Relación entre los niveles séricos de proteína C reactiva y α1-antitripsina y la resistencia a la insulina en mujeres con obesidad / Relationship between serum levels of C-reactive protein and α1-antitrypsin and insulin resistance in obese women

El tejido adiposo produce citocinas implicadas en la resistencia a la insulina (RI) tales como IL-6, IL-8, TNF-α y moléculas proinflamatorias como la proteína C reactiva (PCR). La α1-antitripsina es una proteína plasmática sensible a la inflamación. El objetivo de este estudio fue determinar la correlación existente entre los niveles séricos de PCR ultrasensible (PCRus) y de α1-antitripsina con los índices de RI en mujeres venezolanas obesas. La población del estudio estuvo conformada por 15 mujeres normopeso (IMC 21,8 ± 1,9 kg/m²) y 15 mujeres con obesidad (IMC 35,3 ± 5,3 kg/m²). Se realizó a los grupos la prueba de tolerancia oral a la glucosa (carga de 75g, 2h) y se calcularon los siguientes índices: Modelo de Determinación de la Homeostasis de la resistencia a la insulina (HOMA-IR), Modelo de Determinación de la Homeostasis de la función de la célula-β (HOMA-β), Índice Matsuda e Índice Insulinogénico. Se determinó la relación entre los niveles séricos de PCRus y α1-antitripsina y estos índices. Las mujeres con obesidad presentaron mayores niveles de PCRus (p = 0,001) en comparación con las mujeres normopeso. Los niveles séricos de PCRus se correlacionaron positivamente con HOMA-IR (r= 0,73, p=0,0021), HOMA-β (r= 0,53, p=0,031) y negativamente con el Índice Matsuda (r= -0,60, p=0,017), en las mujeres con obesidad. No se observó ninguna correlación entre los niveles séricos de α1-antitripsina y los índices de RI en el grupo obeso ni en el grupo normopeso. Se encontró una relación entre los niveles séricos de PCRus y la RI, sugiriendo un rol de la inflamación subclínica en la RI.

Adipose tissue produces cytokines involved in insulin resistance (IR) such as IL-6, IL-8, TNF-α and proinflammatory molecules such as C reactive protein (CRP). α1-antitrypsin is an inflammation-sensitive plasma protein. The objective of this study is to determine the correlation between serum CRP high-sensitivity (CRPhs) and α1-antitrypsin levels with IR indices in obese Venezuelan women. The study population consisted of 15 normal weight women (BMI 21.8 ± 1.9 kg/m²) and 15 obese women (BMI 35.3 ± 5.3 kg/m²). Obese and lean women underwent a 2 h-75g oral glucose tolerance test and the following indices were calculated: homeostatic model assessment of insulin resistance (HOMA-IR), homeostatic model assessment of β cell function (HOMA-β), Matsuda Index and Insulinogenic Index. The relationship between serum CRPhs and α1-antitrypsin levels and these indices were determined. Obese women had higher CRPhs levels (p = 0.001) compared with normal weight women. In obese women, serum CRPhs levels were positively correlated with HOMA-IR (r=0.73, p=0.0021), HOMA-β (r=0.53, p=0.031) and negatively correlated with the Matsuda Index (r= -0.60, p=0.017). No correlation between serum levels of α1-antitrypsin and IR indices in the obese group and the lean group was observed. There was a relation between serum CRPhs levels and insulin resistance, suggesting a role of subclinical inflammation in IR.

Interrelationship between serum and sputum inflammatory mediators in chronic obstructive pulmonary disease

Little is known about airway inflammatory markers in chronic obstructive pulmonary disease (COPD). The objective of the present study was to identify and try to correlate pulmonary and peripheral blood inflammatory markers in COPD. In a cross-sectional study on patients with stable COPD, induced sputum and blood samples were collected for the determination of C-reactive protein, eosinophilic cationic protein, serum amyloid A protein, a-1 antitrypsin (a-1AT), and neutrophil elastase. Twenty-two patients were divided into two groups according to post-bronchodilator forced expiratory volume in the first second ( percentFEV1): group 1 (N = 12, FEV1 <40 percent) and group 2 (N = 10, FEV1 ³40 percent). An increase in serum elastase, eosinophilic cationic protein and a-1AT was observed in serum markers in both groups. Cytology revealed the same total number of cells in groups 1 and 2. There was a significantly higher number of neutrophils in group 1 compared to group 2 (P < 0.05). No difference in eosinophils or macrophages was observed between groups. Serum elastase was positively correlated with serum a-1AT (group 1, r = 0.81, P < 0.002 and group 2, r = 0.83, P < 0.17) and negatively correlated with FEV1 (r = -0.85, P < 0.03 and -0.14, P < 0.85, respectively). The results indicate the presence of chronic and persistent pulmonary inflammation in stable patients with COPD. Induced sputum permitted the demonstration of the existence of a subpopulation of cells in which neutrophils predominated. The serum concentration of all inflammatory markers did not correlate with the pulmonary functional impairment.

A case of malignant histiocytosis with various skin manifestations / 대한피부과학회지

Malignant histiocytosis(MH) is a rapidly progressive and usally fatal disorder characterized clinically fever, generalized weakness, lymphadeno athy, hepatosplenomegaly accompanied by jaundice, and purpura. The frequency of skin manifestations has been repoterd about 15% of MH patients. Papules, plaques and niidules are commonly met. Histopathologically MH shows infiltrations of atypical histiocyte; with uarious maturity in many organs including skin. We present a case of a 32-year-old female with MH involving not only lymph node, liver, spleen and bone marrow but also skin with vaorious features ; erythematous papules, annular purpuric patches, subcutaneous nodules and hemomagic nodules. Immunohist,ochemically the majority of patients atypical histiocytes in lesional skin shows a-1 antitrysin positive, but lysozyme negative. It may suggest that these are poorly differentiated atypical histiocytes rather than well differentiated ones.