Comparison of homocysteine and c-reactive protein levels determined at the moment of hospitalization in patients with acute coronary syndrome (ACS) with and without type 2 diabetes

Abstract Background Brain-derived neurotrophic factor (BDNF) is a neurotrophine that plays a key role in the regulation of both central and peripheral nervous system. Moreover, BDNF is secreted in multiple tissues and exerts systemic, autocrine, and paracrine effects in the cardiovascular system. Of importance, BDNF expression was enhanced in macrophages and smooth muscle cells in atherosclerotic coronary arteries and may be involved in thrombus formation. Thus, BDNF has been suggested as an important link between inflammation and thrombosis, potentially involved in the pathogenesis of acute coronary syndrome (ACS). Purpose In our study we aimed at assessing serum levels of BDNF in patients with ACS, evaluating differences according to clinical presentation [ST-segment elevation myocardial infarction (STEMI) vs. Non-ST-segment elevation ACS (NSTE-ACS)]. Moreover, we assessed the presence of optical coherence (OCT)-defined macrophage infiltrates (MØI) in the culprit vessel of ACS patients and evaluated their relationship with BDNF levels. Methods ACS patients were prospectively selected. Blood samples were collected at admission and serum levels of BDNF were subsequently assessed. Presence of OCT-defined MØI along the culprit vessel was assessed. Results 166 ACS patients were enrolled [mean age 65.3±11.9 years, 125 (75.3%) male, 109 STEMI, 57 NSTE-ACS]. Serum levels of BDNF were higher among STEMI patients compared with NSTE-ACS [median (IQR) 2.48 pg/mL (1.54–3.34) vs. 2.12 pg/mL (1.34–2.47), p=0.007], while C-reactive protein levels did not differ between the two groups. OCT assessment was performed in 53 patients and MØI were detected in 27 patients. Of importance, patients with MØI in the culprit vessel had higher levels of BDNF compared with patients without MØI [median (IQR) 2.23 pg/mL (1.38–2.53) vs. 1.41 pg/mL (0.93–2.07), p=0.023], while C-reactive protein levels did not differ between the two groups. Of note, at multivariate regression analysis BDNF levels were independent predictor of MØI [OR: 2.20; 95% CI (1.02–4.74), p=0.043]. Conclusions Serum levels of BDNF may reliable identify the presence of local macrophage inflammatory infiltrates in patients with ACS. Moreover, BDNF levels are higher in patients with STEMI compared with NSTE-ACS. Taken together, these data suggest that BDNF may represent an interesting link between local inflammatory activation and enhanced thrombosis in ACS. BDNF serum levels Funding Acknowledgement Type of funding source: None

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Abstract P137: Aerobic, Resistance or Combination Exercise Training does not Reduce C-Reactive Protein Levels in Individuals with Type 2 Diabetes

Circulation ◽

10.1161/circ.125.suppl_10.ap137 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Damon L Swift ◽

Neil M Johannsen ◽

Conrad P Earnest ◽

Steven N Blair ◽

Timothy S Church

Keyword(s):

Type 2 Diabetes ◽

Exercise Training ◽

Aerobic Exercise ◽

Fat Mass ◽

Fasting Glucose ◽

Aerobic Exercise Training ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein

Introduction: Type 2 diabetes is associated with elevated C-reactive protein levels (CRP), which is an independent risk factor for cardiovascular disease. Aerobic exercise training especially with weight/adiposity reduction has been shown to improve CRP, however few studies have evaluated the effect of other exercise training modalities (aerobic, resistance or combination training) on CRP in individuals with type 2 diabetes. Hypothesis: We hypothesize that combination training will improve CRP to a greater extent than other modalities of exercise training, and change in CRP levels will be associated with changes in weight and adiposity. Methods: The present study is a secondary analysis of the Health Benefits of Aerobic and Resistance Training in Individuals with Type 2 Diabetes (HART-D) study. Participants (n=204) were randomized to aerobic exercise (aerobic), resistance exercise (resistance) or a combination of both (combination) for nine months. Results: Baseline CRP was correlated with fat mass, waist circumference, BMI, and inversely correlated with VO2 peak (p<0.05). CRP was not reduced in the aerobic (0.16 mg•L-1, 95% CI: -1.0, 1.3), resistance (-0.03 mg•L-1, 95% CI: -1.1, 1.0) or combination (-0.49 mg•L-1, 95% CI: -1.5 to 0.6) groups compared to control (0.35 mg•L-1, 95% CI: -1.0, 1.7). Change in CRP was associated with change in fasting glucose (r=0.20, p= 0.009), glycated hemoglobin (HbA1C) (r=0.21 p=0.005), and fat mass (r=0.19, p=0.016), but not change in fitness or weight (p > 0.05). Conclusions: In conclusion, aerobic, resistance or a combination of both did not reduce CRP levels in individuals with type 2 diabetes. However, exercise related improvements in HbA1C, fasting glucose, and fat mass were associated with reductions in CRP.

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Obesity and Serum High Sensitivity C-Reactive Protein Levels Among Elderly Turkish Immigrants in the Netherlands with Type 2 Diabetes

Ageing International ◽

10.1007/s12126-012-9149-0 ◽

2012 ◽

Vol 39 (1) ◽

pp. 68-80 ◽

Cited By ~ 1

Author(s):

Shiryn D. Sukhram ◽

Gustavo G. Zarini ◽

Lamya H. Shaban ◽

Joan A. Vaccaro ◽

Fatma G. Huffman

Keyword(s):

Type 2 Diabetes ◽

The Netherlands ◽

High Sensitivity ◽

C Reactive Protein ◽

Turkish Immigrants ◽

Protein Levels ◽

Reactive Protein

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Evaluation of Ischemia-Modified Albumin and C-Reactive Protein in Type 2 Diabetics with and without Ketosis

Biomarker Insights ◽

10.4137/bmi.s9060 ◽

2012 ◽

Vol 7 ◽

pp. BMI.S9060 ◽

Cited By ~ 7

Author(s):

Shao-gang Ma ◽

Yao Jin ◽

Wen Hu ◽

Feng Bai ◽

Wen Xu ◽

...

Keyword(s):

Type 2 Diabetes ◽

Diabetic Patients ◽

C Reactive Protein ◽

Type 2 Diabetic Patients ◽

Ischemia Modified Albumin ◽

Protein Levels ◽

Reactive Protein ◽

Diabetic Ketosis ◽

Type 2 Diabetics

Overview To investigate whether serum ischemia-modified albumin or C-reactive protein is reliable for predicting type 2 diabetic patients with ketosis. Approach One hundred and four diabetic patients, 48 with diabetic ketosis, and 33 controls were enrolled in the study. Serum ischemia-modified albumin and C-reactive protein were measured and evaluated for their ability to distinguish diabetic ketosis. Results Compared to the controls, the ischemia-modified albumin and C-reactive protein levels were higher in patients with diabetic ketosis and type 2 diabetes at the baseline. The levels of ischemia-modified albumin were higher in patients with type 2 diabetes than in the controls. C-reactive protein and ischemia-modified albumin levels were reduced after insulin treatment. The level of ischemia-modified albumin was an independent risk marker for diabetic ketosis ( OR = 1.085, P = 0.008, 95% CI: 1.022–1.152). Receiver operating characteristic curves revealed that the areas under the curve were 0.917 for the modified albumin and 0.357 for C-reactive protein. Conclusion This study indicates that ischemia-modified albumin was significantly associated with diabetic ketosis and was more sensitive than C-reactive protein in reflecting diabetic ketosis.

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