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Shrestha RM, Pham TTP, Yamamoto S, Nguyen CQ, Fukunaga A, Danh PC, Hachiya M, Le HX, Do HT, Mizoue T, Inoue Y. Comparison of waist circumference and waist-to-height ratio as predictors of clustering of cardiovascular risk factors among middle-aged people in rural Khanh Hoa, Vietnam. Am J Hum Biol 2024; 36:e24063. [PMID: 38470099 DOI: 10.1002/ajhb.24063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/05/2024] [Accepted: 02/26/2024] [Indexed: 03/13/2024] Open
Abstract
OBJECTIVE Given the population-level variation in stature, a universal cut-off for waist circumference (WC) may not be appropriate for some populations. We compared the performance of WC and waist-to-height ratio (WHtR) to detect the clustering of cardiovascular disease (CVD) risk factors in rural Vietnam. METHODS We obtained data from a baseline survey of the Khanh Hoa Cardiovascular Study comprising 2942 middle-aged residents (40-60 years). We used areas under the receiver operating characteristics curve (AUROC), net reclassification index (NRI), and integrated discrimination improvement (IDI) to compare the performance of WC and WHtR in predicting CVD risk clustering (≥2 of the following risk factors: hypertension, diabetes, dyslipidemia, and elevated C-reactive protein). RESULTS The optimal cut-off values for WC were 81.8 and 80.7 cm for men and women, respectively. Regarding the clustering of CVD risk factors, the AUROC (95% CI) of WC and WHtR were 0.707 (0.676 to 0.739) and 0.719 (0.689 to 0.749) in men, and 0.682 (0.654 to 0.709) and 0.690 (0.663 to 0.717) in women, respectively. Compared with WC, WHtR had a better NRI (0.229; 0.102-0.344) and IDI (0.012; 0.004-0.020) in men and a better NRI (0.154; 0.050-0.257) in women. CONCLUSIONS The optimal WC cut-off for Vietnamese men was approximately 10 cm below the recommended Asian cut-off. WHtR might perform slightly better in predicting the clustering of CVD risk factors among the rural population in Vietnam.
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Affiliation(s)
- Rachana Manandhar Shrestha
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Thuy Thi Phuong Pham
- Department of Non-communicable Disease Control and Nutrition, Pasteur Institute in Nha Trang, Khanh Hoa, Vietnam
| | - Shohei Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Chau Que Nguyen
- Department of Non-communicable Disease Control and Nutrition, Pasteur Institute in Nha Trang, Khanh Hoa, Vietnam
| | - Ami Fukunaga
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Phan Cong Danh
- Department of Non-communicable Disease Control and Nutrition, Pasteur Institute in Nha Trang, Khanh Hoa, Vietnam
| | - Masahiko Hachiya
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Huy Xuan Le
- Pasteur Institute in Nha Trang, Khanh Hoa, Vietnam
| | - Hung Thai Do
- Pasteur Institute in Nha Trang, Khanh Hoa, Vietnam
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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Monomeric C-Reactive Protein in Atherosclerotic Cardiovascular Disease: Advances and Perspectives. Int J Mol Sci 2023; 24:ijms24032079. [PMID: 36768404 PMCID: PMC9917083 DOI: 10.3390/ijms24032079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/16/2023] [Accepted: 01/16/2023] [Indexed: 01/21/2023] Open
Abstract
This review aimed to trace the inflammatory pathway from the NLRP3 inflammasome to monomeric C-reactive protein (mCRP) in atherosclerotic cardiovascular disease. CRP is the final product of the interleukin (IL)-1β/IL-6/CRP axis. Its monomeric form can be produced at sites of local inflammation through the dissociation of pentameric CRP and, to some extent, local synthesis. mCRP has a distinct proinflammatory profile. In vitro and animal-model studies have suggested a role for mCRP in: platelet activation, adhesion, and aggregation; endothelial activation; leukocyte recruitment and polarization; foam-cell formation; and neovascularization. mCRP has been shown to deposit in atherosclerotic plaques and damaged tissues. In recent years, the first published papers have reported the development and application of mCRP assays. Principally, these studies demonstrated the feasibility of measuring mCRP levels. With recent advances in detection techniques and the introduction of first assays, mCRP-level measurement should become more accessible and widely used. To date, anti-inflammatory therapy in atherosclerosis has targeted the NLRP3 inflammasome and upstream links of the IL-1β/IL-6/CRP axis. Large clinical trials have provided sufficient evidence to support this strategy. However, few compounds target CRP. Studies on these agents are limited to animal models or small clinical trials.
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Effect of weekend catch-up sleep on high-sensitivity C-reactive protein levels according to bedtime inconsistency: a population-based cross-sectional study. Sci Rep 2022; 12:21619. [PMID: 36517526 PMCID: PMC9751111 DOI: 10.1038/s41598-022-25787-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022] Open
Abstract
To investigate the associations of weekend catch-up sleep (WCS) and high-sensitivity C-reactive protein (hs-CRP) levels according to bedtime inconsistency in the Korean population. In this cross-sectional study using the Korea National Health and Nutrition Examination Survey (2016-2018) with 17,665 participants, four groups were defined: no-WCS (WCS within ± 1 h of weekday sleep time), moderate WCS (1 ≤ , < 3 h), severe WCS (≥ 3 h), and inverse WCS (≤ - 1 h). An inconsistent bedtime was defined as a > 2 h difference between weekend and weekday bedtimes. Outcomes were divided into quartiles based on the hs-CRP level: Lowest (< 0.34), Middle-low (≥ 0.34, < 0.55), Middle-high (≥ 0.55, < 1.10), Highest (≥ 1.10). Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated using multinomial logistic regression, controlling for relevant covariates. Moderate WCS was associated with a lower risk for the highest hs-CRP levels than no WCS (aOR = 0.87, 95% CI 0.78-0.97), and a similar association was observed only in participants with consistent bedtimes (aOR = 0.88, 95% CI 0.78-0.99). Significant interactions of those associations of WCS and hs-CRP levels with bedtime inconsistency were found. These findings provide evidence that people with inconsistent bedtimes would have limited protective effect of WCS on hs-CRP.
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Markozannes G, Koutsioumpa C, Cividini S, Monori G, Tsilidis KK, Kretsavos N, Theodoratou E, Gill D, Ioannidis JP, Tzoulaki I. Global assessment of C-reactive protein and health-related outcomes: an umbrella review of evidence from observational studies and Mendelian randomization studies. Eur J Epidemiol 2021; 36:11-36. [PMID: 32978716 PMCID: PMC7847446 DOI: 10.1007/s10654-020-00681-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 08/25/2020] [Indexed: 02/07/2023]
Abstract
C-reactive protein (CRP) has been studied extensively for association with a large number of non-infectious diseases and outcomes. We aimed to evaluate the breadth and validity of associations between CRP and non-infectious, chronic health outcomes and biomarkers. We conducted an umbrella review of systematic reviews and meta-analyses and a systematic review of Mendelian randomization (MR) studies. PubMed, Scopus, and Cochrane Database of Systematic Reviews were systematically searched from inception up to March 2019. Meta-analyses of observational studies and MR studies examining associations between CRP and health outcomes were identified, excluding studies on the diagnostic value of CRP for infections. We found 113 meta-analytic comparisons of observational studies and 196 MR analyses, covering a wide range of outcomes. The overwhelming majority of the meta-analyses of observational studies reported a nominally statistically significant result (95/113, 84.1%); however, the majority of the meta-analyses displayed substantial heterogeneity (47.8%), small study effects (39.8%) or excess significance (41.6%). Only two outcomes, cardiovascular mortality and venous thromboembolism, showed convincing evidence of association with CRP levels. When examining the MR literature, we found MR studies for 53/113 outcomes examined in the observational study meta-analyses but substantial support for a causal association with CRP was not observed for any phenotype. Despite the striking amount of research on CRP, convincing evidence for associations and causal effects is remarkably limited.
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Affiliation(s)
- Georgios Markozannes
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, 45110, Ioannina, Greece
| | - Charalampia Koutsioumpa
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, 45110, Ioannina, Greece
- Department of Neurobiology, Harvard Medical School, Boston, MA, USA
- BBS Program, Harvard Medical School, 220 Longwood Avenue, Boston, MA, 02115, USA
| | - Sofia Cividini
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Grace Monori
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Konstantinos K Tsilidis
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, 45110, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Nikolaos Kretsavos
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, 45110, Ioannina, Greece
| | - Evropi Theodoratou
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
- Edinburgh Cancer Research Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - John Pa Ioannidis
- Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, 94305, USA
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, 94305, USA
- Department of Biomedical Data Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA
- Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, CA, 94305, USA
- Meta-Research Innovation Center at Stanford (METRICS), Stanford, CA, 94305, USA
| | - Ioanna Tzoulaki
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, 45110, Ioannina, Greece.
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
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Molinero-Fernández Á, Moreno-Guzmán M, López MÁ, Escarpa A. An array-based electrochemical magneto-immunosensor for early neonatal sepsis diagnostic: Fast and accurate determination of C-reactive protein in whole blood and plasma samples. Microchem J 2020. [DOI: 10.1016/j.microc.2020.104913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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6
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Systemic inflammation is associated with incident stroke and heart disease in East Asians. Sci Rep 2020; 10:5605. [PMID: 32221345 PMCID: PMC7101367 DOI: 10.1038/s41598-020-62391-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 03/12/2020] [Indexed: 12/24/2022] Open
Abstract
Systemic inflammation, reflected by increased plasma concentrations of C-reactive protein (CRP) and fibrinogen, is associated with increased risk of coronary heart disease, but its relevance for stroke types remains unclear. Moreover, evidence is limited in non-European populations. We investigated associations of CRP and fibrinogen with risks of incident major coronary events (MCE), ischemic stroke (IS) and intracerebral hemorrhage (ICH) in a cohort of Chinese adults. A nested case-control study within the prospective China Kadoorie Biobank included 1,508 incident MCE cases, 5,418 IS cases, 4,476 ICH cases, and 5,285 common controls, aged 30–79 years. High-sensitivity CRP and low-density lipoprotein cholesterol (LDL-C) were measured in baseline plasma samples from all participants, and fibrinogen in a subset (n = 9,380). Logistic regression yielded adjusted odds ratios (ORs) per SD higher usual levels of log-transformed CRP and fibrinogen. The overall mean (SD) baseline LDL-C was 91.6 mg/dL (24.0) and geometric mean (95% CI) CRP and fibrinogen were 0.90 mg/L (0.87–0.93) and 3.01 g/L (2.98–3.03), respectively. There were approximately log-linear positive associations of CRP with each outcome, which persisted after adjustment for LDL-C and other risk factors, with adjusted ORs (95% CI) per SD higher CRP of 1.67 (1.44–1.94) for MCE and 1.22 (1.10–1.36) for both IS and ICH. No associations of fibrinogen with MCE, IS, or ICH were identified. Adding CRP to prediction models based on established risk factors improved model fit for each of MCE, IS, and ICH, with small improvements in C-statistic and correct reclassification of controls to lower risk groups. Among Chinese adults, who have low mean LDL-C, CRP, but not fibrinogen, was independently associated with increased risks of MCE and stroke.
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Evans CR, Long DL, Howard G, McClure LA, Zakai NA, Jenny NS, Kissela BM, Safford MM, Howard VJ, Cushman M. C-reactive protein and stroke risk in blacks and whites: The REasons for Geographic And Racial Differences in Stroke cohort. Am Heart J 2019; 217:94-100. [PMID: 31520899 PMCID: PMC6861684 DOI: 10.1016/j.ahj.2019.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 08/01/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND C-reactive protein (CRP) is an inflammatory biomarker used in vascular risk prediction, though with less data in people of color. Blacks have higher stroke incidence and also higher CRP than whites. We studied the association of CRP with ischemic stroke risk in blacks and whites. METHODS REGARDS, an observational cohort study, recruited and followed 30,239 black and white Americans 45 years and older for ischemic stroke. We calculated hazard ratios and 95% CIs of ischemic stroke by CRP category (<1, 1-3, 3-10, and ≥10 mg/L) adjusted for age, sex and stroke risk factors. RESULTS There were 292 incident ischemic strokes among blacks and 439 in whites over 6.9 years of follow-up. In whites, the risk was elevated for CRP in the range from 3 to 10 mg/L and even higher for CRP >10 mg/L, whereas in blacks, an association was only seen for CRP >10 mg/L. Considered as a continuous variable, the risk factor-adjusted hazard ratios per SD higher lnCRP were 1.18 (95% CI 1.09-1.28) overall, 1.14 (95% CI 1.00-1.29) in blacks, and 1.22 (95% CI 1.10-1.35) in whites. Spline regression analysis visually confirmed the race difference in the association. CONCLUSIONS CRP may not be equally useful in stroke risk assessment in blacks and whites. Confirmation, similar study for coronary heart disease, and identification of reasons for these racial differences require further study.
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Affiliation(s)
- Christina R Evans
- Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - D Leann Long
- University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - George Howard
- University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Leslie A McClure
- Drexel University School of Public Health, Philadelphia, PA, USA
| | - Neil A Zakai
- Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - Nancy S Jenny
- Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - Brett M Kissela
- University of Cincinnati School of Medicine, Cincinnati, OH, USA
| | | | - Virginia J Howard
- University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Mary Cushman
- Larner College of Medicine at the University of Vermont, Burlington, VT, USA.
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8
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Shin W, Kim SE, Lee JY, Seo JW, Hyun HS, Suh JH, Choi D, Yoon BK. The Effects of Menopausal Hormone Therapy on Serum Level of C-reactive Protein in Postmenopausal Korean Women. J Menopausal Med 2019; 25:49-54. [PMID: 31080789 PMCID: PMC6487285 DOI: 10.6118/jmm.2019.25.1.49] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 11/20/2018] [Accepted: 12/14/2018] [Indexed: 12/03/2022] Open
Abstract
Objectives Inflammation is a major mechanism underlying coronary heart disease (CHD) and C-reactive protein (CRP) is a marker of inflammation. When administered soon after menopause, menopausal hormone therapy (MHT) prevents CHD. This study was conducted to examine the impact of estrogen by administration route on CRP in postmenopausal Korean women using micronized progesterone (MP4) for endometrial protection. Methods This retrospective cohort study included 129 healthy women without CHD risk factors. Eighty-nine women took oral estrogen (conjugated equine estrogen, 0.625 mg/day or equivalent), and 40 women applied a 1.5-mg/day 0.1% percutaneous estradiol gel. MP4 was added in 82 women with an intact uterus. The CRP level was measured at baseline and three and six months after initiation of MHT. Results The baseline characteristics were comparable between the MHT groups except current age and age at menopause. After controlling for age, menopausal age, body mass index, and basal CRP, no significant change in CRP was observed in the oral estrogen group (n = 29). Follow-up CRP levels were also similar to the baseline in the percutaneous estrogen group (n = 18). However, three-month CRP was significantly lower than six-month CRP, and there was a significant time trend within the percutaneous estrogen group. However, the group difference did not reach statistical significance. CRP also did not differ by addition of MP4 in either group. Conclusions In postmenopausal Korean women, no change in CRP was observed with oral estrogen, while percutaneous estrogen might decrease CRP. The estrogenic impacts were not influenced by adding MP4.
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Affiliation(s)
- Whan Shin
- Department of Obstetrics, Gynecology, and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Eun Kim
- Department of Obstetrics, Gynecology, and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jee-Yeon Lee
- Department of Obstetrics, Gynecology, and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong-Wook Seo
- Department of Obstetrics, Gynecology, and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Sun Hyun
- Department of Obstetrics, Gynecology, and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Hyun Suh
- Department of Obstetrics, Gynecology, and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - DooSeok Choi
- Department of Obstetrics, Gynecology, and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung-Koo Yoon
- Department of Obstetrics, Gynecology, and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Nadeem R, Nida M, Jawed S, Nasrallah B. Elevation in Circulating YKL-40 Levels in Patients with Stroke: A Review and Meta-Analysis. DUBAI MEDICAL JOURNAL 2019. [DOI: 10.1159/000500496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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10
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Yang Y, Hozawa A, Kogure M, Narita A, Hirata T, Nakamura T, Tsuchiya N, Nakaya N, Ninomiya T, Okuda N, Kadota A, Ohkubo T, Okamura T, Ueshima H, Okayama A, Miura K. Dietary Inflammatory Index Positively Associated With High-Sensitivity C-Reactive Protein Level in Japanese From NIPPON DATA2010. J Epidemiol 2019; 30:98-107. [PMID: 30745493 PMCID: PMC6949183 DOI: 10.2188/jea.je20180156] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background It has been reported that chronic inflammation may play an important role in the pathogenesis of several serious diseases and could be modulated by diet. Recently, the Dietary Inflammatory Index (DII®) was developed to assess the inflammatory potential of the overall diet. The DII has been reported as relevant to various diseases but has not been validated in Japanese. Thus, in the present study, we analyzed the relationship between DII scores and high-sensitivity C-reactive protein (hs-CRP) levels in a Japanese population. Methods Data of the National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged 2010 (NIPPON DATA2010), which contained 2,898 participants aged 20 years or older from the National Health and Nutrition Survey of Japan (NHNS2010), were analyzed. Nutrient intakes derived from 1-day semi-weighing dietary records were used to calculate DII scores. Energy was adjusted using the residual method. Levels of hs-CRP were evaluated using nephelometric immunoassay. Multiple linear regression analyses were performed. Results After adjusting for age, sex, smoking status, BMI, and physical activity, a significant association was observed between DII scores and log(CRP+1) (standard regression coefficient = 0.05, P < 0.01). Although it was not statistically significant, the positive association was consistently observed in almost all age-sex subgroups and the non-smoker subgroup. Conclusions The current study confirmed that DII score was positively associated with hs-CRP in Japanese.
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Affiliation(s)
- Yunqing Yang
- Division of Personalized Prevention and Epidemiology, Tohoku University Graduate School of Medicine
| | - Atsushi Hozawa
- Division of Personalized Prevention and Epidemiology, Tohoku University Graduate School of Medicine.,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Mana Kogure
- Division of Personalized Prevention and Epidemiology, Tohoku University Graduate School of Medicine.,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Akira Narita
- Division of Personalized Prevention and Epidemiology, Tohoku University Graduate School of Medicine.,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Takumi Hirata
- Division of Personalized Prevention and Epidemiology, Tohoku University Graduate School of Medicine.,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Tomohiro Nakamura
- Division of Personalized Prevention and Epidemiology, Tohoku University Graduate School of Medicine.,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Naho Tsuchiya
- Division of Personalized Prevention and Epidemiology, Tohoku University Graduate School of Medicine.,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Naoki Nakaya
- Division of Personalized Prevention and Epidemiology, Tohoku University Graduate School of Medicine.,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Toshiharu Ninomiya
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science
| | | | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science
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11
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Chen Y, Wu S, Li W, Wang B, Han X, Yang Y, Guan X, Yu H, Khalid BW, Li H, Xia Y. Higher High-Sensitivity C Reactive Protein is Associated with Future Premature Ventricular Contraction: a Community Based Prospective Cohort Study. Sci Rep 2018; 8:5152. [PMID: 29581482 PMCID: PMC5979945 DOI: 10.1038/s41598-018-22868-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 03/02/2018] [Indexed: 12/17/2022] Open
Abstract
We aimed to determine whether hs-CRP is a predictor of future premature ventricular contraction (PVC) events in a community based population. A total of 101,510 participants were recruited at baseline (2006–2007). The follow-up visits were conducted every two years. Participants who were free from PVC at baseline and achieved the fourth visit, or diagnosed of PVC during the subsequent visits were included for analyses. Diagnosis of PVC was based on standard supine resting, 10-s 12-lead ECG. Cox regression was applied to evaluate the association between quartiles of hs-CRP and the incidence of PVCs. 60710 participants (male: 79.9%, mean age 49.4 years) were included for analyses. During a mean follow-up of 74.9 ± 7.4 months, 908 (1.5%) participants were diagnosed with PVC. Participants of the highest quartile of hs-CRP had significantly increased risk of PVC events as compared with the lowest quartile (HR 1.36; 95% CI 1.12–1.66); and stratified analyses showed similar result in males (HR 1.45; 95% CI 1.16–1.80), but not in females (HR 1.12; 95% CI 0.71–1.79). Moreover, elevated serum hs-CRP was associated with future PVC in participants without history of myocardial infarction or stroke (HR 1.34; 95% CI 1.09–1.65). Elevated hs-CRP was an independent predictor of PVC in Chinese population, especially in men.
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Affiliation(s)
- Yue Chen
- Department of cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Shouling Wu
- Department of cardiology, Kailuan Hospital, Hebei United University, Tangshan, China
| | - Wenyu Li
- Department of cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Binhao Wang
- Department of cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Xu Han
- Department of cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Yiheng Yang
- Department of cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Xumin Guan
- Department of cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Haixu Yu
- Department of cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Bin Waleed Khalid
- Department of cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Huihua Li
- Department of cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China.
| | - Yunlong Xia
- Department of cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China.
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Agostinis-Sobrinho C, Brand C, Moreira C, Lopes L, Oliveira-Santos J, Silva P, Reis Gaya A, Gaya A, Mota J, Santos R, Abreu S. Muscular fitness, Southern European Atlantic Diet and inflammation in adolescents. Azorean Physical Activity and Health Study II. Eur J Sport Sci 2017; 18:104-111. [PMID: 29095666 DOI: 10.1080/17461391.2017.1394368] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
High muscular fitness (MF) and high adherence to the Southern European Atlantic Diet (the SEADiet) have been associated with several positive metabolic outcomes. The purpose of the present study was two-fold: (i) to explore the independent associations between MF and C-reactive protein (CRP) levels; and (ii) to investigate the combined impact of MF and SEADiet on the CRP levels in a sample of adolescents. A cross-sectional school-based study was conducted on 463 adolescents (272 girls) aged 15-18 years, from the Portuguese Azorean Archipelago. Anthropometric indicators (stature, body mass, waist circumference (WC)) were measured by standardized protocols and pubertal stages were assessed by Tanner criteria. Blood samples were taken after an overnight fast. MF was assessed by the curl-up and push-up tests (from the Fitnessgram test battery). Adherence to the SEADiet was assessed with a semi-quantitative food frequency questionnaire. Linear regression models showed that MF was inversely associated with hs-CRP (unstandardized B = -0.127; p < .009), after adjustments for age, sex, and pubertal stage, adherence of SEADiet, total energy intake and low-energy reporter and WC. Analysis of covariance (ANCOVA) showed a significant difference between the low adherence of SEADiet with low MF group and those with a high adherence of SEADiet and high MF (p < .05) (F(5, 453) = 2.238, p = .040). Our results showed that MF is inversely associated with hs-CRP. In addition, the adolescents with Low adherence of SEADiet/Low MF group had high levels of hs-CRP compared those who with high adherence of SEADiet/high MF group.
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Affiliation(s)
- César Agostinis-Sobrinho
- a Faculty of Sport, Research Centre in Physical Activity, Health and Leisure , University of Porto , Porto , Portugal
| | - Caroline Brand
- b School of Physical Education, Physiotherapy and Dance , Federal University of the South of Brazil , Porto Alegre , Rio Grande do Sul , Brazil
| | - Carla Moreira
- a Faculty of Sport, Research Centre in Physical Activity, Health and Leisure , University of Porto , Porto , Portugal
| | - Luís Lopes
- a Faculty of Sport, Research Centre in Physical Activity, Health and Leisure , University of Porto , Porto , Portugal
| | - José Oliveira-Santos
- a Faculty of Sport, Research Centre in Physical Activity, Health and Leisure , University of Porto , Porto , Portugal
| | - Pedro Silva
- a Faculty of Sport, Research Centre in Physical Activity, Health and Leisure , University of Porto , Porto , Portugal
| | - Anelise Reis Gaya
- b School of Physical Education, Physiotherapy and Dance , Federal University of the South of Brazil , Porto Alegre , Rio Grande do Sul , Brazil
| | - Adroaldo Gaya
- b School of Physical Education, Physiotherapy and Dance , Federal University of the South of Brazil , Porto Alegre , Rio Grande do Sul , Brazil
| | - Jorge Mota
- a Faculty of Sport, Research Centre in Physical Activity, Health and Leisure , University of Porto , Porto , Portugal
| | - Rute Santos
- a Faculty of Sport, Research Centre in Physical Activity, Health and Leisure , University of Porto , Porto , Portugal.,c Faculty of Social Sciences, School of Education, Early Start Research Institute , University of Wollongong , Wollongong , Australia
| | - Sandra Abreu
- a Faculty of Sport, Research Centre in Physical Activity, Health and Leisure , University of Porto , Porto , Portugal
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13
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Bassig BA, Dai Y, Vermeulen R, Ren D, Hu W, Duan H, Niu Y, Xu J, Shiels MS, Kemp TJ, Pinto LA, Fu W, Meliefste K, Zhou B, Yang J, Ye M, Jia X, Meng T, Wong JYY, Bin P, Hosgood HD, Hildesheim A, Silverman DT, Rothman N, Zheng Y, Lan Q. Occupational exposure to diesel engine exhaust and alterations in immune/inflammatory markers: a cross-sectional molecular epidemiology study in China. Carcinogenesis 2017; 38:1104-1111. [PMID: 28968774 PMCID: PMC5862277 DOI: 10.1093/carcin/bgx081] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 07/28/2017] [Indexed: 12/22/2022] Open
Abstract
The relationship between diesel engine exhaust (DEE), a known lung carcinogen, and immune/inflammatory markers that have been prospectively associated with lung cancer risk is not well understood. To provide insight into these associations, we conducted a cross-sectional molecular epidemiology study of 54 males highly occupationally exposed to DEE and 55 unexposed male controls from representative workplaces in China. We measured plasma levels of 64 immune/inflammatory markers in all subjects using Luminex bead-based assays, and compared our findings to those from a nested case-control study of these markers and lung cancer risk, which had been conducted among never-smoking women in Shanghai using the same multiplex panels. Levels of nine markers that were associated with lung cancer risk in the Shanghai study were altered in DEE-exposed workers in the same direction as the lung cancer associations. Among these, associations with the levels of CRP (β= -0.53; P = 0.01) and CCL15/MIP-1D (β = 0.20; P = 0.02) were observed in workers exposed to DEE and with increasing elemental carbon exposure levels (Ptrends <0.05) in multivariable linear regression models. Levels of a third marker positively associated with an increased lung cancer risk, CCL2/MCP-1, were higher among DEE-exposed workers compared with controls in never and former smokers, but not in current smokers (Pinteraction = 0.01). The immunological differences in these markers in DEE-exposed workers are consistent with associations observed for lung cancer risk in a prospective study of Chinese women and may provide some insight into the mechanistic processes by which DEE causes lung cancer.
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Affiliation(s)
- Bryan A Bassig
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
| | - Yufei Dai
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Roel Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Dianzhi Ren
- Chaoyang Center for Disease Control and Prevention, Chaoyang, Liaoning, China
| | - Wei Hu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
| | - Huawei Duan
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yong Niu
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jun Xu
- Hong Kong University, Hong Kong, Hong Kong
| | - Meredith S Shiels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
| | - Troy J Kemp
- HPV Immunology Laboratory, Leidos Biomedical Research Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Ligia A Pinto
- HPV Immunology Laboratory, Leidos Biomedical Research Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Wei Fu
- Chaoyang Center for Disease Control and Prevention, Chaoyang, Liaoning, China
| | - Kees Meliefste
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Baosen Zhou
- China Medical University, Shenyang, Liaoning, China
| | - Jufang Yang
- Chaoyang Center for Disease Control and Prevention, Chaoyang, Liaoning, China
| | - Meng Ye
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaowei Jia
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tao Meng
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jason YY Wong
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
| | - Ping Bin
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - H Dean Hosgood
- Division of Epidemiology, Albert Einstein College of Medicine, New York, NY, USA
| | - Allan Hildesheim
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
| | - Debra T Silverman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
| | - Yuxin Zheng
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qing Lan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
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14
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Nojiri S, Daida H. Atherosclerotic Cardiovascular Risk in Japan. JAPANESE CLINICAL MEDICINE 2017; 8:1179066017712713. [PMID: 28680271 PMCID: PMC5480958 DOI: 10.1177/1179066017712713] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 04/13/2017] [Indexed: 01/19/2023]
Abstract
Increased global mortality is associated with atherosclerosis, which appears to be independent of race. Cardiovascular disease is one of the leading causes of mortality and morbidity in Japan. Atherosclerosis, an inflammatory disease characterized by abnormal lipid accumulation and inflammation in the arterial wall, is the main underlying cause of cardiovascular disease. Numerous cardiovascular risk scores have been developed and are used to prioritize patients' treatment needs. The predictive performance of risk scores established in Western nations needs to be examined in Japanese populations. For secondary prevention, it is imperative to control hypertension, hyperlipidemia, diabetes mellitus, smoking, and local interventions. In this review, we present a historical overview of atherosclerotic risk research and the risk factors for atherosclerosis in Japan and compare the situation in Japan with that in Western nations. In addition, we discuss relevant cardiovascular risk assessment tools in the context of clinical practice in Japan.
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Affiliation(s)
- Shuko Nojiri
- Clinical Research Support Center, Juntendo University, Tokyo, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine Tokyo, Japan
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15
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Meng J, Li Y, Yuan X, Lu Y. Effects of febuxostat on insulin resistance and expression of high-sensitivity C-reactive protein in patients with primary gout. Rheumatol Int 2016; 37:299-303. [PMID: 27878622 DOI: 10.1007/s00296-016-3612-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 11/17/2016] [Indexed: 12/15/2022]
Abstract
We aimed to investigate the effects of febuxostat on IR and the expression of high-sensitivity C-reactive protein (hs-CRP) in patients with primary gout. Forty-two cases of primary gout patients without uric acid-lowering therapy were included in this study. After a physical examination, 20 age- and sex-matched patients were included as normal controls. The levels of fasting insulin (INS), fasting blood glucose (FBG), and hs-CRP were determined. IR was assessed using the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Gout patients had higher levels of UA, INS, HOMA-IR, and hs-CRP than normal controls (P < 0.05). After 4-, 12-, and 24-week febuxostat treatments, UA and hs-CRP concentrations were significantly lower than baseline (P < 0.05). INS and HOM-IR decreased slightly after a 4-week treatment with febuxostat but declined significantly after 12 and 24 weeks of treatment. Importantly, hs-CRP values positively correlated with those of HOMA-IR (r = 0.353, P = 0.018) and INS (r = 0.426, P = 0.034). Our findings confirm that IR exists in gout patients and implicate that febuxostat can effectively control the level of serum UA and increase insulin sensitivity in primary gout patients.
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Affiliation(s)
- Juan Meng
- Department of Rheumatology and Immunology, Beijing Chao-Yang Hospital, Capital Medical University, 8 GongrenTiyuchangNanlu, Chaoyang District, Beijing, 100020, China
| | - Yanchun Li
- Department of Nephrology, Beijing Chao-Yang Hospital, Capital Medical University, Chaoyang District, Beijing, China
| | - Xiaoxu Yuan
- Department of Rheumatology and Immunology, Beijing Chao-Yang Hospital, Capital Medical University, 8 GongrenTiyuchangNanlu, Chaoyang District, Beijing, 100020, China
| | - Yuewu Lu
- Department of Rheumatology and Immunology, Beijing Chao-Yang Hospital, Capital Medical University, 8 GongrenTiyuchangNanlu, Chaoyang District, Beijing, 100020, China.
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16
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Momiyama Y, Adachi H, Fairweather D, Ishizaka N, Saita E. Inflammation, Atherosclerosis and Coronary Artery Disease. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2016; 8:67-70. [PMID: 27594791 PMCID: PMC5003124 DOI: 10.4137/cmc.s39423] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Yukihiko Momiyama
- Director, Department of Cardiology, NHO Tokyo Medical Center, Tokyo, Japan
| | - Hisashi Adachi
- Professor, Department of Community Medicine, Kurume University School of Medicine, Kurume, Japan
| | - DeLisa Fairweather
- Associate Professor of Cardiovascular Diseases, Mayo Clinic, Jacksonville, FL, USA
| | - Nobukazu Ishizaka
- Professor, Faculty of Medicine, Department of Cardiology, Osaka Medical College, Osaka, Japan
| | - Emi Saita
- Lecturer, Endowed Research Department "Food for Health", Ochanomizu University, Tokyo, Japan
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17
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Li S, Rong H, Guo Q, Chen Y, Zhang G, Yang J. Serum procalcitonin levels distinguish Gram-negative bacterial sepsis from Gram-positive bacterial and fungal sepsis. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2016; 21:39. [PMID: 27904585 PMCID: PMC5122113 DOI: 10.4103/1735-1995.183996] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 01/18/2016] [Accepted: 03/29/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Serum procalcitonin (PCT) levels differ in patients with bacterial or fungal infections and are significantly elevated in patients with Gram-negative bacteremia. We evaluated the diagnostic accuracy of different inflammatory markers to discriminate sepsis caused by different pathogens. MATERIALS AND METHODS We included 328 episodes of bacteremia from 292 patients with sepsis and 31 patients with suspected sepsis in this study. Medical records of patients who had bacteremia caused by Gram-negative bacteria (Gram-negative), Gram-positive bacteria (Gram-positive) or fungi were reviewed, and information about PCT and other inflammatory markers was recorded. The diagnostic performance of inflammatory markers was calculated via receiver operating characteristic (ROC) curves. RESULTS Serum PCT levels in Gram-negative, Gram-positive, and fungal sepsis were 7.47 (interquartile range [IQR]: 1.09-41.26) ng/mL, 0.48 (IQR: 0.15-2.16) ng/mL, and 0.60 (IQR: 0.14-2.06) ng/mL, respectively (P < 0.001). ROC analysis revealed an optimal cut-off value of 2.44 ng/mL for PCT in discriminating Gram-negative sepsis from Gram-positive sepsis, which yielded a sensitivity of 68.4% and a specificity of 77.1%. An optimal cut-off value of 3.11 ng/mL for PCT in discriminating Gram-negative sepsis from fungal sepsis, led to a sensitivity of 63.9% and specificity of 93.3%. Neither PCT nor other inflammatory markers could be used to distinguish between Gram-positive and fungal sepsis. CONCLUSION Serum PCT levels were significantly higher in patients with Gram-negative sepsis than in those with Gram-positive or fungal sepsis. PCT is a potential sensitive biomarker for distinguishing Gram-negative sepsis from Gram-positive and fungal sepsis.
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Affiliation(s)
- Shuhua Li
- Department of Respiratory, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hengmo Rong
- Department of Respiratory, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Qinliang Guo
- Department of Laboratory, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yifei Chen
- Department of Respiratory, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Guqing Zhang
- Department of Respiratory, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jiong Yang
- Department of Respiratory, Zhongnan Hospital of Wuhan University, Wuhan, China
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18
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Gucyetmez B, Atalan HK. C-Reactive Protein and Hemogram Parameters for the Non-Sepsis Systemic Inflammatory Response Syndrome and Sepsis: What Do They Mean? PLoS One 2016; 11:e0148699. [PMID: 26863002 PMCID: PMC4749228 DOI: 10.1371/journal.pone.0148699] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 01/20/2016] [Indexed: 12/28/2022] Open
Abstract
Objectives Sepsis is one of the most common reasons of increased mortality and morbidity in the intensive care unit. The changes in CRP levels and hemogram parameters and their combinations may help to distinguish sepsis from non-sepsis SIRS. The aim of this study is to investigate the CRP and hemogram parameters as an indicator of sepsis. Methods A total of 2777 patients admitted to the ICU of two centers between 2006–2013 were evaluated retrospectively. The patients were diagnosed as SIRS (-), non-sepsis SIRS and sepsis. The patients who were under 18 years old, re-admitted, diagnosed with hematological disease, on corticosteroid and immunosuppressive therapy, SIRS (-), culture negative, undocumented laboratory values and outcomes were excluded. 1257 patients were divided into 2 groups as non-sepsis SIRS and sepsis. The patients’ demographic data, CRP levels, hemogram parameters, length of ICU stay and mortality were recorded. Results 1257 patients were categorized as non-sepsis SIRS (816, 64.9%) and sepsis (441, 35.1%). In the multivariate analysis, the likelihood of sepsis was increased 3.2 (2.2–4.6), 1.7 (1.2–2.4), 1.6 (1.2–2.1), 2.3 (1.4–3.8), 1.5 (1.1–2.1) times by the APACHE II≥13, SOFA score≥4, CRP≥4.0, LymC<0.45 and PLTC<150 respectively (p<0.001 p = 0.007 p = 0.004 p<0.001 p = 0.027). The likelihood of sepsis was increased 18.1 (8.4–38.7) times by the combination of CRP≥4.0, lymC<0.45 and PLTC<150 (P<0.001). Conclusions While WBCC, NeuC, Neu%, NLCR and EoC are far from being the indicators to distinguish sepsis from non-sepsis SIRS, the combinations of CRP, LymC and PLTC can be used to determine the likelihood of sepsis.
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Affiliation(s)
- Bulent Gucyetmez
- Department of Anesthesiology, Acıbadem University Faculty of Medicine, Istanbul, Turkey
- * E-mail:
| | - Hakan K. Atalan
- Intensive Care Unit, Ataşehir Memorial Hospital, Istanbul, Turkey
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