scholarly journals NGAL Correlates with Femoral and Carotid Plaque Volume Assessed by Sonographic 3D Plaque Volumetry

2020 ◽  
Vol 9 (9) ◽  
pp. 2811
Author(s):  
Michael Schreinlechner ◽  
Maria Noflatscher ◽  
Daniela Lener ◽  
Axel Bauer ◽  
Rudolf Kirchmair ◽  
...  

Background/Objectives: Inflammation represents a cornerstone in the development of atherosclerosis and early detection is essential to avoid cardiovascular events. Biomarkers like interleukin-1 beta, interleukin-6, or high sensitivity CRP (hs-CRP) have been investigated intensively in this field. Since they have several limitations, additional biomarkers are needed for cardiovascular risk stratification. The acute phase protein, neutrophil gelatinase-associated lipocalin (NGAL), modulates inflammation and is elevated in cardiovascular disease (CVD). Moreover, it contributes to plaque destabilization. Methods: In this prospective, single-center study, we included 323 asymptomatic patients with at least one cardiovascular risk factor or established CVD. NGAL levels were measured in plasma samples using a commercially available ELISA. Carotid, femoral, and total atherosclerotic plaque volumes (PV) were measured using a 3D ultrasound system (Philips iU22). Patients were separated into a low (n = 243) and high (n = 80) total PV group. Results: NGAL was significantly higher in patients with high total PV versus patients with low total PV. The NGAL amplitude for the prediction of high total PV was significantly higher when compared with hs-CRP. A high predictive value could also be observed for patients without established CVD. Conclusion: NGAL seems to be a promising biomarker for the identification of asymptomatic patients with atherosclerotic disease.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1428.2-1428
Author(s):  
V. Valinotti ◽  
A. Paats ◽  
R. Acosta ◽  
L. Roman ◽  
I. Acosta-Colman ◽  
...  

Background:The mechanism of increased cardiovascular risk in RA is not well understood and is independent of traditional CV risk factors. Intima-media thickness of the common carotid wall measured by ultrasonogram is a safe and useful biomarker of early stage atherosclerosis that correlates with coronary involvement; and it correlates with severity and duration of disease. Several studies have shown a relationship between inflammation markers, endothelial dysfunction markers, and carotid involvement. (1)Objectives:To determine the presence of inflammation biomarkers and its relationship with subclinical atherosclerosis measured by carotid ultrasound, and with the clinical characteristics in patients with established Rheumatoid Arthritis (RA)Methods:Descriptive, cross sectional, prospective study, in a Paraguayan cohort of patients with RA meeting ACR/EULAR2010 criteria. This study had two phases: the first one, included a standardized questionnaire according to the variables included in the Cardiovascular Risk project (PINV15-0346), from the National Sciences and Technology Council (CONACYT), and physical examination; the second one included laboratory sample collection performed by a specialized laboratory for serum biomarkers measurement for cardiovascular risk prediction (i.e endothelin, alpha-TNF, E-selectin, homocysteine, apolipoprotein, fibrinogen, and high sensitivity-CRP levels) and carotid ultrasound evaluation by a trained specialist, to evaluate subclinical atherosclerosis. Subclinical atherosclerosis was defined as carotid intima-media thickness (CIMT) >0,9mm and/or presence of carotid plaques. All patients signed informed consent. SPSS 23rd version was used for data analysis. Quantitative variables were presented as means and qualitative as frequencies. Chi square test was performed for comparisons between dichotomous variables and t Student for continuous, and p ≤ 0.05 for statistical significance.Results:100 patients were included, 87% were women, mean disease duration 130.9±102.64 months, 77% were RF positive, and 84.4% were ACPA positive, 43.4% had bone erosions, mean ESR-DAS28 was 3,42±1,1; 30% had remission criteria. 39% had extra-articular manifestations.Elevated serum biomarkers were found: fibrinogen >400 mg/dL 88.2%, high sensitivity-CRP (hs-CRP) >5mg/dL 42.9%, endothelin >2 ng/mL 20%, alpha-TNF >15,6 pg/mL 13.1%, E-selectin >79,2 ng/mL 6%. 25.3% had CIMT >0,9 mm and mean CIMT was 0.68±0.25mm. 27.14% had carotid plaques. Patients with CIMT>1mm had higher frequency of family history of arterial hypertension (p=0.006), greater mean disease duration (p=0.0007), hip circumference (p=0.014), blood pressure (SBP p=0.038, DBP p=0.027), HAQ levels (p=0,019) and hs-CRP levels (p=0.013), also lower mean height (p=0,04); while carotid plaques were related to higher homocysteine (p=0.026) and hs-CRP levels (p=0.024).Conclusion:A considerable percentage of patients had subclinical atherosclerosis. Patients with CIMT>0,9mm had a longer disease duration, higher HAQ levels, hip circumference, as well as higher BP. High levels of hs-CRP were more frequently related to the presence of subclinical atherosclerosisReferences:[1]Aday, A. targeting residual inflammatory risk: a shifting paradigm for atherosclerotic disease. Frontiers in cardiovascular medicine. 2019. 6:16.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6403155/pdf/fcvm-06-00016.pdfDisclosure of Interests:None declared


2019 ◽  
Vol 45 (1) ◽  
pp. 51-56
Author(s):  
Songul Ozyurt ◽  
Mevlut Karatas ◽  
Medeni Arpa ◽  
Bilge Yilmaz Kara ◽  
Hakan Duman ◽  
...  

Abstract Objective Pulmonary thromboembolism (PTE) is a clinical condition that can be lethal unless promptly diagnosed and treated. The objective was to evaluate the significance of serum neutrophil gelatinase-associated lipocalin (NGAL) in the diagnosis of PTE. Materials and methods In this study, 60 patients hospitalized for acute PTE between May 2015 and December 2016 were enrolled. PTE was diagnosed using spiral computed tomography angiography of the thorax. Cardiac enzyme levels, arterial blood gas, and echocardiography measurements were performed. Whole blood samples were drawn to measure serum NGAL before treatment. Results The PTE group comprised 34 women and 26 men, and the healthy control group included 22 women and 18 men. The mean ages of the patient and control groups were 70.3 ± 14.4 years and 69.0 ± 10.2 years, respectively. Serum NGAL was significantly higher in the patients than in the controls (88.6 ± 33.6 vs. 31.7 ± 10.0 ng/mL, p < 0.001, respectively). The optimal NGAL cut-off value was >50 ng/mL, the sensitivity was 100%, specificity was 98.3%, the negative predictive value was 100%, and the positive predictive value was 68%. Conclusion Serum NGAL is a new biomarker with high sensitivity and specificity to detect, diagnose, and exclude PTE.


2020 ◽  
Vol 5 (3) ◽  
pp. 676
Author(s):  
Rama Dhanivita Djamin

<p><em>Obesitas terjadi karena akumulasi lemak berlebih di dalam tubuh. Akumulasi lemak menimbulkan low grade inflammation pada jaringan adiposa, menyebabkan peningkatan sitokin inflamasi seperti tumor necrosis factor-alpha, interleukin-1 beta, dan interleukin-6 (IL-6). Peningkatan sekresi IL-6 merangsang hepar meningkatkan produksi protein fase akut. High sensitivity C-reactive protein (hs-CRP) sebagai penanda inflamasi merupakan protein fase akut. Low density lipoprotein (LDL-kolesterol) adalah lipoprotein yang paling banyak mengandung kolesterol. Peningkatan kadar hs-CRP dan kadar LDL-kolesterol pada obesitas diidentifikasi sebagai faktor risiko aterosklerosis. Penelitian ini bertujuan menganalisis hubungan hs-CRP dengan LDL-kolesterol pada penyandang obes, merupakan penelitian analitik rancangan potong lintang dilakukan  September 2018 sampai Agustus 2019. Kadar hs-CRP diperiksa dengan metode enzyme linked immunoassay (ELISA), sedangkan kadar LDL-kolesterol dengan metode kalkulasi (rumus Friedewald). Uji korelasi Spearman digunakan untuk menganalisi data, jika didapatkan nilai p&lt;0,05 korelasi dinyatakan bermakna. Subjek penelitian berjumlah 26 penyandang obes terdiri dari 6 laki-laki (23,1%) dan 20 perempuan (76,9%). Rerata umur subjek penelitian adalah 36,46(7,68) tahun. Rerata kadar hs-CRP dan kadar LDL-kolesterol adalah 5,08(1,28) mg/L dan  154,69(45,8) mg/dL. Analisis korelasi menunjukkan korelasi positif lemah dan tidak bermakna secara statistik antara kadar hs-CRP dengan kadar LDL-kolesterol (r= 0,333, p=0,096). Simpulan: Terdapat korelasi positif lemah antara kadar hs-CRP dengan kadar LDL-kolesterol pada penyandang obes.</em></p><p><strong><em>Kata kunci</em></strong><em>: </em><em>Obesitas, High Sensitivity C-Reactive, Low Density Lipoprotein</em><em></em></p>


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Jong Weon Choi ◽  
Tatsuyoshi Fujii ◽  
Noriyoshi Fujii

The aim of this study was to assess the significance of the neutrophil gelatinase-associated lipocalin/serum creatinine ratio (NGAL/sCr ratio) in patients with renal dysfunction. The percent difference between plasma NGAL level and the NGAL/sCr ratio was 36.7% (95% CI, 18.4–83.7%) in patients with sCr level ≥ 1.2 mg/dL. In a multivariate analysis, high sensitivity C-reactive protein (hsCRP) was significantly associated with the NGAL/sCr ratio and plasma NGAL level (r=0.526andr=0.453, resp.,P<0.001). In a receiver operating characteristics curve, the diagnostic ability of the NGAL/sCr ratio to identify hsCRP > 4.0 mg/dL was superior to that of NGAL [0.783 (95% CI, 0.674–0.892) versus 0.733 (95% CI, 0.615–0.852),P=0.032]. The area under the curve of the NGAL/sCr ratio was larger than that of hsCRP to detect corrected erythrocyte sedimentation rate > 25 mm/h and the neutrophil-to-lymphocyte ratio >4.5 in renal dysfunction. In short, the NGAL/sCr ratio may offer useful information when screening patients with both systemic inflammation and renal dysfunction.


2007 ◽  
Vol 2007 ◽  
pp. 1-8 ◽  
Author(s):  
Juha Saltevo ◽  
Mauno Vanhala ◽  
Hannu Kautiainen ◽  
Esko Kumpusalo ◽  
Markku Laakso

This Finnish population-based study, mean age 46 years, evaluates the association of high-sensitivity C-reactive protein (hs-CRP), interleukin-1 receptor antagonist (IL-1Ra), and adiponectin with the NCEP and IDF definitions of metabolic syndrome (MetS). Adiponectin levels were higher, hs-CRP and IL-1Ra levels lower in subjects without MetS compared to subjects with MetS. If MetS was present according to both IDF and NCEP criteria, BMI, waist, triglycerides, hs-CRP, and IL-1Ra were significantly higher compared to subjects who had MetS according to either only IDF or only NCEP criteria. The hs-CRP, IL-1Ra, and adiponectin linearly correlated with the number of the components of MetS according to both definitions. Decreased levels of adiponectin and increased levels of hs-CRP and IL-1Ra are tightly associated with the components of MetS. Individuals who had MetS according to both criteria had the most adverse changes in cardiovascular risk factors.


2021 ◽  
pp. 10-10
Author(s):  
Gabrijela Malesevic ◽  
Snjezana Popovic-Pejicic ◽  
Aleksandra Markovic ◽  
Bojana Caric ◽  
Valentina Soldat-Stankovic

Background/Aim. A special feature of Coronary Heart Disease (CHD) in patients with type 2 diabetes (T2D) is that it is often asymptomatic and occurs as a consecuence of cardiovascular auotonomic neuropathy. Dysregulation of the autonomic nervous system is associated with elevated values of inflammatory markers such as highly sensitive C-reactive protein (hs-CRP) and interleukin 6 (IL-6) which accelerate atherosclerosis and the occurrence of cardiovascular complications in patients with T2D. The aim of the study was to evaluate the importance of determining inflammatory cardiovascular risk markers IL-6 and hs-CRP in screening for the presence of CHD in asymptomatic patients with T2D. Methods: The study included 169 patients with T2D, without any symptoms and signs of CHD. Ergometric testing proved or ruled out the presence of silent CHD. The levels of hs-CRP and IL-6 were determined by ELISA. Results: IL6 values were significantly higher in patients with positive ergometric test (6.83?1.99 pg/mL) compared to patients with negative ergometric test (3.04?1.39 pg/mL) (p<0.001). We also found that hs-CRP values in patients with positive ergometric test was significantly higher in comparison to patients with negative ergometric test (6.37?2.25 vs 1.67?1.41 mg/L; p <0.001). Combinations of IL-6 and hs-CRP with age, HbA1c values and duration of diabetes, presented through three binary logistic regression models, are significant predictors of silent CHD proven by ergometric testing, i.e. with their increase in the probability of positive ergometric testing increased too (p <0.01). The sensitivity of the associated finding of elevated IL-6 and hs-CRP values in the detection of silent CHD by ergometric testing was 90% and the specificity was 86%. Conclusion: hs-CRP and IL-6 are significant predictors of silent CHD, and their determination could be recommended in improving cardiovascular risk stratification in asymptomatic patients with T2D.


2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Binbin Wu ◽  
Jianghua Chen ◽  
Yi Yang

Cardiac surgery-associated acute kidney injury (CSA-AKI) is a major and serious complication in patients undergoing cardiac surgery and is independently associated with perioperative mortality and mortality. Therapeutic intervention aiming at reversing kidney dysfunction seems disappointing across multiple settings. Consequently, attention has shifted from treatment to prevention and early detection. The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines have unified diagnostic standards mainly based on the serum creatinine (Scr) level or urine output, but neither marker is kidney specific. Efforts have been made to identify novel biomarkers with high sensitivity and specificity. The diagnostic capabilities of neutrophil gelatinase-associated lipocalin (NGAL) and G1 cell cycle arrest biomarker as biomarkers have been confirmed in a large number of clinical trials. The utility of biomarkers of cardiac function and inflammation has been validated in clinical studies. Aiming to offer valuable information for further research, we summarize the progress in defining current markers relevant to CSA-AKI in the last three years.


2014 ◽  
Vol 80 (10) ◽  
pp. 1044-1048
Author(s):  
Alana Gebhart ◽  
Monica Young ◽  
James Villamere ◽  
Anderson Shih ◽  
Ninh T. Nguyen

Obesity, hypertension, diabetes, and hyperlipidemia are risk factors for the development of coronary artery disease. High-sensitivity C-reactive protein (hs-CRP) is an inflammatory biomarker that has been shown to be an independent predictor for cardiovascular risk. The aim of the current study was to examine the changes in cardiovascular risk profile in morbidly obese patients who underwent laparoscopic gastric stapling procedures (bypass and sleeve) compared with laparoscopic gastric banding. Levels of hs-CRP were measured preoperatively and at 12 to 24 months post-operatively. Based on hs-CRP levels, cardiovascular risk was categorized as low (less than 1 mg/L), moderate (1 to 3 mg/L), or high (greater than 3 mg/L). A total of 52 patients underwent gastric stapling procedures and 49 underwent gastric banding and both had preoperative and postoperative hs-CRP levels measured. There were no significant differences in age, gender, or preoperative body mass index (BMI) between groups. At baseline, 48.0 per cent of patients undergoing gastric stapling and 38.8 per cent of patients undergoing gastric banding had moderate or high cardiovascular risk. BMI at 24 months was significantly lower in the gastric stapling compared with the gastric banding group (30.4 ± 5.4 vs 36.1 ± 5.5 kg/m2, respectively, P < 0.01). Of the patients with elevated cardiovascular risk, 64.0 per cent of gastric stapling versus 57.8 per cent of gastric banding patients had a reduction in risk category at 12 to 24 months follow-up, whereas 1.9 per cent of patients undergoing gastric stapling versus 4.1 per cent of patients undergoing gastric banding had an increase in risk category. The mean reduction in hs-CRP level for patients with elevated cardiovascular risk was greater for gastric stapling compared with gastric banding procedures (-1.10 ± 0.94 mg/L vs -0.67 ± 0.82 mg/L, respectively, P < 0.05). Cardiovascular risk improved in the majority of patients after bariatric surgery, but a more pronounced improvement occurred in patients who underwent gastric stapling procedures.


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