Pub Date : 2020-05-01DOI: 10.4103/ejode.ejode_4_19
A. Elaghoury, A. Zahran, M. Bondok, R. A. Abo Elwafa, Ahmed Albassiouny
Background Male hypogonadism is a clinical and biochemical syndrome that results from failure to produce adequate testosterone levels, normal sperm count, or both. Male hypogonadism may adversely affect multiple organ functions and quality of life. Vitamin D is a steroid hormone; the major action of vitamin D is linked to maintaining musculoskeletal health. However, several epidemiological studies have suggested extraskeletal benefits of vitamin D. There is an accumulating body of evidence which suggests that vitamin D is involved in reproductive and gonadal functions. Although some studies have demonstrated that vitamin D levels are positively associated with androgen levels and that vitamin D supplementation may increase testosterone levels, other studies have observed a U-shaped association of vitamin D and hypogonadism in middle-aged men, in contrast, other studies fail to find an association between vitamin D and testosterone especially in young healthy men after exclusion of other confounding factors. Thus, the aim of our study was to study the possible association of vitamin D status with male hypogonadism among different age groups. Patients and methods The study included 80 men. Group I included 40 male patients aged 20 to less than 45 years who were further subdivided into two subgroups: group Ia included 20 male patients diagnosed with hypogonadism and group Ib included 20 eugonadal men serving as a control. Group II: included 40 male patients aged 45–70 years subdivided into two subgroups: group IIa included 20 male patients diagnosed with hypogonadism and group IIb included eugonadal men serving as a control. Using enzyme-linked fluorescent assay technique, serum total testosterone (TT), 25-hydroxyvitamin D3 [25(OH)D3], luteinizing hormone, follicle stimulating hormone, estradiol, and prolactin were assessed for all enrolled individuals. Sex-hormone-binding globulin (SHBG) was assessed using the electrochemiluminescence immunoassay technique. Free androgen index (FAI) was calculated using the equation [100×TT (nmol/l)/SHBG (nmol/l)]. Results It was found that TT, FAI, and SHBG were lower in hypogonadal men versus eugonadal men in both groups, there was no significant statistical difference between hypogonadal men in groups I and II as regards TT and SHBG (P=0.708, 0.124, respectively), whereas FAI was found to be significantly statistically lower in hypogonadal men aged 45–70 years as compared with hypogonadal men aged 20 to less than 45 years (P=0.021). There was a high prevalence of vitamin D deficiency and insufficiency in both hypogonadal and eugonadal men in the four studied subgroups. 25(OH)D3 was not statistically different between subgroups in both groups (P=0.681, 0.823, respectively), whereas 25(OH)D3 was significantly higher in hypogonadal men in group II versus hypogonadal men in group I (P=0.037). 25(OH)D3 was found to be positively correlated with TT, FAI, and SHBG, but not to serum estradiol, prolactin. Correlation of
{"title":"Study of vitamin D status in male patients with hypogonadism","authors":"A. Elaghoury, A. Zahran, M. Bondok, R. A. Abo Elwafa, Ahmed Albassiouny","doi":"10.4103/ejode.ejode_4_19","DOIUrl":"https://doi.org/10.4103/ejode.ejode_4_19","url":null,"abstract":"Background Male hypogonadism is a clinical and biochemical syndrome that results from failure to produce adequate testosterone levels, normal sperm count, or both. Male hypogonadism may adversely affect multiple organ functions and quality of life. Vitamin D is a steroid hormone; the major action of vitamin D is linked to maintaining musculoskeletal health. However, several epidemiological studies have suggested extraskeletal benefits of vitamin D. There is an accumulating body of evidence which suggests that vitamin D is involved in reproductive and gonadal functions. Although some studies have demonstrated that vitamin D levels are positively associated with androgen levels and that vitamin D supplementation may increase testosterone levels, other studies have observed a U-shaped association of vitamin D and hypogonadism in middle-aged men, in contrast, other studies fail to find an association between vitamin D and testosterone especially in young healthy men after exclusion of other confounding factors. Thus, the aim of our study was to study the possible association of vitamin D status with male hypogonadism among different age groups. Patients and methods The study included 80 men. Group I included 40 male patients aged 20 to less than 45 years who were further subdivided into two subgroups: group Ia included 20 male patients diagnosed with hypogonadism and group Ib included 20 eugonadal men serving as a control. Group II: included 40 male patients aged 45–70 years subdivided into two subgroups: group IIa included 20 male patients diagnosed with hypogonadism and group IIb included eugonadal men serving as a control. Using enzyme-linked fluorescent assay technique, serum total testosterone (TT), 25-hydroxyvitamin D3 [25(OH)D3], luteinizing hormone, follicle stimulating hormone, estradiol, and prolactin were assessed for all enrolled individuals. Sex-hormone-binding globulin (SHBG) was assessed using the electrochemiluminescence immunoassay technique. Free androgen index (FAI) was calculated using the equation [100×TT (nmol/l)/SHBG (nmol/l)]. Results It was found that TT, FAI, and SHBG were lower in hypogonadal men versus eugonadal men in both groups, there was no significant statistical difference between hypogonadal men in groups I and II as regards TT and SHBG (P=0.708, 0.124, respectively), whereas FAI was found to be significantly statistically lower in hypogonadal men aged 45–70 years as compared with hypogonadal men aged 20 to less than 45 years (P=0.021). There was a high prevalence of vitamin D deficiency and insufficiency in both hypogonadal and eugonadal men in the four studied subgroups. 25(OH)D3 was not statistically different between subgroups in both groups (P=0.681, 0.823, respectively), whereas 25(OH)D3 was significantly higher in hypogonadal men in group II versus hypogonadal men in group I (P=0.037). 25(OH)D3 was found to be positively correlated with TT, FAI, and SHBG, but not to serum estradiol, prolactin. Correlation of ","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"76 8 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":"128076200","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 : 2020-05-01DOI: 10.4103/ejode.ejode_18_19
Ali El-Rehem, A. Adam, Mohamed Zaiton, Wesam El-Gendi, Samar M. Abd El-Hamid
Background Insulin resistance in patients with end-stage renal disease (ESRD) is a strong independent predictor of cardiovascular death. The effect of hemodialysis sessions on the state of insulin resistance in patients with ESRD was not very clear. The aim of this study was to assess the immediate effect of hemodialysis sessions on insulin resistance in this group of patients. Patients and methods This self-control study was carried out at the Alexandria Main University Hospital. The study included 100 patients with ESRD on regular maintenance hemodialysis (50 patients with type 2 diabetes mellitus and 50 patients without diabetes mellitus). Fasting plasma glucose, fasting serum insulin, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), blood urea, serum creatinine, and arterial bicarbonate were assessed before and after the hemodialysis sessions. Results Before the hemodialysis sessions, the mean HOMA-IR was 4.58 in patients with diabetes mellitus and 2.37 in patients without diabetes mellitus. The levels decreased significantly to 1.28 in patient with diabetes mellitus (P<0.001) and decrease to 0.7 in patient without diabetes mellitus (P<0.001) after the hemodialysis sessions. There was a significant negative correlation between HOMA-IR and serum creatinine levels before or after the hemodialysis sessions. Conclusion Hemodialysis sessions may cause an immediate improvement in the insulin resistance state in patients with ESRD. The variability of insulin resistance following hemodialysis sessions can lead to marked glycemic fluctuations. Careful monitoring of blood glucose level following hemodialysis sessions may be indicated in some patients with ESRD.
{"title":"Insulin resistance is immediately reduced after hemodialysis sessions in diabetic and nondiabetic patients with end-stage renal disease","authors":"Ali El-Rehem, A. Adam, Mohamed Zaiton, Wesam El-Gendi, Samar M. Abd El-Hamid","doi":"10.4103/ejode.ejode_18_19","DOIUrl":"https://doi.org/10.4103/ejode.ejode_18_19","url":null,"abstract":"Background Insulin resistance in patients with end-stage renal disease (ESRD) is a strong independent predictor of cardiovascular death. The effect of hemodialysis sessions on the state of insulin resistance in patients with ESRD was not very clear. The aim of this study was to assess the immediate effect of hemodialysis sessions on insulin resistance in this group of patients. Patients and methods This self-control study was carried out at the Alexandria Main University Hospital. The study included 100 patients with ESRD on regular maintenance hemodialysis (50 patients with type 2 diabetes mellitus and 50 patients without diabetes mellitus). Fasting plasma glucose, fasting serum insulin, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), blood urea, serum creatinine, and arterial bicarbonate were assessed before and after the hemodialysis sessions. Results Before the hemodialysis sessions, the mean HOMA-IR was 4.58 in patients with diabetes mellitus and 2.37 in patients without diabetes mellitus. The levels decreased significantly to 1.28 in patient with diabetes mellitus (P<0.001) and decrease to 0.7 in patient without diabetes mellitus (P<0.001) after the hemodialysis sessions. There was a significant negative correlation between HOMA-IR and serum creatinine levels before or after the hemodialysis sessions. Conclusion Hemodialysis sessions may cause an immediate improvement in the insulin resistance state in patients with ESRD. The variability of insulin resistance following hemodialysis sessions can lead to marked glycemic fluctuations. Careful monitoring of blood glucose level following hemodialysis sessions may be indicated in some patients with ESRD.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"2007 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":"125616791","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 : 2020-01-01DOI: 10.4103/ejode.ejode_13_19
M. Awad, Eman Elshorbagy, A. Nasr, M. Hamed
Background Type 1 diabetes, previously known as juvenile diabetes or insulin-dependent diabetes, is a form of diabetes characterized by the body’s inability to produce insulin owing to the autoimmune destruction of the insulin-producing beta cells in the pancreas. Klotho (KL), known as an anti-aging protein, was discovered recently to have a multitude of biological effects. Major attention has been paid to the role of α-klotho (α-KL) in diabetes and its relation with diabetic nephropathy. The circulating form of α-KL, named as soluble KL, functions as an endocrine substance that exerts heterogeneous actions, including the modulation of renal function upon hyperglycemia, regulation of cell compensation, downregulation of inflammation and anti-oxidation effects. Aim The aim of this work is to study plasma KL and plasma copeptin in adolescents with type 1 diabetes and their relation to microvascular complications. Patients and methods This study was conducted in diabetes outpatient clinic in national institute of diabetes and endocrinology. The sample of 117 patients was divided into three groups: diabetes group, with 39 patients; diabetes with complication group, with 39 patients; and healthy controls, with 39 participants. Results Our study shows significant elevation of plasma copeptin level in type 1 diabetic adolescents, which was also significantly higher in the presence of microvascular complications particularly diabetic kidney disease (P=0.000). Although plasma KL is found to be significantly higher in type 1 diabetes without complications group, its level is dropped in the diabetes with complications group (P=0.005). Conclusion Plasma KL and plasma copeptin can be used as novel biomarkers for predicting early kidney injury in type 1 diabetic adolescents.
{"title":"Study of plasma klotho and plasma copeptin level in adolescents with type 1 diabetes mellitus and relation to microvascular complications","authors":"M. Awad, Eman Elshorbagy, A. Nasr, M. Hamed","doi":"10.4103/ejode.ejode_13_19","DOIUrl":"https://doi.org/10.4103/ejode.ejode_13_19","url":null,"abstract":"Background Type 1 diabetes, previously known as juvenile diabetes or insulin-dependent diabetes, is a form of diabetes characterized by the body’s inability to produce insulin owing to the autoimmune destruction of the insulin-producing beta cells in the pancreas. Klotho (KL), known as an anti-aging protein, was discovered recently to have a multitude of biological effects. Major attention has been paid to the role of α-klotho (α-KL) in diabetes and its relation with diabetic nephropathy. The circulating form of α-KL, named as soluble KL, functions as an endocrine substance that exerts heterogeneous actions, including the modulation of renal function upon hyperglycemia, regulation of cell compensation, downregulation of inflammation and anti-oxidation effects. Aim The aim of this work is to study plasma KL and plasma copeptin in adolescents with type 1 diabetes and their relation to microvascular complications. Patients and methods This study was conducted in diabetes outpatient clinic in national institute of diabetes and endocrinology. The sample of 117 patients was divided into three groups: diabetes group, with 39 patients; diabetes with complication group, with 39 patients; and healthy controls, with 39 participants. Results Our study shows significant elevation of plasma copeptin level in type 1 diabetic adolescents, which was also significantly higher in the presence of microvascular complications particularly diabetic kidney disease (P=0.000). Although plasma KL is found to be significantly higher in type 1 diabetes without complications group, its level is dropped in the diabetes with complications group (P=0.005). Conclusion Plasma KL and plasma copeptin can be used as novel biomarkers for predicting early kidney injury in type 1 diabetic adolescents.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126232579","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 : 2020-01-01DOI: 10.4103/ejode.ejode_8_20
Ola Elgaddar, H. Ashraf, E. Abdalla, H. Mahrous, S. Ooda
Background Type 2 diabetes mellitus (T2DM) is a very common polygenic metabolic disorder. Single-nucleotide polymorphisms of the transcription factor 7-like 2 (TCF7L2) gene have been reported to affect T2DM susceptibility by affecting insulin secretion and via its involvement in the Wnt signaling pathway. Patients and methods The present study investigated the association of rs7903146(C/T) polymorphism of the TCF7L2 gene with T2DM. The study involved 42 Egyptian adults who were diagnosed with T2DM and 42 healthy adults taken as controls. Allele-specific PCR was performed to detect TCF7L2 gene polymorphism. Results No association was found between the rs7903146 polymorphisms of TCF7L2 gene and susceptibility to T2DM, using both dominant and recessive models. Conclusion In our study, we could not prove the suggested association between rs7903146(C/T) polymorphism of the TCF7L2 gene and T2DM in Egyptians. Further Egyptian studies are needed to confirm the results of this study.
{"title":"A possible association between rs7903146 (C/T) polymorphism of the transcription factor 7-like 2 gene and type 2 diabetes mellitus in Egyptians","authors":"Ola Elgaddar, H. Ashraf, E. Abdalla, H. Mahrous, S. Ooda","doi":"10.4103/ejode.ejode_8_20","DOIUrl":"https://doi.org/10.4103/ejode.ejode_8_20","url":null,"abstract":"Background Type 2 diabetes mellitus (T2DM) is a very common polygenic metabolic disorder. Single-nucleotide polymorphisms of the transcription factor 7-like 2 (TCF7L2) gene have been reported to affect T2DM susceptibility by affecting insulin secretion and via its involvement in the Wnt signaling pathway. Patients and methods The present study investigated the association of rs7903146(C/T) polymorphism of the TCF7L2 gene with T2DM. The study involved 42 Egyptian adults who were diagnosed with T2DM and 42 healthy adults taken as controls. Allele-specific PCR was performed to detect TCF7L2 gene polymorphism. Results No association was found between the rs7903146 polymorphisms of TCF7L2 gene and susceptibility to T2DM, using both dominant and recessive models. Conclusion In our study, we could not prove the suggested association between rs7903146(C/T) polymorphism of the TCF7L2 gene and T2DM in Egyptians. Further Egyptian studies are needed to confirm the results of this study.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"119 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134499587","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 : 2019-09-01DOI: 10.4103/ejode.ejode_7_20
E. Aboelnaga, Mohamad Aladlany, F. Kyrillos
Background Hyperglycemic emergencies (HEs) are serious acute complications of uncontrolled diabetes, which can be life threatening. In spite of major advances in diagnosis and treatment, it still is an important cause of morbidity and mortality. Aims To evaluate treatment outcomes among diabetic patients presented with HEs and to ascertain the determinants and factors associated with the outcome. Patients and methods This prospective, longitudinal study was conducted on 240 diabetic patients presented with HEs at Specialized Medical Hospital, Mansoura University. They were subjected to full history, physical examination, laboratory assessment, and follow-up. According to the laboratory results, patients were divided into three groups: diabetic ketoacidosis (DKA); hyperglycemic hyperosmolar nonketotic state (HHS); and normo-osmolar nonketotic hyperglycemic state. Results The study included 82 men and 158 women. The most common HE was DKA. Nonadherence to medications was the most common cause of DKA and normo-osmolar nonketotic hyperglycemic state (52.1 and 47.8%, respectively). The overall hospital mortality due to HEs was 12.5%. The highest mortality was recorded in the HHS group (51.7%). Mortality was higher in old-aged, nonobese patients, and in those without education. Nonsurvivors had longer duration of ICU stay than survivors, with no difference in total hospital stay. No hypoglycemic episodes detected in the nonsurvived group versus 37 episodes in the survived one. There were significant associations between mortality and Glasgow coma scale, the presenting and the highest random plasma glucose, serum sodium, osmolarity, creatinine, white blood cells, and glycated hemoglobin. Conclusion DKA is the most common HE, while HHS has the highest mortality rate. The strongest predictors of mortality of HEs are HHS, DKA in type 2 diabetes, old age, chronic kidney disease, coronary artery disease, highest random plasma glucose, glycated hemoglobin, and length of ICU stay.
{"title":"Predictors and treatment outcome of hyperglycemic emergencies: a one-center experience","authors":"E. Aboelnaga, Mohamad Aladlany, F. Kyrillos","doi":"10.4103/ejode.ejode_7_20","DOIUrl":"https://doi.org/10.4103/ejode.ejode_7_20","url":null,"abstract":"Background Hyperglycemic emergencies (HEs) are serious acute complications of uncontrolled diabetes, which can be life threatening. In spite of major advances in diagnosis and treatment, it still is an important cause of morbidity and mortality. Aims To evaluate treatment outcomes among diabetic patients presented with HEs and to ascertain the determinants and factors associated with the outcome. Patients and methods This prospective, longitudinal study was conducted on 240 diabetic patients presented with HEs at Specialized Medical Hospital, Mansoura University. They were subjected to full history, physical examination, laboratory assessment, and follow-up. According to the laboratory results, patients were divided into three groups: diabetic ketoacidosis (DKA); hyperglycemic hyperosmolar nonketotic state (HHS); and normo-osmolar nonketotic hyperglycemic state. Results The study included 82 men and 158 women. The most common HE was DKA. Nonadherence to medications was the most common cause of DKA and normo-osmolar nonketotic hyperglycemic state (52.1 and 47.8%, respectively). The overall hospital mortality due to HEs was 12.5%. The highest mortality was recorded in the HHS group (51.7%). Mortality was higher in old-aged, nonobese patients, and in those without education. Nonsurvivors had longer duration of ICU stay than survivors, with no difference in total hospital stay. No hypoglycemic episodes detected in the nonsurvived group versus 37 episodes in the survived one. There were significant associations between mortality and Glasgow coma scale, the presenting and the highest random plasma glucose, serum sodium, osmolarity, creatinine, white blood cells, and glycated hemoglobin. Conclusion DKA is the most common HE, while HHS has the highest mortality rate. The strongest predictors of mortality of HEs are HHS, DKA in type 2 diabetes, old age, chronic kidney disease, coronary artery disease, highest random plasma glucose, glycated hemoglobin, and length of ICU stay.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"15 19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130183973","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 : 2019-09-01DOI: 10.4103/ejode.ejode_2_20
A. Mahmoud, A. Fekry, S. Afif
Background The relationship among vitamin D (VD) deficiency, metabolic syndrome, and type 2 diabetes mellitus (T2DM) is still doubtful, whether it is causal or jumbling. Aim To assess the link between VD deficiency and T2DM in old obese Egyptian patients and to evaluate the correlation between VD and some variables in T2DM. Patients and methods The study was conducted in Internal Medicine and Clinical Pathology Departments, Zagazig University Hospitals, from 02/2018 to 10/2018, involving 60 patients, aged more than or equal to 60 years, comprising 18 males and 42 females, who were divided into two groups: 30 patients with T2DM and 30 patients were proved to be without diabetes during the sample collection. Each group was subdivided according to their BMI into obese and nonobese. Results A highly significant difference was detected in VD level between nondiabetes and diabetes groups (23.85±12.1 vs. 16.2±7.9 ng/ml, respectively, P=0.001). VD deficiency was significantly higher in diabetes group (χ2=10.38, P=0.006). Insignificant difference was detected regarding age (67.3±2.4 vs. 67.7±2.5, P=0.5) and BMI (30.7±5.1 vs. 32.7±5.3 kg/m2, P=0.14) between nondiabetes and diabetes. There was a highly significant difference in VD level between obese nondiabetes and obese diabetes (27±17.5 vs. 13.3±8.2 ng/ml, respectively, P=0.001). A positive correlation was detected between VD level and fasting blood sugar (r=0.438, P=0.032), whereas a negative correlation between VD level and BMI in diabetes group only (r=−0.437, P=0.033) and in obese group only (r=−0.515, P=0.012). Conclusion Approximately 78.3% of patients had hypovitaminosis D (51.7% deficiency and 26.6% insufficiency). VD deficiency was significantly higher in diabetes group and in obese diabetics.
{"title":"Vitamin D assessment in elderly diabetic obese Egyptian patients in Zagazig University Hospitals","authors":"A. Mahmoud, A. Fekry, S. Afif","doi":"10.4103/ejode.ejode_2_20","DOIUrl":"https://doi.org/10.4103/ejode.ejode_2_20","url":null,"abstract":"Background The relationship among vitamin D (VD) deficiency, metabolic syndrome, and type 2 diabetes mellitus (T2DM) is still doubtful, whether it is causal or jumbling. Aim To assess the link between VD deficiency and T2DM in old obese Egyptian patients and to evaluate the correlation between VD and some variables in T2DM. Patients and methods The study was conducted in Internal Medicine and Clinical Pathology Departments, Zagazig University Hospitals, from 02/2018 to 10/2018, involving 60 patients, aged more than or equal to 60 years, comprising 18 males and 42 females, who were divided into two groups: 30 patients with T2DM and 30 patients were proved to be without diabetes during the sample collection. Each group was subdivided according to their BMI into obese and nonobese. Results A highly significant difference was detected in VD level between nondiabetes and diabetes groups (23.85±12.1 vs. 16.2±7.9 ng/ml, respectively, P=0.001). VD deficiency was significantly higher in diabetes group (χ2=10.38, P=0.006). Insignificant difference was detected regarding age (67.3±2.4 vs. 67.7±2.5, P=0.5) and BMI (30.7±5.1 vs. 32.7±5.3 kg/m2, P=0.14) between nondiabetes and diabetes. There was a highly significant difference in VD level between obese nondiabetes and obese diabetes (27±17.5 vs. 13.3±8.2 ng/ml, respectively, P=0.001). A positive correlation was detected between VD level and fasting blood sugar (r=0.438, P=0.032), whereas a negative correlation between VD level and BMI in diabetes group only (r=−0.437, P=0.033) and in obese group only (r=−0.515, P=0.012). Conclusion Approximately 78.3% of patients had hypovitaminosis D (51.7% deficiency and 26.6% insufficiency). VD deficiency was significantly higher in diabetes group and in obese diabetics.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121212920","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 : 2019-05-01DOI: 10.4103/ejode.ejode_12_20
Rania Bahriz, M. Mansour, Ahmed Albehairy
Introduction High-sensitivity C-reactive protein (hs-CRP) is considered a biomarker of cardiovascular disease (CVD). WHO has recommended waist circumference (WC), waist-to-hip ratio, and waist-to-height ratio as screening tools for CVD. Various studies used neck circumference (NC) as a method for measuring of the upper-body fat, and it was positively correlated to WC and BMI. Aim The aim was to investigate the correlation between NC as a screening tool for cardiovascular risk in type 2 diabetic patients and circulatory levels of hs-CRP and fibrinogen as biomarkers of inflammation in CVD. Patients and methods A total of 100 patients with type 2 diabetes were recruited from the diabetes clinic in Mansoura specialized medical hospital fulfilling the inclusion and exclusion criteria and were divided into two groups according to the measured circulatory levels of hs-CRP: group 1 included 46 participants whose circulatory levels of hs-CRP were less than 5, and group 2 included 54 participants whose circulatory levels of hs-CRP were greater than or equal to 5. All recruited participants were subjected to fasting blood sample to measure low-density lipoprotein, high-density lipoprotein, A1c, fibrinogen, and hs-CRP. Results Group 1 with hs-CRP less than 5 showed a significant increase in BMI, WC, NC, ischemic heart disease, fibrinogen, and HBA1c in relation to group 2. There was a significant positive correlation between NC and BMI, WC, and low-density lipoprotein (r=0.397, 0.520, and 0.317, respectively), with P value less than 0.05. Cutoff value of NC more than 40.50 cm is a predictor of CVD. Conclusion NC can be effectively used as a screening parameter for identification of cardiovascular risk factors in type 2 diabetic patients.
{"title":"Neck circumference: a simple screening parameter for cardiovascular risk in diabetics","authors":"Rania Bahriz, M. Mansour, Ahmed Albehairy","doi":"10.4103/ejode.ejode_12_20","DOIUrl":"https://doi.org/10.4103/ejode.ejode_12_20","url":null,"abstract":"Introduction High-sensitivity C-reactive protein (hs-CRP) is considered a biomarker of cardiovascular disease (CVD). WHO has recommended waist circumference (WC), waist-to-hip ratio, and waist-to-height ratio as screening tools for CVD. Various studies used neck circumference (NC) as a method for measuring of the upper-body fat, and it was positively correlated to WC and BMI. Aim The aim was to investigate the correlation between NC as a screening tool for cardiovascular risk in type 2 diabetic patients and circulatory levels of hs-CRP and fibrinogen as biomarkers of inflammation in CVD. Patients and methods A total of 100 patients with type 2 diabetes were recruited from the diabetes clinic in Mansoura specialized medical hospital fulfilling the inclusion and exclusion criteria and were divided into two groups according to the measured circulatory levels of hs-CRP: group 1 included 46 participants whose circulatory levels of hs-CRP were less than 5, and group 2 included 54 participants whose circulatory levels of hs-CRP were greater than or equal to 5. All recruited participants were subjected to fasting blood sample to measure low-density lipoprotein, high-density lipoprotein, A1c, fibrinogen, and hs-CRP. Results Group 1 with hs-CRP less than 5 showed a significant increase in BMI, WC, NC, ischemic heart disease, fibrinogen, and HBA1c in relation to group 2. There was a significant positive correlation between NC and BMI, WC, and low-density lipoprotein (r=0.397, 0.520, and 0.317, respectively), with P value less than 0.05. Cutoff value of NC more than 40.50 cm is a predictor of CVD. Conclusion NC can be effectively used as a screening parameter for identification of cardiovascular risk factors in type 2 diabetic patients.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123193536","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 : 2019-05-01DOI: 10.4103/ejode.ejode_1_20
SoheirS. Kamel, S. Marzouk, M. Abdel‐Moneim, H. El-Zawawy, Riham Hafez
Background Vitamin D deficiency (VDD) is an important public health problem worldwide, and polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age, with prevalence up to 10%. It is characterized by ovulatory dysfunction, resulting in oligomenorrhea and/or anovulation, hyperandrogenism, and polycystic ovarian morphology by ultrasound. Metabolic disturbances are present in most women with PCOS, including impaired glucose tolerance and insulin resistance (IR) with compensatory hyperinsulinemia. It may also create health risks such as T2DM, endometrial cancer, and cardiovascular disease. Accumulating evidence from several studies suggests that VDD may be involved in the pathogenesis of PCOS as the possible missing link between IR and PCOS. The aim of this study was to evaluate the suggested role of vitamin D in PCOS. Participants and methods The study included 70 women in reproductive age (16–44 years old) divided into two groups: group I included 50 women in reproductive age with PCOS, and group II included 20 healthy women in reproductive age with regular menstrual cycles. All were subjected to history taking; clinical examination, including blood pressure measurement; anthropometric measurements, such as body weight, height, and calculation of BMI, and waist and hip circumference with calculation of the waist/hip ratio; skin examination for acanthosis nigricans (sign of IR) and signs of androgen excess, such as hirsutism, androgenic alopecia, and acne; laboratory investigations, such as fasting blood glucose, lipid profile (total cholesterol, serum triglycerides, low-density lipoprotein-cholesterol, and high-density lipoprotein-cholesterol), serum levels of ionized calcium, serum levels of 25 (OH) vitamin D3, serum insulin level with calculation of Homeostatic Model Assessment of Insulin Resistance, serum luteinizing hormone, serum follicle-stimulating hormone with calculation of luteinizing hormone/follicle-stimulating hormone ratio, serum prolactin, serum total testosterone, and sex hormone-binding globulin with calculation of free androgen index; and imaging studies, such as pelvic ultrasonography with a 3.5 MHz convex electronic probe to examine the ovaries or transvaginal ultrasound. Results Serum 25 OH vitamin D level was statistically significantly lower in group I (women with PCOS) than group II (the control group) (mean: 6.05±2.56 vs 21.58±1.92 ng/ml) (P< 0.001). There was a statistically significant positive correlation between serum 25 (OH) vitamin D level and serum ionized calcium (r=0.465, P=0.001) and sex hormone-binding globulin (r=0.407, P=0.003). However, there was a statistically significant negative correlation between serum 25 (OH) vitamin D level and BMI (r=−0.363, P=0.010), waist/hip ratio (r=−0.255, P=0.049), serum fasting insulin level (r=-0.487, P<0.001), Homeostatic Model Assessment of Insulin Resistance (r=−0.521, P<0.001), serum total testosterone (r=−0.418, P=0.003), free androge
{"title":"Vitamin D status in polycystic ovary syndrome","authors":"SoheirS. Kamel, S. Marzouk, M. Abdel‐Moneim, H. El-Zawawy, Riham Hafez","doi":"10.4103/ejode.ejode_1_20","DOIUrl":"https://doi.org/10.4103/ejode.ejode_1_20","url":null,"abstract":"Background Vitamin D deficiency (VDD) is an important public health problem worldwide, and polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age, with prevalence up to 10%. It is characterized by ovulatory dysfunction, resulting in oligomenorrhea and/or anovulation, hyperandrogenism, and polycystic ovarian morphology by ultrasound. Metabolic disturbances are present in most women with PCOS, including impaired glucose tolerance and insulin resistance (IR) with compensatory hyperinsulinemia. It may also create health risks such as T2DM, endometrial cancer, and cardiovascular disease. Accumulating evidence from several studies suggests that VDD may be involved in the pathogenesis of PCOS as the possible missing link between IR and PCOS. The aim of this study was to evaluate the suggested role of vitamin D in PCOS. Participants and methods The study included 70 women in reproductive age (16–44 years old) divided into two groups: group I included 50 women in reproductive age with PCOS, and group II included 20 healthy women in reproductive age with regular menstrual cycles. All were subjected to history taking; clinical examination, including blood pressure measurement; anthropometric measurements, such as body weight, height, and calculation of BMI, and waist and hip circumference with calculation of the waist/hip ratio; skin examination for acanthosis nigricans (sign of IR) and signs of androgen excess, such as hirsutism, androgenic alopecia, and acne; laboratory investigations, such as fasting blood glucose, lipid profile (total cholesterol, serum triglycerides, low-density lipoprotein-cholesterol, and high-density lipoprotein-cholesterol), serum levels of ionized calcium, serum levels of 25 (OH) vitamin D3, serum insulin level with calculation of Homeostatic Model Assessment of Insulin Resistance, serum luteinizing hormone, serum follicle-stimulating hormone with calculation of luteinizing hormone/follicle-stimulating hormone ratio, serum prolactin, serum total testosterone, and sex hormone-binding globulin with calculation of free androgen index; and imaging studies, such as pelvic ultrasonography with a 3.5 MHz convex electronic probe to examine the ovaries or transvaginal ultrasound. Results Serum 25 OH vitamin D level was statistically significantly lower in group I (women with PCOS) than group II (the control group) (mean: 6.05±2.56 vs 21.58±1.92 ng/ml) (P< 0.001). There was a statistically significant positive correlation between serum 25 (OH) vitamin D level and serum ionized calcium (r=0.465, P=0.001) and sex hormone-binding globulin (r=0.407, P=0.003). However, there was a statistically significant negative correlation between serum 25 (OH) vitamin D level and BMI (r=−0.363, P=0.010), waist/hip ratio (r=−0.255, P=0.049), serum fasting insulin level (r=-0.487, P<0.001), Homeostatic Model Assessment of Insulin Resistance (r=−0.521, P<0.001), serum total testosterone (r=−0.418, P=0.003), free androge","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124566619","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 : 2019-01-01DOI: 10.4103/ejode.ejode_9_18
L. E. El Toony, El-Gibaly Omaima, W. Khalifa, El-Sayed Rowyda
Background Gestational diabetes mellitus (GDM), defined as glucose intolerance with onset or first recognition in pregnancy, is a common complication of pregnancy. The American Diabetes Association 2017 redefined GDM as follows: ‘diabetes diagnosed in the second and third trimesters of pregnancy.’ It is estimated by the International Diabetes Federation that 21.3 million or 16.2% of live births to women in 2017 had some form of hyperglycemia in pregnancy. An estimated 86.4% of those cases were due to GDM. Aim The aim was to evaluate the prevalence of gestational diabetes using Diabetes in Pregnancy Study Group India criteria and to determine the magnitude of gestational diabetes among pregnant women at 24–28 weeks gestation attending Al-Fath Primary Health-care Center in Assiut Governorate to identify the possible risk factors of GDM among this group of pregnant women and to increase awareness about GDM and importance of early detection in primary health-care providers and among population as a whole. Patients and methods A cross-sectional clinical study which included 500 pregnant women not known to have diabetes mellitus before gestation, who attended the Al-Fath Primary Health-care Center in Assiut Governorate between the period of July 2015 and July 2016.. Non-fasting oral glucose tolerance test at 24–28 weeks gestation using 75 g glucose anhydrous in 250–300 ml water and woman was considered to have GDM if 2h-postprandial blood glucose exceeded 140 mg/dl (Diabetes in Pregnancy Study Group India criteria) and HBA1C was indicated only if 2 h Blood sugar greater than or equal to 200 g/dl to exclude pre-pregnancy diabetes from GDM. This study was part of a Gestational Diabetes Care in Upper Egypt project in collaboration with World Diabetes Foundation 13–797. Results The present study included 500 pregnant women, 8% of them had GDM, 24 (60%) GDM women had significantly different risk factors for GDM, 10 of them (25%) had a family history of GDM, eight of them (20%) had multiple risk factors, and four (10%) women had a previous history of twins. A high percentage of GDM women (about 40%) had no definite risk factor and this encourages universal screening of GDM to pick up more and more cases of GDM. Increased age of pregnant women (>30 years, 40%) is a significant risk factor for GDM. BMI was significantly higher in those with GDM (85%), As regards dietary habits, significant difference between women with GDM and those without GDM presented only with excess consumption of sweets/desserts. Conclusion The prevalence of GDM in the Al-Fath district of Assiut was 8%, in which a family history of diabetes mellitus was the most frequent risk factor for GDM. Presence of multiple risk factors, previous history of twins, advanced maternal age, and increased BMI were other risk factors for GDM. Sweet/deserts were the most frequent type of food among GDM women.
{"title":"Screening and diagnosis of gestational diabetes mellitus in a primary health-care center in Assiut","authors":"L. E. El Toony, El-Gibaly Omaima, W. Khalifa, El-Sayed Rowyda","doi":"10.4103/ejode.ejode_9_18","DOIUrl":"https://doi.org/10.4103/ejode.ejode_9_18","url":null,"abstract":"Background Gestational diabetes mellitus (GDM), defined as glucose intolerance with onset or first recognition in pregnancy, is a common complication of pregnancy. The American Diabetes Association 2017 redefined GDM as follows: ‘diabetes diagnosed in the second and third trimesters of pregnancy.’ It is estimated by the International Diabetes Federation that 21.3 million or 16.2% of live births to women in 2017 had some form of hyperglycemia in pregnancy. An estimated 86.4% of those cases were due to GDM. Aim The aim was to evaluate the prevalence of gestational diabetes using Diabetes in Pregnancy Study Group India criteria and to determine the magnitude of gestational diabetes among pregnant women at 24–28 weeks gestation attending Al-Fath Primary Health-care Center in Assiut Governorate to identify the possible risk factors of GDM among this group of pregnant women and to increase awareness about GDM and importance of early detection in primary health-care providers and among population as a whole. Patients and methods A cross-sectional clinical study which included 500 pregnant women not known to have diabetes mellitus before gestation, who attended the Al-Fath Primary Health-care Center in Assiut Governorate between the period of July 2015 and July 2016.. Non-fasting oral glucose tolerance test at 24–28 weeks gestation using 75 g glucose anhydrous in 250–300 ml water and woman was considered to have GDM if 2h-postprandial blood glucose exceeded 140 mg/dl (Diabetes in Pregnancy Study Group India criteria) and HBA1C was indicated only if 2 h Blood sugar greater than or equal to 200 g/dl to exclude pre-pregnancy diabetes from GDM. This study was part of a Gestational Diabetes Care in Upper Egypt project in collaboration with World Diabetes Foundation 13–797. Results The present study included 500 pregnant women, 8% of them had GDM, 24 (60%) GDM women had significantly different risk factors for GDM, 10 of them (25%) had a family history of GDM, eight of them (20%) had multiple risk factors, and four (10%) women had a previous history of twins. A high percentage of GDM women (about 40%) had no definite risk factor and this encourages universal screening of GDM to pick up more and more cases of GDM. Increased age of pregnant women (>30 years, 40%) is a significant risk factor for GDM. BMI was significantly higher in those with GDM (85%), As regards dietary habits, significant difference between women with GDM and those without GDM presented only with excess consumption of sweets/desserts. Conclusion The prevalence of GDM in the Al-Fath district of Assiut was 8%, in which a family history of diabetes mellitus was the most frequent risk factor for GDM. Presence of multiple risk factors, previous history of twins, advanced maternal age, and increased BMI were other risk factors for GDM. Sweet/deserts were the most frequent type of food among GDM women.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128512131","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 : 2019-01-01DOI: 10.4103/ejode.ejode_24_19
Ragaa Abdel Kader Mahmoud, M. Abdel Megid, M. Mahmoud, Eman Ghani Sayed Mahmoud, Abeer El-Dousouky
Introduction Rheumatoid arthritis (RA) is a systemic inflammatory disorder that most commonly affects the joints. Interstitial lung disease (ILD) is the most common pulmonary manifestation of RA-associated ILD. Patients with RA typically have circulating auto-antibodies, the most common being rheumatoid factor and anti-cyclic citrullinated protein antibodies (ACPA). Aim To determine the occurrence of ILD in patients with RA and its relation to anti-citrullinated protein antibodies. Patients and methods The study was conducted on 40 patients diagnosed according to ACR/EULAR 2010 criteria for diagnosis of RA. They were divided into two groups according to ACPA positivity: group I included 20 patients with RA who were ACPA positive, and group II included 20 patients with RA who were ACPA negative. Exclusion criteria Patients with interstitial pneumonia, asbestos exposure, other connective tissue diseases such as systemic lupus erythematosus and systemic sclerosis, autoimmune hepatitis, and hepatitis C virus infection were excluded. Patients and methods The participates underwent thorough medical history taking, full clinical examination, disease activity score-28 based on C-reactive protein and functional assessment questionnaire (Health Assessment Questionnaire) score, complete blood count, SGPT, SPOT, urea, creatinine, erythrocyte sedimentation rate first hour and rheumatoid factor, ACPA titer, high-resolution computed tomography of the chest, radiological examination for both hands and feet, BMI, ECHO, pulmonary function tests, and assessment of pulmonary artery pressure. An informed consent was taken from all patients in the study. Results ACPA-positive patients with RA are accompanied with a statistically significant restrictive pattern of pulmonary function tests. Positive high-resolution computed tomography findings indicate RA-ILD. Conclusions In RA, high titer of ACPA may be related to the development of ILD.
{"title":"Study of the relationship between anti-citrullinated protein antibodies and occurrence of interstitial lung disease in patients with rheumatoid arthritis","authors":"Ragaa Abdel Kader Mahmoud, M. Abdel Megid, M. Mahmoud, Eman Ghani Sayed Mahmoud, Abeer El-Dousouky","doi":"10.4103/ejode.ejode_24_19","DOIUrl":"https://doi.org/10.4103/ejode.ejode_24_19","url":null,"abstract":"Introduction Rheumatoid arthritis (RA) is a systemic inflammatory disorder that most commonly affects the joints. Interstitial lung disease (ILD) is the most common pulmonary manifestation of RA-associated ILD. Patients with RA typically have circulating auto-antibodies, the most common being rheumatoid factor and anti-cyclic citrullinated protein antibodies (ACPA). Aim To determine the occurrence of ILD in patients with RA and its relation to anti-citrullinated protein antibodies. Patients and methods The study was conducted on 40 patients diagnosed according to ACR/EULAR 2010 criteria for diagnosis of RA. They were divided into two groups according to ACPA positivity: group I included 20 patients with RA who were ACPA positive, and group II included 20 patients with RA who were ACPA negative. Exclusion criteria Patients with interstitial pneumonia, asbestos exposure, other connective tissue diseases such as systemic lupus erythematosus and systemic sclerosis, autoimmune hepatitis, and hepatitis C virus infection were excluded. Patients and methods The participates underwent thorough medical history taking, full clinical examination, disease activity score-28 based on C-reactive protein and functional assessment questionnaire (Health Assessment Questionnaire) score, complete blood count, SGPT, SPOT, urea, creatinine, erythrocyte sedimentation rate first hour and rheumatoid factor, ACPA titer, high-resolution computed tomography of the chest, radiological examination for both hands and feet, BMI, ECHO, pulmonary function tests, and assessment of pulmonary artery pressure. An informed consent was taken from all patients in the study. Results ACPA-positive patients with RA are accompanied with a statistically significant restrictive pattern of pulmonary function tests. Positive high-resolution computed tomography findings indicate RA-ILD. Conclusions In RA, high titer of ACPA may be related to the development of ILD.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114430572","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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