Meta-analysis of the effect of thiazolidinediones on serum C-reactive protein levels

We conducted a meta-analysis of randomized clinical trials to evaluate the effect of thiazolidinediones on serum C-reactive protein levels. Compared with placebo, treatment with thiazolidinediones significantly decreased the serum C-reactive protein levels (mean -0.82 mg/L, 95% confidence interval -1.15 to -0.49 mg/L, p <0.0001). In a subgroup analysis, the effect of thiazolidinediones on the serum C-reactive protein levels was more pronounced in diabetic patients (mean -1.24 mg/L, 95% confidence interval -2.15 to -0.32 mg/L, p = 0.008) compared with nondiabetic patients (mean -0.27 mg/L, 95% confidence interval -0.41 to -0.14 mg/L, p <0.0001).     

血清降钙素原和超敏C-反应蛋白在AECOPD的作用

目的探讨血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)水平在AECOPD患者的治疗及预后判断的临床意义。方法选择48例AECOPD及46例COPD稳定期患者,分别测定其PCT、hs-CRP。同时行痰细菌培养。结果 AECOPD组的PCT、hs-CRP水平明显高于COPD稳定期组(P<0.05)。PCT水平与细菌感染有关,AECOPD组中细菌学培养阳性者PCT水平高于阴性者。AECOPD患者中PCT阳性组好转率70.37%,PCT阴性组好转率85.71%。结论在AECOPD患者中,PCT和hs-CRP是较好的诊断指标,尤其在细菌感染的判断上PCT较hs-CRP更有临床价值。PCT可提示病情的严重程度及预后情况。     

A strabismus susceptibility locus on chromosome 7p

Strabismus has been known to have a significant genetic component, but the mode of inheritance and the identity of the relevant genes have been enigmatic. This paper reports linkage analysis of nonsyndromic strabismus. The principal results of this study are: (i) the demonstrated feasibility of identifying and recruiting large families in which multiple members have (or had) strabismus; (ii) the linkage in one large family of a presumptive strabismus susceptibility locus to 7p22.1 with a multipoint logarithm of odds score of 4.51 under a model of recessive inheritance; and (iii) the failure to observe significant linkage to 7p in six other multiplex families, consistent with genetic heterogeneity among families. These findings suggest that it will be possible to localize and ultimately identify strabismus susceptibility genes by linkage analysis and mutation screening of candidate genes.     

Refinement of heterozygosity loss on chromosome 5p15 in sporadic colorectal cancer

AIM: To refine the loss of heterozygosity on chromosome 5p15 and to identify the new tumor suppressor gene (s) in colorectal tumorigenesis. METHODS: Sixteen polymorphic microsatellite markers were analyzed on chromosome 5 and another 6 markers were applied on chromosome 5p15 in 83 cases of colorectal and normal DNA by PCR. PCR products were electrophoresed on an ABI 377 DNA sequencer. Genescan 3.1 and Genotype 2.1 software were used for LOH scanning and analysis. RESULTS: We observed 2 distinct regions of frequent allelic deletions on Chromosome 5, at D5S416 on 5p15 and D5S428-D5S410 on 5q. Another 6 polymorphric microsatellite markers were applied to 5p15 and the minimal region of frequent loss of heterozygosity was established on 5p15 spanning the D5S416 locus. CONCLUSION: Through our detailed deletion mapping studies, we have found a critical and precise location of 5p deletions, 5p15.2-5p15.3, which must contain one or more unknown tumor suppressor gene (s) of colorectal cancer.     

Effect of fosinopril treatment on serum C-reactive protein levels in patients with microalbuminuria

Inflammation is an important factor in the development and progression of atherosclerosis. Observational studies have suggested that renin-angiotensin system inhibition might lower C-reactive protein (CRP). The aim of this study was to test the hypothesis that angiotensin-converting enzyme inhibition with fosinopril would reduce inflammation in a placebo-controlled trial involving 621 subjects. CRP was determined using a high-sensitivity assay at baseline and after 3 months of fosinopril treatment. The median CRP level at baseline was 1.38 mg/dl (interquartile range 0.64 to 2.86) and did not significantly differ between treatment groups. CRP levels at baseline were significantly associated with future cardiovascular events, even after adjustment for age and gender (odds ratio 1.76, 95% confidence interval 1.16 to 2.67, p = 0.008). Fosinopril treatment during 3 months did not result in a significantly higher reduction of CRP levels compared with placebo (difference -0.11, p = 0.20). Exploratory analysis suggested an interaction between gender and fosinopril treatment on CRP reduction (p = 0.07). Male gender was associated with a significantly larger reduction in CRP compared to female gender. In conclusion, contrary to previous observational studies, no effect of angiotensin-converting enzyme inhibition on CRP levels was found.     

Evidence for a novel rheumatoid arthritis susceptibility locus on chromosome 6p

OBJECTIVE: To investigate whether the large linkage peak on chromosome 6p harbors rheumatoid arthritis (RA) susceptibility loci in addition to the well-characterized HLA-DRB1 gene. METHODS: DNA samples obtained from 377 UK RA affected sibling pair (ASP) families, comprising test (181 ASPs) and replication (196 ASPs) cohorts, were used for linkage analysis. Three hundred eighty-four patients with RA derived from a subset of 192 ASPs were compared with a panel of 288 unrelated healthy controls for association studies. Samples were genotyped for 35 microsatellites and 25 single-nucleotide polymorphisms (SNPs). RESULTS: In the test cohort, the maximum logarithm of odds (LOD) score was obtained over D6S1260 (LOD 7.1). Evidence for linkage to the telomeric portion of the peak was increased in subsets of ASPs in which both individuals had erosive disease or both carried 2 copies of the shared epitope. HLA-A, HLA-DRB1, and 8 additional markers showed evidence of linkage in the presence of association with RA (using the extended transmission disequilibrium test [ETDT]). The positive ETDT result for 2 adjacent markers (D6S1665 and 210901-4) mapping to the telomeric end of the linked region ( approximately 11 Mb from DRB1) was replicated (for D6S1665) in the second cohort of ASPs. Haplotypic overtransmission of pairwise combinations between D6S1665*7 and 210901-4*4 was identified through the TDTPhase program. Multipoint conditional analysis showed this effect to be independent of HLA-DRB1. SNP-based association studies of the region identified a 4-marker haplotype in the DEK gene that was significantly associated with RA (P = 0.009). CONCLUSION: Evidence has been presented for an RA susceptibility locus mapping under the linkage peak on 6p, 11 Mb telomeric of HLA-DRB1. Preliminary association data implicate the gene DEK.     

急性胰腺炎患者血清miR-551-5p和miR-126a-5p水平与病情严重程度的相关性

目的:探讨急性胰腺炎(AP)患者血清微小RNA-551-5p(miR-551-5p)、微小RNA-126a-5p(miR-126a-5p)表达水平与AP严重程度的相关性。方法:收集127例AP患者的临床资料,根据病情严重程度分为轻症AP(MAP组) 63例和重症AP(SAP组) 64例;另选取健康体检者60例为对照组。采用实时定量PCR(qRT-PCR)检测3组血清miR-551-5p和miR-126a-5p水平,采用酶联免疫吸附法(ELISA)检测血清白介素6(IL-6)、白介素18(IL-18)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、淀粉酶(AMS)及脂肪酶(LPS)水平;利用Pearson法分析血清miR-551-5p及miR-126a-5p水平与患者Ranson评分、急性生理与慢性健康评估(APCHEⅡ)评分、血清生化指标的关系;绘制受试者工作特征(ROC)曲线,评估血清miR-551-5p及miR-126a-5p水平对AP的诊断价值;采用Logistic回归分析评估影响AP的危险因素。结果:与对照组比较,SAP组血清TNF-α、IL-6、IL-18、CRP、AMS、LPS水平、Ranson及APCHEⅡ评分显著升高(均P 0. 05),MAP组血清IL-6、IL-18、AMS、LPS水平、Ranson及APCHEⅡ评分显著升高(均P 0. 05);与MAP组比较,SAP组血清TNF-α、IL-6、CRP水平、Ranson及APCHEⅡ评分显著升高(均P 0. 05)。Pearson相关性分析显示,血清miR-551-5p与TNF-α、IL-6、AMS、LPS水平、Ranson及APCHEⅡ评分呈正相关(r值依次为0. 755,0. 684,0. 531,0. 519,0. 712,0. 679,均P 0. 05);血清miR-126a-5p与IL-6、IL-18、AMS水平及Ranson评分呈正相关(r值依次为0. 711,0. 678,0. 628,0. 701,均P 0. 05);血清miR-551-5p、miR-126a-5p诊断SAP的ROC曲线下面积(AUC)分别为0. 809、0. 800,截断值分别为2. 01、1. 54,敏感度分别为73. 1%、85. 3%,特异性分别为82. 8%、72. 4%;二者联合诊断的AUC为0. 965,敏感度为96. 5%,特异性为82. 4%;多因素Logistic分析结果显示高水平血清AMS、LPS、miR-551-5p、miR-126a-5p是AP的危险因素。结论:血清高水平miR-551-5p及miR-126a-5p可能反映AP患者病情严重程度,是评估SAP患者预后的潜在指标。     

Metformin reduces serum C-reactive protein levels in women with polycystic ovary syndrome

Low-grade chronic inflammation, reflected in elevated levels of serum C-reactive protein (CRP), has recently been linked to obesity, insulin resistance syndromes such as polycystic ovary syndrome (PCOS), and an increased risk of cardiovascular disease. Because the insulin sensitizer metformin has been shown to improve metabolic disturbances in PCOS, it was of particular interest to examine serum CRP levels during metformin therapy. Twenty nonobese women [body mass index (BMI) /==" BORDER="0"> 27 kg/m(2)) with PCOS were randomized to receive either metformin (500 mg twice daily for 3 months, then 1000 mg twice daily for 3 months) or ethinyl estradiol (35 micro g)-cyproterone acetate (2 mg) oral contraceptive pills. The serum concentrations of CRP were significantly higher in obese than in nonobese subjects at baseline [4.08 +/- 0.53 (SE) vs. 1.31 +/- 0.28 mg/liter; P < 0.001] and correlated to BMI and to a lesser extent waist-hip ratio, suggesting that the elevated CRP levels may be related to obesity and not only to PCOS itself. During metformin treatment, serum CRP levels decreased significantly from 3.08 +/- 0.7 mg/liter to 1.52 +/- 0.26 mg/liter at 6 months in the whole study population (P = 0.006) and especially in obese subjects. In contrast, the treatment with ethinyl estradiol-cyproterone acetate increased serum CRP levels from 2.91 +/- 0.68 mg/liter to 4.58 +/- 0.84 mg/liter (P < 0.001). Whether this effect is related to estrogen action in the liver or whether it reflects increased inflammation process and possible risks for cardiovascular disease remains unclear. The decrease of serum CRP levels during metformin therapy is in accordance with the known beneficial metabolic effects of this drug and suggests that CRP or other inflammation parameters could be used as markers of treatment efficiency in women with PCOS.     

感染性休克患者降钙素原和C-反应蛋白动态变化研究

目的观察降钙素原(PCT)、C-反应蛋白(CRP)等指标在感染性休克患者中的动态变化和急性生理和慢性健康(APACHEⅡ)评分在预后评估中的作用。方法回顾性分析45例感染性休克患者入院第1、3、5天以及出院或死亡前最后一次的血清PCT、CRP及入院时APACHEⅡ评分,根据预后将患者分为死亡组及存活组,并对其进行分析。结果 45例感染性休克患者生存20例,死亡25例,病死率为55.6%。死亡组患者入院时APACHEⅡ评分明显高于存活组[(28.84±8.03)分vs(21.82±7.10)分]。两组在入组第1、3天的PCT和CRP水平比较差异均无统计学意义。死亡组PCT和CRP水平在第5天及观察终点均明显高于存活组。各组内PCT和CRP与观察第1天相比,存活组随观察时间延长而明显下降,差异有统计学意义,而死亡组则无明显变化。结论患者血清中PCT、CRP呈持续高水平提示预后不佳,指标的高低对临床指导治疗和评估预后有参考意义。     

冠心病患者血清脂联素和高敏C反应蛋白的观察

目的探讨冠心病患者血清脂联素和高敏C反应蛋白(hs-CRP)水平的相关性。方法可疑冠心病患者83例行冠状动脉造影,确诊冠心病患者65例,分为稳定性心绞痛组(SAP组,21例)和急性冠状动脉综合征组(ACS组,44例),冠状动脉造影正常者作为对照组(18例)。测定各组患者血清脂联素和hs-CRP水平。结果ACS组患者血清脂联素对数水平较对照组和SAP组明显降低(P<0.05);ACS组患者hs-CRP水平高于SAP组和对照组(P<0.05)。线性相关分析表明,血清脂联素对数与hs-CRP水平呈负相关(r=-0.25,P<0.05)。结论血清脂联素与hs-CRP相互作用可能共同参与了冠状动脉粥样硬化的发生与发展。     

The effects of prior beta-blocker therapy on serum C-reactive protein levels after percutaneous coronary intervention

BACKGROUND: There are no studies in the literature related to the effect of beta blockers (BB) on changes in C-reactive protein (CRP) levels after percutaneous coronary intervention (PCI). HYPOTHESIS: We designed a prospective randomized study to investigate the impact of BB therapy on CRP in patients who underwent elective PCI. METHODS: In all, 300 patients with coronary artery disease were included. Patients were randomized to either a metoprolol or to a control group before PCI. Blood samples for CRP levels were obtained before BB treatment, and at the 6th, 24th, and 36th h after PCI. RESULTS: Of 300 patients, 150 received metoprolol 100 mg/day (mean age, 59.0 +/- 10.2 years; 106 men, 44 women), and 150 received no BB (mean age, 59.8 +/- 9.8 years; 114 men, 36 women) and served as the control group. Baseline clinical characteristics of both groups were similar. Basal CRP levels between the two groups were similar. Of the patients included in the study, 40.8% in the BB group and 39.6% in the control group had elevated basal CRP levels. The CRP levels increased above baseline values in 85% of patients in the BB group and in 89.3% of patients in the control group (p > 0.05) during follow-up. The CRP levels in patients in the BB group at the 6th, 24th, and 36th h were lower than those in the control group; however, this difference did not reach statistical significance. CONCLUSIONS: Prior BB therapy seems to have no effect on CRP levels after PCI.     

Effect of physical activity on serum C-reactive protein

This study examines the association between physical activity and C-reactive protein levels, indicating that high levels of strenuous aerobic activity are associated with lower C-reactive protein levels among men.     

Elevation of serum C-reactive protein levels is associated with obesity in boys.

This study aimed to reveal the relationships among C-reactive protein (CRP), obesity, blood pressure (BP), and serum lipids in children. Eighty-six obese and 58 non-obese boys aged an average of 11.2 years were examined. Serum CRP levels were measured by high sensitivity latex turbidimetric immunoassay and subjects with CRP levels below 0.3 mg/dl were adopted. Comparisons of serum CRP levels, BP, and serum lipids levels between age-matched obese and non-obese groups were performed. A comparison of serum CRP levels among the percentage of relative weight quartiles and the relationships among percentage of relative weight, BP, and serum lipids in CRP quartiles were analyzed. The relationships between CRP and other parameters were analyzed by simple and stepwise multiple regressions. Obese children had significantly higher high-sensitivity CRP (hs-CRP) levels than their non-obese counterparts. The mean hs-CRP level was 5.5-fold higher in the top quartile of the percentage of relative weight than in the bottom quartile. In the top quartile of CRP, the percentage of relative weight, systolic BP, diastolic BP, pulse pressure, and low density/high density lipoprotein-cholesterol (LDL-C/HDL-C) were significantly higher than in the bottom quartile. The percentage of relative weight, BP, LDL-C, and apolipoprotein B (ApoB) showed positive correlations and HDL-C showed a negative correlation with log CRP by simple regression. Stepwise multiple regression analysis indicated that only the percentage of relative weight was strongly related to CRP. In conclusion, this study revealed a significant relationship between CRP and obesity in children. Obese children tended to have high CRP levels, BP elevation, and slight dyslipidemia. These results support the findings that CRP is one of the useful indices of childhood obesity that would affect the progression to future atherosclerotic disease. We consider that a strategy of preventing obesity from childhood would contribute to a drop in the future incidence of metabolic syndromes.     

Disease activities and serum C-reactive protein levels in patients with vasospastic angina pectoris

OBJECTIVES. To evaluate the relationship between serum C-reactive protein (CRP) levels and disease activities of vasospastic angina pectoris. METHODS. We reviewed 284 consecutive patients who underwent the coronary artery vasospasm provocation test with intracoronary administration of acetylcholine. No patient had significant organic stenosis in the coronary artery on control angiography. No patient was given nitrates, calcium channel blockers, aspirin or statins before the provocation test. Serum CRP levels were measured on the day before the provocation test. RESULTS. Significant transient coronary artery stenoses associated with chest symptoms and ST-T changes in electrocardiogram was found in 132 patients (positive group), but the remaining 152 showed no spasm (negative group). Serum CRP levels were significantly higher in the positive group than in the negative group (0.29 +/- 0.12 vs 0.08 +/- 0.06mg/dl, p < 0.01). Furthermore, high frequency of angina pectoris ( > or = 3 times/week), low dose of acetylcholine required to induce vasospasm, provocation of total occlusion and provocation of multivessel spasm were associated with significantly higher serum CRP levels in the positive group. Multivariate logistic regression analysis showed low dose of acetylcholine required to induce vasospasm as the strongest predictor of elevated levels of serum CRP (p < 0.001, odds ratio 4.52, 95% confidence interval 2.00-10.44). CONCLUSIONS. Serum CRP levels were related to the inductivity of coronary artery spasm in patients clinically suspected of having vasospastic angina pectoris. Inflammation may be important in the disease activity through the endothelial dysfunction of coronary artery trees.     

Elevated serum levels of C-reactive protein are indicative of a poor prognosis in patients with esophageal cancer

SUMMARY: Despite improved results gained by the combination of neoadjuvant chemotherapy and radiotherapy with surgery, the prognosis for the esophageal carcinoma patient remains poor. There is a need for prognostic markers that can help improve patient selection. The aim of this study was to evaluate whether serum levels of C-reactive protein (CRP) have any influence on the patient prognosis in terms of prediction of chemoradiosensibility, and overall and disease-free survival. Blood samples were obtained at the time of diagnosis in 67 patients with biopsy-proven primary carcinoma of the esophagus. Although not significantly, the mean CRP level was higher than that of 20 patients with benign esophageal pathology who served as controls. No significant correlation could be found between CRP levels and baseline characteristics such as age, gender, histology, cancer localization, tumor depth, lymph node status or metastatic spread. However, patients with CRP levels higher than 6 mg/L were more frequently non-responders to chemoradiotherapy (P = 0.035), had a shorter overall survival (P = 0.061) and a shorter disease-free survival (P = 0.016). It is concluded from these results that pretreatment measurement of serum CRP levels in patients with esophageal cancer could to be used in routine practice as indicators of chemoradiosensibility and prognosis.