c-reactive protein

C 反应蛋白
  • 文章类型: Journal Article
    背景:生物钟基因的调节,协调免疫系统的活动,在炎症性肠病(IBD)中受到干扰。新出现的证据表明丁酸盐,由肠道微生物群产生的短链脂肪酸参与炎症反应以及生物钟基因的调节。这项研究是为了研究丁酸钠补充对昼夜节律基因表达的影响,炎症,活动性溃疡性结肠炎(UC)患者的睡眠和生活质量。
    方法:在目前的随机安慰剂对照试验中,36名活动性UC患者随机分为丁酸钠(600mg/kg)或安慰剂,为期12周。在这项研究中,通过实时聚合酶链反应(qPCR)评估了昼夜节律基因(CRY1,CRY2,PER1,PER2,BMAL1和CLOCK)在全血中的表达。基因表达变化表示为相对于基线的表达的倍数变化(2^-ΔΔCT)。采用酶联免疫吸附法(ELIZA)检测粪便钙卫蛋白和血清超敏C反应蛋白(hs-CRP)水平。此外,干预前后分别采用匹兹堡睡眠质量指数(PSQI)和炎症性肠病问卷-9(IBDQ-9)对患者的睡眠质量和IBD生活质量(QoL)进行评估。
    结果:结果表明,与安慰剂相比,丁酸钠的补充显着降低了钙卫蛋白的水平(-133.82±155.62vs.51.58±95.57,P值<0.001)和hs-CRP(-0.36(-1.57,-0.05)vs.0.48(-0.09-4.77),P值<0.001),并上调CRY1的倍数变化表达(2.22±1.59vs.0.63±0.49,P值<0.001),CRY2(2.15±1.26vs.0.93±0.80,P值=0.001),PER1(1.86±1.77vs.0.65±0.48,P值=0.005),BMAL1(1.85±0.97vs.0.86±0.63,P值=0.003)。此外,丁酸钠可改善睡眠质量(PSQI评分:-2.94±3.50vs.1.16±3.61,P值<0.001)和QoL(IBDQ-9:17.00±11.36vs.-3.50±6.87,P值<0.001)。
    结论:丁酸酯可能是活动期UC患者的一种有效的辅助治疗方法,通过减少炎症的生物标志物,生物钟基因上调,改善睡眠质量和生活质量。
    BACKGROUND: The regulation of the circadian clock genes, which coordinate the activity of the immune system, is disturbed in inflammatory bowel disease (IBD). Emerging evidence suggests that butyrate, a short-chain fatty acid produced by the gut microbiota is involved in the regulation of inflammatory responses as well as circadian-clock genes. This study was conducted to investigate the effects of sodium-butyrate supplementation on the expression of circadian-clock genes, inflammation, sleep and life quality in active ulcerative colitis (UC) patients.
    METHODS: In the current randomized placebo-controlled trial, 36 active UC patients were randomly divided to receive sodium-butyrate (600 mg/kg) or placebo for 12-weeks. In this study the expression of circadian clock genes (CRY1, CRY2, PER1, PER2, BMAl1 and CLOCK) were assessed by real time polymerase chain reaction (qPCR) in whole blood. Gene expression changes were presented as fold changes in expression (2^-ΔΔCT) relative to the baseline. The faecal calprotectin and serum level of high-sensitivity C-reactive protein (hs-CRP) were assessed by enzyme-linked immunosorbent assay method (ELIZA). Moreover, the sleep quality and IBD quality of life (QoL) were assessed by Pittsburgh sleep quality index (PSQI) and inflammatory bowel disease questionnaire-9 (IBDQ-9) respectively before and after the intervention.
    RESULTS: The results showed that sodium-butyrate supplementation in comparison with placebo significantly decreased the level of calprotectin (-133.82 ± 155.62 vs. 51.58 ± 95.57, P-value < 0.001) and hs-CRP (-0.36 (-1.57, -0.05) vs. 0.48 (-0.09-4.77), P-value < 0.001) and upregulated the fold change expression of CRY1 (2.22 ± 1.59 vs. 0.63 ± 0.49, P-value < 0.001), CRY2 (2.15 ± 1.26 vs. 0.93 ± 0.80, P-value = 0.001), PER1 (1.86 ± 1.77 vs. 0.65 ± 0.48, P-value = 0.005), BMAL1 (1.85 ± 0.97 vs. 0.86 ± 0.63, P-value = 0.003). Also, sodium-butyrate caused an improvement in the sleep quality (PSQI score: -2.94 ± 3.50 vs. 1.16 ± 3.61, P-value < 0.001) and QoL (IBDQ-9: 17.00 ± 11.36 vs. -3.50 ± 6.87, P-value < 0.001).
    CONCLUSIONS: Butyrate may be an effective adjunct treatment for active UC patients by reducing biomarkers of inflammation, upregulation of circadian-clock genes and improving sleep quality and QoL.
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  • 文章类型: Journal Article
    结直肠癌(CRC)是全球医疗保健的沉重负担,在世界范围内导致显著的发病率和死亡率。尽管筛查方法取得了进展,它的发病率仍然很高,需要在早期发现和治疗方面继续努力。肿瘤侵袭和转移是CRC致死率的主要决定因素,强调了解制定有效治疗策略的潜在机制的紧迫性。本研究旨在探讨血清生物标志物在预测CRC患者生存结局方面的潜力。以组织蛋白酶B(CB)为重点,白细胞弹性蛋白酶(LE),总唾液酸(TSA),脂质相关唾液酸(LASA),抗胰蛋白酶活性(ATA),C反应蛋白(CRP),和胱抑素C(CC)。我们招募了185名CRC患者和35名健康对照,评估人口统计学变量,肿瘤特征,和7个血清生物标志物水平,包括(1)CB,(2)LE,(3)TSA,(4)LASA,(5)ATA,(6)CRP,(7)CC。统计分析包括方差分析与Tukey的事后检验和连续变量的MANOVA。学生t检验用于依赖样本,而非参数检验如曼-惠特尼U和Wilcoxon符号秩检验适用于偏离正态分布的变量。使用卡方和Kruskal-Wallis检验评估分类变量。利用Spearman的等级相关系数来检验变量相关性。生存分析采用Kaplan-Meier方法和对数秩检验来比较组间的生存时间。观察到CB之间存在显著关联(p=0.04),LE(p=0.01),和TSA(p=0.008)水平和CRC患者的生存结果。Dukes分类阶段也显示出与生存率显著相关(p=0.001)。然而,LASA没有发现明显的关联,ATA,CRP,CC。LE的多变量分析,运输安全管理局,ATA与生存率有显著相关性(p=0.041),尽管ATA在单变量分析中缺乏意义(p=0.13)。CB,LE,和TSA成为在CRC中具有预后价值的有希望的诊断标志物,可能有助于早期诊断和治疗计划。需要进一步的研究来验证这些发现并探索其他预后指标。
    Colorectal cancer (CRC) represents a substantial burden on global healthcare, contributing to significant morbidity and mortality worldwide. Despite advances in screening methodologies, its incidence remains high, necessitating continued efforts in early detection and treatment. Neoplastic invasion and metastasis are primary determinants of CRC lethality, emphasizing the urgency of understanding underlying mechanisms to develop effective therapeutic strategies. This study aimed to explore the potential of serum biomarkers in predicting survival outcomes in CRC patients, with a focus on cathepsin B (CB), leukocytic elastase (LE), total sialic acid (TSA), lipid-associated sialic acid (LASA), antitrypsin activity (ATA), C-reactive protein (CRP), and cystatin C (CC). We recruited 185 CRC patients and 35 healthy controls, assessing demographic variables, tumor characteristics, and 7 serum biomarker levels, including (1) CB, (2) LE, (3) TSA, (4) LASA, (5) ATA, (6) CRP, and (7) CC. Statistical analyses included ANOVA with Tukey\'s post hoc tests and MANOVA for continuous variables. Student\'s t-test was used for dependent samples, while non-parametric tests like Mann-Whitney U and Wilcoxon signed-rank tests were applied for variables deviating from the normal distribution. Categorical variables were assessed using chi-square and Kruskal-Wallis tests. Spearman\'s rank correlation coefficient was utilized to examine variable correlations. Survival analysis employed the Kaplan-Meier method with a log-rank test for comparing survival times between groups. Significant associations were observed between CB (p = 0.04), LE (p = 0.01), and TSA (p = 0.008) levels and survival outcomes in CRC patients. Dukes\' classification stages also showed a significant correlation with survival (p = 0.001). However, no significant associations were found for LASA, ATA, CRP, and CC. Multivariate analysis of LE, TSA, and ATA demonstrated a notable correlation with survival (p = 0.041), notwithstanding ATA\'s lack of significance in univariate analysis (p = 0.13). CB, LE, and TSA emerged as promising diagnostic markers with prognostic value in CRC, potentially aiding in early diagnosis and treatment planning. Further research is needed to validate these findings and explore additional prognostic indicators.
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  • 文章类型: Journal Article
    本研究旨在探讨单台式压力机(BP)与腿部按压(LP)睾丸激素的阻力训练课程,皮质醇,C反应蛋白(CRP)白细胞介素-6(IL-6),肿瘤坏死因子-α(TNF-α)浓度,和肌酸激酶(CK)活性在力量训练的男性。11名受过力量训练的男性参加了一项交叉随机试验,进行两次实验,每次由五组BP或LP练习组成,以达到一次重复最大负荷的50%。在基线(BA)时采集血样,立即发布(POST),和运动停止后1小时(POST-1)。在LP条件下观察到IL-6浓度从BA到POST-1的显着增加(p=0.004;效应大小[ES]=0.64)。此外,从BA到POST运动,发现时间对增加睾丸激素浓度具有显着的主要影响(p=0.014;ES=0.25)。在BP条件下,与POST相比,POST-1的皮质醇浓度显着降低(p=0.001;ES=1.02)。此外,与LP条件相比,BP中POST-1的皮质醇浓度显着降低(p=0.022;ES=1.3)。在LP条件下,从BA到POST(p=0.024;ES=0.69)和POST-1(p=0.045;ES=0.55),CK活性显着增加,在BP条件下,从BA到POST-1(p=0.014;ES=0.96)。CRP(p=0.659)和TNF-α(p=0.487)浓度差异无统计学意义。这些结果表明,在抗阻运动中参与的肌肉量可能会影响IL-6和皮质醇浓度的变化。较大的肌肉群,从事LP,更有可能导致IL-6Myokine浓度升高。
    This study aimed to investigate the effects of a single bench press (BP) vs. leg press (LP) resistance training sessions on testosterone, cortisol, C-reactive protein (CRP) interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) concentrations, and creatine kinase (CK) activity in strength-trained males. Eleven strength-trained males participated in a cross-over randomized trial, undergoing two experimental sessions each consisting of five sets of the BP or the LP exercise to volitional failure with a load corresponding to 50% of one-repetition maximum. Blood samples were taken at baseline (BA), immediately post (POST), and 1 h after the cessation of exercise (POST-1). A significant increase in IL-6 concentration from BA to POST-1 was observed during the LP condition (p = 0.004; effect size [ES] = 0.64). Additionally, a significant main effect of time was found for increasing testosterone concentrations from BA to POST exercise (p = 0.014; ES = 0.25). A significantly lower cortisol concentration at POST-1 compared to POST (p = 0.001; ES = 1.02) was noted in the BP condition. Furthermore, a significantly lower cortisol concentration was found at POST-1 in the BP compared to the LP condition (p = 0.022; ES = 1.3). A significant increase in CK activity was reported from BA to POST (p = 0.024; ES = 0.69) and POST-1 (p = 0.045; ES = 0.55) during the LP condition, and from BA to POST-1 (p = 0.014; ES = 0.96) during the BP condition. No significant differences were found in the CRP (p = 0.659) and TNF-α concentrations (p = 0.487). These results suggest that the amount of muscle mass engaged during the resistance exercise may influence the changes in IL-6 and cortisol concentrations. Larger muscle groups, as engaged in the LP, more likely lead to elevated concentrations of IL-6 myokine.
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  • 文章类型: Journal Article
    在系统性硬化症(SSc)中,心肌纤维化以及持续的自身免疫性炎症可以改变心肌细胞的电功能,这可能会增加室性心律失常和心源性猝死的风险。我们分析了描述心室复极的心电图(ECG)变量,例如QT间期,QT离散度(QTd),T波峰端间隔(Tpe),26例SSc患者和36例健康对照者的心律失常性指数(AIX)。此外,检查了超声心动图和实验室参数,关注炎症蛋白,如C反应蛋白(CRP),可溶性细胞内粘附分子-1(sICAM-1),可溶性血管粘附分子-1(sVCAM-1),和前颗粒蛋白(PGRN)。CRP,sICAM-1和sVCAM-1水平与QT间期长度呈正相关。尽管与对照组相比,SSc组的血清PGRN水平没有增加,在SSc患者中,PGRN水平与QT间期和AIX呈正相关。根据我们的结果,我们得出的结论是,自身免疫性炎症与SSc患者室性心律失常的风险之间可能存在潜在关联.我们强调,包括CRP在内的炎症活动的实验室参数的测量,PGRN,sVCAM-1和sICAM-1可能有助于预测SSc患者的心源性猝死。
    In systemic sclerosis (SSc), fibrosis of the myocardium along with ongoing autoimmune inflammation can alter the electric function of the cardiac myocytes, which may increase the risk for ventricular arrhythmias and sudden cardiac death. We analyzed the electrocardiographic (ECG) variables describing ventricular repolarization such as QT interval, QT dispersion (QTd), T wave peak-to-end interval (Tpe), and arrhythmogeneity index (AIX) of 26 patients with SSc and 36 healthy controls. Furthermore, echocardiographic and laboratory parameters were examined, with a focus on inflammatory proteins like C-reactive ptotein (CRP), soluble intracellular adhesion molecule-1 (sICAM-1), soluble vascular adhesion molecule-1 (sVCAM-1), and progranulin (PGRN). The CRP, sICAM-1, and sVCAM-1 levels were positively correlated with the length of the QT interval. Although the serum PGRN levels were not increased in the SSc group compared to the controls, in SSc patients, the PGRN levels were positively correlated with the QT interval and the AIX. According to our results, we conclude that there may be a potential association between autoimmune inflammation and the risk for ventricular arrhythmias in patients with SSc. We emphasize that the measurement of laboratory parameters of inflammatory activity including CRP, PGRN, sVCAM-1, and sICAM-1 could be helpful in the prediction of sudden cardiac death in patients with SSc.
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  • 文章类型: Journal Article
    越来越多的证据表明炎症损害红细胞结构和功能。我们评估了三种不同环境中轻度全身性炎症对红细胞脆性的影响。为了调查因果关系,在用减毒活细菌菌株攻击以诱导低度全身性炎症的小鼠中测量红细胞渗透脆性;观察到红细胞渗透脆性的显着增加。为了收集系统性炎症与人类红细胞脆性相关的证据,进行了两项观察性研究.首先,使用回顾性研究设计,在UKBiobank项目的9292名健康参与者中,研究了基于网织红细胞的溶血替代标志物与高敏C反应蛋白之间的关系.其次,我们前瞻性评估了健康志愿者和有长期疾病的个体的混合人群(n=54)中全身性炎症(用尿新蝶呤/肌酐比值衡量)与红细胞渗透脆性之间的关系.两项人体研究均符合炎症与红细胞脆性之间的关系。一起来看,我们得出的结论是,轻度全身性炎症会增加红细胞脆性,并可能导致溶血.需要进一步的研究来评估该途径的分子基础以及在炎症条件中的临床意义。
    There is growing evidence that inflammation impairs erythrocyte structure and function. We assessed the impact of mild systemic inflammation on erythrocyte fragility in three different settings. In order to investigate causation, erythrocyte osmotic fragility was measured in mice challenged with a live attenuated bacterial strain to induce low-grade systemic inflammation; a significant increase in erythrocyte osmotic fragility was observed. To gather evidence that systemic inflammation is associated with erythrocyte fragility in humans, two observational studies were conducted. First, using a retrospective study design, the relationship between reticulocyte-based surrogate markers of haemolysis and high-sensitivity C-reactive protein was investigated in 9292 healthy participants of the UK Biobank project. Secondly, we prospectively assessed the relationship between systemic inflammation (measured by the urinary neopterin/creatinine ratio) and erythrocyte osmotic fragility in a mixed population (n = 54) of healthy volunteers and individuals with long-term medical conditions. Both human studies were in keeping with a relationship between inflammation and erythrocyte fragility. Taken together, we conclude that mild systemic inflammation increases erythrocyte fragility and may contribute to haemolysis. Further research is needed to assess the molecular underpinnings of this pathway and the clinical implications in inflammatory conditions.
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  • 文章类型: Journal Article
    孕前体重指数(pBMI)是妊娠期体重增加(GWG)的预测指标。然而,其他因素,如脂肪因子和炎症标志物,也可以与GWG相关联。这项研究的目的是确定瘦素的相关性,脂联素,irisin,和C反应蛋白,在青少年中使用GWG。从2018年到2023年,在临床健康怀孕的青少年中进行了一项纵向研究。评估包括社会人口统计学和临床数据,pBMI,身体脂肪的百分比,血清瘦素浓度,脂联素,irisin,高敏C反应蛋白(hsCRP),和总GWG充足性。进行了Cox回归模型,结果变量不足和过高的GWG。在198名参与者中,超重/肥胖与对不足GWG的保护作用轻微相关(HR=0.44,95CI=0.18-1.06),不管母亲的特征和脂肪因子。瘦素(HR=1.014,95CI=1.008-1.021),和体脂百分比(HR=1.11,95CI=1.05-1.17)与更高的GWG过度风险相关,独立于其他母亲变量,如pBMI,而脂联素与较低的风险相关。这些发现表明,在墨西哥青少年中,妊娠期间的脂肪组织及其脂肪因子在最终GWG中的作用可能比体重更重要。
    Pre-pregnancy body mass index (pBMI) is a predictor of gestational weight gain (GWG). However, other factors, such as adipokines and inflammation markers, may also be associated with GWG. The aim of the study was to determine the association of leptin, adiponectin, irisin, and C-reactive protein, with GWG in adolescents. A longitudinal study was conducted from 2018 to 2023 in adolescents with a clinically healthy pregnancy. The assessments included sociodemographic and clinical data, pBMI, percent of body fat, serum concentrations of leptin, adiponectin, irisin, and high-sensitivity C-reactive protein (hsCRP), and total GWG adequacy. Cox regression models were performed, the outcome variables were inadequate and excessive GWG. In 198 participants, being overweight/obesity was marginally associated with a protective effect against inadequate GWG (HR = 0.44, 95%CI = 0.18-1.06), regardless of maternal characteristics and adipokines. Leptin (HR = 1.014, 95%CI = 1.008-1.021), and body fat percent (HR = 1.11, 95%CI = 1.05-1.17) were associated with a higher risk of excessive GWG, independent of other maternal variables such as pBMI, while adiponectin was associated with a lower risk. These findings suggest that, in Mexican adolescents, adipose tissue and its adipokines during pregnancy may play a more significant role in the final GWG than body weight.
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  • 文章类型: Journal Article
    据推测,神经性厌食症(AN)的发病机理涉及多个生物系统。然而,可靠的AN生物标志物尚未建立。本研究旨在鉴定与AN相关的具有统计学意义和临床意义的外周生物标志物。进行了系统的文献检索,以确定从开始到2022年6月30日以英语发表的研究。我们进行了两级随机效应荟萃分析,以检查在52种不同的生物标志物中AN和对照组之间的差异,发现酰化生长素释放肽,促肾上腺皮质激素(ACTH),羧基末端胶原交联(CTX),胆固醇,皮质醇,去酰基生长素释放肽,ghrelin,生长激素(GH),obestatin,与非AN对照相比,AN病例的可溶性瘦素受体水平显着升高。相反,C反应蛋白(CRP),CD3阳性,CD8,肌酐,雌二醇,卵泡刺激素(FSH),游离甲状腺素,游离三碘甲状腺原氨酸,葡萄糖,胰岛素,胰岛素样生长因子1(IGF-1),瘦素,黄体生成素,淋巴细胞,与非AN对照组相比,AN中的催乳素水平显着降低。我们的发现表明,外周生物标志物可能与AN的病理生理学有关,比如适应饥饿的过程。对外周生物标志物的科学研究可能最终在AN的个性化临床护理中取得突破。
    The pathogenesis of anorexia nervosa (AN) has been hypothesized to involve several biological systems. However, reliable biomarkers for AN have yet to be established. This study was aimed to identify statistically significant and clinically meaningful peripheral biomarkers associated with AN. A systematic literature search was conducted to identify studies published in English from inception until 30 June 2022. We conducted two-level random-effects meta-analyses to examine the difference between AN and comparison groups across 52 distinct biomarkers and found that acylated ghrelin, adrenocorticotropic hormone (ACTH), carboxy-terminal collagen crosslinks (CTX), cholesterol, cortisol, des-acyl ghrelin, ghrelin, growth hormone (GH), obestatin, and soluble leptin receptor levels were significantly higher in cases of AN compared with those in non-AN controls. Conversely, C-reactive protein (CRP), CD3 positive, CD8, creatinine, estradiol, follicle-stimulating hormone (FSH), free thyroxine, free triiodothyronine, glucose, insulin, insulin-like growth factor 1 (IGF-1), leptin, luteinizing hormone, lymphocyte, and prolactin levels were significantly lower in AN compared with those in non-AN controls. Our findings indicate that peripheral biomarkers may be linked to the pathophysiology of AN, such as processes of adaptation to starvation. Scientific investigation into peripheral biomarkers may ultimately yield breakthroughs in personalized clinical care for AN.
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  • 文章类型: Journal Article
    超敏C反应蛋白(hs-CRP)是广泛使用的全身性炎症的临床生物标志物,与许多慢性病有关,包括1型糖尿病(T1D)。尽管人们越来越重视饮食摄入作为全身性炎症的可改变的危险因素,在T1D中,hs-CRP与水果和蔬菜消费的相关性相对缺乏.为了解决这个差距,我们调查了有和没有T1D的成人中膳食模式衍生的水果和蔬菜评分与hs-CRP的纵向关联.此外,我们研究了浆果消费作为一个独特的食物群体的影响。在1型糖尿病的冠状动脉钙化研究中收集了间隔三年的两次访问的数据。每次访问,参与者完成了食物频率问卷,和hs-CRP使用颗粒增强的免疫比浊法测定。使用混合效应模型来检查水果和蔬菜评分与hs-CRP的三年关联。调整后的模型发现,在非糖尿病(非DM)组中,蓝莓摄入量与hs-CRP之间存在显着负相关。在非DM组中,停止高血压和替代健康饮食指数得出的蔬菜评分与hs-CRP呈负相关(所有p值≤0.05)。相反,在T1D组中没有观察到显著的相关性.总之,在非DM成人中,基于膳食模式的蔬菜评分与hs-CRP呈负相关.尽管如此,在T1D中,慢性高血糖和相关的代谢异常可能会在习惯性食用的食物中超越这些食物组的心脏保护特征.
    High-sensitivity C-reactive protein (hs-CRP) is a widely used clinical biomarker of systemic inflammation, implicated in many chronic conditions, including type 1 diabetes (T1D). Despite the increasing emphasis on dietary intake as a modifiable risk factor for systemic inflammation, the association of hs-CRP with fruit and vegetable consumption is relatively underexplored in T1D. To address this gap, we investigated the longitudinal associations of dietary pattern-derived fruit and vegetable scores with hs-CRP in adults with and without T1D. Additionally, we examined the impact of berry consumption as a distinct food group. Data were collected in the Coronary Artery Calcification in Type 1 Diabetes study over two visits that were three years apart. At each visit, participants completed a food frequency questionnaire, and hs-CRP was measured using a particle-enhanced immunonephelometric assay. Mixed effect models were used to examine the three-year association of fruit and vegetable scores with hs-CRP. Adjusted models found a significant inverse association between blueberry intake and hs-CRP in the nondiabetic (non-DM) group. Dietary Approaches to Stop Hypertension- and Alternative Healthy Eating Index-derived vegetable scores were also inversely associated with hs-CRP in the non-DM group (all p-values ≤ 0.05). Conversely, no significant associations were observed in the T1D group. In conclusion, dietary pattern-derived vegetable scores are inversely associated with hs-CRP in non-DM adults. Nonetheless, in T1D, chronic hyperglycemia and related metabolic abnormalities may override the cardioprotective features of these food groups at habitually consumed servings.
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  • 文章类型: Journal Article
    这项研究的目的是探讨腹膜透析患者的相关危险因素及其对认知障碍(CI)的影响。回顾性分析2020年1月至2023年9月在我院行持续性非卧床腹膜透析(CAPD)的268例患者的基本资料。在随后的透析访视期间使用蒙特利尔认知评估量表评估认知功能。参与者分为aCI组和认知正常组。收集血液和其他生物样品用于相关生物标志物分析。随后,对影响CI的因素进行分析比较。CAPD患者的CI患病率为58.2%。与认知正常组相比,CI组的饮酒患病率较高,教育水平较低,降低血清尿酸水平(P<0.05)。CI组自身免疫性疾病如系统性红斑狼疮的发生率也较高(P<0.05)。就透析疗效而言,与认知正常组相比,CI组的残余肾Kt/V和残余肾Ccr明显降低。在血液参数中,CI组总胆固醇水平升高,血清钙浓度降低(P<0.05)。Logistic回归分析确定男性性别,年龄较大,受教育程度较低,高胆固醇血症,高敏C反应蛋白水平升高是CAPD患者发生CI的独立危险因素(P<0.05)。此外,在这个病人队列中,透析时间和残余肾功能是CI的保护因素(P<0.05)。CI在PD患者中普遍存在。高敏C反应蛋白水平升高,男性,年龄较大,受教育程度较低,高胆固醇血症构成CAPD患者CI的独立危险因素,而残余的肾功能作为保护元素。
    The objective of this study is to investigate the associated risk factors and their effects on cognitive impairment (CI) in patients undergoing peritoneal dialysis. A retrospective analysis was conducted on the basic information of 268 patients who underwent continuous ambulatory peritoneal dialysis (CAPD) at our hospital from January 2020 to September 2023. Cognitive function was assessed using the Montreal Cognitive Assessment Scale during their subsequent dialysis visits. Participants were categorized into a CI group and a cognitively normal group. Blood and other biological samples were collected for relevant biomarker analysis. Subsequently, we analyzed and compared the factors influencing CI between the 2 groups. The prevalence of CI among CAPD patients was 58.2%. Compared to the cognitively normal group, the CI group had a higher prevalence of alcohol consumption, lower levels of education, and reduced serum uric acid levels (P < .05). There was also a higher incidence of autoimmune diseases such as systemic lupus erythematosus in the CI group (P < .05). In terms of dialysis efficacy, the residual kidney Kt/V and residual kidney Ccr were significantly lower in the CI group compared to the cognitively normal group. In blood parameters, the CI group showed elevated total cholesterol levels and lower serum calcium concentrations (P < .05). Logistic regression analysis identified male gender, older age, lower educational attainment, hypercholesterolemia, and elevated high-sensitivity C-reactive protein levels as independent risk factors for CI in CAPD patients (P < .05). Additionally, in this patient cohort, dialysis duration and residual renal function were protective factors against CI (P < .05). CI is prevalent among PD patients. Elevated high-sensitivity C-reactive protein levels, male gender, older age, lower educational attainment, and hypercholesterolemia constitute an independent risk factor for CI in CAPD patients, whereas residual renal function acts as a protective element.
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  • 文章类型: Journal Article
    研究表明,一些炎症标志物可以预测心血管疾病(CVD)的风险,并影响心脏的结构和功能。然而,炎症标志物与心脏结构和功能之间的因果关系尚未确定.因此,我们进行了2个样本孟德尔随机化(MR)研究,以探讨炎症标志物与预后相关左心室(LV)参数之间的潜在因果关系.C反应蛋白(CRP)的仪器变量(IVs),白细胞介素-6(IL-6),和髓过氧化物酶(MPO)水平从大型全基因组关联研究(GWAS)的数据库中选择。低压参数汇总统计,包括左心室质量,射血分数,舒张末期和收缩容积,和左心室质量与舒张末期容积的比率,来自英国生物库的心血管磁共振研究(n=16923)。逆方差加权(IVW)方法是使用的主要分析方法,并补充了MR-Egger,加权中位数,简单模式,加权模式,和MR多效性残差和离群值(MR-PRESSO)方法。进行敏感性分析以评估结果的稳健性。在IVW方法中,CRP与LV质量显着相关(β=-0.13g[95%置信区间[CI],0.78g-1.00g],P=.046)。遗传预测的CRP水平的较高标准偏差与低LV质量的0.13±0.06g相关。未发现IL-6和MPO与LV参数的因果关系。未检测到异质性和多效性的证据。敏感性分析证实了结果的稳健性。双样本MR分析显示CRP水平升高和LV质量降低之间存在因果关系,而IL-6和MPO水平不影响LV参数。然而,我们需要进一步的研究来验证我们的发现.
    Studies have shown that some inflammatory markers can predict the risk of cardiovascular disease (CVD) and affect the structure and function of the heart. However, a causal relationship between inflammatory markers and the cardiac structure and function has not yet been established. Thus, we conducted a 2-sample Mendelian randomization (MR) study to explore the potential causal relationship between inflammatory markers and prognostically-related left ventricular (LV) parameters. Instrumental variables (IVs) for C-reactive protein (CRP), interleukin-6 (IL-6), and myeloperoxidase (MPO) levels were selected from the databases of large genome-wide association studies (GWAS). Summary statistics for LV parameters, including LV mass, ejection fraction, end-diastolic and systolic volumes, and the ratio of LV mass to end-diastolic volume, were obtained from cardiovascular magnetic resonance studies of the UK Biobank (n = 16923). The inverse-variance weighted (IVW) method was the primary analytical method used, and was complemented with the MR-Egger, weighted median, simple mode, weighted mode, and MR pleiotropy residual sum and outlier (MR-PRESSO) methods. Sensitivity analysis was performed to evaluate the robustness of the results. CRP was significantly associated with the LV mass in the IVW method (β = -0.13 g [95% confidence interval [CI], 0.78 g-1.00 g], P = .046). A higher standard deviation of genetically-predicted CRP levels was associated with a 0.13 ± 0.06 g lower LV mass. No causal relationships of IL-6 and MPO with LV parameters were found. No evidence of heterogeneity and pleiotropy was detected. Sensitivity analyses confirmed the robustness of the results. Two-sample MR analysis revealed a causal association between increased CRP level and decreased LV mass, whereas IL-6 and MPO levels did not influence the LV parameters. However, further research is required to validate our findings.
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