality as well as with cardiovascular diseases, diabetes and rheumatoid arthritis is found for s-CRP above 10 mg/l, which is the arbitrary lower level for the earlier routine low-sensitivity s-CRP methods. The association of s-CRP with serum urate, folate and the ApoB/ApoA1 quotient should be considered.
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Affiliation(s)
- P E Evrin
- Department of Clinical Chemistry, Ryhov Hospital, Jönköping, Sweden
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Stronger relationship between central adiposity and C-reactive protein in older women than men. Menopause 2009; 16:84-9. [DOI: 10.1097/gme.0b013e31817fcb8f] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Flores-Alfaro E, Parra-Rojas I, Salgado-Bernabé AB, Chávez-Maldonado JP, Salazar-Martinez E. Cardiovascular risk evaluated by C-reactive protein levels in diabetic and obese Mexican subjects. Circ J 2008; 72:1170-4. [PMID: 18577830 DOI: 10.1253/circj.72.1170] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Previous studies have reported elevated levels of C-reactive protein (CRP) in obese and diabetic subjects, but it is unclear whether both these conditions have an additive effect on the variability of serum CRP levels. METHODS AND RESULTS The study enrolled 385 men and women who were classified into 4 groups: (1) diabetes (n=97), (2) obesity (n=108), (3) diabetes/obesity (n=78), and (4) healthy (n=102). All were Mexican subjects from Guerrero State. Serum high-sensitivity CRP (hs-CRP) levels were higher in both type 2 diabetes mellitus (T2DM)/obesity and obesity (5.1 mg/L) groups than in the diabetics (1.8 mg/L) without obesity. Only the measurements of obesity were strongly related to hs-CRP (body mass index, r=0.46 and waist circumference, r=0.41). The presence of T2DM and obesity explain 20% of the circulating hs-CRP level, following waist circumference (16%), leukocyte count (10%), diastolic blood pressure (6%), and female gender (4%). Obese subjects (odds ratio (OR)=6.3) and T2DM/obesity patients (OR=6.9) showed high risk for coronary disease and this effect was increased in T2DM/obesity women (OR=9.9). Also, abdominal obesity was associated with high coronary disease risk (OR=5.4), showing an increase in women (OR=7.3). CONCLUSION High hs-CRP levels are related to obesity and central distribution of body fat, leading to a higher cardiovascular risk among Mexican subjects.
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Affiliation(s)
- Eugenia Flores-Alfaro
- Autonomous University of Guerrero, Laboratory of Chronic Diseases, Chilpancingo, Guerrero, Mexico
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Five-year alterations in BMI are associated with clustering of changes in cardiovascular risk factors in a gender-dependant way: the Stanislas study. Int J Obes (Lond) 2008; 32:1279-88. [PMID: 18607382 DOI: 10.1038/ijo.2008.94] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The purpose of the present longitudinal study was to describe the associations between the 5-year changes in body mass index (BMI) and alterations in the clusters of metabolic syndrome (MS)-related factors. METHODS The study population comprised 1099 middle-aged adults drawn from the Stanislas study. Individuals were stratified into four groups according to the 5-year changes in BMI (weight loss (<0 kg/m(2)), and weight gain (0-1, 1-2 and >2 kg/m(2))). Changes in various MS-related variables and clusters were compared between groups: anthropometric indices, blood pressure, lipid and inflammatory markers, liver enzymes, uric acid and the five summary factors extracted by using factor analysis ('risk lipids', 'liver enzymes', 'inflammation', 'protective lipids' and 'blood pressure'). RESULTS There was a strong linear trend between increasing BMI and worsening of risk lipids and blood pressure factors for both men and women (P<or=0.001). In men only, liver enzymes and protective lipids factors were significantly related to the 5-year gain of BMI (P<or=0.001), whereas inflammation factor positively increased across the four BMI-change groups, in women only. Interaction terms for sex were statistically significant for inflammation and liver enzymes clusters. CONCLUSION In our population, there was a strong linear trend between increasing BMI and worsening of various MS-related variables. More interestingly, the identification of five factors associated with BMI changes dependent to gender, support the hypothesis that weight gain, and probably obesity, trigger metabolic mechanisms that differ between men and women.
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C-reactive protein is linked to lower cognitive performance in overweight and obese women. Inflammation 2008; 31:198-207. [PMID: 18347963 DOI: 10.1007/s10753-008-9065-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2008] [Accepted: 02/26/2008] [Indexed: 10/22/2022]
Abstract
Our objective was to ascertain the nature of the associations between C-reactive protein (CRP) and cognition, and to examine how they are affected by gender and obesity. We evaluated 62 females and 63 males between 42 and 82 years of age. There were 20 lean females with a body mass index (BMI) of <25 kg/m2 and 42 overweight or obese females, with BMIs > or =25 kg/m2. There were 14 lean males and 49 with BMIs >/=25 kg/m2. CRP was associated with lower scores on cognitive tests of frontal lobe function among females and these associations were driven by the overweight/obese female group. In these data no associations between CRP and cognition were found among males. Obesity-associated inflammation is much more prominent in females and it appears to be associated with cognitive dysfunction, particularly of frontal lobe tasks.
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Arcari A, Zito F, Di Castelnuovo A, De Curtis A, Dirckx C, Arnout J, Cappuccio FP, van Dongen MCJM, De Lorgeril M, Krogh V, Siani A, Donati MB, De Gaetano G, Iacoviello L. C reactive protein and its determinants in healthy men and women from European regions at different risk of coronary disease: the IMMIDIET Project. J Thromb Haemost 2008; 6:436-43. [PMID: 18036188 DOI: 10.1111/j.1538-7836.2007.02851.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM Differences in C-reactive protein (CRP) levels and its determinants in three European populations at different risk of coronary artery disease (CAD) were studied. METHODS Subjects were recruited randomly in Limburg (Belgium), Abruzzo (Italy) and south-west (SW) London (England). RESULTS Ten-year risk of fatal coronary events (estimated using risk equations provided by the SCORE Project) was lower both in men and women from Abruzzo, intermediate in people from Limburg and higher in subjects from SW London. Within each country, high sensitivity (hs)-CRP levels were higher in the high-risk class in men but not in women. Men from Abruzzo had higher hs-CRP levels than those from Limburg and SW London. Women always had higher hs-CRP levels than men. The strongest hs-CRP determinant was body mass index (BMI, R(2) = 0.14) in women and waist circumference (WC, R(2) = 0.046) in men. The highest hs-CRP levels were observed in subjects with both high BMI and high WC. Metabolic syndrome was associated with high levels of CRP both in men and women, even after adjustment for confounders. DISCUSSION Difference in CRP levels cannot explain the European gradient of CVD risk, although CRP levels are associated with the calculated SCORE risk of fatal coronary events within each country.
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Affiliation(s)
- A Arcari
- Research Laboratories, John Paul II Centre for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso, Italy
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Abdullah SM, Khera A, Leonard D, Das SR, Canham RM, Kamath SA, Vega GL, Grundy SM, McGuire DK, de Lemos JA. Sex differences in the association between leptin and CRP: Results from the Dallas Heart Study. Atherosclerosis 2007; 195:404-10. [PMID: 17141244 DOI: 10.1016/j.atherosclerosis.2006.10.022] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2006] [Revised: 07/31/2006] [Accepted: 10/20/2006] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Higher C-reactive protein (CRP) levels in women compared with men may reflect sex differences in the relationship between obesity and inflammation. We evaluated how the adipokine leptin influenced these relationships. METHODS AND RESULTS Dual energy X-ray absorptometry measurements of fat mass and plasma levels of leptin and CRP were measured in 1188 women and 1102 men from the Dallas Heart Study. Analyses were stratified by sex and a leptin/percent fat index was created to evaluate the association between leptin and CRP independent of fat mass. Women had higher body mass index, percent fat mass, and plasma levels of CRP and leptin. CRP levels correlated with leptin levels in both women (Spearman rho=0.48, p<0.0001) and in men (rho=0.27, p<0.0001). In multivariable models adjusting for confounders including total fat mass, leptin/percent fat index remained significantly associated with logCRP in women (p=0.005), but not in men (p=0.95). A significant interaction was observed between sex and leptin levels on CRP (p(interaction)=0.03). CONCLUSION Leptin was associated with CRP independent of other measures of obesity in women, but not in men. These findings suggest that sex differences in CRP may reflect sex-related differences in the inflammatory responses to obesity, and may in part, be mediated by leptin.
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Affiliation(s)
- Shuaib M Abdullah
- Donald W. Reynolds Cardiovascular Clinical Research Center at the University of Texas Southwestern Medical Center, Dallas, TX 75390-9047, USA.
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The Predictive Value of CRP Levels on Future Severe Renal Disease in Overweight and Obese Subjects Without Diabetes Mellitus and Hypertension. Am J Med Sci 2007; 334:444-51. [DOI: 10.1097/maj.0b013e3180f62b8d] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Chung S, Yoon IY, Shin YK, Lee CH, Kim JW, Lee T, Choi DJ, Ahn HJ. Endothelial dysfunction and C-reactive protein in relation with the severity of obstructive sleep apnea syndrome. Sleep 2007; 30:997-1001. [PMID: 17702269 PMCID: PMC1978380 DOI: 10.1093/sleep/30.8.997] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES To investigate flow-mediated dilatation (FMD) and C-reactive protein (CRP) levels in patients with obstructive sleep apnea syndrome (OSAS) in relation with the severity of respiratory disturbances and hypoxemia. DESIGN After subjects had completed nocturnal polysomnography, FMD was measured in the brachial artery, and blood samples were obtained to determine serum CRP levels. SETTING Sleep laboratory in Seoul National University Bundang Hospital. PATIENTS Ninety men: 22 normal controls, 28 subjects with mild to moderate OSAS, and 40 with severe OSAS. MEASUREMENTS AND RESULTS FMD was found to be correlated with oxygen desaturation index (ODI), percentage of time below 90% O2 saturation, average O2 saturation, lowest O2 saturation, systolic blood pressure, apnea hypopnea index (AHI), and body mass index. In addition, CRP was correlated with body mass index, waist-to-hip ratio, neck circumference, diastolic pressure, average O2 saturation and percentage of time below 90% O2 saturation but not with AHI. Stepwise multiple regression showed that the ODI was a significant determinant of FMD (adjusted R2 = 10%, beta = -0.33, P < 0.01). In addition, body mass index (beta = 0.25, P < 0.05) and waist-to-hip ratio (beta = 0.21, P < 0.05) were found to be significantly correlated with CRP (adjusted R2 = 12%, P < 0.05), independently of other factors. There was no correlation between FMD and CRP. CONCLUSION As a marker of nocturnal hypoxemia, ODI rather than AHI might better explain the relationship between OSAS and FMD. Because body mass index and waist-to-hip ratio were identified as risk factors of high serum CRP in OSAS, obesity should be considered when predicting cardiovascular complications in OSAS.
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Affiliation(s)
| | | | | | | | | | | | - Dong-Ju Choi
- Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
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Sharma SK, Mishra HK, Sharma H, Goel A, Sreenivas V, Gulati V, Tahir M. Obesity, and not obstructive sleep apnea, is responsible for increased serum hs-CRP levels in patients with sleep-disordered breathing in Delhi. Sleep Med 2007; 9:149-56. [PMID: 17638590 DOI: 10.1016/j.sleep.2007.02.004] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2006] [Revised: 02/27/2007] [Accepted: 02/28/2007] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The present study was conducted to evaluate serum levels of high-sensitivity C-reactive protein (hs-CRP) in newly diagnosed patients with obstructive sleep apnea (OSA). SUBJECTS AND METHODS Between April 2005 and March 2006, a total of 231 consecutive adult habitual snorers underwent polysomnography (PSG) in the sleep laboratory. Ninety-seven subjects were found suitable for hs-CRP measurement after application of the following exclusion criteria: patients with diabetes mellitus, hypertension, coronary artery disease, acromegaly, hypothyroidism, chronic renal failure, congestive cardiac failure, or smoking history, patients who were pregnant, on steroid treatment, on hormone replacement therapy, or with chronic use of drugs such as non-steroidal anti-inflammatory drugs, oral anticoagulants and lipid-lowering drugs and patients having undergone upper airway surgery. Patients were classified as apneic [apnea-hypopnea index (AHI)>5], obese non-apneic [body mass index (BMI)>25, AHI<5] and non-obese non-apneic (BMI<25, AHI<5). C-reactive protein levels were measured in stored sera by high-sensitivity enzyme immunoassay (Biocheck, Inc. Foster City, CA, USA). After checking normality with the Kolmogorov-Smirnov test and using a square-root transformation, Pearson's and partial correlation coefficients were calculated for identified risk factors and confounders. A multiple linear regression model was used to identify variables that were independently associated with hs-CRP. RESULTS The mean serum levels of hs-CRP were found to be 0.25+/-0.23, 0.58+/-0.55, and 0.51+/-0.37 mg/dl in non-obese non-apneics (n=23), obese non-apneics (n=45) and apneics (obese and non-obese, n=29), respectively. Pearson's correlation coefficient of hs-CRP with BMI was found to be 0.25 (p=0.01), and with AHI 0.16 (p=0.12). Partial correlation analysis showed that hs-CRP levels correlated significantly with BMI after adjustment for AHI and age (r=0.22, p=0.03), while correlation with disease severity as assessed by AHI after adjustment for BMI and age was not significant (r=0.10, p=0.33). After stepwise multiple linear regression, only BMI was found to be significantly associated with serum hs-CRP levels (beta=0.02, p=0.01). CONCLUSIONS In this first comprehensive cross-sectional study on Indian subjects, we found that obesity, and not obstructive sleep apnea, is associated with elevated serum levels of hs-CRP. No independent correlation was found between severity of OSA and hs-CRP in the present study.
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Affiliation(s)
- S K Sharma
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
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Albert SG, Haas MJ, Mooradian AD. The effects of recombinant human growth hormone (rhGH) supplementation on adipokines and C-reactive protein in obese subjects. Growth Horm IGF Res 2007; 17:19-25. [PMID: 17118687 DOI: 10.1016/j.ghir.2006.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2006] [Revised: 10/09/2006] [Accepted: 10/10/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Obese subjects have functional growth hormone deficiency (GHD). Recombinant human GH (rhGH) treatment of pituitary GHD improves serum levels of leptin, adiponectin and C-reactive protein (CRP). This study was undertaken to determine whether these rhGH-induced changes occur in obese subjects during rhGH supplementation. DESIGN Randomized double-blind placebo-controlled trial of low-dose rhGH (200 microg/day for the first month, then 400 microg/day for men and 600 microg/day for women thereafter) or placebo supplementation as an adjuvant to a standard weight loss program. SUBJECTS Forty healthy obese subjects, 28 premenopausal menstruating women (35+/-7 SD years) and 12 men (37+/-6 years). MEASUREMENTS Body weight, BMI, body composition (assessed by dual energy X-ray absorptiometry [DEXA]), and serum levels of glucose, insulin, IGF-I, IGFBP-3, insulin resistance index (homeostasis modal assessment [HOMA]), leptin, CRP and adiponectin were performed at baseline and at 6 months. RESULTS For similar entry BMI values, women when compared with men had higher percent body fat (BF) (43.5+/-4.6% vs. 29.8+/-4.0%, p<0.001), higher leptin levels (16.9+/-8.4 microg/L vs. 4.2+/-3.0 microg/L, p<0.001), and higher CRP levels (13.8+/-16.8 mg/L vs. 2.4+/-3.2mg/L, p=0.04). Serum levels of leptin and CRP, but not adiponectin, correlated significantly with BF in both sexes. Recombinant human GH treatment increased levels of IGF-I Z-Score between baseline and 6 months (from -0.7+/-0.9 SD to 0.1+/-1.1 SD, p=0.01) and modestly decreased BF (from 38.4+/-7.8% to 35.6+/-7.5%, p=0.046). Despite increased IGF-I, there were no differences between rhGH and placebo with regard to changes in leptin, CRP, or adiponectin. CONCLUSION It is concluded that in obesity, although rhGH treatment significantly increases IGF-I and modestly reduces body fat, the lack of significant changes in serum leptin, adiponectin or CRP levels suggests that rhGH treatment does not have a significant effect on these serum markers of adiposity.
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Affiliation(s)
- Stewart G Albert
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Saint Louis University School of Medicine, 1402 South Grand Blvd., St. Louis, MO 63104, USA.
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Shemesh T, Rowley KG, Jenkins A, Brimblecombe J, Best JD, O'Dea K. Differential association of C-reactive protein with adiposity in men and women in an Aboriginal community in northeast Arnhem Land of Australia. Int J Obes (Lond) 2006; 31:103-8. [PMID: 16682979 DOI: 10.1038/sj.ijo.0803350] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine the relationship between C-reactive protein (CRP), adiposity and other metabolic abnormalities in an Aboriginal community in Northern Australia. DESIGN Cross-sectional analysis of data obtained between 2001 and 2003 from 379 Aboriginal people residing in a geographically isolated community. RESULTS Mean (95% CI) CRP in women and men was 4.06 cholesterol (3.53, 4.66) mg/l and 3.42 (2.94, 3.97) mg/l, respectively (P=NS). The prevalence of the metabolic syndrome (US National Cholesterol Education [corrected] Program (NCEP) definition) was significantly higher for women than men (41 vs 18%, chi (2)=20.94, P<0.001). C-reactive protein correlated strongly with adiposity in women (waist circumference, waist to hip ratio and body mass index; r>/=0.514, P<0.01) but much less strongly in men (r</=0.221, P<0.05). In a multivariate stepwise linear regression model, waist circumference was the strongest independent predictor explaining 35% of CRP concentration variance in women, but only 5.4% in men (WHR). Incremental increases in CRP concentration across four BMI categories were significant in women (P (linear trend)<0.001) but not in men. CONCLUSIONS High CRP levels in the surveyed population are consistent with the high prevalence of vascular disease morbidity and mortality in Aboriginal Australians. The relationship of CRP with increasing body fat was strong and consistent in women but not in men. Prospective studies are needed to elucidate the role of CRP (if any) as a predictive marker for cardiovascular events in this high-risk population.
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Affiliation(s)
- T Shemesh
- Menzies School of Health Research, Royal Darwin Hospital, Rocklands Drive Tiwi, Northern Territory, Australia.
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Araújo F, Antelmi I, Pereira AC, Latorre MDRDO, Grupi CJ, Krieger JE, Mansur AJ. Lower heart rate variability is associated with higher serum high-sensitivity C-reactive protein concentration in healthy individuals aged 46 years or more. Int J Cardiol 2006; 107:333-7. [PMID: 16503254 DOI: 10.1016/j.ijcard.2005.03.044] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2004] [Revised: 03/14/2005] [Accepted: 03/26/2005] [Indexed: 11/26/2022]
Abstract
BACKGROUND To test the hypothesis of an association between cardiac autonomic activity evaluated by heart rate variability and systemic inflammatory markers such as C-reactive protein, we studied the correlation of the indices of heart rate variability relative to serum high-sensitivity C-reactive protein (hs-CRP) in a healthy Brazilian population. METHODS Four hundred twenty-one healthy individuals aged 15-82 years (mean 40.4 years), 184 men (43.7%) and 237 women (56.3%) were enrolled between July 1998 and July 2001. The relationship between the log-transformed indices of the heart rate variability and the serum concentration of hs-CRP were analyzed stratified by age tertile using the Spearman correlation coefficient and multiple linear regression. RESULTS The log standard deviation of all normal sinus RR intervals over 24 h (SDNN) (r = -0.801; p = 0.024) was independently correlated with log hs-CRP in the individuals with age in the oldest tertile (> or = 46 years). In addition, the body mass index (BMI) was independently correlated with hs-CRP in all of the age groups. CONCLUSIONS In the healthy subjects aged 46 years or more the lower heart rate variability correlated with higher concentration of hs-CRP.
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Affiliation(s)
- Fernando Araújo
- Heart Institute (InCor), University of São Paulo Medical School, General Outpatient Clinics, Av. Dr. Enéas de Carvalho Aguiar, 44 05403-000 São Paulo SP, Brazil.
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Hilpert KF, Kris-Etherton PM, West SG. Lipid response to a low-fat diet with or without soy is modified by C-reactive protein status in moderately hypercholesterolemic adults. J Nutr 2005; 135:1075-9. [PMID: 15867284 DOI: 10.1093/jn/135.5.1075] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Recent evidence suggests that individuals with high concentrations of C-reactive protein (CRP), a marker of inflammation, are less responsive to cholesterol-lowering diets. CRP concentrations are increased by oral estrogen; however, the effect of soy phytoestrogens on inflammation has not been studied comprehensively, especially in women receiving hormone replacement therapy (HRT). This study was conducted to determine whether adding soy to a low-fat, high-fiber diet affects CRP and interleukin (IL)-6, and to examine the association between CRP levels and lipid response in moderately hypercholesterolemic adults (men = 18, postmenopausal women = 14; 6 receiving HRT). After a 3-wk run-in period with consumption of a Step I diet (27% total fat, 7% saturated fat, 275 mg cholesterol), participants were randomly assigned to diets containing 25 g/d soy protein (+ 90 mg/d isoflavones) or 25 g/d milk protein for 6 wk in a crossover design. Lipids and lipoproteins, CRP, and IL-6 were measured at the end of each diet and participants were categorized into high (>3.5 mg/L) or low CRP groups based on a median split. The addition of soy or milk protein to the Step I diet did not affect lipids or inflammatory markers. Regardless of protein source, those with low CRP exhibited significant decreases in LDL cholesterol (-3.5%) and the LDL:HDL cholesterol ratio (-4.8%), whereas those with high CRP had significant increases in LDL cholesterol (+4.8%), the LDL:HDL cholesterol ratio (+5.2%), apolipoprotein B (+3.8%), and lipoprotein(a) (+13.5%) compared with the run-in diet. These results suggest that inflammation may not only attenuate lipid responses, but also aggravate dyslipidemia in hypercholesterolemic subjects consuming a cholesterol-lowering diet.
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Affiliation(s)
- Kirsten F Hilpert
- Department of Nutritional Sciences, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA, USA.
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Di Napoli M, Schwaninger M, Cappelli R, Ceccarelli E, Di Gianfilippo G, Donati C, Emsley HCA, Forconi S, Hopkins SJ, Masotti L, Muir KW, Paciucci A, Papa F, Roncacci S, Sander D, Sander K, Smith CJ, Stefanini A, Weber D. Evaluation of C-Reactive Protein Measurement for Assessing the Risk and Prognosis in Ischemic Stroke. Stroke 2005; 36:1316-29. [PMID: 15879341 DOI: 10.1161/01.str.0000165929.78756.ed] [Citation(s) in RCA: 210] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background and Purpose—
Several studies have shown, in different populations, that modest elevation of plasma C-reactive protein (CRP) in the range seen in apparently healthy individuals is a strong predictor of future vascular events. Elevated plasma CRP concentrations are also associated with an increased risk of cerebrovascular events and an increased risk of fatal and nonfatal cardiovascular events in ischemic stroke patients. These epidemiological and clinical observations suggest that determination of plasma CRP concentrations could be used as an adjunct for risk assessment in primary and secondary prevention of cerebrovascular disease and be of prognostic value. The aim of this review is to summarize the evidence for CRP as an independent predictor of cerebrovascular events in at-risk individuals and ischemic stroke patients and to consider its usefulness in evaluating prognosis after stroke.
Summary of Review—
CRP fulfils most of the requirements of a new risk and prognostic predictor, but several issues await further confirmation and clarification before this marker can be included in the routine evaluation of stroke patients and subjects at risk for cerebrovascular disease. Potentially important associations have been established between elevated plasma CRP concentrations and increased efficacy of established therapies, particularly lipid-lowering therapy with statins.
Conclusion—
At present, there is not sufficient evidence to recommend measurement of CRP in the routine evaluation of cerebrovascular disease risk in primary prevention, because there is insufficient evidence as to whether early detection, or intervention based on detection, improves health outcomes, although shared risk of cardiovascular disease indicates this may be of value. In secondary prevention of stroke, elevated CRP adds to existing prognostic markers, but it remains to be established whether specific therapeutic options can be derived from this.
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Francisco G, Hernández C, Chacón P, Mesa J, Simó R. [Factors influencing CRP levels in the diabetic population]. Med Clin (Barc) 2005; 124:336-7. [PMID: 15760600 DOI: 10.1157/13072422] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVE The aim of the present study was to investigate the factors influencing CRP serum levels in the diabetic population. PATIENTS AND METHOD Eighty-six patients with type 2 diabetes mellitus were prospectively included. The following variables were considered: age, gender, smoking habit, body mass index (BMI), glucose, HbA1c, total cholesterol, low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), triglycerides, albumin excretion rate, CRP and E-selectin. RESULTS CRP serum levels were associated with: gender (men: 1.4 mg/L [0.03-12.8] vs. women: 3.4 [0.07-80.7]; p = 0.02), age (r = 0.34, p = 0.001), BMI (r = 0.45, p < 0.001), triglycerides (r = 0.24, p = 0.03) and E-selectin (r = 0.21, p = 0.02). Those patients with at least one component of the metabolic syndrome, besides diabetes mellitus, had higher CRP concentrations in comparison with those patients without other components of the metabolic syndrome (2.4 mg/L [0.3-23.1] vs. 4.2 mg/L [0.6-80.7]; p = 0.05). In the multivariate analysis, gender (p = 0.001) and BMI (p = 0.01) were independently associated with the CRP concentration. CONCLUSIONS Gender and BMI are the main factors to be considered when analyzing CRP levels in the diabetic population. Metabolic syndrome components other than diabetes are related to CRP levels in type 2 diabetic patients.
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Affiliation(s)
- Gemma Francisco
- Sección de Endocrinología, Hospital Univesitari Vall d'Hebron, Barcelona, España
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Abstract
Although most patients who experience a coronary heart disease (CHD) event have one or more of the conventional risk factors for atherosclerosis, so do many people who have not yet experienced such an event. Therefore, predictive models based on conventional risk factors have a lower than desired accuracy, providing a stimulus to search for new tools to refine CHD risk prediction. In particular, there is intense interest in evaluating circulating biomarkers related to the atherosclerotic process that might add to our ability to better predict CHD risk. One such group of biomarkers was termed conditional risk factors in an American Heart Association/American College of Cardiology statement in 1999. The conditional risk factors include homocysteine, fibrinogen, lipoprotein(a), low-density lipoprotein particle size, and C-reactive protein. This review updates the conditional risk factors. The main focus is on the potential utility of these risk factors, which are currently available to clinicians, in the prediction of CHD risk in asymptomatic persons. The putative mechanisms of risk, available assays, evidence for association with CHD, and the clinical implications thereof are discussed for each of the risk factors.
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Affiliation(s)
- Iftikhar J Kullo
- Department of Internal Medicine and Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA.
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Coulon J, Willems D, Dorchy H. Augmentation de la concentration plasmatique de la protéine C-réactive dans le diabète de l’enfant et de l’adulte jeune. Presse Med 2005; 34:89-93. [PMID: 15687975 DOI: 10.1016/s0755-4982(05)88234-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To investigate whether high sensitivity C-reactive protein (hs CRP) levels are elevated in young type 1 diabetic patients and to determine the relationships with age, degree of metabolic control determined by glycated hemoglobin (HbA1c), blood lipids, and subclinical complications. METHODS High sensitivity CRP was determined in young type 1 diabetic patients and in healthy controls. Blood lipids and HbA1c were also determined. The patients were divided into 2 groups. In group A, patients were free from subclinical complications (retinopathy, nephropathy and neuropathy) and in group B, patients had at least one subclinical complication. RESULTS The hs CRP concentrations were significantly higher in the 126 diabetic patients (55 girls and 71 boys) than in the 52 controls (2.6+/-4mg/L vs 0.7+/-0.7mg/L; p<0.001). This difference persisted when comparing the normal subjects with the 81 patients of group A (2.0+/-3.1mg/L; p<0.01) and the 45 patients of group B (3.6+/-5.1mg/L; p<0.001). The hs CRP concentrations were significantly correlated with total cholesterol, total cholesterol/HDL-cholesterol ratio, and LDL cholesterol for the 2 groups of patients. In the patients of group A, significant correlations were observed between hs CRP and age or duration of diabetes. No correlation was observed between hs CRP levels and glycaemia, HbA1c and HDL-cholesterol in the two groups of patients. CONCLUSION Levels of hs CRP were 3-fold greater in diabetic patients without complications than in controls and 5-fold greater in diabetic patients with subclinical complications. High sensitive CRP therefore appears to be an interesting indicator of the risk for developing complications.
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Affiliation(s)
- J Coulon
- Clinique de diabétologie, Hôpital universitaire des Enfants Reine Fabiola, Bruxelles, Belgique
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Araújo F, Pereira AC, Latorre MDRDO, Krieger JE, Mansur AJ. High-sensitivity C-reactive protein concentration in a healthy Brazilian population. Int J Cardiol 2004; 97:433-8. [PMID: 15561330 DOI: 10.1016/j.ijcard.2003.10.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2003] [Revised: 10/09/2003] [Accepted: 10/14/2003] [Indexed: 11/20/2022]
Abstract
BACKGROUND The use of serum high-sensitivity C-reactive protein (hs-CRP) for cardiovascular risk profiling requires knowledge of the distribution in different populations. We studied serum hs-CRP in a healthy Brazilian population, with no evidence of heart disease, relative to gender and smoking status as well as other clinical and laboratory variables. METHODS 684 healthy Brazilian individuals, aged 14-74 years (mean 40.6 years), 295 men (43.1%) and 389 women (56.9%), were enrolled between July 1998 and July 2001. The relationship between the log-transformed hs-CRP, stratified by gender and smoking status (non-smokers, smokers), and clinical and laboratory variables were analyzed using the Spearman correlation coefficient and multiple linear regression. RESULTS In a multiple linear regression model age (beta=1.0069, p=0.03), body mass index (BMI) (beta=1.0093, p<0.01), total cholesterol/HDL cholesterol ratio (TC/HDL-C) (beta=1.1015, p<0.01) and heart rate (beta=1.0139, p<0.01) were independently correlated with hs-CRP. Stratification according to gender and smoking was able to disclose different interactions between these variables and hs-CRP. Variables significantly correlated in each stratum were as follows: in smoker men, age (beta=1.0236, p=0.04) and TC/HDL-C (beta=1.2065, p<0.01); in non-smoker men, BMI (beta=1.0786, p<0.01) and TC/HDL-C (beta=1.1397, p=0.01); in smoker women, BMI (beta=1.1006, p=0.03); and in non-smoker women, BMI (beta=1.0873, p<0.01), TC/HDL-C (beta=1.1405, p=0.01) and heart rate (beta=1.0165, p=0.02). CONCLUSIONS The clinical and laboratory variables studied influenced the concentration of hs-CRP according to gender and smoking. In assessing the risk of cardiovascular events in relation to serum hs-CRP level, stratification by gender and smoking status is indicated.
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Affiliation(s)
- Fernando Araújo
- Heart Institute (InCor), University of São Paulo Medical School, General Outpatient Clinics, Av. Dr. Enéas de Carvalho Aguiar, 44, 05403-000 São Paulo, SP, Brazil.
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Chase HP, Cooper S, Osberg I, Stene LC, Barriga K, Norris J, Eisenbarth GS, Rewers M. Elevated C-reactive protein levels in the development of type 1 diabetes. Diabetes 2004; 53:2569-73. [PMID: 15448085 DOI: 10.2337/diabetes.53.10.2569] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Elevated C-reactive protein (CRP) levels have previously been described before the onset of type 2 diabetes and gestational diabetes. We hypothesized that inflammation, as reflected by elevated CRP levels, can help predict development of islet autoimmunity or type 1 diabetes. Children at risk for type 1 diabetes and followed in the Diabetes Autoimmunity Study of the Young (DAISY) had blood samples drawn and frozen serum saved at various intervals after birth. CRP was measured using a high-sensitivity sandwich enzyme immunoassay. Islet autoantibodies (IAs) were measured using biochemical immunoassays. Elevations in CRP concentrations were significantly more frequent (P < 0.01) in children who later developed type 1 diabetes (8 of 16 children) than in children negative for IAs at their last testing (3 of 26). Children with one or more positive IA were more likely to have elevated CRP concentrations (15 of 36) than IA-negative children (3 of 26; P < 0.01). The finding of elevated CRP levels in infants and young children before the onset of type 1 diabetes adds to the evidence that the disease is an immunoinflammatory disorder. The elevated CRP levels may provide an additional marker for risk of progression to type 1 diabetes.
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Affiliation(s)
- H Peter Chase
- Department of Pediatrics, The Barbara Davis Center for Childhood Diabetes, Denver, Colorado, USA.
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Maachi M, Piéroni L, Bruckert E, Jardel C, Fellahi S, Hainque B, Capeau J, Bastard JP. Systemic low-grade inflammation is related to both circulating and adipose tissue TNFalpha, leptin and IL-6 levels in obese women. Int J Obes (Lond) 2004; 28:993-7. [PMID: 15211360 DOI: 10.1038/sj.ijo.0802718] [Citation(s) in RCA: 266] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE We assessed the relationships between four circulating acute phase proteins and the circulating and adipose tissue levels of three adipocytokines. SUBJECTS In all, 15 nondiabetic obese women with a body mass index (BMI) above 32 kg/m(2) were investigated. METHOD Circulating concentrations of C-reactive protein (CRP), alpha 1 acid glycoprotein (AAG), fibrinogen, alpha 1 antitrypsin and both circulating and adipose tissue levels of interleukin (IL)-6, tumor necrosis factor (TNF)alpha and leptin were measured by either nephelometry or enzyme-linked immunosorbent assay. RESULTS We found a strong positive correlation between both circulating and adipose tissue levels of IL-6, TNFalpha and leptin and serum CRP levels. All these adipose tissue adipocytokines were also positively correlated with serum AAG levels. These correlations disappeared when adjusted for fat mass, suggesting that the relationship observed was dependent on fat amount. CONCLUSION Our results indicate a strong relationship between adipocytokines and inflammatory markers, and suggest that cytokines secreted by adipose tissue in obese subjects could play a role in increased inflammatory proteins secretion by the liver.
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Affiliation(s)
- M Maachi
- Service de Biochimie et Hormonologie, Hôpital Tenon, AP-HP, France
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Suarez EC. C-reactive protein is associated with psychological risk factors of cardiovascular disease in apparently healthy adults. Psychosom Med 2004; 66:684-91. [PMID: 15385692 DOI: 10.1097/01.psy.0000138281.73634.67] [Citation(s) in RCA: 111] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The current study examined the relation of anger, hostility, and severity of depressive symptoms, alone and in combination, to C-reactive protein (CRP) in healthy men and women. METHODS A high sensitivity enzyme linked immuno sorbent assay (ELISA) was used to evaluate CRP levels in a multiethnic sample of 127 healthy, nonsmoking men and women. Fasting blood samples were collected the same day the assessments were done of anger and hostility using the Buss-Perry Aggression Questionnaire (BPAQ) and depressive symptomatology using the Beck Depression Inventory (BDI). A psychological risk factor (PRF) score representing a composite summary indicator of BDI and BPAQ-anger and -hostility was generated using principal component analysis. Log-transformed CRP values were examined using univariate and multivariate analyses adjusting for control variables of age, gender, body mass index (BMI), alcohol use, exercise frequency, ratio of total to high-density lipoprotein cholesterol, and family history of premature coronary heart disease (CHD). RESULTS Log-normalized CRP was correlated with BDI (r = 0.21, p =.02) and BPAQ anger (r = 0.20, p =.02), but not with BPAQ hostility. After adjustment for control variables, BDI (beta = 0.05, p =.011), BPAQ anger (beta = 0.05, p =.007), and the PRF composite score (beta = 0.27, p =.005), but not BPAQ hostility (beta = 0.03, p =.11), were significantly associated with log-normalized CRP. CONCLUSIONS Greater anger and severity of depressive symptoms, separately and in combination with hostility, were significantly associated with elevations in CRP in apparently healthy men and women. These associations were independent of potential confounding factors.
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Affiliation(s)
- Edward C Suarez
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA.
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