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Background: The impact of high-sensitivity C-reactive protein (hs-CRP) as a biomarker of inflammation on the prognosis of stroke patients remains controversial, this study was conducted to evaluate the prognostic value of hs- CRP levels for patients with stroke. Methods: PubMed, Web of Science, Embase, and Cochrane Library databases were searched from inception to October 28, 2022. Outcome measures were allcause mortality, recurrent stroke, and poor prognosis. The relationship between the highest versus lowest levels of hs-CRP or per unit increment and outcomes as measured by risk ratio (RR) and corresponding 95% confidence intervals (CI). Results: A total of 39 articles were eligible for meta-analysis. High hs-CRP levels at admission were associated with mortality among patients with acute ischemic stroke (AIS) [RR = 3.84, 95% CI (2.41 ~ 6.111); p < 0.001], risk of recurrent stroke [RR = 1.88, 95%CI (1.41 ~ 2.52); p < 0.001], and poor prognosis [RR = 1.77, 95% CI (1.59 ~ 1.97); p < 0.001]. The risk ratios for the association of per unit increase in hs-CRP levels with mortality, risk of recurrent stroke, and poor prognosis were as follows, respectively: 1.42 [95% CI (1.19–1.69); p < 0.001], 1.03 [95% CI (1.01–1.04); p = 0.003], and 1.27 [95% CI (1.10–1.47); p = 0.001]. For hemorrhagic stroke (HS), the risk ratios (RR) for the highest versus the lowest (reference) category of hsCRP or per unit increment to all-cause mortality were 4.36 [95% CI (1.38–13.73); p = 0.012] and 1.03 [95% CI (0.98–1.08); p = 0.238]. Conclusion: Hs-CRP levels are strongly associated with mortality, risk of stroke recurrence and poor prognosis in stroke patients. Therefore, hs-CRP levels may contribute to the prognosis prediction of these patients. [ABSTRACT FROM AUTHOR]

Limited evidence exists on the combined and mediating effects of systemic inflammation on the association between insulin resistance and cardiovascular events in patients with diabetes and chronic coronary syndrome (CCS). This secondary analysis of a multicenter prospective cohort included 4419 diabetic CCS patients. Triglyceride–glucose index (TyG) and high-sensitivity C-reactive protein (hsCRP) were applied to evaluate insulin resistance and systemic inflammation, respectively. The primary endpoint was major adverse cardiac event (MACE). Associations of TyG and hsCRP with cardiovascular events were estimated using Cox regression. A mediation analysis was performed to assess whether hsCRP mediates the relationship between TyG and cardiovascular events. Within a median 2.1-year follow-up period, 405 MACEs occurred. Patients with high levels of TyG and hsCRP experienced the highest MACE risk (hazard ratio = 1.82, 95% confidence interval: 1.24–2.70, p = 0.002) compared to individuals with low levels of both markers. HsCRP significantly mediated 14.37% of the relationship between TyG and MACE (p < 0.001). In diabetic CCS patients, insulin resistance and systemic inflammation synergically increased the risk of cardiovascular events, and systemic inflammation partially mediated the association between insulin resistance and clinical outcomes. Combining TyG and hsCRP can help identify high-risk patients. Controlling inflammation in patients with insulin resistance may bring added benefits. [ABSTRACT FROM AUTHOR]

Background: Acute radiation dermatitis (ARD) is one of the most common acute adverse reactions in breast cancer patients during and immediately after radiotherapy. As ARD affects patient quality of life, it is important to conduct individualized risk assessments of patients in order to identify those patients most at risk of developing severe ARD. Methods: The data of breast cancer patients who received radiotherapy were prospectively collected and analyzed. Serum ferritin, high-sensitivity C-reactive protein (hs-CRP) levels, and percentages of lymphocyte subsets were measured before radiotherapy. ARD was graded (0–6 grade), according to the Oncology Nursing Society Skin Toxicity Scale. Univariate and multivariate logistic regression analyses were used and the odds ratio (OR) and 95% confidence interval (CI) of each factor were calculated. Results: This study included 455 breast cancer patients. After radiotherapy, 59.6% and 17.8% of patients developed at least 3 (3+) grade and at least 4 (4+) grade ARD, respectively. Multivariate logistic regression analysis found that body mass index (OR: 1.11, 95% CI: 1.01–1.22), diabetes (OR: 2.70, 95% CI: 1.11–6.60), smoking (OR: 3.04, 95% CI: 1.15–8.02), higher ferritin (OR: 3.31, 95% CI: 1.78–6.17), higher hs-CRP (OR: 1.96, 95% CI: 1.02–3.77), and higher CD3 + T cells (OR: 2.99, 95% CI: 1.10–3.58) were independent risk factors for 4 + grade ARD. Based on these findings, a nomogram model of 4 + grade ARD was further established. The nomogram AUC was 0.80 (95% CI: 0.75–0.86), making it more discriminative than any single factor. Conclusion: BMI, diabetes, smoking history, higher ferritin, higher hs-CRP, and higher CD3 + T cells prior to radiotherapy for breast cancer are all independent risk factors for 4 + grade ARD. The results can provide evidence for clinicians to screen out high-risk patients, take precautions and carefully follow up on these patients before and during radiotherapy. [ABSTRACT FROM AUTHOR]

Mortality from cardiovascular diseases (CVDs) is higher in Russia compared to other European countries. High-sensitivity C-reactive protein (hs-CRP) is a biomarker of inflammation, and its elevated levels indicate increased CVD risks. We aim to describe the prevalence of low-grade systemic inflammation (LGSI) and the associated factors in a Russian population. The Know Your Heart cross-sectional study was conducted in Arkhangelsk, Russia in 2015–2017 with a population sample aged 35–69 years (n = 2380). LGSI was defined as hs-CRP ≥ 2 and <10 mg/L, and its associations with socio-demographic, lifestyle, and cardiometabolic characteristics were analyzed. The prevalence of LGSI (age-standardized to European Standard Population 2013) was 34.1% (33.5% in men and 36.1% in women). In the total sample, the increased odds ratios (ORs) of LGSI were associated with abdominal obesity (2.1), smoking (1.9), dyslipidemia (1.5), pulmonary diseases (1.4), and hypertension (1.3); the decreased ORs were in women (0.6) and in married participants (0.6). In men, the ORs were higher with abdominal obesity (2.1), smoking (2.0), CVDs (1.5), and hazardous drinking (1.5); in women—with abdominal obesity (4.4) and pulmonary diseases (1.5). In conclusion, one-third of the adult population in Arkhangelsk had LGSI. Abdominal obesity was the strongest LGSI correlate in both sexes, while the profiles of other associated factors were different between men and women. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM) and atherosclerosis are multifactorial conditions and share a common inflammatory basis. Three-vessel disease (TVD) represents a major challenge for coronary intervention. Nonetheless, the predictive value of high-sensitivity C-reactive protein (hs-CRP) for TVD patients with or without type 2 DM remains unknown. Herein, we aimed to ascertain the long-term predictive value of hs-CRP in TVD patients according to type 2 DM status from a large cohort. Methods: A total of 2734 TVD patients with (n = 1040, 38%) and without (n = 1694, 62%) type 2 diabetes were stratified based on the hs-CRP (< 2 mg/L vs. ≥ 2 mg/L). Three multivariable analysis models were performed to evaluate the effect of potential confounders on the relationship between hs-CRP level and clinical outcomes. The Concordance index, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated to assess the added effect of hs-CRP and the baseline model with established risk factors on the discrimination of clinical outcomes. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE). Results: The median follow-up duration was 2.4 years. Multivariate Cox regression analyses showed that the incidence of MACCE (adjusted hazard ratio [HR] 1.17, 95% confidence interval [CI] 1.01–1.35, p = 0.031) and all-cause death (HR 1.82, 95% CI 1.07–3.11, p = 0.026) were significantly higher in the diabetic group compared to the non-diabetic group. In the diabetic group, the incidence of MACCE (adjusted HR 1.51, 95% CI 1.09–2.10, p = 0.013) was significantly higher in the high hs-CRP group than in the low hs-CRP group; no significant difference was found for all-cause death (HR 1.63; 95% CI 0.58–4.58, p = 0.349). In the non-diabetic group, the prevalence of MACCE (adjusted HR 0.93, 95% CI 0.71–1.22, p = 0.613) was comparable between the two groups. Finally, the NRI (0.2074, p = 0.001) and IDI (0.0086, p = 0.003) for MACCE were also significantly increased after hs-CRP was added to the baseline model in the diabetic group. Conclusions: Elevated hs-CRP is an independent prognostic factor for long-term outcomes of MACCE in TVD patients with type 2 diabetes but not in those without type 2 diabetes. Compared to traditional risk factors, hs-CRP improved the risk prediction of adverse cardiovascular events in TVD patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Introduction: Type 2 diabetes (T2D), a frequent comorbidity in AMI, has been associated to an increased risk of long-term in-hospital mortality and upcoming cardiovascular events. "Inflammation underlies both the complicated diseases diabetes mellitus and atherosclerosis. Acute myocardial infarction is really a risk factor for type 2 diabetes, which is assessed in a state of low-grade inflammation. Aims: To identify the "CRP level at the time of admission as a reliable indicator of hospital mortality and morbidity in both patients with and without diabetes mellitus who experienced an acute myocardial infarction Materials and Methods: The material for the present study was collected from patients who are admitted in Katihar Medical College and Hospital over a period of one and a half year from December 2020 to May 2022.100 Patients were included in this study. Result: This study found that diabetes patients with acute myocardial infarction had statistically significant higher admission CRP levels than non-diabetic patients. Patients with diabetes who had higher CRP levels had a greater incidence of death and morbidity when compared to non-diabetic patients. Conclusion: According to the results of this investigation, CRP is a potent predictor of hospital morbidity and mortality in both diabetes and nondiabetic individuals with acute myocardial infarction. [ABSTRACT FROM AUTHOR]

Introduction: In this study, we prospectively investigated changes in serum interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP) and full white blood cell (WBC) counts during the diagnosis and treatment of paediatric patients with appendicitis. We also investigated the effects of the COVID-19 pandemic on the diagnosis and treatment processes of paediatric appendicitis patients. Materials and Methods: A non-perforated appendicitis group (n = 110), a perforated appendicitis group (n = 35) and an appendicitis + COVID-19 group (n = 8) were formed. Blood samples were taken upon admission and every day until the three studied parameters returned to normal values. To investigate the effects of the COVID-19 pandemic on paediatric appendicitis patients, the perforated appendicitis rates and the times from the onset of the first symptoms to the operation before and during the pandemic were compared. Results: WBC, IL-6, and hsCRP dropped below the upper limits on the second postoperative day in the non-perforated appendicitis group, four to six days postoperatively in the perforated appendicitis group, and three to six days postoperatively in the appendicitis + COVID-19 group. These parameters were not within normal range in patients who developed complications during follow-up. The time from the onset of abdominal pain to the surgery was significantly longer during than before the pandemic in both the non-perforated appendicitis group and the perforated appendicitis group. Conclusions: Our results show that WBC, IL-6, and hsCRP are useful laboratory parameters that can complete clinical examinations in the diagnosis of appendicitis in paediatric patients and the identification of complications that may develop postoperatively. [ABSTRACT FROM AUTHOR]

Aim. To study the level of high-sensitivity C-reactive protein (hsCRP) before coronary artery bypass surgery (CABG) and on days 7-10, as well as to assess the association of perioperative changes in hsCRP with the risk of postoperative atrial fibrillation (POAF).Material and methods. The study included 80 patients (71 (88,75%) men) who underwent an elective CABG in Cardiac Surgery Department of Sklifosovsky Research Institute of Emergency Medicine. The first episode of POAF was considered an episode of arrhythmia, registered by electrocardiography (ECG), Holter monitoring (HM) or bedside cardiac monitor in the intensive care unit. Depending on the development of atrial fibrillation in the postoperative period, patients were divided into 2 following groups: patients with POAF (n=20), patients without POAF (n=60). The serum level of hsCRP was studied twice: before surgery and 7-10 after CABG in patients of both groups.Results. Both groups did not differ significantly in the initial concentration of hsCRP (p=0,802). In the postoperative period, patients in both groups showed a significant increase in hsCRP compared with the initial concentration — up to 39,1 [19,6; 64,0] mg/l in the POAF group (p0,05).Conclusion. In patients after CABG, on days 7-10, there is a significantly higher level of hsCRP compared with the initial concentration. There were no significant differences in the level of hsCRP between patients with and without POAF. The POAF of is not associated with an initially elevated level of hsCRP and hsCRP level on days 7-10 after CABG.

BackgroundWe aimed to determine women’s risk of major depressive disorder (MDD) in relation to obesity phenotypes characterized by levels of circulating high-sensitivity C-reactive protein (hsCRP).MethodsThis population-based retrospective cohort study comprised 808 women (ages 20–84 y) recruited 1994–1997 and followed for a median 16.1 y (IQR 11.9–16.8). At baseline, body fat and lean tissue mass were measured by whole body dual-energy x-ray absorptiometry (DXA). Obesity was identified as high fat mass index (>12.9 kg/m2), body fat percentage (≥35%) and body mass index (≥30 kg/m2); sarcopenic obesity referred to a high ratio fat mass/fat-free mass (≥0.80). Systemic inflammation was operationalized as serum hsCRP concentration in the upper tertile (>2.99 mg/L). Obesity phenotypes were: non-obese + lowCRP, non-obese + highCRP, obese + lowCRP, and obese + highCRP. During follow-up, the Structured Clinical Interview for DSM-IV-TR (SCID-I/NP) was used to identify lifetime history of MDD and age of onset. Poisson regression models were used to estimate the MDD rate for each obesity phenotype during follow-up. Demographic, health and lifestyle factors were tested as potential confounders.ResultsDuring 11,869 p-y of follow-up, 161 (19.9%) women experienced an MDD episode. For obesity phenotypes based on fat mass index, models adjusted for baseline age and prior MDD, and non-obese + lowCRP as reference, RR for non-obese + highCRP was 1.21 (95% CI 0.80, 1.82), obese + lowCRP 1.46 (0.86, 2.47) and obese + highCRP 1.56 (1.03, 2.37). Patterns were similar for obesity by body fat percentage, body mass index and sarcopenic obesity.ConclusionConsistently across different obesity definitions, this longitudinal study reports that women with both obesity and systemic inflammation are at increased risk of subsequent MDD. Future research should examine whether tackling this metabolically unhealthy obesity type – through, for example, lifestyle or medication approaches – can reduce depression risk.

OBJECTIVE: To assess the prevalence and determinants of food insecurity among people living with HIV (PLWH) in Pune, India and its association with biomarkers known to confer increased risks of morbidity and mortality in this population. DESIGN: Cross-sectional analysis assessing food insecurity using the standardized Household Food Insecurity Access Scale. Participants were dichotomized into two groups: food insecure and food secure. Logistic regression models were used to assess associations between socio-economic, demographic, clinical, biochemical factors and food insecurity. SETTING: Antiretroviral therapy (ART) centre of Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals (BJGMC-SGH), Pune, a large publicly funded tertiary and teaching hospital in western India.ParticpantsAdult (≥18 years) PLWH attending the ART centre between September 2015 and May 2016 who had received ART for either ≤7d (ART-naïve) or ≥1 year (ART-experienced). RESULTS: Food insecurity was reported by 40 % of 483 participants. Independent risk factors (adjusted OR; 95 % CI) included monthly family income

Background: Women with hypertensive disorders of pregnancy are at increased risk of cardiovascular disease in later life. We sought to determine the association between lactation and markers of maternal cardiovascular health among postpartum women with and without hypertensive disorders of pregnancy via measures of inflammation (high-sensitivity C-reactive protein [hsCRP]) and renal function (cystatin C). Materials and Methods: This prospective cohort study enrolled primarily overweight and obese women during early pregnancy. At a postpartum study visit occurring 6-24 months after delivery, we collected data on lactation duration and measured hsCRP and cystatin C. We assessed associations between lactation duration and levels of hsCRP and cystatin C among normotensive women and women with preeclampsia or gestational hypertension using analysis of variance and chi-squared tests. Linear regression models adjusted for age, race, education, prepregnancy body mass index, current smoking, and time since delivery. Results: Of 425 women, 37 (9%) had preeclampsia and 48 (11%) had gestational hypertension during enrollment pregnancy. The postpartum visit occurred at a mean of 8.6 ± 4.4 months after delivery. Women with a history of preeclampsia had significantly higher levels of cystatin C (mean 0.86 versus 0.78 mg/L; p = 0.03) compared with normotensive women, but nonsignificant elevation in hsCRP (mean 8.39 versus 6.04 mg/L; p = 0.08). Women with gestational hypertension had no differences in mean hsCRP or cystatin C compared with normotensive women. Among the 237 women with any lactation, 78 (18%) lactated for at least 6 months. Lactation duration both in the overall sample and among women with gestational hypertension or preeclampsia was not associated with levels of hsCRP or cystatin C. Conclusions: Preeclampsia history was associated with elevated postpartum levels of cystatin C; however, duration of lactation was not associated with postpartum hsCRP or cystatin C, regardless of history of gestational hypertension or preeclampsia. Further research is needed on mechanisms through which lactation may affect maternal risk of cardiovascular disease.

Abstract Background Exploratory analysis to determine the effect of semaglutide versus comparators on high-sensitivity C-reactive protein (hsCRP) in subjects with type 2 diabetes. Methods Trials of once-weekly subcutaneous (SUSTAIN 3) and once-daily oral (PIONEER 1, 2, 5) semaglutide with hsCRP data were analyzed. Subjects with type 2 diabetes (N = 2482) received semaglutide (n = 1328) or comparators (placebo, n = 339; exenatide extended-release, n = 405; empagliflozin, n = 410). hsCRP ratio to baseline at end-of-treatment was analyzed overall, by clinical cutoff ( 3.0 mg/L), by tertile, and by estimated glomerular filtration rate in PIONEER 5 (a trial which was conducted in a population with type 2 diabetes and chronic kidney disease [CKD]). Mediation analyses assessed the effect of change in glycated hemoglobin (HbA1c) and/or change in body weight (BW) on hsCRP reductions. Results Geometric mean baseline hsCRP was similar across trials (range 2.7–3.0 mg/L). Semaglutide reduced hsCRP levels by clinical cutoffs and tertiles from baseline to end-of-treatment in all trials versus comparators (estimated treatment ratios [ETRs] versus comparators: 0.70–0.76; p 0.05). The effect of semaglutide on hsCRP was partially mediated (20.6–61.8%) by change in HbA1c and BW. Conclusions Semaglutide reduced hsCRP ratios-to-baseline versus comparators in subjects with type 2 diabetes (not significant with CKD). This effect was partially mediated via reductions in HbA1c and BW and potentially by a direct effect of semaglutide. Semaglutide appears to have an anti-inflammatory effect, which is being further investigated in ongoing trials. Trial registrations: ClinicalTrials.gov identifiers: NCT01885208 (first registered June 2013), NCT02906930 (first registered September 2016), NCT02863328 (first registered August 2016), NCT02827708 (first registered July 2016).

Epigenetics links perinatal influences with later obesity. We identifed differentially methylated CpG (dmCpG) loci measured at 17 years associated with concurrent adiposity measures and examined whether these were associated with hsCRP, adipokines, and early life environmental factors. Genome-wide DNA methylation from 1192 Raine Study participants at 17 years, identified 29 dmCpGs (Bonferroni corrected p

Yuting Pu,1,2 Shuangyang Li,2 Lingxue Wang,2 Bangjiang Fang,1 Xue Bai2 1LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, People’s Republic of China; 2Department of Neurology and National Traditional Chinese Medicine Clinical Research Base, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, 646000, People’s Republic of ChinaCorrespondence: Xue Bai, Department of Neurology and National Traditional Chinese Medicine Clinical Research Base, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China, Email baixue@swmu.edu.cnPurpose: To investigate the association of serum high-sensitivity C-reactive protein (hs-CRP) with the severity of neurological deficits and prognosis in patients with acute cerebral infarction (ACI).Patients and Methods: In this retrospective analysis, 119 patients with ACI were recruited from January to December 2020. The serum hs-CRP level was measured by a latex-enhanced immunoturbidimetric assay. The severity of neurological deficits and prognosis of ACI patients were assessed using the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS). Multivariate logistic analysis was performed and receiver operating characteristic (ROC) curves were plotted to evaluate the value of hs-CRP in predicting the prognosis of ACI.Results: The patients with a more favorable prognosis (mRS score 0– 2) had a lower median serum hs-CRP level than those with a worse prognosis (mRS score 3– 6) (3.32 IQR: 1.51, 8.04 to 17.93 IQR:16.02, 19.01; P< 0.001). After adjusting for potential confounders, multivariable linear regression showed that serum hs-CRP level was independently associated with NIHSS score (Beta = 0.952, P< 0.001) and mRS score (Beta=0.878, P< 0.001). Multivariate logistic analysis revealed that high hs-CRP level was an independent predictor of the poor prognosis in patients with ACI (adjusted1 OR = 1.995; 95% CI = 1.499– 2.655; adjusted2 OR = 2.75; 95% CI = 1.015– 7.457). ROC curve analysis indicated that the area under the curve for hs-CRP to predict poor prognosis was 0.986. The cutoff value, sensitivity, and specificity were 11.835 mg/L, 95%, and 92.5%, respectively. In terms of ischemic stroke subtypes, the serum hs-CRP level was higher in large-artery atherosclerosis (LAA) patients than in those with small-artery occlusion (SAO) and cardioembolism (CE). In addition, the patients with LAA had higher scores of NIHSS and mRS than those with SAO and CE.Conclusion: Serum hs-CRP level is an independent predictor of prognosis, and an efficient index to discriminate patients with ACI, especially for those with LAA.Keywords: acute cerebral infarction, high-sensitivity C-reactive protein, neurological deficits

IntroductionDelivery via caesarean section (C-section) has been associated with an increased risk of childhood chronic diseases such as obesity and asthma, which may be due to underlying systemic inflammation. However, the impact of specific C-section types may be differential, as emergency C-sections typically involve partial labor and/or membrane rupture. Our objectives were to determine if mode of delivery associates with longitudinal profiles of high sensitivity CRP (hs-CRP) —a marker of systemic inflammation—from birth through preadolescence, and to examine if CRP mediates the association between mode of delivery and preadolescent body mass index (BMI).MethodsData from the WHEALS birth cohort (N = 1,258) were analyzed; 564 of the 1,258 children in the cohort had data available for analysis. Longitudinal plasma samples (birth through 10-years of age) from 564 children from were assayed for hs-CRP levels. Maternal medical records were abstracted to obtain mode of delivery. Growth mixture models (GMMs) were used to determine classes of hs-CRP trajectories. Poisson regression with robust error variance was used to calculate risk ratios (RRs).ResultsTwo hs-CRP trajectory classes were identified: class 1 (76% of children) was characterized by low hs-CRP, while class 2 (24% of children) was characterized by high and steadily increasing hs-CRP. In multivariable models, children delivered via planned C-section had 1.15 times higher risk of being in hs-CRP class 2, compared to vaginal deliveries (p = 0.028), while no association was found for unplanned C-section deliveries [RR (95% CI) = 0.96 (0.84, 1.09); p = 0.49]. Further, the effect of planned C-section on BMI z-score at age 10 was significantly mediated by hs-CRP class (percent mediated = 43.4%).ConclusionsThese findings suggest potentially beneficial effects of experiencing partial or full labor, leading to a lower trajectory of systemic inflammation throughout childhood and decreased BMI during preadolescence. These findings may have implications for chronic disease development later in life.

Background: The incidence of hypertension is high in people living with HIV (PLWH). High-sensitivity C-reactive protein (hsCRP), systemic inflammation response index (SIRI), and neutrophil-to-monocyte ratio (NMR) are considered economic and convenient parameters that reflect the levels of inflammation in patients. Our aim was to explore whether indirect inflammation markers are associated with hypertension in PLWH. Methods: This was a case-control study. The case group (hypertension) comprised PLWH with hypertension, and the control group (non-hypertension) comprised sex- and age-(± 3 years)-matched PLWH without hypertension. Demographic parameters, hsCRP, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune- inflammation index (SII), SIRI, lymphocyte-to-monocyte ratio (LMR), platelet-to-neutrophil ratio (PNR), platelet-to-monocyte ratio (PMR), NMR, time to HIV diagnosis, antiretroviral therapy (ART) duration, recent CD4+ and CD8+ cell counts, recent CD4+ /CD8+ ratio, recent HIV viral load (HIV-RNA),and recent ART regimen were obtained from the patients’ electronic medical records. A t-test or Wilcoxon rank-sum test was performed to compare differences between the two groups, and conditional logistic regression was used to analyze the risk factors of hypertension. Correlations between inflammation markers and CD4+ cell counts, CD8+ cell counts, and CD4+ /CD8+ ratio were analyzed using Spearman’s correlation. Results: In the hypertension group, body mass index (BMI), hsCRP, NLR, SII, SIRI, NMR, time to HIV diagnosis, ART duration, CD4+ and CD8+ cell counts, and CD4+ /CD8+ ratio, the ratio of HIV-RNA < 100 copies/mL were all higher than those in the non-hypertension group, while the PNR was lower than that in the non-hypertension group. ART duration, CD4+ cell counts, HIV-RNA < 100 copies/mL, hsCRP, SIRI, and NMR were positively associated with hypertensive risk in PLWH. CD8+ cell counts and CD4+ /CD8+ ratio was negatively associated with hypertensive risk in PLWH. SIRI was negatively correlated with CD4+ cell counts and CD8+ cell counts, but positively correlated with CD4+ /CD8+ ratio. Conclusions: We identified positive associations between inflammation markers hsCRP, SIRI, NMR and hypertensive risk in PLWH. Alleviating inflammation may help control or delay the occurrence of hypertension in PLWH. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVD) are the leading cause of death worldwide. Since the establishment of the "lipid hypothesis", according to which, cholesterol level is directly correlated to the risk of CVD, many different lipid-lowering agents have been introduced in clinical practice. A majority of these drugs, in addition to their lipid-lowering properties, may also exhibit some anti-inflammatory and immunomodulatory activities. This hypothesis was based on the observation that a decrease in lipid levels occurs along with a decrease in inflammation. Insufficient reduction in the inflammation during treatment with lipid-lowering drugs could be one of the explanations for treatment failure and recurrent CVD events. Thus, the aim of this narrative review was to evaluate the anti-inflammatory properties of currently available lipid-lowering medications including statins, ezetimibe, bile acid sequestrants (BAS), proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, fibrates, omega-3 fatty acids, and niacin, as well as dietary supplements and novel drugs used in modern times. [ABSTRACT FROM AUTHOR]

Introduction: Oxidative stress known as a predictive marker for cardiovascular and metabolic diseases could be measured through pro‐oxidant antioxidant balance (PAB). The present study aimed to evaluate PAB and its association with high‐sensitivity C‐reactive protein (hs‐CRP) in the serum of postmenopausal women with diabetes mellitus. Methods: In this case–control study, 99 diabetic and 100 healthy postmenopausal women without diabetes mellitus were recruited. Serum PAB values, hs‐CRP, lipid profile, insulin, and vitamin D levels were measured. Moreover, insulin resistance (HOMA‐IR, HOMA‐β and QUICKI), waist circumference (WC), waist‐to‐hip ratio (WHR), waist‐to‐height ratio (WHtR), and body mass index (BMI) were calculated. Results: Serum PAB, hs‐CRP, insulin resistance, HOMA‐β, QUICKI, low‐density lipoprotein cholesterol (LDL‐C), high‐density lipoprotein cholesterol (HDL‐C), and triglycerides (TG) levels were significantly higher in the postmenopausal women with diabetes mellitus, while there was no significant difference in the total cholesterol (TC), serum insulin, WC, WHR, WHtR and vitamin D levels between the groups. Pearson correlation coefficient showed that HDL‐C and insulin levels were directly correlated with serum PAB. Also, there was a significant direct relationship between LDL‐C and insulin levels and hs‐CRP. There was no meaningful relationship between serum insulin and vitamin D levels and other assessed parameters. Backward logistic regression showed a positive relationship between diabetes mellitus and serum PAB and an inverse relationship with serum HDL levels. Conclusions: Serum PAB, hs‐CRP concentration, and lipid profile were significantly different between postmenopausal women with and without diabetes mellitus. These differences may contribute to the development of coronary complications. [ABSTRACT FROM AUTHOR]

Purpose: To determine the efficacy and safety of locally-applied vancomycin powder injection as precaution against prosthetic joint infection (PJI). Methods: A total of ninety subjects on admission in Department of Limb and Joint Surgery, PLA Medical Center, who underwent surgery for arthroplasty of knee and hip, were selected for this study. They were divided into two groups comprising control group (n = 45) given routine preventive antibiotic therapy as well as treatment group (n = 45) which received routine prophylactic antibiotics in combination with vancomycin therapy. PJI and the incidence of adverse reactions within 3 months after surgery were recorded. Body temperature of the patients was recorded with a thermometer. The number of neutrophils was measured by flow cytometry, while the expression levels of IL-6 and hs-CRP in peripheral blood were determined using enzyme-linked immunosorbent assay (ELISA) preoperatively and at 24, 72 and 168 h post- therapy. Results: At 90 days post-therapy, there was obviously significant reduction in the degree of PJI in the vancomycin-treated subjects compared with control group (p > 0.05). Moreover, within 3 days, normothermia, lowered neutrophil population and downregulated expressions of Il-6 and hs-CRP were seen in the vancomycin group, when compared to control subjects (p < 0.05). However, there was no significant difference in the incidence of adverse reactions between the treatment and control groups after therapy (p > 0.05). Conclusion: Topical application of vancomycin powder injection is safe, and regulates the body temperature of PJI patients in the short-term after surgery. Moreover, it decreases the levels of inflammatory indices. However, further clinical trials should be carried out prior to application in clinical practice. [ABSTRACT FROM AUTHOR]

Background: To explore the associations of serum highsensitivity C-reactive protein (hs-CRP) and prealbumin (PAB) with the number of diseased coronary vessels, degree of stenosis and heart failure in patients with myocardial infarction (MI). Methods: A total of 39 MI patients treated in the Cardiology were selected as the observation group, and another 41 patients with normal results of coronary angiography during the same period were selected as the control group. The general data of patients were recorded in detail, the content of serum hs-CRP and PAB in the peripheral blood was detected, and the number of diseased coronary vessels and the degree of stenosis were detected via coronary angiography. Results: Compared with those in control group, the blood pressure and heart rate significantly rose, the content of indexes related to the severity of MI were significantly increased, the content of hs-CRP was significantly increased, and the content of PAB was significantly decreased in observation group. Hs-CRP was positively correlated with the number of diseased coronary vessels, degree of stenosis and heart failure in patients, but PAB was negatively correlated with the above factors. The survival rate of MI patients with high content of hs-CRP was obviously lower than that of patients with low content of hsCRP. Conclusions: Serum hs-CRP and PAB are closely associated with the number of diseased coronary vessels, degree of stenosis and heart failure in MI patients. [ABSTRACT FROM AUTHOR]

Elevated serum uric acid (UA) level is related to type 2 diabetic retinopathy (DR). Vascular endothelial growth factor (VEGF), high-sensitivity C-reactive protein (hs-CRP), and cystatin C (Cys-C) have involvement in type 2 DR complicated with hyperuricemia (HUA) (HUDR), and we explored their clinical values in HUDR. Type 2 DR patients were allocated into HUDR/DR groups, with type 2 diabetes mellitus (T2DM) patients as the control group. Serum VEGF and inflammation markers hs-CRP, and Cys-C levels were assessed by ELISA and immunoturbidimetry. The correlations between serum UA level and VEGF/ hs-CRP/Cys-C were analyzed by Pearson tests, diagnostic values of VEGF/hs-CRP/Cys-C were analyzed by receiver operating characteristic curves, and the independent risk factors in HUDR were analyzed by logistic multivariate regression. Serum VEGF/hs-CRP/Cys-C level differences among the T2DM/ DR/HUDR groups were statistically significant, with the levels in HUDR > DR > T2DM. Serum UA level in HUDR patients was positively correlated with serum VEGF/hs-CRP/Cys-C. Serum VEGF/hs-CRP/Cys-C assisted in HUDR diagnosis, with their combination showing the greatest diagnostic value. UA/FPG/HbA1C/VEGF/hs-CRP/Cys-C were independent risk factors for HUDR. The incidence of proliferative DR was increased in HUDR patients. Collectively, serum VEGF, hsCRP, and Cys-C levels in HUDR patients were increased, and HUA might promote DR progression. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine the relationship of perivascular adipose tissue (PVAT) stranding in coronary computed tomography angiography (CCTA) with high-sensitivity C-reactive protein (hsCRP) and the determinants of PVAT stranding in coronary artery disease (CAD) patients. Material and methods: This retrospective cross-sectional study was done by collecting data from CAD patients who were referred to Rajaie Cardiovascular Centre between January 2018 and September 2020, with CCTA and hsCRP test 72 hours apart from the CCTA. PVAT stranding was defined as irregular obscuration of PVAT adjacent to the coronary arteries. An attempt was made to find a correlation between included variables and PVAT stranding by comparing them between 2 groups: patients with and without PVAT stranding. Results: From 92 patients, 31 participants had PVAT stranding, and statistically significant higher levels of hsCRP were detected in them (p = 0.007). We demonstrated significantly higher prevalence of history of hyperlipidaemia (OR = 3.83, p = 0.029), high-risk plaque features (OR = 11.80, p = 0.015), and obstructive coronary luminal stenosis (OR = 3.25, p = 0.025) in patients with PVAT stranding. Also, significantly higher PVAT attenuation was detected in patients with PVAT stranding (p < 0.001) independently from mean attenuation of epicardial fat. Conclusion: PVAT stranding could be used as a novel non-invasive marker in CCTA of CAD patients. More studies focusing on patient outcomes are required to better evaluate the reliability and prognostic value of this marker. [ABSTRACT FROM AUTHOR]

Objectives: Adiponectin and resistin are adipokines involved in insulin resistance, glucometabolic control and adiposity. There is evidence that hypoadiponectinemia and hyperresistinemia are associated with cardiovascular disease. Whether the ratio of Adiponectin-Resistin (AR) and Insulin Resistance Adiponectin-Resistin (IRAR) indices can be used as non-invasive biomarker of cardiovascular disease needs more attention. Therefore, the aim of this study was to assess the relationships of AR and IRAR indices with adiposity, glucometabolic control and cardiovascular risk incurred by high-sensitivity C-reactive protein (hsCRP) in healthy subjects and patients with Type 2 Diabetes Mellitus. Methods: This observational case control study was conducted in the Department of Physiology and Medicine, King Saud University, Riyadh. A total of 191 (control = 84 and diabetic = 107) subjects were recruited. Body composition was assessed by bioelectrical impendence analyzer (BIA). Fasting blood samples were analyzed for glucose, glycosylated hemoglobin (HbA1c), high-sensitivity C-reactive protein (hsCRP), lipid profile, adiponectin, and resistin levels. The AR and IRAR indices were determined by formulas. Results: Serum adiponectin levels were significantly lower in diabetics compared to control (95.45 ± 39.27 ng/ml vs 146.64 ± 56.36 ng/ml, p < .001) while serum resistin was significantly higher in diabetic when compared to control (2.94 ± 1.30 ng/ml vs 2.40 ± 1.09 ng/ml, p = .003). Furthermore, AR and IRAR indices were significantly increased in diabetic subjects when compared to control (.82 ± .29 vs .48 ± .35, p < .001) and (.30 ± .10 vs .17 ± .12, p < .001) respectively. ROC analysis revealed that these indices predicted increased cardiovascular risk with area under the curve (AUC) for adiponectin = .717 (p = .001), resistin = .635 (p = .002), AR index = .740 (p < .001), and IRAR index = .737 (p < .001) respectively. AR index correlated positively with Triglycerides (r = .354, p < .01), hsCRP (r = .264, p < .01), HbA1c (r = .425, p < .01), fat mass (r = .164, p < .05), Waist/Hip Ratio (WHR) (r = .248, p < .01), and negatively with high density lipoprotein (r=¡.327, p < .01). Furthermore, IRAR index more strongly correlated with Triglycerides (r = .409, p < .01), hsCRP (r = .268, p < .01), HbA1c (r = .508, p < .01), fat mass (r = .152, p < .05), WHR (r = .256, p < .01), and negatively with high density lipoprotein (r = ¡.340, p < .01). Conclusions: AR and IRAR indices correlate significantly with adiposity, glucometabolic control and cardiovascular risk in type 2 diabetic patients and non-diabetic individuals. They may prove to be useful integrated biomarkers to predict metabolic dysregulation and cardiovascular risk. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) is a state of inflammatory condition carrying several risk factors that lead to insulin resistance (IR), atherosclerotic events, and related complications. Serum ferritin is an acute phase reactant. As an acute phase, serum ferritin increases inflammatory condition which can contribute for IR and MetS. Gamma-glutamyl transferase (GGT) is a pro-inflammatory marker, which participates in various pathophysiological processes such as oxidative stress and lipid peroxidation which are important in the pathogenesis of IR and MetS. This study was undertaken to understand the association of serum ferritin and GGT levels with IR and MetS. Methodology: A comparative, descriptive cross-sectional study was conducted including 50 MetS cases and 50 matched healthy controls. Clinical examination was followed by laboratory investigations of GGT, ferritin, insulin, lipid profile, glycated hemoglobin (HbA1c), and IR were calculated by homeostasis model assessment-IR (HOMA-IR). Results: In the MetS patients' group, IR (HOMA-IR) was found to have significant positive correlations with serum GGT, ferritin, insulin, and high-sensitivity C-reactive protein (HsCRP). It was also found that body mass index, fasting blood sugar, postprandial blood sugar, and HbA1c were significant risk factors of IR. Conclusion: The present study suggests that fasting insulin, HsCRP, GGT, and ferritin levels were found to be significantly associated with HOMA-IR. GGT and ferritin play a significant role toward the increasing oxidant stress and inflammatory load which predisposes to MetS. Hence, these parameters could be used as markers for the early diagnosis of MetS. [ABSTRACT FROM AUTHOR]

Background Non-alcoholic fatty liver disease (NAFLD) is a major contributor to liver diseases globally, yet there are limited studies investigating the impact of diet and lifestyle factors on its development. This study aimed to examine the association between the prevalence of NAFLD and predicted pro-inflammatory high-sensitivity C-reactive protein (hs-CRP) score. Methods We included 1,076 Korean adults who underwent a medical examination at the Seoul National University Hospital Gangnam Healthcare Center in Korea between May and December 2011 and updated in 2021. The predicted pro-inflammatory hs-CRP score was derived from pro-inflammatory demographic, lifestyle, dietary, and anthropometric factors, and NAFLD was diagnosed using liver ultrasound. Multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of NAFLD odds according to predicted pro-inflammatory hs-CRP score were estimated using logistic regression at a two-sided P  <   0.05. Results Among the 1,076 participants, 320 had NAFLD. The multivariable-adjusted ORs and 95% CIs for NAFLD by tertiles of predicted pro-inflammatory hs-CRP score were 1.00, 3.30 (2.06, 5.30), 18.25 (10.47, 31.81; P  <   0.0001) in men and women combined, 1.00, 1.77 (1.10, 2.84), and 3.26 (2.02, 5.28; P  <   0.0001) among men only, and 1.00, 3.03 (1.39, 6.62), and 16.71 (7.05, 39.63; P  <   0.0001) among women only. Conclusions Predicted pro-inflammatory hs-CRP score was associated with higher odds of NAFLD. Adopting dietary and lifestyle changes related to lower inflammation might be a valuable strategy for preventing NAFLD. [ABSTRACT FROM AUTHOR]

Kai Ma,1 Hang Qiu,1 Yinghua Zhu,1 Yuan Lu,2 Wenhua Li1,2 1Institute of Cardiovascular Diseases, Xuzhou Medical University, Xuzhou, People’s Republic of China; 2Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, People’s Republic of ChinaCorrespondence: Wenhua Li, Tel +86 18052268293, Email xzwenhua0202@163.comObjective: To investigate the relationship between the incidence of contrast-induced acute kidney injury (CI-AKI) and the levels of the systemic immune-inflammatory index (SII, platelet × neutrophil/lymphocyte ratio) and high-sensitivity C-reactive protein (hsCRP) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI), to analyze further the predictive value of the combination of SII and hsCRP for CI-AKI.Methods: Retrospectively analyze the clinical data of STEMI patients who underwent PCI in our cardiology department from November 2019 to March 2021. Restricted cubic splines were used to determine the correlation between SII and hsCRP and the risk of CI-AKI. Patients were divided into the CI-AKI group (n=71) and the non-CI-AKI group (n=344) according to postoperative creatinine changes. Logistic regression was used to analyze the factors influencing CI-AKI. ROC curves were used to evaluate the predictive value of SII, hsCRP, and their combined levels on CI-AKI.Results: Restricted cubic spline analysis showed that when SII> 653.73× 109/L and hsCRP> 5.52mg/dl, there was a positive correlation with the incidence of CI-AKI. And the incidence of CI-AKI rose with the inflammation status. The receiver operating characteristic curve of SII combined with hsCRP was 0.831, which was higher than SII or hsCRP alone. The logistic regression analysis showed that high-risk factors of CI-AKI were diabetes mellitus, platelet count, and highly elevated SII and hsCRP.Conclusion: Within a certain range, elevated inflammatory biomarkers SII and hsCRP were risk factors for CI-AKI after PCI in patients with STEMI. This study suggests that the combination of SII and hsCRP predicts the risk of CI-AKI more accurately than either biomarker alone.Keywords: restricted cubic spline, systemic immune-inflammatory index, high-sensitivity C-reactive protein, contrast-induced acute kidney injury, ST-segment elevation myocardial infarction, percutaneous coronary intervention

Abstract Background Currently, remnant cholesterol (RC), lipoprotein(a) [Lp(a)], and inflammation are considered the principal residual cardiovascular risk (RCVR) factors. This study sought to evaluate the combined impact of RC, Lp(a), and inflammation on prognosis of statin-treated patients with chronic coronary syndrome (CCS), which has not been investigated. Methods A total of 6839 patients with CCS were consecutively enrolled. Baseline RC, Lp(a), and high-sensitivity C-reactive protein (hsCRP) concentrations were measured and their medians were used for categorizations. All patients were followed for the major adverse cardiovascular events (MACEs), including cardiovascular death, non-fatal myocardial infarction, and stroke. The individual and combined effects of RC, Lp(a), and hsCRP on MACEs were examined and stratification analysis according to low-density lipoprotein cholesterol (LDL-C) was performed. Results Over an average of 54.93 ± 18.59 months follow-up, 462 MACEs were recorded. Multivariate Cox analysis showed that elevated RC and Lp(a) levels were significantly associated with an increased risk of MACEs, while high hsCRP levels were related to a slightly but non-significantly increased MACEs risk. Moreover, when participants were subgrouped according to RC, Lp(a), and hsCRP levels together, only High RC-High Lp(a)-High hsCRP group had significantly higher risk of MACEs [hazard ratio (HR) 1.99, 95% confidence interval (CI) 1.15–3.47] compared with the reference group (Low RC-Low Lp(a)-Low hsCRP), especially in patients with LDL-C

Abstract Background There are many studies on high-sensitivity C-reactive protein (hs-CRP) association with cardiovascular disease (CVD); however, just a few studies investigated whether the low-density lipoprotein cholesterol (LDL-C) could participate in hs-CRP prognostic strength. This study aimed to determine the alliance of hs-CRP and LDL-C in different concentrations in occurrence cardiovascular events in the Isfahan Cohort Study (ICS). Methods 3277 participants aged 35 and above were included in the current analysis. We evaluated the association of elevated hs-CRP levels (≥ 3 mg/dL) and CVD events including myocardial infarction, ischemic heart disease, stroke, CVD, CVD mortality, and all-cause mortality in those with LDL-C ≥ or

Li Cao,1,2 Zhongwu Sun1 1Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China; 2Department of Neurology, Anhui No.2 Provincial People’s Hospital, Hefei, Anhui, 230041, People’s Republic of ChinaCorrespondence: Zhongwu Sun, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China, Email sunzhwu@126.comIntroduction: Vascular cognitive impairment is one of the main clinical manifestations of cerebral small vessel disease (CSVD). Reliable molecular markers are needed urgently to predict cognitive impairments in CSVD patients. This study aimed to investigate the possible diagnostic values of serum levels of Hcy, Hsp70 and hs-CRP for predicting vascular cognitive impairment in patients with CSVD.Methods: According to the presence of CSVD and cognitive impairment (CI), healthy patients and CSVD patients were divided into three groups. Serum Hcy, HSP70 and hs-CRP were abnormal in the CI group. Clinical characteristics and MOCA cognitive function score statistics were performed for the three groups: the control group, CSVD without cognitive impairment group and CSVD with cognitive impairment group. Finally, Hcy, HSP70 and hs-CRP were correlated with MOCA to analyze the correlation between serum Hcy, HSP70 and hs-CRP and cognitive dysfunction caused by CSVD.Results: The levels of serum Hcy, Hsp70, and hsCRP had significantly higher expression in the CSVD groups than those in the control group (p< 0.05). Moreover, basic clinical characteristics, cardiovascular risk factors and other clinical details had no significantly differences among the three groups. Serum Hcy, Hsp70 and hs-CRP levels were negatively correlated with MoCA total scores.Conclusion: Serum levels of Hcy, HSP70 and hs-CRP were negatively correlated with cognitive impairment caused by CSVD, which could be used as a predictor to predict the risk of cognitive impairment caused by CSVD.Keywords: cerebral small vessel disease, homocysteine, heat shock protein 70, high-sensitivity C-reactive protein, vascular cognitive impairment

Nga Phi Thi Nguyen,1,2,&ast; Thuc Luong Cong,3,4,&ast; Thi Thanh Hoa Tran,5 Binh Nhu Do,6 Son Tien Nguyen,1,2 Binh Thanh Vu,7,&ast; Lan Ho Thi Nguyen,8 Manh Van Ngo,9 Hoa Trung Dinh,10 Hoang Duong Huy,11 Nghia Xuan Vu,12 Kien Nguyen Trung,13 Duong Ngoc Vu,14 Nghia The Pham,14 Tuan Dinh Le2,15,&ast; 1Department of Endocrinology, Military Hospital 103, Hanoi, Vietnam; 2Department of Rheumatology and Endocrinology, Vietnam Military Medical University, Hanoi, Vietnam; 3Cardiovascular Center, Military Hospital 103, Hanoi, Vietnam; 4Department of Cardiology, Vietnam Military Medical University, Hanoi, Vietnam; 5Emergency Resuscitation Department, National Hospital of Endocrinology, Hanoi, Vietnam; 6Division of Military Science, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 7Department of Internal Medicine, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 8Department of General Internal Medicine, National Hospital of Endocrinology, Hanoi, Vietnam; 9Postgraduate Training Management Department, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 10Department of Requested Treatment, National Hospital of Endocrinology, Hanoi, Vietnam; 11Department of Neurology, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 12Department of Blood Transfusion, 108 Military Central Hospital, Hanoi, Vietnam; 13Department of Science Management, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 14Department of Imaging Diagnosis, Hanoi Medical University, Hanoi, Vietnam; 15Center of Emergency, Critical Care Medicine and Clinical Toxicology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam&ast;These authors contributed equally to this workCorrespondence: Tuan Dinh Le, Center of Emergency, Critical Care Medicine and Clinical Toxicology, Military Hospital 103, Vietnam Military Medical University, 261 Phung Hung Street, Phuc La Ward, Ha Dong District, Hanoi, Vietnam, Tel +84 388166078, Email letuan985@gmail.com Binh Thanh Vu, Department of Internal Medicine, Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Ky Ba Ward, Thai Binh, Vietnam, Tel +84 334588298, Email binhvt@tbump.edu.vnIntroduction: Low albumin levels, high levels of high-sensitivity C-reactive protein (hs-CRP), and high white blood cell count were risk factors for changes in arterial intima-media thickness (IMT). Femoral artery IMT damages were one of the common peripheral artery type 2 diabetes. This study was conducted to determine the association between femoral artery IMT and plasma albumin, hs-CRP levels, and white blood cell count in newly diagnosed patients with type 2 diabetes mellitus (nT2D).Materials and Methods: From January 2015 to May 2020, 306 patients with nT2D were recruited for this cross-sectional descriptive study at Vietnam’s National Endocrinology Hospital. We measured IMT by Doppler ultrasound.Results: There was a statistically significant difference in albumin, hs-CRP levels, hs-CRP-to-albumin ratio, and white blood cell counts between three different IMT groups namely normal IMT, thick IMT, and atherosclerosis (p = 0.003, p = 0.001, p = 0.001 and p = 0.049, respectively). In the multivariate linear regression analysis, white blood cell count, and hs-CRP levels showed a significantly positive correlation to IMT (standardized B and p of 0.17, 0.015 and 0.163, 0.024, respectively), but albumin levels were a significantly negative correlation to IMT (standardized B = – 0.151, p = 0.029). The multivariate logistic regression analysis showed that albumin (OR = 0.79, 95% CI 0.65– 0.90, p = 0.018), hs-CRP (OR = 1.09, 95% CI 1.01– 1.18, p = 0.026), and white blood cell count (OR = 1.36, 95% CI 1.03– 1.81, p = 0.033) had correlation to atherosclerosis of femoral artery.Conclusion: Reduced plasma albumin, elevated hs-CRP, and white blood cell count associated with IMT increased the odds for atherosclerosis of femoral artery among nT2D.Keywords: plasma albumin, high-sensitivity C-reactive protein, white blood cell count, newly diagnosed type 2 diabetes mellitus, intima-media thickness, atherosclerotic plaque, femoral artery

Objective: To determine if chronic inflammation, assessed by basal high-sensitivity C-reactive protein (hs-CRP) levels, is associated with pregnancy outcomes in women with unexplained infertility undergoing ovarian stimulation with intrauterine insemination. Design: Prospective cohort analysis of the Reproductive Medicine Network’s Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS) randomized controlled trial. Setting: Multicenter university-based randomized controlled trial. Patient(s): A total of 781 couples with unexplained infertility. Intervention(s): Secondary analysis. Main Outcome Measure(s): Adjusted risk ratios of live birth, clinical pregnancy, and pregnancy loss rates by hs-CRP levels. Result(s): Associations between hs-CRP levels and clinical pregnancy rates were not observed after adjustment for baseline body mass index. There were fewer live births among women with higher hs-CRP levels, although confidence intervals crossed 1.0. The risk of pregnancy loss was greater in women with increased hs-CRP levels (1–3 mg/L: risk ratio [RR], 1.67; 95% confidence interval [CI], 1.00–2.79; >3–10 mg/L: RR, 1.84; 95% CI, 1.06–3.20; and >10 mg/L: RR, 2.14; 95% CI, 1.05–4.36 compared to women with hs-CRP

Takashi Hoshikawa,1 Naomichi Okamoto,1 Tomoya Natsuyama,1 Rintaro Fujii,1 Atsuko Ikenouchi,1 Yuichi Honma,2 Masaru Harada,2 Reiji Yoshimura1 1Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, 8078555, Japan; 2 3rd Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, 8078555, JapanCorrespondence: Reiji YoshimuraDepartment of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, 8078555, Japan, Tel +81936917253, Fax +81936924894, Email yoshi621@med.uoeh-u.ac.jpPurpose: We investigated the serum levels of cytokines, including interleukin 1β (IL-β), IL-6, IL-8, IL-10, tumor necrosis factor-alpha (TNF-α), and growth factors, including brain-derived neurotrophic factor, vascular endothelial growth factor, and insulin-like growth factor 1, and their association with major depression in patients with and without type 2 diabetes mellitus. We also investigated the response to antidepressant treatment in both groups.Patients and Methods: Forty-one patients with major depression were recruited at the University Hospital of Occupational and Environmental Health. All patients were diagnosed with major depression using the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition. Type 2 diabetes mellitus was diagnosed according to the criteria of the Japan Diabetes Society. Six healthy controls with no history of psychiatric or physical diseases were also enrolled. Serum levels of several cytokines, growth factors, and high-sensitivity C-reactive protein (hs-CRP) were measured. The clinical symptoms of patients with major depression were assessed using the Montgomery-Asberg Depression Rating Scale.Results: Significant differences in cytokines, growth factors, and hs-CRP were observed between the major depression and healthy control groups. Serum TNF-α levels were significantly higher in patients with major depression and type 2 diabetes mellitus than in those without type 2 diabetes mellitus. In the major depression group, serum IL-6 and hs-CRP levels tended to be higher in patients with type 2 diabetes mellitus than in those without. Several correlations among cytokines, growth factors, and hs-CRP were observed in patients with major depression with and without type 2 diabetes mellitus. Responses to pharmacological interventions for major depression did not differ between patients with and without type 2 diabetes mellitus.Conclusion: Serum levels of TNF-α, hs-CRP, and IL-6 were different between patients with major depression with and without type 2 diabetes mellitus. Also, correlations were found between serum levels of cytokines, growth factors, and hs-CRP in patients with major depression. Inflammatory factors, which may be associated with growth factors, may be involved in the pathophysiology of major depression, particularly among patients with comorbid type 2 diabetes mellitus.Keywords: major depression, diabetes mellitus, cytokine, growth factor, high-sensitivity C-reactive protein, brain-derived neurotrophic factor

Background: In recent times, single-sitting root canal therapy has gained momentum over multiple-sitting root canal therapy due to its superior clinical outcome and less time required for treating the patient. Aim: Thus, the aim of current study was to compare the expression of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and high-sensitivity C-reactive protein (hs-CRP) in the serum of patients undergoing single-sitting and multiple-sitting root canal treatment. Materials and Methods: This cross-sectional experimental study was conducted on 300 subjects who were indicated for root canal treatment. Subjects were categorized into Group I (single visit) and Group II (multiple visits). Clinical data was obtained and serum samples were collected both before and after 1 week of treatment completion. Inclusion criteria were those patients (a) over 18 years of age, (b) without any disease of inflammatory etiology, and (c) who had not previously received endodontic treatment or any related therapeutic treatment. Exclusion criteria were those (a) without a complete clinical history, (b) with greater than one indicated tooth, (c) who did not complete their treatment, and (d) with any periodontal disease. Chi-square and Student's t-test were applied. Results: It was found that in single-sitting root canal treatment, there was a statistically significant reduction in these inflammatory biomarkers, although no difference in clinical efficacy was observed. Conclusion: Single-visit root canal treatment is a better option for treatment of pulpitis compared to multiple-sitting treatment.

Background: Polycystic ovary syndrome (PCOS) is a state of chronic low-grade inflammation. Low-grade inflammation has been linked to the development of cardiovascular disease (CVD). There is evidence of clustering for metabolic syndrome, hypertension, dyslipidaemia in type 2 diabetes mellitus and insulin resistance (IR) in mothers, fathers, sisters and brothers of women with PCOS. Aims: The aim is to study the levels of inflammatory markers and IR in first-degree relatives of patients with PCOS and find any correlation with hormonal parameters, metabolic parameters and adiposity indices in them. Settings and Design: A total of 66 first-degree relatives of a patient with PCOS were included in this cross-sectional study. Materials and Methods: All participants underwent detailed clinical evaluation and biochemical investigations, including high-sensitivity C-reactive protein (hsCRP), interleukin 6 (IL-6), luteinising hormone (LH), follicle-stimulating hormone (FSH) and total testosterone (only in females). Homeostasis model assessment of IR (HOMA-IR), lipid accumulation product and visceral adiposity index were calculated using standard equations. Visceral adipose tissue thickness and subcutaneous adipose tissue thickness were assessed using ultrasonography. Statistical Analysis Used: Spearman's and Pearson's correlation coefficients were used to analyse the correlation between different non-parametric and parametric data, respectively. Multiple linear regression was used to correlate multiple dependent factors. Results: The mean hs-CRP level was 2.4 ± 1.1 mg/L, which is greater than the cut-off of 2 mg/L and hs-CRP >2 mg/L was found in 62% (n = 41) participants. The mean IL-6 (3.5 ± 1.1 pg/ml) and total white blood cell count (7244 ± 2190/mm3) were in the normal range. The mean HOMA-IR was 2.35 ± 0.76, which is elevated, considering HOMA IR >2 as a predictor of IR and metabolic syndrome. HOMA IR >2 was found in 64% (n = 42) of the participants. Inflammatory markers were significantly correlated with LH and HOMA IR, even after multiple linear regression was fitted for each marker individually. Conclusion: Apparently, healthy first-degree relatives of PCOS patients had evidence of chronic low-grade inflammation. The chronic inflammation in them correlated well with HOMA-IR and LH but was independent of body mass index. This low-grade inflammation may predispose the first-degree relatives of PCOS to CVD.

BACKGROUND: Recurrent strokes cause greater complications and worse outcomes by adding to the existing neurological deficit. There is the paucity of data on serum markers of inflammation as predictors of recurrent stroke. This study was planned to analyze the clinico-etiological profile of recurrent noncardioembolic ischemic stroke, estimate aspirin resistance among regular aspirin users and evaluate blood biomarkers high-sensitivity C-reactive protein (hsCRP), Tumor necrosis factor-alpha (TNF-α), Lipoprotein-associated phospholipase A2 (Lp-PLA2) as probable predictors of stroke recurrence. METHODS: Patients of recurrent noncardioembolic ischemic stroke fulfilling the inclusion criteria were enrolled. Detailed history, clinical examination, and investigations were obtained as per protocol. Aspirin resistance was determined by light transmission aggregometry. Serum hsCRP, TNF-α, and Lp-PLA2 levels were estimated. RESULTS: This study included 34 males and 16 females. Majority of the patients were > 60 years (n = 30, 60%). Thirty (60%) cases had a repeat stroke after 1 year of primary event. Thirty-nine (78%) study participants had hypertension, while 15 (30%) had diabetes. Middle cerebral artery (n = 40, 80%) was the most common vascular territory. Thirty-one (62%) cases belonged to TOAST subtype 1 (large artery atherosclerosis). Seventy two percent cases were prescribed aspirin after index stroke, but only 36% were compliant. Median (range) hsCRP level was 7.5 (0.3–155) mg/L with 72% of patients having high hsCRP level (>3 mg/L). Median (range) serum PLA2 level was 11.98 (3.31–87.24) ng/ml in patients and 6.96 (0.15–61.42) ng/ml in controls (P = 0.029). Median (range) serum TNF-α level in patients was significantly higher than controls (68.22 [1.3–287] pg/ml versus 0.098 [0.002–36.31] pg/ml, P < 0.001). Aspirin resistance was found in 41.7% patients while 16.7% were semi-resistant. Mean % platelet aggregation was 34.75 ± 21.58 in patients and 64.75 ± 16.98 for controls (P < 0.001). CONCLUSIONS: Majority of patients with recurrent stroke were elderly (>60 years), hypertensive, and non-compliant with aspirin. Aspirin resistance was an important factor in patients with antiplatelet compliance. Inflammatory biomarkers hsCRP, PLA2, and TNF-α were found to be significantly elevated in patients compared to controls.

Introduction: The most plausible factor for coronary artery ectasia (CAE), a subset of coronary artery disease (CAD), is extensive inflammation. High-sensitivity C-reactive protein (hs-CRP) and serum uric acid (sUA) are well known markers of inflammation. Most of the previous studies (done in the Western population and of Middle East Asia) evaluated their role individually as a marker of inflammation in CAD. We aimed to investigate the possible association of isolated CAE with inflammation as assessed by the hs-CRP and sUA levels and check whether the inflammatory hypothesis holds good in the south Asian population. Materials and Methods: Patients admitted for coronary angiography with age ≥30 years were evaluated. Patients with both CAE and CAD were excluded. A total of 60 patients were studied. Patients with isolated CAE (30) were compared with an equal number of patients with obstructive CAD (30) and their clinical profile was studied. The hs-CRP, sUA, and novel inflammatory markers such as neutrophil–lymphocyte ratio (NLR), mean platelet volume (MPV), and red cell distribution width (RDW) were compared between the groups. Results: Of the 60 patients studied, males were 56% in the isolated CAE group and 50% in the obstructive CAD group. The hs-CRP (2.39 ± 0.41 vs. 1.41 ± 0.29, P < 0.001) and sUA levels (6.46 ± 0.58 vs. 5.36 ± 0.40, P < 0.001) were significantly elevated in the isolated CAE group compared to the obstructive CAD group. Among the novel inflammatory markers, the NLR (3.98 ± 0.42 vs. 2.91 ± 0.30, P < 0.001) and RDW (12.69 ± 0.27 vs. 12.13 ± 0.48, P < 0.001) were significantly higher in the CAE group compared to obstructive CAD group, whereas the MPV did not have a statistically significant difference (9.5 ± 0.98 vs. 9.6 ± 1.08, P = 0.525). Conclusion: The inflammatory etiology of CAE was supported by an elevated hs-CRP, sUA, and other novel inflammatory markers compared to the atherosclerotic obstructive CAD group.

Abstract Introduction Oxidative stress known as a predictive marker for cardiovascular and metabolic diseases could be measured through pro‐oxidant antioxidant balance (PAB). The present study aimed to evaluate PAB and its association with high‐sensitivity C‐reactive protein (hs‐CRP) in the serum of postmenopausal women with diabetes mellitus. Methods In this case–control study, 99 diabetic and 100 healthy postmenopausal women without diabetes mellitus were recruited. Serum PAB values, hs‐CRP, lipid profile, insulin, and vitamin D levels were measured. Moreover, insulin resistance (HOMA‐IR, HOMA‐β and QUICKI), waist circumference (WC), waist‐to‐hip ratio (WHR), waist‐to‐height ratio (WHtR), and body mass index (BMI) were calculated. Results Serum PAB, hs‐CRP, insulin resistance, HOMA‐β, QUICKI, low‐density lipoprotein cholesterol (LDL‐C), high‐density lipoprotein cholesterol (HDL‐C), and triglycerides (TG) levels were significantly higher in the postmenopausal women with diabetes mellitus, while there was no significant difference in the total cholesterol (TC), serum insulin, WC, WHR, WHtR and vitamin D levels between the groups. Pearson correlation coefficient showed that HDL‐C and insulin levels were directly correlated with serum PAB. Also, there was a significant direct relationship between LDL‐C and insulin levels and hs‐CRP. There was no meaningful relationship between serum insulin and vitamin D levels and other assessed parameters. Backward logistic regression showed a positive relationship between diabetes mellitus and serum PAB and an inverse relationship with serum HDL levels. Conclusions Serum PAB, hs‐CRP concentration, and lipid profile were significantly different between postmenopausal women with and without diabetes mellitus. These differences may contribute to the development of coronary complications.

Although there is evidence that mercury (Hg) exposure may be a potential risk factor for cardiovascular disease (CVD), few nationwide epidemiological researches have analyzed the association between blood Hg concentration and serum high-sensitivity C-reactive protein (hs-CRP) level as a biomarker of CVD. The present population-based national study was performed with data from the 2016–2017 National Health and Nutrition Examination Survey. In the total sample of 3,773 adults aged ≥20 years, the serum hs-CRP concentrations were 1.03 mg/L among participants in the lowest quartile of blood Hg level and 1.18 mg/L among those in highest quartile. The trend for the prevalence of a risky (>1.0 mg/L) hs-CRP level (moderate risk and high risk) was significantly related to an increased quartile blood Hg concentration. After adjustment for confounders, participants with the highest quartiles of blood Hg had increased odds of a risky (>1.0 mg/L) hs-CRP level (adjusted odds ratio = 1.34; 95% confidence interval, 1.02–1.77) compared with those with the lowest quartile of blood Hg. These findings demonstrate that a high blood Hg level increases the concentration of serum hs-CRP, a sensitive marker of chronic low-grade inflammation, and imply that the increased body burden associated with high blood Hg is a potential risk factor in the development of many inflammatory diseases, including CVD.

In order to explore the effects of comfort care combined with blue-light phototherapy on neonatal jaundice and total bilirubin (TBIL) and high-sensitivity C-reactive protein (hsCRP) levels, this study selected 100 neonates as research objects. Those 100 neonates were diagnosed with neonatal jaundice in a designated hospital of this study from December 2020 to December 2021, and randomly divided into observation group and control group with 50 cases in each group. The neonates in control group were given blue-light phototherapy, while the neonates in observation group were given comfort care combined with blue-light phototherapy. Before and after the treatment, the neonates in the two groups were evaluated for their quiet sleep time, the number of crying, decrease in jaundice, weight gain, and TBIL and hs-CRP levels, and compared those indicators for follow-up analysis. The results of this study show that the total effective rate was 96.0 % (48/50) in the observation group and 82.0 % (41/50) in the control group, with statistically significant difference between the two groups (P 0.05); after treatment, the TBIL level [(99.27 ± 11.35) μmol/l] and hs-CRP level [(1.18 ± 0.32) μmol/l] of the observation group and the TBIL level [(123.25 ± 19.43) μmol/l] and hs-CRP level [(1.62 ± 0.45) μmol/l] of the control group were both lower than those before treatment, while the reduction degree of those in the observation group was better than that of the control group with statistically significant difference (P

Elevated serum high‐sensitivity C‐reactive protein (hs‐CRP) and lipoprotein(a) (Lp(a)) levels are associated with the development of native coronary atherosclerosis. We aimed to establish a new method for the simultaneous detection of hs‐CRP and Lp(a) to predict the development of atherosclerosis. A one‐step time‐resolved fluorescence immunoassay (TRFIA) with europium(III) (Eu3+) or samarium(III) (Sm3+) labels was established, and the performance of this TRFIA (in terms of sensitivity, specificity, accuracy, and cutoff values) was evaluated using clinical serum samples and compared with those of registered kits. The sensitivity was 0.052 μg/ml for hs‐CRP and 0.64 μg/ml for Lp(a). The intra‐assay and inter‐assay cross‐reactivities (CVs) were very low, ranging from 2.05% to 4.67% for hs‐CRP and from 2.42% to 6.43% for Lp(a). The CVs were very low (<0.34% and <2.65%, respectively) with five interferents. Additionally, there was a high Pearson coefficient between the present TRFIA method and the registered kits (R2 = 0.9967 and 0.9906, respectively). These data indicate that this study developed a TRFIA method that can be used for the quantitative detection of hs‐CRP and Lp(a) in serum with high sensitivity, specificity, and accuracy. This TRFIA provides a new method for predicting the development of atherosclerosis. [ABSTRACT FROM AUTHOR]

Few studies have investigated the association between high-sensitivity C-reactive protein (hsCRP) level and site-specific cancer mortality. In this study, we aimed to examine the associations of hsCRP with overall and site-specific cancer mortality among South Koreans using data on the Health Examinees (HEXA) Study cohort (41,070 men and 81,011 women aged ≥40 years). We obtained mortality information from the National Statistical Office of Korea, which provided the dates and causes of all deaths occurring through December 31, 2015, by linking mortality data with each participant's unique national identifier. Cox proportional hazards and restricted cubic spline models were used to assess the association between hsCRP and cancer mortality with adjustment for covariates. An analysis of site-specific cancer mortality was focused on 5 major cancers (lung, liver, gastric, colorectal, and breast/prostate). Median hsCRP levels were 0.77 mg/L and 0.59 mg/L for men and women, respectively. A dose-response association between hsCRP and overall cancer mortality was observed in men but disappeared in women after exclusion of deaths occurring in the first 1 or 2 years of follow-up. Elevated hsCRP levels increased the risks of lung, liver, and gastric cancer mortality in men, but the risks of colorectal and breast cancer mortality were not increased. The dose-response association between hsCRP and cancer mortality was observed differently depending on site-specific cancer mortality by sex. [ABSTRACT FROM AUTHOR]

Purpose: The factors associated with aneurysm sac shrinkage after endovascular aneurysm repair (EVAR) are not well established. As inflammation is implicated in aneurysm pathophysiology, we hypothesized that high-sensitivity C-reactive protein (hsCRP) was associated with aneurysm sac shrinkage after EVAR and compared the preoperative level of hsCRP between patients with and without postoperative aneurysm sac shrinkage after EVAR. Methods: From November 2013 to April 2019, 143 patients undergoing EVAR using Gore C3 Excluder (W. L. Gore & Associates, Inc, Flagstaff, Arizona) at our university hospital were included in this study. Aneurysm sac size was compared between that on baseline preoperative computed tomography (CT) and that on postoperative CT scans. A change in aneurysm sac size ≥5 mm was considered to be significant, whether due to enlargement or shrinkage. Results: Aneurysm sac size showed a significant decrease from 50.6 ± 9.8 mm to 47.1 ± 10.3 mm at 1 year. At 1 year postoperatively, aneurysm sac shrinkage (≥5 mm) was observed in 48 patients (34%), a stable aneurysm sac was noted in 93 patients (65%), and aneurysm sac enlargement was noted in 2 patients (1.4%). The mean preoperative hsCRP was 0.33 ± 0.54 mg/dL. Univariable analysis showed that preoperative hsCRP (p=0.029) and the presence of a renal cyst (p=0.002) were associated with aneurysm sac shrinkage. Multivariable analysis showed that preoperative hsCRP [>0.19mg/dL] (odds ratio [OR] = 0.22; 95% confidence interval [CI] = 0.05–0.96; p=0.042), and the presence of a renal cyst (OR = 0.31; 95% CI = 0.15–0.67; p=0.002) were independent risk factors for aneurysm sac shrinkage after EVAR. Conclusions: The level of preoperative hsCRP was independently associated with aneurysm sac shrinkage after EVAR in patients with abdominal aortic aneurysms. These data suggest that the high level of hsCRP can be a negative predictor for aneurysm sac shrinkage after EVAR. [ABSTRACT FROM AUTHOR]

This study investigated the associations between relative telomere length (RTL) and resting metabolic rate (RMR), resting fat oxidation (RFO), and aerobic capacity and whether oxidative stress and inflammation are the underlying mechanisms in sedentary women. We also aimed to determine whether the correlations depend on age and obesity. Sixty-eight normal weight and 66 obese women participated in this study. After adjustment for age, energy expenditure, energy intake, and education level, the RTL of all participants was negatively correlated with absolute RMR (RMRAB) and serum high-sensitivity C-reactive protein (hsCRP) concentration, and positively correlated with maximum oxygen consumption ( V ˙ O2max) (all p < 0.05). After additional adjustment for adiposity indices and fat-free mass (FFM), RTL was positively correlated with plasma vitamin C concentration (p < 0.05). Furthermore, after adjustment for fasting blood glucose concentration, RTL was negatively correlated with age and positively correlated with V ˙ O2max (mL/kg FFM/min). We found that normal weight women had longer RTL than obese women (p < 0.001). We suggest that RTL is negatively correlated with RMRAB and positively correlated with aerobic capacity, possibly via antioxidant and anti-inflammatory mechanisms. Furthermore, age and obesity influenced the associations. We provide useful information for the management of promotion strategies for health-related physical fitness in women. [ABSTRACT FROM AUTHOR]

Background: As a serious and common out-of-hospital infectious disease, community-acquired pneumonia (CAP) ranks among the leading causes of death in both developing and developed countries. In recent years, the increasing incidence of CAP has led to an increase in the number of hospitalizations. Although CURB-65 (or CRB-65) and pneumonia severity Index (PSI) scoring systems are widely used in CAP prognostic scoring systems, each score had some limitations in predicting whether patients with CAP would require prolonged hospitalization. The aim of this study was to analyze serum inflammatory biomarkers combined with age to establish a novel predictive model for predicting prolonged hospitalization in patients with CAP. Methods: In a retrospective study, serum inflammatory biomarkers were collected from all enrolled CAP patients, including white blood cell count (WBC), high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), D-dimer, procalcitonin (PCT), fibrinogen (FIB), and ICU treatment. Length of hospital stay and age were also recorded. The 75th percentile of length of stay in the enrolled population was defined as long hospitalization over time, and the primary predictor of outcome was prolonged hospitalization. Univariate analysis and binary logistic regression analysis were used to explore the independent risk factors which could be components of a new predicting model for prolonged hospitalization in CAP patients. ROC curves were used to evaluate the sensitivity and specificity of the new model, which consisted of the combination of all independent risk factors in predicting the main outcomes. Results: The results showed that among 364 patients with CAP, 85 had extended hospitalization (85/364). Further analysis showed that age, white blood cell, fibrinogen, and high-sensitivity C-reactive protein were independent risk factors for extended hospitalization in patients with CAP. Finally, the AUC of the ROC curve of the new prediction model (the joint model consists of age, WBC, FIB, and hs-CRP) was 0.93 (95% CI 0.90 - 0.96), and the sensitivity and specificity were 87.1% and 87.8%, respectively. Conclusions: Serum inflammatory biomarkers combined age have high specificity and sensitivity in predicting prolonged hospitalization in adult CAP patients. [ABSTRACT FROM AUTHOR]

Background: Noninvasive ventilation (NIV) is an established first-line treatment of acute respiratory failure both in emergency departments (ED) and intensive care unit (ICU) settings. It is however not always successful. Materials and methods: Prospective, observational study was done among patients above 18 years presenting with acute respiratory failure initiated on NIV. Patients were placed in one of two groups covering successful NIV treatment and NIV failure. Two groups were compared on four variables: initial respiratory rate (RR), initial high-sensitivity C-reactive protein (hs-CRP), PaO2/FiO2 ratio (p/f ratio), and heart rate, acidosis, consciousness, oxygenation, and respiratory rate (HACOR) score at the end of 1 hour of initiation of NIV. Results: A total of 104 patients fulfilling the inclusion criteria were included in the study, of which 55 (52.88%) were exclusively treated with NIV (NIV success group), and 49 (47.11%) required endotracheal intubation and mechanical ventilation (NIV failure group). Noninvasive ventilation failure group had a higher mean initial RR compared with NIV success group (40.65 ± 3.88 vs 31.98 ± 3.15, p <0.001). Mean initial PaO2/FiO2 ratio was also significantly lower in the NIV failure group (184.57 ± 50.33 vs 277.29 ± 34.70, p <0.001). Odds ratio for successful NIV treatment with a high initial RR was 0.503 (95% confidence interval (CI), 0.390-0.649) and with a higher initial PaO2/FiO2 ratio was 1.053 (95% CI: 1.032-1.071 and with a HACOR score of >5 at the end of 1 hour of initiation of NIV was highly associated with NIV failure (p <0.001). A high initial level of hs-CRP was 0.949 (95% CI: 0.927-0.970). Conclusion: Noninvasive ventilation failure could be predicted with information available at presentation in ED, and unnecessary delay in endotracheal intubation could possibly be prevented. [ABSTRACT FROM AUTHOR]

Background: Atherosclerosis being the keystone in the pathology of coronary artery disease (CAD) is a chronic inflammation of arterial intima mediated by various inflammatory markers. Pentraxin 3 (PTX3) and high-sensitivity C-reactive protein (hs-CRP) are the two important biomarkers of chronic inflammation that causes atherosclerosis. Aims: This study aims to investigate the association of serum PTX3 and hs-CRP with the severity of coronary stenosis in patients undergoing coronary angiogram. Subjects and Methods: A total of 80 patients who underwent elective coronary angiogram were included. Their blood sample was collected for PTX3 and hs-CRP estimation prior to angiogram. Based on the angiogram, the participants were divided into four groups based on the number of arteries affected. PTX3 was estimated using enzyme-linked immunosorbent assay and hs-CRP was assayed using latex-enhanced immunosorbent assay. Statistical Analysis Used: Kruskal--Wallis test was used to find the association of PTX3 and hs-CRP in each group and Pearson's correlation was used to correlate PTX3 and hs-CRP with the extent of stenosis. Results: The mean PTX3 and hs-CRP levels in patients with some lesions in the coronary artery were 231.5 ± 129.9 pg/mL and 2.4 ± 0.4 mg/mL, respectively. The PTX3 levels elevate gradually with the severity of stenosis with P = 0.000 which is highly significant. A strong positive correlation was observed (R = 0.7929, P < 0.00001) with PTX3 and severity of stenosis. Whereas, for hs-CRP, the correlation was weaker (R = 0.3011, P = 0.006). Conclusions: PTX3 and hs-CRP can not only predict the number of arteries affected but also can differentiate between normal coronaries and CAD which can minimize the use of angiography. [ABSTRACT FROM AUTHOR]

Objectives To characterize and clarify evidence as to whether the ectopic bone formations of DISH in patients with ossification of the posterior longitudinal ligament (OPLL) are caused by inflammatory or degenerative processes. Methods Whole-spine CT and serum high-sensitivity CRP (hs-CRP) levels were obtained from 182 cervical OPLL patients (DISH+, n  = 104; DISH−, n  = 78). In the DISH+ group, ectopic bone formations were categorized into Flat and Jaggy types, then further divided into three subgroups: group 1 (Jaggy-dominant pattern), group 2 (Equivalence of pattern) and group 3 (Flat-dominant pattern). Data were compared between the DISH+ and DISH− groups, and among the three subgroups. Results The upper thoracic spine was most affected by the Flat type, whereas the Jaggy type was more frequent in the middle and lower thoracic regions. There was no difference in hs-CRP levels between the DISH+ and DISH− groups. Among the three subgroups, hs-CRP levels in group 3 [mean (s. d.) 0.16 (0.09) mg/dl] were significantly higher than in group 1 [0.04 (0.02) mg/dl] and group 2 [0.08 (0.06) mg/dl]. Higher levels of hs-CRP were associated with a greater number of vertebral units with Flat-type formations (β  = 0.691 , P < 0.0001) and with a lesser number of vertebral units with Jaggy-type formations (β  = −0.147, P  = 0.036). Conclusion The Flat type in DISH might be caused by an inflammatory pathogenesis rather than a degenerative process presented in the Jaggy type. [ABSTRACT FROM AUTHOR]

Limited studies have focused on the impact of high-sensitivity C-reactive protein (hsCRP) to albumin ratio (CAR) on cardiovascular outcomes in patients undergoing percutaneous coronary intervention (PCI). Hence, the present study evaluates the association between CAR and cardiovascular outcomes in patients undergoing drug-eluting stent (DES) implantation. We consecutively enrolled 9375 CHD patients undergoing DES implantation. All patients were divided into 3 groups according to their CAR: tertile 1 (CAR ≤.02, n=3125), tertile 2 (.02.06, n = 3125). The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE). Kaplan-Meier analysis indicated that the incidences of MACCE and MI increased with high tertiles of the CAR (MACCE: 8.7 vs 10.5 vs 12.3%, log-rank P <.001; MI: 3.3 vs 4.0 vs 4.7%, long-rank P =.015). Cox regression analysis suggested that CAR was an independent risk factors for MACCE (HR per standard deviation (SD) increase: 1.07, 95% CI, 1.01–1.14, P =.024), and MI (HR per SD increase: 1.11, 95% CI, 1.01–1.22, P =.028). In conclusion, the CAR is an independent predictor of MACCE and MI in CHD patients. [ABSTRACT FROM AUTHOR]