Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0432222 (SEM)
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The aim of this study was to prospectively analyze the possible association of delayed gastric emptying and postoperative pancreatic complications after pancreaticoduodenectomy. Although hospital mortality after pancreaticoduodenectomy is minimal, morbidity is still high; delayed gastric emptying is one of the most frequent complications. Thirty-nine consecutive patients undergoing pancreaticoduodenectomy were included in this study: 14 females and 25 males (median age 65 years; range, 7-82). Delayed gastric emptying was defined as the need for a nasogastric tube or recurrent vomiting that prevented normal feeding on the 10th postoperative day. Blood analysis was performed on postoperative days 4, 6, and 10; Gastrografin examination on day 6; CT scan on days 2 and 5; and drain amylases were measured on day 5. Pancreatitis was defined as pancreatitis changes in CT scan interpreted by an experienced radiologist without knowing other data. Pancreatic fistula was defined according to the recent international recommendations. We had no mortality. Twelve patients (31%) developed delayed gastric emptying. Surgical (9/12 vs. 5/27; P = 0.001) but not medical complications occurred more often in the delayed gastric emptying group. Of the single complications, postoperative CT-detected pancreatitis (6/12 vs. 4/27; P = 0.03) and postoperative pancreatic fistula (5/12 vs. 1/27; P = 0.0007) were significantly associated with delayed gastric emptying compared with the patients without delayed gastric emptying. This pancreatitis was already detected in CT scan on day 2 in most patients (6/10, 60%). In delayed gastric emptying patients, the only parameters in blood analysis that differed significantly from patients without this complication were serum amylase activity (mean +/- SEM, 715 +/- 205 vs. 152 +/- 70 IU/L; P = 0.02), blood leukocyte count (16 +/- 2 vs. 9 +/- 0.6 x 10(9)/L; P = 0.007) and serum C-reactive protein (CRP) concentration (144 +/- 28 vs. 51 +/- 14 mg/L, P = 0.01). Postoperative pancreatic (subclinical) fistula was also associated with postoperative pancreatitis (6/10 vs. 0/29; P = 0.003). Preoperative coronary artery disease (OR = 16; 95% CI, 1.0-241; P = 0.05) and soft pancreatic texture at operation (OR = 9; 95% CI, 1.4-52; P = 0.02) were significant risk factors for the development of postoperative pancreatitis. The diagnosis of delayed gastric emptying after pancreaticoduodenectomy often follows postoperative pancreatitis. Delayed gastric emptying is also associated with postoperative pancreatic fistula, for which this pancreatitis seems to be a risk factor. Preoperative coronary artery disease and soft texture of the pancreas are significant risk factors for postoperative CT-detected pancreatitis.
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PMID:Postoperative acute pancreatitis as a major determinant of postoperative delayed gastric emptying after pancreaticoduodenectomy. 1696 32

The aim of the study was to use the meta-analytic approach to examine the effects of aerobic exercise on C-reactive protein (CRP) in adults. Secondary outcomes included changes in body weight in kilograms, percentage of body fat, and maximum oxygen consumption (VO2max) in mL kg(-1) min(-1). Studies were retrieved using computerized literature searches, cross-referencing, and hand searching. Inclusion criteria were assessment of CRP in randomized controlled trials published in the English language between January 1, 1990, and January 1, 2006. Studies were also limited to aerobic exercise interventions lasting 4 weeks or more in adults 18 years or older. Five studies representing 323 male and female subjects (171 exercise, 152 control) and 6 outcomes for CRP were available for pooling. A nonsignificant reduction of approximately 3% was observed for CRP in the exercise groups (mean +/- SEM, -0.11 +/- 0.14 mg/L; 95% confidence interval [CI], -0.39 to 0.17 mg/L) using a random-effects model. Statistically significant reductions of approximately 4% were found for body weight (mean +/- SEM, -3.4 +/- 1.0 kg; 95% CI, -5.3 to -1.5 kg) and percentage of body fat (mean +/- SEM, -1.4% +/- 0.4%; 95% CI, -2.3% to -0.6%), whereas a statistically significant increase of 12% was found for VO2max (mean +/- SEM, 3.3 +/- 0.9 mL kg(-1) min(-1); 95% CI, 1.5 to 5.1 mL kg(-1) min(-1)). The results of our study suggest that aerobic exercise does not reduce CRP levels in adults, but does improve measures of body composition and physical fitness.
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PMID:Effects of aerobic exercise on C-reactive protein, body composition, and maximum oxygen consumption in adults: a meta-analysis of randomized controlled trials. 1704 53

The aim of this study was to investigate the time course of C-reactive protein (CRP) reduction with simvastatin in patients with type 2 diabetes mellitus. Thirty-five subjects (mean +/- SEM body mass index 32.8 +/- 1 kg/m(2), mean +/- SEM glycated hemoglobin 7.3 +/- 0.2%) were studied using a randomized, crossover, double-blind design. Patients were treated with simvastatin 40 mg or placebo for 28 days, with a minimum 28-day intervening washout. On entry, all subjects had low-density lipoprotein cholesterol >100 mg/dl and/or non-high-density lipoprotein cholesterol >130 mg/dl. High-sensitivity CRP (hs-CRP) was measured on days 0, 1, 3, 7, 14, 21, and 28 of each phase; fasting lipids were measured weekly. The mean hs-CRP level was 4.2 +/- 0.6 mg/L at baseline (>3.0 mg/L represents high risk). After simvastatin administration, there was a significant reduction in levels of log(hs-CRP) (p = 0.001). This effect of simvastatin was seen by day 7 (p = 0.008), with maximal reduction seen at day 14 (p = 0.004; hs-CRP in original units 3.1 +/- 0.5 mg/L with simvastatin and 4.1 +/- 0.6 mg/L with placebo). As expected, the change in hs-CRP was not related to low-density lipoprotein cholesterol reduction. By day 28 with simvastatin, hs-CRP had returned to near baseline levels. In conclusion, in patients with type 2 diabetes mellitus, simvastatin reduced hs-CRP within 7 days. However, this potentially beneficial effect was lost within 28 days.
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PMID:Time course of C-reactive protein reduction with simvastatin therapy in patients with type 2 diabetes mellitus. 1714 29

Inhibition of the renin-angiotensin system reportedly exerts potent antiatherogenic effects by reducing vascular inflammation. We tested the hypothesis that pioglitazone, a peroxisome proliferator-activated receptor gamma agonist, further reduces vascular inflammation in patients receiving angiotensin II receptor blockers. Patients with hypertension who had developed type 2 diabetes mellitus were randomly assigned to receive either pioglitazone (15 mg/d, n = 20) or voglibose, an alpha-glucosidase inhibitor (0.6 mg/d, n=19) for 6 months, and changes in their serum concentrations of C-reactive protein (CRP), intercellular adhesion molecule 1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1) were monitored. Pioglitazone, but not voglibose, reduced CRP levels within 1 month (-51%+/-7%, mean+/-SEM; P<.001). C-reactive protein levels were decreased after 6 months of treatment with either pioglitazone or voglibose, with the former being more effective (-57%+/-8% vs -9%+/-18%; P<.05). The levels of ICAM-1 and VCAM-1 were significantly reduced after 1 month of pioglitazone therapy (-9%+/-3% and -8%+/-3%, respectively; both P<.05), with the beneficial effects persisting throughout the study period. In contrast, the levels of ICAM-1 and VCAM-1 were not altered during the study period in patients on voglibose. There was no correlation between the reduction of hemoglobin A1c and that of CRP, ICAM-1, or VCAM-1. These results suggest that augmentation with pioglitazone further reduces vascular inflammation in patients with hypertension and diabetes who are receiving angiotensin II receptor blockers. This may contribute to the reduction of cardiovascular events in this at-risk population.
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PMID:Pioglitazone produces rapid and persistent reduction of vascular inflammation in patients with hypertension and type 2 diabetes mellitus who are receiving angiotensin II receptor blockers. 1737 17

Smoking causes multiple organ dysfunction. The effect of smoking on skeletal muscle protein metabolism is unknown. We hypothesized that the rate of skeletal muscle protein synthesis is depressed in smokers compared with non-smokers. We studied eight smokers (> or =20 cigarettes/day for > or =20 years) and eight non-smokers matched for sex (4 men and 4 women per group), age (65 +/- 3 and 63 +/- 3 yr, respectively; means +/- SEM) and body mass index (25.9 +/- 0.9 and 25.1 +/- 1.2 kg/m(2), respectively). Each subject underwent an intravenous infusion of stable isotope-labeled leucine in conjunction with blood and muscle tissue sampling to measure the mixed muscle protein fractional synthesis rate (FSR) and whole body leucine rate of appearance (Ra) in plasma (an index of whole body proteolysis), the expression of genes involved in the regulation of muscle mass (myostatin, a muscle growth inhibitor, and MAFBx and MuRF-1, which encode E3 ubiquitin ligases in the proteasome proteolytic pathway) and that for the inflammatory cytokine TNF-alpha in muscle, and the concentration of inflammatory markers in plasma (C-reactive protein, TNF-alpha, interleukin-6) which are associated with muscle wasting in other conditions. There were no differences between nonsmokers and smokers in plasma leucine concentration, leucine rate of appearance, and plasma concentrations of inflammatory markers, or TNF-alpha mRNA in muscle, but muscle protein FSR was much less (0.037 +/- 0.005 vs. 0.059 +/- 0.005%/h, respectively, P = 0.004), and myostatin and MAFBx (but not MuRF-1) expression were much greater (by approximately 33 and 45%, respectivley, P < 0.05) in the muscle of smokers than of nonsmokers. We conclude that smoking impairs the muscle protein synthesis process and increases the expression of genes associated with impaired muscle maintenance; smoking therefore likely increases the risk of sarcopenia.
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PMID:Smoking impairs muscle protein synthesis and increases the expression of myostatin and MAFbx in muscle. 1760 55

Patients with bronchiectasis often have impaired quality of life (QoL), which deteriorates with exacerbations. The aim of this study was to investigate changes in QoL and how these were influenced by changes in airway physiology and inflammation in patients with bronchiectasis before and after resolution of an exacerbation. Sputum induction and a QoL questionnaire were undertaken on the first day, day 14, and 4 weeks after completion of intravenous antibiotics (day 42). Eighteen patients (12 female) were recruited, median (IQ range) age of 54 (47-60) years. There was a trend towards an improvement in lung function from visit 1 to visit 2, but this was not statistically significant. C-reactive protein (CRP) [mean (SEM)] reduced between visit 1 and visit 2 [55.4 (21.5) vs 9.4 (3.1) mg/L, P = 0.03] but did not increase significantly on visit 3 [44.4 (32.9) mg/L, P = 0.27]. The median (interquartile range) sputum cell count (x10(6) cells/g of sputum) decreased from visit 1 to visit 2 [21.6 (11.8-37.6)-13.3 (6.7-22.9) x 10(6) cells/g, respectively, P = 0.008] and increased from visit 2 to visit 3 [26.3 (14.1-33.6) x 10(6) cells/g, P = 0.03]. All soluble markers of inflammation significantly reduced from visit 1 to visit 2 but increased on visit 3 with the exception of TNF-alpha. Regarding QoL, three of the four domains (dyspnoea, emotional, mastery) significantly improved from visit 1 to visit 2 but did not change between visit 2 and visit 3. The improvements in QoL scores could not be explained by the improvements in lung function or inflammatory markers.
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PMID:Quality of life and inflammation in exacerbations of bronchiectasis. 1868 92

We investigated the effect of atorvastatin monotherapy and combined treatment with atorvastatin and pioglitazone on intima-media thickness, vascular function and the cardiovascular risk profile. In all, 148 patients (76 male, 72 female; aged 61.4+/-6.5 years; body mass index [BMI] 29.2+/-4.1 kg/m2; mean +/- SD) with increased cardiovascular (CV) risk factors were randomised. Intima-media thickness (IMT), the augmentation index (Aix@75), the microvascular response to acetylcholine (LDF), lipid status, and plasma levels of intact proinsulin, adiponectin, interleukin-6 (IL-6), monocyte chemotactic protein-1 (MCP-1), matrix metalloproteinase-9 (MMP-9), sCD40L, P-selectin, tissue plasminogen activator (t-PA) and blood lipids were monitored over six months. Atorvastatin treatment, alone and in combination with pioglitazone, revealed a significant regression in IMT (0.923+/-0.013 to 0.874+/-0.012 mm and 0.921+/-0.015 to 0.882+/-0.015 mm; mean +/- SEM; p<0.05 respectively) and Aix@75 (27.3+/-1.2 to 25.9+/-1.4; and 25.6+/-1.4 to 24.8+/-1.7%; p<0.05). The endothelial response to acetylcholine as measured by laser Doppler fluximetry (LDF) improved during combined treatment (373+/-57 to 576+/-153 AU; p<0.05). Addition of pioglitazone to atorva-statin resulted in significant further effects on high-sensitivity C-reactive protein (hsCRP), t-PA, P-selectin, adiponectin, triglycerides and high-density lipoprotein (HDL) cholesterol (p<0.05 respectively). Atorvastatin significantly improved IMT and vascular elasticity. Co-administration of pioglitazone provided additional effects on endothelial function, lipid profile and laboratory markers of inflammation.
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PMID:Investigation of the vascular and pleiotropic effects of atorvastatin and pioglitazone in a population at high cardiovascular risk. 1895 40

Although red meat consumption has been related to the prevalence of diabetes, few data are available showing the relation among red meat intake, inflammation, and metabolic syndrome. We aimed to identify the association between red meat intake, metabolic syndrome, and circulating concentrations of C-reactive protein (CRP) as a surrogate measure of inflammation. In a cross-sectional study of 482 Tehrani female teachers aged 40-60 y, we used a FFQ to assess red meat intake. Anthropometric measures, blood pressure, fasting plasma glucose, lipid profiles, and plasma CRP concentrations were evaluated according to standard methods. Metabolic syndrome was defined as recommended by National Cholesterol Education Program Adult Treatment Panel III guidelines. Red meat intake (mean +/- SEM) was 45.9 +/- 3.0 g/d. After statistically controlling for potential confounders, geometric mean plasma CRP concentrations across increasing quintile categories of red meat intake were 1.46, 1.66, 1.73, 1.89 +/- 1.89, and 2.03 mg/L (P-trend < 0.01). In the crude model, individuals in the top quintile of red meat intake had greater odds of having metabolic syndrome compared with those in the bottom quintile [odds ratio (OR): 2.33; 95% CI: 1.24, 4.38, P-trend < 0.01]. This association remained significant even after adjustment for potential confounders (OR, 2.15; CI, 1.18, 4.01; P-trend <0.01). Adjustment for CRP did not affect this association (OR, 2.06; CI, 1.16, 3.98; P-trend <0.01). In conclusion, increased red meat consumption is cross-sectionally associated with greater risk of metabolic syndrome and inflammation. Further prospective investigations will be needed to confirm this finding.
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PMID:Red meat intake is associated with metabolic syndrome and the plasma C-reactive protein concentration in women. 1907 9

Inflammation may play a role in the pathogenesis of cardiovascular disease and type 2 diabetes, and it has been suggested that the protective effects of whole-grain consumption could be mediated by an effect on inflammation, although few studies have examined the relationships between grain intakes and inflammatory protein concentrations. Our objectives in this study were to examine the associations of whole grain and refined grain intake with plasminogen activator inhibitor type 1 (PAI-1), C-reactive protein (CRP), and fibrinogen plasma concentrations. Cross-sectional data from the Insulin Resistance Atherosclerosis Study were used to perform multiple regression analyses using dietary information on whole and refined grain intakes from a FFQ and clinical measures of plasma inflammatory protein concentrations in participants free of type 2 diabetes. After adjustment for demographic, lifestyle, and dietary variables, whole-grain intake was inversely related to log PAI-1 (beta = -0.102; SEM = 0.038; P = 0.0077) and log CRP (beta = -0.102; SEM = 0.048; P = 0.0340). Adding insulin sensitivity, waist circumference, and 2-h postload glucose to the model attenuated both associations to nonsignificance. Refined grain was positively related to log PAI-1 in the multivariate model (beta = 0.076; SEM = 0.034; P = 0.0251) and the relationship remained unchanged by additional adjustment for metabolic variables. Fibrinogen concentrations were not related to whole or refined grain intake. In summary, whole grain intake was inversely related to PAI-1 and CRP plasma concentrations, but these relationships were attenuated by the addition of metabolic variables to the model. Refined grain intake was positively independently related to plasma PAI-1 concentrations.
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PMID:Whole and refined grain intakes are related to inflammatory protein concentrations in human plasma. 2008 89

The current study investigated the acute effects of accumulating short bouts of running on circulating concentrations of postprandial triacylglycerol (TAG) and C-reactive protein (CRP). Ten men, age 21-32 yr, completed two 1-d trials. On 1 occasion participants ran at 70% of maximum oxygen uptake in six 5-min bouts (i.e., 8:30, 10, and 11:30 a.m. and 1, 2:30, and 4 p.m.) with 85 min rest between runs. On another occasion participants rested throughout the day. In both trials, participants consumed test meals at 9 a.m. and 12 p.m. In each trial, venous blood samples were collected at 8:30, 10, and 11:30 a.m. and 1, 2:30, 4, and 5:30 p.m. for plasma TAG measurement and at 8:30 a.m. and 5:30 p.m. for serum CRP measurement. Total area under the curve for plasma TAG concentration versus time was 10% lower on the exercise trial than the control trial (M +/- SEM: 13.5 +/- 1.8 vs. 15.0 +/- 1.9 mmol x 9 hr(-1) x L(-1); p = .004). Serum CRP concentrations did not differ between trials or over time. This study demonstrates that accumulating short bouts of running reduces postprandial plasma TAG concentrations (a marker for cardiovascular disease risk) but does not alter serum CRP concentrations.
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PMID:Acute effects of accumulating exercise on postprandial lipemia and C-reactive protein concentrations in young men. 2017 27


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