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Reynoso-Villalpando GL, Casillas-Muñoz FA, Padilla-Gutiérrez JR, Sevillano-Collantes C, Moreno-Ruiz I, Del Cañizo-Gómez FJ, Valdez-Haro A, Martínez-Fernández DE, Valle Y. The Genetic Variants -717T>C (rs2794521), 1444G>A (rs1130864), and 1846 C > T (rs1205) of CRP Gene, Their Haplotypes, and Their Association with Serum CRP Levels, Acute Coronary Syndrome, and Diabetes in Patients from Western Mexico. Metab Syndr Relat Disord 2020; 19:127-136. [PMID: 33296257 DOI: 10.1089/met.2020.0080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background: C-reactive protein (CRP) is involved in inflammatory pathways that are associated with the onset and progression of type 2 diabetes mellitus (T2DM) as well as an increased risk of an acute coronary syndrome (ACS). This research aimed to evaluate the potential association of the genetic variants -717T>C, 1444G>A, and 1846 C > T of CRP gene on CRP levels, ACS, and T2DM in participants from Western Mexico. Methods: Six hundred three participants were studied: (1) control group (CG); (2) ACS participants classified as unstable angina (UA), myocardial infarction without ST-segment elevation (NSTEMI), and myocardial infarction with ST-segment elevation (STEMI); (3) T2DM Participants; and (4) ACS plus T2DM participants (ACS+T2DM). Genetic variants were genotyped using allelic discrimination with TaqMan® probes, and high-sensitivity CRP (hs-CRP) was measured by Turbidimetry. Results: TAC haplotype frequency was significantly higher in ACS+T2DM versus CG and versus ACS participants (odds ratio [OR] = 2.774, P = 0.017 and OR = 3.479, P = 0.020, respectively). hs-CRP levels were especially higher for ACS and for ACS+T2DM participants with respect to CG and T2DM (with P < 0.0001). We observed higher hs-CRP levels in NSTEMI and STEMI versus UA in ACS scenario (P = 0.001, P = 0.027, respectively) and for ACS+T2DM scenario (P = 0.0001, P = 0.002, respectively). Conclusion: hs-CRP level fluctuations are related to the presence of T2DM and the presence and severity of ACS. Very high levels (>10 mg/L) are a risk marker of cardiovascular complications. Our results demonstrate a possible relationship between TAC haplotype and an increased risk for T2DM and ACS.
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Affiliation(s)
- Gabriela Lizet Reynoso-Villalpando
- Departamento de Clínicas Médicas, Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), Colonia Independencia, Guadalajara, México.,Doctorado en Genética Humana, Centro Universitario de Ciencias de la Salud, Guadalajara, México
| | - Fidel Antonio Casillas-Muñoz
- Departamento de Clínicas Médicas, Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), Colonia Independencia, Guadalajara, México.,Doctorado en Genética Humana, Centro Universitario de Ciencias de la Salud, Guadalajara, México
| | - Jorge Ramón Padilla-Gutiérrez
- Departamento de Clínicas Médicas, Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), Colonia Independencia, Guadalajara, México
| | - Cristina Sevillano-Collantes
- Sección de Endocrinología y Nutrición, Hospital Universitario Infanta Leonor, Facultad de Medicina, Universidad Complutense, Madrid, España
| | - Inmaculada Moreno-Ruiz
- Sección de Endocrinología y Nutrición, Hospital Universitario Infanta Leonor, Facultad de Medicina, Universidad Complutense, Madrid, España
| | - Francisco Javier Del Cañizo-Gómez
- Sección de Endocrinología y Nutrición, Hospital Universitario Infanta Leonor, Facultad de Medicina, Universidad Complutense, Madrid, España
| | - Angélica Valdez-Haro
- Hospital Infantil del Estado de Sonora, Departamento de Enseñanza y Calidad, Hermosillo, Sonora, Mexico
| | | | - Yeminia Valle
- Departamento de Clínicas Médicas, Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), Colonia Independencia, Guadalajara, México
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Zhang Z, Wang Q, Chen B, Wang Y, Miao Y, Han L. Association study of genetic variations of inflammatory biomarkers with susceptibility and severity of obstructive sleep apnea. Mol Genet Genomic Med 2019; 7:e801. [PMID: 31210414 PMCID: PMC6712723 DOI: 10.1002/mgg3.801] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/19/2019] [Accepted: 05/23/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea (OSA) increases health risks of cardiovascular disease and stroke. Both genetic factors and environmental exposures contribute to the occurrence of OSA. The purpose of this study was to determine the role of four functional inflammatory single nucleotide polymorphisms (SNPs) (VWF rs1063856, IL-6 rs1800796, TNF rs1800629, and CRP rs2794521) in the susceptibility and severity of OSA. METHODS A case-control study of OSA among Chinese population was conducted. Genotyping was performed using ABI TaqMan SNP genotyping technique. RESULTS We found VWF rs1063856 (OR = 1.50, 95% CIs = 1.10-2.04; p = 0.010), IL-6 rs1800796 (OR = 1.32, 95% CIs = 1.11-1.56; p = 0.002), TNF rs1800629 (OR = 1.44, 95% CIs = 1.13-1.83; p = 0.003), and CRP rs2794521 (OR = 1.27, 95% CIs = 1.04-1.55; p = 0.021) were all significantly associated with increased susceptibility of OSA, while VWF rs1063856 (OR = 1.75, 95% CIs = 1.18-2.62; p = 0.006), IL-6 rs1800796 (OR = 1.39, 95% CIs = 1.10-1.76; p = 0.006) were associated with the severity of OSA. CONCLUSIONS Our study indicated that functional variants of inflammatory biomarkers could cause the occurrence of OSA and influence the severity of OSA. These findings further support that inflammatory cytokines were closely related to the occurrence and development of OSA.
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Affiliation(s)
- Zeming Zhang
- Department of Respiratory Medicine, Shanghai University of medicine & health Sciences Affiliated Zhoupu hospital, Shanghai, China
| | - Qiubo Wang
- Department of Respiratory Medicine, Shanghai University of medicine & health Sciences Affiliated Zhoupu hospital, Shanghai, China
| | - Baoyuan Chen
- Department of Respiratory Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Yancun Wang
- Department of Neurology Medicine, Shanghai University of medicine & health Sciences Affiliated Zhoupu hospital, Shanghai, China
| | - Yafang Miao
- Department of Respiratory Medicine, Shanghai University of medicine & health Sciences Affiliated Zhoupu hospital, Shanghai, China
| | - Li Han
- Department of Respiratory Medicine, Shanghai University of medicine & health Sciences Affiliated Zhoupu hospital, Shanghai, China
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3
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Moura TCF, Amoras EDSG, Queiroz MAF, Conde SRSDS, Grisólia ABA, Ishak R, Vallinoto ACR. Association of serum levels of C-reactive protein with CRP-717 T/C polymorphism and viremia in HCV and HBV carriers. Rev Soc Bras Med Trop 2019; 52:e20180455. [PMID: 30810658 DOI: 10.1590/0037-8682-0455-2018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 01/04/2019] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The present study investigated the association of the rs2794521 polymorphism in the CRP gene in individuals with chronic hepatitis B and C, correlating it with markers of hepatic inflammation, fibrosis scores, viral load, and plasma protein levels. METHODS The study analyzed 185 blood samples obtained from patients with hepatitis B (n=74) and hepatitis C (n=111) and 300 samples from healthy donors. Genotyping was performed by real-time polymerase chain reaction, and protein levels were quantified using the automated immunoturbidimetric method. RESULTS The TT genotype was the most frequent in all studied groups and was associated with higher plasma levels of the protein but not with the progression of liver disease. Low levels of C-reactive protein were associated with increased viremia and scores indicative of severe fibrosis and cirrhosis. CONCLUSIONS The present results demonstrated a close relationship between the ability of the virus to replicate and cause liver damage and low serum concentrations of C-reactive protein. Future research may determine if these results can be interpreted as a possible form of escape for the virus by decreasing its action as an opsonin and decreasing phagocytosis, which are functions of C-reactive protein in the immune response.
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Affiliation(s)
- Tuane Carolina Ferreira Moura
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA, Brasil.,Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Bioloógicas, Universidade Federal do Pará, Belém, PA, Brasil
| | | | - Maria Alice Freitas Queiroz
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA, Brasil.,Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Bioloógicas, Universidade Federal do Pará, Belém, PA, Brasil
| | - Simone Regina Souza da Silva Conde
- Serviço de Hepatologia, Hospital Santa Casa de Misericórdia do Pará, Belém, PA, Brasil.,Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém, PA, Brasil.,Faculdade de Medicina, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, PA, Brasil
| | | | - Ricardo Ishak
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA, Brasil
| | - Antonio Carlos Rosário Vallinoto
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA, Brasil.,Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Bioloógicas, Universidade Federal do Pará, Belém, PA, Brasil
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Yan S, Chen W, Peng C, Zhu W, Chen M, Zhang J, Su J, Li F, Liu Z, Zhang W, Li Q, Li J, Chen X. C-reactive protein (CRP) rs3093059Cpredicts poor mizolastine response in chronic spontaneous urticaria patients with elevated serum CRP level. Exp Dermatol 2019; 28:240-246. [PMID: 30632650 DOI: 10.1111/exd.13874] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 12/18/2018] [Accepted: 01/07/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Siyu Yan
- Department of Dermatology; Xiangya Hospital; Central South University; Changsha China
- Hunan Key Laboratory of Skin Cancer and Psoriasis; Xiangya Hospital; Central South University; Changsha Hunan China
- Hunan Engineering Research Center of Skin Health and Disease; Changsha Hunan China
| | - Wangqing Chen
- Department of Dermatology; Xiangya Hospital; Central South University; Changsha China
- Hunan Key Laboratory of Skin Cancer and Psoriasis; Xiangya Hospital; Central South University; Changsha Hunan China
- Institute of Clinical Pharmacology; Xiangya Hospital; Central South University; Changsha China
| | - Cong Peng
- Department of Dermatology; Xiangya Hospital; Central South University; Changsha China
- Hunan Key Laboratory of Skin Cancer and Psoriasis; Xiangya Hospital; Central South University; Changsha Hunan China
- Hunan Engineering Research Center of Skin Health and Disease; Changsha Hunan China
| | - Wu Zhu
- Department of Dermatology; Xiangya Hospital; Central South University; Changsha China
- Hunan Key Laboratory of Skin Cancer and Psoriasis; Xiangya Hospital; Central South University; Changsha Hunan China
- Hunan Engineering Research Center of Skin Health and Disease; Changsha Hunan China
| | - Mingliang Chen
- Department of Dermatology; Xiangya Hospital; Central South University; Changsha China
- Hunan Key Laboratory of Skin Cancer and Psoriasis; Xiangya Hospital; Central South University; Changsha Hunan China
- Hunan Engineering Research Center of Skin Health and Disease; Changsha Hunan China
| | - Jianglin Zhang
- Department of Dermatology; Xiangya Hospital; Central South University; Changsha China
- Hunan Key Laboratory of Skin Cancer and Psoriasis; Xiangya Hospital; Central South University; Changsha Hunan China
- Hunan Engineering Research Center of Skin Health and Disease; Changsha Hunan China
| | - Juan Su
- Department of Dermatology; Xiangya Hospital; Central South University; Changsha China
- Hunan Key Laboratory of Skin Cancer and Psoriasis; Xiangya Hospital; Central South University; Changsha Hunan China
- Hunan Engineering Research Center of Skin Health and Disease; Changsha Hunan China
| | - Fangfang Li
- Department of Dermatology; Xiangya Hospital; Central South University; Changsha China
- Hunan Key Laboratory of Skin Cancer and Psoriasis; Xiangya Hospital; Central South University; Changsha Hunan China
- Hunan Engineering Research Center of Skin Health and Disease; Changsha Hunan China
| | - Zhaoqian Liu
- Institute of Clinical Pharmacology; Xiangya Hospital; Central South University; Changsha China
| | - Wei Zhang
- Institute of Clinical Pharmacology; Xiangya Hospital; Central South University; Changsha China
| | - Qingling Li
- Department of Pathology; Xiangya Hospital; Central South University; Changsha China
| | - Jie Li
- Department of Dermatology; Xiangya Hospital; Central South University; Changsha China
- Hunan Key Laboratory of Skin Cancer and Psoriasis; Xiangya Hospital; Central South University; Changsha Hunan China
- Hunan Engineering Research Center of Skin Health and Disease; Changsha Hunan China
| | - Xiang Chen
- Department of Dermatology; Xiangya Hospital; Central South University; Changsha China
- Hunan Key Laboratory of Skin Cancer and Psoriasis; Xiangya Hospital; Central South University; Changsha Hunan China
- Hunan Engineering Research Center of Skin Health and Disease; Changsha Hunan China
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Golimbet VE, Volel BA, Korovaitseva GI, Kasparov SV, Kondratiev NV, Kopylov FY. [Association of inflammatory genes with neuroticism, anxiety and depression in male patients with coronary heart disease]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:74-79. [PMID: 28399100 DOI: 10.17116/jnevro20171173174-79] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIM To explore the relationship of depression and its endophenotypes (neuroticism and trait anxiety) with inflammatory genes in patients with coronary heart disease (CHD). MATERIAL AND METHODS A sample consisted of 78 male CHD patients with depression, 91 CHD patients without depression and 127 healthy men. Polymorphisms of the genes encoding interleukine-4 (IL-4 -589 C/T), interleukine-6 (IL-6 -174 G/C), tumor-necrosis factor alpha (TNF-α -308 G/A) and C-reactive protein (CRP -717A/G) were studied. RESULTS There was the association between the IL-6 -174 G/C and depression comorbid to CHD (р=0.01; OR=2.3 CI 95% 1.2-4.3). The frequency of the 'high expression' allele G in this group was higher compared to controls. The association between IL-4 -589 C/T and CHD was found. Compared to the control group, the frequency of the IL-4 -589CC genotype was higher in patients regardless of whether they had symptoms of depression (р=0.007; OR=2.1 CI 95% 1.2-3.4). No association between the TNF-α -308G/A and the CRP -717A/G with depression in CHD was observed. There were no differences between neuroticism and anxiety scores in patients with different IL-4 -589 C/T, IL-6 -174 G/C, TNF-α -308 G/A, CRP -717A/G genotypes. CONCLUSION The finding of the association between the IL-6 -174G/C and depression, comorbid to CHD, is in line with literature on a role of IL-6 in the development of depression in patients with CHD.
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Affiliation(s)
| | - B A Volel
- Sechenov First Moscow Medical University, Moscow, Russia
| | | | | | | | - F Yu Kopylov
- Sechenov First Moscow Medical University, Moscow, Russia
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6
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Xue Y, Zhang L, Fan Y, Li Q, Jiang Y, Shen C. C-Reactive Protein Gene Contributes to the Genetic Susceptibility of Hemorrhagic Stroke in Men: a Case-Control Study in Chinese Han Population. J Mol Neurosci 2017; 62:395-401. [PMID: 28721654 DOI: 10.1007/s12031-017-0945-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 06/28/2017] [Indexed: 11/28/2022]
Abstract
High-sensitivity C-reactive protein (hsCRP) is an inflammatory marker for the prediction and prognosis of ischemic stroke but there is an absence of evidence for cerebral hemorrhagic events. The aim of this study is to investigate the effects of elevated plasma hsCRP and CRP genetic variants on hemorrhagic stroke (HS). Two hundred thirty-six inpatients with HS and 993 age-matched controls from a community-based population were included in a case-control study and four tagging single nucleotide polymorphsims (tagSNPs) at CRP were genotyped. The association of hsCRP elevation and CRP variants with HS was evaluated by multiple logistic regression. HS cases had a higher median (interquartile) of hsCRP with 5.40 (1.30-10.7) mg/L and a proportion of hsCRP elevation (≥3 mg/L, 63.4%) than controls [1.20 (0.80-2.20) mg/L, 16.6%], respectively (P < 0.05 for all). No significant difference of genotype or allele frequency of the four SNPs was observed between HS patients and controls (P > 0.05). Further stratified analysis by gender showed that the variants of rs3093059 (T/C) and rs3091244 (C/T/A) were significantly associated with the decreased risk of HS in men and odds ratios (ORs) and 95% confidence intervals (95% CIs) for additive models were 0.515 (0.294-0.903) and 0.578 (0.349-0.96), respectively, after adjusting for covariates. In HS patients, rs3091244 was positively associated with the hsCRP elevation and rs2794521 was negatively associated with hsCRP elevation (P < 0.05). Our findings suggest that hsCRP elevation is associated with the risk of HS and CRP contributes genetic susceptibility to HS in men as well as hsCRP elevation in HS.
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Affiliation(s)
- Yong Xue
- Department of Medical Laboratory, Huai'an Third Hospital, Huai'an, 223300, China
| | - Long Zhang
- Department of Emergency, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210009, China
| | - Yao Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Wannan Medical College, Wuhu, 241001, China
| | - Qianhui Li
- Department of Medical Laboratory, Huai'an First Hospital, People's Hospital of Huai'an, Affiliated to Nanjing Medical University, Huai'an, 223300, China
| | - Yuzhang Jiang
- Department of Medical Laboratory, Huai'an First Hospital, People's Hospital of Huai'an, Affiliated to Nanjing Medical University, Huai'an, 223300, China.
| | - Chong Shen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
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Navarro P, de Dios O, Gavela-Pérez T, Soriano-Guillen L, Garcés C. Relationship between polymorphisms in the CRP, LEP and LEPR genes and high sensitivity C-reactive protein levels in Spanish children. ACTA ACUST UNITED AC 2017; 55:1690-1695. [DOI: 10.1515/cclm-2017-0134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 02/19/2017] [Indexed: 01/19/2023]
Abstract
AbstractBackground:We investigated the association of single nucleotide polymorphisms (SNPs) in the C-reactive protein (Methods:We measured hs-CRP levels in 646 6–8-year-old and 707 12–16-year-old children using a high-sensitivity C-Reactive Protein ELISA kit. Four SNPs in theResults:The four CRP SNPs studied were significantly (p<0.05) associated with hs-CRP levels in both cohorts. Furthermore, two common CRP haplotypes (constructed using the SNPs in order: rs1205, rs1130864, rs1800947, rs2794521) ACGA and GCGG were associated with significantly lower CRP levels (p<0.05) at both ages. The LEPR SNPs rs1137100 (K109R) and rs1137101 (Q223R), and LEP SNP rs7799039 (G2548A) were also associated to hs-CRP levels (p<0.05) in both cohorts.Conclusions:hs-CRP levels in healthy Spanish children, besides being associated to common polymorphisms in the
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Zhang Q, Qiu DX, Fu RL, Xu TF, Jing MJ, Zhang HS, Geng HH, Zheng LC, Wang PX. H-Type Hypertension and C Reactive Protein in Recurrence of Ischemic Stroke. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13050477. [PMID: 27164124 PMCID: PMC4881102 DOI: 10.3390/ijerph13050477] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 04/27/2016] [Accepted: 05/04/2016] [Indexed: 01/04/2023]
Abstract
Hypertension with high homocysteine (HHcy) (H-type hypertension) and C reactive protein (CRP) can increase the incidence of ischemic stroke. However, it is not clear whether recurrent ischemic stroke (RIS) is related to H-type hypertension and CRP. The present study investigated the correlation of H-type hypertension and CRP level with RIS. Totally, 987 consecutive patients with acute ischemic stroke were recruited in a teaching hospital in Henan province, China during March 2014 to March 2015. The demographic and clinical characteristics and blood biochemical parameters of patients were analyzed. Elevated levels of CRP and homocysteine (Hcy) were defined as >8.2 mg/L and 10 μmol/L, respectively. Among the 987 patients, 234 were RIS. Thirty-eight percent of RIS patients had elevated CRP level and 91.5% of RIS patients had HHcy. In multivariate analysis, adjusted odds ratio (OR) of RIS in patients aged ≥60 years was 1.576 (95% CI: 1.125–2.207), in male patients 1.935 (95% CI: 1.385–2.704), in patients with diabetes 1.463 (95% CI: 1.037–2.064), CRP levels 1.013 (95% CI: 1.006–1.019), simple hypertension 3.370 (95% CI: 1.15–10.183), and H-type hypertension 2.990 (95% CI: 1.176–7.600). RIS was associated with older age, male, diabetes, H-type hypertension and CRP. Controlling H-type hypertension and CRP level may reduce the risk of RIS.
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Affiliation(s)
- Qing Zhang
- Institute of Public Health, School of Nursing, Henan University, Kaifeng 475004, China.
| | - De-Xing Qiu
- Guangming New District People's Hospital & Community Health Service Management Center of Guangming Area, Shenzhen 518000, China.
| | - Rong-Li Fu
- Internal Medicine-Neurology, Huaihe Hospital, Henan University, Kaifeng 475000, China.
| | - Tian-Fen Xu
- Basical School, Guangzhou Medical University, Guangzhou 510180, China.
| | - Meng-Juan Jing
- Institute of Public Health, School of Nursing, Henan University, Kaifeng 475004, China.
| | - Hui-Shan Zhang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou 510180, China.
| | - He-Hong Geng
- Institute of Public Health, School of Nursing, Henan University, Kaifeng 475004, China.
| | - Long-Chao Zheng
- Department of Public Health, School of Public Health, Graduate School of Guizhou Medical University, Guiyang 550025, China.
| | - Pei-Xi Wang
- Institute of Public Health, School of Nursing, Henan University, Kaifeng 475004, China.
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou 510180, China.
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