Fasting plasma glucose may behave as a positive in mild but as a negative acute phase reactant in moderate and severe inflammatory disorders

Abstract

Background: There may be significant relationships between fasting plasma glucose (FPG) and severity of inflammations. Method: All cases with digital clubbing were included. Results: The study included 104 cases with clubbing detected among 2.428 cases (1.044 males). So clubbing was higher in males (8.1% versus 1.3%, p<0.001). Mean age of clubbing cases was 49.2 years, and there was a male predominance (81.7%), again. Parallel to the male predominance, there were higher prevalences of smoking (69.2% versus 41.6%, p<0.001), chronic obstructive pulmonary disease (COPD) (27.8% versus 10.8%, p<0.001), and coronary heart disease (CHD) and/or peripheric artery disease (PAD) (7.6% versus 0.0%, p<0.01) in the clubbing cases. Whereas the body weight, body mass index (BMI), and FPG were lower in the clubbing cases but the differences were nonsignificant probably due to the small sample size. But diabetes mellitus (DM) (12.5% versus 21.6%, p<0.05) and systolic blood pressure (BP) (127.6 versus 136.9 mmHg, p= 0.011) were lower in the clubbing cases, significantly. Conclusion: There are significant relationships between smoking, digital clubbing, COPD, CHD, and PAD probably due to strong atherosclerotic effects of smoking. Similarly, the body weight, BMI, FPG, systolic BP, and DM are inversely related with the clubbing probably due to the severe inflammatory effects of smoking on the vascular endothelium, again. FPG may behave as a positive acute phase reactant (APR) in mild inflammatory disorders such as irritable bowel syndrome but as a negative APR in moderate and severe inflammatory disorders such as smoking, digital clubbing, and sickle cell diseases. Key words: Fasting plasma glucose, diabetes mellitus, irritable bowel syndrome, smoking, digital clubbing, sickle cell diseases, atherosclerosis