Repositório Institucional - Unifesp :: Navegando por Palavras-chave "C-reactive protein"

Navegando por Palavras-chave "C-reactive protein"

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Ability of vitamin D to reduce inflammation in adults without acute illness
(Wiley-Blackwell, 2014-02-01) Zanetti, Mayra [UNIFESP]; Harris, Susan S.; Dawson-Hughes, Bess; Universidade Federal de São Paulo (UNIFESP); Tufts Univ
In vitro studies and some clinical studies suggest that vitamin D plays an important role in reducing inflammation. the objective of this review was to examine recent evidence that vitamin D status influences the level of inflammation in adults without acute illness or injury. Five large cross-sectional studies and two randomized controlled trials are the focus of this review. Associations between 25-hydroxyvitamin D (25OHD) and inflammation markers are significant and inverse in study populations with low 25OHD levels (<21ng/mL). They are also inverse in adults with relatively high inflammation levels. These associations in the few available randomized controlled vitamin D intervention trials have been null; this may be because they were not examined in populations with sufficiently low levels of 25OHD or high levels of inflammation. (C) 2013 International Life Sciences Institute
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Aerobic exercise does not change C-reactive protein levels in non-obese patients with obstructive sleep apnoea
(Taylor & Francis Ltd, 2014-01-01) Cavagnolli, Daniel Alves [UNIFESP]; Esteves, Andrea Maculano [UNIFESP]; Ackel-D'Elia, Carolina [UNIFESP]; Maeda, Marilia Yuri [UNIFESP]; Faria, Alexandre Paulino de; Tufik, Sergio [UNIFESP]; Mello, Marco Tulio de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Ctr Estudo Multidisciplinar Sonolencia & Acidente
The aim of this study is to evaluate the effects of a 2-month aerobic exercise training programme on C-reactive protein (CRP) levels in non-obese patients with obstructive sleep apnoea. Twenty non-obese and sedentary adult male volunteers underwent polysomnography (PSG) to assess their sleep parameters. After the PSG analysis, the subjects were divided into two groups (CTRL, control and OSA, obstructive sleep apnoea). Twenty-four sessions of aerobic exercise were performed, and PSG was repeated on the night that followed the last physical training session (24th). Blood samples were collected for CRP analysis before the first exercise session and after the last session. the OSA group demonstrated a reduction in sleep latency (SL) after 2 months of physical exercise, and 80% of them showed a lower apnoea-hypopnoea index (AHI), although this difference was not statistically significant. the differences between the CRP values for the CTRL and OSA groups were also not statistically significant at baseline or after 2 months of physical exercise. Furthermore, there was no correlation between the CRP levels and body mass index (BMI) in the two groups assessed. Our results suggest that in non-obese patients with OSA, CRP levels were normal and did not change after 2 months of aerobic exercise training.
Acesso aberto (Open Access)
Association between peripheral arterial disease and creactive protein in the japanese-brazilian population
(Colégio Brasileiro de Cirurgiões, 2014-06-01) Garofolo, Luciana [UNIFESP]; Ferreira, Sandra Roberta Gouvea [UNIFESP]; Miranda Junior, Fausto; Unversidade Federal de São Paulo; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
OBJECTIVE:To evaluate the relationship between peripheral arterial disease and elevated levels of C-reactive protein in the Japanese-Brazilian population of high cardiovascular risk.METHODS:We conducted a cross-sectional study derived from a population-based study on the prevalence of diabetes and associated diseases in the Japanese-Brazilian population. One thousand, three hundred and thirty individuals aged e 30 underwent clinical and laboratory examination, including measurement of ultrasensitive C-reactive protein. The diagnosis of peripheral arterial disease was performed by calculating the ankle-brachial index. We considered with peripheral arterial disease patients who had ankle-brachial index d 0.9. After applying the exclusion criteria, 1,038 subjects completed the study.RESULTS:The mean age of the population was 56.8 years; 46% were male. The prevalence of peripheral arterial disease was 21%, with no difference between genders. Data analysis showed no association between peripheral arterial disease and ultrasensitive C-reactive protein. Patients with ankle-brachial index d 0.70 showed higher values of ultrasensitive C-reactive protein and worse cardiometabolic profile. We found a positive independent association of peripheral arterial disease with hypertension and smoking.CONCLUSION:The association between low levels of ankle-brachial index and elevated levels of ultrasensitive C-reactive protein may suggest a relationship of gravity, aiding in the mapping of high-risk patients.
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Association of oxidative stress markers and C-reactive protein with multidimensional indexes in COPD
(Sage Publications Ltd, 2011-05-01) Folchini, F. [UNIFESP]; Nonato, N. L. [UNIFESP]; Feofiloff, E. [UNIFESP]; D'Almeida, V. [UNIFESP]; Nascimento, O. [UNIFESP]; Jardim, J. R. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
To evaluate the oxidative stress and the C-reactive protein (CRP) in chronic obstructive pulmonary disease (COPD) patients and their correlation between the severity of the disease according to GOLD criteria and multidimensional indexes such as BODE index. A blood sample was collected for thiobarbituric acid reactive substances (TBARS), superoxide dismutase (SOD), catalase, glutathione (GSH), homocysteine (HCY) and CRP analysis from 45 stable COPD patients. Lung function, body nutritional status, dyspnea and 6-min walk test (6MWT) were evaluated. Patients with GOLD stage IV presented a higher value for the TBARS than stage I patients (4.47 + 1.58 versus 2.27 + 1.04 nmol/mL, p < 0.05). CRP was higher for GOLD IV (2.46 + 3.68 mg/dL) than other stages (GOLD I: 0.39 + 0.25, GOLD II: 0.39 + 0.18 and GOLD III: 0.48 + 0.36 mg/dL, p < 0.05). Oxidative stress markers measured as TBARS presented a negative correlation between forced expiratory volume in the first second (FEV1) post bronchodilatador (% predicted; r = -0.39, p = 0.01) and positive correlations with Modified Medical Research Council Scale (MMRC) dyspnea index (r = 0.40, p = 0.01), multidimensional index (r = 0.49, p = 0.001) and BODE index (r = 0.51, p = 0.001).
Acesso aberto (Open Access)
Avaliação da variação da temperatura cutânea, proteína C reativa e velocidade de hemossedimentação na artroplastia total do joelho primária, isenta de complicações
(Sociedade Brasileira de Ortopedia e Traumatologia, 2006-01-01) Carvalho Júnior, Lúcio Honório De [UNIFESP]; Santos, Rogério Luciano Dos; Mendonça, Celso Júnio Aguiar; Campos, Cícero Teixeira; Andrade, Marco Antônio Percope De [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); UFMG Faculdade de Medicina Departamento do Aparelho locomotor; UFMG Serviço de Ortopedia do HC
OBJECTIVE: To study the variation of skin temperature values (deltaT) on operative site, of reactive C protein (RCP) and of hemosedimentation speed (HSS) in patients submitted to primary knee total arthroplasty (KTA), in an attempt to establish a correlation among its curves over time. MATERIALS AND METHODS: This prospective clinical study evaluated 29 patients followed up during 12 weeks, with measurements of skin temperature in both knees and RCP and HSS serum dosages. RESULTS: After comparing the variables tested (deltaT, RCP and HSS), no statistical correlation was observed for both the Pearson s test (parametric test) and the Spearman s test (non-parametric test) among variables. Skin temperature variation follows a different pattern from that observed both for RCP and for HSS, with no correlation among curves. A standard curve was established for the three variables, and a statistically significant reduction was seen in RCP and HSS values from pre- to post-operative period. CONCLUSION: No correlation was observed between skin temperature and HSS and RCP levels in patients submitted to uncomplicated primary KTA.
Acesso aberto (Open Access)
Avaliação de provas de fase aguda em crianças e adolescentes com artrite idiopática juvenil e sua correlação com atividade da doença
(Sociedade de Pediatria de São Paulo, 2009-06-01) Nicácio, Aline Alencar Martins Fernandes [UNIFESP]; Damazio, Karine Cobucci; Terreri, Maria Teresa Ramos Ascensão [UNIFESP]; Rassi, Ivan Elias; Hilário, Maria Odete Esteves [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hospital Professor Edmundo Vasconcelos
OBJECTIVE:To analyze the relationship between the acute phase reactants and the disease activity of Juvenile Idiopathic Arthritis (JIA) and to evaluate the agreement between erythrocyte sedimentation rate and C-reactive protein during the acute phase of the disease. METHODS: a cohort retrospective study has been conducted based on the analysis of 30 children and adolescents who fulfilled the diagnostic criteria of JIA. All of them were in current follow-up at the pediatric rheumatology outpatient clinic and had acute phase reactants blood tests performed. RESULTS: Studied population comprised 30 patients: 21 (70%) of them were females and 19 (63.3%) presented oligoarticular subtype. The mean age at disease onset was 65.6 months; the age at diagnosis was 85.3 months and the follow-up had 57.2 months of duration. The acute phase reactants showed positive association with the disease activity. Anemia was not associated with disease activity. During the acute phase of the disease, agreement between erythrocyte sedimentation rate and C-reactive protein was greater than 80%. CONCLUSIONS: The acute phase reactants have a positive association with the activity of the disease and using both tests simultaneously increases their specificity.
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Comparison between procalcitonin and C-reactive protein for early diagnosis of children with sepsis or septic shock
(Springer, 2010-08-01) Fioretto, Jose R.; Martin, Joelma G.; Kurokawa, Cilmery S.; Carpi, Mario F.; Bonatto, Rossano C.; Moraes, Marcos A. de; Ricchetti, Sandra M. Q.; Universidade Federal de São Paulo (UNIFESP)
The objective of the paper is to examine the behavior of C-reactive protein (CRP) and procalcitonin (PCT) in the first 12 h of admission and verify which performs better to differentiate children with septic conditions.Septic children aged between 28 days and 14 years were divided into sepsis (SG; n = 46) and septic shock (SSG; n = 41) groups. CRP and PCT were measured at admission (T0) and 12 h later (T12 h). PCT results were classed as: 0.5 ng/ml = sepsis unlikely; a parts per thousand yen0.5 to < 2 = sepsis possible; a parts per thousand yen2 to < 10 = systemic inflammation; a parts per thousand yen10 = septic shock.At T0, there was a higher frequency of SSG with PCT > 10 compared to SG [SSG: 30 (73.1%) > SG: 14 (30.4%); P < 0.05]. Similar results were observed at T12 h. Pediatric Risk of Mortality I score was significantly higher for SSG patients with higher PCT than SG patients. CRP levels were not statistically different for groups and time points.PCT was better than CRP for diagnosing sepsis and septic shock, mainly at admission, and is related to disease severity.
Acesso aberto (Open Access)
Demência, homocisteína, proteína C reativa, HDL-Colesterol, função renal e Vitamina D em idosos longevos - análise de cluster
(Universidade Federal de São Paulo (UNIFESP), 2016-09-30) Laks, Renato [UNIFESP]; Cendoroglo, Maysa Seabra [UNIFESP]; http://lattes.cnpq.br/6897068755022692; http://lattes.cnpq.br/4056688080816727; Universidade Federal de São Paulo (UNIFESP)
Introduction: Identifying the risk factors for dementia is very important in order to avoid the onset of illness. Some risk markers such as homocysteine, 25 (OH) VITD, CRP, HDL-Col and renal function are very prevalent in the elderly, potentially modifiable and can be risk factors for dementia. Objective: To evaluate through cluster analysis the relationship between cognitive function and the risk markers homocysteine, C-reactive protein, renal function, 25-hydroxyvitamin D3 and HDL-cholesterol. Validate formed clusters relating them to the incidence of dementia, stroke and death. Methods: Elderly individuals aged 80 years and older, with no cognitive or functional loss underwent an initial assessment and data applied to cluster analysis by two steps method. The formed clusters were compared with respect to demographic variables, the performance on the clock drawing test, verbal fluency animals, brief cognitive battery, Mini Mental State examination, GDS and serum biochemical markers. To validate the cluster, we evaluated the incidence of dementia, stroke and occurrence of death in the period of 2010 to 2016. Results: At baseline were included 156 elderlies, 69.2% female, mean age 84.8 years. The clustering obtained positive silhouette coefficient (+0.3). The decreasing order of importance of risk markers to the clustering process was BIS_Cr, HDL-Col, homocysteine, CRP, and 25 (OH) VitD. Comparing the initial cognitive tests among the three formed clusters, they differed only on the clock drawing test. During the follow-up to six years 13.5% of all participants developed dementia, 5.1% Stroke and 10.9% died. The incidence of dementia, stroke and deaths in this period was significantly lower in the cluster 2 (p = 0.005), which had intermediate values of homocysteine and creatinine clearance, and the highest CRP, HDL-cholesterol and 25 (OH)VitD. The cluster with lower levels of creatinine clearance, HDL-col and 25 (OH) VITD, higher levels of homocysteine and intermediate levels of CRP, showed higher incidence of dementia, stroke and death. Moreover, the incidence of these outcomes was significantly lower in the cluster 2 (p = 0.005), which had intermediate levels of homocysteine and creatinine clearance, and higher HDL-cholesterol levels, 25-dihydroxyvitamin D3 and CRP. Conclusion: The combination of creatinine clearance greater than 45 mL / min / 1.73m2, HDL-Col greater than 60 mg / dL, 25 (OH)vit D greater than 20 mmol /L
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Effects of Ezetimibe on Endothelial Progenitor Cells and Microparticles in High-Risk Patients
(Humana Press Inc, 2014-09-01) Amaral Lins, Livia Campos [UNIFESP]; Franca, Carolina Nunes [UNIFESP]; Helfenstein Fonseca, Francisco Antonio [UNIFESP]; Melo Barbosa, Simone Pinto [UNIFESP]; Matos, Livia Nascimento [UNIFESP]; Aguirre, Ana Carolina [UNIFESP]; Bianco, Henrique Tria [UNIFESP]; Amaral, Jonatas Bussador do [UNIFESP]; Izar, Maria Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Imbalance on endothelial turnover can predict cardiovascular outcomes. We aimed at evaluating the effects of lipid-modifying therapies on circulating endothelial progenitor cells (EPCs), endothelial microparticles (EMPs), and platelet microparticles (PMPs) in high cardiovascular risk subjects with elevated C-reactive protein (CRP). Sixty-three individuals with coronary heart disease (CHD) or CHD risk equivalent on stable statin therapy, with LDL-cholesterol < 100 mg/dL and CRP a parts per thousand yen2.0 mg/L were selected. After a 4-week run-in period with atorvastatin 10 mg, those with persistent CRP a parts per thousand yen2.0 mg/L were randomized to another 4-week treatment period with atorvastatin 40 mg, ezetimibe 10 mg or atorvastatin 40 mg/ezetimibe 10 mg. EPC (CD34(+)/CD133(+)/KDR+), EMP (CD51(+)), and PMP (CD42(+)/CD31(+)) were quantified by flow cytometry. Atorvastatin 40 mg and atorvastatin 40 mg/ezetimibe 10 mg reduced LDL-cholesterol (P < 0.001, paired T test, vs. baseline). Combined therapy, but not ezetimibe reduced CRP. CD34(+)/KDR+ EPC were reduced after ezetimibe alone (P = 0.011 vs. baseline, Wilcoxon test) or combined with atorvastatin (P = 0.016 vs. baseline, Wilcoxon test). in addition, ezetimibe increased CD51(+) EMP (P = 0.017 vs. baseline, Wilcoxon test). No correlations between these markers and LDL-cholesterol or CRP were observed. These results contribute to understand the link between inflammation and vascular homeostasis and highlight the broader benefit of statins decreasing inflammation and preventing microparticles release, an effect not observed with ezetimibe alone.
Acesso aberto (Open Access)
Effects of mindfulness-based interventions on biomarkers in healthy and cancer populations: a systematic review
(Biomed Central Ltd, 2017) Sanada, Kenji; Alda Diez, Marta; Salas Valero, Montserrat; Perez-Yus, Maria C.; Demarzo, Marcelo M. P. [UNIFESP]; Montero-Marin, Jesus; Garcia-Toro, Mauro; Garcia-Campayo, Javier
Background: Only a small number of articles have investigated the relationship between mindfulness-based interventions (MBIs) and biomarkers. The aim of this systematic review was to study the effect of MBIs on specific biomarkers (cytokines, neuropeptides and C-reactive protein (CRP)) in both healthy subjects and cancer patients. Methods: A search was conducted using PubMed, EMBASE, PsycINFO and the Cochrane library between 1980 and September 2016. Results: A total of 13 studies with 1110 participants were included. In the healthy population, MBIs had no effect on cytokines, but were found to increase the levels of the neuropeptide insulin-like growth factor 1 (IGF-1). With respect to neuropeptide Y, despite the absence of post-intervention differences, MBIs may enhance recovery from stress. With regard to CRP, MBIs could be effective in lower Body Mass Index (BMI) individuals. In cancer patients, MBIs seem to have some effect on cytokine levels, although it was not possible to determine which specific cytokines were affected. One possibility is that MBIs might aid recovery of the immune system, increasing the production of interleukin (IL)-4 and decreasing interferon gamma (IFN-gamma). Conclusions: MBIs may be involved in changes from a depressive/carcinogenic profile to a more normalized one. However, given the complexity and different contexts of the immune system, and the fact that this investigation is still in its preliminary stage, additional randomized controlled trials are needed to further establish the impact of MBI programmes on biomarkers in both clinical and non-clinical populations.
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High circulating autoantibodies against human oxidized low-density lipoprotein are related to stable and lower titers to unstable clinical situation
(Elsevier B.V., 2009-08-11) Santos, Andreza O. [UNIFESP]; Fonseca, Francisco A. H. [UNIFESP]; Fischer, Simone M. [UNIFESP]; Monteiro, Carlos M. C. [UNIFESP]; Brandao, Sergio A. B. [UNIFESP]; Povoa, Rui M. S. [UNIFESP]; Bombig, Maria T. N. [UNIFESP]; Carvalho, Antonio C. [UNIFESP]; Monteiro, Andrea M. [UNIFESP]; Ramos, Eduardo [UNIFESP]; Gidlund, Magnus; Figueiredo Neto, Antonio M. [UNIFESP]; Izar, Maria C. O. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Background: Oxidized lipoproteins and antibodies anti-oxidized low-density lipoprotein (anti-oxLDL) have been detected in human plasma and in atherosclerotic lesions. However, the role of these autoantibodies in the maintenance of vascular health or in the pathogenesis of acute vascular insults remains unclear. We examined the relationship of human immunoglobulin G (IgG) anti-oxLDL antibodies with cardiovascular disease risk markers in stable subjects and in patients after an acute coronary syndrome (ACS).Methods: Titers of human anti-oxLDL antibodies were measured in hypertensive subjects in primary prevention (n = 94), without other risk factors, and in individuals after a recent ACS event who also had metabolic syndrome (n = 116). Autoantibodies against copper ion oxidized LDL were measured by enzyme-linked-immunosorbent assay.Results: Anti-oxLDL titers were higher in hypertensive patients and these subjects presented lower high sensitivity C-reactive protein (hs-CRP) than those with ACS (p < 0.0001). We found significant correlations between anti-oxLDL and hs-CRP (r = -0.284), body mass index (r = -0.256), waist circumference (r = -0.368), apolipoprotein B (r = -0.191), glucose (r = -0.303), systolic blood pressure (r = 0.319), diastolic blood pressure (r = 0.167), high-density lipoprotein cholesterol (r = 0.224) and apolipoprotein A1 (r = 0.257) (p < 0.02 for all). After multiple linear regression hs-CRP, fasting glucose and waist circumference remained independently and inversely associated with anti-oxLDL.Conclusions: Acute inflammatory and metabolic conditions decrease titers of human antibodies of IgG class against oxidized LDL, and that circulating anti-oxLDL antibodies could be associated with a protective role in atherosclerosis. (C) 2009 Elsevier B.V. All rights reserved.
Acesso aberto (Open Access)
Highly sensitive C-reactive protein and male gender are independently related to the severity of coronary disease in patients with metabolic syndrome and an acute coronary event
(Associação Brasileira de Divulgação Científica, 2010-03-01) Monteiro, Carlos Manoel de Castro [UNIFESP]; Pinheiro, Luiz Fernando Muniz [UNIFESP]; Izar, Maria Cristina de Oliveira [UNIFESP]; Barros, Sahana W. [UNIFESP]; Vasco, M.Brandão [UNIFESP]; Fischer, Simone M. [UNIFESP]; Póvoa, Rui Manuel dos Santos [UNIFESP]; Brandão, Sergio Augusto Bueno [UNIFESP]; Santos, Andreza Oliveira dos [UNIFESP]; Oliveira, Luciene [UNIFESP]; Carvalho, Antonio Carlos [UNIFESP]; Fonseca, Francisco Antonio Helfenstein [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Patients with metabolic syndrome are at high-risk for development of atherosclerosis and cardiovascular events. The objective of this study was to examine the major determinants of coronary disease severity, including those coronary risk factors associated with metabolic syndrome, during the early period after an acute coronary episode. We tested the hypothesis that inflammatory markers, especially highly sensitive C-reactive protein (hsCRP), are related to coronary atherosclerosis, in addition to traditional coronary risk factors. Subjects of both genders aged 30 to 75 years (N = 116) were prospectively included if they had suffered a recent acute coronary syndrome (acute myocardial infarction or unstable angina pectoris requiring hospitalization) and if they had metabolic syndrome diagnosed according to the National Cholesterol Education Program/Adult Treatment Panel III. Patients were submitted to a coronary angiography and the burden of atherosclerosis was estimated by the Gensini score. The severity of coronary disease was correlated (Spearman’s or Pearson’s coefficient) with gender (r = 0.291, P = 0.008), age (r = 0.218, P = 0.048), hsCRP (r = 0.256, P = 0.020), ApoB/ApoA ratio (r = 0.233, P = 0.041), and carotid intima-media thickness (r = 0.236, P = 0.041). After multiple linear regression, only male gender (P = 0.046) and hsCRP (P = 0.012) remained independently associated with the Gensini score. In this high-risk population, male gender and high levels of hsCRP, two variables that can be easily obtained, were associated with more extensive coronary disease, identifying patients with the highest potential of developing new coronary events.
Acesso aberto (Open Access)
Impacto da perda de peso nas adipocitocinas, na proteína C-reativa e na sensibilidade à insulina em mulheres hipertensas com obesidade central
(Sociedade Brasileira de Cardiologia - SBC, 2007-12-01) Borges, Rodolfo Leão [UNIFESP]; Ribeiro-filho, Fernando Flexa [UNIFESP]; Carvalho, Kenia Mara Baiocchi [UNIFESP]; Zanella, Maria Teresa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de Brasília
OBJECTIVE: To assess the impact of weight reduction on serum adipocytokines, C-reactive protein (CRP), and insulin sensitivity in hypertensive female patients with central obesity. METHODS: This study was performed using the database and stored serum samples of female patients who had participated in an intervention study focused on weight loss. Thirty hypertensive women aged 18 to 65, body mass index (BMI) > 27 kg/m², and central obesity were selected. They were randomly assigned to receive either a low-calorie diet plus orlistat 120 mg three times daily or a low-calorie diet alone for 16 weeks. Patients who experienced weight loss greater than 5% (n = 24) were assessed for blood pressure, anthropometric parameters, visceral fat, insulin resistance (HOMA-R - homeostasis model assessment of insulin resistance) and sensitivity (ISI - Insulin Sensitivity Index) indices, plus serum lipids, adipocytokines (adiponectin, leptin, IL-6, and TNF-a) and CRP levels. RESULTS: After BMI had been reduced by approximately 5% in both groups, visceral fat, fasting glucose, triglycerides, and TNF-a decreased. Only the orlistat group, which was more insulin resistant at baseline, showed a significant reduction in blood glucose after oral glucose load, in addition to increased insulin sensitivity. CONCLUSION: This study's findings indicate that a weight loss greater than 5% is associated with improved inflammatory status and decreased insulin resistance, regardless of changes in adiponectin and TNF-a levels. The greatest improvements in insulin sensitivity experienced by the orlistat-treated patients could not be attributed to the use of this drug because of the higher number of insulin-resistant subjects in this group.
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Inflammation is associated with increased energy expenditure in patients with chronic kidney disease
(Amer Soc Clinical Nutrition, 2005-10-01) Utaka, Simone [UNIFESP]; Avesani, Carla Maria [UNIFESP]; Draibe, Sergio Antonio [UNIFESP]; Kamimura, Maria Ayako [UNIFESP]; Andreoni, Solange [UNIFESP]; Cuppari, Lilian [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Background: Inflammation, a clinical condition observed in patients with chronic kidney disease (CKD), may be related to increased resting energy expenditure (REE).Objectives: The main objective was to investigate the relation between inflammation and REE in patients with CKD who are not undergoing dialysis. We also aimed to analyze whether a decrease in C-reactive protein (CRP) would result in a reduction in REE.Design: This study enrolled 132 patients with CKD who were not undergoing dialysis, who had creatinine clearance from 5 to 65 mL (.) min(-1) (.) 1.73 m(-2), and who were 53.6 +/- 16 y old; 82 (62.1%) were men. Twenty-nine patients had clinical signs of infection. REE was measured by using indirect calorimetry, and inflammation was evaluated by using high-sensitivity CRP measurement. Patients were divided according to tertiles of CRP with the following intertertile ranges: first tertile, CRP <= 0.14 mg/dL (n = 43); second tertile, CRP 0.15- 0.59 mg/dL (n = 46); and third tertile, CRP >= 0.60 mg/dL (n = 43). REE was measured before and after treatment in 10 patients who had inflammation or infection.Results: After adjustment for age, sex, and lean body mass, the REE of the third (1395 kcal/d; P = 0.02) and second (1355 kcal/d; P = 0.04) tertiles was significantly higher than that of the first tertile (1286 kcal/d). In the multiple linear regression analysis (n = 132), the independent determinants of REE were lean body mass, CRP, and age (R-2 = 0.55). After treatment of infection in a subgroup of 10 patients, it was observed that a significant reduction in CRP concentration was accompanied by a significant reduction of 174 165 kcal that accounted for 13% of the initial REE.Conclusion: This study showed that inflammation is associated with increased REE in patients with CKD.
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Is serum albumin a marker of nutritional status in hemodialysis patients without evidence of inflammation?
(Blackwell Publishing Inc, 2003-08-01) Santos, Nelma Scheyla Jose dos [UNIFESP]; Draibe, Sergio Antonio [UNIFESP]; Kamimura, Maria Ayako [UNIFESP]; Canziani, Maria Eugênia Fernandes [UNIFESP]; Cendoroglo, Miguel [UNIFESP]; Gabriel Junior, Alexandre [UNIFESP]; Cuppari, Lilian [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Hypoalbuminemia, a strong predictor of morbidity and mortality in hemodialysis patients, can be a consequence of a combination of malnutrition and inflammatory reactions. The purpose of this study was to analyze serum albumin as a marker of nutritional status in maintenance hemodialysis patients with no signs of inflammation. In a cross-sectional study, we selected 40 stable hemodialysis patients with normal levels of C-reactive protein (<0.8 mg/dL). The patients were classified as well nourished (65%) or malnourished (35%) according to the subjective global assessment. No significant differences were observed in serum albumin concentrations (immunoturbidimetric method) between well-nourished (4.3 +/- 0.3 g/dL) and malnourished (4.0 +/- 0.5 g/dL) patients, and the mean values were within the normal range in both groups. Albumin was inversely correlated with age (n=40; r=-0.32; P =0.02) and directly with energy intake (n=28; r=0.43; P =0.04). In this study, serum albumin did not discriminate well-nourished and malnourished hemodialysis patients without evidence of inflammation.
Acesso aberto (Open Access)
Pró-calcitonina e proteína C reativa em processos infecciosos graves
(Sociedade Brasileira de Patologia ClínicaSociedade Brasileira de PatologiaSociedade Brasileira de Citopatologia, 2004-06-01) Andriolo, Adagmar [UNIFESP]; Costa, Roberta Pasianotto [UNIFESP]; Novo, Neil Ferreira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Fleury - Centro de Medicina Diagnóstica; Universidade de Santo Amaro Faculdade de Medicina
Biochemical markers for septic processes are necessary in order to obtain objective evidence of sepsis. The C-reactive protein (CRP) has been used to that, despite its low specificity. The procalcitonin (PCT) was proposed as a more specific marker, but its predictive value is not yet well established. We evaluated which one of that markers could anticipate the clinical output of septic patients. Determination of PCT/CRP was performed in 19 sera from patients from ITU of Hospital São Paulo/EPM. Procalcitonin was measured by immunoluminometric assay (LUMItest PCT, Brahms Diagnostica GmB, Berlin, Germany) and C-reactive protein by immunonephelometric assay (N High Sensitivity CRP, Dade Behring, Marburg, Germany). The PCT concentrations are significantly higher in non-survivors than in survivors group (p < 0.002), what did not occur with CRP. We did not observe significant correlation between procalcitonin and C-reactive protein concentrations as in non-survival as survival group (SR = 0.205, critic value 0.533 and SR = 0.029, critic value 0.811, respectively). We concluded that both markers are sensitive for septic process and that higher procalcitonin concentration could be related to a worse prognostic.
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Procalcitonin and C-reactive protein kinetics in postoperative pediatric cardiac surgical patients
(W B Saunders Co, 2004-04-01) Arkader, R.; Troster, E. J.; Abellan, D. M.; Lopes, M. R.; Raiz, R.; Carcillo, J. A.; Okay, T. S.; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Univ Pittsburgh
Objective: To determine the kinetics of procalcitonin (PCT) and C-reactive protein (CRP) concentration after pediatric cardiac surgery with cardiopulmonary bypass.Design: Prospective, clinical cohort study.Setting: A fifteen-bed tertiary-care pediatric intensive care unit.Patients: Fourteen pediatric patients admitted for cardiac surgery.Measurements and Main Results: Serum PCT and CRP were measured before cardiopulmonary bypass (CPB); after CPB; and on the first, second, and third days after surgery by means of immunoluminometry and nephelometry, respectively. Reference values for systemic inflammatory response syndrome are 0.5 to 2.0 ng/mL for PCT and <5 mg/L for CRP. Baseline serum PCT and CRP concentrations were 0.24 +/- 0.13 ng/mL and 4.06 +/- 3.60 mg/L (median 25th percentile-75th percentile), respectively. PCT concentrations increased progressively from the end of CPB (0.62 +/- 0.30 ng/mL), peaked at 24 hours postoperatively (POD1) (0.77 +/- 0.49 ng/mL), and began to decrease at 48 hours or POD2 (0.35 +/- 0.21 ng/mL). CRP increased just after CPB (58.82 +/- 42.23 mg/L) and decreased after 72 hours (7.09 +/- 9.81 mg/L).Conclusion: An increment of both PCT and CRP was observed just after CPB. However, PCT values remained within reference values, whereas CRP concentrations increased significantly after CPB until the third day. These preliminary results suggest that PCT was more effective than CRP to monitor patients with SIRS and a favorable outcome. (C) 2004 Elsevier Inc. All rights reserved.
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Risks of anemia in infants according to dietary iron density and weight gain rate
(Elsevier B.V., 2004-10-01) Hadler, MCCM; Colugnati, FAB; Sigulem, D. M.; Fed Univ Goias; Universidade Federal de São Paulo (UNIFESP)
Background. the objective of the study was to identify risk factors of infant anemia and to assess a new indirect method to identify the risks of anemia using a probability curve based on dietary iron density and weight gain rate.Methods. A cross-sectional study was conducted on 110 term infants in a public health unit in Goiania, Brazil. A socioeconomic, demographic, anthropometric survey and dietary assessment were performed. Hemoglobin, red blood cell distribution width (RDW), ferritin, and C-reactive protein were determined.Results. the risk factors identified by final adjusted logistic regression were male infants (OR = 2.38), infants whose mothers were housewives (OR = 5.01), and households with more than three members (OR = 3.08). Another risk factor was the introduction of meat after 6 months (OR = 3.3). There was a positive dose-response effect between milk consumption and prevalence of anemia adjusted for sex and age (Effect = 0.120; 95% CI: 0.015, 0.225). Dietary iron density (from 6 to 9 months) and weight gain rate (from 9 to 12 months) significantly affected the probability of the infant having anemia.Conclusions. the probability curve for anemia obtained from dietary iron density and weight gain rate can be used to identify the risks of anemia, and together with the risk factors identified are important for anemia prevention programs. (C) 2004 the Institute for Cancer Prevention and Elsevier Inc. All rights reserved.
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Serum calprotectin levels correlate with biochemical and histological markers of disease activity in TNBS colitis
(Elsevier B.V., 2013-03-01) Cury, Didia Bismara [UNIFESP]; Mizsputen, Sender Jankiel [UNIFESP]; Versolato, Clara [UNIFESP]; Miiji, Luciana Odashiro [UNIFESP]; Pereira, Edson [UNIFESP]; Delboni, Maria Aparecida [UNIFESP]; Schor, Nestor [UNIFESP]; Moss, Alan C.; Universidade Federal de São Paulo (UNIFESP); Harvard Univ
Background and aim: Serum calprotectin is elevated in patients with inflammatory bowel disease (IBD). Whether it correlates other markers of disease activity is unknown. the aim of this study was to correlate serum calprotectin with biochemical and histological measures of intestinal inflammation.Materials and methods: TNBS colitis was induced in wistar rats, and serial blood samples were collected at 0, 3, and 12 days. Animals were subsequently sacrificed for pathological evaluation at day 12. Serum calprotectin and cytokines were measured by ELISA. Pathologic changes were classified at the macroscopic and microscopic levels.Results: TNBS colitis induced elevated serum calprotectin, TNF and IL-6 within 24 h. Levels of serum calprotectin remained elevated in parallel to persistence of loose stool and weight loss to day 12. Serum calprotectin levels correlated with serum levels of TNF-alpha, and IL6 (p < 0.001), but not CRP. Animals with liquid stool had significantly higher levels of serum calprotectin than control animals. There was a correlation between macroscopic colitis scores, and levels of serum calprotectin.Conclusion: Serum calprotectin levels correlate with biochemical and histological markers of inflammation in TNBS colitis. This biomarker may have potential for diagnostic use in patients with IBD. (C) 2013 Elsevier Inc. All rights reserved.
Acesso aberto (Open Access)
Sleepiness, inflammation and oxidative stress markers in middle-aged males with obstructive sleep apnea without metabolic syndrome: a cross-sectional study
(Biomed Central Ltd, 2015-01-14) Andaku, Daniela Kuguimoto [UNIFESP]; D'Almeida, Vania [UNIFESP]; Carneiro, Glaucia [UNIFESP]; Hix, Sonia [UNIFESP]; Tufik, Sergio [UNIFESP]; Togeiro, Sonia Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Fac Med ABC FUABC
Background: the simultaneous occurrence of metabolic syndrome and excessive daytime sleepiness are very common in obstructive sleep apnea (OSA) patients. Both conditions, if present in OSA, have been reported to be associated with inflammation and disruption of oxidative stress balance that impair the cardiovascular system. To verify the impact of daytime sleepiness on inflammatory and oxidative stress markers, we evaluated OSA patients without significant metabolic disturbance.Methods: Thirty-five male subjects without diagnostic criteria for metabolic syndrome (Adult Treatment Panel III) were distributed into a control group (n = 10) (43 +/- 10.56 years, apnea-hypopnea index - AHI 2.71 +/- 1.48/hour), a non-sleepy OSA group (n = 11) (42.36 +/- 9.48 years, AHI 29.48 +/- 22.83/hour) and a sleepy OSA group (n = 14) (45.43 +/- 10.06 years, AHI 38.20 +/- 25.54/hour). Excessive daytime sleepiness was considered when Epworth sleepiness scale score was >= 10. Levels of high-sensitivity C-reactive protein, homocysteine and cysteine, and paraoxonase-1 activity and arylesterase activity of paraoxonase-1 were evaluated.Results: Patients with OSA and excessive daytime sleepiness presented increased high-sensitivity C-reactive protein levels even after controlling for confounders. No significant differences were found among the groups in paraoxonase-1 activity nor arylesterase activity of paraoxonase-1. AHI was independently associated and excessive daytime sleepiness tended to have an association with high-sensitivity C-reactive protein.Conclusions: in the absence of metabolic syndrome, increased inflammatory response was associated with AHI and daytime sleepiness, while OSA was not associated with abnormalities in oxidative stress markers.

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