Background and aims Endothelial dysfunction, vascular inflammation and oxidative stress have been integrally linked to the pathogenesis of both type 2 diabetes and cardiovascular disease. Aged Garlic Extract (AGE), a potent antioxidant, has been shown in previous studies to attenuate these novel risk factors in a non-diabetic population. Aims This study tested the hypothesis that AGE may improve endothelial function, oxidative stress, vascular inflammation and insulin resistance in high risk cardiovascular subjects with type 2 diabetes. Methods A double blind, placebo controlled crossover pilot study was performed in 26 subjects with type 2 diabetes who received 1200 mg of AGE or placebo daily for 4 weeks with a 4 week washout period. Plasma HsCRP was measured as a marker of inflammation. Plasma TAOS, blood GSH/GSSG and plasma LHP were measured as markers of oxidative stress/anti-oxidant defense. Insulin resistance was measured using the HOMA-IR method. Endothelial function was measured using change in the reflective index (RI) post-salbutamol using digital photoplethysmography and urinary albumin/creatinine ratio was measured as a biochemical surrogate. Measurements were taken at baseline and after intervention with AGE or placebo. Results Of the 26 patients studied (male 17, female 9), age was 61 ± 8 years (mean ± 1 SD), HbA1c 7.2 ± 1.1%, BP 130/75 ± 15.9/9.8 mmHg, total cholesterol 4.2 ± 0.81 mmol/l, triglyceride 2.11 ± 1.51 mmol/l, and HDL cholesterol 1.04 ± 0.29 mmol/l. The majority of patients were being treated with metformin (59%), aspirin (50%) and statin (96%) therapy. 36% were treated with an ACEI. There were no changes in these therapies throughout the study. Treatment with AGE had no significant effect upon the above metabolic parameters including insulin resistance. Treatment with AGE also had no significant effect on markers of endothelial function (plethysmography), oxidative stress (TAOS, GSH/GSSG, LHP) or inflammation (HsCRP). Conclusion In this group of type 2 diabetic patients at high cardiovascular risk, 4 weeks treatment with AGE did not significantly improve endothelial function, vascular inflammation, oxidative stress or insulin resistance.

https://researchportal.port.ac.uk/portal/files/6700035/The_effects_of_garlic_extract_upon_endothelial_function.pdf

The effects of garlic extract upon endothelial function, vascular inflammation, oxidative stress and insulin resistance in adults with type 2 diabetes at high cardiovascular risk. A pilot double blind randomized placebo controlled trial

Background: Inflammation plays a key role in the pathogenesis of atherosclerosis and coronary artery disease (CAD). Aim and Objectives: The aim of this study was to assess the relation of serum high-sensitivity C-reactive protein (hs-CRP) with the presence and severity of CAD. Study Design: This was a cross-sectional, observational study done on patients with diagnosis of acute coronary syndrome (ACS) undergoing coronary angiogram (CAG). Materials and Methods: A total of 100 patients were included in this study satisfying the inclusion criteria. The inclusion criteria were patients with the diagnosis of ACS undergoing CAG. All enrolled patients underwent hs-CRP, hemoglobin, serum creatinine, fasting lipid profile, blood sugar level, resting 12-lead electrocardiogram, creatine kinase–myocardial band, troponin -I, and CAG. Statistical Analysis: Data were analyzed for mean, percentage, standard deviation and Chi-square test for quantitative data using SPSS software version 21 (trial version), and P 3 mg/L. The significant number of patients with double-vessel disease (DVD) and triple-vessel disease (TVD) had an hs-CRP level between 1 and 3 mg/L compared to single-vessel disease (SVD) with P 3 mg/L (P

High-sensitive C-reactive protein in patients with coronary artery disease

Association between the SUMO4 M55V (A163G) polymorphism and susceptibility to type 1 diabetes: A meta-analysis

Background Statin and aspirin form the therapeutic cornerstone in patients with coronary artery disease (CAD) and diabetes. Little is known about relationship of statins with blood thrombogenicity and inflammation in these patients. Methods Two hundred nine consecutive patients with diabetes and suspected CAD undergoing elective cardiac catheterization were divided in groups based on statin treatment in the Multi-Analyte, Thrombogenic, and Genetic Markers Atherosclerosis study. Urinary 11-dehydrothromboxane B2 (11-dh-TxB2), lipid profile and oxLDL/β2GPI were measured by AspirinWorks™ ELISA assay, vertical density gradient ultracentrifugation and immunoassay respectively. Thrombelastography, and ADP- and collagen-induced light transmittance aggregometry assessed thrombogenicity. CAD was classified as none/minor [ 75% DS). Results Severe, moderate, and no CAD was observed in 66, 19, and 15% of patients respectively. Patients on statins had significantly lower 11-dh-TxB2, collagen-induced aggregation, total cholesterol, total LDL, LDL3, oxidized-LDL, Apo B100, and ApoB100/A1 ratio ( p 1500pg 11-dh-TxB2/mg creatinine) (25 vs. 57%, p =0.01). Conclusion Statins along with aspirin, confers additional anti-inflammatory and antithrombotic effect in diabetics with CAD. Urinary 11-dh-TxB2 may be a useful biomarker for personalizing statin therapy.

Statin therapy and inflammation in patients with diabetes treated with high dose aspirin

C-reactive protein(CRP) is the most common acute phase response proteins in the bodyAs an inflammatory marker for diabetes has been identified as independent predictors of cardiovascular events,and which is closely related to cardiovascular events and diabetesHigh sensitivity C-reactive protein(hs-CRP) is more sensitive than the standard CRP for cardiovascular complications of diabetes and its risk analysis,hs-CRP have been proved to be a strong predictor of cardiovascular events by a number of prospective studiesThis article will introduce recent studies on the relationship among CRP,hs-CRP,diabetes mellitus and cardiovascular diseases

Role of Inflammatory Markers C-reactive Protein,High Sensitivity C-reactive Protein in Diabetes and Its Cardiovascular Complications

BACKGROUND/AIMS Patients with diabetes are prone to coronary artery disease (CAD); however, the majority of diabetic patients show normal coronary arteries. We examined differences in the clinical aspects of diabetic patients with insignificant and with significant stenosis of the coronary artery. METHODS A total of 418 consecutive diabetic patients with stable angina who had undergone coronary angiography from January 2004 to March 2007 were included in this study. Patients were subdivided into control and CAD groups and then clinical characteristics and CAD-associated factors were evaluated. RESULTS A total of 92 (22%) patients were assigned to the control group and 326 (78%) patients were assigned to the CAD group. Using univariate regression analysis, we found that patients with CAD were significantly older (control vs. CAD; 59+/-21 vs. 64.7+/-33.7, years, p<0.001), had a longer duration of diabetes (8.2+/-21.8 vs. 10.2+/-29.8, years, p=0.027), higher titers of high sensitivity C-reactive protein (hsCRP; 0.3+/-6.79 vs. 0.9+/-12.6, mg/dL, p=0.015), and increased hemoglobin A1c (HbA1c) levels (7.1+/-3.8 vs. 7.5+/-4.8, %, p=0.007) compared to control patients. Multivariate regression analysis showed that only differences in age, hsCRP, and HbA1c were statistically significant. When patients were subdivided into groups based on hsCRP levels (208 patients in the low group [49.8%], 210 patients in the high group [50.2%]), we found that patients with higher hsCRP levels showed more frequent multivessel disease. CONCLUSIONS In diabetic patients, age, hsCRP, and HbA1c were associated with stable CAD. Among these factors, hsCRP levels were significantly correlated with multivessel involvement in diabetic CAD. Therefore, high hsCRP levels may be a strong predictor for atherosclerotic progression of the coronary arteries in diabetic patients, suggesting that regular screening tests should be performed.

Significance of inflammatory markers in diabetic patients with stable coronary artery disease.

Historically, bronchioloalveolar carcinoma has been recognized as a subtype of pulmonary adenocarcinoma and was included in both the 1967 and 1981 World Health Organization (WHO) classifications of lung tumors. The WHO defines bronchioloalveolar carcinoma as a subtype of adenocarcinoma with growth along the alveolar septa and without evidence of stromal, vascular, or pleural invasion. Bronchioloalveolar carcinoma may have three computed tomography patterns: solitary, pneumonic, and diffuse forms. Diffuse, multiple cavitary bronchioloalveolar carcinoma is very rare. Here, we report a case of bronchioloalveolar carcinoma with a diffuse multiple cystic pattern, an uncommon finding.

A case of bronchioloalveolar carcinoma with a diffuse multiple cystic pattern

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Significance of inflammatory markers in diabetic patients with stable coronary artery disease.

A case of bronchioloalveolar carcinoma with a diffuse multiple cystic pattern