Differential changes in maternal proinflammatory IL6 plasmalevels as a putatively surrogate marker of candidacy andclinical utility during mid- and late pregnancy hyperglycemia:interventional impact of clinical pharmacist on maternal andneonatal outcomes in a randomized clinical trial / Cambios diferenciales en los niveles plasmáticos de IL6 proinflamatoria materna como un marcador supuestamente sustituto de candidatura y utilidad clínica durante la hiperglucemia a mitad y final del embarazo: impacto intervencionista del farmacéutico clínico en los resultados maternos y neonatales en un ensayo clínico aleatorizado

Background/methods: The impact of clinical pharmacist on undiagnosed pregnancy hyperglycemia (PHG) in mid- and late- pregnancy as a major preventable cause of maternal and neonatal (M/N) complications is investigated. This longitudinal randomized controlled study of changes in plasma levels of predictive/prognostic/diagnostic biomarkers of oxytocin, thrombospondin, MCP1, IL6, MIF, insulin and LAR and undesirable M/N pregnancy outcomes in women with/out PHG (pregnancy normoglycemia; PNG) following the implementation of clinical pharmacist interventions were investigated. Results: A total of 68 PHG (36 intervention vs. 32 non-intervention) vs. 21 PNG participants were enrolled at 20–28 weeks and followed up till delivery. BMI of intervention PHG (unlike non-intervention) was greater (p=0.036) compared to PNG’s. LAR and insulin, oxytocin, thrombospondin1, adiponectin and MCP1 plasma levels and their differences between 2nd and 3rd pregnancy trimesters lacked discrepancies in participants. Both PHG groups in mid pregnancy had substantially greater HbA1c %, FPG and IL6 levels vs. PNG, while PHG non-intervention’ leptin was greater than PNG’s. In late pregnancy, greater SBP, IL6 and MIF levels between either PHG groups vs. PNG’s were observed. Unlike PHG non-intervention and PNG; IL6 level in PHG intervention group decreased (-2.54±6.61; vs. non-intervention PHG’s 4.26±5.28; p<0.001 and vs. PNG’s 2.30±4.27; p=0.023). None of the assessed M/N outcomes was found of differential significance between any of the three study groups. Conclusions: Proinflammatory IL6 as a robust and generalizable cardiometabolic risk-based and related pharmacotherapy biomarker in mid and late hyperglycemic pregnancy with likely implications of novel therapeutic targets was delineated by clinical pharmacist interventions.(AU)

Cross-sectional correlates of myeloperoxidase and alpha-1-acid glycoprotein with adiposity, atherogenic and hematological indices in metabolic syndrome patients with or without diabetes.

BACKGROUND: Type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS) are associated with obesity, which triggers the release of inflammatory substances. Myeloperoxidase (MPO), a peroxidase enzyme, and alpha-1-acid glycoprotein (AGP), an acute-phase protein, are known to be released in patients with inflammatory conditions and cardiovascular disease (CVD). METHODS: In this study, we investigated the correlation between MPO and AGP levels in pre/diabetic and MetS patients by conducting a cross-sectional study at The University of Jordan Hospital (UoJH) at the diabetes and endocrinology outpatient clinics. A total of 237 patients were recruited and assessed for eligibility. Of these, 149 patients were excluded, and 88 patients were assigned as: 29 patients in a healthy lean normoglycemic control group; 29 patients in a nondiabetic MetS group; and 30 patients in a prediabetic/newly diagnosed T2DM MetS group. RESULTS: MPO levels were only significantly higher in the nondiabetic MetS group compared with the control group (p = 0.026). AGP levels were significantly higher in both nondiabetic MetS and MetS-prediabetic/T2DM groups versus control (p = 0.007 and p = 0.015, respectively). Both biomarkers lacked inter-MetS-group discrepancy. CONCLUSIONS: Our results demonstrate an association between MPO and AGP with obesity and hyperglycemia, alongside their correlation with several adiposity, hematology and atherogenicity indices. Our findings reinforce the use of MPO and AGP as potentially putative and surrogate predictive/prognostic tools for MetS and its related disorders.