Association of serum gamma-glutamyltransferase with C-reactive protein levels and white blood cell count in Korean adults

BACKGROUND: Elevated gamma-glutamyltransferase (GGT) has emerged as an independent predictor of cardiovascular disease (CVD) which is increasingly viewed as an inflammatory disease. Thus, the mechanism underlying the link between elevated GGT and CVD may be inflammation. METHODS: We examined the relationship between GGT and C-reactive protein (CRP) levels and white blood cell (WBC) count in 4562 Korean adults (2104 men, 2458 women). The odds ratio (OR) and 95% confidence interval (CI) for high CRP and WBC count (> or = 75th percentile) for both men and women were calculated across each quartile of serum GGT. RESULTS: Results for the OR (95% CI) for high CRP levels by GGT quartiles were 1.00, 1.67 (1.21-2.29), 2.10 (1.51-2.93) and 2.51 (1.81-3.60) in men, and 1.00, 1.05 (0.65-1.68), 1.45 (0.79-2.02) and 2.16 (1.37-3.41) in women after adjustment for age, smoking status, alcohol intake, exercise, body mass index, blood pressure, fasting plasma glucose, triglyceride, high-density lipoprotein-cholesterol, and uric acid. Similarly, positive associations between serum GGT and WBC count were also observed. CONCLUSIONS: The present study demonstrates a positive correlation between GGT and two markers of inflammation, serum CRP and WBC count. Our findings suggest that serum GGT may be a surrogate inflammatory marker and a useful additional measure in assessing cardiovascular risk.     

Relationship between C-reactive protein and atherosclerotic risk factors and oxidative stress markers among young persons 10-18 years old

BACKGROUND: This study was undertaken to determine the association of serum C-reactive protein (CRP) with generalized and abdominal obesity, body fat composition, the metabolic syndrome, and oxidative stress markers among young people. METHODS: We conducted a population-based study of 512 young people, aged 10-18 years. We obtained anthropometric and blood pressure measurements. Fasting blood sugar, total cholesterol (TC), HDL-cholesterol, triglycerides, CRP, malondialdehyde (MDA), and conjugated diene (CDE) were quantified. LDL-cholesterol (LDL-C) was calculated for samples with TG < or =4.52 mmol/L RESULTS: Mean triglycerides, waist and hip circumferences, percentage body fat, subcutaneous fat, and systolic blood pressure increased significantly with increasing body mass index (BMI). In contrast, the mean LDL and TC were higher in underweight than normal weight individuals, and then increased significantly from normal to higher BMI categories. Mean HDL cholesterol significantly decreased with increasing BMI. Overall, CRP, MDA, and CDE were significantly correlated with measures of abdominal obesity. Serum CRP, MDA, and CDE significantly increased in the upper quartiles of waist circumference. Study participants with higher CRP concentrations were more likely to have metabolic syndrome and high oxidative stress markers. CONCLUSION: We found a significant positive association between CRP and oxidative stress markers in healthy young people, as well as an increase in these markers in the upper quartiles of waist circumference, but not BMI. Oxidative stress and CRP may interact in the early inflammatory processes of atherosclerosis.     

血清降钙素原鉴别细菌性感染的临床价值

目的比较血清降钙素原(PCT)水平与其他炎症指标对鉴别诊断细菌性感染的临床价值。方法采用回顾性队列研究,按临床病例终诊结果将患者分为细菌性感染和非细菌性感染两组,采用受试者工作特征曲线比较PCT、C反应蛋白(CRP)、白细胞计数(WBC)3项炎症指标对细菌性感染的诊断价值。结果预测细菌性感染的ROC曲线下面积PCT为0.89,CRP为0.70,WBC为0.60;以PCT>0.25 ng/mL为阳性界值诊断细菌性感染的灵敏度为46%,特异度为100%;以PCT≥0.1 ng/mL为临界值则灵敏度达75%,特异度96%;CRP>5 mg/L的诊断灵敏度为85%,特异度为38%;WBC>10.0×109/L的诊断灵敏度为39%,特异度为82%。结论在鉴别细菌性感染和其他炎症疾病上,血清PCT优于CRP和WBC,以PCT≥0.1 ng/mL为阳性界值,对诊断有最佳的灵敏度和特异度。     

Potential role of soluble angiopoietin-2 and Tie-2 in patients with inflammatory bowel disease

BACKGROUND: Angiogenesis has been suggested to play an important role in inflammatory bowel disease (IBD). The aim of the study was to evaluate the serum markers of angiogenesis angiopoietin-2 (Ang-2) and soluble angiopoietin receptor Tie-2 in patients with ulcerative colitis (UC) and Crohn's disease (CD). MATERIALS AND METHODS: Serum Ang-2 and Tie-2 serum levels were measured in 160 IBD patients (79 UC and 81 CD) and in 80 matched healthy controls using commercially available enzyme-linked immunosorbent assays. Serum Ang-2 and Tie-2 levels were correlated with the disease activity, as well as the type, localization and treatment of the disease. RESULTS: Median serum Ang-2 and Tie-2 levels were significantly higher in both the UC patients and the CD patients compared with the healthy controls (P < 0.05 and P < 0.001, respectively). The IBD patients with early disease (diagnosis < 2 years) had significantly higher (P = 0.04) median serum Ang-2 levels but significantly lower (P = 0.02) median serum Tie-2 levels as compared with IBD patients with late disease (diagnosis > 2 years). The CD patients with active disease had significantly higher levels of Ang-2 compared with non-active disease (P = 0.02). Serum levels of both Ang-2 and Tie-2 were not correlated with laboratory markers such as ESR, CRP, white blood cell count, platelet count and albumin. CONCLUSIONS: Serum Ang-2 and Tie-2 levels are elevated in patients with IBD. These markers may mediate angiogenesis and vascular permeability in the mucosa of patients with IBD.     

Serum 25-hydroxyvitamin D,cardiovascular risk markers,and incident cardiovascular disease in a high risk community population

BackgroundIt is unclear whether vitamin D status is related to cardiovascular risk beyond that explained by conventional risk markers. We examined the relationship between serum 25-hydroxy (OH) vitamin D and incident cardiovascular disease (CVD; heart attack/stroke) after adjusting for individual- and community-level covariates from laboratory, administrative and survey data.MethodsPatients receiving their first 25-OH vitamin D test in Calgary, Alberta from 2009 to 2013 without a past CVD diagnosis but an electrocardiogram and body mass index (BMI) +/− 3 months from testing were included. The following was merged to this data: first results for laboratory-measured CVD risk markers (lipid profile, fasting plasma glucose, and HbA1c) measured +/− 3 months from testing; Census Dissemination Area (CDA)-level indicators of socioeconomic status (SES) in 2011; and CVD diagnoses > 3 months from testing between 2009 and 2016. Linear and Poisson regression were used to examine associations between 25-OH vitamin D quartile and covariates, and Cox proportional hazard models were used to examine associations with incident CVD before and after adjusting for covariates.ResultsAmong 72 348 patients, there were 1898 CVD events over a median of 6.0 years. Increasing quartile of 25-OH vitamin D was associated with improved lipid and glycemic profiles (p < 0.01), higher proportion of CDA-level indicators of high SES (p < 0.01), and a lower risk of CVD (Q4 vs Q1: HR: 0.72, 95% CI: 0.63–0.81, p for trend < 0.01) after adjusting for age, sex and average daily hours of sunlight during month of testing. The association with CVD was unchanged after adjusting for BMI, slightly attenuated after adjusting for SES but completely abolished after adjusting for laboratory-measured cardiovascular risk markers.ConclusionsVitamin D status likely offers no additional information on CVD risk over conventional laboratory-measured risk markers.     

Smoking and serum alpha 1-antitrypsin in 1296 healthy men (author's transl)]

Serum alpha 1-antitrypsin (alpha 1AT) was measured by radial immunodiffusion in 1296 healthy men aged 18--50 years. Other biological criteria, including leukocyte count and alpha 2-globulins were measured and the subjects were given a detailed questionnaire on their smoking habits. Results showed a very strong positive relationship between smoking and serum alpha 1AT: the heavy smokers had a serum alpha 1AT 20% higher than the non-smokers, and among subjects who stopped smoking, the level returned rapidly to normal. There were also close interrelationships between serum alpha 1AT, smoking, leukocyte count and a alpha 2-globulins. A discussion of these results is presented.     

Results of blood inflammatory markers are associated more strongly with toe-brachial index than with ankle-brachial index in patients with type 2 diabetes

OBJECTIVE: Three blood markers of inflammation (high-sensitivity C-reactive protein [hsCRP], interleukin [IL]-6, and fibrinogen) were compared with markers of atherosclerotic cardiovascular disease (CVD) (history of stroke or cardiac ischemia and measured toe-brachial index [TBI]) to determine whether inflammatory markers are associated with atherosclerosis in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: Of 103 patients with type 2 diabetes, 26 had CVD. TBI was plethysmographically determined in both great toes. Serum hsCRP was immunonephelometrically determined. Plasma IL-6 was measured by an enzyme immunoassay. RESULTS: Both ABI and TBI were lower in diabetic patients with CVD than in those without CVD (1.05 +/- 0.19 vs. 1.14 +/- 0.09, P < 0.05, and 0.75 +/- 0.20 vs. 0.95 +/- 0.21, P < 0.001, respectively). By linear regression, right TBI but not right ABI showed a significant negative correlation with serum hsCRP (r = -0.372, P < 0.01) and plasma fibrinogen (r = -0.224, P < 0.05). Serum hsCRP was also negatively correlated with lower TBI, but not lower ABI. We found no significant correlation between plasma IL-6 and ABI or TBI. CONCLUSIONS: TBI was strongly associated with CVD, serum hsCRP, and plasma fibrinogen. Of these inflammatory markers, serum hsCRP may be the most promising marker for vascular inflammation.     

Soluble klotho as an effective biomarker to characterize inflammatory states

Background & AimsSoluble α-Klotho (s-Klotho) is a circulating protein with pleiotropic effects that mainly induce protective effects. Our study investigates the associations between s-Klotho and several established inflammatory biomarkers, with the aim of examining whether s-Klotho levels are representative of inflammatory states.MethodsA total of 11,128 eligible participants from NHANES 2007–2016 were included in our study. Levels of four inflammatory biomarkers, uric acid (UA), C-reactive protein (CRP), white blood cell (WBC) count, and mean platelet volume (MPV), were examined for their relationship with s-Klotho levels. Sub-analyses sorted the total population by gender and into four quartiles. Linear regression models were used to evaluate the strengths of associations.ResultsAll four inflammatory biomarkers were significantly associated with s-Klotho levels. UA, CRP, and WBC count showed an inverse association, while MPV showed a direct one. Of the four markers, UA was most strongly correlated with s-Klotho levels (β coefficient: −28.89 in unadjusted model, p<.001), and this relationship was stronger in women than in men (β coefficient of UA in men: −22.01, p<.001; in women: −31.54, p<.001). In addition, all four biomarkers manifested stronger associations with s-Klotho in higher quartiles, and the highest absolute values of β coefficients appeared in Q4 vs. Q1.Conclusions-Klotho is significantly associated with well-recognized inflammatory biomarkers. A decrease in s-Klotho levels implies a general inflammatory status; therefore, s-Klotho serves as a potential biomarker that is inversely correlated with inflammatory conditions. Further applications in clinical practice will provide us with a better understanding of its role.

Key messages

• Soluble α-Klotho (s-Klotho) levels are significantly associated with the inflammatory markers uric acid, C-reactive protein, white blood cell count, and mean platelet volume.
• S-Klotho is involved in inflammatory processes and plays a protective role.
• S-Klotho may serve as an inverse indicator of inflammation.

     

Formation of 8-nitroguanine in blood of patients with inflammatory gouty arthritis

BACKGROUND: NOx causes DNA damage due to an inflammatory effect of gouty arthritis. We investigated the concentration of 8-nitroguanine (8-NO(2)-G) in the blood of patients with arthritis. METHODS: Subjects were divided into 3 groups: (1) high inflammatory (HI) group (n = 21) with hyperuricemia (mean, 8.9 mg/dl) and leukocytosis, (2) low inflammatory (LI) group (n = 14) with mild hyperuricemia (mean, 7.6 mg/dl) but normal leukocyte count, (3) non-inflammatory (NI) healthy control (n = 19) with mean serum uric acid concentration 5.3 mg/dl and normal leukocyte count. Serum C-reactive protein (CRP) concentrations were measured by a visual agglutination method. The blood concentrations of 8-NO(2)-G were determined by high performance liquid chromatography-electrochemical detection and were compared between groups. RESULTS: There was significant difference in percentage of positive CRP (NI: 55.6%, LI: 64.3%, HI: 100%, p = 0.003) between the 3 groups. The leukocyte count (mean +/- S.E., NI: 7400 +/- 528, LI: 7686 +/- 433, HI: 10952 +/- 691/mm(3), p < 0.001), uric acid (NI: 5.3 +/- 0.24, LI: 7.6 +/- 0.4, HI: 8.9 +/- 0.36 mg/dl, p < 0.001), NO(2) (NI: 6.5 +/- 1.2, LI: 11.1 +/- 2.9, HI: 35.6 +/- 5.1 microg/ml, p < 0.001) and the 8-NO(2)-G (NI: 0.08 +/- 0.03; LI: 0.34 +/- 0.13; HI: 0.59 +/- 0.09 ng/microg DNA, p = 0.002) were significantly increased by inflammation. CONCLUSION: Gouty inflammation induces DNA damage by increasing 8-NO(2)-G through endogenous NO and ROS formation.     

Inflammation and hemostasis biomarkers and cardiovascular risk in the elderly: the Cardiovascular Health Study

BACKGROUND: There are few studies of inflammation and hemostasis biomarkers and cardiovascular disease risk (CVD) in older adults. OBJECTIVES: To assess multiple biomarkers simultaneously and in combinations for CVD risk assessment in older individuals. PATIENTS/METHODS: Thirteen biomarkers, interleukin-6 (IL-6), C-reactive protein (CRP), D-dimer, fibrinogen, factor VII, factor VIII, leukocyte count (WBC), platelet count, lipoprotein(a), soluble intercellular adhesion molecule-1 (sICAM-1), albumin, homocysteine and uric acid, were correlated with incident CVD in 4510 individuals in the Cardiovascular Health Study. Baseline biomarkers were analyzed as gender-specific SD increments and quintiles in proportional hazards models adjusted for demographics, CVD risk factors and medications. RESULTS: Over 9 years with 1700 CVD events, seven biomarkers were associated with CVD. Adjusted hazard ratios (HRs, 95% CI) per SD increment were 1.16 (1.09, 1.23) for IL-6, 1.16 (1.09, 1.23) for CRP, 1.13 (1.05, 1.21) for D-dimer, 1.17 (1.09, 1.25) for homocysteine, 1.06 (1.00, 1.12) for WBC, 1.06 (1.00, 1.12) for factor VIII, and 1.07 (1.00, 1.13) for lipoprotein(a). Fibrinogen was associated with CVD in men only (HR 1.12, 95% CI 1.04, 1.22) and sICAM-1 in women only (HR 1.16, 95% CI 1.05, 1.27). IL-6 and CRP remained associated with CVD when modeled with WBC. Participants were classified by all combinations of two biomarkers being high or low (IL-6, CRP, WBC, factor VIII, cholesterol/HDL). All were associated with CVD when cholesterol/HDL was low and none when CRP was low. CONCLUSIONS: Seven biomarkers were associated with CVD in older adults, with CRP having some advantages compared with others. Even larger studies are needed to better characterize these associations.     

Relationship of neutrophil-lymphocyte ratio with arterial stiffness and coronary calcium score

BackgroundEmerging evidence suggests that the neutrophil/lymphocyte ratio (NLR) may be a useful marker of cardiovascular disease and a more powerful predictor than any other leukocyte subtypes. We determined whether NLR is related to atherosclerosis measured by brachial–ankle pulse wave velocity (baPWV) and coronary calcium score (CCS).MethodsWe examined the relationship of NLR with baPWV and CCS in 849 Korean adults in a health examination program. The odds ratios for a high baPWV or a high CCS were calculated using multivariate logistic regression analysis across NLR quartiles. A high baPWV was defined as > 1500 cm/s (> 75th percentile) and a high CCS was defined as over 100 (at least moderate atherosclerotic plaque burden).ResultsThe ORs (95% CIs) for a high baPWV by NLR quartiles were 1.00, 0.76 (0.41–1.39), 1.08 (0.61–1.90), and 2.12 (1.18–3.83) after adjusting for confounding variables.Similarly, positive associations between NLR and a high CCS were also observed after adjusting for the same co-variables.ConclusionA higher NLR was independently associated with arterial stiffness and CCS. Accordingly, a higher NLR may be a useful additional measure in assessing cardiovascular risks in clinical practice.     

High sensitivity C-reactive protein: biological variations and reference limits.

Serum C-reactive protein (CRP) concentration was determined for 3605 subjects using an immunonephelometric assay improved to provide greater sensitivity. Subjects were from 5 to 75 years old and belonging to 1003 nuclear families recruited from the Stanislas Cohort Study between January 1994 and August 1995. Sample values for CRP ranged from 0.17 mg/l to 100 mg/l. Geometric means (mean - SD; mean +/- SD) were in the 5-14 years old group 0.37 (0.17-1.07) mg/l, in the 15-28 years old group 0.47 (0.17-1.38) mg/l and in the 29-75 years old group 0.98 (0.34-2.85) mg/l. For women, the geometric means were 0.38 (0.17-1.10) mg/l, 0.62 (0.20-1.90) mg/l and 0.98 mg/l (0.31-3.13) mg/l respectively. The interindividual variability ranged from 138% to 759% among different age classes. Biological factors associated with CRP concentration variations were examined and accounted for 25% of the CRP variability in men and 40% in women. The main biological factors statistically associated with CRP concentration variations in men were: drugs, leukocyte count, body mass index, tobacco consumption, age, and in women: drugs, leukocyte count, age, body mass index and hemoglobin concentration. These factors were used to define the exclusion and partition criteria when obtaining the reference samples. Medians for reference values ranged from 0.20 to 0.68 mg/l in males and from 0.20 to 0.78 mg/l in women.     

Diagnostic accuracy of fibrinogen to differentiate appendicitis from nonspecific abdominal pain in children

Aim

The aim of this study was to assess the diagnostic accuracy of the biomarker fibrinogen (FB), along with the more traditional markers white blood cell count (WBC), absolute neutrophil count (ANC), and C-reactive protein (CRP), to discriminate appendicitis from nonspecific abdominal pain (NSAP) in children.

C-reactive protein, leukocyte count and D-dimer monitoring after orthopedic surgery: early diagnosis of infectious or thromboembolic complications. Part one: C-reactive protein and leukocyte count as an aid in diagnosing postoperative infection]

OBJECTIVES: To evaluate the usefulness of monitoring C-reactive protein (CRP) level and leukocyte count for early diagnosis of infection following orthopedic surgery. METHOD: A cohort of 179 patients was followed: group 1 comprised 128 patients undergoing lower limb arthroplasty, group 2 comprised 29 patients undergoing lower limb surgery without implant, and group 3 comprised 22 patients undergoing spinal or upper limb surgery. CRP level and leukocyte count were systematically measured on admission and then once a week for 4 weeks. Wound infections, other infections, wound disconnection without infection and hematoma were noted. CRP level and leukocyte count were monitored postoperatively in patients with and without complications. RESULTS: CRP level was 4- to 8-fold above the normal range at the first postoperative measurement but normalized within the next 3 weeks (reaching normal levels by the 30th postoperative day, on average). In the 7 cases of wound infection (WI), the CRP level rose to 28-fold above normal and was significantly different from that in without infection or with intercurrent infection (P<0.01). A receiver operating characteristic (ROC) curve was established for CRP level, and for a value of 60 (12-fold above the normal range) the sensitivity was 100%, the specificity 83.6% and the negative predictive value 100%. The variation in leukocyte count was minor, with a significant difference noted between only patients not infected or those with WI (P<0.05). DISCUSSION AND CONCLUSIONS: Measurement of CRP level can be used for early diagnosis of wound infection. In the case of strong clinical suspicion or in the presence of high risk factors, when the level is at 12-fold or more above the normal range, the diagnosis of infection is highly probable.     

3项指标诊断老年菌血症的价值

目的探讨降钙素原(PCT)、C-反应蛋白(CRP)、白细胞计数(WBC)诊断年龄大于65岁的老年患者菌血症的价值。方法采用回顾性研究,对四川省人民医院年龄大于65岁疑似感染的1 688例住院患者检测PCT、CRP和WBC水平。结果 1 688例患者中菌血症患者275例。菌血症患者血清PCT和CRP水平较非菌血症患者高(P0.05)。在菌血症患者中,革兰阴性菌感染患者PCT水平高于革兰阳性菌感染患者,差异具有统计学意义(P0.05)。将患者按年龄分为老年组1(65~74岁)和老年组2(≥75岁)两个组,血清PCT、CRP水平在两组间差异有统计学意义(P0.05)。诊断菌血症,PCT的最适cut off值为1.30ng/mL,其特异度为77.69%,灵敏度为81.81%。CRP的cut off值为3.0mg/L时,灵敏度为97.45%。PCT诊断菌血症的ROC曲线下面积(AUC)为0.835(95%CI:0.809~0.860),优于CRP(AUC=0.608,95%CI:0.571~0.644)和WBC(AUC=0.531,95%CI:0.496~0.567),差异有统计学意义(P0.05)。结论对疑似菌血症的老年患者,PCT较CRP、WBC有更好的诊断效能,PCT可以作为预测老年菌血症患者的快速且可靠的指标。     

血清降钙素原在早期诊断脓毒症中的临床研究

目的 观察危重病人在脓毒症及全身性炎症反应综合征(SIRS)时血清降钙素原(PCT)水平的变化及临床意义。方法 38例入选患者分为脓毒症组和SIRS组,分别采用BRAHMS快速半定量法(PCT-Q)和免疫比浊法测定血清PCT、C-反应蛋白(CRP)浓度,同时比较两组间最高体温(BT)、白细胞计数(WBC计数)及中性粒细胞分类,评价PCT、CRP、WBC计数及中性粒细胞分类、BT在SIRS患者中对脓毒症的诊断价值。结果 RCT在脓毒症组较SIRS组显著升高(x±s分别是2.72±1.07分和1.55±0.76分,P=0.001),两组间CRP、WBC计数及中性粒细胞分类、BT比较无差异,对脓毒症的诊断价值由高到低分别为PCT、CRP、BT、中性粒细胞分类和白细胞计数(AUC分别是0.80、0.64、0.64、0.61、0.43)。结论 PCT可以作为早期诊断脓毒症的可靠指标,其他传统炎症指标在区分感染性与非感染性SIRS中的意义有限。     

Association between plasma alkaline phosphatase and C-reactive protein in Hong Kong Chinese

BACKGROUND: Alkaline phosphatase (ALP) is a biomarker for hepatobiliary and skeletal diseases. It is also raised in sepsis. In atherosclerotic plaques, ALP is expressed. Similar to C-reactive protein (CRP), it may be another marker of systemic inflammation. Therefore, we investigated their association in a Hong Kong Chinese population. METHODS: Plasma ALP and CRP were measured in 205 subjects (110 men, 95 women; age 55.2+/-11.6 years) in the Hong Kong Cardiovascular Risk Factor Prevalence Study-2 cohort. RESULTS: The blood levels of ALP and CRP were significantly correlated (r=0.30, p<0.001), which was due to a significant correlation in women (r=0.43, p<0.001). In a multivariate model, CRP level was related to ALP (beta=0.18, p=0.008). After adjusting for confounding factors and other liver enzymes, the relationship between ALP and CRP remained significant in women (beta=0.28, p=0.019), but in men, ALP was not an independent determinant of CRP levels. CONCLUSIONS: ALP may be another marker of systemic inflammation, especially in women. Whether it provides clinical information additional to CRP requires further study.     

Long-term prognostic impact of hyperuricemia in community

The debate whether an elevated level of serum uric acid (SUA) is an independent marker of cardiovascular risk is still going on. We examined morbidity and mortality related to SUA and hyperuricemia in a well-characterized population with very long follow-up. Study included 4696 participants (aged 30–59 years at baseline) of the coronary heart disease (CHD) Study of the Finnish Mobile Clinic Health Examination Survey. Adjusted hazard ratios (HRs) of hyperuricemia (defined as ≥360 µmol/l and ≥420 µmol/l) and SUA quintiles for mortality and adverse cardiovascular outcomes are reported. During the mean follow up of 30.6 years there were 2723 deaths, 887 deaths for CHD of which 340 were classified as sudden cardiac deaths, 1642 hospitalizations due to CHD and 798 hospitalizations due to congestive heart failure. After adjusting to baseline risk factors and presence of cardiovascular diseases as well as the use of diuretics there were no significant differences in the risk of any of the outcomes when analyzed either according to quintiles of SUA or using a cut-off point SUA ≥360 µmol/l for hyperuricemia. Only a rare finding of hyperuricemia SUA ≥420 µmol/l among women (n?=?17, 0.9%) was independently associated with significantly higher risk of mortality (adjusted HR: 2.59, 95% CI: 1.54–4.34) and a combination end-point of major adverse cardiac events (MACEs) (HR: 2.69; 95% CI: 1.56–4.66). SUA was not an independent indicator of morbidity and mortality, with the exception of particularly high levels of SUA among women.     

Novel serum inflammatory markers in acute appendicitis

Background: Cytokines and leukocyte adhesion molecules are activated and found in increased concentrations in bacterial infection. The purpose of this study was to investigate whether some of these new serum markers could be feasible as a single on-admission test to predict acute appendicitis (AA). Methods: In an open prospective study the diagnostic potentials of two cytokine measurements (interleukin-6 and interleukin-8), soluble leukocyte adhesion molecule (CD44), C-reactive protein (CRP) and white blood cell (WBC) count were compared in 80 consecutive patients who had undergone surgery for suspected AA. The diagnostic performance of each parameter was tested by using receiver operating characteristic (ROC) curves. Results: Phlegmonous AA was found in 34%, gangrenous AA in 40% and perforated AA in 5% of the patients. The proportion of negative explorations was 21%. Preoperative serum concentrations of IL-6 and CRP were elevated only in gangrenous and perforated AA. The concentrations of IL-8 and CD44 remained unchanged in AA. The sensitivity (84%), specificity (79%) and diagnostic accuracy (82%) of IL-6 were higher than the values for CRP, WBC, IL-8 and CD44 in predicting AA. Conclusion: ROC analysis confirmed that IL-6 showed the best trend in the diagnosis of AA. However, the diagnosis of AA was not greatly improved by any of the new serum markers as single on-admission tests.     

Novel serum inflammatory markers in acute appendicitis

BACKGROUND: Cytokines and leukocyte adhesion molecules are activated and found in increased concentrations in bacterial infection. The purpose of this study was to investigate whether some of these new serum markers could be feasible as a single on-admission test to predict acute appendicitis (AA). METHODS: In an open prospective study the diagnostic potentials of two cytokine measurements (interleukin-6 and interleukin-8), soluble leukocyte adhesion molecule (CD44), C-reactive protein (CRP) and white blood cell (WBC) count were compared in 80 consecutive patients who had undergone surgery for suspected AA. The diagnostic performance of each parameter was tested by using receiver operating characteristic (ROC) curves. RESULTS: Phlegmonous AA was found in 34%, gangrenous AA in 40% and perforated AA in 5% of the patients. The proportion of negative explorations was 21%. Preoperative serum concentrations of IL-6 and CRP were elevated only in gangrenous and perforated AA. The concentrations of IL-8 and CD44 remained unchanged in AA. The sensitivity (84%), specificity (79%) and diagnostic accuracy (82%) of IL-6 were higher than the values for CRP, WBC, IL-8 and CD44 in predicting AA. CONCLUSION: ROC analysis confirmed that IL-6 showed the best trend in the diagnosis of AA. However, the diagnosis of AA was not greatly improved by any of the new serum markers as single on-admission tests.