Association of high sensitivity C-reactive protein concentrations and metabolic syndrome among Thai adults.

Background: Limited information is available regarding associations of metabolic syndrome with C-reactive protein (CRP) concentrations among Asian populations. Objective: Investigate the association of high sensitivity CRP (hsCRP) concentrations and metabolic syndrome among Thai adults. Methods: This cross-sectional study was comprised of 467 Thai participants (209 men and 258 women) receiving annual health check-up. Spearman’s rank correlation coefficients were used to assess the associations between metabolic parameters (age, waist circumference, blood pressure, triglycerides, HDL-C, fasting plasma glucose, fasting insulin and uric acid) with hsCRP concentrations for men and women, respectively. Multivariable logistic regression procedures were used to estimate the risk (odds ratios (OR), and 95% confidence intervals (CI) of metabolic syndrome according to low, moderate, and high hsCRP concentrations (<1.0, 1.0-3.0, and >3.0 mg/L, respectively). Results: Measures of adiposity and fasting insulin were positively and significantly correlated with hsCRP concentrations among women with and without metabolic syndrome. Similar associations were observed among men without metabolic syndrome. After controlling for confounders, moderately elevated hsCRP concentrations were associated with a 2.38-fold increased risk of metabolic syndrome (OR=2.38, 95%CI=1.20-4.72) among men. Men with high hsCRP concentrations had a 5.45-fold increased risk of metabolic syndrome (OR=5.45, 95%CI=2.24- 13.27) when compared with those who had low hsCRP concentrations. The corresponding OR for women with moderately elevated and high hsCRP concentrations were 4.92 (OR=4.92, 95%CI=2.34-10.35) and 11.93 (OR=11.93, 95%CI=5.54-25.72), respectively. Conclusions: These findings are consistent with the literature suggesting a role of hsCRP as a biomarker for metabolic syndrome.

Evaluation of Helicobacter pylori stool antigen test in Thai patients with upper gastrointestinal bleeding.

OBJECTIVE: Stool antigen test was evaluated in comparison with other diagnostic tests for the diagnosis of H. pylori infection in Thai patients presented with upper gastrointestinal bleeding. MATERIAL AND METHOD: Fifty-six patients were enrolled and fecal specimen was obtained from 34 patients. The presence of H. pylori was considered if the culture was positive or at lease two of the other diagnostic tests (urea breath test, serology, rapid urease test or histology) were positive. Stool antigen test was performed by using commercially available monoclonal enzyme immunoassay (Amplified IDEIA HpStAR, Dako, Denmark). RESULTS: Of the 56patients, 35 (62.5%0) were considered H. pylori infected, while in 34patients tested by stool antigen test, 22 (64.71%) were infected. The prevalence of H. pylori infection as determined by each test is considered low (47.06% from stool antigen test; 42.50%from UBT, 65.85%from serology; 51.78%0from RUT- and 46.34% from histology). The sensitivity/specificity/accuracy (%) of stool antigen test was 69.56/100/ 79.41 compared to 73.91/100/85 of UBT 79.17/52.94/68.29 of serology, 80/95.23/85.71 of RUT and 82.61/ 100/90.24 of histology, respectively. CONCLUSION: In summary, the results of this study reveal that the prevalence of H. pylori was relatively low in upper gastrointestinal bleeding patients. Yielding a low sensitivity and accuracy, the stool antigen test is therefore not reliable for the diagnosis of H. pylori infection in patients with upper gastrointestinal bleeding.

Prevalence of positive antinuclear antibodies in healthy children.

Antinuclear antibodies (ANA) frequently arise in the sera of children with connective tissue disease and is used in the diagnosis of these diseases. Therefore it is also important to know the prevalence of ANA in normal children. The main objective of the present study was to determine the prevalence of antinuclear antibody (ANA) in healthy children. Ninety-nine serum samples from a serum bank and 108 samples from patients who had attended elective surgery and whose blood had been withdrawn for other investigations, were tested for ANA by indirect immunofluorescence method using HEp-2 cells as substrate. Sera from 52 children with SLE were also tested during the same period. It was found that antinuclear antibodies were present in 32 (15%) of the 207 sera of healthy children at a dilution of 1:40 or higher. ANA were positive in 9% at a serum dilution of 1:40, in 3% at 1:80 and in 3% at 1:160. The patterns of immunofluorescence staining were as follows: homogeneous in 46.7%, speckled in 20%, and nucleolar in 10%. In SLE patients, ANA were positive in 91%; 13% at a serum dilution of 1:40, 7% at 1:80, 20% at 1:160, 15% at 1:320, 9% at 1:640, 20% at 1:1,280 and 9% at > or = 1:2,560. It was concluded that the prevalence of positive ANA using the HEp-2 cells as substrate was 15% in healthy children at dilutions of 1:40 or higher. Using the cutoff serum dilution of 1:40, the sensitivity of this test was 91%, the specificity was 85%, the positive predictive value was 57% and the negative predictive value was 97%.

Prevalence of autoantibodies in Thai elderly.

To investigate the prevalence of autoantibodies in a normal Thai elderly group, the authors measured anti-thyroid antibodies (anti-thyroglobulin, anti-thyroid microsome), antinuclear antibodies (ANA) and rheumatoid factors (RF) in 429 normal elderly (206 men, 223 women, age range 50-102 years). The participants recruited from Romklao Village, Lat Krabang, a suburb of Bangkok and compared to 219 young normal subjects (110 men, 109 women; age range 19-49 years). The prevalence of anti-thyroid antibodies was significantly increased in the elderly group when compared to the younger age control group (14.69% vs 5.02%, p = 0.0005). The antibody titers were found to be higher and the prevalence was more predominant in women than in men both in the elderly (21.53% vs 7.28%, p = 0.00005) and control groups (10.09% vs 0%, p = 0.0018). The prevalence of ANA in the elderly group was lower (1.17%) when compared to the control group (4.11%). ANA were characterized by low titer of antibodies and several staining patterns, and there was no difference between men and women. For RF, the prevalence was almost the same in both groups (2.79% in the elderly and 2.73% in control group) and no difference was observed. However, when all the three autoantibodies were considered, 20.28 per cent of the elderly individuals were found to have at least one of the autoantibodies which was significantly higher than in the younger control group (11.41%, p = 0.006). The prevalence was more predominant in women than in men. The results from this study can be used as basic data for the evaluation of autoantibodies testing in an elderly Thai population.

Detection of antibody in serum and secretion for the diagnosis of Helicobacter pylori infection.

Helicobacter pylori plays a major role in chronic gastritis and peptic ulcer. In addition, it has been shown to be associated with gastric carcinoma. In this study, the authors compared the detection of IgG antibodies specific to H. pylori by enzyme-immunoassay with culture, histology and a CLO test as tools for diagnosis of H. pylori infection. If the criteria that patients will be considered as H. pylori infected only when their samples are positive by culture or CLO test and histology were used, the sensitivity and specificity of detecting IgG in sera were 96.84 and 72.04 per cent respectively. The use of serological test will be useful as a screening test for H. pylori infection without the need of endoscopy. The authors also performed the assay for detecting IgA antibodies in saliva and gastric juice. The sensitivity and specificity of IgA detection in saliva were 26.79 per oent and 75.00 per cent. As for the assay in gastric juice, although the specificity was as high as 91.67 per cent, the sensitivity is very low (22.22%).

Evaluation of inhouse rapid urease test for detection of Helicobacter pylori from gastric biopsy specimens.

Inhouse rapid urease test for detecting Helicobacter pylori was evaluated. Biopsy specimens were taken for inhouse urease test, commercial rapid urease CLO test, culture, gram stain and histology from the antrium or duodenum of patients who had peptic ulcer. The culture and/or histologic examination and CLO test were used as the gold standard. One hundred and twelve specimens were evaluated. The sensitivity and specificity of the inhouse urease test was 100 per cent and 90 per cent respectively. The inhouse urease test was suitable for detecting Helicobacter pylori from gastric antral biopsy specimens. The medium can be kept in a refrigerator for up to 6 months.