Proteïna C-Rectiva. Estudis en població de l'àrea Mediterrànea

by Bertran Ferrús, Núria

UNIVERSITAT ROVIRA I VIRGILI. FACULTAT DE MECICINA I CIÈNCIES DE LA SALUT. DEPARTAMENT DE CIÈNCIES MÈDIQUES BÀSIQUES, Doctoral Thesis. M.Núria Bertran Ferrús July 2006 C- Reactive Protein. A study on populations in a mediterranean region. Summary Introduction. Cardiovascular diseases are associated to a high mortality rate in the western world. This study of the C-reactive protein (CRP) was motivated by the need to establish the levels of risk of contracting these diseases and their association with the inflammation process. The American Heart Association (AHA) has established criteria for determining clinical protocols and public health guidelines based on numerous studies on the risk of contracting these diseases, which is considered to be higher in patients with a higher concentration of CRP than those with lower concentrations. Three levels of risk have been identified (?1.0; 1.0-3.0; ?3.0 mg/L). However, there is also a need to know population differences when applying these criteria. This thesis aims to contribute to the knowledge of CRP in order to improve strategies for the prevention of the arteriosclerotic process and/or cardiovascular disease. Study objectives. (1) To evaluate a highly sensitive turbidimetric immunoassays for the measurement of using CPR concentrations. (2) To investigate chronological changes in the concentration of CPR in fertile women from preconception through the normal pregnancy term and to evaluate the associations of CRP with the Body Mass Index (BMI) and weight increase among other variables. (3) To establish reference values of CPR in a healthy population and to study the effects on CPR concentrations of nutrition and other factors connected to lifestyle choices. (4) To evaluate the association of CPR and the inflammatory protein MCP-1 in patients with a history of chronic hepatitis. Conclusions. On evaluating the hs-CPR method, a sensitivity of 0.3mg/L was found. There was no substancial nterference from hyperlipidemia (triglycerides ? 6 mmol/L), jaundice ( bilirubine ? 175 ?mol/L), haemoglobin ? 5 g/L, and paraproteins (IgG, IgA, IgM ? 20 g/L). In pregnant woman, the mothers weight influence the concentration of CRP. The BMI before conception is related to the levels of CPR in the first term of pregnancy, and the increase in the mothers body weight during pregnancy is associated to the CPR at the birth of the child.The second study, was representative of the healthy adult population in the Mediterranean area. CPR reference values obtained were similar to those of the population in Northern Europe and the USA. The association with nutritional habits were studied. A multivariate analysis between different nutrients and CRP demonstrated an association with the ingestion of folates. Thus, a type of diet (rich in fruit and vegetables) could be implicated to low values of CRP. In the third study, the MCP-1 marker involved in the inflamation process was also studied together with its association to CRP at different levels of inflammation defined in the histology. No association was found between the concentrations of CRP in the blood and the level of liver disfunction even though the values of MCP-1 were indeed related to the evolution of the illness. UNIVERSITAT ROVIRA I VIRGILI. FACULTAT DE MEDICINA I CIÈNCIES DE LA SALUT. DEPARTAMENT DE CIÈNCIES MÈDIQUES BÀSIQUES. Tesi Doctoral M..Nuria Bertran Ferrús Juliol 2006 Proteïna C - reactiva. Estudis en poblacions de làrea mediterrània.