Pub Date : 2019-01-01DOI: 10.4103/ejode.ejode_15_19
E. Moursi, H. Hassan, N. Amin, N. Kandil, Narjis Almusagry
Purpose To evaluate the association of various metabolic risk factors with percent mammographic breast density (PMD), and to assess the advantage of screening mammogram in type 2 diabetes mellitus (T2DM) postmenopausal diabetic women. Patients and methods This was a cross-sectional study which included 90 postmenopausal women, who were divided into two groups: group I included 60 patients diagnosed with T2DM and group II included 30 controls. All participants were subjected to history taking, clinical assessment, fasting serum glucose, glycated hemoglobin, Homeostatic Model Assessment 2-IR calculation, serum lipid profile, and screening mammogram (PMD). Results There was significant inverse associations between PMD and weight (P=0.006, 0.022, 0.010), BMI (P=0.003, 0.015, 0.001), and waist circumference (P=0.001, 0.019, 0.001) in cases, control, and total sample, respectively. After adjustment for weight in the total sample, the extremely dense group (breast imaging-reporting and data system D) was only associated with age of menarche (odds ratio, 0.404), while in cases group, breast imaging-reporting and data system D was only significantly associated with waist circumference (odds ratio, 0.756). Conclusions PMD levels were not increased in the presence of multiple metabolic risks, pointing to an alternative pathway explaining the increased risk of cancer breast in T2DM postmenopausal women.
{"title":"Metabolic risk factors and mammographic breast density among Egyptian postmenopausal women with type 2 diabetes mellitus","authors":"E. Moursi, H. Hassan, N. Amin, N. Kandil, Narjis Almusagry","doi":"10.4103/ejode.ejode_15_19","DOIUrl":"https://doi.org/10.4103/ejode.ejode_15_19","url":null,"abstract":"Purpose To evaluate the association of various metabolic risk factors with percent mammographic breast density (PMD), and to assess the advantage of screening mammogram in type 2 diabetes mellitus (T2DM) postmenopausal diabetic women. Patients and methods This was a cross-sectional study which included 90 postmenopausal women, who were divided into two groups: group I included 60 patients diagnosed with T2DM and group II included 30 controls. All participants were subjected to history taking, clinical assessment, fasting serum glucose, glycated hemoglobin, Homeostatic Model Assessment 2-IR calculation, serum lipid profile, and screening mammogram (PMD). Results There was significant inverse associations between PMD and weight (P=0.006, 0.022, 0.010), BMI (P=0.003, 0.015, 0.001), and waist circumference (P=0.001, 0.019, 0.001) in cases, control, and total sample, respectively. After adjustment for weight in the total sample, the extremely dense group (breast imaging-reporting and data system D) was only associated with age of menarche (odds ratio, 0.404), while in cases group, breast imaging-reporting and data system D was only significantly associated with waist circumference (odds ratio, 0.756). Conclusions PMD levels were not increased in the presence of multiple metabolic risks, pointing to an alternative pathway explaining the increased risk of cancer breast in T2DM postmenopausal women.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"10 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":"125455943","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 : 2018-09-01DOI: 10.4103/ejode.ejode_7_19
Abd Fathy Zeid, A. Hussein, Mohamed Mahmoud Awad, Mohamed Atia Ibrahim
Background Obesity is considered a severe rapidly growing health problem all over the world. Adiponectin is an adipokine produced and secreted by adipose tissues and widely known as antidiabetic, anti-inflammatory, antiatherogenic, and cardioprotective factor. The adiponectin gene has various single nucleotide polymorphisms (SNPs). Objective Our aim of this study was to determine the genotype frequency of SNPs (276 G→T) in adiponectin gene and its relationship with the occurrence of obesity and to detect the association between adiponectin gene polymorphism and different degrees of obesity. Patients and methods A total of 96 volunteers were included and divided into the following: group I had 48 healthy nonobese control volunteers, and group II included 48 obese patients not having any disease. Anthropometric parameters were measured by standard procedures. Random blood sample was collected for routine and research investigations. PCR assay with restriction fragment length polymorphism was used to examine the adiponectin gene SNP276G>T polymorphism. Results Genotypes distributions of 276G>T polymorphisms were significantly different between obese and nonobese cases. T allele was significantly associated with obese individuals (P<0.05) with odds ratio (OR) of 2.13 and found to be significantly associated (P<0.05) and risky for BMI more than or equal to 30, with OR 3.86. Both of the genotype TT and allele T were significantly associated and risky for abdominal obesity (P<0.05) with OR of 3.57 for TT genotype and 3.61 for T allele. Conclusion The T allele and TT genotypes at the 276 locus of the ADIPOQ gene were associated with higher risk of obesity.
{"title":"The relationship between adiponectin gene polymorphism and occurrence of obesity at Zagazig University Hospitals","authors":"Abd Fathy Zeid, A. Hussein, Mohamed Mahmoud Awad, Mohamed Atia Ibrahim","doi":"10.4103/ejode.ejode_7_19","DOIUrl":"https://doi.org/10.4103/ejode.ejode_7_19","url":null,"abstract":"Background Obesity is considered a severe rapidly growing health problem all over the world. Adiponectin is an adipokine produced and secreted by adipose tissues and widely known as antidiabetic, anti-inflammatory, antiatherogenic, and cardioprotective factor. The adiponectin gene has various single nucleotide polymorphisms (SNPs). Objective Our aim of this study was to determine the genotype frequency of SNPs (276 G→T) in adiponectin gene and its relationship with the occurrence of obesity and to detect the association between adiponectin gene polymorphism and different degrees of obesity. Patients and methods A total of 96 volunteers were included and divided into the following: group I had 48 healthy nonobese control volunteers, and group II included 48 obese patients not having any disease. Anthropometric parameters were measured by standard procedures. Random blood sample was collected for routine and research investigations. PCR assay with restriction fragment length polymorphism was used to examine the adiponectin gene SNP276G>T polymorphism. Results Genotypes distributions of 276G>T polymorphisms were significantly different between obese and nonobese cases. T allele was significantly associated with obese individuals (P<0.05) with odds ratio (OR) of 2.13 and found to be significantly associated (P<0.05) and risky for BMI more than or equal to 30, with OR 3.86. Both of the genotype TT and allele T were significantly associated and risky for abdominal obesity (P<0.05) with OR of 3.57 for TT genotype and 3.61 for T allele. Conclusion The T allele and TT genotypes at the 276 locus of the ADIPOQ gene were associated with higher risk of obesity.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125204072","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 : 2018-09-01DOI: 10.4103/ejode.ejode_3_19
Abdel Mona, B. Barakat, A. Mona, A. Eman, Bakri Heba
Background Bone loss in rheumatoid arthritis is caused by increased bone resorption without increasing bone formation. The Wnt pathway is important in the control of bone formation through the regulation of osteoblast activity. Sclerostin is an important regulator of the Wnt pathway by blocking Wnt binding to its receptor and thereby , inhibiting bone formation. Aim Of The Work was to correlate the relation between level of serum sclerostin and bone mineral density with disease severity in rheumatoid arthritis patients. Subjects The study was conducted on 50 subjects divided into two groups: Group I : Thirty patients of rheumatoid arthritis subjects diagnosed according to 2010 ACR / EULAR diagnostic criteria. Group II : Twenty persons as a control group. Methods All patients were subjected to ; thorough medical history taking, DAS -28, disability Index, complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), RF, antinuclear antibody (ANA), Anti-CCP Antibodies, Human Sclerostin levels using ELISA technique, Plain X- ray on both hands and feets, U/S on both hands, and (DEXA) scan. Results There was a statistical significant difference between the two studied groups regarding the age, gender, sclerostin level, and DAS-28 (P>0.05). Conclusion Most of patients were under treatment with disease modifying anti-rheumatic drugs (DMARDs) as methotrexate, fracture risk was not assessed, and measurements for renal function were not measured. However, it is possible that circulating sclerostin levels may not reflect changes of sclerostin at a local level. Despite the many questions that remain, pre-clinical studies and clinical trial results would imply that sclerostin antibodies will emerge as a dominant first- line treatment in the management of osteoporosis.
{"title":"Sclerostin level in rheumatoid arthritis patients and its relationship to disease severity and bone mineral density","authors":"Abdel Mona, B. Barakat, A. Mona, A. Eman, Bakri Heba","doi":"10.4103/ejode.ejode_3_19","DOIUrl":"https://doi.org/10.4103/ejode.ejode_3_19","url":null,"abstract":"Background Bone loss in rheumatoid arthritis is caused by increased bone resorption without increasing bone formation. The Wnt pathway is important in the control of bone formation through the regulation of osteoblast activity. Sclerostin is an important regulator of the Wnt pathway by blocking Wnt binding to its receptor and thereby , inhibiting bone formation. Aim Of The Work was to correlate the relation between level of serum sclerostin and bone mineral density with disease severity in rheumatoid arthritis patients. Subjects The study was conducted on 50 subjects divided into two groups: Group I : Thirty patients of rheumatoid arthritis subjects diagnosed according to 2010 ACR / EULAR diagnostic criteria. Group II : Twenty persons as a control group. Methods All patients were subjected to ; thorough medical history taking, DAS -28, disability Index, complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), RF, antinuclear antibody (ANA), Anti-CCP Antibodies, Human Sclerostin levels using ELISA technique, Plain X- ray on both hands and feets, U/S on both hands, and (DEXA) scan. Results There was a statistical significant difference between the two studied groups regarding the age, gender, sclerostin level, and DAS-28 (P>0.05). Conclusion Most of patients were under treatment with disease modifying anti-rheumatic drugs (DMARDs) as methotrexate, fracture risk was not assessed, and measurements for renal function were not measured. However, it is possible that circulating sclerostin levels may not reflect changes of sclerostin at a local level. Despite the many questions that remain, pre-clinical studies and clinical trial results would imply that sclerostin antibodies will emerge as a dominant first- line treatment in the management of osteoporosis.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121645850","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 : 2018-09-01DOI: 10.4103/ejode.ejode_1_19
S. Abou‐Raya, Doria Meyers, Eman Sayed, Mervat Kamal-El Deen
Background Obesity is associated with an increased risk of osteoarthritis (OA). Metabolic syndrome (Met S) has been associated with a state of chronic low-grade inflammation and increased macrophages in the fat tissue. Hypertension and hyperglycaemia seem to be important BMI-independent factors of changes in osteoarthritic joints. Moreover, type 2 diabetes mellitus (DM) has been found to be an independent risk predictor for arthroplasty. Aim of the work To determine frequency and association of metabolic syndrome with knee osteoarthritis in elderly patients and its impact on the physical activity in elderly patients with knee osteoarthritis. Patients The study included patients aged above 65 years complaining of primary knee OA. The study included two groups: Gp A: Sixty patients >65 years with primary OA. Gp B: Forty apparently healthy elderly persons without knee OA as a control group. Exclusion Criteria: Patients with secondary knee OA. Methods All Patients were subjected to the following: Complete history taking, self-rated was measured by (SF-36), BMI, complete clinical musculoskeletal examination. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) 1st hr,fasting glucose level, 2 hr-post-prandial glucose level, triglycerides (TG), cholesterol, uric acid, high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c) and radiographic imaging of affected knee joints. Results According to (k/L) score of severity; grade 3 and grade 4 OA were significantly higher in patients with Met S than patients without Met S. The mean WOMAC pain subscale score was significantly higher in patients with OA and Met S than in patients with OA and without Met S with P value (<0.001). There was a significant positive correlation between the both joint pain, stiffness and fasting blood glucose level (r=−0.463 P=<0.001; r=0.324, P=0.012 respectively); systolic, diastolic blood pressure and waist circumference in OA patients (group I) with Met S. Conclusion Elevated systemic markers of inflammation are linked with components of Met S, with an increased prevalence of radiographic OA and joint symptoms.
{"title":"Study of metabolic syndrome frequency in elderly patients with knee osteoarthritis and its impact on the physical activity","authors":"S. Abou‐Raya, Doria Meyers, Eman Sayed, Mervat Kamal-El Deen","doi":"10.4103/ejode.ejode_1_19","DOIUrl":"https://doi.org/10.4103/ejode.ejode_1_19","url":null,"abstract":"Background Obesity is associated with an increased risk of osteoarthritis (OA). Metabolic syndrome (Met S) has been associated with a state of chronic low-grade inflammation and increased macrophages in the fat tissue. Hypertension and hyperglycaemia seem to be important BMI-independent factors of changes in osteoarthritic joints. Moreover, type 2 diabetes mellitus (DM) has been found to be an independent risk predictor for arthroplasty. Aim of the work To determine frequency and association of metabolic syndrome with knee osteoarthritis in elderly patients and its impact on the physical activity in elderly patients with knee osteoarthritis. Patients The study included patients aged above 65 years complaining of primary knee OA. The study included two groups: Gp A: Sixty patients >65 years with primary OA. Gp B: Forty apparently healthy elderly persons without knee OA as a control group. Exclusion Criteria: Patients with secondary knee OA. Methods All Patients were subjected to the following: Complete history taking, self-rated was measured by (SF-36), BMI, complete clinical musculoskeletal examination. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) 1st hr,fasting glucose level, 2 hr-post-prandial glucose level, triglycerides (TG), cholesterol, uric acid, high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c) and radiographic imaging of affected knee joints. Results According to (k/L) score of severity; grade 3 and grade 4 OA were significantly higher in patients with Met S than patients without Met S. The mean WOMAC pain subscale score was significantly higher in patients with OA and Met S than in patients with OA and without Met S with P value (<0.001). There was a significant positive correlation between the both joint pain, stiffness and fasting blood glucose level (r=−0.463 P=<0.001; r=0.324, P=0.012 respectively); systolic, diastolic blood pressure and waist circumference in OA patients (group I) with Met S. Conclusion Elevated systemic markers of inflammation are linked with components of Met S, with an increased prevalence of radiographic OA and joint symptoms.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"37 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124841046","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 : 2018-05-01DOI: 10.4103/ejode.ejode_13_18
S. Abou‐Raya, M. Zeid, M. Ayad, Maher Abdnaby, M. Arafa
Objective The aims of the current study were to investigate the role of toll-like receptor (TLR)2, TLR4, and nuclear factor κB (NF-κB) expression in the pathogenesis of diabetic nephropathy (DN) in elderly type 2 diabetics, and also to determine the functional role of TLR2, TLR4, and NF-κB in tubular inflammation. Background Chronic kidney disease is one of the major complications of type 2 diabetes mellitus (T2DM) and is the leading cause of end-stage renal disease. There is growing evidence indicating that chronic low-grade inflammatory response is a recognized factor in the pathogenesis and progression of diabetic renal injury. Patients and methods Our study included a human part and an animal part, in the human part, participants were divided into four groups; old patients: 30 T2DM patients aged 65 years and above with documented DN in stage 2 incipient nephropathy and stage 3 overt nephropathy, old control: 20 age- matched and sex-matched healthy persons aged 65 years and above serving as a control group, young patients: 30 T2DM patients aged less than 65 years with documented DN in stage 2 incipient nephropathy and stage 3 overt nephropathy and young control: 20 age-matched and sex-matched healthy persons aged less than 65 years serving as a control group. We took a full history of all patients and concluded complete physical examination. Mean arterial pressure, BMI and fundus examination were done. We measured fasting plasma glucose, 2 h postprandial plasma glucose, glycated haemoglobin, complete urine analysis, serum creatinine, blood urea nitrogen, C-reactive protein, urinary albumin/creatinine ratio, estimated glomerular filtration rate using Modification of Diet in Renal Disease Abbreviated Equation, level of TLR2, TLR4, and nuclear NF-κB. In the animal part, the study was conducted on 20 aged (1.5-year old) male wistar rats, the rats were divided into two main groups; group I (control): 10 normal healthy male rats, group II (diabetic): 10 rats with high-fat diet)/streptozotocin-induced diabetes. Blood samples were collected for the determination of fasting plasma glucose, fasting serum insulin, insulin resistance was assessed by calculating the homeostatic model assessment of insulin resistance, blood urea nitrogen, serum creatinine and C-reactive protein and analysis of TLR2, TLR4, and NF-κB in renal tissue was done. Results In the human part of our study: the level of TLRs2, TLR4, and NF-κB was significantly higher in old diabetic patients group than young diabetic patients group and control group. In the animal part of our study: the level of TLRs2 and 4 and NF-κB was significantly higher in diabetic rat group than healthy rat control group. Conclusion TLRs2, TLR4, and NF-κB were higher in old diabetic patients compared with young diabetic patients and normal individuals. These observations significantly added to the emerging role of TLRs in T2DM development and its possible role in the pathogenesis and progression of DN. Also, the
{"title":"Diabetic tubulopathy: effect of toll-like receptor 2, toll-like receptor 4, and nuclear factor κb in elderly type 2 diabetes mellitus patients","authors":"S. Abou‐Raya, M. Zeid, M. Ayad, Maher Abdnaby, M. Arafa","doi":"10.4103/ejode.ejode_13_18","DOIUrl":"https://doi.org/10.4103/ejode.ejode_13_18","url":null,"abstract":"Objective The aims of the current study were to investigate the role of toll-like receptor (TLR)2, TLR4, and nuclear factor κB (NF-κB) expression in the pathogenesis of diabetic nephropathy (DN) in elderly type 2 diabetics, and also to determine the functional role of TLR2, TLR4, and NF-κB in tubular inflammation. Background Chronic kidney disease is one of the major complications of type 2 diabetes mellitus (T2DM) and is the leading cause of end-stage renal disease. There is growing evidence indicating that chronic low-grade inflammatory response is a recognized factor in the pathogenesis and progression of diabetic renal injury. Patients and methods Our study included a human part and an animal part, in the human part, participants were divided into four groups; old patients: 30 T2DM patients aged 65 years and above with documented DN in stage 2 incipient nephropathy and stage 3 overt nephropathy, old control: 20 age- matched and sex-matched healthy persons aged 65 years and above serving as a control group, young patients: 30 T2DM patients aged less than 65 years with documented DN in stage 2 incipient nephropathy and stage 3 overt nephropathy and young control: 20 age-matched and sex-matched healthy persons aged less than 65 years serving as a control group. We took a full history of all patients and concluded complete physical examination. Mean arterial pressure, BMI and fundus examination were done. We measured fasting plasma glucose, 2 h postprandial plasma glucose, glycated haemoglobin, complete urine analysis, serum creatinine, blood urea nitrogen, C-reactive protein, urinary albumin/creatinine ratio, estimated glomerular filtration rate using Modification of Diet in Renal Disease Abbreviated Equation, level of TLR2, TLR4, and nuclear NF-κB. In the animal part, the study was conducted on 20 aged (1.5-year old) male wistar rats, the rats were divided into two main groups; group I (control): 10 normal healthy male rats, group II (diabetic): 10 rats with high-fat diet)/streptozotocin-induced diabetes. Blood samples were collected for the determination of fasting plasma glucose, fasting serum insulin, insulin resistance was assessed by calculating the homeostatic model assessment of insulin resistance, blood urea nitrogen, serum creatinine and C-reactive protein and analysis of TLR2, TLR4, and NF-κB in renal tissue was done. Results In the human part of our study: the level of TLRs2, TLR4, and NF-κB was significantly higher in old diabetic patients group than young diabetic patients group and control group. In the animal part of our study: the level of TLRs2 and 4 and NF-κB was significantly higher in diabetic rat group than healthy rat control group. Conclusion TLRs2, TLR4, and NF-κB were higher in old diabetic patients compared with young diabetic patients and normal individuals. These observations significantly added to the emerging role of TLRs in T2DM development and its possible role in the pathogenesis and progression of DN. Also, the","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125494443","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 : 2018-05-01DOI: 10.4103/ejode.ejode_21_17
Sekina Ahmed, Noha Elsabbagh, M. Bondok, Amr Mohamed, M. Eldin, Mohamed Gongo
Background Subclinical hypothyroidism (SCH) is defined as an isolated elevation of thyroid stimulating hormone (TSH) levels in conjugation with normal circulating levels of free triiodothyronine and free thyroxine. It is a highly prevalent disease especially in the elderly population. Thyroid hormones affect the heart and vasculature by both genomic and nongenomic pathways. However, the impact of SCH on the cardiovascular system is a matter of debate. Researches have been conducted to study the effect of SCH on cardiovascular system, yielding conflicting results. Although some studies support increased risk of cardiovascular events in patients with SCH, others show no significant increased risk. Aim This study was conducted to evaluate if SCH is associated with higher risk of coronary heart diseases in the elderly and if dyslipidemia, endothelial dysfunction as measured by flow-mediated dilatation (FMD) and carotid artery intima-media thickness were associated with SCH. Patients and methods Fifty elderly individuals aged 65 years and older were enrolled in this study and were divided into two groups, group I: 30 patients with SCH and group II comprised 20 age-matched and sex-matched euthyroid elderly serving as a control group. In all participants we performed serum TSH, free thyroxine, and antithyroperoxidase antibodies. SCH was defined as an elevated thyrotropin (TSH) (>4.5 mU/l) and normal free thyroxine level. Complete lipid profile, thyroid ultrasound, echocardiography to assess cardiac function and markers of endothelial dysfunction namely carotid artery intima-media thickness and FMD of the brachial artery (BA) after occlusion were done to all cases. Results The mean age of group I was 69.2±3.1 years and the mean age of group II was 68.6±3.2 years. Overall, 50% of the elderly patients with SCH (group I) were suffering from hypertension, whereas 35% in the elderly euthyroid group (group II) were hypertensive. The systolic and diastolic blood pressures are higher in group I as compared with group II (140±20 and 86±12, respectively vs. group II were 131±19 and 82±12, respectively), but the differences were statistically insignificant (P=0.12 and 0.21, respectively). No significant statistical difference was observed when the elderly SCH patients were compared with a euthyroid control group as regards the mean cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein levels (P=0.69, 0.79, 0.77, 0.42, respectively). For the elderly SCH group I the mean BA diameter before dilation was 3.12±0.44 versus 3.44±0.68 mm for euthyroid group II. However, the mean BA diameter after dilation was 3.64±0.60 mm compared with 4.05±0.73 mm for the euthyroid group. The mean percentage of FMD% of BA after occlusion was 16.2±5.7 in group I versus 17.9±5.5 in group II. There was no statistically significant difference between the two groups as regards flow-mediated vasodilatation% of the BA after occlusion (P=0.29). Conclusion T
{"title":"Does subclinical hypothyroidism confer an increased risk of coronary heart disease in the elderly?","authors":"Sekina Ahmed, Noha Elsabbagh, M. Bondok, Amr Mohamed, M. Eldin, Mohamed Gongo","doi":"10.4103/ejode.ejode_21_17","DOIUrl":"https://doi.org/10.4103/ejode.ejode_21_17","url":null,"abstract":"Background Subclinical hypothyroidism (SCH) is defined as an isolated elevation of thyroid stimulating hormone (TSH) levels in conjugation with normal circulating levels of free triiodothyronine and free thyroxine. It is a highly prevalent disease especially in the elderly population. Thyroid hormones affect the heart and vasculature by both genomic and nongenomic pathways. However, the impact of SCH on the cardiovascular system is a matter of debate. Researches have been conducted to study the effect of SCH on cardiovascular system, yielding conflicting results. Although some studies support increased risk of cardiovascular events in patients with SCH, others show no significant increased risk. Aim This study was conducted to evaluate if SCH is associated with higher risk of coronary heart diseases in the elderly and if dyslipidemia, endothelial dysfunction as measured by flow-mediated dilatation (FMD) and carotid artery intima-media thickness were associated with SCH. Patients and methods Fifty elderly individuals aged 65 years and older were enrolled in this study and were divided into two groups, group I: 30 patients with SCH and group II comprised 20 age-matched and sex-matched euthyroid elderly serving as a control group. In all participants we performed serum TSH, free thyroxine, and antithyroperoxidase antibodies. SCH was defined as an elevated thyrotropin (TSH) (>4.5 mU/l) and normal free thyroxine level. Complete lipid profile, thyroid ultrasound, echocardiography to assess cardiac function and markers of endothelial dysfunction namely carotid artery intima-media thickness and FMD of the brachial artery (BA) after occlusion were done to all cases. Results The mean age of group I was 69.2±3.1 years and the mean age of group II was 68.6±3.2 years. Overall, 50% of the elderly patients with SCH (group I) were suffering from hypertension, whereas 35% in the elderly euthyroid group (group II) were hypertensive. The systolic and diastolic blood pressures are higher in group I as compared with group II (140±20 and 86±12, respectively vs. group II were 131±19 and 82±12, respectively), but the differences were statistically insignificant (P=0.12 and 0.21, respectively). No significant statistical difference was observed when the elderly SCH patients were compared with a euthyroid control group as regards the mean cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein levels (P=0.69, 0.79, 0.77, 0.42, respectively). For the elderly SCH group I the mean BA diameter before dilation was 3.12±0.44 versus 3.44±0.68 mm for euthyroid group II. However, the mean BA diameter after dilation was 3.64±0.60 mm compared with 4.05±0.73 mm for the euthyroid group. The mean percentage of FMD% of BA after occlusion was 16.2±5.7 in group I versus 17.9±5.5 in group II. There was no statistically significant difference between the two groups as regards flow-mediated vasodilatation% of the BA after occlusion (P=0.29). Conclusion T","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123805178","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 : 2018-05-01DOI: 10.4103/ejode.ejode_4_18
S. Abou‐Raya, A. Abdou, M. Kamel, Ali Ramadan
Introduction Alzheimer’s disease (AD) is the most common form of dementia in the elderly, accounting for 60–80% of cases. The present study was to explore the role of insulin resistance and inflammatory processes in AD patients and to assess the effect of an insulin sensitizer (pioglitazone) on cognition and plasma levels of the amyloid beta derivative. Also, the study aimed to verify experimentally the effect of pioglitazone on the components of brain insulin signaling pathway and inflammatory pathway. Materials and methods We studied the impact of pioglitazone treatment on diabetic AD patients for 6 months with concomitant study of pioglitazone effect on insulin signaling pathway on diabetic AD rats. Results We report that pioglitazone 6 months treated patients has a positive effect on cognitive deficit, improve neurometabolic and decreasing neuroinflammation in diabetic AD patients, and it also was associated with a positive effect on insulin-signaling pathway plus its antioxidant effect on the brain of rats. Conclusion There is a strong association between AD and type 2 diabetes mellitus indicating that they share similar underlying pathophysiological mechanisms. Pioglitazone-treated diabetic AD patients were associated with improvement in cognition.
{"title":"Insulin resistance and Alzheimer’s disease: the role of defective insulin signaling and inflammation","authors":"S. Abou‐Raya, A. Abdou, M. Kamel, Ali Ramadan","doi":"10.4103/ejode.ejode_4_18","DOIUrl":"https://doi.org/10.4103/ejode.ejode_4_18","url":null,"abstract":"Introduction Alzheimer’s disease (AD) is the most common form of dementia in the elderly, accounting for 60–80% of cases. The present study was to explore the role of insulin resistance and inflammatory processes in AD patients and to assess the effect of an insulin sensitizer (pioglitazone) on cognition and plasma levels of the amyloid beta derivative. Also, the study aimed to verify experimentally the effect of pioglitazone on the components of brain insulin signaling pathway and inflammatory pathway. Materials and methods We studied the impact of pioglitazone treatment on diabetic AD patients for 6 months with concomitant study of pioglitazone effect on insulin signaling pathway on diabetic AD rats. Results We report that pioglitazone 6 months treated patients has a positive effect on cognitive deficit, improve neurometabolic and decreasing neuroinflammation in diabetic AD patients, and it also was associated with a positive effect on insulin-signaling pathway plus its antioxidant effect on the brain of rats. Conclusion There is a strong association between AD and type 2 diabetes mellitus indicating that they share similar underlying pathophysiological mechanisms. Pioglitazone-treated diabetic AD patients were associated with improvement in cognition.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125985880","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 : 2017-09-01DOI: 10.4103/ejode.ejode_17_17
Z. Atef, M. A. Bamashmos, Gameel Alghazali
Background The habit of chewing Qat is one of Yemen’s social and cultural characteristics. Most Yemeni adults chew Qat regularly. The general belief among the Yemeni diabetics is that Qat chewing helps to lower their blood glucose. Objective In this study, we investigated the effect of Qat chewing on the level of blood glucose on patients with type 2 diabetes. Patients and methods The study included 260 patients with type 2 diabetes who were divided into two groups: Group 1 included 130 patients who were non-Qat chewers. Group 2 included 130 patients who were Qat chewers All patients underwent clinical examination; fasting, postprandial, and random blood glucose examination before and after Qat chewing; and glycated hemoglobin and lipid profile. Results The results of the study demonstrated that there was a significant increase in heart rate and arterial blood pressure after Qat chewing, whereas there were no significant changes in the level of blood glucose before and after Qat chewing. Moreover, we found that there were no effects in the levels of total cholesterol and triglyceride, whereas there was a nonsignificant decrease and a nonsignificant increase in the levels of low-density lipoprotein-cholesterol and high-density lipoprotein-cholesterol, respectively, among the Qat chewers. Conclusion We found that there was a significant effect of Qat on heart rate and hypertension. There was no significant effect of Qat on the blood glucose or lipids levels. The only effect, which leads to wrong belief, is that Qat chewing produces feeling of euphoria, stimulation, heightened awareness, increased confidence, alertness, and energy, resulting in temporary alleviation of fatigue which the diabetic patients experience. All these effects are because of the cathinone and moderate sympathetic effects.
{"title":"Effect of Qat on the level of blood glucose and lipids among Yemeni patients with type 2 diabetes","authors":"Z. Atef, M. A. Bamashmos, Gameel Alghazali","doi":"10.4103/ejode.ejode_17_17","DOIUrl":"https://doi.org/10.4103/ejode.ejode_17_17","url":null,"abstract":"Background The habit of chewing Qat is one of Yemen’s social and cultural characteristics. Most Yemeni adults chew Qat regularly. The general belief among the Yemeni diabetics is that Qat chewing helps to lower their blood glucose. Objective In this study, we investigated the effect of Qat chewing on the level of blood glucose on patients with type 2 diabetes. Patients and methods The study included 260 patients with type 2 diabetes who were divided into two groups: Group 1 included 130 patients who were non-Qat chewers. Group 2 included 130 patients who were Qat chewers All patients underwent clinical examination; fasting, postprandial, and random blood glucose examination before and after Qat chewing; and glycated hemoglobin and lipid profile. Results The results of the study demonstrated that there was a significant increase in heart rate and arterial blood pressure after Qat chewing, whereas there were no significant changes in the level of blood glucose before and after Qat chewing. Moreover, we found that there were no effects in the levels of total cholesterol and triglyceride, whereas there was a nonsignificant decrease and a nonsignificant increase in the levels of low-density lipoprotein-cholesterol and high-density lipoprotein-cholesterol, respectively, among the Qat chewers. Conclusion We found that there was a significant effect of Qat on heart rate and hypertension. There was no significant effect of Qat on the blood glucose or lipids levels. The only effect, which leads to wrong belief, is that Qat chewing produces feeling of euphoria, stimulation, heightened awareness, increased confidence, alertness, and energy, resulting in temporary alleviation of fatigue which the diabetic patients experience. All these effects are because of the cathinone and moderate sympathetic effects.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130141819","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 : 2017-09-01DOI: 10.4103/ejode.ejode_23_17
E. Ibrahim, Mohamed I. Mowafy, Dalia Maharem, A. Awad, Sherif Mamdouh Mohammed
Background and aim The prevalence of hepatitis C virus (HCV) infection among dialysis patients is higher than in the general population. The prevalence of cognitive impairment (CI) is common among hemodialysis (HD) patients. Also patients with end-stage liver disease are vulnerable to cognitive dysfunction. Malnutrition and inflammation are common occurrences in maintenance HD patients. About 40–78% of individuals on HD suffer from hypozincemia. Zinc deficiency has been observed with high prevalence in liver cirrhosis. This study was carried out to assess the effect of chronic HCV on serum zinc level and its relation as a cofactor to CI and nutritional status in HD patients. Patients and methods The study involved 80 HD participants who were enrolled into two groups: group I: 40 HCV-positive HD patients (20 without liver cirrhosis and 20 with liver cirrhosis) and group II: 40 HCV-negative HD patients without liver cirrhosis. All participants were evaluated as regards detailed history and clinical examination, standardized mini-mental state examination (MMSE), malnutrition inflammation score (MIS), Child–Pugh classification, complete blood picture (CBP), prothrombin time, international normalized ratio, alanine aminotransferase, aspartate aminotransferase, serum albumin, bilirubin, blood urea, serum creatinine, Na, K, Ca, P, transferrin, ammonia, serum zinc level (predialysis and postdialysis session), virology including anti-HCV Ab, quantitative HCV PCR and hepatitis B surface antigen, Kt/V, fibrosis-4 score (FIB-4 score), and abdominal ultrasonography. Results We found that MMSE and zinc level were significantly lower and MIS was significantly higher in HCV HD patients with liver cirrhosis when compared with HCV HD patients without liver cirrhosis and HCV-negative HD patients. A positive significant correlation was found between zinc level and MMSE while there was a negative significant correlation between zinc level and MIS. Conclusion There may be an association between hypozincemia, CI, and malnutrition in HD patients especially those with chronic hepatitis C associated with liver cirrhosis.
{"title":"Effect of chronic hepatitis C on serum zinc and its relation as a cofactor to cognitive impairment and nutritional status in hemodialysis patients","authors":"E. Ibrahim, Mohamed I. Mowafy, Dalia Maharem, A. Awad, Sherif Mamdouh Mohammed","doi":"10.4103/ejode.ejode_23_17","DOIUrl":"https://doi.org/10.4103/ejode.ejode_23_17","url":null,"abstract":"Background and aim The prevalence of hepatitis C virus (HCV) infection among dialysis patients is higher than in the general population. The prevalence of cognitive impairment (CI) is common among hemodialysis (HD) patients. Also patients with end-stage liver disease are vulnerable to cognitive dysfunction. Malnutrition and inflammation are common occurrences in maintenance HD patients. About 40–78% of individuals on HD suffer from hypozincemia. Zinc deficiency has been observed with high prevalence in liver cirrhosis. This study was carried out to assess the effect of chronic HCV on serum zinc level and its relation as a cofactor to CI and nutritional status in HD patients. Patients and methods The study involved 80 HD participants who were enrolled into two groups: group I: 40 HCV-positive HD patients (20 without liver cirrhosis and 20 with liver cirrhosis) and group II: 40 HCV-negative HD patients without liver cirrhosis. All participants were evaluated as regards detailed history and clinical examination, standardized mini-mental state examination (MMSE), malnutrition inflammation score (MIS), Child–Pugh classification, complete blood picture (CBP), prothrombin time, international normalized ratio, alanine aminotransferase, aspartate aminotransferase, serum albumin, bilirubin, blood urea, serum creatinine, Na, K, Ca, P, transferrin, ammonia, serum zinc level (predialysis and postdialysis session), virology including anti-HCV Ab, quantitative HCV PCR and hepatitis B surface antigen, Kt/V, fibrosis-4 score (FIB-4 score), and abdominal ultrasonography. Results We found that MMSE and zinc level were significantly lower and MIS was significantly higher in HCV HD patients with liver cirrhosis when compared with HCV HD patients without liver cirrhosis and HCV-negative HD patients. A positive significant correlation was found between zinc level and MMSE while there was a negative significant correlation between zinc level and MIS. Conclusion There may be an association between hypozincemia, CI, and malnutrition in HD patients especially those with chronic hepatitis C associated with liver cirrhosis.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115174424","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 : 2017-09-01DOI: 10.4103/ejode.ejode_22_17
M. Fathelbab, E. Fahmy, A. Elshormilisy, Ahmed E. Gaafar, Nermien E. Waly
Objectives Cardiovascular disease associated with diabetes remains the leading cause of morbidity and mortality worldwide. There is a growing scientific and public interest in connecting oxidative stress as a cause of endothelial dysfunction associated with pathological conditions such as diabetes mellitus (DM). Free radicals’ scavengers play a pivotal role in maintaining homeostasis. We investigated potential risk factors and the role of oxidative stress in the pathophysiology of diabetic cardiomyopathy. Patients and methods Eighty type 2 DM patients along with 65 normal healthy volunteers were recruited for this study. We calculated BMI, and measured arterial blood pressure. We measured glycosylated hemoglobin (HbA1C), lipid profile levels, catalase, nitric oxide, the enzymes superoxide dismutase, and malondialdehyde in plasma. Results We found that the mean BMI (32.63±3.42), HbA1C (8.07±1.39), malondialdehyde (1007.21±299.341), and nitric oxide (6.79±1.95) were significantly higher in the patient group compared with the control group. On the other hand, superoxide dismutase (2.97±0.69) and catalase (35.44±10.56) in diabetic patients were significantly lower compared with controls. Conclusion Our results confirm the role of oxidative stress in pathophysiology of DM. This suggests that antioxidants may have a putative therapeutic and a prognostic role in diabetic cardiomyopathy.
{"title":"A putative role for oxidative stress in pathophysiology of diabetic cardiomyopathy","authors":"M. Fathelbab, E. Fahmy, A. Elshormilisy, Ahmed E. Gaafar, Nermien E. Waly","doi":"10.4103/ejode.ejode_22_17","DOIUrl":"https://doi.org/10.4103/ejode.ejode_22_17","url":null,"abstract":"Objectives Cardiovascular disease associated with diabetes remains the leading cause of morbidity and mortality worldwide. There is a growing scientific and public interest in connecting oxidative stress as a cause of endothelial dysfunction associated with pathological conditions such as diabetes mellitus (DM). Free radicals’ scavengers play a pivotal role in maintaining homeostasis. We investigated potential risk factors and the role of oxidative stress in the pathophysiology of diabetic cardiomyopathy. Patients and methods Eighty type 2 DM patients along with 65 normal healthy volunteers were recruited for this study. We calculated BMI, and measured arterial blood pressure. We measured glycosylated hemoglobin (HbA1C), lipid profile levels, catalase, nitric oxide, the enzymes superoxide dismutase, and malondialdehyde in plasma. Results We found that the mean BMI (32.63±3.42), HbA1C (8.07±1.39), malondialdehyde (1007.21±299.341), and nitric oxide (6.79±1.95) were significantly higher in the patient group compared with the control group. On the other hand, superoxide dismutase (2.97±0.69) and catalase (35.44±10.56) in diabetic patients were significantly lower compared with controls. Conclusion Our results confirm the role of oxidative stress in pathophysiology of DM. This suggests that antioxidants may have a putative therapeutic and a prognostic role in diabetic cardiomyopathy.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126167007","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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