Pub Date : 2021-05-01DOI: 10.4103/ejode.ejode_15_21
Rasha A. Elsisy, Marwa M. Mona, Sanad S Elkholy
Background The ketogenic diet (KD) is effective to fight obesity and has therapeutic effects on various body systems. Aim/objectives This study aimed to evaluate the role of KD in improving immune response against cyclophosphamide (CTX)-induced immunosuppression in rats. Methods Young adult albino rats (21 male) were divided into three groups: G1 (Cnt), normal control fed on a basal diet; G2 (CTX), injected with CTX and fed on a basal diet; and G3 (Keto), injected with CTX and fed on a ketogenic diet for 4 weeks. Results This study revealed that treatment with CTX decreased serum levels of total protein, albumin, globulin. Administration of CTX also resulted in a significant decrease in catalase (CAT), superoxide dismutase (SOD) levels and a significant increase in the levels of malondialdehyde (MDA) in the spleen. Histopathological examination revealed that CTX caused lymphocyte depletion in the spleen and thymus. Molecularly, CTX significantly downregulated the expression of interferon-gamma (IFN-γ), while it upregulated interleukin 1 beta (IL1b) in the spleen. Co-administration of the ketogenic diet was able to normalize the antioxidant status and most of the biochemical and immunological parameters. Conclusion With these findings, we could conclude that feeding on ketogenic diet could improve the immunity.
生酮饮食是对抗肥胖的有效方法，对人体各系统都有治疗作用。目的:探讨KD在改善大鼠对环磷酰胺(CTX)诱导的免疫抑制的免疫应答中的作用。方法年轻成年白化病大鼠21只，分为3组:G1组，正常对照组，饲喂基础日粮;G2 (CTX)，注射CTX，饲喂基础日粮;G3(酮组)注射CTX，饲喂生酮饮食4周。结果CTX治疗可降低血清总蛋白、白蛋白、球蛋白水平。CTX还导致脾脏过氧化氢酶(CAT)、超氧化物歧化酶(SOD)水平显著降低，丙二醛(MDA)水平显著升高。组织病理学检查显示CTX引起脾脏和胸腺淋巴细胞减少。在分子上，CTX显著下调干扰素γ (IFN-γ)的表达，同时上调脾脏中白细胞介素1 β (il - 1b)的表达。同时给予生酮饮食能够使抗氧化状态和大部分生化和免疫参数正常化。结论生酮饮食可以提高小鼠的免疫力。
{"title":"Immunostimulatory effect of ketogenic diet in cyclophosphamide-induced immunosuppression in adult albino rats","authors":"Rasha A. Elsisy, Marwa M. Mona, Sanad S Elkholy","doi":"10.4103/ejode.ejode_15_21","DOIUrl":"https://doi.org/10.4103/ejode.ejode_15_21","url":null,"abstract":"Background The ketogenic diet (KD) is effective to fight obesity and has therapeutic effects on various body systems. Aim/objectives This study aimed to evaluate the role of KD in improving immune response against cyclophosphamide (CTX)-induced immunosuppression in rats. Methods Young adult albino rats (21 male) were divided into three groups: G1 (Cnt), normal control fed on a basal diet; G2 (CTX), injected with CTX and fed on a basal diet; and G3 (Keto), injected with CTX and fed on a ketogenic diet for 4 weeks. Results This study revealed that treatment with CTX decreased serum levels of total protein, albumin, globulin. Administration of CTX also resulted in a significant decrease in catalase (CAT), superoxide dismutase (SOD) levels and a significant increase in the levels of malondialdehyde (MDA) in the spleen. Histopathological examination revealed that CTX caused lymphocyte depletion in the spleen and thymus. Molecularly, CTX significantly downregulated the expression of interferon-gamma (IFN-γ), while it upregulated interleukin 1 beta (IL1b) in the spleen. Co-administration of the ketogenic diet was able to normalize the antioxidant status and most of the biochemical and immunological parameters. Conclusion With these findings, we could conclude that feeding on ketogenic diet could improve the immunity.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114525100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-01DOI: 10.4103/ejode.ejode_21_21
Reem Fathalla, N. Lachine, Mohamed Badbess, M. Tahoun, M. Zeitoun
Background Neck circumference (NC) is an easy and reliable anthropometric measurement. The use of NC as an indicator of obesity among Egyptians was previously established. However, the relationship between NC and different cardiometabolic risk (CMR) parameters was not previously studied in the Egyptian population. Objective The aim of this work was to study the relationship between NC and some CMR parameters in obese adult Egyptian individuals. Participants and methods This cross-sectional study was carried out on 100 apparently healthy obese adult Egyptian participants (BMI ≥30 kg/m2), above the age of 18 years, 50% of them were males and the other 50% were females. NC and other traditional anthropometric measurements were evaluated. Blood samples were assayed for glycosylated hemoglobin, total cholesterol, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, and high-sensitivity C-reactive protein. Results There were significant positive correlations between NC and each of systolic and diastolic blood pressure [(r=0.527, P<0.001), (r=0.430, P<0.001), respectively], waist circumference (r=0.538, P<0.001), BMI (r=0.403, P<0.001), and high-sensitivity C-reactive protein (r=0.304, P=0.002). While a significant negative correlation was found between NC and HDL-C. Multivariate regression analysis revealed an independent association of NC with waist circumference in males and with systolic blood pressure in females. Conclusion This study does not only confirm the association of NC with anthropometric measurements in the Egyptian population, but it also establishes the NC association with CMR factors that support the possibility of using NC as a CMR marker among Egyptians.
{"title":"Relationship of neck circumference to some cardiometabolic risk parameters: a cross-sectional study among obese adult Egyptians","authors":"Reem Fathalla, N. Lachine, Mohamed Badbess, M. Tahoun, M. Zeitoun","doi":"10.4103/ejode.ejode_21_21","DOIUrl":"https://doi.org/10.4103/ejode.ejode_21_21","url":null,"abstract":"Background Neck circumference (NC) is an easy and reliable anthropometric measurement. The use of NC as an indicator of obesity among Egyptians was previously established. However, the relationship between NC and different cardiometabolic risk (CMR) parameters was not previously studied in the Egyptian population. Objective The aim of this work was to study the relationship between NC and some CMR parameters in obese adult Egyptian individuals. Participants and methods This cross-sectional study was carried out on 100 apparently healthy obese adult Egyptian participants (BMI ≥30 kg/m2), above the age of 18 years, 50% of them were males and the other 50% were females. NC and other traditional anthropometric measurements were evaluated. Blood samples were assayed for glycosylated hemoglobin, total cholesterol, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, and high-sensitivity C-reactive protein. Results There were significant positive correlations between NC and each of systolic and diastolic blood pressure [(r=0.527, P<0.001), (r=0.430, P<0.001), respectively], waist circumference (r=0.538, P<0.001), BMI (r=0.403, P<0.001), and high-sensitivity C-reactive protein (r=0.304, P=0.002). While a significant negative correlation was found between NC and HDL-C. Multivariate regression analysis revealed an independent association of NC with waist circumference in males and with systolic blood pressure in females. Conclusion This study does not only confirm the association of NC with anthropometric measurements in the Egyptian population, but it also establishes the NC association with CMR factors that support the possibility of using NC as a CMR marker among Egyptians.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125156322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-01DOI: 10.4103/ejode.ejode_18_21
Rasha Gawish, Ahmed Abd Hatab, Montaser Zeid
Background Vitamin D metabolism might be influenced by impaired allograft function and by persistently elevated parathyroid hormone (PTH) and fibroblast growth factor 23 levels as well. Hyperparathyroidism is a frequent and sometimes severe complication following renal transplantation. Purpose The primary objective was to measure the prevalence of vitamin D deficiency in renal transplant recipients in a single center (Almowasah Hospital). The secondary objective was to determine predictors of low 25-hydroxyvitamin D levels using patient characteristics to identify patients at a higher risk of vitamin D deficiency. Patients and methods A retrospective cross-sectional study was conducted on 55 renal transplant recipients for whom 25-hydroxyvitamin D was measured. Intact PTH was measured as well and compared with pretransplant values. Results The majority of the patients, representing ∼81.8%, were vitamin D deficient, whereas 14.5% had insufficient serum vitamin D level. A minority of the patients (3.6%) showed sufficient vitamin D level. The mean vitamin D level was 15.13±7.03 ng/ml. Approximately 38.2% of the patients showed evidence of persistent hyperparathyroidism. The median PTH level was higher in the pretransplant period, with a value of 308.0 pg/ml, compared with the posttransplant period (121.0 pg/ml). The difference was statistically significant (P<0.001). Serum PTH level showed a reduction in its level by ∼55.79% after transplantation. Conclusion Vitamin D deficiency is highly prevalent in renal transplant recipients. It is also more prevalent in early than late transplant recipients, and there is a statistically significant inverse correlation between vitamin D and PTH.
{"title":"Prevalence of vitamin D deficiency and persistent hyperparathyroidism in an Egyptian cohort of renal transplant recipients: a cross-sectional study","authors":"Rasha Gawish, Ahmed Abd Hatab, Montaser Zeid","doi":"10.4103/ejode.ejode_18_21","DOIUrl":"https://doi.org/10.4103/ejode.ejode_18_21","url":null,"abstract":"Background Vitamin D metabolism might be influenced by impaired allograft function and by persistently elevated parathyroid hormone (PTH) and fibroblast growth factor 23 levels as well. Hyperparathyroidism is a frequent and sometimes severe complication following renal transplantation. Purpose The primary objective was to measure the prevalence of vitamin D deficiency in renal transplant recipients in a single center (Almowasah Hospital). The secondary objective was to determine predictors of low 25-hydroxyvitamin D levels using patient characteristics to identify patients at a higher risk of vitamin D deficiency. Patients and methods A retrospective cross-sectional study was conducted on 55 renal transplant recipients for whom 25-hydroxyvitamin D was measured. Intact PTH was measured as well and compared with pretransplant values. Results The majority of the patients, representing ∼81.8%, were vitamin D deficient, whereas 14.5% had insufficient serum vitamin D level. A minority of the patients (3.6%) showed sufficient vitamin D level. The mean vitamin D level was 15.13±7.03 ng/ml. Approximately 38.2% of the patients showed evidence of persistent hyperparathyroidism. The median PTH level was higher in the pretransplant period, with a value of 308.0 pg/ml, compared with the posttransplant period (121.0 pg/ml). The difference was statistically significant (P<0.001). Serum PTH level showed a reduction in its level by ∼55.79% after transplantation. Conclusion Vitamin D deficiency is highly prevalent in renal transplant recipients. It is also more prevalent in early than late transplant recipients, and there is a statistically significant inverse correlation between vitamin D and PTH.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115443603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4103/ejode.ejode_10_21
S. Abou‐Raya, Sekina Ahmed, L. Nofal, Mariane Labib, Reem Shaala
Introduction Diabetes mellitus type 2 (T2DM) is a chronic metabolic disease with a great impact on health status and quality of life (QoL) in terms of physical, social, and psychological well-being. The aim of the present study was to measure diabetes-dependent QoL and affecting factors in patients with T2DM. Patients and methods The study participants were men and women aged 65 years and older affected by T2DM recruited from the Geriatric Medicine Unit ward and from the outpatient Geriatric Medicine Clinic of the Alexandria University Hospital. ADDQoL and short form-12 health survey were used to assess QoL. Results Diabetes had a negative impact on QoL, especially in terms of the physical health according to ADDQoL and mild physical and moderate mental disability according to the short form-12 health survey. Multivariate analysis revealed that glycemic control was not a determinant of QoL. Conclusion The results of the study suggest that good glycemic control has a weak relationship with QoL.
{"title":"Relationship between glycemic control and quality of life in elderly patients with type 2 diabetes in Alexandria University Hospitals","authors":"S. Abou‐Raya, Sekina Ahmed, L. Nofal, Mariane Labib, Reem Shaala","doi":"10.4103/ejode.ejode_10_21","DOIUrl":"https://doi.org/10.4103/ejode.ejode_10_21","url":null,"abstract":"Introduction Diabetes mellitus type 2 (T2DM) is a chronic metabolic disease with a great impact on health status and quality of life (QoL) in terms of physical, social, and psychological well-being. The aim of the present study was to measure diabetes-dependent QoL and affecting factors in patients with T2DM. Patients and methods The study participants were men and women aged 65 years and older affected by T2DM recruited from the Geriatric Medicine Unit ward and from the outpatient Geriatric Medicine Clinic of the Alexandria University Hospital. ADDQoL and short form-12 health survey were used to assess QoL. Results Diabetes had a negative impact on QoL, especially in terms of the physical health according to ADDQoL and mild physical and moderate mental disability according to the short form-12 health survey. Multivariate analysis revealed that glycemic control was not a determinant of QoL. Conclusion The results of the study suggest that good glycemic control has a weak relationship with QoL.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130618475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim To assess the adequacy of urinary podocalyxin (PCX) as a biomarker for early detection and disease progression of podocytopathy in high-BMI patients with metabolic syndrome with normal and impaired kidney functions. Patients and methods This is a cross-sectional study where all participants were subjected to full history taking, complete physical examination with assessment of BMI, and laboratory investigation to assess the inclusion and exclusion criteria. Then, a fresh morning urinary sample was obtained to measure both urinary albumin/creatinine ratio (UACR) and urinary PCX, where urinary PCX is measured by using human PCX ELISA kit. Results Urinary PCX showed that it can differentiate between group BI (albuminuric with normal renal functions) and BII (impaired renal functions) at the suggested cutoff point of 285 pg/ml, with 52% sensitivity and 45% specificity with low positive predictive value 48.8% and negative predictive value 48.6% by using receiver operating characteristic analysis, with P value 0.008, but it cannot differentiate between group A (completely normal renal functions) and neither of group BI nor BII. Conclusion Although urinary PCX is more sensitive for the diagnosis of early diabetic nephropathy than UACR and is used as a marker of chronic kidney disease progression in diabetic patients, UACR is still the gold standard for diagnosis and follow-up of diabetic nephropathy. Urinary PCX is nonspecific and cannot be related to BMI in patients with metabolic syndrome.
{"title":"Urinary levels of podocalyxin as a marker for podocytopathy in patients with metabolic syndrome having high body mass index: a diagnostic test accuracy study","authors":"Ammar Neanaa, Montaser Zeid, Heba El-Shair, Hadeer Abbaassy","doi":"10.4103/ejode.ejode_6_21","DOIUrl":"https://doi.org/10.4103/ejode.ejode_6_21","url":null,"abstract":"Aim To assess the adequacy of urinary podocalyxin (PCX) as a biomarker for early detection and disease progression of podocytopathy in high-BMI patients with metabolic syndrome with normal and impaired kidney functions. Patients and methods This is a cross-sectional study where all participants were subjected to full history taking, complete physical examination with assessment of BMI, and laboratory investigation to assess the inclusion and exclusion criteria. Then, a fresh morning urinary sample was obtained to measure both urinary albumin/creatinine ratio (UACR) and urinary PCX, where urinary PCX is measured by using human PCX ELISA kit. Results Urinary PCX showed that it can differentiate between group BI (albuminuric with normal renal functions) and BII (impaired renal functions) at the suggested cutoff point of 285 pg/ml, with 52% sensitivity and 45% specificity with low positive predictive value 48.8% and negative predictive value 48.6% by using receiver operating characteristic analysis, with P value 0.008, but it cannot differentiate between group A (completely normal renal functions) and neither of group BI nor BII. Conclusion Although urinary PCX is more sensitive for the diagnosis of early diabetic nephropathy than UACR and is used as a marker of chronic kidney disease progression in diabetic patients, UACR is still the gold standard for diagnosis and follow-up of diabetic nephropathy. Urinary PCX is nonspecific and cannot be related to BMI in patients with metabolic syndrome.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123067961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4103/ejode.ejode_2_21
Noha Elsabbagh, Marwa A. Saad, Marwa Mahmoud, Amr Salamah
Background Ageing is a multifactorial process, and telomere shortening is one of the possible mechanisms of cellular ageing. Many factors can affect telomere length (TL). Our study investigated the effect of vitamin D and high-sensitivity C-reactive protein (hs-CRP), as one of the inflammatory markers, on TL in older people. Patients and methods This was a cross-sectional study on 100 older people who did not have malignancy, autoimmune diseases, or renal disease and did not take vitamin D supplementation. Measurement of TL was done using real-time PCR, and for each sample, calculation of the T/S ratio was done. Telomere (T) signals in experimental DNA samples and single-copy gene (S) signals were measured in separate wells, in comparison with a reference DNA, to yield relative T/S ratios that are proportional to average TL. Results The results showed that vitamin D was significantly lower in females than males, and there was a significant positive correlation between vitamin D and the level of education of our participants. We found a highly significant negative correlation between vitamin D and hs-CRP. However, there was no significant correlation between T/S ratio and either vitamin D or hs-CRP. Conclusion In conclusion, vitamin D has an anti-inflammatory effect that decreased the hs-CRP level in our study. However, factors other than vitamin D and hs-CRP may be responsible for shortening telomere in elderly patients.
{"title":"Study of the possible relations between vitamin D, telomere length, and high-sensitivity C-reactive protein in older people","authors":"Noha Elsabbagh, Marwa A. Saad, Marwa Mahmoud, Amr Salamah","doi":"10.4103/ejode.ejode_2_21","DOIUrl":"https://doi.org/10.4103/ejode.ejode_2_21","url":null,"abstract":"Background Ageing is a multifactorial process, and telomere shortening is one of the possible mechanisms of cellular ageing. Many factors can affect telomere length (TL). Our study investigated the effect of vitamin D and high-sensitivity C-reactive protein (hs-CRP), as one of the inflammatory markers, on TL in older people. Patients and methods This was a cross-sectional study on 100 older people who did not have malignancy, autoimmune diseases, or renal disease and did not take vitamin D supplementation. Measurement of TL was done using real-time PCR, and for each sample, calculation of the T/S ratio was done. Telomere (T) signals in experimental DNA samples and single-copy gene (S) signals were measured in separate wells, in comparison with a reference DNA, to yield relative T/S ratios that are proportional to average TL. Results The results showed that vitamin D was significantly lower in females than males, and there was a significant positive correlation between vitamin D and the level of education of our participants. We found a highly significant negative correlation between vitamin D and hs-CRP. However, there was no significant correlation between T/S ratio and either vitamin D or hs-CRP. Conclusion In conclusion, vitamin D has an anti-inflammatory effect that decreased the hs-CRP level in our study. However, factors other than vitamin D and hs-CRP may be responsible for shortening telomere in elderly patients.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121466419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.4103/ejode.ejode_14_20
Mohamad el Bahrawey, S. Imbaby, H. El Fazary, M. Badrah, Heba El Deen
Background Gestational diabetes mellitus (GDM) is any degree of abnormal glucose tolerance first recognized in the period of pregnancy, and is detected in the second or third trimester of pregnancy. Its incidence has paralleled the epidemic of obesity. It also leads to increasing the risk for glucose intolerance, macrosomia, and development type 2 diabetes mellitus after pregnancy. Many markers were tested for the ability of early diagnosis of GDM. Zonulin is the basic protein that modulates tight junctions to regulate intercellular passage. Zonulin was found to be positively correlated with increased markers of inflammation and with insulin resistance in nonpregnant populations. Objective To assess serum zonulin level in pregnant women and to evaluate whether it could be an early predictor for development of GDM. Patients and methods The study included 80 pregnant females in the first trimester who were recruited from the obstetrics outpatient clinic at Al-Shatby University Hospital, Alexandria University. Basic data, clinical examination, and laboratory analysis were obtained from all the cases. Serum zonulin level was measured using human enzyme-linked immunosorbent assay kits. Results The median level of early serum zonulin level in the females who did not develop GDM was statistically significantly lower than the levels in the females who developed GDM. The best cut-off point to identify the diabetic females in pregnancy was more than 30 ng/ml with 97.22% sensitivity and 100% specificity. There was a highly significant association between the BMI and risk of GDM. Conclusion This study revealed that gestational diabetes is a common complication of pregnancy in the middle-aged females. Increasing BMI is associated with high incidence of GDM and high serum zonulin level in the first trimester. It is a sensitive predictor for development of GDM later during pregnancy.
{"title":"Study of serum zonulin level as an early predictor for gestational diabetes in Egyptian females","authors":"Mohamad el Bahrawey, S. Imbaby, H. El Fazary, M. Badrah, Heba El Deen","doi":"10.4103/ejode.ejode_14_20","DOIUrl":"https://doi.org/10.4103/ejode.ejode_14_20","url":null,"abstract":"Background Gestational diabetes mellitus (GDM) is any degree of abnormal glucose tolerance first recognized in the period of pregnancy, and is detected in the second or third trimester of pregnancy. Its incidence has paralleled the epidemic of obesity. It also leads to increasing the risk for glucose intolerance, macrosomia, and development type 2 diabetes mellitus after pregnancy. Many markers were tested for the ability of early diagnosis of GDM. Zonulin is the basic protein that modulates tight junctions to regulate intercellular passage. Zonulin was found to be positively correlated with increased markers of inflammation and with insulin resistance in nonpregnant populations. Objective To assess serum zonulin level in pregnant women and to evaluate whether it could be an early predictor for development of GDM. Patients and methods The study included 80 pregnant females in the first trimester who were recruited from the obstetrics outpatient clinic at Al-Shatby University Hospital, Alexandria University. Basic data, clinical examination, and laboratory analysis were obtained from all the cases. Serum zonulin level was measured using human enzyme-linked immunosorbent assay kits. Results The median level of early serum zonulin level in the females who did not develop GDM was statistically significantly lower than the levels in the females who developed GDM. The best cut-off point to identify the diabetic females in pregnancy was more than 30 ng/ml with 97.22% sensitivity and 100% specificity. There was a highly significant association between the BMI and risk of GDM. Conclusion This study revealed that gestational diabetes is a common complication of pregnancy in the middle-aged females. Increasing BMI is associated with high incidence of GDM and high serum zonulin level in the first trimester. It is a sensitive predictor for development of GDM later during pregnancy.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127012479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.4103/ejode.ejode_1_21
M. Ahmed, O. Saleh, A. Mesbah, Ahmed Albehairy
Background Thyroid hormones play a major role in thermogenesis, lipid, and glucose metabolism. Previous studies suggested that minor laboratory differences in thyroid function tests, within reference range, can contribute to increased incidence of weight gain. So, we aimed to investigate the possibility of a lower cutoff value of subclinical hypothyroidism in patients with obesity based on leptin levels to start treatment earlier and prevent further weight gain. Results Upon analysis of data from two groups obese (55 patients) and nonobese (35 patients) for whom serum leptin and thyroid-stimulating hormone (TSH) were measured to assess the relation between serum leptin and TSH levels in obese patients, the mean TSH level (mIU/l) of the obese group was 4.13±2.44, whereas in the control nonobese group was 2.32±1.19, and the mean leptin level (ng/ml) of the obese group was 47.25±28.03, whereas in the nonobese group was 4.90±3.13. The receiver operating characteristic curve showed that the diagnostic cutoff point for TSH was 4.09, with sensitivity of 41.8% and specificity of 88.6%, whereas the diagnostic cutoff point for leptin was 12.75, with sensitivity of 98.2% and specificity of 97.1%. Conclusions The results of the study showed that TSH levels more than 4.09 mIU/l can be considered diagnostic of subclinical hypothyroidism in obese people, similar to other population, apart from pregnant women. So, based on leptin levels, a lower cutoff value of TSH cannot be considered diagnostic of subclinical hypothyroidism in obese population.
{"title":"Can we consider a lower cutoff value for diagnosis of subclinical hypothyroidism in patients with obesity based on leptin levels?","authors":"M. Ahmed, O. Saleh, A. Mesbah, Ahmed Albehairy","doi":"10.4103/ejode.ejode_1_21","DOIUrl":"https://doi.org/10.4103/ejode.ejode_1_21","url":null,"abstract":"Background Thyroid hormones play a major role in thermogenesis, lipid, and glucose metabolism. Previous studies suggested that minor laboratory differences in thyroid function tests, within reference range, can contribute to increased incidence of weight gain. So, we aimed to investigate the possibility of a lower cutoff value of subclinical hypothyroidism in patients with obesity based on leptin levels to start treatment earlier and prevent further weight gain. Results Upon analysis of data from two groups obese (55 patients) and nonobese (35 patients) for whom serum leptin and thyroid-stimulating hormone (TSH) were measured to assess the relation between serum leptin and TSH levels in obese patients, the mean TSH level (mIU/l) of the obese group was 4.13±2.44, whereas in the control nonobese group was 2.32±1.19, and the mean leptin level (ng/ml) of the obese group was 47.25±28.03, whereas in the nonobese group was 4.90±3.13. The receiver operating characteristic curve showed that the diagnostic cutoff point for TSH was 4.09, with sensitivity of 41.8% and specificity of 88.6%, whereas the diagnostic cutoff point for leptin was 12.75, with sensitivity of 98.2% and specificity of 97.1%. Conclusions The results of the study showed that TSH levels more than 4.09 mIU/l can be considered diagnostic of subclinical hypothyroidism in obese people, similar to other population, apart from pregnant women. So, based on leptin levels, a lower cutoff value of TSH cannot be considered diagnostic of subclinical hypothyroidism in obese population.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131158061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.4103/ejode.ejode_5_21
Marwa Asar, M. Mansour, Nader Eleneen, Rania Bahriz
Introduction Diabetic peripheral neuropathy (DPN) is one of the commonest chronic complications of diabetes mellitus. It is documented that 26.4% of the cases with type 2 diabetes mellitus have painful DPN, whereas approximately half of the DPN cases may not have symptoms. Although neurophysiologic studies represent an objective and sensitive tool in the diagnosis of diabetic neuropathy, they remain limited owing to many factors; thus, there is a need to develop simpler tools that can fit into this gap, hence the development of different neuropathy scores. Aim To evaluate different tools and methods either subjective or objective in diagnosis of painful DPN in type 2 diabetic patients. Patients and methods We included 200 cases with type 2 diabetes mellitus recruited from the diabetes and diabetic neuropathy clinics in Mansoura Specialized Medical Hospital fulfilling the inclusion and exclusion criteria. They were divided into two groups: group 1 included 150 diabetic cases with painful peripheral diabetic neuropathy, and group 2 included 50 diabetic cases without neuropathy. Results Glycated hemoglobin was significantly elevated in the peripheral neuropathy group compared with the other group (8.24 vs. 7.27%; P<0.001). Regarding neutrophil/lymphocytic ratio in our study, it was not significantly different between the two groups (P=0581). It had mean values of 2.17 and 2.1 in groups 1 and 2, respectively. Conclusion Higher grades of the scores performed in this study were associated with a severe form of neuropathy. Both duration of diabetes and glycated hemoglobin levels had a significant positive correlation with these scores. Regarding neutrophil/lymphocytic ratio in our study, it did not show a significant difference between the two groups.
糖尿病周围神经病变是糖尿病最常见的慢性并发症之一。据文献记载，26.4%的2型糖尿病患者有疼痛的DPN，而大约一半的DPN病例可能没有症状。虽然神经生理学研究是诊断糖尿病神经病变的客观和敏感的工具，但由于许多因素，它们仍然受到限制;因此，有必要开发更简单的工具来填补这一空白，从而开发出不同的神经病变评分。目的探讨主客观诊断2型糖尿病患者疼痛性DPN的不同工具和方法。患者和方法我们从曼苏拉专科医院糖尿病和糖尿病神经病变门诊招募200例符合纳入和排除标准的2型糖尿病患者。将患者分为两组:1组150例伴有疼痛性糖尿病周围神经病变，2组50例无神经病变。结果周围神经病变组糖化血红蛋白明显升高(8.24% vs. 7.27%;P < 0.001)。在我们的研究中，中性粒细胞/淋巴细胞比率在两组之间无显著差异(P=0581)。1组和2组的平均值分别为2.17和2.1。结论:在这项研究中，较高的评分与严重的神经病变有关。糖尿病持续时间和糖化血红蛋白水平与这些评分均有显著正相关。在我们的研究中，中性粒细胞/淋巴细胞比率在两组之间没有明显差异。
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Pub Date : 2020-05-01DOI: 10.4103/ejode.ejode_2_19
E. Azzam, Noha Elsabagh, Nany Elgiar, D. Younan, M.H.S. Badreldeen
Background This study aimed at evaluating serum level of vitamin D in normal elderly persons above or equal to 65 years of age and its relation to geriatric syndrome. Patients and methods A prospective study was done on 50 normal elderly persons above 65 years (23 persons from nursery home and 27 persons from geriatric outpatient clinic in Alexandria Main University Hospital). All the participants were subjecting to full history taking, complete physical examination, laboratory assessment including serum 25-hydroxyvitamin D (OH)D by enzyme-linked immunosorbent assay, and geriatric syndrome assessment using five methods, namely, fall risk assessment using timed up and go test, mini-mental state examination, geriatric depressive scale, mini-nutritional assessment, and Tinetti performance-oriented mobility assessment. Results According to vitamin D level (ng/ml), the number of patients who were deficient (<12), insufficient (12–20), and sufficient (>20) was 11, 24, and 15, respectively. The mean±SD vitamin D level was 18.44±10.71 for all patients. According to the relation between vitamin D level and demographic data for the studied group, there were significant positive associations between low vitamin D level on one side and female sex (P=0.024), advanced age (P=0.026), no sun-exposure jobs (P=0.001), and nursing home residency on the other side. Mini-mental state examination (P=0.006) and geriatric depressive scale (P=0.002) had a significant positive correlation with low vitamin D level, whereas mini-nutritional assessment (P=1.000), timed up and go test (P=0.225), and performance-oriented mobility assessment score (P=0.133) had no significant correlation with low vitamin D level. Conclusion There is a correlation between vitamin D deficiency and advanced age, cognitive dysfunction, and depression, whereas no correlation was found between vitamin D deficiency and nutritional state and risk of falling.
本研究旨在评估65岁以上正常老年人血清维生素D水平及其与老年综合征的关系。患者与方法对50例65岁以上的正常老年人进行前瞻性研究，其中23例来自亚历山德兰大学附属医院托儿所，27例来自亚历山德兰大学附属医院老年门诊。所有参与者均接受了完整的病史记录、完整的体格检查、血清25-羟基维生素D (OH)D(酶联免疫吸附法)的实验室评估和老年综合征评估，包括跌倒风险评估(定时起床和走测试)、简易精神状态检查、老年抑郁量表、简易营养评估和Tinetti运动能力评估。结果根据维生素D水平(ng/ml)，维生素D缺乏的患者(20例)分别为11例、24例和15例。所有患者的维生素D水平平均值为18.44±10.71。根据研究人群维生素D水平与人口统计学数据的关系，一侧维生素D水平低与女性(P=0.024)、高龄(P=0.026)、无日晒工作(P=0.001)、养老院居住有显著正相关。微量精神状态检查(P=0.006)和老年抑郁量表(P=0.002)与低维生素D水平有显著正相关，微量营养评估(P=1.000)、timed up and go测试(P=0.225)和性能取向运动能力评估评分(P=0.133)与低维生素D水平无显著相关。结论维生素D缺乏与高龄、认知功能障碍、抑郁有相关性，而维生素D缺乏与营养状况、跌倒风险无相关性。
{"title":"Relationship of serum vitamin D level on the possibility of geriatric syndrome in elderly persons","authors":"E. Azzam, Noha Elsabagh, Nany Elgiar, D. Younan, M.H.S. Badreldeen","doi":"10.4103/ejode.ejode_2_19","DOIUrl":"https://doi.org/10.4103/ejode.ejode_2_19","url":null,"abstract":"Background This study aimed at evaluating serum level of vitamin D in normal elderly persons above or equal to 65 years of age and its relation to geriatric syndrome. Patients and methods A prospective study was done on 50 normal elderly persons above 65 years (23 persons from nursery home and 27 persons from geriatric outpatient clinic in Alexandria Main University Hospital). All the participants were subjecting to full history taking, complete physical examination, laboratory assessment including serum 25-hydroxyvitamin D (OH)D by enzyme-linked immunosorbent assay, and geriatric syndrome assessment using five methods, namely, fall risk assessment using timed up and go test, mini-mental state examination, geriatric depressive scale, mini-nutritional assessment, and Tinetti performance-oriented mobility assessment. Results According to vitamin D level (ng/ml), the number of patients who were deficient (<12), insufficient (12–20), and sufficient (>20) was 11, 24, and 15, respectively. The mean±SD vitamin D level was 18.44±10.71 for all patients. According to the relation between vitamin D level and demographic data for the studied group, there were significant positive associations between low vitamin D level on one side and female sex (P=0.024), advanced age (P=0.026), no sun-exposure jobs (P=0.001), and nursing home residency on the other side. Mini-mental state examination (P=0.006) and geriatric depressive scale (P=0.002) had a significant positive correlation with low vitamin D level, whereas mini-nutritional assessment (P=1.000), timed up and go test (P=0.225), and performance-oriented mobility assessment score (P=0.133) had no significant correlation with low vitamin D level. Conclusion There is a correlation between vitamin D deficiency and advanced age, cognitive dysfunction, and depression, whereas no correlation was found between vitamin D deficiency and nutritional state and risk of falling.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130422250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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