Search Results (12)

(1) The link between periodontal disease (PD) and acute coronary syndromes (ACSs) is predominantly attributed to the atherosclerotic process, mediated by systemic inflammation. However, the correlation between the severity of PD, characterized by the presence of periodontal pathogens, and systemic inflammation in patients with ACS remains inadequately clarified. (2) This study aims to assess the association between the severity of PD and systemic inflammatory biomarkers, along with lipid profiles, in patients with ACS. (3) In total, 42 patients with ACS and concomitant PD were divided into two groups based on the presence of periodontal pathogens belonging to the red or red-orange complexes. Group 1–29 patients displayed pathogens from the red complex (RC) and group 2–13 patients displayed pathogens from the red-orange complex (ROC). All participants underwent a comprehensive dental examination, including DNA sampling from the periodontal pockets for pathogen detection. Systemic inflammation was evaluated alongside assessments of lipid profiles. (4) Inflammatory markers were more pronounced in the RC group compared with the ROC group. Moreover, patients in the RC group showed significantly higher monocyte-to-lymphocyte ratios (0.41 ± 0.20 vs. 0.28 ± 0.12; p = 0.002), platelet-to-lymphocyte ratios (139.50 ± 33.85 vs. 100.90 ± 8.84; p = 0.02), serum C-reactive protein levels (9.34 ± 1.08 mg/L vs. 5.46 ± 1.03 mg/L; p = 0.03), and serum uric acid levels (6.9 ± 0.49 mg/dL vs. 5.4 ± 0.26 mg/dL; p = 0.006). Concerning lipid profiles, the RC group exhibited significantly higher low-density lipoprotein cholesterol (LDL) levels (169.60 ± 12.63 mg/dL vs. 106.70 ± 9.34 mg/dL; p = 0.0007) and significantly lower high-density lipoprotein cholesterol (HDL) levels (29.29 ± 3.50 mg/dL vs. 39.56 ± 2.07 mg/dL; p = 0.002). (5) The severity of PD, indicated by the concomitant presence of pathogens from the red and orange complexes, is associated with an unfavorable lipid profile and elevated inflammatory biomarkers. These findings highlight the potential importance of periodontal intervention in the prevention of ACS. Full article

Objectives: Our aim was to investigate whether admission advanced lung cancer inflammation index (ALI) values have a prognostic role on one-year major adverse cardiovascular and cerebrovascular events (MACCEs) in non-ST elevation myocardial infarction (NSTEMI) patients undergoing percutaneous coronary intervention (PCI). Methods: Our study consisted of 1173 consecutive patients aged 61.9 ± 12.5 years. The study population was divided into two groups according to the occurrence of MACCEs. BMI (body mass index), serum albumin levels and NLR (neutrophil to lymphocyte ratio) of patients were collected from hospital records, and ALI was calculated based on the following formula: BMI × serum albumin/NLR. We also calculated neutrophil to lymphocyte ratio (NLR), C-reactive protein/albumin ratio (CAR) and uric acid to albumin ratio (UAR) and investigated the association of these inflammation-based biomarkers with one-year MACCEs. Results: During the 12-month follow-up period, 158 (13.5%) patients had MACCEs, 55 (4.7%) of whom had all-cause mortality, 96 (8.2%) had nonfatal MI and 7 (0.6%) had nonfatal stroke. Patients with MACCEs had significantly lower ALI (p < 0.001), and also ALI (area under the curve [AUC] = 0.658, p < 0.001) had better discriminatory power and predictive accuracy in determining one-year MACCEs compared to albumin (AUC = 0.594, p < 0.001), NLR (AUC = 0.631, p < 0.001), CAR (AUC = 0.595, p < 0.001) and UAR (AUC = 0.577, p = 0.001) in the ROC analysis. Individuals with an ALI value lower than 43.9 were at greater risk of developing MACCEs (p < 0.001) due to the Delong test. Conclusions: Determining the level of ALI may have the potential to improve risk prognostication in NSTEMI patients undergoing revascularization therapy. Full article

Background and Objectives: Chronic kidney disease (CKD) is a growing public health problem and one of the leading causes of premature death worldwide. The progressive nature of CKD is associated with serious complications that can reduce the quality of life in CKD patients. Additional factors that can worsen well-being include dialysis treatment, malnutrition, inflammation, and lack of social support. The aim of our study was to analyze the quality of life of CKD patients undergoing hemodialysis and its association with certain biochemical and immunonutritional parameters, as well as with social support. Materials and Methods: This research was conducted as a cross-sectional study that included 170 patients, divided into two groups: a group of patients undergoing hemodialysis (HD group) (n = 85), and a control group of non-hemodialysis patients (group with CKD stage 3–4) (n = 85). The Health-Related Quality of Life (HRQoL) score was used to assess the quality of life of the study population. Measurement of biochemical and immunonutritional parameters was also performed in all patients. The Oslo-3 Social Support Scale (OSSS-3) was used to analyze social support. Results: The HRQoL score was significantly lower in HD patients compared to patients with CKD stage 3–4 (0.701 ± 0.137 vs. 0.832 ± 0.122, p < 0.001). It declined significantly as the concentrations of urea (β = −0.347, p < 0.001), creatinine (β = −0.699, p = 0.005), uric acid (β = −0.184, p = 0.016), β2-microglobulin (β = −0.432, p < 0.001), and parathormone (β = −0.209, p = 0.006) increased in HD patients. In addition to uremic toxins, an increase in glucose (β = −0.278, p = 0.010) and triglyceride (β = −0.354, p = 0.001) concentrations was associated with poor HRQoL in patients with CKD stage 3–4. There was a significant connection between the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score and HRQoL in HD patients (β = 0.229, p = 0.035). Additionally, C-reactive protein (β = −0.361, p < 0.001) and neutrophil-to-lymphocyte ratio (β = −0.288, p < 0.001), as markers of systemic inflammation, directly affected HRQoL in HD patients. In both study groups, perceived social support positively influenced the HRQoL scores (β = 0.192, p = 0.012 for hemodialysis; β = 0.225, p = 0.038 for non-hemodialysis). Conclusions: There is a decline in HRQoL in chronic hemodialysis patients, significantly affected by certain biochemical and immunonutritional parameters, along with perceived social support. Full article

Acute respiratory distress syndrome (ARDS) is a life-threatening condition in which the lungs fail to provide sufficient oxygen to the body’s vital organs. It is commonly associated with COVID-19 patients. Severe cases of COVID-19 can lead to lung damage and organ failure due to an immune response in the body. To mitigate these effects, corticosteroids, which are known for their anti-inflammatory properties, have been suggested as a potential treatment option. The primary focus of this study was to assess the impact of various corticosteroid administration methods on the outcomes of patients with COVID-19. Methods: The current study was conducted on COVID-19 patients divided into three groups. The first group was administered 6 mg of intravenous (IV) dexamethasone; the second group received 1 mg/kg of IV methylprednisolone (methylprednisolone); and the third group received budesonide respirable solution at a dosage of 1mg twice daily. The neubilizer used was a vibrating mesh nebulizer (VMN). All patients received standard care. We found that dexamethasone administered intravenously led to a significant reduction in C-reactive protein levels, surpassing the effectiveness of both IV methylprednisolone and inhaled budesonide. Oxygen saturation without mask change over time showed statistically significant differences (p = 0.004) in favor of the budesonide and dexamethasone groups for all days. Individuals who received methylprednisolone showed a significant decrease in mortality rate and an extended survival duration, with statistical significance observed at p = 0.024. The rest of the parameters, including ferritin, lymphocytes, total leukocyte count, platelets, hemoglobin, urea, serum potassium, serum sodium, serum creatinine, serum glutamic-pyruvic transaminase, serum glutamic-oxaloacetic transaminase, uric acid, albumin, globulin, erythrocyte sedimentation rate, international normalized ratio, oxygen saturation with flow, and oxygen flow, showed no statistically significant differences between the three drugs. In conclusion, treatment with IV methylprednisolone (1 mg/kg) resulted in a shorter hospital stay, decreased reliance on ventilation, and improved health outcomes for COVID-19 patients compared to using dexamethasone at a daily dosage of 6 mg or budesonide respirable solution at a dosage of 1mg twice daily. Full article

Background: Studies have shown that serum uric acid levels and uric acid-related ratios, such as uric acid-to-albumin ratio (UAR), uric acid-to-creatinine ratio (UCR), uric acid-to-high-density lipoprotein cholesterol (HDL cholesterol) ratio (UHR), and uric acid-to-lymphocyte ratio (ULR), are associated with various diseases and their complications, and that these ratios can be used as biomarkers. In the current study, we aimed to investigate uric acid levels in obese adolescents and the relationship of uric acid-related ratios with insulin resistance and obesity for the first time in the literature. Methods: A total of 100 adolescents (60 obese and 40 healthy) aged 10–17 years were retrospectively included. Participants were assigned to two groups: the obese group and the healthy control group. Obesity was defined as a body mass index (BMI) >the 95th percentile for age and gender. Demographic and laboratory data (serum glucose, urea, creatinine, uric acid, albumin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), C-reactive protein (CRP), total cholesterol, triglyceride, HDL cholesterol, thyroid-stimulating hormone (TSH), free T4 (fT4), insulin levels, and complete blood count) were obtained from the laboratory information management system. A homeostatic model of assessment for insulin resistance (HOMA-IR), low-density lipoprotein cholesterol (LDL cholesterol), and uric acid-related ratios were calculated. Results: Uric acid, UAR, UCR, and UHR levels of obese adolescents were significantly higher than the healthy group (p < 0.05). We found that HOMA-IR was positively correlated with uric acid, UAR, and UHR. No correlation was found between BMI and uric acid or uric acid-related ratios. We did not find any difference between the two groups in terms of ULR levels, and we did not find any correlation between BMI and HOMA-IR. Conclusion: High levels of serum uric acid, UAR, UCR, and UHR were associated with obesity. Furthermore, we found that uric acid, UAR, and UHR were positively correlated with insulin resistance. Full article

The current study aimed to explore the effect of Spirulina platensis (SP) inclusion at various levels in quail diets, in terms of their production performance, physiological traits, stress measurements, and immunological parameters under heat stress (HS) conditions. Four hundred Japanese quail (Coturnix japonica) chicks, one day old, were equally distributed into forty wire cages, and the cages were placed in two chambers with environmentally controlled systems (20 cages in each chamber). From 21 to 42 d of age, the quails were randomly subjected to a factorial design of two HS treatments × four SP treatments. To induce HS treatments in the quails, the first chamber was maintained at a thermoneutral temperature of 24 °C (TN group), while the temperature of the second chamber was elevated to 35 °C during the daytime (9:00–17:00 h), followed by a thermoneutral temperature for the remaining 24 h cycle (HS group). The birds in each chamber were further allocated into four SP treatments (5 replicate cages × 10 birds per cage in each treatment), where the quails were fed on a basal diet that included 0, 5, 10, or 15 g/kg SP (SP0, SP5, SP10, and SP15 groups, respectively). After exposure to the HS, a significant (p < 0.05) reduction of 5% in body weight and 9% in both weight gain and feed intake was recorded, and the slaughter performance of the quails was adversely (p < 0.05) affected. In addition, HS significantly (p < 0.05) impaired the physiological traits (total protein, albumin, globulin, alanine transferase, aspartate transferase, creatinine, uric acid, cholesterol, and triglycerides) and immunological parameters (total white blood cells, heterophil to lymphocyte ratio, and T- and B-lymphocyte stimulation indexes), but increased the stress measurements (corticosterone, malondialdehyde, interleukin-1β, and tumor necrosis factor-α). In contrast, most of these parameters were linearly (p < 0.05) improved by increasing the SP levels in the diets of the TN quail group. When the SP was included in the diets of the HS quail group, the deleterious effects of HS on the alanine and aspartate transferase activities, creatinine, uric acid, triglycerides, corticosterone, interleukin-1β, and tumor necrosis factor-α levels, heterophil to lymphocyte ratio, and T- and B-lymphocyte stimulation indexes were remarkably (p < 0.05) relieved. These results concluded that SP nutritional application can improve the production performance and the overall physiological homeostasis of the Japanese quail, especially when suffering from heat stress. Full article

Low-grade inflammation is associated with complications of type 2 diabetes. Glucagon-like peptide-1 receptor agonists and sodium-glucose transporter-2 inhibitors have shown cardioprotective effects that are independent of their glucose-lowering effects. Cardio-protection could be mediated by the anti-inflammatory effects of these medications, but there is currently limited evidence to support this hypothesis. We conducted a prospective clinical study in patients with type 2 diabetes requiring treatment intensification. Ten patients were assigned to receive empagliflozin 10 mg and 10 patients to receive s/c semaglutide (titrated to 1 mg once a week) in a non-randomised manner. All parameters were measured at baseline and after 3 months. Fasting plasma glucose and glycated haemoglobin improved significantly in both treatment groups, with no between-group differences. Body weight and body mass index reduced significantly more in the semaglutide group, whereas waist circumference decreased only in the empagliflozin group. There was a trend for high-sensitivity CRP reduction in both treatment groups that did not reach statistical significance. Interleukin-6 and the neutrophil-to-lymphocyte ratio did not change in either group. Ferritin and uric acid decreased significantly only in the empagliflozin group, and ceruloplasmin decreased significantly only in the semaglutide group. Though there were clinically meaningful improvements in diabetes control in both treatment arms, we could detect only minor changes in some inflammatory markers. Full article

Oxidative stress and inflammation are key factors in cardiometabolic diseases. We set out to evaluate the relationship between serum uric acid (UA) and the neutrophil-to-lymphocyte ratio (NLR) with cardiometabolic risk factors in coronary artery disease (CAD) patients, and their additive and multiplicative interactive effects on outcomes (cardiac death/CD and hard events (HE)—death plus reinfarction). A total of 2712 patients (67 ± 11 years, 1960 males) who underwent coronary angiography was retrospectively analyzed and categorized into no-CAD patients (n = 806), stable-CAD patients (n = 1545), and patients with acute myocardial infarction (AMI) (n = 361). UA and NLR were reciprocally correlated and associated with cardiometabolic risk factors. During a mean follow-up period of 27 ± 20 months, 99 ± 3.6% deaths, and 213 ± 7.8% HE were registered. The Kaplan–Meier survival estimates showed significantly worse outcomes in patients with elevated UA or NLR levels. Multivariate Cox regression analysis demonstrated that NLR independently predicted CD and HE. There was no multiplicative interaction between UA and NLR; however, the use of measures of additive interaction evidenced a positive additive interaction between UA and NLR for CD and HE. Although it is clear that correlation does not imply causation, the coexistence of NRL and UA appears to have a synergistic effect, providing further information for the risk stratification of CAD patients. Full article

Background: Amyotrophic lateral sclerosis (ALS) is a devastating and untreatable motor neuron disease, with a 3–5-year survival from diagnosis. Possible prognostic serum biomarkers include albumin, C-reactive protein, ferritin, creatinine, uric acid, hemoglobin, potassium, sodium, calcium, glucose, and the neutrophil-to-lymphocyte ratio (NLR), a marker of subclinical inflammation. Objective: To ascertain the influence of NLR on ALS progression rate and survival. Methods: Cross-sectional multicenter study including 146 consecutive incident and prevalent patients (88 males), aged >18 years, diagnosed according to the El Escorial criteria. The exclusion criteria were: (1) patients with tracheostomy or receiving mechanical ventilation; (2) patients with percutaneous endoscopic gastrostomy; and (3) patients who did not sign the informed consent. The rate of disease progression (ΔFS score) represents the monthly decline of the ALSFRS-R score, and was computed as (48 − total ALSFRS-R at recruitment)/symptom duration in months. Patients were followed up to tracheotomy, death, or the end of the follow-up, whichever occurred first. To validate our findings, we used data retrieved from the Pooled Resource Open-Access ALS Clinical Trials (PRO-ACT) Database. Results: The median disease duration was 15 (range = 2–30) months. The mean ALSFRS-R score at recruitment was 35.8 ± 8.0 (range: 10–48), and the median ΔFS was 0.66 (range: 0–5.33). Age at onset, at diagnosis, and at recruitment were significantly lower in the lowest NLR tertile. NLR values positively correlated with ΔFS values (r = 0.28): the regression slope of NLR (log-values) was 0.60 (p < 0.001) before and 0.49 (p = 0.006) after adjustment for age at recruitment. The ΔFS score progressively increased from the lowest to the highest NLR tertile: 0.35 (IQR: 0.18–0.93), 0.62 (IQR: 0.25–1.09), and 0.86 (IQR: 0.53–1.92). Patients were followed for a median of 2 years. The mortality rate passed from 15.9 events per 100 person-years in patients belonging to the lowest NLR tertile to 52.8 in those in the highest tertile. The optimal cut-off value which best classified patients with the lowest and the highest mortality rate was set at the NLR value of 2.315. Indeed, the mortality rate of patients with an NLR value above such cut-off was twice the mortality rate of patients with a value below the cut-off (age adjusted hazard ratio (HR): 2.16, 95% confidence interval (CI): 1.32–3.53). In the PRO-ACT validation sample, patients with an NLR value above the cut-off consistently had a higher mortality rate than those with a value below the cut-off (age adjusted HR: 1.17, 95%CI: 1.01–1.35). Conclusions: NLR could be a candidate easy, fast, and low-cost marker of disease progression and survival in ALS. It may be associated with low-grade inflammation either as a direct mirror of the pathological process of disease progression, or as a consequence of neuronal death (reverse causation). However, prospective studies are needed to understand whether NLR changes during the course of the disease, before using it to monitor disease progression in ALS. Full article

Background and Objectives: This study aimed to investigate the important factors that affect COPD prognosis. Materials and Methods: We included 160 hospitalized patients with COPD exacerbation in the study. The hemoglobin (HB), hematocrit (HCT), leukocytes, red cell distribution width (RDW), mean platelet volume, platelet distribution width, plateletcrits, platelets, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, eosinophils, uric acid, albumin, C-reactive protein (CRP), procalcitonin, arterial blood gases (PO2 and PCO2), pulmonary function test (FEV1 and FVC), echocardiography (ejection fraction-EF), Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage, Modified Medical Research Council (mMRC) and Borg scales, Charlson comorbidity index, body mass index (BMI), and the length of hospital stay were examined on the first day of hospitalization. Admission to the hospital with a new attack, hospitalization in the intensive care unit (ICU), and mortality during the six months after discharge were evaluated. Results: High CRP and procalcitonin levels were observed in the group with a long hospital stay. In the mortality group, the HB, HCT, BMI, and PO2 values were significantly lower than in the group without mortality, while the age and GOLD stage were higher. The age, Borg and mMRC scores, number of exacerbations experienced in the previous year, RDW, eosinophil count, and PCO2 were significantly higher in the ICU group than that without an ICU stay. The HCT and EF values were lower in the ICU group than that without an ICU stay. The FEV1 and FVC values were significantly lower in the follow-up attack group than those without a follow-up attack. The duration of COPD and the number of attacks that were experienced in the previous year were high. Conclusion: Scoring combining selected biomarkers and other factors is a strong determinant of the prognosis. Full article

Background: Cytokeratin 19-positive (CK19(+)) hepatocellular carcinomas (HCC) are generally associated with poor prognosis after hepatectomy. It is typically detected from postoperative immunochemistry. We have analyzed several clinically available biomarkers, in particular, neutrophil to lymphocyte ratio (NLR) and aim to develop a panel of biomarkers in identifying CK19 expression in (HCC) preoperatively. Methods: We retrospectively reviewed 36 HCC patients who underwent liver resections during January 2017 to March 2018 in Chang Gung Memorial Hospital. Patients were grouped based on the status of CK19 expression and their baseline characteristics, perioperative and oncologic outcomes were compared. Novel biomarkers including NLR, alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA) and uric acid were analyzed and correlated with CK19 expression. Results: NLR is highly associated with CK19 expression. NLR alone gave an AUROC of 0.728 (p-value = 0.043), higher than AFP, CEA or tumor size alone. NLR when combined with AFP, CEA and uric acid, gave an AUROC as high as 0.933 (p-value = 0.004). Conclusion: The current study demonstrated the predictive capability of NLR in combination with AFP, CEA and uric acid for CK19 expression in HCC patients preoperatively. Further prospective, large-scale studies are warranted to validate our findings. Full article

Background and Objectives: Inflammation is a recognized factor in disease progression in both heart failure (HF) patients with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). Neutrophils take part in maintaining the pro-inflammatory state in HF. Hypercholesterolemia is stated to heighten neutrophil production, which contributes to accelerated cardiovascular inflammation. HF pathogenesis differences in the different HF phenotypes are yet to be investigated. Aim: To determine differences in complete blood count, C-reactive protein (CRP) concentration and lipidogram between chronic HF patients with an absence/presence of myocardial infarction (MI) history and preserved/reduced EF. Materials and Methods: We separated the patients (n = 266) according to chronic HF phenotype: (1) HFrEF patients (n = 149) into groups according to presence of MI: those who had had no MI (n = 91) and those with MI (n = 58); (2) chronic HF without MI according to left ventricular ejection fraction (LVEF): LVEF ≥ 50%, n = 117; LVEF < 50%, n = 91. Laboratory and clinical readings (age, weight, pulse, blood pressure, and body mass index (BMI)) were taken from the patients’ medical histories. Results: Mean corpuscular hemoglobin concentration (MCHC) was lower and red cell distribution width—coefficient of variation (RDW-CV) was higher in the lower EF group without a history of MI (337.32 (10.60) and 331.46 (13.13), p = 0.004; 13.6 (11.5–16.9), and 14.7 (12.6–19.1), p = 0.001). Lymphocyte percentage and lymphocyte-to-monocyte ratio (LYM/MON) were lower in the lower EF group without a history of MI (30.48 (10.87), 26.98 (9.08), p = 0.045; 3.33 (1.22–9.33), 3 (0.44–6.5), p = 0.011). In the group according to LVEF without MI neutrophil count positively correlated with weight (r_p = 0.196, p = 0.024); lymphocyte count correlated with RDW-CV (r_s = −0.223; p = 0.032) and body mass index (r_p = 0.186, p = 0.032). RDW-CV and monocyte count correlated with NT-proBNP and serum creatinine (r_s = 0.358, p = 0.034; r_s = 0.424, p < 0.001 and r_s = 0.354, p = 0.012; r_s= 0.205, p = 0.018 respectively). CRP concentration (6.9 (1.46–62.97), 7 (1–33.99), p = 0.012) was higher and HDL concentration was lower (0.96 (0.44–2.2), 0.92 (0.56–1.97), p = 0.010) in HFrEF with MI in comparison with the group without MI. LVEF correlated with MCHC and RDW-CV (r_s = 0.273, p = 0.001; r_s = −0.404, p < 0.001). HDL cholesterol concentration was lower (0.96 (0.44–2.2); 0.92 (0.56–1.97, p = 0.010) and CRP concentration (6.9 (1.46–62.97), 7 (1–33.99), p = 0.012) was higher in the HFrEF with MI group. Uric acid concentration correlated with platelet-to-lymphocyte ratio and LYM/MON (r_s = 0.321, p = 0.032; r_s = −0.341, p = 0.023). Creatinine concentration correlated with monocyte percentage and count (r_p = 0.312, p = 0.001; r_p = 0.287, p = 0.003). A correlation between CRP and MCHC (r_s = 0.262, p = 0.008) was observed. Conclusions: Our findings revealed the higher pro-inflammatory condition in HFrEF group without MI in comparison with HFpEF without MI. LYM/MON can be appropriate as additional reading for evaluation of functional condition in HFrEF group without MI. It seems inflammation environment could be higher in HFrEF with MI in disease history in comparison with those without MI. HDL concentration inversely correlated with monocyte count and the percentages could show the relationship between the low-grade inflammation and lipid metabolism in HFrEF. Both MCHC and RDW-CV may be relevant in assessing the chronic HF patients’ condition. Full article