An association of serum vistafin level and number of circulating endothelial progenitor cells in type 2 diabetes mellitus patients

BackgroundThe decreased number and impaired functions of endothelial progenitor cells (EPCs) may associate with cardiovascular disease (CV) including atherosclerosis. However, the role of vistafin in regulation of angiogenic EPC subset maturation in T2DM patients without known atherosclerosis is still not fully understood.The aim of the studyTo investigate an association of serum vistafin level and number of circulating EPCs in T2DM patients beyond known CV disease.MethodsThis case–control observational investigation was evolved 54 subjects with T2DM and 35 healthy volunteers. The flow cytometry was used for predictably distinguishing cell subsets, which depend on expression of CD45, CD34, CD14, Tie-2, and VEGFR2. Biomarkers were measured at baseline of the study.ResultsAll T2DM patients were divided depending median of vistafin level (5.88 ng/mL) in to two cohorts with low vistafin level (<5.88 ng/mL; n = 29) and high vistafin level (≥5.88 ng/mL; n = 25) respectively. Logistic regression analysis has shown that visfatin, hs-CRP, age and BMI were the best variables in the prediction of EPC number labeled as CD14⁺CD309⁺ and CD14⁺CD309⁺Tie²⁺ cells. After adjustment of the model to age and BMI elevated visfatin level remained the best predictor for both CD14⁺CD309⁺ and CD14⁺CD309⁺Tie²⁺ EPCs (OR 0.92, 95% CI: 0.88–0.95; P = 0.001 and OR 0.90, 95% CI: 0.87–0.96; P = 0.001 respectively).ConclusionWe found that elevated level of vistafin was an independent predictor for declined numerous of non-classical EPCs labeled as CD14⁺CD309⁺ and CD14⁺CD309⁺Tie²⁺, whereas CD34⁺ subsets of EPCs did not associate with vistafin level in T2DM individuals.     

FTO gene variant and risk of hypertension: A meta-analysis of 57,464 hypertensive cases and 41,256 controls

ObjectivesRecent studies have suggested that fat mass and obesity-associated gene (FTO) may predispose individuals to develop hypertension. However, the results have been inconsistent. We performed a meta-analysis to investigate the relationship of FTO gene variant with risk of hypertension and influence of body mass index (BMI) on this risk.Materials/methodsA systematic literature search in PubMed, Embase and ISI web of science databases was performed to identify eligible published literatures. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.ResultsA total of seven studies comprising 57,464 hypertensive cases and 41,256 controls met the inclusion criteria and were included in the meta-analysis. The FTO gene variant(s) showed significant association with the risk of hypertension (OR = 1.16, 95% CI = 1.07–1.25, P < 0.001) which disappeared on adjustment for BMI (OR = 1.04, 95% CI = 0.98–1.10, P = 0.162). In addition, stratified analysis demonstrated a significant association of the FTO variant with the risk of hypertension in obese subjects (OR = 1.10, 95% CI = 1.01–1.19, P = 0.032) but not in non-obese individuals (OR = 1.00, 95% CI = 0.97–1.03, P = 0.832). Subgroup analysis based on ethnicity showed significant association between FTO variant and hypertension in both European (OR = 1.07, 95% CI = 1.01–1.14, P = 0.028) and Asian populations (OR = 1.37, 95% CI = 1.23–1.53, P < 0.001). However, the association remained significant only in Asians (OR = 1.17, 95% CI = 1.01–1.35, P = 0.035) but not in the Europeans (OR = 1.02, 95% CI = 0.97–1.07, P = 0.390) on adjustment for BMI.ConclusionsThe present meta-analysis confirms that FTO genotype mediates obesity-related hypertension.     

OCTN1 variant L503F is associated with familial and sporadic inflammatory bowel disease

PurposeA two-allele haplotype of TC (OCTN1 rs1050152 and OCTN2 -207G→C) is associated with Crohn's disease (CD). The association has been replicated in different populations, but also failed in some studies. The present study is to replicate the association of OCTN1 rs1050152 and examine another variant rs272879 with familial and sporadic inflammatory bowel disease (IBD) in a cohort from central Pennsylvania, USA.MethodsThe study samples (n = 465) included 212 inflammatory bowel disease patients (CD = 115, UC = 97), including 103 familial (CD = 55, UC = 46) and 111 sporadic (CD = 60, UC = 51) IBD, 139 non-IBD family members from a familial IBD registry, and 114 unrelated healthy controls. A total of 12 OCTN1 variants within exonic sequences were examined. Two nonsynonymous SNPs, rs1050152 (L503F) and rs272879 (L395V) were genotyped by a PCR-based RFLP/cRFLP method and statistically analyzed. These samples with an additional 141 unrelated healthy samples were also genotyped for rs1050152 using the SNPlex? Genotyping System.ResultsThe OCTN1 rs1050152 is associated with CD (OR = 1.745, 95% CI = 1.019–2.990, χ² = 4.129, p = 0.042) and with IBD (OR = 1.68, 95% CI = 1.052–2.676, χ² = 4.732, p = 0.030); while the variant rs272879 is not associated with IBD, CD or ulcerative colitis (UC). The distribution of the rs1050152 variant showed a high level of the T allele in male UC (OR = 2.585, 95% CI = 1.139–5.869, p = 0.023) and IBD (OR = 2.039, 95% CI = 1.024–4.059, p = 0.042) patients, and in female CD patients (OR = 2.329, 95% CI = 1.038–5.226, ρ value = 0.039).ConclusionThe present results replicated the association of the OCTN1 rs1050152 (L503F) variant with CD and IBD overall. A weak gender-specific effect of rs1050152 (L503F) on male UC and female CD was observed.     

Factors affecting outcomes of individualised treatment for drug resistant tuberculosis in an endemic region

BackgroundIndividualised treatment regimens for drug resistant tuberculosis have improved outcomes. This retrospective observational study examined potential factors that affect individualised treatment in an endemic region, and highlighted predictors of a successful outcome.MethodsWe examined records of proven MDR, pre-XDR and XDR TB patients diagnosed and started on treatment between 2010 and 2014, and collected the following data for each patient: age, gender, comorbidities, past history of TB, diagnosis, site of disease, drug susceptibility testing (DST) results, treatment, adverse reactions to anti-tubercular drugs, treatment changes and outcomes, which were recorded as positive, negative or neutral. Tests of association were carried out between factors and outcomes, following which multiple logistic regression analysis was done to determine the predictors of a positive outcome such as patient cured after completion of treatment at 18 months or longer.ResultsFifty-nine patients completed treatment at our centre. The median age was 26 years (range 8–65 years). There were 31 (52.5%) female patients. Forty-four (74.6%) were successfully treated over a median treatment period of 23 months (range 18–30 months). Successful outcomes were associated with age less than 45 years (P = 0.01, OR = 6.67, 95% CI = 1.73–23.47), resistance to fewer than five drugs (P = 0.001, OR = 9.51, 95% CI = 2.50–38.18) and susceptibility to Group 4 drugs (P = 0.04, OR = 4.71, 95% CI = 1.03–16.83).ConclusionsAge and drug susceptibility were important predictors of treatment outcome.     

E23K variant in KCNJ11 gene is associated with susceptibility to type 2 diabetes in the Mauritanian population

AimsMany genetic association studies reported the contribution of KCNJ11 gene to type 2 diabetes susceptibility in different populations. We aimed to evaluate the association between E23K variant of KCNJ11 and type 2 diabetes in the Mauritanian population.Materials and methodsWe performed a case-control association study including 135 type 2 diabetes Mauritanian patients and 135 controls. Genotyping for the E23K variant was performed using a TaqMan allelic discrimination assay.ResultsWe found significant association between KCNJ11 E23K variant and type 2 diabetes (Global model, OR = 2.08, 95% CI = 1.09–3.97, p = 0.026). In the Moor ethnic group, E23K was also associated with type 2 diabetes in the general model (OR = 2.08, 95% CI = 1.09–3.97, p = 0.026) and under the dominant model (OR = 2.49, 95% CI = 1.12–5.55, p = 0.026). In the Mauritanians of African descent, KK genotype was not found. Besides, E23K variant was not associated with type 2 diabetes (OR = 0.69, 95% CI = 0.04–11.32, p = 0.793).ConclusionsOur results revealed the risk of type 2 diabetes conferred by KCNJ11 E23K gene variant in the Mauritanian population.     

Clinical analysis of risk factors for severe COVID-19 patients with type 2 diabetes

AimsTo describe characteristics of COVID-19 patients with type 2 diabetes and to analyze risk factors for severity.MethodsDemographics, comorbidities, symptoms, laboratory findings, treatments and outcomes of COVID-19 patients with diabetes were collected and analyzed.ResultsSeventy-four COVID-19 patients with diabetes were included. Twenty-seven patients (36.5%) were severe and 10 patients (13.5%) died. Higher levels of blood glucose, serum amyloid A (SAA), C reactive protein and interleukin 6 were associated with severe patients compared to non-severe ones (P < 0.05). Levels of albumin, cholesterol, high density lipoprotein, small and dense low density lipoprotein and CD4⁺ T lymphocyte counts in severe patients were lower than those in non-severe patients (P < 0.05). Logistic regression analysis identified decreased CD4⁺ T lymphocyte counts (odds ratio [OR] = 0.988, 95%Confidence interval [95%CI] 0.979–0.997) and increased SAA levels (OR = 1.029, 95%CI 1.002–1.058) as risk factors for severity of COVID-19 with diabetes (P < 0.05).ConclusionsType 2 diabetic patients were more susceptible to COVID-19 than overall population, which might be associated with hyperglycemia and dyslipidemia. Aggressive treatment should be suggested, especially when these patients had low CD4⁺ T lymphocyte counts and high SAA levels.     

Influence of apolipoprotein E gene polymorphism on development of type 2 diabetes mellitus in Chinese Han population: A meta-analysis of 29 studies

ObjectivesPublished data regarding the association between apolipoprotein E (ApoE) gene polymorphism and type 2 diabetes mellitus (T2DM) risk in Chinese Han population were inconclusive. To derive a more precise estimation of the relationship between this variant and T2DM risk in Chinese Han population, we performed this meta-analysis.Design and methodsA computerized literature search was conducted to identify the relevant studies from PubMed, EMbase, Web of Science, CBMdisc, CNKI, and Google Scholar. Additionally, hand searching of the references of identified articles was performed. All the statistical tests were performed using Stata 11.0.ResultsA total of 29 articles with 4615 T2DM cases and 2867 controls were included in the present meta-analysis. The results showed evidence for significant association between ApoE gene polymorphism and T2DM risk (for ε2/ε3 vs. ε3/ε3: OR = 1.37, 95% CI = 1.12–1.68, P < 0.01; for ε3/ε4 vs. ε3/ε3: OR = 1.53, 95% CI = 1.23–1.91, P < 0.01; for ε4/ε4 vs. ε3/ε3: OR = 1.86, 95% CI = 1.22–2.84, P < 0.01; for ε2 allele vs. ε3 allele: OR = 1.28, 95% CI = 1.08–1.52, P = 0.01; for ε4 allele vs. ε3 allele: OR = 1.43, 95% CI = 1.22–1.68, P < 0.01). In addition, significant association was also found between ApoE gene polymorphism and diabetic nephropathy (DN) risk.ConclusionsThe results of this meta-analysis suggest that the ApoE ε2 and ε4 alleles may be associated with increased risks of T2DM and DN in Chinese Han population. Additional well-designed genome-wide association studies are required to confirm these results.     

The impact of angiotensin converting enzyme insertion/deletion gene polymorphism on diabetic kidney disease: A debatable issue

ObjectiveThe objective of this study was to evaluate the influence of ACE I/D gene polymorphisms on diabetic kidney disease (DKD) risk.MethodsAll eligible investigations were identified, the number of various genotype in the case and control group were reviewed. The pooled analysis was performed using Stata software.ResultsIn overall subjects, 24,321 participants with 12,961 cases and 11,360 controls were included. the pooled analysis showed a significant link between D allele, DD or II genotype and DKD risk (D versus I: OR = 1.316, 95% CI: 1.213–1.427, P = 0.000; DD versus ID + II: OR = 1.414, 95% CI: 1.253–1.595, P = 0.000; II versus DD + ID: OR = 0.750, 95% CI: 0.647–0.869, P = 0.000). The subgroup pooled analysis showed that ACE I/D gene polymorphism was correlated with DKD both in Asian and in Chinese population. In addition, ACE I/D gene polymorphism was correlated with type 2 DKD (D versus I: OR = 1.361, 95% CI: 1.243–1.490, P = 0.000; DD versus ID + II: OR = 1.503, 95% CI: 1.310–1.726, P = 0.000; II versus DD + ID: OR = 0.738, 95% CI: 0.626 –0.870, P = 0.000). However, there was no obvious correlation in Caucasian subjects and type 1 diabetic patients.ConclusionACE I/D polymorphisms were correlated with DKD in Asian and type 2 diabetic populations. ACE D allele/DD genotype might be a risk factor, while ACE II genotype might be a protective factor for DKD.     

Facteurs prédictifs d’amputation après angioplastie de l’artère iliaque chez les patients avec artériopathie sévère

IntroductionDespite the success of angioplasty of the iliac artery, this technique remains associated with significant amputation rates. The purpose of this study was to identify predictive factors for lower limb amputation after iliac angioplasty in patients with critical ischemia.MethodsWe reported a retrospective study including patients who successfully underwent angioplasty of the iliac artery between 2014 and 2018. The primary endpoint was limb salvage at 1 month. The variables were studied in univariate and multivariate analysis.ResultsOur study included 86 patients. The median age was 57 ± 10 and the sex ratio was 4.7. Cardiovascular risk factors were represented by smoking in 14 cases (16.3%), diabetes in 25 cases (29.1%), arterial hypertension in 2 cases (2.3%) and dyslipidemia in 2 cases (2.3%). Seventy patients (81.3%) were classified as stage 4 according to the Leriche and Fontaine classification and 16 patients (18.7%) were classified as stage 3. The lesions were stenosing in 48 cases (55.8%) and occlusive in 38 cases (44.2%). These lesions were classified according to the TASC classification “Trans-Atlantic-Society-Consensus” in TASC A-B in 61 cases (70.9%) and TASC C-D in 35 cases (29.1%). Distal arteritis was found in 8 cases (9.3%). Balloon angioplasty was performed in 36 cases (41.8%) and angioplasty stenting in 50 cases (58.2%). At 1 month, the amputation rate was 9.3%. Univariate analysis showed that diabetes and smoking were the most important factors associated with amputation (respectively P = 0.007, OR = 9.31, 95% CI = [1.73–50.07] and P = 0.022; OR = 6.8; 95% CI = [1.46 to 31.61]). Multivariate analysis showed that diabetes and distal arteritis were the predictive factors for amputation (respectively P = 0.034, OR = 21.06, 95% CI = [1.25 to 354.46] and P = 0.008, OR = 11,61, 95% CI = [1.88 to 71.69]).ConclusionDiabetes and distal arteritis are the predictive factors for lower limb amputation after iliac angioplasty.     

Association of metabolic syndrome with testosterone and inflammation in men

ObjectiveThere is limited data on the assessment of relationship between sex hormones, metabolic syndrome (MS) and inflammation. Therefore, our objective was to examine the relationship between metabolic syndrome, testosterone and inflammation.Patients and methodsIt was a cross-sectional study which included 309 subjects in the age range of 30–70 years. Blood was analyzed for plasma glucose, serum lipids, total testosterone (TT) and high-sensitivity C-reactive protein (hs-CRP).ResultsThere were 153 patients with metabolic syndrome and 156 without MS according to modified NCEP guidelines. Age, BMI, obesity, dyslipidaemia, smoking (OR = 2.35, CI = 1.35–4.09), LDL-Ch, low TT (OR = 0.76, CI = 0.38–1.52) and elevated hs-CRP (OR = 1.56, CI = 0.87–2.80) were significant independent predictors of MS (all P < 0.05).ConclusionsThe low testosterone and high hs-CRP levels are independent predictors of metabolic syndrome.     

Increased rate of abdominal surgery both before and after diagnosis of celiac disease

BackgroundThe detection of celiac disease (CD) is suboptimal.AimsWe hypothesized that misdiagnosis is leading to diagnostic delays, and examine this assertion by determining if patients have increased risk of abdominal surgery before CD diagnosis.MethodsThrough biopsy reports from Sweden’s 28 pathology departments we identified all individuals with CD (Marsh stage 3; n = 29,096). Using hospital-based data on inpatient and outpatient surgery recorded in the Swedish Patient Register, we compared abdominal surgery (appendectomy, laparotomy, biliary tract surgery, and uterine surgery) with that in 144,522 controls matched for age, sex, county and calendar year. Conditional logistic regression estimated odds ratios (ORs).Results4064 (14.0%) individuals with CD and 15,760 (10.9%) controls had a record of earlier abdominal surgery (OR = 1.36, 95% CI = 1.31–1.42). Risk estimates were highest in the first year after surgery (OR = 2.00; 95% CI = 1.79–2.22). Appendectomy, laparotomy, biliary tract surgery, and uterine surgery were all associated with having a later CD diagnosis. Of note, abdominal surgery was also more common after CD diagnosis (hazard ratio = 1.34; 95% CI = 1.29–1.39).ConclusionsThere is an increased risk of abdominal surgery both before and after CD diagnosis. Surgical complications associated with CD may best explain these outcomes. Medical nihilism and lack of CD awareness may be contributing to outcomes.     

Diarrhoea is not the only symptom that needs to be treated in patients with microscopic colitis

BackgroundMany patients with microscopic colitis (MC) also suffer from symptoms of irritable bowel syndrome (IBS), but the only treatment given is corticosteroids for the diarrhoea. The aim of this study was to examine how social factors, life style factors and drug treatment affect symptoms and well-being in patients suffering from MC.MethodsWomen, over the age of 73 years, with biopsy-verified MC, at any Departments of Gastroenterology, Skåne, between 2002 and 2010 were invited. The questionnaires Gastrointestinal Symptom Rating Scale (GSRS) and Psychological General Well-being Index (PGWB) were sent by mail, along with questions about social and life style factors, and medical history.ResultsOf 240 invited, 158 patients (66%) were included (median age 63 years, range 27–73 years). Only 26% had never smoked. Smoking and concomitant IBS were associated with both impaired gastrointestinal symptoms (OR = 3.96, 95% CI = 1.47–10.66 and OR = 4.40, 95% CI = 2.09–9.26, respectively) and impaired psychological well-being (OR = 2.77, 95% CI = 1.04–7.34 and OR = 3.82, 95% CI = 1.83–7.99, respectively). Treatment with proton pump inhibitors (PPI) was associated with increased gastrointestinal symptoms (OR = 3.44, 95% CI = 1.45–8.16). Age, social factors, and corticosteroids had no effect on symptoms or well-being. Smoking was the only risk factor associated with IBS (OR = 2.68, 95% CI = 1.115–6.26).ConclusionSmoking and IBS are associated with impaired gastrointestinal symptoms and psychological well-being in MC patients. PPI is associated with impaired gastrointestinal symptoms.     

Allergy is associated with reduced risk of glioma: A meta-analysis

BackgroundIncreasing evidences suggest that allergy may reduce the risk of glioma, so it is necessary to perform an up-to-data literature search and investigate this relationship by meta-analysis.MethodsWe identified the included studies by searching PubMed and Web of Science and excluding irrelevant or ineligible articles. Nineteen studies from 15 articles, including 8435 cases and 118,719 controls, were selected for data extraction and synthesis.ResultsPooled outcomes showed that there was an inverse association between allergy and risk of glioma (OR = 0.64, 95% CI = 0.52–0.78, P < 0.001). Meanwhile, asthma and eczema would reduce the risk of glioma by 33% and 23% (OR = 0.67, 95% CI = 0.59–0.75, P < 0.001; OR = 0.77, 95% CI = 0.68–0.86, P < 0.001), respectively. Sensitivity analyses confirmed the stability of these findings. Besides, no publication biases were detected regarding all the investigations.ConclusionsOverall or specific allergy is protective against glioma. More prospective cohort studies or molecular laboratory experiments are warranted to elucidate the causation and key mechanism.     

Recours à l’automédication chez l’hypertendu noir africain : ses facteurs et ses conséquences

IntroductionSelf-medication practice is under-evaluated among black African hypertensive patients.AimTo assess the level of self-medication among black African hypertensive patients and to determine the factors favoring this practice and their consequences.MethodsProspective study during a 3-month period including 612 hypertensive patients followed in Abidjan cardiology institute.ResultsMean age was 55.1. The patients had a self-medication use in 60.1% of cases. Medicinal plants and derived products were commonly involved. Self-medication use reasons were: influence of relatives (89.8%) and the fear of antihypertensive drugs adverses effects (54.9%). Multivariate analysis shows that factors of self-medication were age (56.6 years vs. 50.3 years, P < 0.001), income less than 762 euros/month (88% vs. 75.4%; OR = 2.73; 95% CI: 1.62–4.6; P < 0,0001), obesity (70.4% vs. 35.6%; OR = 1.24; 95% CI: 0.75–1.15; P = 0.037), dyslipidemia (40.8% vs. 27.9%; OR = 6.72; 95% CI: 0.57–2.13; P = 0.043), antihypertensive association therapy (61.7% vs. 51.4%; OR = 2.27; 95% CI: 0.25–0.97; P = 0.037). Poor control of high blood pressure (HBP) was a consequence of self-medication (6.5% vs. 47.1%; OR = 10.27; 95% CI: 4.65–56.4; P = 0.034), repercussions of HBP on major organ (75% vs. 17.2%; OR = 12.9; 95% CI: 8.5–19.6; P = 0.0001).ConclusionSelf-medication is a common practice in African hypertensive patients. It has many consequences.     

Clinical characteristics and outcomes of community-onset acute pyelonephritis caused by Escherichia coli in elderly patients

PurposeTo evaluate clinical characteristics and outcomes of community-onset acute pyelonephritis (APN) caused by Escherichia coli in elderly patients.Patients/methodsCases of adult patients with community-onset APN caused by E. coli were collected from 10 referral centres in Korea from November 2006 to August 2007. Demographic, clinical and microbiological data were analysed.ResultsDiabetes mellitus (38% vs 23%, P = 0.036), chills (83% vs 66%, P = 0.015), gastrointestinal symptoms (55% vs 34%, P = 0.008), altered mental status on admission (21% vs 9%, P = 0.032), acute renal failure (17% vs 3%, P = 0.004) and concomitant bacteraemia (34% vs 17%, P = 0.015) were more frequently observed in patients aged ≥ 65 years compared with those aged < 65 years. The overall intergroup mortality rates did not differ. However, diabetes mellitus (OR = 3.54, 95% CI = 1.40–9.00, P = 0.008) and age of ≥ 65 years (OR = 2.34, 95% CI = 1.05–5.19, P = 0.037) were significantly related to a longer duration of hospital stay (≥ 5 days).ConclusionElderly patients with APN have a higher frequency of atypical manifestations, such as gastrointestinal symptoms, altered mental status and longer durations of hospital stays. Age was independently associated with longer duration of hospital stays among patients with APN. Careful diagnosis and appropriate treatment are crucial in the management of elderly patients with APN.     

Leprosy and hepatitis B coinfection in southern Brazil

To investigate the association of leprosy with hepatitis B virus (HBV) infection, as yet unknown for South Brazil, we assessed hepatitis B virus coinfection in 199 South Brazilian leprosy patients (119 lepromatous, 15 tuberculoid, 30 borderline, 12 undetermined and 23 unspecified) and in 681 matched blood donors by screening for the hepatitis B virus markers HBSAg and anti-HBc, using ELISA. Positive samples were retested and anti-HBc+ only samples were tested for the hepatitis B surface antibody (anti-HBs). There was a strong association between leprosy and hepatitis B virus infection (OR = 9.8, 95% CI = 6.4–14.7; p = 0.004·E⁻³⁰), as well as an association between HBV infection and lepromatous leprosy, compared to other forms (OR = 2.4, 95% CI = 1.2–4.8; p = 0.017). We also found that confinement due to leprosy was associated with hepatitis B virus infection (OR = 3.9, 95% CI = 2.1–7.4; p = 0.015·E⁻³). Leprosy patients are susceptible to develop hepatitis B virus infection, especially lepromatous. Institutionalized patients, who probably present a stronger Th2 response, have higher risk of being exposed to hepatitis B virus. This clearly emphasizes the need for special care to leprosy patients in preventing hepatitis B virus coinfection in South Brazil.     

Association of serum soluble Fas concentrations and mortality of septic patients

IntroductionScarce data on Fas, one of the main receptors that activates the apoptosis extrinsic pathway, in septic patients exists. Higher blood soluble Fas (sFas) concentrations in non-survivor septic patients compared with survivors have been found in small studies; however, the association of blood sFas concentrations with mortality controlling for sepsis severity has not been stablished due to this small sample size in those studies. Thus, our main objective study was to determine whether an association between blood sFas concentrations and sepsis mortality controlling for sepsis severity exists.MethodsWe included septic patients in this observational and prospective study carried out in three Spanish Intensive Care Units. We obtained serum samples at sepsis diagnosis sepsis for sFas levels determination.ResultsThirty-day non-surviving patients (n = 85) compared to surviving patients (n = 151) had higher serum sFas levels (p < 0.001). We found in multiple logistic regression analysis an association of serum sFas levels with mortality controlling for age and SOFA (OR = 1.004; 95% CI = 1.002–1.006; p < 0.001), and for age and APACHE-II (OR = 1.004; 95% CI = 1.002–1.006; p < 0.001). Serum sFas levels showed and area under the curve for mortality prediction of 71% (95% CI = 65–71%; p < 0.001). Kaplan–Meier analysis showed higher mortality rate in patients with serum sFas levels > 83.5 ng/mL (Hazard ratio = 3.2; 95% CI = 2.1–5.0; p < 0.001).ConclusionsThat an association between blood sFas concentrations and sepsis mortality controlling for sepsis severity exists was our main new finding study.     

The association between interleukin-6 promoter polymorphisms and rheumatoid arthritis by ethnicity: A meta-analysis of 33 studies

ObjectiveWe performed a meta-analysis to determine the effect Interleukin-6 (IL-6) promoter polymorphism (−174 G>C, −572 G>C, and −597 G>A) have on the development rheumatoid arthritis (RA) by ethnicity.Material and methodsPubMed, EBSCO, LILACS, and Scopus databases were searched for studies exploring the association between any IL6 polymorphisms and RA until November 2018. Genotype distributions were extracted and, depending on the level heterogeneity, determined by the ψ²-based Q test and the Inconsistency Index (I²), fixed-effects or random-effects models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (95%CIs) for the heterozygous, homozygous, dominant, recessive, and allelic genetic models.ResultsFrom 708 identified publications, 33 were used in this analysis. For the −174 polymorphism, Asians (OR_heterozygous = 7.57, 95%CI: 2.28–25.14, OR_homozygous = 5.84, 95%CI: 2.06–16.56, OR_dominant = 7.21, 95%CI: 2.30–22.63, OR_recessive = 5.04, 95%CI: 1.78–14.28, OR_allelic = 6.60, 95%CI: 2.26–19.28, p < .05) and Middle East countries (OR_heterozygous = 2.30, 95%CI: 1.10–4.81, OR_dominant = 2.27, 95%CI: 1.22–4.22, OR_allelic = 2.29, 95%CI: 1.24–4.23, p < .05) were associated with a significant risk of developing RA. Whereas, for Latinos, the C-allele was associated with a benefit (OR_homozygous = 0.26, 95%CI: .08–.82, OR_recessive = .25, 95%CI: .08–.80, p < .05). For the −572 polymorphism, Asians demonstrated a significant association for the homozygous and recessive genetic models (8 studies, OR_homozygous = 1.56, 95%CI: 1.16–2.09, OR_recessive = 1.63, 95%CI: 1.08–2.45, p < .05). For the −597 polymorphism, no association was observed.ConclusionsHere, the −174 G>C polymorphism increased the risk of developing RA in Asians and Middle East populations. Interestingly, for Latinos, the polymorphism was associated with a benefit. For the −572 polymorphism, only the Asian population showed an increased risk of developing RA for the CC genotype.     

Angiotensin-converting enzyme gene insertion/deletion polymorphisms and the susceptibility to allergic rhinitis

BackgroundAngiotensin-converting enzyme (ACE) gene I/D polymorphism might be linked to the risk of the allergic rhinitis (AR).ObjectiveIn the present study, we assessed the association of ACE gene I/D polymorphisms with AR susceptibility using a meta-analysis.Materials and methodsWe carried out a retrieval of studies and included the eligible studies if they met the criteria. After the data extraction, the Stata software was used to analyse the genotype frequencies.ResultsIn total, five studies with 561 patients and 603 controls were included. However, the genotype distribution among the control of one study was not consistent with the Hardy–Weinberg equilibrium. After pooling all studies, the results indicated an association between ACE gene I/D polymorphism and AR risk in the overall analysis (II vs. others: OR = 0.70, 95% CI = 0.54–0.92, P = 0.010; D vs. I: OR = 1.29, 95% CI = 1.08–1.54, P = 0.005). In the further analysis of the East Asians, no association between ACE gene I/D polymorphism and AR risk was observed.ConclusionACE gene I/D polymorphisms were not associated with the risk of AR in East Asians. These results need to be confirmed in the following studies.