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  • We compared the age BMI and


    We compared the age, BMI and relevant laboratory variables between the two groups of risk factor multiplicity. The results are presented in Table 7 for the women and in Table 8 for the men. The individuals with an increased erythrocyte adhesiveness/aggregation can clearly be seen to be older, more obese, have a worse lipid profile, and have evidence of a more intense inflammatory response. There was no significant difference in the hs-CRP level for women with single or multiple atherosclerotic risk factors. Finally, we performed discriminant analysis to classify the subjects into groups of none and single versus multiple risk factors. As can be seen in Table 9, the predictive values for the different inflammatory variables are comparable.
    Discussion Our findings clearly demonstrate that the use of sensitive markers of the acute phase response reveals the presence of low-grade inflammation in apparently healthy individuals and in those with a spectrum of risk factors for atherothrombosis. Recent studies have presented several lines of evidence that the down-regulation of the inflammatory response might prove beneficial [20]. Hence, the use of these markers in clinical practice might have a role in the risk stratification of the patients and in the following therapeutic interventions. Several markers have been shown to correlate with the individual's morbid biology profile: hs-CRP [2], erythrocyte sedimentation [3], fibrinogen concentrations [4], WBCC [21], serum amyloid A [6], IL6 [6], tumor necrosis factor (TNF) and other proteins that are synthesized during inflammation [7]. Cost constraints will preclude the possibility to evaluate most of these variables in a given patient. Our search, therefore, is to determine whether we can present a simple, rapid and inexpensive biomarker that is influenced by the presence of increased concentrations of multiple acute phase proteins. In fact, this assay actually evaluates the adhesive behavior of the patient's own cantharidin receptor in their milieu of plasmatic acute phase response adhesive macromolecules. The prerequisite for such an alternative is that it will correlate at least with some of the above-mentioned acute phase response markers. Bearing this in mind, we turned to erythrocyte aggregability because increased erythrocyte aggregation has been shown to appear during unfavorable conditions in terms of atherosclerotic biorheology. In fact, increased erythrocyte aggregability has been shown to be associated with increased concentrations of fibrinogen [14], lipids [22] during diabetes [23] hypertension [24] smoking [25], menopause [26]and inflammation [27], all of which are associated with an unfavorable biorheological profile. Furthermore, increased erythrocyte aggregation was associated with the prevalence and with the poorer prognosis in coronary artery disease [28]. In considering the usefulness of this phenomenon for diagnosis, it should be taken into consideration that a number of acute phase response proteins, including gamma globulins, ceruloplasmin, antitrypsin, fibrinogen, haptoglobin and even CRP itself, have been shown to contribute to the appearance of an increased erythrocyte aggregability [14], [15], [16], [22]. Therefore, we assume that a direct look at the phenomenon of increased erythrocyte adhesiveness/aggregation during inflammation might convey a relevant message in patients with atherothrombosis. We analyzed the results for women and men separately since several researches have already demonstrated sex-related differences in the baseline level of the inflammatory markers such as erythrocyte sedimentation, fibrinogen concentration and CRP. Our results also showed difference between the sexes in their inflammatory profiles. We found better Pearson correlation coefficients between the EAAT and the variables of the acute phase response in the men (Table 1). Also, the concentration of hs-CRP in relation to the multiplicity of risk factors differs between the sexes (Table 5, Table 7, Table 8).