BACKGROUND: Eosinophilia in hemodialysis (HD) patients has been associated with allergic reactions to dialyzers and exaggerated activation of complement during HD. Complement activation can lead to cytokine production. The cause of the eosinophilia is controversial and maybe multifactorial. Eosinophilia is stimulated by T lymphocytes and maybe related to the immune dysfunction of uremic patients. The aim of this study is to elucidate the relationship between the eosinophilia and serum cytokine concentrations in maintenance HD patients and to reveal whether the eosinophilia in HD patients reflects HD-associated cytokine production. METHODS: We examined 40 HD patients who were stable for a minimum of 3 months at our hemodialysis unit. We measured eosinophil count and eosinophil percent on peripheral blood smear. Eosinophilia was defined as >or=350 cells/mm3 or >or=5% on smear. The serum concentrations of Interleukin-1beta (IL-1beta), Interleukin-2 (IL-2), Interleukin-5 (IL-5), Interleukin-6 (IL-6) were measured by ELISA before (pre) and after (post) dialysis. RESULTS: Thirteen patients with eosinophilia were compared 27 patients without eosinophilia. In patients with eosinophilia, serum concentrations of IL-1beta and IL-2 were significantly elevated after dialysis than before dialysis (p<0.05). Post-HD IL-6 concentrations also were elevated, but statistically insignificant. IL-5 concentrations were not elevated after dialysis. In patients without eosinophilia, serum concentrations of IL-1beta, IL-2 and IL-6 were significantly elevated after dialysis (p<0.05). IL-5 concentrations were not elevated after dialysis. The eosinophil counts were not correlated to age, gender, underlying disease, serum levels of blood urea nitrogen, creatinine, albumin, CRP and the levels of post dialysis cytokines. CONCLUSION: Independently on eosinophilia in HD, the serum concentrations of cytokines (IL-1beta, IL-2 and IL-6) were elevated after HD. IL-5 concentrations were not elevated after dialysis. But we could not reveal whether the eosinophilia in maintenance HD patients may be a surrogate marker for the reflection of exaggerated cellular cytokine production during HD or not by this study.
Biomarkers ; Blood Urea Nitrogen ; Complement Activation ; Complement System Proteins ; Creatinine ; Cytokines ; Dialysis ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia* ; Eosinophils ; Humans ; Hypersensitivity ; Interleukin-1beta ; Interleukin-2 ; Interleukin-5 ; Interleukin-6 ; Renal Dialysis* ; T-Lymphocytes

BACKGROUND AND OBJECTIVES: There is a seasonal variation in the incidence of diabetes mellitus and cardiovascular disease. Insulin resistance is important in the development of both non-insulin dependent diabetes mellitus (Type II DM) and cardiovascular disease. Hyperinsulinemia, induced by an insulin resistant state, causes the development of a chronic inflammatory response in vascular structures, which is one of the main causes of cardiovascular disease. There have been several studies on seasonal variation in insulin resistance. Therefore, seasonal variation in insulin resistance were investigated to discover if any relationship existed. SUBJECTS AND METHODS: Korean people examined at a health care center were included. The subjects were divided into four groups, according to the season, and a homeostasis model assessment index (HOMA) calculated, as an indicator of insulin resistance, and compared between the groups. RESULTS: Using the homeostasis model assessment, the highest insulin resistance was observed during winter. Also, the body mass index and waist-hip ratio were highest during winter. CONCLUSION: Compensating for other metabolic factors (age, gender, body mass index, waist-hip ratio and season), insulin resistance was still found to be higher during winter. Seasonal variation in insulin resistance can be associated with the incidence of DM or cardiovascular disease. Therefore, a prospective study will be needed.
Body Mass Index ; Cardiovascular Diseases ; Delivery of Health Care ; Diabetes Mellitus ; Homeostasis ; Hyperinsulinism ; Incidence ; Insulin Resistance* ; Insulin* ; Seasons* ; Waist-Hip Ratio

BACKGROUND AND OBJECTIVES: There is growing evidence that inflammation plays an important role in atherosclerosis and in the elevation of cardiac troponin I (cTnI) after coronary intervention. The aim of this study was to evaluate the relationship between inflammatory markers and the elevation of cTnI after coronary intervention in patients with stable angina. SUBJECTS AND METHODS: Twenty-three patients who underwent successful percutaneous transluminal coronary angioplasty with stent were examined as the subjects. Serial blood samples were obtained for High Sensitivity C-reactive protein (hs-CRP), which served as markers of systemic inflammation, and cTnI. The difference of cTnI before and 24 hours after coronary intervention was defined as the gradient of cTnI. RESULTS: The mean gradient of cTnI was 1.77+/-3.4 ng/mL. The concentrations of baseline and post-procedural hs-CRP were 1.57+/-1.3 mg/L and 6.31+/-3.8 mg/L, respectively (p=0.001). There were no significant differences in the gradient of cTnI with hypertention, diabetes, smoking, and hypercholesterolemia. The variable that significantly correlated with the gradient of cTnI was the baseline hs-CRP (R2=0.374, p=0.048). CONCLUSION: Systemic inflammation correlated with periprocedural elevation of cTnI in stable angina patients. These results suggest that inflammation plays a pivotal role in the predictive value of myocardial injury after coronary intervention.
Angina Pectoris ; Angina, Stable* ; Angioplasty, Balloon, Coronary* ; Atherosclerosis ; C-Reactive Protein ; Humans ; Hypercholesterolemia ; Inflammation* ; Smoke ; Smoking ; Stents* ; Troponin I* ; Troponin*

BACKGROUND AND OBJECTIVES: Recent studies have implicated inflammation as playing an important role in the occurrence, persistence and recurrence of atrial fibrillation and that C-reactive protein is a useful marker of the inflammation. The purpose of this study is to evaluate the association between serum CRP levels and the risk of atrial fibrillation. SUBJECTS AND METHODS: This study was performed on 9,487 subjects (5,263 men and 4,224 women; mean age: 58.8+/-6.6 years) who underwent medical check-ups at the Health Promotion Center in Kanbuk Samsung Hospital. 9,438 normal control subjects and 49 atrial fibrillation patients were included in the study. The CRP was measured using a highly sensitive Behring Nephelometer II. RESULTS: When comparing the two groups, there were significant differences in age, gender and the presence of hypertension and cerebrovascular accident, and these are the previously known risk factors for atrial fibrillation. After adjustment was made for the clinical significant variables of atrial fibrillation, multiple regression analysis revealed that the hsCRP levels were not associated with the risk for atrial fibrillation (p=0.52). CONCLUSION: The inflammatory markers (CRP, WBC count) were not predictive of a higher risk for atrial fibrillation in the Korean population.
Adult* ; Atrial Fibrillation* ; C-Reactive Protein* ; Female ; Health Promotion ; Humans ; Hypertension ; Inflammation ; Male ; Recurrence ; Risk Factors ; Stroke