Association Between Increased Vascular Nitric Oxide Bioavailability and Progression to Dengue Hemorrhagic Fever in Adults.
In a prospective longitudinal adult study, vascular nitric oxide bioavailability measured as reactive hyperemia index was significantly higher at enrollment in patients who developed dengue hemorrhagic fever (DHF) (n = 11), compared with the non-DHF group (n = 63) and those with other febrile illnesses (n = 25) (P = .01). After adjustment for age, fever day, and body mass index, enrollment reactive hyperemia index was associated with a 4-fold increased risk for DHF, and predicted DHF with an area under the receiver operating curve of 0.86. Increased vascular nitric oxide in dengue is associated with increased vascular permeability and impaired homeostasis and may have utility as a predictor of DHF.
Communicable Disease Centre, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital.
Tun-Linn
TL
Thein
Communicable Disease Centre, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital.
Joshua
J
Wong
Communicable Disease Centre, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital Yong Loo Lin School of Medicine, National University of Singapore Lee Kong Chian School of Medicine, Nanyang Technological University.
Yee-Sin
YS
Leo
Duke-NUS Graduate Medical School, Singapore.
Eng-Eong
EE
Ooi
Communicable Disease Centre, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital Yong Loo Lin School of Medicine, National University of Singapore.
David
D
Lye
Communicable Disease Centre, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital Lee Kong Chian School of Medicine, Nanyang Technological University.
Tsin W
TW
Yeo
D000328:Adult; D000368:Aged; D001682:Biological Availability; D001808:Blood Vessels / Q000737:chemistry*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000139:chemically induced; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis*; D011379:Prognosis; D011446:Prospective Studies; D019595:Severe Dengue / Q000175:diagnosis* / Q000473:pathology*; D055815:Young Adult
D009569:Nitric Oxide
adult; dengue hemorrhagic fever; endothelial function; nitric oxide; noninvasive; peripheral arterial tone; reactive hyperemia index; vascular