ABSTRACT
Background: Breast cancer, second commonest malignancy in women is a multifactorial disease. Key role of chronic low grade inflammation has been linked with pathophysiology of breast cancer. High sensitivity C-Reactive Protein (hsCRP) is an acute phase reactant proinflammatory protein synthesized in hepatocytes. Present case control study was aimed with primary objective of estimation of serum hsCRP levels in newly diagnosed breast cancer patients and to correlate them with the staging of the disease. Methods: We enrolled 60 newly histologically diagnosed cases of breast cancer and 60 healthy age matched controls. Demographic features, anthropometric measures were recorded. After overnight fast, blood samples were collected and analyzed for serum hsCRP levels. Results: We observed significant differences between cases and controls in anthropometric parameters BMI and waist: hip (P <0.05) and hsCRP levels (P <0.001). Depending of the stage, serum hsCRP levels were associated with advanced stage. In stage I, association of hsCRP was not significant with disease while in stage II and III there was significant association. In stage IV patients with distant metastasis, serum hsCRP values were highly significantly raised compared to stage II and III. This suggests significant association of state of inflammation with stage of breast cancer. Conclusion: Inflammatory component plays key role in all stages of tumourigenesis from initiation of the tumor, infiltration, local and systemic invasion. Estimation of hsCRP may be simple, inexpensive and useful tool for risk assessment, screening of high risk individuals and to predict outcome in diagnosed cases.
ABSTRACT
Objective To investigate the changes in tumor necrosis factor-α(TNF-α) and plasminogen activator inhibitor(PAI) in the presence of obstructive sleep apnea syndrome(OSAS) in patients with type 2 diabetes mellitus,and to investigate if that 2 inflammatory factors is associated with hypoxemia during sleep.Methods Fiftyfour patients with type 2 diabetes mellitus hospitalized for glycemic control were subgrouped into 27 patients with OSAS (group O) and 27 patients without OSAS (group N).26 people without diabetes and OSAS were selected from a health check-up program to serve as control group (group C).Serum TNF-α and PAI levels were measured by commercial ELISA kits.Apnea hypopnea index (AHI),the lowest pulse oxygen saturation (LSpO2) at night were detected by portable sleep monitor.The relativity regarding TNF-α,PAI,homeostasis model assessment for insulin resistance (HOMA-IR),fasting blood glucose(FBG),AHI,LSpO2,and age was discussed.TNF-α and PAI were regard as dependent variables,and FBG,HOMA-IR,AHI,LSpO2,and age as independent variables in multivariate stepwise linear analysis.Results The levels of HOMA-IR,TNF-α,PAI in group O [2.69 ± 1.53,(1.97 ±0.13) ng/ml,and (2.27 ± 0.85) ng/ml] were higher than the those in other 2 groups,and those in group N [1.70 ± 0.88,(1.09 ±0.29) ng/ml,and (1.59 ± 0.13) ng/ml] were higher than group C [1.15 ± 0.67,(0.73 ± 0.19) ng/ml,and (0.89 ±0.25) ng/ml].The levels of FBG in the 2 diabetic groups were higher than those in group C.The level of AHI in group O was higher than that in group N and group C,while LSpO2 in group O was lower than that in group N and group C.Spearman univariate analysis showed that TNF-α and PAl both were associated positively with HOMA-IR,FBG,and AHI,while negatively with LSpO2.Multivariate stepwise linear analysis denoted that TNF-α was independently associated with AHI,FBG,while PAI was independently associated with AHI and HOMA-IR.Conclusions Patients with diabetes and OSAS manifest raised level of chronic inflammatory activity,and therefore,OSAS might be implicated in the pathogenesis of chronic complication of patients with type 2 diabetes.
ABSTRACT
Objective To evaluate the effect of acarbose on the circulating concentration of inflammatory factors in patients with type 2 diabetes mellitus(T2DM). Methods Total 118 patients with T2DM who did not take acarbose before enrollment within 4 weeks were recruited by a randomizing formula into 2 groups ( group A and B). 57 healthy subjects were included into group C as control. After excluding those of inadequate samples, 57 patients with T2DM were enrolled into group A in which acarbose was prescribed 50 mg three times a day, 59 patients with T2DM were enrolled into group B in which acarbose was not given and other hypoglycemic approaches were similar to group A. Serum samples at the time of enrollment and at the end of 4 weeks intervention were collected and stored in refrigerator at -80℃ until analysis. Analysis of biochemical indexes was performed in central lab of the institution,inflammatory factors were determined with commercial ELISA kits. Results (1) The metabolic indexes were significantly decreased after intervention in two diabetic groups. (2) The baseline levels of monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-α( TNF-α), prothrombin activator inhibitor-1 (PAI-1), lipopolysaccharide (LPS), high sensitive C reactive protein ( hs-CRP), and advanced glycation index (AGI) in diabetic patients were significantly higher than in group C MCP-1 [( 463.4± 187.1 vs 267.1 ± 158.3 ) pg/ml, TNF-α( 12.07 ± 19.59 vs 4.18 ±3.03 ) pg/ml, PAI-1 ( 2.47 ± 1.87 vs 1.38 ± 2.37 )ng/ ml, LPS ( 130.6 ± 128.5 vs 29.39 ± 17.93 ) pg/ml, hsCRP(4.25 ±2.29 vs 2.11 ± 1.07 ) μg/ml, AGI (3.78 ± 2.61 vs 0. 74 ± 0. 15 ) AU, all P ＜ 0. 05]. (3) Repeated measurement ANOVA analysis showed that after four weeks of intervention, MCP-1 [F( 1,106 ) = 19. 830, P＜0.001],LPS[F(1,106)=7.815, P＜0.01], PAI-1 [F(1,106)= 7.792, P＜0.01], TNF-α[F(1,106=24. 656, P=0.001 )] ,AGI[F( 1,106)= 12. 971 ,P=0. 01] decreased significantly in group A than in group B. Although hsCRP decreased in both group A and group B, but the trend was not different [F( 1,102 )= 0. 915, P = 0. 342].Conclusion The levels of inflammatory factors were elevated in patients with type 2 diabetes mellitus, which could be mostly reduced by acarbose.