C-reactive protein levels in non-obese pregnant women with gestational diabetes

A low-grade systemic inflammation is concomitant in diabetes. There is a pathophysiological relation between gestational diabetes mellitus and type 2 diabetes mellitus, which was further supported by significantly elevated risk of type 2 diabetes in women with a history of previous gestational diabetes mellitus. We investigated the relation between low-grade systemic inflammation expressed as C-reactive protein and gestational diabetes in non-obese pregnant women. This study included 20 non-obese pregnant women with gestational diabetes mellitus and 30 non-obese pregnant women without gestational diabetes mellitus as a control group. The body mass index of all the subjects were < 25 kg/m2. During 26-28 gestational weeks 100-g oral glucose tolerance test was performed and simultaneously fasting C-reactive protein levels were measured. Serum median C-reactive protein level was higher in patients with gestational diabetes mellitus (p = 0.0001). C-reactive protein was strongly associated with glycemic parameters and weight gain during pregnancy. A model consisting of glucose intolerance, age, parity, and weight gain during pregnancy accounted for 61% of the variance in log C-reactive protein. We demonstrated that serum C-reactive protein level was related with gestational diabetes mellitus and weight gain during pregnancy in late second and early third trimesters.     

Asthma is an independent risk for elevation of plasma C-reactive protein levels

BACKGROUND: Chronic inflammation of the airways plays a major role in the pathogenesis of asthma. Although C-reactive protein (CRP) is now an established circulating marker for cardiovascular diseases, it remains unclear whether asthma is an independent risk for increased plasma CRP. METHODS: In Study 1, we evaluated CRP levels in 329 asthmatic patients and 1684 non-asthmatic subjects. Inhaled corticosteroids were regularly used by 308 asthmatics. In Study 2, the effects of inhaled corticosteroids on CRP levels were examined in 64 corticosteroid-naive asthmatic patients. RESULTS: In Study 1, plasma CRP levels were associated with body mass index (R=0.349, P<0.0001) and age (R=0.111, P<0.0001) in all study subjects, but were higher in patients with asthma, hypertension, diabetes and/or dyslipidemia than in those without these disorders. Multivariate regression analysis identified body mass index, age and asthma, but not hypertension, diabetes or dyslipidemia, as independently associated with an elevation of CRP levels. In Study 2, treatment of 64 corticosteroid-naive asthmatic patients with inhaled corticosteroids for 3 months significantly reduced plasma CRP levels. CONCLUSIONS: Asthma is a disorder associated with increased plasma CRP levels independent of various other factors. Treatment with inhaled corticosteroids was associated with a significant reduction in plasma CRP levels, which may reflect their clinical effect on the inflammatory process within airways.     

正常妊娠妇女血清瘦素水平测定及临床意义

目的探讨正常妊娠妇女血清瘦素水平的变化及其临床意义.方法测定89例正常妊娠妇女(研究组)和18例年龄、体重等指数相近的正常非孕妇女(对照组)的血清瘦素水平,并分析瘦素水平与孕妇的孕周、体重及体重指数的相关性.结果①研究组瘦素水平为(14.9±7.2)g/L,对照组瘦素水平为(7.88±4.32)μg/L,两组比较,有显著性差异(P＜0.01).相关分析显示,孕妇血清瘦素水平与其孕周有相关性,随孕周增加,血清瘦素水平逐渐上升;②妊娠晚期妇女血清瘦素水平与体重及体重指数明显正相关(r分别为0.33、0.35,P＜0.05);③对照组妇女血清瘦素水平与其体重、体重指数明显正相关(r分别为0.72、0.75,P＜0.001).结论正常妊娠妇女除妊娠时胎盘能够分泌一定量瘦素外,妊娠时的激素变化也能刺激脂肪组织合成瘦素,可能与妊娠期间瘦素水平升高有关.     

Raised C-reactive protein levels in serum from smokers

Investigation of a possible quantitative relationship between the extent of tissue injury due to inhalation of tobacco smoke and changes in concentrations of a number of acute phase proteins were studied in smokers. Smokers showed an acute phase response as indicated by significantly raised serum C-reactive protein levels. Significant lowering of serum albumin levels was also observed in smokers. Serum levels of alpha 1-antitrypsin, alpha 1-antichymotrypsin, alpha 1-acid glycoprotein, transferrin and haptoglobin did not show any significant changes due to inhalation of tobacco smoke. Although the C-reactive protein test is non-specific, evidence for elevated levels of C-reactive protein indicates the presence of tissue inflammation.     

Low cardiorespiratory fitness is associated with elevated C-reactive protein levels in women with type 2 diabetes

OBJECTIVE: The purpose of this study was to examine differences in novel markers of cardiovascular disease (CVD) in women with type 2 diabetes stratified according to cardiorespiratory fitness. RESEARCH DESIGN AND METHODS: A total of 28 women (mean age 57 +/- 6 years) with type 2 diabetes who were free from overt CVD were placed into low cardiorespiratory fitness (LCF) or average cardiorespiratory fitness (ACF) groups based on a graded exercise test to exhaustion. A group of eight women without type 2 diabetes were also examined and served as healthy control subjects. The median VO(2peak) value was used as a cutoff for group determination. We assessed both conventional CVD risk factors, including blood pressure, BMI, and lipid profile, as well as novel CVD risk factors, such as left ventricular filling dynamics, arterial stiffness, fasting insulin, and C-reactive protein (CRP). RESULTS: VO(2peak) values were 69 +/- 14 and 91 +/- 24% of predicted values for sedentary age-matched healthy individuals in the LCF and ACF groups, respectively. BMI was significantly greater in the LCF group (P < 0.05); however, no differences were observed in age, lipid profile, or resting hemodynamics. CRP was 3.3-fold higher in the LCF group (6.3 +/- 41. vs. 1.9 +/- 1.7 mg/l, P < 0.05), whereas other novel markers of CVD were not significantly different between the groups. Significant negative relationships were observed between VO(2peak) and both CRP (r = -0.49) and the homeostasis model assessment index (r = -0.48) (P < 0.05). CONCLUSIONS: The novel finding of this investigation is that low cardiorespiratory fitness is associated with elevated CRP and reduced fasting glucose control in women with type 2 diabetes.     

孕妇在不同糖耐量状态下超敏C-反应蛋白与胰岛素抵抗相关性研究

目的 研究孕妇在不同糖耐量状态下血清超敏C-反应蛋白(hs-CRP)与胰岛素抵抗(IR)的关系.方法 孕妇孕24～28周行50 g口服葡萄糖负荷试验,阳性者再行75 g口服葡萄糖耐量试验,根据血糖结果分为妊娠糖尿病组41例、糖耐量减低组30例和糖耐量正常组27例,用ELISA方法测定hs-CRP水平,同时计算稳态模式胰岛素抵抗指数(HOMA-IR)、稳态模式胰岛B细胞功能指数(HBCI)和30 min净增胰岛素/30 min净增血糖(△I30/△G30).结果 ①从糖耐量正常组到糖耐量减低组到妊娠糖尿病组,hs-CRP [(6.15±2.63)、(7.65±4.27)、(10.80 ±3.57)mg/L,F=5.628,P=0.021]、HOMA-IR(2.54±0.74、3.51±0.29、3.96 ±2.16,F=6.928,P=0.011)呈递增趋势,而HBCI(426.08±89.85、266.69±203.32、223.82 ±148.58,F=4.283,P:0.043)和△I30/△G30(27.90±19.22、15.12±12.50、13.13 ±12.98,F=6.505,P=0.014)呈递减倾向;②Pearson相关分析显示孕前BMI、空腹胰岛素(Fins)、hs-CRP与HOMA-IR正相关(r=0.320、0.833、0.288,P均＜0.01);多元回归分析显示,孕前BMI、FBG、Fins、hs-CRP是影响HOMA-IR的显著因素(回归系数分别为0.320、0.340、0.709、0.288,R2=0.92,P均＜0.01).结论 妊娠糖尿病患者的血清hs-CRP水平为影响IR的显著因素,提示hs-CRP可能通过多种机制加重IR,参与妊娠糖尿病的发病.     

Obesity, plasma high sensitivity C-reactive protein levels and insulin resistance status among school children in Taiwan

OBJECTIVE: To evaluate the degree of obesity and plasma high sensitivity C-reactive protein (hs-CRP) levels in relation to insulin resistance status among school children in Taiwan. METHODS: After multistage sampling, we randomly selected 1438 children (701 boys and 737 girls) with the mean age of 13.4 years (from 12 to 16) in Taipei in 2003. Anthropometric measures and plasma biochemical variables (including lipid profiles, glucose and insulin) were measured using standard methods. Plasma hs-CRP levels were measured using nephelometric methods. We calculated insulin resistance (IR) index using HOMA methods and further calculated a gender-specific insulin resistance syndrome (IRS) summary score by adding the quartile ranks from the distribution of systolic blood pressure (SBP), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and insulin levels of each children. A high IRS summary score corresponds to higher levels of SBP, TG and insulin levels and lower levels of HDL-C. RESULTS: Boys were taller, heavier, had larger BMI, glucose, IRS summary score and hs-CRP than girls; however, there is no difference in plasma TG, insulin levels, and IR index between genders. Plasma hs-CRP levels were positively correlated with anthropometric measures, TG, insulin levels, IR index, and IRS summary score and negatively correlated with HDL-C. Anthropometric measures, plasma TG, insulin levels, IR index and IRS summary score were significantly higher in children with higher plasma hs-CRP levels (test for trend p<0.05). After adjustment for age, heart rate, smoking and drinking, hs-CRP continued to be positively associated with anthropometric variables (weight and BMI), insulin levels, and IR index and negatively correlated with HDL-C in both genders. Plasma hs-CRP levels were also positively associated with TG and IRS summary score in boys and glucose in girls. However, after further adjusting for BMI, the association of hs-CRP on TG, insulin levels, IR index and IRS summary score disappeared in boys and on body weight, HDL-C, insulin level and IR index disappeared in girls. CONCLUSION: Plasma hs-CRP levels are positively related to anthropometric variables, such as body weight and BMI, insulin levels, IR index and IRS summary score and negatively related to HDL-C in Taiwanese children. Moreover, the degree of body fat status (as measured by BMI) plays a more significantly role on insulin resistance status than hs-CRP levels among Taiwanese children.     

联合检查D-二聚体纤维蛋白原和C反应蛋白在2型糖尿病肾病中临床应用价值

目的 探讨联合检测血D-二聚体(DD)、纤维蛋白原(FIB)、C反应蛋白(CRP)水平对2型糖尿病肾病(DN)并发症的临床应用价值.方法 对已确诊的180例2型糖尿病患者同时检测其清晨空腹血DD、FIB、CRP水平,并同时收集24h尿液进行尿微量白蛋白(MA)测定,按24h尿白蛋白排泄率(UAER)将糖尿病组分3组:单纯糖尿病组(SDM组,UAER＜30mg/24h);早期糖尿病肾病组(EDN组,UAER 30～300mg/24h);临床糖尿病肾病组(CDN组,UAER＞300mg/24h).结果 2型糖尿病组患者DD、FIB和CRP水平在单纯糖尿病组已升高,与对照组比较差异有统计学意义(P＜0.01),且随UAER增加而增高,呈正相关.三组之间各指标比较,差异均有统计学意义(P＜0.01).结论 联合检查DD、FIB和CRP水平,可明显提高糖尿病早期肾脏损伤检出率,同时还发现其与糖尿病肾病的发生、发展关系密切.     

冠状动脉病变程度和血浆脑钠肽超敏C反应蛋白水平相关性的研究

目的 探讨冠心病患者冠状动脉病粥样硬化程度和血浆脑钠肽（BNP）、超敏C反应蛋白（hs-CRP）水平之间的相关性。方法163例经冠状动脉造影确诊为冠心病的患者分为稳定型心绞痛（SAP）组（79例）、不稳定型心绞痛（UAP）组（43例）和急性心肌梗死（AMI）组（41例），比较三组患者的冠状动脉病变支数、左主干病变、冠状动脉Gensini评分、血浆BNP和hs-CRP水平差异有无统计学意义。结果 三组患者的冠状动脉病变支数、左主干病变比较，差异有统计学意义（P〈0．01）；SAP组患者的Gensini评分、BNP、hs-CRP水平分别与UAP组和AMI组比较，差异有统计学意义（P〈0．01）；UAP组和AMI组患者的hs-CRP水平比较，差异有统计学意义（P〈0．05），两组患者的Gensini评分、BNP水平比较，差异无统计学意义（P〉0．05）。结论 冠心病患者的血浆BNP、hs-CRP水平和冠状动脉病变程度之间存在的相关性，可以反映心肌受损的程度，具有重要的临床意义。     

C-reactive protein and neopterin levels in healthy non-obese adults.

BACKGROUND: Obesity and increased waist-to-hip ratio, emphasizing the importance of truncal obesity, have been found to correlate positively with increased cardiovascular disease risk and mortality. Owing to the inflammatory nature of atherosclerosis, the aim of our study was to find possible correlations between body mass index and waist-to-hip ratio, and the inflammatory markers C-reactive protein (CRP) and neopterin in healthy lean and overweight adults. METHODS: A total of 49 healthy adults (mean age 42.4 +/- 1.8 years, 32 females and 17 males) were classified according to their body mass index (BMI) and waist-to-hip ratio values. CRP and neopterin levels were measured. RESULTS: CRP levels were found to be significantly higher in the group with BMI > or = 25 kg/m2 compared to the group with BMI < 25 kg/m2 (p = 0.014). Subjects with increased waist-to-hip ratio displayed significantly higher serum CRP and neopterin levels (p = 0.014 and p = 0.033, respectively) compared with the group in which the waist-to-hip ratio was < 0.9. A strong positive correlation was found between CRP and BMI in the whole group (r = 0.658, p = 0.0001). CONCLUSIONS: Grouping overweight subjects according to their waist-to-hip ratio, which is an indicator of truncal obesity, seems to be convenient in studying the inflammatory process in relation to the elevation of adipose tissue. Elevated CRP and neopterin levels may be useful in the assessment of cardiovascular risk in overweight as well as obese subjects.     

Four immunochemical methods for measuring C-reactive protein in plasma compared

Four immunochemical methods for measuring C-reactive protein (CRP) in plasma were compared: radial immunodiffusion (RID), electroimmunoassay (EIA), immunoturbidimetry (IT), and laser nephelometry (LN). Close agreement was found between RID and EIA (EIA = 0.96 RID + 7.7 mg/L, r = 0.977, n = 100), IT and EIA (EIA = 1.11 IT - 15.8 mg/L, r = 0.951, n = 100), IT and RID (RID = 1.10 IT - 11.5 mg/L r = 0.959, n = 94). In initial studies in 1983, LN showed good agreement with RID (LN = 0.98 RID + 11.9 mg/L, r = 0.973, n = 60). Since then, normal CRP values measured by LN have tended to increase and, at the time of the present study (1986), LN agreed poorly with other methods. The reason for this change is obscure. Having excluded the possibility of enzymatic degradation of CRP, we conclude that instrumentation problems are involved, and therefore we no longer use this method.     

A polymorphism in the resistin gene promoter is related to increased C-reactive protein levels in patients with coronary artery disease.

BACKGROUND: Resistin, a novel adipocyte-derived peptide, has been linked to inflammatory process and coronary artery disease (CAD). The -420C>G polymorphism located in the resistin gene (RETN) promoter has recently been suggested to play a potential role in proinflammatory conditions (e.g., atherogenesis). However, whether this polymorphism has any effect on the inflammatory process in patients with stable CAD is unclear. METHODS: The RETN -420C>G polymorphism was determined by using PCR-restriction fragment length polymorphism. Plasma lipid profiles, glucose and high-sensitivity C-reactive protein (hs-CRP) were measured in fasting state. RESULTS: Patients with variant genotypes (CG+GG) had significantly higher levels of hs-CRP than CC carriers (adjusted p<0.001). In addition, the variant genotypes were observed to be independently associated with higher hs-CRP levels (>3 mg/L, p=0.004). However, no association was found between this polymorphism and plasma lipids or glucose levels. CONCLUSION: Our data suggest that the RETN -420C-to-G variant is associated with increased CRP levels in patients with stable CAD, suggesting that the RETN -420C>G polymorphism may be potentially involved in the inflammatory component of atherogenesis through an enhanced production of CRP.     

急性冠状动脉综合征血浆hs-CRP、vWF及其裂解酶含量改变的意义

目的:检测不稳定型心绞痛、急性心肌梗死患者血浆中高敏C反应蛋白和血管性血友病因子及其裂解酶水平,探讨其在发病机制中的作用和相互联系.方法:研究对象分不稳定心绞痛组和急性心肌梗死组、稳定型心绞痛组和正常对照组,应用酶联免疫吸附试验测定血浆血管性血友病因子浓度和高敏C反应蛋白含量,以残余胶原结合力试验测定血浆血管性血友病因子裂解酶活性水平.结果:(1)不稳定型心绞痛组和急性心肌梗死组血浆高敏C反应蛋白与血管性血友病因子水平均高于稳定型心绞痛组和正常对照组﹙P＜0.01﹚;(2)不稳定型心绞痛组和急性心肌梗死组血浆血管性血友病因子裂解酶活性水平均低于稳定型心绞痛组和正常对照组﹙P＜0.01﹚.结论:(1)血浆高敏C反应蛋白、血管性血友病因子水平升高可能是预测急性冠状动脉综合征斑块破裂和血栓形成的指标;(2)血浆血管性血友病因子裂解酶降低在急性冠状动脉综合征血栓形成中可能起重要作用.     

C-reactive protein levels in serum: a rapid enzyme immunoassay.

A simple and rapid competitive-inhibition enzyme linked immunoassay for serum C-reactive protein (C-RP) is described. The assay has a working range of 4.4-700 mg/l of C-RP, uses two serum dilutions and requires only 90 min to perform. Comparisons are presented between this assay and three commercially-available kits. The assay performs as well as the best of these kits but with added advantages of speed, ease of use and increased working range.