calca-protein--human and Hyperglycemia

Despite the condition's high prevalence, the influence of hyperglycaemia on clinical outcomes in non-critical-care inpatients with infections remains ill defined. In this study, we analysed associations of glucose levels at admission and during initial inpatient treatment with the inflammatory response and clinical outcome in community-acquired pneumonia (CAP) patients.. This secondary observational analysis included 880 confirmed CAP patients. We used severity-adjusted multivariate regression models to investigate associations of initial and 96 h mean glucose levels with serially measured biomarker levels over 7 days (C-reactive protein [CRP], procalcitonin, white blood cell count [WBC], pro-adrenomedullin [ProADM]) and adverse clinical course (death and intensive-care unit admission).. In the 724 non-diabetic patients (82.3% of the study population), moderate or severe hyperglycaemia (glucose 6-11 mmol/l and >11 mmol/l, respectively) was associated with increased risk for adverse clinical course (adjusted OR [95% CI] 1.4 [0.8, 2.4] and 3.0 [1.1, 8.0], respectively) and with higher CRP, WBC and ProADM levels over 7 days (p < 0.05, ANOVA, all days). In diabetic patients (n = 156), no similar associations were found for initial hyperglycaemia, although mean 96 h glucose levels  ≥ 9 mmol/l were associated with adverse clinical course (adjusted OR 5.4 [1.1, 25.8]; p = 0.03). No effect modification by insulin treatment was detected (interaction terms p > 0.2 for all analyses).. Initial hyperglycaemia in non-diabetic CAP patients, and prolonged hyperglycaemia in diabetic or non-diabetic CAP patients, are associated with a more pronounced inflammatory response and CAP-related adverse clinical outcome. Optimal glucose targets for insulin treatment of hyperglycaemia in non-critical-care settings should be defined.

Topics: Aged; Anti-Bacterial Agents; Biomarkers; Blood Glucose; Body Mass Index; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Community-Acquired Infections; Diabetes Mellitus; Female; Hospitalization; Humans; Hyperglycemia; Inflammation; Leukocyte Count; Male; Pneumonia; Prognosis; Prospective Studies; Protein Precursors; Randomized Controlled Trials as Topic; Stress, Physiological

Hyperglycemia is a common complication of diabetes melitis (DM) and in the absence of metabolic decompensation is a common finding in the Emergency Department (ED). We aimed to evaluate the 25 OH Vit D [25(OH)D] and procalcitonin (PCT) levels during hyperglycemia and after normalization of blood glucose.. The study included 88 patients over the age of 18 years who presented with acute hyperglycemia at the Hacettepe University Department of Emergency Medicine. Euglycemia was obtained within 6-12 hours and serum samples were taken from patients on admission and 6 hours after normalization of blood glucose. Along with plasma glucose, plasma 25(OH)D and PCT levels were measured using ELISA.. There were 88 (45 males) patients, with a median age of 60.0±13.9 years. Serum 25(OH)D levels increased in all patients after normalization of blood glucose, and serum PCT levels decreased in the whole group. This decrease was independent of type of diabetes or presence of infection.. We demonstrated an increase in 25(OH)D after normalization of blood glucose, and a decrease in PCT in patients with hyperglycemia. This effect was independent of the type of diabetes and presence of infection. Further studies are needed to evaluate the faster link between metabolic abnormalities, vitamin D, PCT, and inflammation.

Topics: Acute Disease; Calcitonin; Calcitonin Gene-Related Peptide; Female; Humans; Hyperglycemia; Insulin; Male; Middle Aged; Protein Precursors; Vitamin D

Periodontitis and type 2 diabetes are co-morbid conditions, both characterized by infectious susceptibility. We investigated procalcitonin (ProCT) levels in the serum and saliva of persons with periodontitis and type 2 diabetes (n = 20), to determine if these levels are altered by periodontitis activity or by hyperglycemia. Persons with severe periodontitis showed higher levels of salivary-ProCT than did those with moderate periodontitis (241 +/- 71 vs. 77 +/- 516 pg/mL, p = 0.02) and higher levels than did healthy control individuals (118 +/- 26 pg/mL, p = 0.05). Salivary-ProCT levels were correlated with bleeding-on-probing (r = 0.45, p = 0.05), as well as with HgbA(1c) (r = 0.49, p = 0.03). Salivary levels of ProCT were higher than serum levels for the periodontitis/diabetes group (152 +/- 37 vs. 78 +/- 17 pg/mL, p = 0.02) and the control group (118 +/- 146 vs. 48 +/- 17 pg/mL, p = 0.01). Persons with periodontitis and type 2 diabetes have salivary-ProCT levels that reflect their degree of periodontitis activity and hyperglycemia. This study demonstrates, for the first time, the presence of procalcitonin (ProCT), an established serum marker of infection, in saliva.

Topics: Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Case-Control Studies; Diabetes Mellitus, Type 2; Follow-Up Studies; Humans; Hyperglycemia; Male; Middle Aged; Periodontal Index; Periodontitis; Protein Precursors; Reference Values; Saliva; Severity of Illness Index; Statistics, Nonparametric; Treatment Outcome