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Zhang D, Zhu Z, Bi J, Feng D, Zhang L, Liu H, Gao Y. Clinical Characteristics and Risk Factors in Coronavirus Disease 2019 Patients with Liver Injury. Med Sci Monit 2020; 26:e928849. [PMID: 33339813 PMCID: PMC7757021 DOI: 10.12659/msm.928849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Emerging studies noted that liver injury in coronavirus disease 2019 (COVID-19) patients may be induced by virus-mediated inflammation, which was confirmed by liver pathology. The aim of this study was to observe clinical characteristics and explore risk factors in COVID-19 patients with liver injury. MATERIAL AND METHODS In this retrospective study, 40 confirmed COVID-19 patients with normal alanine transaminase (ALT) on admission were divided into a group of normal ALT patients whose ALT was always less than 40 U/l during hospitalization and a group of elevated ALT patients whose ALT was at least once more than 40 U/l after admission. Clinical data, especially virus-induced inflammatory parameters, were analyzed for risk factors and predictive value. The Mann-Whitney U test and t test for comparing means and logistic regression were performed for analysis of risk factors. Area under the ROC curve was used for predictive values. RESULTS Sixteen of 40 (40.0%) patients developed elevated ALT, many of them with more severe COVID-19. The highest ALT level was 101 U/l. The risk factors for liver injury were C-reactive protein (CRP), interleukin 6 (IL6), erythrocyte sedimentation rate (ESR), CD8+T cell count, and severity of disease, and CRP (OR 1.13, 95% CI 1.045-1.222, p=0.002) was the independent risk factor. CONCLUSIONS Liver injury in COVID-19 patients was mild and associated with inflammatory markers, especially CRP, which suggests that liver injury may be induced by virus-mediated inflammation in COVID-19 patients.
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Affiliation(s)
- Dali Zhang
- Liver Transplantation and Research Center, The 5th Medical Center, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland)
| | - Zhenyu Zhu
- Liver Transplantation and Research Center, The 5th Medical Center, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland)
| | - Jingfeng Bi
- Research Centre for Clinical and Translational Medicine, The 5th Medical Center, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland)
| | - Danni Feng
- Liver Transplantation and Research Center, The 5th Medical Center, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland)
| | - Lijuan Zhang
- Liver Transplantation and Research Center, The 5th Medical Center, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland)
| | - Hongling Liu
- Liver Transplantation and Research Center, The 5th Medical Center, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland)
| | - Yinjie Gao
- Liver Transplantation and Research Center, The 5th Medical Center, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland)
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Meisel P, Pink C, Pitchika V, Nauck M, Völzke H, Kocher T. Competing interplay between systemic and periodontal inflammation: obesity overrides the impact of oral periphery. Clin Oral Investig 2020; 25:2045-2053. [PMID: 32827080 PMCID: PMC8238770 DOI: 10.1007/s00784-020-03514-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/06/2020] [Indexed: 12/19/2022]
Abstract
Objectives We aimed at investigating whether the interaction between the local inflammation, periodontitis, and obesity is independently associated with systemic inflammation. Methods From the population-based Study of Health in Pomerania, 3366 participants, without (2366) and with (1000) obesity, were studied for the association of periodontitis, measured as probing depth (PD) and plaque together with body mass index (BMI) on C-reactive protein (CRP). Quantile regression was used to evaluate the association between periodontal, anthropometric, and inflammatory variables (outcomes). Results The overall prevalence of obesity in this adult population was 31.4% in men and 28.1% in women. Both PD and plaque were positively associated with CRP, revealing an increasing impact across the CRP concentration distribution. Adjusting the regression of CRP or fibrinogen on PD for waist circumference attenuated but did not abolish the PD coefficients. Dental plaque was similarly associated with these interrelations. Association between PD and a dental plaque was different among participants with low-, medium-, or high-risk CRP concentrations. Conclusion Local and systemic sources of inflammation contribute to blood levels of inflammatory markers. The respective contributions depend on the relative rate in each of the inflammation-inducing risks and are dominated by adiposity. Clinical relevance Keeping systemic inflammation low in order to prevent age-related disease sequelae. Electronic supplementary material The online version of this article (10.1007/s00784-020-03514-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Peter Meisel
- Dental Clinics, Department of Periodontology, School of Dentistry, University Medicine Greifswald, Fleischmann-Strasse 42, D-17475, Greifswald, Germany.
| | - Christiane Pink
- Dental Clinics, Department of Periodontology, School of Dentistry, University Medicine Greifswald, Fleischmann-Strasse 42, D-17475, Greifswald, Germany
| | - Vinay Pitchika
- Dental Clinics, Department of Periodontology, School of Dentistry, University Medicine Greifswald, Fleischmann-Strasse 42, D-17475, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Diagnostics, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany
| | - Henry Völzke
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany.,Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Dental Clinics, Department of Periodontology, School of Dentistry, University Medicine Greifswald, Fleischmann-Strasse 42, D-17475, Greifswald, Germany
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Jin D, Zhu DM, Hu HL, Yao MN, Yin WJ, Tao RX, Zhu P. Vitamin D status affects the relationship between lipid profile and high-sensitivity C-reactive protein. Nutr Metab (Lond) 2020; 17:57. [PMID: 32684941 PMCID: PMC7359462 DOI: 10.1186/s12986-020-00455-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 05/07/2020] [Indexed: 12/18/2022] Open
Abstract
Background The biological pathways through which vitamin D is involved in the regulation of systemic inflammation remain largely unknown. Objective The objective of this study was to evaluate the role of vitamin D status on the relationship between lipid profile and high-sensitivity C-reactive protein (hs-CRP) in pregnant women. Design Serum 25-hydroxyvitamin D (25(OH)D), hs-CRP, and indicators of lipid profiles (total cholesterol, TC; triglyceride, TG; high-density lipoprotein cholesterol, HDL-C; low-density lipoprotein cholesterol, LDL-C), were measured in 2479 pregnant women during the second trimester. Potential confounding including maternal sociodemographic characteristics, perinatal health status, diet, and lifestyle was prospectively collected. Multiple regression models and cubic models were used to evaluate the associations. Results There was a significant non-linear relationship between lipid profile (TC, TG, HDL-C, LDL-C) and hs-CRP (P < 0.05). Increased serum 25(OH)D was significantly associated with decreasing TC, TG, HDL-C, LDL-C, and hs-CRP levels. Compared with medium levels of lipids group, pregnant women with higher levels of TC or TG have higher levels of hs-CRP, and pregnant women with lower levels of TC, HDL-C or LDL-C also have higher levels of hs-CRP in the vitamin D deficient group, and there was a significant correlation between low levels of TG and decreased hs-CRP (adjusted β for TG: -0.063, 95%CI: − 0.120,-0.007) in the non-vitamin D deficient group. Mediators that had appreciable shares of the associations between 25(OH)D and hs-CRP was TG (10.2% of the association; β = − 0.011; total indirect effect: 95% CI: − 0.019, − 0.002). The cubic model suggested that a steep increase in the adjusted regression coefficient of lipid with hs-CRP up to 50 nmol/L of 25(OH)D, and the highest adjusted regression coefficients were observed in pregnant women with 25(OH)D above 50 nmol/L. Conclusion Our findings suggest that high levels of vitamin D during pregnancy may improve lipid profile levels and inhibit elevated hs-CRP induced by high lipid metabolism.
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Affiliation(s)
- Dan Jin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Dao-Min Zhu
- Department of Sleep Disorders, Hefei Fourth People's Hospital, Hefei, China
| | - Hong-Lin Hu
- Department of Endocrinology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Meng-Nan Yao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Wan-Jun Yin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Rui-Xue Tao
- Department of Gynecology and Obstetrics, Hefei First People's Hospital, Hefei, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
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Henze LA, Luong TT, Boehme B, Masyout J, Schneider MP, Brachs S, Lang F, Pieske B, Pasch A, Eckardt KU, Voelkl J, Alesutan I. Impact of C-reactive protein on osteo-/chondrogenic transdifferentiation and calcification of vascular smooth muscle cells. Aging (Albany NY) 2019; 11:5445-5462. [PMID: 31377747 PMCID: PMC6710049 DOI: 10.18632/aging.102130] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 07/25/2019] [Indexed: 05/01/2023]
Abstract
Medial vascular calcification occurs during the aging process and is strongly accelerated by chronic kidney disease (CKD). Elevated C-reactive protein (CRP) levels are associated with vascular calcification, cardiovascular events and mortality in CKD patients. CRP is an important promoter of vascular inflammation. Inflammatory processes are critically involved in initiation and progression of vascular calcification. Thus, the present study explored a possible impact of CRP on vascular calcification. We found that CRP promoted osteo-/chondrogenic transdifferentiation and aggravated phosphate-induced osteo-/chondrogenic transdifferentiation and calcification of primary human aortic smooth muscle cells (HAoSMCs). These effects were paralleled by increased cellular oxidative stress and corresponding pro-calcific downstream-signaling. Antioxidants or p38 MAPK inhibition suppressed CRP-induced osteo-/chondrogenic signaling and mineralization. Furthermore, silencing of Fc fragment of IgG receptor IIa (FCGR2A) blunted the pro-calcific effects of CRP. Vascular CRP expression was increased in the klotho-hypomorphic mouse model of aging as well as in HAoSMCs during calcifying conditions. In conclusion, CRP augments osteo-/chondrogenic transdifferentiation of vascular smooth muscle cells through mechanisms involving FCGR2A-dependent induction of oxidative stress. Thus, systemic inflammation may actively contribute to the progression of vascular calcification.
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MESH Headings
- Aging/metabolism
- Aging/pathology
- Animals
- C-Reactive Protein/metabolism
- Cell Transdifferentiation/physiology
- Cells, Cultured
- Chondrogenesis/physiology
- Disease Models, Animal
- Glucuronidase/genetics
- Glucuronidase/metabolism
- Humans
- Klotho Proteins
- Mice
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Myocytes, Smooth Muscle/metabolism
- Myocytes, Smooth Muscle/pathology
- Osteogenesis/physiology
- Oxidative Stress
- RNA, Small Interfering/genetics
- Receptors, IgG/antagonists & inhibitors
- Receptors, IgG/genetics
- Receptors, IgG/metabolism
- Renal Insufficiency, Chronic/complications
- Renal Insufficiency, Chronic/metabolism
- Renal Insufficiency, Chronic/pathology
- Signal Transduction
- Vascular Calcification/etiology
- Vascular Calcification/metabolism
- Vascular Calcification/pathology
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Affiliation(s)
- Laura A. Henze
- Department of Internal Medicine and Cardiology, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin 13353, Germany
| | - Trang T.D. Luong
- Department of Internal Medicine and Cardiology, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin 13353, Germany
- Institute for Physiology and Pathophysiology, Johannes Kepler University Linz, Linz 4040, Austria
| | - Beate Boehme
- Department of Internal Medicine and Cardiology, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin 13353, Germany
| | - Jaber Masyout
- Department of Internal Medicine and Cardiology, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin 13353, Germany
| | - Markus P. Schneider
- Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Sebastian Brachs
- Department of Endocrinology, Diabetes and Nutrition, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin 10115, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin 10115, Germany
| | - Florian Lang
- Department of Physiology I, Eberhard-Karls University, Tübingen 72076, Germany
| | - Burkert Pieske
- Department of Internal Medicine and Cardiology, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin 13353, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin 10115, Germany
- Berlin Institute of Health (BIH), Berlin 10178, Germany
- Department of Internal Medicine and Cardiology, German Heart Center Berlin (DHZB), Berlin 13353, Germany
| | - Andreas Pasch
- Institute for Physiology and Pathophysiology, Johannes Kepler University Linz, Linz 4040, Austria
- Calciscon AG, 2560 Nidau-Biel, Switzerland
| | - Kai-Uwe Eckardt
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, Berlin 10117, Germany
| | - Jakob Voelkl
- Department of Internal Medicine and Cardiology, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin 13353, Germany
- Institute for Physiology and Pathophysiology, Johannes Kepler University Linz, Linz 4040, Austria
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin 10115, Germany
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, Berlin 10117, Germany
| | - Ioana Alesutan
- Department of Internal Medicine and Cardiology, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin 13353, Germany
- Institute for Physiology and Pathophysiology, Johannes Kepler University Linz, Linz 4040, Austria
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin 10115, Germany
- Berlin Institute of Health (BIH), Berlin 10178, Germany
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Braga D, Lemos LB, Silva CR, Andrade CEB, Reis JTR, Oliveira LL, Moreira RO. Avaliação dos níveis de albuminúria em adultos obesos e sua associação com marcadores de risco cardiovascular. HU REVISTA 2019. [DOI: 10.34019/1982-8047.2018.v44.13965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introdução: A obesidade é um dos fatores mais importantes para explicar o aumento incidência das Doenças Cardiovasculares (DCV). Dentre os múltiplos fatores de risco para estas doenças, a albuminúria é dos mais importantes. Objetivos: Avaliar os níveis de albuminúria e correlacionar com outros marcadores de risco cardiovascular em pacientes obesos que procuraram tratamento para obesidade. Materiais e métodos: Estudo transversal, retrospectivo, através dos prontuários de 183 pacientes de ambos os sexos, entre 18 e 65 anos, com índice de massa corpórea (IMC) ≥ 30 Kg/m². Todos os pacientes foram submetidos a exame físico e receberam um pedido de rotina laboratorial, incluindo de albuminúria em amostra isolada de urina. Resultados: Dados de albuminúria estavam disponíveis em 81 prontuários. Destes, 15 pacientes (18,5%) tinham valores acima de 17 mg/L de albuminúria. Nenhuma correlação foi encontrada entre os níveis de albuminúria e os parâmetros antropométricos (IMC, r=0,08; p=0,47; Cintura, r=0,17; p=0.11; Quadril, r=0,11; p=0,35; RCQ, r=0,03; p=0,75), Pressão Arterial (PA) sistólica (r=0,013; p=0,21) ou diastólica (r=0,11; p=0,32). Nenhuma diferença foi encontrada entre os pacientes que já usavam anti-hipertensivos ou não (p=0,25). Foi encontrada correlação entre os níveis de albuminúria e o high-density lipoprotein cholesterol (HDLc), (r=-0,27; p=0,012), além de uma tendência a significância com os níveis de Proteína C Reativa Ultrassensível (PCR-us; r=0,21; p= 0,081). Conclusão: Apesar da alta frequência (18,5%) de albuminúria em pacientes obesos, não foi encontrada correlação entre este marcador e os parâmetros antropométricos. Foi encontrado uma relação inversa da albuminúria com HDLc e uma tendência a significância com a PCR-us, sugerindo uma associação limitada entre a albuminúria e alguns marcadores específicos de risco cardiovascular.
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