C-reactive protein is differentially modulated by co-existing infections,vitamin deficiencies and maternal factors in pregnant and lactating indigenous Panamanian women  

作　　者：Doris Gonzalez-Fernandez Emerita del Carmen Pons Delfina Rueda Odalis Teresa Sinisterra Enrique Murillo Marilyn E.Scott Kristine G.Koski 

机构地区：[1]School of Dietetics and Human Nutrition,Macdonald Campus of McGill University,21,111 Lakeshore Road,Ste-Anne-de-Bellevue,QC H9X 3V9,Canada [2]Department of Nutritional Health,Ministry of Health,Ancon,Panama City,Panama [3]“Comarca Ngabe-Bugle”Health Region,Ministry of Health,San Felix,Chiriqui Province,Panama [4]“Panama Norte”Health Region,Ministry of Health,Las Cumbres Square,Transithmian Highway,Panama City,Panama [5]Department of Biochemistry,University of Panama,Simon Bolivar Avenue(Transithmian Highway),Panama City,Panama [6]Department of Biochemistry,University of Panama,Manuel Espinoza Batista and Jose De Fabrega Avenues,Panama City,Panama [7]Institute of Parasitology and Centre for Host-Parasite Interactions,Macdonald Campus of McGill University,21,111 Lakeshore Road,Ste-Anne-de-Bellevue,QC H9X 3 V9,Canada [8]School of Dietetics and Human Nutrition and Centre for Host-Parasite Interactions,Macdonald Campus,McGill University,21,111 Lakeshore Road,Ste-Anne-de-Bellevue,QC H9X 3 V9,Canada

出　　处：《Infectious Diseases of Poverty》2017年第1期819-832,共14页贫困所致传染病（英文）

基　　金：Panamanian“Secretaria Nacional de Ciencia,Tecnologia e Innovacion”(SENACYT)COL08-009;McGill Vitamin Fund.

摘　　要：Background:The usefulness of C-reactive protein(CRP)as a non-specific marker of inflammation during pregnancy and lactation is unclear in impoverished populations where co-existing infections and vitamin deficiencies are common.Methods:This cross-sectional study in Panama recruited 120 pregnant and 99 lactating Ngäbe-Buglewomen from 14 communities in rural Panama.Obstetric history,indoor wood smoke exposure,fieldwork,BMI,vitamins A,B_(12),D,and folic acid,and inflammation markers(CRP,neutrophil/lymphocyte ratio(NLR),plateletcrit and cytokines)were measured.Multiple regressions explored both associations of CRP with other inflammatory markers and associations of CRP and elevated CRP based on trimester-specific cut-offs with maternal factors,infections and vitamin deficiencies.Results:CRP was higher in pregnancy(51.4±4.7 nmol/L)than lactation(27.8±3.5 nmol/L)and was elevated above trimester specific cut-offs in 21%of pregnant and 30%of lactating women.Vitamin deficiencies were common(vitamin A 29.6%;vitamin D 68.5%;vitamin B1268%;folic acid 25.5%)and over 50%of women had two or more concurrent deficiencies as well as multiple infections.Multiple regression models highlighted differences in variables associated with CRP between pregnancy and lactation.In pregnancy,CRP was positively associated with greater indoor wood smoke exposure,caries and hookworm and negatively associated with Ascaris and vaginal Lactobacillus and Bacteroides/Gardnerella scores.Consistent with this,greater wood smoke exposure,caries as well as higher diplococcal infection score increased the odds of trimester-elevated CRP concentrations whereas longer gestational age lowered the likelihood of a trimester-elevated CRP.During lactation,folic acid deficiency was associated with higher CRP whereas parity,number of eosinophils and Mobiluncus score were associated with lower CRP.Also,a higher BMI and Trichomonas vaginalis score increased the likelihood of an elevated CRP whereas higher parity and number of eosinophils were associated with lower l

关 键 词：CRP Intestinal parasites CARIES Vaginal infections Folic acid deficiency Wood smoke Neutrophil/lymphocyte ratio PLATELETCRIT Pregnancy LACTATION 

分 类 号：R71[医药卫生—妇产科学]