Biomarkers are early predictors of various disorders, circulating level of C-reactive protein is a sensitive biomarker of systemic inflammation and may also be associated with the development of diabetic, hepatic, and...Biomarkers are early predictors of various disorders, circulating level of C-reactive protein is a sensitive biomarker of systemic inflammation and may also be associated with the development of diabetic, hepatic, and cardiovascular diseases. In the present study, we aimed to investigate the association between circulating levels of high sensitive C-reactive protein (hs-CRP) and various biomarkers for hepatic, diabetic, and cardiovascular health. The retrospective analysis included 438 individuals who were tested for these panels simultaneously at Vibrant America Clinical Laboratory. The study population included free-living individuals without any preexisting clinical conditions. Among the cardiovascular markers, a positive correlation and significant association was found between high levels of hs-CRP and serum levels of triglycerides (r = 0.0964, p −0.1423, p −0.1216, p < 0.0105) with circulating levels of hs-CRP. Among all the diabetic markers, glucose (r = 0.1547, p < 0.0011) and glycated serum protein (r = 0.1725, p < 0.0003) were positively correlated with circulating hs-CRP. In the hepatic panel, AST, a transaminase that plays a vital role in amino acid metabolism, was found to have a strong positive correlation with hs-CRP (r = 0.2139, p < 0.0001). In conclusion, the results clearly show the association of hs-CRP with diabetic, hepatic, and cardiovascular risk factors indicating its central value as a key marker for several lifestyle-associated disorders.展开更多
1 Introduction Inflammation is one of the main mechanisms in the pathogenesis of atherosclerosis,and the interest to the evaluation of inflammatory biomarkers in coronary artery disease(CAD)has been increasing over th...1 Introduction Inflammation is one of the main mechanisms in the pathogenesis of atherosclerosis,and the interest to the evaluation of inflammatory biomarkers in coronary artery disease(CAD)has been increasing over the last decade.[1,2]Destabilization of chronic artery plaques,which leads to acute coronary syndromes,has been associated with inflammatory status.[1,3]。展开更多
Background Coronary artery disease(CAD)remains a leading cause of morbidity and mortality.Cytokines play a potential role in atherosclerosis pathogenesis and progression.We investigated the association between high se...Background Coronary artery disease(CAD)remains a leading cause of morbidity and mortality.Cytokines play a potential role in atherosclerosis pathogenesis and progression.We investigated the association between high sensitive C-reactive protein(hs CRP)and severity of CAD.Methods CAD patients were stratified according to hs CRP cut-off value into high levels hs CRP group(≥8.4 mg/L)and low levels hs CRP group(<8.4 mg/L).Severity of CAD was assessed according to artery stenosis degree and the number of vessel involved.Statistical analysis was performed using Statistical Package for the Social Sciences(SPSS,version 23.0).Results The mean age was 60.3±11.0 years.The level of hs CRP was increased and ranged from 0.2 to 1020.0 mg/L.Biochemical risk factors and severity of CAD didn’t show significant differences between the two groups.In multivariate linear analysis,cardiac troponin I(c Tn I)and serum amyloid A(SAA)were predictors of hs CRP.As shown in receiver operating characteristic(ROC)curve analysis performed in patients with ST-segment elevation myocardial infarction(STEMI)and compared to myonecrosis biomarkers,hs CRP(area under the curve(AUC):0.905;95%CI:0.844-0.966;P<0.001)could be a powerful predictor marker in evaluating the infarct size after myocardial infarction but not better than c Tn I.Conclusions Hs CRP levels were not associated with the severity of CAD but could be useful in the evaluation of myocardial necrosis in patients with STEMI.展开更多
Background: Research has shown that high-sensitivity C-reactive protein (hs-CRP) is a major inflammatory marker for prediction of acute coronary syndrome (ACS). Myeloperoxidase (MPO) also plays an important role in at...Background: Research has shown that high-sensitivity C-reactive protein (hs-CRP) is a major inflammatory marker for prediction of acute coronary syndrome (ACS). Myeloperoxidase (MPO) also plays an important role in atherosclerosis initiation and development. In present study, the major adverse cardiovascular events (MACEs) of patients with coronary heart disease (CHD) were investigated. Methods: MPO, hs-CRP and ACS-related risk factors from 201 ACS (78 AMI and 123 UAP) and 210 non-ACS (84 SAP and 126 non-CHD) patients confirmed by coronary angiography were detected, and the data were analyzed with receiver operating characteristic (ROC) curve and Spearman’s correlation coefficients. MACEs of 285 CHD patients were investigated during the 4-year period follow-up from March 2010 to May 2014. Results: The areas under ROC curve for diagnosing ACS were 0.888 (95% CI 0.843 - 0.933) for MPO, and 0.862 (95% CI 0.815-0.910) for hs-CRP, respectively. There were significantly correlations between MPO and hs-CRP in both ACS and non-ACS groups. Regarding to ACS patients, both MPO and hs-CRP were positively correlated with BMI, TC, TG, LDL-C and Hcy. Prospective study demonstrated that the incidences of MACEs associated significantly with elevated MPO baseline level (yes vs no, OR 7.383, 95% CI 4.095 - 13.309) and high hs-CRP baseline level (yes vs no, OR 4.186, 95% CI 2.469 - 7.097) in CHD patients. Conclusions: The present study provides the epidemiological evidence that elevated baseline MPO and hs-CRP levels are both valuable predictors of MACEs in CHD patients. MPO and hs-CRP would prompt the progression of atherosclerosis and development from SAP to ACS.展开更多
This study was undertaken to investigate the correlation of the enhancement degree on contrast-enhanced ultrasound(CEUS) with the histopathology of carotid plaques and the serum high sensitive C-reactive protein(hs-CR...This study was undertaken to investigate the correlation of the enhancement degree on contrast-enhanced ultrasound(CEUS) with the histopathology of carotid plaques and the serum high sensitive C-reactive protein(hs-CRP) levels in patients undergoing carotid endarterectomy(CEA). Carotid CEUS was performed preoperatively in 115 patients who would undergo CEA, and the enhancement degree of the carotid plaques was evaluated by both the visual semiquantitative analysis and the quantitative time-intensity curve analysis. Serum hs-CRP levels were detected using the particle-enhanced immunoturbidimetric assay also before the operation. Additionally, the carotid plaque samples were subjected to histopathological examination postoperatively. The density of neovessels and the number of macrophages in the plaques were assessed by immunohistochemistry. The results showed that among the 115 patients, grade 0 plaque contrast enhancement was noted in 35 patients, grade 1 in 48 patients and grade 2 in 32 patients. The degree of plaque enhancement, the density of neovessels, the number of macrophages, and the hs-CRP levels were highest in the grade 2 patients. Correlation analysis showed that the enhancement degree of the carotid plaques was closely related to the immunohistochemical parameters of the plaques and the serum hs-CRP levels. It was suggested that the carotid plaque enhancement on CEUS can be used to evaluate the vulnerability of carotid plaques.展开更多
Background The relationship between inflammatory markers and the characteristics of coronary atherosclerosis plaques is uncertain. The aim of the present study was to evaluate the relationship between the characterist...Background The relationship between inflammatory markers and the characteristics of coronary atherosclerosis plaques is uncertain. The aim of the present study was to evaluate the relationship between the characteristics of coronary atherosclerosis plaques and inflammatory markers such as high sensitivity C-reactive proteins (Hs-CRP) and interleukin-6 (IL-6). Methods All patients suspected of having coronary heart disease (CHD) underwent Siemens 64-slice CT angiography (64-SCTA) to distinguish the quality of plaque of coronary artery lesions. Blood samples were taken to measure levels of serum Hs-CRP and IL-6 in different plaque groups and the control group and compared with the value of 64-SCTA for detection of coronary artery plaque. Results The sensitivity of detecting coronary artery plaque by 64-SCTA was 87.4%, the specificity was 87.1%, the positive predictive value was 82.2%, and the negative predictive value was 91.0%. Comparing the levels of serum Hs-CRP and IL-6 among plaque groups, the mean levels of serum Hs-CRP and IL-6 in three plaque groups were significantly higher than those in the control group (P 〈0.01). The mean levels of serum Hs-CRP and IL-6 in the soft plaque group and mixed plaque group were significantly higher than those in hard plaque group (P〈0.01). Plaque burden in the soft plaque group and mixed plaque group was significantly higher than in the hard plaque group (P 〈0.01), but there was no statistical difference between the soft plaque group and mixed plaque group (P=-0.246). There was a negative correlation between the CT scale and Hs-CRP and IL-6 levels in the soft plaque group (r= -0.621, P〈0.01, and r= -0.593, P 〈0.01 respectively). There was a positive correlation between the plaque burden and Hs-CRP and IL-6 levels in the soft plaque group (r=0.579, P〈0.05 and r=0.429, P〈0.05 respectively). Conclusions 64-SCTA is an effective way to distinguish the different quality of coronary atherosclerosis plaque. Serum Hs-CRP and IL-6 levels can be considered as the indexes to judge the degree of CHD and may reflect the activity of plaque in CHD patients. Thus it is important for clinical diagnosis and risk evaluation of acute coronary syndrome (ACS) patients.展开更多
Background Inflammation within vulnerable coronary plaques may cause unstable angina by promoting rupture and erosion. C-reactive protein (CRP) is the most reliable and accessible test method for clinical use for id...Background Inflammation within vulnerable coronary plaques may cause unstable angina by promoting rupture and erosion. C-reactive protein (CRP) is the most reliable and accessible test method for clinical use for identifying coronary artery disease event. Matrix metalloproteinase 9 (MMP-9) is highly over-expressed in the vulnerable regions of a plaque. Our aim was to evaluate the plasma levels of MMP-9 and hsCRP in subjects with both unstable angina and coronary plaques, as well as in those with unstable angina without coronary plaques.展开更多
Background Many clinical studies suggest the inverse relationship between testosterone levels and insulin sensitivity in men, however the causative relationship of these two events is still not determined. The purpose...Background Many clinical studies suggest the inverse relationship between testosterone levels and insulin sensitivity in men, however the causative relationship of these two events is still not determined. The purpose of this study was to investigate the effects of testosterone replacement therapy (TRT) on insulin sensitivity, body composition, serum lipid profiles and high sensitivity C-reactive protein (hsCRP) in hypogonadotropic hypogonadal (HH) puberty undeveloped male patients. Methods In this prospectively designed study, we compared homeostasis model assessment of insulin resistance (HOMA-IR), insulin areas under the curves (AUC) of 3-hour oral glucose tolerance test (OGTT) and other metabolic parameters between 26 HH patients and 26 healthy men. The patients' HOMA-IR, insulin AUC, body composition, lipid profiles, hsCRP and other parameters were compared before and after nine-month TRT. Results The average levels of total testosterone (TT) in HH and healthy group were (0.9±0.6) nmol/L and (18.8±3.4) nmol/L, respectively. HOMA-IR in HH group was significantly higher than the healthy group (5.14±5.16 vs 2.00±1.38, P 〈0.005). Insulin AUC in 3-hour OGTT in HH group was significantly higher than the healthy group (698.6±414.7 vs 414.2±267.5, P 〈0.01). Fasting glucose level in H H group was significantly higher than control group ((5.1±0.6) mmol/L vs (4.7±0.3) mmol/l, P 〈0.005). Height, weight and grasp strength of the patients were significantly increased after 9-month TRT. Significant reductions in HOMA-IR (from 5.14±5.16 to 2.97±2.16, P 〈0.01), insulin AUC (from 698.6±414.7 to 511.7±253.9, P 〈0.01) and hsCRP (from (1.49±1.18) mg/L to (0.70±0.56) mg/L, P 〈0.05) were found after TRT. Serum total cholesterol, LDL-C, HDL-C and triglyceride were all decreased, albeit with no significant difference compared to the level prior to TRT. Conclusions HOMA-IR, insulin AUC and fasting glucose level in HH young male patients were significantly higher than those of the control group, which suggests that low level of testosterone in male adolescents might be a risk factor for insulin resistance. TRT can significantly improve patients' insulin sensitivity and suppress serum hsCRP, which in return suggests that TRT may prevent the HH patients from developing diabetes mellitus and cardiovascular diseases (CVD) in future.展开更多
AIM: To evaluate the high sensitivity C-reactive protein(hs CRP), Fetuin-A and matrix γ-carboxyglutamate protein(MGP) as the main factors for vascular calcification and inflammation in serum of patients with advanced...AIM: To evaluate the high sensitivity C-reactive protein(hs CRP), Fetuin-A and matrix γ-carboxyglutamate protein(MGP) as the main factors for vascular calcification and inflammation in serum of patients with advanced age-related macular degeneration(ARMD) in comparison to healthy controls. METHODS: The subjects were 40 patients with choroidal neovascularization(CNV) having a mean age of70.9 ±9.1y and a matched group of 49 apparently healthy control subjects. The ARMD was diagnosed using a slitlamp with superfield lens, fundus photography and fluorescein angiography. Measurement of hs CRP was done by nephelometry method. Levels of Fetuin-A and MGP were measured by enzyme-linked immunosorbent assay(ELISA) technique.RESULTS: hs CRP [0.45(0.07-2.63) mg/L vs 0.25(0.03-1.2) mg/L, P =0.02)] and Fetuin-A levels(50.27 ±5.04 vs44.99±10.28 ng/m L, P =0.009) were higher in the patients than in the control groups. We could not find significant difference in MGP level between two groups(P =0.08).There was not a significant correlation between MGP with Fetuin-A and hs CRP among the patients(P =0.7, P =0.9respectively). A significant negative correlation of hs CRP with Fetuin-A was observed in both case and control groups(P =0.004, r =-0.33 and P =0.001, r =-0.54,respectively).CONCLUSION: Although our study shows that serum hs CRP and Fetuin-A is increased in CNV patients as well as negatively correlated with both study groups, their direct role on pathogenesis of ARMD required future studies.展开更多
Background The role of plasma high sensitivity C-reactive protein (hs-CRP) in in-stent restenosis (ISR) remains controversial. We investigated plasma hs-CRP level at both admission and follow-up in patients with s...Background The role of plasma high sensitivity C-reactive protein (hs-CRP) in in-stent restenosis (ISR) remains controversial. We investigated plasma hs-CRP level at both admission and follow-up in patients with stable angina (SA)after successful coronary stenting in order to clarify the predictive value of hs-CRP for ISR.Methods We summarized 303 consecutive chronic SA patients with coronary drug-eluting stent (DES) implantation.The ISR was analyzed by quantitative coronary analysis (QCA) at a mean follow-up of 8 months, and the patients were divided into two groups according to the detected ISR as ISR group (n=48) and non-ISR group (n=255). Plasma hs-CRP was examined at both admission and 8-month follow-up in all patients, standard medication continued throughout the investigation period.Results QCA presented that 48 patients (15.8%) suffered from ISR at follow-up. The basic clinical characteristics were similar between the two groups, while plasma hs-CRP was higher in ISR group than that in non-ISR group at both admission and follow-up, P 〈0.001 respectively. Multivariate regression analysis indicated that plasma hs-CRP level at either admission or follow-up could independently predict ISR occurrence (OR=5.581, 95% Cl 2.532-12.302, P〈0.001and OR=6.299, 95% CI 2.722-14.577, P 〈0.001, respectively).Conclusions Our data indicate that plasma hs-CRP level may independently predict ISR at both admission and follow-up in SA patients with coronary DES implantation, which implies that a chronic, sustained systemic inflammatory response might be involved in ISR pathogenesis.展开更多
Background: Quantifying ten-year cardiovascular risk can be challenging. Different online risk calculators provide different risk estimates and online risk calculators use only one point in time. However, risk factors...Background: Quantifying ten-year cardiovascular risk can be challenging. Different online risk calculators provide different risk estimates and online risk calculators use only one point in time. However, risk factors occur over the lifetime of the individual. Purpose: This manuscript provides three solutions to improving ten-year cardiovascular risk assessment in individuals at intermediate risk. Methods: Measuring Lipoprotein(a)—Lp(a) is recommended for assessing cardiovascular risk in all individuals who are in the intermediate risk category by standard online risk calculators. Lp(a) is primarily determined by genetic inheritance. It has the undesirable properties of being proatherosclerotic, proinflammatory, and prothrombotic. Measuring apolipoprotein B (apo B) provides a good index of the number of atherosclerotic particles present. Studies have demonstrated that small, dense LDL cholesterol particles are more atherogenic than larger, less dense LDL cholesterol particles. Measuring high sensitivity C-reactive protein (hsCRP) provides a good estimation of the degree of inflammation in the vascular system. Inflammation is a critical component of heart attacks and strokes. It is increased in diabetes and obesity. Treatment to reduce inflammation results in a reduction of cardiovascular events, independent of lipid values. Results: The above three risk factors should be measured in all patients with an intermediate risk score. Routine assays are readily available at a reasonable cost. They are independent risk factors for cardiovascular disease. Their recommendation is based on the pathophysiology of atherosclerotic cardiovascular disease. Successful therapy will result in the decrease of each of these risk factors. Conclusion: The recommended approach will improve the assessment of cardiovascular risk and guide the physician and patient to the correct treatment recommendations.展开更多
文摘Biomarkers are early predictors of various disorders, circulating level of C-reactive protein is a sensitive biomarker of systemic inflammation and may also be associated with the development of diabetic, hepatic, and cardiovascular diseases. In the present study, we aimed to investigate the association between circulating levels of high sensitive C-reactive protein (hs-CRP) and various biomarkers for hepatic, diabetic, and cardiovascular health. The retrospective analysis included 438 individuals who were tested for these panels simultaneously at Vibrant America Clinical Laboratory. The study population included free-living individuals without any preexisting clinical conditions. Among the cardiovascular markers, a positive correlation and significant association was found between high levels of hs-CRP and serum levels of triglycerides (r = 0.0964, p −0.1423, p −0.1216, p < 0.0105) with circulating levels of hs-CRP. Among all the diabetic markers, glucose (r = 0.1547, p < 0.0011) and glycated serum protein (r = 0.1725, p < 0.0003) were positively correlated with circulating hs-CRP. In the hepatic panel, AST, a transaminase that plays a vital role in amino acid metabolism, was found to have a strong positive correlation with hs-CRP (r = 0.2139, p < 0.0001). In conclusion, the results clearly show the association of hs-CRP with diabetic, hepatic, and cardiovascular risk factors indicating its central value as a key marker for several lifestyle-associated disorders.
基金Supported by the Ministry of Science and Higher Education grant(#MD-2314.2020.7).The authors declare no conflict of interest.
文摘1 Introduction Inflammation is one of the main mechanisms in the pathogenesis of atherosclerosis,and the interest to the evaluation of inflammatory biomarkers in coronary artery disease(CAD)has been increasing over the last decade.[1,2]Destabilization of chronic artery plaques,which leads to acute coronary syndromes,has been associated with inflammatory status.[1,3]。
基金funded by research organizations in Tunisia(Ministry of Public Health and Ministry of Higher Education and Scientific Research)。
文摘Background Coronary artery disease(CAD)remains a leading cause of morbidity and mortality.Cytokines play a potential role in atherosclerosis pathogenesis and progression.We investigated the association between high sensitive C-reactive protein(hs CRP)and severity of CAD.Methods CAD patients were stratified according to hs CRP cut-off value into high levels hs CRP group(≥8.4 mg/L)and low levels hs CRP group(<8.4 mg/L).Severity of CAD was assessed according to artery stenosis degree and the number of vessel involved.Statistical analysis was performed using Statistical Package for the Social Sciences(SPSS,version 23.0).Results The mean age was 60.3±11.0 years.The level of hs CRP was increased and ranged from 0.2 to 1020.0 mg/L.Biochemical risk factors and severity of CAD didn’t show significant differences between the two groups.In multivariate linear analysis,cardiac troponin I(c Tn I)and serum amyloid A(SAA)were predictors of hs CRP.As shown in receiver operating characteristic(ROC)curve analysis performed in patients with ST-segment elevation myocardial infarction(STEMI)and compared to myonecrosis biomarkers,hs CRP(area under the curve(AUC):0.905;95%CI:0.844-0.966;P<0.001)could be a powerful predictor marker in evaluating the infarct size after myocardial infarction but not better than c Tn I.Conclusions Hs CRP levels were not associated with the severity of CAD but could be useful in the evaluation of myocardial necrosis in patients with STEMI.
文摘Background: Research has shown that high-sensitivity C-reactive protein (hs-CRP) is a major inflammatory marker for prediction of acute coronary syndrome (ACS). Myeloperoxidase (MPO) also plays an important role in atherosclerosis initiation and development. In present study, the major adverse cardiovascular events (MACEs) of patients with coronary heart disease (CHD) were investigated. Methods: MPO, hs-CRP and ACS-related risk factors from 201 ACS (78 AMI and 123 UAP) and 210 non-ACS (84 SAP and 126 non-CHD) patients confirmed by coronary angiography were detected, and the data were analyzed with receiver operating characteristic (ROC) curve and Spearman’s correlation coefficients. MACEs of 285 CHD patients were investigated during the 4-year period follow-up from March 2010 to May 2014. Results: The areas under ROC curve for diagnosing ACS were 0.888 (95% CI 0.843 - 0.933) for MPO, and 0.862 (95% CI 0.815-0.910) for hs-CRP, respectively. There were significantly correlations between MPO and hs-CRP in both ACS and non-ACS groups. Regarding to ACS patients, both MPO and hs-CRP were positively correlated with BMI, TC, TG, LDL-C and Hcy. Prospective study demonstrated that the incidences of MACEs associated significantly with elevated MPO baseline level (yes vs no, OR 7.383, 95% CI 4.095 - 13.309) and high hs-CRP baseline level (yes vs no, OR 4.186, 95% CI 2.469 - 7.097) in CHD patients. Conclusions: The present study provides the epidemiological evidence that elevated baseline MPO and hs-CRP levels are both valuable predictors of MACEs in CHD patients. MPO and hs-CRP would prompt the progression of atherosclerosis and development from SAP to ACS.
基金supported by the Natural Science Foundation of Zhejiang Province,China(No.LY13H180007)
文摘This study was undertaken to investigate the correlation of the enhancement degree on contrast-enhanced ultrasound(CEUS) with the histopathology of carotid plaques and the serum high sensitive C-reactive protein(hs-CRP) levels in patients undergoing carotid endarterectomy(CEA). Carotid CEUS was performed preoperatively in 115 patients who would undergo CEA, and the enhancement degree of the carotid plaques was evaluated by both the visual semiquantitative analysis and the quantitative time-intensity curve analysis. Serum hs-CRP levels were detected using the particle-enhanced immunoturbidimetric assay also before the operation. Additionally, the carotid plaque samples were subjected to histopathological examination postoperatively. The density of neovessels and the number of macrophages in the plaques were assessed by immunohistochemistry. The results showed that among the 115 patients, grade 0 plaque contrast enhancement was noted in 35 patients, grade 1 in 48 patients and grade 2 in 32 patients. The degree of plaque enhancement, the density of neovessels, the number of macrophages, and the hs-CRP levels were highest in the grade 2 patients. Correlation analysis showed that the enhancement degree of the carotid plaques was closely related to the immunohistochemical parameters of the plaques and the serum hs-CRP levels. It was suggested that the carotid plaque enhancement on CEUS can be used to evaluate the vulnerability of carotid plaques.
文摘Background The relationship between inflammatory markers and the characteristics of coronary atherosclerosis plaques is uncertain. The aim of the present study was to evaluate the relationship between the characteristics of coronary atherosclerosis plaques and inflammatory markers such as high sensitivity C-reactive proteins (Hs-CRP) and interleukin-6 (IL-6). Methods All patients suspected of having coronary heart disease (CHD) underwent Siemens 64-slice CT angiography (64-SCTA) to distinguish the quality of plaque of coronary artery lesions. Blood samples were taken to measure levels of serum Hs-CRP and IL-6 in different plaque groups and the control group and compared with the value of 64-SCTA for detection of coronary artery plaque. Results The sensitivity of detecting coronary artery plaque by 64-SCTA was 87.4%, the specificity was 87.1%, the positive predictive value was 82.2%, and the negative predictive value was 91.0%. Comparing the levels of serum Hs-CRP and IL-6 among plaque groups, the mean levels of serum Hs-CRP and IL-6 in three plaque groups were significantly higher than those in the control group (P 〈0.01). The mean levels of serum Hs-CRP and IL-6 in the soft plaque group and mixed plaque group were significantly higher than those in hard plaque group (P〈0.01). Plaque burden in the soft plaque group and mixed plaque group was significantly higher than in the hard plaque group (P 〈0.01), but there was no statistical difference between the soft plaque group and mixed plaque group (P=-0.246). There was a negative correlation between the CT scale and Hs-CRP and IL-6 levels in the soft plaque group (r= -0.621, P〈0.01, and r= -0.593, P 〈0.01 respectively). There was a positive correlation between the plaque burden and Hs-CRP and IL-6 levels in the soft plaque group (r=0.579, P〈0.05 and r=0.429, P〈0.05 respectively). Conclusions 64-SCTA is an effective way to distinguish the different quality of coronary atherosclerosis plaque. Serum Hs-CRP and IL-6 levels can be considered as the indexes to judge the degree of CHD and may reflect the activity of plaque in CHD patients. Thus it is important for clinical diagnosis and risk evaluation of acute coronary syndrome (ACS) patients.
文摘Background Inflammation within vulnerable coronary plaques may cause unstable angina by promoting rupture and erosion. C-reactive protein (CRP) is the most reliable and accessible test method for clinical use for identifying coronary artery disease event. Matrix metalloproteinase 9 (MMP-9) is highly over-expressed in the vulnerable regions of a plaque. Our aim was to evaluate the plasma levels of MMP-9 and hsCRP in subjects with both unstable angina and coronary plaques, as well as in those with unstable angina without coronary plaques.
文摘Background Many clinical studies suggest the inverse relationship between testosterone levels and insulin sensitivity in men, however the causative relationship of these two events is still not determined. The purpose of this study was to investigate the effects of testosterone replacement therapy (TRT) on insulin sensitivity, body composition, serum lipid profiles and high sensitivity C-reactive protein (hsCRP) in hypogonadotropic hypogonadal (HH) puberty undeveloped male patients. Methods In this prospectively designed study, we compared homeostasis model assessment of insulin resistance (HOMA-IR), insulin areas under the curves (AUC) of 3-hour oral glucose tolerance test (OGTT) and other metabolic parameters between 26 HH patients and 26 healthy men. The patients' HOMA-IR, insulin AUC, body composition, lipid profiles, hsCRP and other parameters were compared before and after nine-month TRT. Results The average levels of total testosterone (TT) in HH and healthy group were (0.9±0.6) nmol/L and (18.8±3.4) nmol/L, respectively. HOMA-IR in HH group was significantly higher than the healthy group (5.14±5.16 vs 2.00±1.38, P 〈0.005). Insulin AUC in 3-hour OGTT in HH group was significantly higher than the healthy group (698.6±414.7 vs 414.2±267.5, P 〈0.01). Fasting glucose level in H H group was significantly higher than control group ((5.1±0.6) mmol/L vs (4.7±0.3) mmol/l, P 〈0.005). Height, weight and grasp strength of the patients were significantly increased after 9-month TRT. Significant reductions in HOMA-IR (from 5.14±5.16 to 2.97±2.16, P 〈0.01), insulin AUC (from 698.6±414.7 to 511.7±253.9, P 〈0.01) and hsCRP (from (1.49±1.18) mg/L to (0.70±0.56) mg/L, P 〈0.05) were found after TRT. Serum total cholesterol, LDL-C, HDL-C and triglyceride were all decreased, albeit with no significant difference compared to the level prior to TRT. Conclusions HOMA-IR, insulin AUC and fasting glucose level in HH young male patients were significantly higher than those of the control group, which suggests that low level of testosterone in male adolescents might be a risk factor for insulin resistance. TRT can significantly improve patients' insulin sensitivity and suppress serum hsCRP, which in return suggests that TRT may prevent the HH patients from developing diabetes mellitus and cardiovascular diseases (CVD) in future.
基金Supported by the vice-chancellor for research of Tabriz University of Medical Sciences, Tabriz, Iran
文摘AIM: To evaluate the high sensitivity C-reactive protein(hs CRP), Fetuin-A and matrix γ-carboxyglutamate protein(MGP) as the main factors for vascular calcification and inflammation in serum of patients with advanced age-related macular degeneration(ARMD) in comparison to healthy controls. METHODS: The subjects were 40 patients with choroidal neovascularization(CNV) having a mean age of70.9 ±9.1y and a matched group of 49 apparently healthy control subjects. The ARMD was diagnosed using a slitlamp with superfield lens, fundus photography and fluorescein angiography. Measurement of hs CRP was done by nephelometry method. Levels of Fetuin-A and MGP were measured by enzyme-linked immunosorbent assay(ELISA) technique.RESULTS: hs CRP [0.45(0.07-2.63) mg/L vs 0.25(0.03-1.2) mg/L, P =0.02)] and Fetuin-A levels(50.27 ±5.04 vs44.99±10.28 ng/m L, P =0.009) were higher in the patients than in the control groups. We could not find significant difference in MGP level between two groups(P =0.08).There was not a significant correlation between MGP with Fetuin-A and hs CRP among the patients(P =0.7, P =0.9respectively). A significant negative correlation of hs CRP with Fetuin-A was observed in both case and control groups(P =0.004, r =-0.33 and P =0.001, r =-0.54,respectively).CONCLUSION: Although our study shows that serum hs CRP and Fetuin-A is increased in CNV patients as well as negatively correlated with both study groups, their direct role on pathogenesis of ARMD required future studies.
基金This study was partly supported by grants from National Natural Science Foundation of China (No. 30670861, No.30871055 and No. 8107017l), Beijing Natural Science Foundation (No.7082081), and Specialized Research Fund for the Doctoral Program of High Education of China (No. 20070023047).
文摘Background The role of plasma high sensitivity C-reactive protein (hs-CRP) in in-stent restenosis (ISR) remains controversial. We investigated plasma hs-CRP level at both admission and follow-up in patients with stable angina (SA)after successful coronary stenting in order to clarify the predictive value of hs-CRP for ISR.Methods We summarized 303 consecutive chronic SA patients with coronary drug-eluting stent (DES) implantation.The ISR was analyzed by quantitative coronary analysis (QCA) at a mean follow-up of 8 months, and the patients were divided into two groups according to the detected ISR as ISR group (n=48) and non-ISR group (n=255). Plasma hs-CRP was examined at both admission and 8-month follow-up in all patients, standard medication continued throughout the investigation period.Results QCA presented that 48 patients (15.8%) suffered from ISR at follow-up. The basic clinical characteristics were similar between the two groups, while plasma hs-CRP was higher in ISR group than that in non-ISR group at both admission and follow-up, P 〈0.001 respectively. Multivariate regression analysis indicated that plasma hs-CRP level at either admission or follow-up could independently predict ISR occurrence (OR=5.581, 95% Cl 2.532-12.302, P〈0.001and OR=6.299, 95% CI 2.722-14.577, P 〈0.001, respectively).Conclusions Our data indicate that plasma hs-CRP level may independently predict ISR at both admission and follow-up in SA patients with coronary DES implantation, which implies that a chronic, sustained systemic inflammatory response might be involved in ISR pathogenesis.
文摘Background: Quantifying ten-year cardiovascular risk can be challenging. Different online risk calculators provide different risk estimates and online risk calculators use only one point in time. However, risk factors occur over the lifetime of the individual. Purpose: This manuscript provides three solutions to improving ten-year cardiovascular risk assessment in individuals at intermediate risk. Methods: Measuring Lipoprotein(a)—Lp(a) is recommended for assessing cardiovascular risk in all individuals who are in the intermediate risk category by standard online risk calculators. Lp(a) is primarily determined by genetic inheritance. It has the undesirable properties of being proatherosclerotic, proinflammatory, and prothrombotic. Measuring apolipoprotein B (apo B) provides a good index of the number of atherosclerotic particles present. Studies have demonstrated that small, dense LDL cholesterol particles are more atherogenic than larger, less dense LDL cholesterol particles. Measuring high sensitivity C-reactive protein (hsCRP) provides a good estimation of the degree of inflammation in the vascular system. Inflammation is a critical component of heart attacks and strokes. It is increased in diabetes and obesity. Treatment to reduce inflammation results in a reduction of cardiovascular events, independent of lipid values. Results: The above three risk factors should be measured in all patients with an intermediate risk score. Routine assays are readily available at a reasonable cost. They are independent risk factors for cardiovascular disease. Their recommendation is based on the pathophysiology of atherosclerotic cardiovascular disease. Successful therapy will result in the decrease of each of these risk factors. Conclusion: The recommended approach will improve the assessment of cardiovascular risk and guide the physician and patient to the correct treatment recommendations.