Evidence for the use of the Alere Afinion™ AS100 for measuring the levels of C-reactive protein in an elderly South African population

Introduction: This study evaluated the performance of the Alere Afinion™ AS100 analyser for the measurement of C-reactive protein (CRP) levels in a population of older adults from South Africa. Methods: This study was a sub-study of the Sexual Health, HIV infection and comorbidity with non-communicable diseases among Older Persons (SHIOP) study. The median age of SHIOP participants was 61 years (interquartile range 12). Serum samples collected through SHIOP were used to measure CRP levels on the Alere Afinion™ AS100 (Point-of-care) and ABX Pentra 400 (reference method), respectively. Bland–Altman analysis and Lin’s concordance correlation coefficients were used to assess the agreement between the two analysers. Results: A total of 183 serum samples were tested in the study. The Alere Afinion™ AS100 median values for CRP were 9.5 mg/L and 11.5 mg/L in women and men respectively (p = 0.275). The ABX Pentra 400 median levels were lower with 5.6 mg/L and 3.6 mg/L for women and men (p = 0.027), respectively. Bland–Altman analysis and linear regression analysis showed an excellent correlation between the Pentra and Afinion analysers, with a Lin’s concordance correlation coefficient of 0.971. The Alere Afinion™ AS100 was able to correctly classify > 90% (165/183) of the CRP results when compared to the ABX Pentra 400. Conclusion: This study showed that the Alere Afinion™ AS100 had an excellent correlation with a standard laboratory method. However, the Afinion™ AS100 did not correlate well at elevated CRP levels. This may not be clinically significant since the cut-points for CVD risk are at much lower levels.

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FRI0420 ASSOCIATION BETWEEN RED BLOOD CELLS DISTRIBUTION WIDTH AND CARDIOVASCULAR RISK IN OSTEOARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2647 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 808.2-808

Author(s):

N. Hammam ◽

G. Salem ◽

D. Fouad ◽

S. Rashad

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Functional Limitations ◽

Functional Limitation ◽

C Reactive Protein ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Distribution Width ◽

Reactive Protein ◽

Lipid Panel

Background:Osteoarthritis (OA) is the most common joint disease that results in patient’s morbidity and disabilities. There is strong evidence that OA is a significant risk factor for cardiovascular disease (CVD). Red cell distribution width (RDW) blood test is a measure of the variation in red blood cell volume and size. Elevated RDW has recently been found to correlate with CVD risk in patients with and without heart disease and autoimmune diseases. RDW may be a marker for factors driving CVS risk.Objectives:: To investigate whether RDW can serve as a potential parameter for indicating cardiovascular risk in OA patients.Methods:A subsample of 819 OA patients was extracted from 2003-2006 National Health & Nutrition Examination Survey in a cross-sectional study. 63.7% of them were females. Their mean age was 66.4 ± 14.1 yrs. Demographic, medical data, inflammatory markers & lipid panel were obtained. Only patients with Haemoglobin>12 mg/dl were included. Functional limitations were assessed using a physical function questionnaire.Results:Elevated levels of RDW were associated with CVD risk factors in OA patients. 532 (65.8%) OA patients had functional limitations, while 78 (9.5%) and 63 (7.6%) known to have heart attacks or stroke ever. Mean RDW was 12.9±1.1fL. There was a positive significant correlation between RDW & CVD risk factors including body mass index (r=0.17, p<0.001), C-reactive protein (r=0.29, p<0.001), serum uric acid (r=0.12, p<0.001), and functional limitation (0.16, p<0.001). No significant association between RDW & lipid panel was found. In multiple regression analysis controlling for age, sex as covariates, body mass index (β =0.02, 95%CI: 0.01, 0.03, p=0.002), C-reactive protein (β =0.35, 95%CI: 0.26, 0.45, p<0.001), and functional limitation (β =0.18, 95%CI: 0.13, 0.35, p=0.03).Conclusion:In addition to known CVD risk in OA patients, elevated RDW levels should prompt physicians to aggressively screen and treat their patients for modifiable CVS risk factors, in addition to OA.Disclosure of Interests:None declared

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Siphon-Controlled Automation on a Lab-on-a-Disc Using Event-Triggered Dissolvable Film Valves

Biosensors ◽

10.3390/bios11030073 ◽

2021 ◽

Vol 11 (3) ◽

pp. 73

Author(s):

Brian D. Henderson ◽

David J. Kinahan ◽

Jeanne Rio ◽

Rohit Mishra ◽

Damien King ◽

...

Keyword(s):

Risk Factor ◽

Limit Of Detection ◽

C Reactive Protein ◽

Cvd Risk ◽

Low Resource Settings ◽

Low Resource ◽

Reactive Protein ◽

Limit Of Quantitation ◽

Chemiluminescent Immunoassay ◽

Event Triggered

Within microfluidic technologies, the centrifugal microfluidic “Lab-on-a-Disc” (LoaD) platform offers great potential for use at the PoC and in low-resource settings due to its robustness and the ability to port and miniaturize ‘wet bench’ laboratory protocols. We present the combination of ‘event-triggered dissolvable film valves’ with a centrifugo-pneumatic siphon structure to enable control and timing, through changes in disc spin-speed, of the release and incubations of eight samples/reagents/wash buffers. Based on these microfluidic techniques, we integrated and automated a chemiluminescent immunoassay for detection of the CVD risk factor marker C-reactive protein displaying a limit of detection (LOD) of 44.87 ng mL−1 and limit of quantitation (LoQ) of 135.87 ng mL−1.

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Serum C-Reactive Protein and Interleukin-6 Levels as Biomarkers for Disease Severity and Clinical Outcomes in Patients with Idiopathic Granulomatous Mastitis

Journal of Clinical Medicine ◽

10.3390/jcm10102077 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2077

Author(s):

Yi-Min Huang ◽

Chiao Lo ◽

Chiao-Feng Cheng ◽

Cheng-Hsun Lu ◽

Song-Chou Hsieh ◽

...

Keyword(s):

Disease Severity ◽

Severe Disease ◽

Linear Regression Analysis ◽

Multiple Linear Regression Analysis ◽

Serum Biomarkers ◽

Healthy Controls ◽

Granulomatous Mastitis ◽

C Reactive Protein ◽

Idiopathic Granulomatous Mastitis ◽

Reactive Protein

Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease mimicking breast cancer. Limited research has been conducted on the application of serum biomarkers. This study aims to investigate the association of serum biomarkers with disease severity in patients with IGM. From November 2011 to March 2020, medical records of patients with IGM were reviewed. Serum cytokine levels were measured in patients and healthy controls between July 2018 and March 2020. A total of 41 patients with histologically proven IGM were found. Serum interleukin (IL)-6 level was significantly higher in patients with IGM (n = 11) than healthy controls (n = 7). Serum IL-6 and C-reactive protein (CRP) levels were significantly higher in patients with severe disease than mild and moderate disease. Serum IL-6 (Spearman’s ρ = 0.855; p < 0.001) and CRP (Spearman’s ρ = 0.838; p = 0.001) levels were associated with time to resolution. A higher serum CRP level was associated with a longer time to resolution (B = 0.322; p < 0.001) in multiple linear regression analysis. Serum IL-6 and CRP levels can be used as biomarkers for the evaluation of disease severity in IGM. IL-6 may play a crucial role in the immunopathology of IGM.

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Abstract P292: Severe Obesity is Associated with Dramatic Increase in Cardiovascular Disease Risk Factor Prevalence: Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Circulation ◽

10.1161/circ.127.suppl_12.ap292 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Robert Kaplan ◽

Larissa M Avilés-Santa ◽

Christina M Parrinello ◽

Sheila Castañeda ◽

Arlene L Hankinson ◽

...

Keyword(s):

Risk Factors ◽

Class Ii ◽

Normal Weight ◽

Class Iii ◽

C Reactive Protein ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Total N ◽

Reactive Protein ◽

Class Iii Obesity

Introduction: Prevalence of severe obesity is increasing, especially among the young Hispanic population. Methods: In the HCHS/SOL cohort of 18-74 year old US Hispanics, we examined gradients across BMI and age in CVD risk factors. Results: Approximately one in five males (total N = 6,547) and one in ten females (total N=9,797) met criteria for class II obesity (BMI 35 - 40 kg/m 2 ) or class III obesity (BMI ≥ 40 kg/m 2 ). The prevalence of hypertension, diabetes, and elevated C-reactive protein rose with each successive class of overweight/obesity. In contrast, the prevalence of elevated levels of total cholesterol, LDL-c and triglycerides increased across normal weight, overweight (BMI 25 - 30 kg/m 2 ), and class I obese (BMI 30 - 35 kg/m 2 ) groups, but did not increase in frequency across class I, class II, and class III obesity groups. The Figure depicts isolines that identify age- specific subgroups of the normal-weight and class II - III obese groups that had the same estimated prevalence of CVD risk factors, with 95 percent confidence intervals. Among young adults with class II or III obesity, the prevalence of hypertension, diabetes, and the combination of three or more CVD risk factors was similar to that among normal-weight individuals (BMI 18.5 - 25 kg/m 2 ) who were 15 to 30 years older. Among young obese individuals, the prevalence of low HDL-c levels and high C-reactive protein levels exceeded that among the oldest adults in the cohort. CVD risk factors had stronger, more consistent gradients across the BMI categories among men than among women. Conclusion: Class II and III obesity, defined as BMI ≥ 35 kg/m 2 , are common in the Hispanic/Latino population. Young adults with these severe forms of obesity have dramatically increased frequency of cardiometabolic risk factors. The age-related accumulation of multiple CVD risk factors, such as is typically seen in normal-weight individuals, is accelerated by 1-2 decades in severly overweight women and by 2-3 decades in severely overweight men.

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Abstract P139: Association of Energy Flux with Change in Cardiovascular Risk Factors in Weight Stable Individuals

Circulation ◽

10.1161/circ.133.suppl_1.p139 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Baqiyyah Conway ◽

Peter Giacobbi ◽

Clemens Drenowatz ◽

Stephen Blair ◽

Gregory Hand

Keyword(s):

Risk Factors ◽

Energy Flux ◽

Impaired Fasting Glucose ◽

Fasting Glucose ◽

Exercise Group ◽

C Reactive Protein ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Reactive Protein ◽

Group Assignment

Background: It is generally accepted that body weight is maintained when there is energy balance between intake and expenditure. Energy balance can be achieved at different rates of expenditure through exercise and caloric intake which has been referred to as energy flux: high flux reflects high expenditure and high intake while low flux describes low energy expenditure and intake. Overweight, obesity, and diabetes are major risk factors for cardiovascular disease and CVD risk factors tend to increase with hyperglycemia and BMI. Exercise is a viable way to achieve weight maintenance, however, there is limited data about the role of energy flux on CVD risk factors when individuals maintain their body weight. We investigated the effect of energy flux and change in energy flux on CVD risk factors in when body weight is maintained. Methods: One hundred and thirteen overweight or obese class I adults ages 21 to 45 were randomized to a control group, moderate exercise (17.5 kcal/kg/week) or high exercise group (35 kcal/kg/week). The exercise groups performed supervised exercise at and intensity of 70-75% of their heart rate maximum. Impaired fasting glucose was defined as a fasting glucose of 100-125 mg/dL. General linear models were used to test the relationship of exercise intensity and impaired fasting glucose on change in energy flux from baseline to six months, as well as the relationship of 6-month change in energy flux with change in CVD risk factors, namely, HDLc, LDLc, vLDLc, total cholesterol, triglycerides, Apolipoprotein B (ApoB), and C-reactive protein. Results: Seventy-two percent of the population was overweight and 22% were obese. Mean change in energy flux from baseline to month six was 128.8 kcal/day. In multivariable analyses including age, sex, BMI, impaired fasting glucose, and energy expenditure group assignment, neither exercise group assignment nor baseline obesity status had any effect on change in energy flux, lipids, or inflammatory markers. Impaired fasting glucose was associated with a significantly greater increase in energy flux from baseline to six months (p=0.03). There was a stepwise change in C-reactive protein from baseline to six months, with a decrease (-2.46 mg/dL) in controls, a moderate increase (+0.32 mg/dL) in the moderate intensity exercise group and a larger increase (+0.82 mg/dL) in the very intensive exercise group, p= 0.03 for moderate intensity and p=0.02 for very intensive exercise groups compared to controls. Finally, increases in energy flux from baseline to six months were associated with increased ApoB (p=0.04), though there were no significant changes in energy flux by group assignment. Conclusion: Intensification of exercise and increases in energy flux while maintaining stable weight is associated with increases in certain cardiovascular risk factors, namely C-reactive protein and ApoB.

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Studying the Role of C-Reactive Protein in Patients with Sleeve Gastrectomy in Baghdad

Journal of Techniques ◽

10.51173/jt.v3i1.282 ◽

2021 ◽

Vol 3 (1) ◽

pp. 55-60

Author(s):

Mohammed Abbas Fadil ◽

Raya Ezat Maroof ◽

Moayed Abbas Fadil

Keyword(s):

Sleeve Gastrectomy ◽

Healthy Person ◽

Control Group ◽

C Reactive Protein ◽

Serum Samples ◽

Reactive Protein ◽

Medical City ◽

Healthy Control ◽

And Control

Obesity and severe obesity are increasing serious health problems with an epidemic percentage in most countries. In Sleeve gastrectomy, a part of the stomach structure is removed, limiting its capacity by about two to three. A total of thirty blood samples were collected from patients with obesity and the result was compared with healthy person throughout the time from November 2019 to September 2020. Before sleeve gastrectomy and after more than 6 months of sleeve surgery, the sample was collected from the Medical City/Baghdad Teaching Hospital, the withdrawal was again taken at home to have pre and post sleeve gastrectomy, Patient age ranged between [20-46] years for obese patients and healthy control. Then the serum samples were obtained from patients and control group to screen for C-reactive protein by agglutination method. The result of the present study found that the positivity of CRP in pre-operation is higher than that of post-operative with high significance [P<0.005].

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C-reactive Protein Is a More Sensitive and Specific Marker for Diagnosing Bacterial Infections in Systemic Lupus Erythematosus Compared to S100A8/A9 and Procalcitonin

The Journal of Rheumatology ◽

10.3899/jrheum.111044 ◽

2012 ◽

Vol 39 (4) ◽

pp. 728-734 ◽

Cited By ~ 45

Author(s):

HYOUN-AH KIM ◽

JA-YOUNG JEON ◽

JEONG-MI AN ◽

BO-RAM KOH ◽

CHANG-HEE SUH

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Bacterial Infections ◽

Area Under The Curve ◽

Specific Marker ◽

Operating Characteristics ◽

C Reactive Protein ◽

Systemic Lupus ◽

Serum Samples ◽

Reactive Protein

Objective.C-reactive protein (CRP), S100A8/A9, and procalcitonin have been suggested as markers of infection in patients with systemic lupus erythematosus (SLE). We investigated the clinical significance of these factors for indication of infection in SLE.Methods.Blood samples were prospectively collected from 34 patients with SLE who had bacterial infections and 39 patients with SLE who had disease flares and no evidence of infection. A second set of serum samples was collected after the infections or flares were resolved.Results.CRP levels of SLE patients with infections were higher than those with flares [5.9 mg/dl (IQR 2.42, 10.53) vs 0.06 mg/dl (IQR 0.03, 0.15), p < 0.001] and decreased after the infection was resolved. S100A8/A9 and procalcitonin levels of SLE patients with infection were also higher [4.69 μg/ml (IQR 2.25, 12.07) vs 1.07 (IQR 0.49, 3.05) (p < 0.001) and 0 ng/ml (IQR 0–0.38) vs 0 (0–0) (p < 0.001), respectively]; these levels were also reduced once the infection disappeared. In the receiver-operating characteristics analysis of CRP, S100A8/A9, and procalcitonin, the area under the curve was 0.966 (95% CI 0.925–1.007), 0.732 (95% CI 0.61–0.854), and 0.667 (95% CI 0.534–0.799), respectively. CRP indicated the presence of an infection with a sensitivity of 100% and a specificity of 90%, with a cutoff value of 1.35 mg/dl.Conclusion.Our data suggest that CRP is the most sensitive and specific marker for diagnosing bacterial infections in SLE.

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Obesity and Metabolic Phenotypes (Metabolically Healthy and Unhealthy Variants) Are Significantly Associated with Prevalence of Elevated C-Reactive Protein and Hepatic Steatosis in a Large Healthy Brazilian Population

Journal of Obesity ◽

10.1155/2015/178526 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 23

Author(s):

Sameer Shaharyar ◽

Lara L. Roberson ◽

Omar Jamal ◽

Adnan Younus ◽

Michael J. Blaha ◽

...

Keyword(s):

Hepatic Steatosis ◽

High Sensitivity ◽

Abdominal Ultrasound ◽

Normal Weight ◽

C Reactive Protein ◽

Cvd Risk ◽

Reactive Protein ◽

Metabolically Healthy Obese ◽

Metabolically Healthy ◽

Relationship Of

Background. Among the obese, the so-called metabolically healthy obese (MHO) phenotype is thought to confer a lower CVD risk as compared to obesity with typical associated metabolic changes. The present study aims to determine the relationship of different subtypes of obesity with inflammatory-cardiometabolic abnormalities.Methods. We evaluated 5,519 healthy, Brazilian subjects (43±10years, 78% males), free of known cardiovascular disease. Those with <2 metabolic risk factors (MRF) were considered metabolically healthy, and those with BMI ≥ 25 kg/m2and/or waist circumference meeting NCEP criteria for metabolic syndrome as overweight/obese (OW). High sensitivity C reactive protein (hsCRP) was measured to assess underlying inflammation and hepatic steatosis (HS) was determined via abdominal ultrasound.Results. Overall, 40% of OW individuals were metabolically healthy, and 12% normal-weight had ≥2 MRF. The prevalence of elevated CRP (≥3 mg/dL) and HS in MHO versus normal weight metabolically healthy group was 22% versus 12%, and 40% versus 8% respectively (P<0.001). Both MHO individuals and metabolically unhealthy normal weight (MUNW) phenotypes were associated with elevated hsCRP and HS.Conclusion. Our study suggests that MHO and MUNW phenotypes may not be benign and physicians should strive to treat individuals in these subgroups to reverse these conditions.

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Assessment of a dried blood spot C-reactive protein method to identify disease flares in rheumatoid arthritis patients

Scientific Reports ◽

10.1038/s41598-020-77826-0 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Leon G. D’Cruz ◽

Kevin G. McEleney ◽

Chris Cochrane ◽

Kyle B. C. Tan ◽

Priyank Shukla ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Joint Damage ◽

Reference Method ◽

Detection Sensitivity ◽

Dried Blood Spot ◽

Enzyme Linked Immunosorbent Assay ◽

C Reactive Protein ◽

Reactive Protein ◽

Deming Regression ◽

Blood Spot

AbstractRheumatoid arthritis (RA) is characterised by painful, stiff and swollen joints. RA features sporadic ‘flares’ or inflammatory episodes—mostly occurring outside clinics—where symptoms worsen and plasma C-reactive protein (CRP) becomes elevated. Poor control of inflammation results in higher rates of irreversible joint damage, increased disability, and poorer quality of life. Flares need to be accurately identified and managed. A method comparison study was designed to assess agreement between CRP values obtained by dried blood spot (DBS) versus conventional venepuncture sampling. The ability of a weekly DBS sampling and CRP test regime to detect flare outside the clinic was also assessed. Matched venepuncture and finger lancet DBS samples were collected from n = 100 RA patients with active disease at baseline and 6 weeks (NCT02809547). A subset of n = 30 RA patients submitted weekly DBS samples over the study period. Patient demographics, including self-reported flares were recorded. DBS sample CRP measurements were made by enzyme-linked immunosorbent assay, and venepuncture samples by a reference immunoturbometric assay. Data was compared between sample types by Bland–Altman and weighted Deming regression analyses. Flare detection sensitivity and specificity were compared between ‘minimal’ baseline and 6 week sample CRP data and the ‘continuous’ weekly CRP data. Baseline DBS ELISA assay CRP measures yielded a mean positive bias of 2.693 ± 8.640 (95% limits of agreement − 14.24 to 19.63%), when compared to reference assay data. Deming regression revealed good agreement between the DBS ELISA method and reference assay data, with baseline data slope of 0.978 and intercept -0.153. The specificity of ‘continuous’ area under the curve (AUC) CRP data (72.7%) to identify flares, was greater than ‘minimal’ AUC CRP data (54.5%). This study indicates reasonable agreement between DBS and the reference method, especially at low to mid-range CRP values. Importantly, longitudinal CRP measurement in RA patients helps to clearly identify flare and thus could assist in remote monitoring strategies and may facilitate timely therapeutic intervention.Trial registration: The Remote Arthritis Disease Activity MonitoR (RADAR) study was registered on 22/06/2016 at ClinicalTrials.gov Identifier: NCT02809547. https://clinicaltrials.gov/ct2/show/NCT02809547.

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Influence of apolipoprotein E genotype and dietary α-tocopherol on redox status and C-reactive protein levels in apolipoprotein E3 and E4 targeted replacement mice

British Journal Of Nutrition ◽

10.1017/s000711450788634x ◽

2008 ◽

Vol 100 (1) ◽

pp. 44-53 ◽

Cited By ~ 10

Author(s):

Laia Jofre-Monseny ◽

Patricia Huebbe ◽

Inken Stange ◽

Christine Boesch-Saadatmandi ◽

Jan Frank ◽

...

Keyword(s):

Apoe Genotype ◽

Positive Association ◽

Thiobarbituric Acid ◽

Redox Status ◽

C Reactive Protein ◽

Cvd Risk ◽

Reactive Protein ◽

Antioxidant Defence System

The molecular basis of the positive association between apoE4 genotype and CVD remains unclear. There is direct in vitro evidence indicating that apoE4 is a poorer antioxidant relative to the apoE3 isoform, with some indirect in vivo evidence also available. Therefore it was hypothesised that apoE4 carriers may benefit from α-tocopherol (α-Toc) supplementation. Targeted replacement mice expressing the human apoE3 and apoE4 were fed with a diet poor (0 mg/kg diet) or rich (200 mg/kg diet) in α-Toc for 12 weeks. Neither apoE genotype nor dietary α-Toc exerted any effects on the antioxidant defence system, including glutathione, catalase, superoxide dismutase, glutathione peroxidase and glutathione reductase activities. In addition, no differences were observed in mitogen-induced lymphocyte proliferation. α-Toc concentrations were modestly higher in plasma and lower in tissues of apoE4 compared with apoE3 mice, with the greatest differences evident in the lung, suggesting that an apoE4 genotype may reduce α-Toc delivery to tissues. A tendency towards increased plasma F2-isoprostanes in apoE4 mice was observed, while liver thiobarbituric acid-reactive substances did not differ between apoE3 and apoE4 mice. In addition, C-reactive protein (CRP) concentrations were reduced in apoE4 mice indicating that this positive effect on CRP may in part negate the increased CVD risk associated with an apoE4 genotype.

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