High sensitivity C-reactive protein in metabolic syndrome

Gowdaiah, Prakash Kikkeri; Mamatha, T R; Nirgude, Dyaneshwar; Hosamani, Prakash Basappa

doi:10.18203/2349-3933.ijam20162503

Cited by 7 publications

(7 citation statements)

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“…17 In the present study, there was higher mean concentration of hs-CRP in patients with metabolic syndrome (1.5±0.1mg/l v/s 2.2±0.2mg/l V/S 2.1±0.1mg/l) and there was a linear increase in the values with increasing number of components of the metabolic syndrome. These results were in accordance with a study by Gowdaiah PK et al 18 Similar finding was found by Bo S et al 19 Anubha Mahajan et al also had similar results where hs-CRP values were significantly elevated in subjects with metabolic syndrome compared to subjects without metabolic syndrome. 20 This suggests the fact that higher the number of components of metabolic syndrome in a patient, higher the values of hs-CRP and the risk of development of cardiovascular events.…”

Section: Discussionsupporting

confidence: 92%

Role of non-lipid risk factors like hs-CRP, uric acid and thyroid stimulating hormone in metabolic syndrome

2018

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Background: Metabolic syndrome is the cluster of diseases which arises due to excess of plasma glucose, cholesterol, fatty acids, blood pressure and obesity. The role of lipids in the development of MetS had been extensively studied. Though some non-lipid factors like hsCRP, uric acid and TSH level also remain elevated in the serum of the MetS patients, the role of these non-lipid risk factors remain incompletely understood. The objective of this study was to investigate which of these factors better predicts Mets, in order to help prevention and early detection of MetS and its associated type 2 diabetes mellitus and cardiovascular diseases. Aim and objectives was to study the significance of serum highly sensitive C-reactive protein (hs-CRP), serum uric acid (SUA) and thyroid stimulating hormone (TSH) levels in metabolic syndrome.Methods: A total of four hundred and fifty subjects (211 men and 239 women) aged ≥35 years attending the hospital were divided into three groups based on the components level of MetS as control (CS), normal (MS) and severe (SMS) MetS groups. Their fasting blood sample were taken and analyzed for the serum hs-CRP, uric acid and TSH levels. The result showed that the mean hs-CRP and uric acid levels were significantly higher in Metabolic Syndrome group (MS) and in Severe Metabolic Syndrome group (SMS) when compared to control group. But the mean TSH levels were more in MS group and in SMS group than the control which was statistically not significant. The analysis of relative significance of these risk factors showed that serum hs-CRP level had a positive linear correlation with the severity of MetS whereas, the TSH level was significantly high only in SMS and the uric acid level was not correlated with the MetS.Results: Our study revealed that type II (absence of sutural bones) was commoner than type I (presence of type I) asterion. The asterion was 4.82±0.58 cm from tip of the mastoid process on the right side and 4.70±0.70 cm on the left. It was greater in males than in females, p value being statistically significant (P = 0.00 and P = 0.02 for right and left sides respectively). The distance of asterion from supramastoid crest was 4.22±0.73 cm on the right and 4.23±0.58 cm on the left. The distance in males was more than in females. The P value 0.00 was statistically significant on the right side. Regarding the position of the asterion in relation to transverse sinus, it was on the transverse sinus in 62% cases, below it in 32% and above in 6%.Conclusions: In the present study, there was higher mean serum hs-CRP level in patients with metabolic syndrome which showed a linear increase with increasing number of components of the metabolic syndrome. Though available literature indicated that hyperuricemia adult subjects tend to develop MetS more frequently our findings showed this increase was not dependent on the severity of MetS. Also, significantly high TSH levels were found only in severe MetS suggest that as per this study the serum hs-CRP values may be consider as the diagnostic criteria for metabolic syndrome and helps to improve future prediction of development of type 2 DM and cardiovascular diseases.

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Section: Discussionsupporting

confidence: 92%

Role of non-lipid risk factors like hs-CRP, uric acid and thyroid stimulating hormone in metabolic syndrome

2018

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“…hs-CRP levels less than 1, 1 to 3, and greater than 3 mg/L indicate a low, moderate, and high risk for future CHD events and stroke. In the present study, the baseline hsCRP values were more than 6 mg/L, indicating a very high cardiovascular event risk [27]. As seen from Tables 17 and 18 mean percentage decrease in hsCRP levels by all the groups was significant at almost all treatment periods.…”

Section: Resultssupporting

confidence: 43%

A randomized, double-blind, positive-controlled, prospective, dose-response clinical study to evaluate the efficacy and tolerability of an aqueous extract of Terminalia bellerica in lowering uric acid and creatinine levels in chronic kidney disease subjects with hyperuricemia

Pingali

Nutalapati

Koilagundla

et al. 2020

BMC Complement Med Ther

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Background Hyperuricemia is an independent risk factor in chronic kidney disease (CKD). Allopurinol and febuxostat are prescription medicines used to treat hyperuricemia but suffer side-effects. Earlier clinical study has shown that an aqueous extract of Terminalia bellerica (TBE), significantly reduced uric acid levels with no serious adverse effects in hyperuricemic subjects. The objective of this study is to determine the efficacy and tolerability of TB in reducing uric acid and creatinine levels in CKD subjects. Methods 59-subjects were randomized to three groups-40 mg-once-daily febuxostat, 500 mg-twice-daily and 1000 mg-twice-daily of TBE. Serum uric acid, creatinine levels and estimated-glometular-filtration-rate were measured at baseline, 4, 8, 12, 16, 20, 24-weeks. Biomarkers of oxidative-stress, endothelial function, systemic inflammation, and platelet-aggregation were evaluated at baseline, 4, 8, 12, 24-weeks. Adverse drug reactions were recorded. Statistical analysis evaluated using GraphPadPrism4. Results 55-subjects completed 24-week study. Starting at 4-weeks, all treatment groups showed a significant decrease in serum uric acid levels from baseline (p ≤ 0.0001). At 24-weeks, febuxostat, T.bellerica 500 mg-twice-daily, and T.bellerica 1000 mg-twice-daily doses decreased mean-percentage serum uric acid by 63.70 ± 4.62, 19.84 ± 6.43 and 33.88% ± 4.95% respectively (p ≤ 0.0001). Significant decrease in serum creatinine with all the groups starting at 16-weeks was seen (p ≤ 0.005-p ≤ 0.0001). At 24-weeks, the mean-percentage change in creatinine levels was 23.71 ± 12.50, 11.70 ± 9.0, and 24.42 ± 8.14, respectively with febuxostat, T.bellerica 500 mg-twice-daily and T.bellerica 1000 mg-twice-daily. Statistically significant (p ≤ 0.05) increase in estimated glomerular filtration rate-(eGFR) was seen at 20 (p ≤ 0.05) and 24-weeks (p ≤ 0.01) for both febuxostat vs T.bellerica 500 mg-twice-daily and T.bellerica 1000 mg-twice-daily vs T.bellerica 500 mg-twice-daily. There was no statistically significant difference between febuxostat and T.bellerica 1000 mg-twice-daily, with an increase of eGFR of 41.38 and 40.39 ml/min/1.73m2 respectively, with the inference that T.bellerica at 1000 mg-twice-daily dose is as good as febuxostat 40 mg-once-daily. Positive improvements were made by all the groups in endothelial function and the related biomarkers and high-sensitivity C-reactive protein. None of the products showed effect on platelet aggregation. Conclusion In this 24-week study Febuxostat 40 mg, T. bellerica 500 mg-twice-daily and 1000 mg-twice-daily, significantly decreased the serum uric acid and creatinine levels, increased eGFR in CKD subjects. T. bellerica 500 mg-twice-daily and 1000 mg-twice-daily were one-third and more than half as effective at 24-weeks, respectively. T. bellerica extract may be considered a natural alternative for reducing serum uric acid levels. Trial registration This study was registered with the Clinical Trials Registry – India (CTRI) with the registration number: CTRI/2019/11/022093 [Registered on: 21/11/2019] Trial Registered Retrospectively.

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“…Abdominal obesity and insulin resistance have a significant role in MS development 19 . Recent studies have shown that patients with MS have significantly higher levels of high sensitive CRP, compared to the control group, which is a marker of chronic inflammation in patients with MS, whose values increased linearly with the increase number of factors for MS 20 . Obesity is characterized by elevated levels of inflammatory factors such as CRP and prothrombogenic factors such as fibrinogen, which occur before other MS disorders and are useful in the assessment of cardiovascular risk 21 .…”

Section: Discussionmentioning

confidence: 99%

The correlation between metabolic syndrome quantification scores and numerous laboratory parameters related to this syndrome

et al. 2020

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Background/Aim. Metabolic syndrome (MS) is characterized by basic cluster risk factors-waist circumference (WC), glucoregulation disorders, hypertension, hypertriglyceridemia, low HDL-cholesterol followed by associated factors such as insulin resistance (IR), C-reactive protein (CRP), uric acid, plasminogen activator inhibitor-1 (PAI-1), fibrinogen, hyperhomocysteinemia (HHcy), nonalcoholic fatty liver disease (NAFLD) and microalbuminuira. The aim of this study was to analyze basic and associated factors of MS in patients with and without MS as well as correlation of siMS score, siMS risk score with basic and confounding factors of MS. Methods. The study included 148 overweight [body mass index (BMI) 25-30 kg/m 2 and obese patients (BMI > 30 kg/m 2)], age 30-75 years, classified into two groups: I-with MS (68 patients); II-without MS (80 patients). For quantification of MS, siMS score was used as a method, and siMS risk score was used as atherosclerotic complications risk indicator. Results. Patients with MS had statistically higher values of WC, hypertension, triglycerides (p < 0.001), glycemia (p = 0.006), as well as values of associated factors of MS [homeostatic model assessment (HOMA-IR)] (p = 0.002), CRP (p = 0.01), uric acid (p < 0.001), alanin transaminase (ALT) (p = 0.007) i gammaglutamyl transferase (GGT) (p = 0.001) and lower values of HDL-cholesterol (p < 0.001) compared to patients without MS. siMS score has shown correlation with associated factors of MS (log HOMA IR, logCRP, uric acid, (p < 0.001), fibrinogen (p = 0.005), liver enzymes logALT (p = 0.001) and log GGT (p < 0.001) and renal parametars (creatinine (p = 0.013) and serum protein (p = 0.006). siMS risk score correlated significantly with homocysteine, platelets, uric acid, blood urea nitrogen, albumins and proteins. Conclusion. In our study we found that patients with MS had higher values of associated factors of MS (HOMA-IR, CRP, uric acid, ALT, GGT), which was confirmed by correlation with siMS score. siMS score further indicated that IR, CRP, fibrinogen, uric acid and NAFLD are associated factors of MS. siMS risk score is another score that indicated that obesity and hyperprotein diet aggravates HHCy with age, increasing the risk for renal dysfunction and promoting atherosclerotic complications.

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High sensitivity C-reactive protein in metabolic syndrome

Cited by 7 publications

References 8 publications

Role of non-lipid risk factors like hs-CRP, uric acid and thyroid stimulating hormone in metabolic syndrome

Role of non-lipid risk factors like hs-CRP, uric acid and thyroid stimulating hormone in metabolic syndrome

A randomized, double-blind, positive-controlled, prospective, dose-response clinical study to evaluate the efficacy and tolerability of an aqueous extract of Terminalia bellerica in lowering uric acid and creatinine levels in chronic kidney disease subjects with hyperuricemia

The correlation between metabolic syndrome quantification scores and numerous laboratory parameters related to this syndrome

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