Factors influencing erythrocyte sedimentation rate in adults New evidence for an old test

The erythrocyte sedimentation rate (ESR) is a routine test for inflammation. Few studies have investigated the potential influence of lifestyle factors and common metabolic abnormalities on the ESR. This study investigates the influence of demographic factors, alcohol consumption, smoking, physical activity, obesity, and metabolic syndrome on the ESR in adults.This cross-sectional study covered 1472 individuals (44.5% males; age range, 18-91 years) randomly selected from the population of a Spanish municipality. The ESR was measured using a standardized method. We assessed habitual alcohol consumption in standard drinking units, along with tobacco smoking, regular physical exercise (by questionnaire), body mass index, and variables defining metabolic syndrome. Multivariate analyses were performed, including mean corpuscular volume and hemoglobin concentration in the models.The ESR was higher in females than in males, and increased steadily with age. Median ESR of females was 2-fold higher than that of males, and median ESR of individuals aged >65 years was 2-fold higher than that of individuals in the youngest category (ages 18-35 years). Body mass index, presence of metabolic syndrome, and smoking were independently and positively associated with higher ESR values. Light alcohol drinkers and individuals with high regular physical activity displayed lower ESR values than did alcohol abstainers and individuals with low physical activity, respectively.ESR varies greatly with age and sex, and corresponding reference values are proposed. Lifestyle factors (physical activity, smoking, and alcohol consumption) and common metabolic abnormalities (obesity and related metabolic syndrome) may also influence ESR values

Survey of potential toxic exposure in patients with systemic sclerosinin rescle registry. A preliminary study

Background Systemic sclerosis (SSc) is a systemic autoimmune disease with extremely heterogeneous clinical features and unknown etiology, although numerous studies suggest a relationship with environmental and occupational factors. So far there is little information on whether toxic substances can play a relevant role in its phenotypic expression (1). Objectives To analyze in a cohort of patients with SSc the proportion of patients exposed to toxic and their correlation with epidemiologic, clinical and serological data. Methods A survey was conducted aimed at the knowledge of the working life of patients from six centers belonging to the Spanish Scleroderma Registry (RESCLE), categorizing them in six groups: no potential exposure to toxic substances, potential exposure to silica, to hydrocarbons, to organic solvents, to mixed toxics (silica and/or hydrocarbons and/or organic solvents) and to another toxics. In all patients 87 epidemiological, clinical and analytical variables included in the registry were analyzed, carrying out a comparative study between groups. Results 225 SSc patients were selected. Of these, 81 patients (36%) had worked in professions with potential risk of toxic exposure, 64 women out of the 227 included (28%) and 17 men out of the 28 included (60%). The toxic agent most frequently involved was silica in 29 patients (35.8%), followed by hydrocarbons in 21 (25.9%), mixture of toxic substances in 21 other patients (25.9%), organic solvents in 4 patients (4.9%) and other toxic in 6 cases (7.4%). Toxic exposure was associated with a lower risk of being female (OR 0.15, p <0.001), having been exposed to tobacco (OR 0.4, p 0.037) and digital ulcers (OR 0.43, p 0.016) and with a greater likelihood of hepatic involvement (OR 3.63, p 0.021), musculoskeletal involvement (OR 2.13, p 0.017) and the slow capillary pattern of Maricq (OR 1.8, p 0.063). Analyzing the exposure groups separately, patients exposed to silica had a lower probability of Raynaud?s phenomenon (OR 0.25, p 0.005) and a higher probability of diagnosis at older ages (OR: 1.04, p 0.005), presence of Topoisomerase I antibody (OR 3.71, p 0.023) and slow capillary pattern of Maricq (OR 4.15, p 0.008). Patients exposed to hydrocarbons had an increased risk of liver involvement (OR 5.34, p 0.029). Conclusion In our cohort of 225 patients with SSc, 60% of male patients and 28% of women worked in a profession with a potential risk of toxic exposure. In this preliminary study, important differences were observed in the probability of a different phenotypic expression of the SSc according to the history of occupational exposure to toxins. Studies with a larger number of patients are needed to establish these associations in a solid way