Relationship between body mass index, liver enzymes and high-sensitivity C-reactive protein in type 2 diabetes mellitus patients

Background: Obesity is a frequent co-morbid condition associated with excessive increase in weight. It is one of the most important modifiable risk factors in the pathogenesis of type 2 diabetes mellitus (T2DM). Obesity may be associated with liver disease and the progression of hepatic dysfunction. Also, highly sensitive C-reactive protein (hsCRP), which is elevated in inflammatory situations, can be produced by monocyte-derived macrophages in adipose tissue may also disrupt liver functions. Methods: A case control study with 50 patients of T2DM and 50 age and sex matched individuals were taken to serve as controls. Results: The body mass index (BMI) and waist circumference were increased in T2DM patients as compared to controls. However, the variations in liver enzymes alanine aminotransferase (ALT), aspartate aminotransferase (AST), and serum alkaline phosphatase (ALP) and hsCRP were increased in individuals of normal BMI as compared with individuals of overweight BMI. Conclusions: Individuals with normal Body mass index had an increased risk of developing T2DM along with progression of hepatic dysfunction. No associations were observed between chronic low-grade inflammation and BMI and with pathogenesis of obesity-related insulin resistance.

The predictive value of serum hs-CRP and sFlt-1 levels for fetal growth restriction in patients with ges-tational hypertension / 现代医院

Objective To investigate the changes in the levels of serum high-sensitivity C-reactive protein(hs-CRP)and soluble fms-like tyrosine kinase-1(sFlt-1)in hypertensive disorder of pregnancy(HDP)patients with fetal growth restriction(FGR),and to evaluate their predictive value for FGR.Methods A total of 137 HDP patients admitted to the Obstetrics De-partment of Ganzhou Maternal and Child Health Hospital from December 2021 to May 2023 were selected as the study subjects.According to whether their fetuses had growth restriction,they were divided into the restricted group(n=46)and the non-re-stricted group(n=91).The general information and serum levels of hs-CRP and sFlt-1 were collected and analyzed.Multiple lo-gistic regression analysis was used to identify the influencing factors for fetal growth restriction in HDP patients,and receiver oper-ating characteristic(ROC)curve was plotted to evaluate the predictive value of serum hs-CRP and sFlt-1 levels for fetal growth restriction in HDP patients.Results Univariate analysis showed that the serum levels of folic acid(FA),vitamin B12(VitB12),and placental growth factor(PIGF)in the restricted group were lower than those in the non-restricted group,while the serum lev-els of hs-CRP and sFlt-1 were higher than those in the non-restricted group,with statistically significant differences(P＜0.05).Multivariate analysis showed that serum hs-CRP,sFlt-1,and PIGF levels were independent risk factors for fetal growth restriction in HDP patients.The H-L test of the model showedx2=7.014,P=0.535,indicating a good fit.The area under the ROC curve(AUC)was 0.932,with a 95％CI of 0.889-0.975(P＜0.05),a sensitivity of 93.50％,and a specificity of 89.00％.Conclusion Serum hs-CRP and sFlt-1 levels are upregulated in HDP patients with fetal growth restriction,indicating their good predictive value for the occurrence of fetal growth restriction.

Correlation of oxidative stress and metabolic risk factors in apparently healthy adults

Background: Diabetes, hypertension, obesity, and dyslipidemia, all are the risk factors of metabolic syndrome (MS). Various studies have shown that each risk factor is associated with increased inflammation. hsCRP is a non-specific, sensitive inflammatory marker that is raised in various inflammatory conditions. Similarly, glutathione is an antioxidant which binds with ROS produced during inflammation and reduces damage caused by ROS. Aims and Objectives: This study has been planned to find the correlation between oxidative stress and metabolic risk factors in apparently healthy adults. Materials and Methods: We recruited apparently healthy adults (n = 120) and measured waist circumference, blood pressure, lipid profile, Fasting blood sugar, serum GSH, and hsCRP in all the subjects. Seventy-seven subjects were found to have at least one or more metabolic risk factors (Group A) according to NCEP ATP III criteria with waist circumference >90 cm for male and >80 cm for female and 43 were without any metabolic risk factors (Group B). Thereafter, we compared the serum levels of hsCRP and serum GSH with persons having one or more risk factors for MS. Results: In this study, we observed that subjects with metabolic risk factors were having more oxidative stress indicated by increased hsCRP (4783.1 ± 2060.21) and low serum GSH (3.17 ± 0.81) in comparison to controls (1640.5 ± 547.47 and 4.79 ± 0.77, respectively). This increase in hsCRP and decrease in GSH in case group was statistically significant. We also found the higher basal hsCRP levels in control group as per AHA/CDC study. Conclusion: We observed in this study that Indians without any risk factors for MS have relatively higher CRP levels and are at intermediate risk for cardiovascular disease. It was also observed that as the number of metabolic risk factors increases, the levels of hsCRP increases, and serum GSH decreases. This indicates that more risk factors are associated with higher oxidative stress.

Bioactive ingredients in activated platelet-rich plasma derived from cord blood and adult blood via Luminex technology: a comparative study / 中国输血杂志

【Objective】 To compare the bioactive ingredients in activated platelet-rich plasma (PRP) from cord blood and adult blood, explore its reasonable indicators reflecting the inflammatory regulation ability, in order to guide the preparation. 【Methods】 PRP was prepared and activated from 63 healthy adults (31 males, 32 females) and 61 neonates (30 males, 31 females), and 20 cytokines were measured using Luminex technology for assessing the age- and sex-based bioactive differences of PRP. High-sensitivity C-reactive protein(hs-CRP), procalcitonin and MMPs/TIMPs from each sample were measured for their correlations with the 10 inflammation-related cytokines. 【Results】 The activated cord blood PRP released 10 growth factors and chemokines more than the adult blood PRP, whereas IGF-1, HGF and 8 pro-inflammatory cytokines lower than the latter. Most cytokines of adult PRP were more in females than in males (P<0.05), except for IGF-1 and HGF, which showed no difference by gender. Compared with hs-CRP and PCT, MMPs/TIMPs ratio was more closely related with the inflammation-related cytokines, which can reflect the inflammatory regulation of PRP. 【Conclusion】 Due to the lower immunocompetence and no age or gender disturbance, cord blood PRP has the rational MMPs/TIMPs ratio and more cytokines which promote the inflammation and wound healing.

Association of Circulating Matrix Metalloproteinase-9 and the Risk of Coronary Heart Disease in Young Smokers

@#Introduction: Smoking causes cardiovascular risk which may alter the stability between the production and degradation of the extracellular matrix. Matrix metalloproteinase-9 (MMP-9) is a zinc-containing endopeptidase that degrades the extracellular matrix and plays a vital role in tissue remodeling. As a result, elevated serum MMP-9 levels produced by smoking, particularly at young age, raise the risk of future CHD. So this study aims to find out the possible relationship between circulating MMP-9 and the risk of cardiovascular disease in young smokers. Methods: The study was conducted on smokers with CHD subjects attending cardiology and medicine OP of the SRM Medical College Hospital and research center Tamil Nadu, India. The study group was divided into three groups. Group 1 includes 120 healthy controls as nonsmokers, Group 2 includes 120 smokers with Coronary heart disease (CHD), and Group 3 includes 120 smokers with diabetes and CHD subjects in the age group of 20-55 years. Serum MMP-9, hs-CRP, and APO-E levels were measured using the ELISA method and the lipid level was measured enzymatically using AU480 automatic analyzer (back man coulter). Results: The mean serum MMP-9, hs-CRP, and APO-E levels were significantly higher in both groups (p<0.05) when compared to controls. The study also shows a significant positive association between MMP-9 with hs-CRP, APO-E, smoking burden, and smoking intensity. Conclusion: The study concludes a significant association exists between cigarette smoking with MMP-9 and also relative exposure to circulating inflammation markers plays a potential role in the pathogenesis of CHD.

Comparison of Serum Homocysteine and Highly Sensitive C- reactive protein Levels in Patients of Acute Coronary Syndrome with and without Type-2 Diabetes

Background: The association of high serum homocysteine concentration and C- reactive protein as a risk factor for the acute coronary syndrome. The aim of study was to evaluate serum homocysteine and hs-CRP level in newly diagnosed ACS patients together with comparison of homocysteine and hs-CRP level in ACS patients with & without type 2 diabetes and also to find out the correlation between serum homocysteine and hs- CRP level among the ACS patient with and without type 2 DM.Material & Methods:This was a cross sectional study and total of 260 patients with new onset of ACS admitted in the CCU, Department of Cardiology, DMCH were included in the study during Jan, 2011 to Feb, 2012. Among them 72 ACS patients with type 2 diabetes was considered as group I and 188 ACS patients without diabetes was considered as group II. Serum total homocysteine level, hs-CRP level and traditional risk factors for ACS were documented from all the study population.Results:Most of the patients were found in 4th decade in both groups. Acute STEMI was more common clinical feature in both groups. The mean serum homocysteine level in all groups of ACS patients were significantly higher in patients without DM in comparison to type 2 DM. Similarly, the mean hs-CRP level in all groups of ACS patients were significantly higher in patients without type 2 DM. The mean serum homocysteine and hs-CRP level were significantly higher in nondiabetic ACS patients. However, dyslipidaemia was significantly higher in patients with type 2 DM. Hypertension, obesity and family history of ACS were not significant between two groups. There was no correlation found between serum homocysteine with serum hs-CRP in ACS patients with type 2 DM and ACS patients without DM respectively.Conclusion: So, both serum homocysteine and hs-CRP level in ACS patients were significantly higher in patients without DM. In ACS, C-reactive protein elevation was a better marker of extension of myocardial damage than homocyesteine. No correlation was found between serum homocysteine with hs-CRP level in ACS patients with and without type 2 DM respectively.

Effect of serum uric acid on recurrent stroke in patients with acute cerebral infarction / 中华急诊医学杂志

Objective:investigate the effect of serum uric acid (SUA) on long-term cerebrovascular mortality and recurrent stroke in patients with acute cerebral infarction.Methods:A total of 132 patients from the same center were enrolled in this study. The patients were divided into three groups according to the quartile level of SUA: group 1 (SUA < 442 μmol/L, n= 69) , group 2 (SUA 442-620 μmol/L, n=35) and group 3 (SUA > 620 μmol/L, n= 28). SUA, blood urea nitrogen, serum creatinine, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol, triglyceride and hypersensitive c-reactive protein (hs-CRP) were measured in the three groups, the National Institutes of Health Stroke Scale (NIHSS) score was determined on the day of admission, and the patients were followed up until December 31, 2020. The differences of recurrent stroke and cerebrovascular mortality in the three groups were analyzed. Results:Sixty-nine patients were selected in group 1, 35 in group 2 and 28 in group 3. Patients in group 2 and group 3 were younger, and had higher hs-CRP levels, higher SUA levels, and higher rates of recurrent stroke and cerebrovascular mortality, and the differences were statistically significant (all P<0.05). Cerebrovascular mortality (log-rank χ2 =13.19, P=0.001) and recurrent stroke (log-rank χ2 =10.30, P=0.006) were significantly increased in group 3. The risk of recurrent stroke in group 3 was 3.55 times higher than that in group 1. Conclusions:The risks of long-term cerebrovascular mortality and recurrent stroke were significantly increased in patients of acute cerebral infarction with elevated serum uric acid.

Effect of non-nucleoside reverse transcriptase inhibitors and protease inhibitors on serum levels of myeloperoxidase and C-reactive protein in HIV-infected individuals

Abstract It remains unclear whether increased inflammatory and cardiovascular risk biomarkers differ depending on the class of antiretroviral that is used. This study evaluated the plasma levels of inflammatory and cardiovascular risk biomarkers, such as MPO, hs-CRP, glucose, lipid profile, ALT (GPT), AST (GOT), urea and creatinine, as well as the blood count, of all the 164 participants in the study, either infected or un-infected with HIV. Thirty of the 104 HIV-infected individuals did not receive any antiretroviral; twenty-four of them were treated with non-nucleoside reverse transcriptase inhibitor class; and fifty took protease inhibitors. The control group consisted of sixty non-HIV infected individuals. In the case of the HIV-infected volunteers, the CD4+ T lymphocyte counts and viral load were also analyzed. Regardless of the hematological and biochemical changes resulting from the antiretroviral therapy (ART), the MPO and hs-CRP values significantly increased for the HIV-infected individuals (treated or untreated), irrespective of the class of ART that was used. This is important because these biomarkers are designed to be predictors of the risk of cardiovascular disease. The results of this study provide supporting evidence for the hypothesis that HIV-infected individuals are at increased risk of developing cardiovascular disease related to chronic inflammations, despite virological control with ART, and regardless of the class of ART that is used.

Lower LDL-cholesterol levels associated with increased inflammatory burden in patients with acute ST-segment elevation myocardial infarction

SUMMARY OBJECTIVE: Association of low-density lipoprotein cholesterol and highly sensitive C-reactive protein in ST-elevation myocardial infarction patients was assessed in this study. METHODS: 591 consecutive patients who were hospitalized with a diagnosis of ST-elevation myocardial infarction were enrolled and assigned into tertiles according to their serum low-density lipoprotein cholesterol levels. Differences in highly sensitive C-reactive protein among low-density lipoprotein cholesterol tertiles and correlations between highly sensitive C-reactive protein and low-density lipoprotein cholesterol were assessed. RESULTS: Highly sensitive C-reactive protein levels differed significantly among the groups (p<0.001) and found to be highest in the low-density lipoprotein cholesterol tertile 1 and lowest in the low-density lipoprotein cholesterol tertile 3 (post-hoc p-values: tertile 1 vs. 2 <0.001; tertile 1 vs. 3 <0.001; tertile 2 vs. 3=0.019). There was a negative correlation between hs-CRP and both low-density lipoprotein cholesterol (r=-0.332, p<0.001) and total cholesterol (r=-0.326, p<0.001). There was also a negative correlation between highly sensitive C-reactive protein and high-density lipoprotein cholesterol, though the strength of this relationship was weak (r=-0.103, p=0.014). CONCLUSION: Lower low-density lipoprotein cholesterol levels are associated with higher inflammatory burden in patients with acute STEMI. Further studies are required to elucidate the significance of low-density lipoprotein cholesterol levels in ST-elevation myocardial infarction settings.

High sensitivity C-reactive protein (hsCRP): Its relationship with metabolic syndrome and Framingham Risk Score

@#Introduction: Cardiovascular disease (CVD) remains the leading cause of death in Malaysia. Identification of asymptomatic at-risk individuals is often achieved by means of a risk prediction algorithm. Traditional CVD risk factors and their associated algorithms are, however, limited by residual CVD risk. High sensitivity C-reactive protein (hsCRP) has emerged as a novel CVD risk factor. This study aimed to evaluate hsCRP as an adjunct CVD risk marker among the adult Malaysian population by determining its correlation with the Framingham Risk Score (FRS). Comparison analyses were done according to sociodemographic, clinical and laboratory factors and between subjects with and without Metabolic Syndrome (MetS). Method: This cross-sectional study involved eighty-three (n=83) adults attending a health screening program at Universiti Putra Malaysia (UPM). Demographic data, anthropometric measurements and blood samples for fasting blood glucose (FBG), fasting lipid profile (FSL), glycated haemoglobin (HbA1c) and hsCRP were taken. Respondents were grouped according toFRSand the Joint Interim Statementinto 10-year CVD risk categories (low, intermediate and high) and MetS, respectively. Results: hsCRP was significantly increased in patients with high body mass index (BMI) (p=0.001), at-risk waist circumference (WC) (p=0.001) and MetS (p=0.009). Spearman’s correlation coefficient showed a significant positive correlation between hsCRP level and total FRS score (r=0.26, p<0.05) and HDL-C score (r=0.22, p<0.05). Conclusion: The significant difference of hsCRP levels across obesity levels and MetS with its modest correlation with FRS scores supported the adjunctive role of hsCRP in CVD risk prediction, most likely capturing the inflammatory pathological aspect and thus partly accounting for the residual CVD risk.

In vitro anti-inflammatory effects of vitamin D supplementation may be blurred in hemodialysis patients

OBJECTIVES: This study aimed to evaluate the potential anti-inflammatory effects of vitamin D supplementation under uremic conditions, both in vivo and in vitro, and its effects on the parameters of mineral metabolism. METHODS: Thirty-two hemodialysis patients were randomly assigned to receive placebo (N=14) or cholecalciferol (N=18) for six months. Serum levels of calcium, phosphate, total alkaline phosphatase, intact parathyroid hormone (iPTH), and vitamin D were measured at baseline and after three and six months. The levels of fibroblast growth factor-23 (FGF-23), interleukin-1β (IL-1β), and high-sensitivity C-reactive protein (hs-CRP) were also measured at baseline and at six months. Human monocytes were used for in vitro experiments and treated with cholecalciferol (150 nM) and uremic serum. Cell viability, reactive oxygen species (ROS) production, and cathelicidin (CAMP) expression were evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, dichloro-dihydro-fluorescein diacetate assay, and real time-quantitative polymerase chain reaction, respectively. RESULTS: Both patient groups were clinically and biochemically similar at baseline. After six months, the levels of vitamin D and iPTH were higher and lower, respectively, in the cholecalciferol group than in the placebo group (p<0.05). There was no significant difference between the parameters of mineral metabolism, such as IL-1β and hs-CRP levels, in both groups. Treatment with uremic serum lowered the monocyte viability (p<0.0001) and increased ROS production (p<0.01) and CAMP expression (p<0.05); these effects were counterbalanced by cholecalciferol treatment (p<0.05). CONCLUSIONS: Thus, cholecalciferol supplementation is an efficient strategy to ameliorate hypovitaminosis D in hemodialysis patients, but its beneficial effects on the control of secondary hyperparathyroidism are relatively unclear. Even though cholecalciferol exhibited anti-inflammatory effects in vitro, its short-term supplementation was not effective in improving the inflammatory profile of patients on hemodialysis, as indicated by the IL-1β and hs-CRP levels.

25-Hydroxyl Vitamin D Deficiency in Nasal Polyposis

Abstract Introduction Vitamin D is known to have immunomodulatory functions and has action on chronic inflammatory processes, such as nasal polyposis. Objective The present study assessed the levels of 25-hydroxy vitamin D and high-sensitivity C-reactive protein (hs-CRP) in patients with nasal polyposis, as compared with healthy control subjects, and identified their association with disease severity in nasal polyposis. It further assessed the levels of 25-hydroxyl vitamin D and hs-CRP in patients with nasal polyposis and atopy and compared it with patients with nasal polyposis without atopy. Methods This was a cross-sectional study involving 2 groups: 80 patients with nasal polyposis and 80 healthy subjects. In patients with nasal polyposis, the disease severity is assessed by the sino-nasal outcome test (SNOT20) and by the Lund & Mackay staging system. Levels of 25-hydroxy vitamin D and hs-CRP were measured by enzyme-linked immunosorbent assay (ELISA). Result The mean 25-hydroxyl vitamin D levels (ng/ml) was 12.01 ± 7.29 for cases and 22.87 ± 14.95 for controls, with p< 0.0001. The mean hs-CRP levels (mg/L) was 5.99 ± 2.74 in cases and 2.41 ± 1.95 in controls, with p< 0.0001. The severity of polyposis correlated negatively with serum levels of 25-hydroxy vitamin D and positively with hs-CRP. Conclusion The study has thus shown significant correlation between vitamin D deficiency and inflammation in patients with nasal polyps.

Study of prognostic importance of hs-CRP levels in acute stroke patients coming to Theerthanker Mahaveer Medical College, Moradabad, Uttar Pradesh, India

Background: Stroke has been found to be the fourth most fatal cause of death around the globe. Decreased activity and physical work are the major causes of increased incidences of stoke worldwide. It has also been studied that elevated levels of high-sensitivity C-reactive protein (hs-CRP) have been related to vascular inflammation whereas CRP is an important biomarker of systemic inflammation. Aim of this study to measure serum high-sensitivity C-reactive protein (hs-CRP) levels in the patients presenting with stroke, and evaluating its correlation as a prognostic marker in stroke patients.Methods: It was an observational prospective hospital-based case study carried out at Teerthanker Mahaveer Medical College and Research Centre, a tertiary care hospital situated in Moradabad, India for 5 months period from 1st November 2018 to 31st March 2019. 100 patients of new-onset stroke were included in the study.Results: According to the Scandinavian score, the majority of the patients who had ischemic stroke depicted a score range from 2-8. On the other hand, the majority the patients with hemorrhagic score had a Scandinavian score >14. The mean hs-CRP, when observed between different ranges of the Scandinavian score, showed that in 2-8 range the mean hs-CRP was 31.49±15.00, the mean hs-CRP for 9-14 range was 7.99±6.32 and the mean hs-CRP for >14 range was 7.10±0.32.Conclusions: It can be identified that levels of hs-CRP can be used as a marker to predict the long term prognosis of patients with stroke. In addition to this, it can also be identified that patients with higher levels of hs-CRP have lower Scandinavian score and the patients with lower hs-CRP levels have a higher Scandinavian score. Also, the results show that patients with ischaemic stroke have higher hs-CRP levels as compared to hemorrhagic stroke.

High sensitive C reactive protein as an inflammatory indicator in preeclampsia

Background: Preeclampsia is one of the most serious complications of pregnancy and one of the leading cause of maternal, prenatal morbidity and mortality. The present study was carried out to estimate serum high sensitive C- reactive protein in both mild and severe preeclampsia as an indicator of inflammation and to correlate Hs-CRP with blood pressure.Methods: A case control study was conducted in the Department of Biochemistry and Department of Obstetrics and Gynecology, MIMER Medical College and Bhausaheb Sardesai Rural Hospital Talegaon Dabhade, Pune. The study group include 50 cases of normal pregnant women, 43 clinically diagnosed cases of mild preeclampsia and 7 cases of severe preeclampsia in second and third trimester of pregnancy. 2 ml venous blood samples was collected from all the study participants for estimation of Hs-CRP by ultra-sensitive immunoturbidometric assay spin react method.Results: There was significant increase in the mean serum Hs-CRP levels in normal pregnant women and mild preeclamptic women (p<0.001). Serum Hs-CRP levels were significantly higher in severe preeclamspia than mild preeclamptic women (p<0.001). The degree of inflammation increases as HsCRP rises. Hence, present study shows that HsCRP levels increases as disease progresses from mild to severe condition. Significant positive correlations was found between Hs-CRP and Blood Pressure in preeclampsia.Conclusions: In preeclampsia there is an exaggeration of systemic inflammatory response that might induce reactive oxygen species which further induces endothelial dysfunction. This leads to clinical symptoms of hypertension and proteinuria in preeclampsia. Early detection might minimise systemic complications and maternal death due to preeclampsia. Hence, HsCRP may be used as an important indicator of severity of preeclampsia.

High Sensitivity C- Reactive Protein Level in Acute Cerebrovascular Accident (Stroke) at a Tertiary Care Centre.

Stroke is the leading cause of death worldwide and one of the main causes of long term disability. According to WHO, 15 million suffer from stroke each year. Studies have shown that levels of hsCRP measured shortly after stroke predicted complimentary aspects of prognosis. There is possibility that elevated hsCRP levels has direct relation to extent of cerebral tissue injury. We wanted to measure the levels of hsCRP in acute cerebrovascular accident. To correlate the level of hsCRP with severity of stroke and outcome.METHODSStudy was conducted in patients admitted in medical ward and medical ICU in tertiary care hospital (Grant Government Medical College and Sir JJ Group of Hospitals). It was a cross sectional study. A total of 150 patients who presented with stroke and fulfilled inclusion and exclusion criteria were enrolled in the study. In all patients hsCRP levels were measured within 48 hours of admission. Data was collected prospectively in a Microsoft Excel database. Statistical analysis was done using non-parametric ANOVA (Kruskal Wallis test) and Mann Whitney test.RESULTSMean age of patients was 59 ± 12 years. hsCRP levels were raised in stroke patients. Also values were found to be more in haemorrhagic stroke (value) than in ischemic stroke (value) and the difference was found to be significant. Significant correlation was also found between hsCRP levels and GCS with lower GCS scores associated with higher hsCRP levels in both types of stroke. Mean hsCRP level in survivors was 21.83 ± 23.17 mg/L and in non survivors was 82.07 ± 25.83 mg/L and the difference was statistically significant (p <0.0001)CONCLUSIONSWe concluded that hsCRP level is increased in cases of stroke (both ischemic and haemorrhagic) suggesting an inflammatory response in acute stroke. Increased levels of hsCRP correlated with severity of neurological deficit and worse outcome.

Assessment of Acute Phase Protein Serum hs-CRP Levels and its Role in Severity of Disease in Vitiligo Patients – A Hospital Based Case Control Study in M.Y. Hospital, Indore M.P.

Introduction: Vitiligo an acquired pigmentary disorderof the skin and mucous membranes characterized by wellcircumscribed, depigmented macules and patches resultingfrom selective destruction of melanocytes. CRP is an acutephase protein secreted by the liver in response to severalinflammatory cytokines such as IL6. Since inflammatoryand immune factors plays a key role in the pathogenesis ofvitiligo, we aimed to assess the relationship between theserum level of hs-CRP and pathogenesis and severity ofvitiligo.Material and methods: The study was conducted in theDept. of Biochemistry and Dept. of Dermatology andVenereology in MGM Medical College & M Y HospitalIndore after approval from ethical committee on 70Confirmed & diagnosed cases of Vitiligo patients of agegroup 18 to 55 years attending Dermatology OPD in MYHospital Indore during a period of April 2018 to April 2019.Patients were divided into three groups according to thearea of skin affected. Healthy individual without vitiligowere taken as controls. Venous blood sample was analyzedfor serum hs-CRP levels and liver function. Appropriatestatistical tests were applied on Minitab Version 17.0 and pvalues < 0.01was considered significant.Results: In our study the mean serum hs-CRP in case groupwas higher 12.09 ± 11.64 than in control group it was 1.99 ±2.05 with negative but statistically significant correlation withage of onset of disease and positive statistically significantcorrelation with duration of disease thus, serum hs-CRPlevel might be useful for evaluating the disease activity ofvitiligo as Novel biomarker.Conclusion: As high-sensitive C-reactive protein (hs-CRP)is an important sensitive diagnostic and prognostic markerin many systemic inflammatory diseases and very lowconcentrations of hs-CRP can be analyzed in the serum, itsdetection and serial measurements helps to provide a novellink to evaluate the disease activity and severity and responseto treatment

Study of Carotid Intima Media Thickness (CIMT) In Type 2 Diabetes Mellitus and Its Correlation with Glycaemic Control and Inflammatory Marker HsCRP

Background: Carotid Intima Media Thickness (CIMT) andCRP (C Reactive Protein) are have been used for measuringAtherosclerotic Risk in Diabetics. However there is paucity ofdata regarding their importance in Statin Naïve Diabetics.Aim: To study Correlation of CIMT with glycaemic control andhsCRP in Statin Naïve Diabetics.Materials and Methods: 80 Cases (Patient suffering from type2 Diabetes Mellitus) and 20 controls (non- diabetic healthpatients) presenting in outpatient department of a tertiaryHospital were included in this observational cross sectionalobservational study. Complete Blood Count, urine Routine andMicroscopy, urine for microalbuminuria, fasting plasma glucose(FPG), postprandial plasma glucose (PPPG), glycatedhaemoglobin (HbA1C), lipid profile, renal function test, hs-CRPand CIMT were evaluated in each individual. Independentsamples T-test was used to compare CIMT and hs-CRP bothcases and controls. Test of proportion and chi-square test wasused for association between categorical variables.Spearman’s method was used to assess correlation betweenhsCRP and CIMT.Results: 80 cases (Statin naïve and Non-smoker Diabeticpatients and 20 healthy controls were included in this study.Average CIMT in cases was significantly higher in Diabeticcases than Control (0.66 + 0.14 vs 0.56±0.05, difference= 0.10 mm, 95% C.I. (0.1 - 0.17), p < 0.0001). HsCRP wassignificantly correlated with average CIMT in Diabetic cases.(r=0.512, 95% C.I. 0.33-0.658, p<0.0001). Fasting Blood Sugarwas correlated with average CIMT in Diabetic cases. (r=0.234,95% C.I. 0.015-0.432, p=0.0366). Post Prandial Blood Sugarwas also correlated with average CIMT (r=0.300, 95% C.I.0.086-0.488, p=0.00677).Conclusion: Cardiovascular risk factors like glycaemic controland inflammatory markers like hsCRP are significantlyassociated with CIMT even in non-smoking and statin naïveDiabetics.

Analysis of clinical features and related factors of coronavirus disease 2019 in Shanghai / 上海交通大学学报（医学版）

Objective • To explore the common clinical features of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)-infected local patients in Shanghai and their related influencing factors. Methods • A total of 320 patients admitted to Shanghai Public Health Clinical Center from January to March 2020 and diagnosed as having coronavirus disease 2019(COVID-19) were selected. Clinical data of the patients were collected to analyze their characteristics. Using the statistical operation formula of R language, the correlation analysis of hospitalization days, days of increased hypersensitive C-reactive protein concentration (allergic days), days of lung CT improvement (CT days), and days required for nucleic acid turning negative with the main clinical manifestations and laboratory data was carried out. The correlation factors affecting the above four variables were analyzed. Results • Among the 320 patients, the proportions of mild type, moderate type, serious type and critical type were 6.25%, 83.44%, 6.88% and 3.44%, respectively; 91.25% of them had a history of exposure to Hubei. The proportions of fever, cough, sputum and fatigue were 79.06%, 46.56%, 21.56% and 15.31%, respectively. Spearman correlation analysis showed that the concentrations of lactate dehydrogenase, interleukin-2(IL-2) and IL-6 were positively correlated with the above four variables, respectively (all P<0.05), albumin concentration was negatively correlated with allergic days (P=0.018), and CD4+ cell count was negatively correlated with CT days and days required for nucleic acid turning negative (both P<0.05). Stepwise multiple linear regression analysis showed that procalcitonin (PCT) concentration was negatively correlated with hospitalization days, CT days and allergic days (both P<0.05), and disease type was positively correlated with hospitalization days, allergic days, CT days and days required for nucleic acid turning negative (all P<0.05). Conclusion • Moderate type is common in the local patients in Shanghai; fever, cough and fatigue are common symptoms, and most of the patients are accompanied by lung CT abnormalities. The therapeutic effect and prognosis of these patients are closely related to disease type, concentrations of PCT and IL-6, as well as CD4+ cell count.

Effects of butylphthalide injection on different OCSP types of acute cerebral infarction and its effect on Hs-CRP and FIB levels / 中风与神经疾病杂志

@#Objective　To study the effects of butylphthalide injection on different OCSP types of acute cerebral infarction（ACI） and its effect on hypersensitive c-reactive protein（Hs-CRP） and FIB. Methods　Two hundred and forty-eight ACI patients admitted to our hospital were randomly divided into control group（n-113） and observation group（n=135），The observation group was treated with additional butylphthalide injection. All patients received OCSP typing at the time of admission，and at the same time，NIHSS score，Hs-CRP and FIB were measured at the time of admission and 2 weeks later. The changes of Hs-CRP and FIB were compared between the two groups in terms of overall efficacy and different subtypes. Results　After 2 weeks of treatment，NIHSS score，Hs-CRP and FIB levels of the observation group were significantly lower than those of the control group （P<0.05），and the overall effective rate of the observation group was higher than that of the control group （P<0.05）；The NIHSS score and FIB level of TACI，PACI，POCI and LACI was significantly lower in observation group than control group after 2 weeks（P<0.05）；TACI and POCI curative effect of observation group is better than that of control group （P<0.05），while there was no statistically significant difference between the PACI and LACI groups and the control group （P>0.05）；NIHSS score was positively correlated with Hs-CRPand FIB.Conclusion　The curative effect of butylphthalide injection is rather good for all OCSP types of ACI，especially for TACI and POCI，and butylphthalide injection can effectively reduce the inflammatory response. The mechanism may be to achieve therapeutic effect by reducing the inflammatory response.

Study of highly sensitive C-reactive protein in type 2 diabetes mellitus and prediction of cardiovascular risk with glycemic status

Inflammation plays a vital role in accentuating the formation of atherosclerotic plaque in diabetes mellitus. So, the measurements of inflammatory markers provide a method of assessing cardiovascular risk. Among the inflammatory markers, highly sensitive C-reactive protein (hs-CRP) is used to detect the low-level inflammation when it is within the normal range. Also, hs-CRP measurement may be useful for assessment of the risk of complication in diabetes patients. So, the present study is conducted to measure plasma hs-CRP level in T2DM and to determine adequate glycaemic control reduces hs-CRP level. The objectives of this study were to correlate HbA1c and hs-CRP in T2DM and predict cardiovascular risk with glycaemic status.Methods: Authors took 50 diabetic patients. The investigation includes FBS, PPBS, hs-CRP and HbA1c. hs-CRP is measured by immunoturbidimetry method. The reports were collected and compared with normal reference range.Results: The correlation between hs-CRP levels and HbA1c level after six months show a significant relationship where mean HbA1c values on day 1 and after 6 months were 8.088±1.219 and 7.518±0.693 respectively. The hs-CRP values were 2.508±1.050 on day 1 and 2.15±0.927 after 6 months proving that better glycaemic controls decrease hs-CRP thereby decreasing cardiovascular risk.Conclusions: hs-CRP values are directly related to HbA1c and better glycaemic control reduces risk of CVD.