Pub Date : 1900-01-01DOI: 10.4103/ejode.ejode_1_18
Hafez Abd-Elhafeez, El-Sayed El-Meghawry, Sabry Al-Azhary, K. Elfayoumy, T. Emran, A. Amin, Saad M. Alzokm
Introduction Hashimoto’s thyroiditis and Graves’ disease both constitute autoimmune thyroid diseases (AITD) that frequently coexist with other autoimmune disorders (AID). This study was conducted to evaluate the frequency of rheumatoid arthritis (RA) in patients diagnosed with AITD in relation to the general population. Patients and methods This was a cross-sectional case–control study, conducted on 103 patients with AITD of either Hashimoto’s thyroiditis or Graves’ disease with positive antithyroid peroxidase (TPOAb). A group 100 volunteers, matched for age and sex, with normal thyroid function and negative history of AID, were investigated for the prevalence of RA in the general population (control group). Participants in the study were tested for thyroid profile, rheumatoid factor (RF), erythrocyte sedimentation rate, and C-reactive protein. When appropriate, anticitrullinated peptide antibody was checked. Results Patients with AITD had a higher frequency of RA than the control (P=0.031). Thyroid profile showed no significant difference between patients with and without RA within the group of AITD. In that group, a positive correlation between titers of both RF and TPOAb was observed (r=0.474, P<0.001). The coexistence of RA with AITD was noticed to be associated with higher RF, C-reactive protein, and TPOAb titers as well as. the presence of type 2 diabetes mellitus, other AID and family history of RA. Conclusion RA is more prevalent in patients with AITD than the general population, and the underlying autoimmunity is likely to be the link. Our data highlight the importance of screening thyroid patients for RA especially if present with type 2 diabetes mellitus, another AID, or having a family history of RA.
{"title":"Frequency of rheumatoid arthritis in patients with autoimmune thyroid disease: a case–control study","authors":"Hafez Abd-Elhafeez, El-Sayed El-Meghawry, Sabry Al-Azhary, K. Elfayoumy, T. Emran, A. Amin, Saad M. Alzokm","doi":"10.4103/ejode.ejode_1_18","DOIUrl":"https://doi.org/10.4103/ejode.ejode_1_18","url":null,"abstract":"Introduction Hashimoto’s thyroiditis and Graves’ disease both constitute autoimmune thyroid diseases (AITD) that frequently coexist with other autoimmune disorders (AID). This study was conducted to evaluate the frequency of rheumatoid arthritis (RA) in patients diagnosed with AITD in relation to the general population. Patients and methods This was a cross-sectional case–control study, conducted on 103 patients with AITD of either Hashimoto’s thyroiditis or Graves’ disease with positive antithyroid peroxidase (TPOAb). A group 100 volunteers, matched for age and sex, with normal thyroid function and negative history of AID, were investigated for the prevalence of RA in the general population (control group). Participants in the study were tested for thyroid profile, rheumatoid factor (RF), erythrocyte sedimentation rate, and C-reactive protein. When appropriate, anticitrullinated peptide antibody was checked. Results Patients with AITD had a higher frequency of RA than the control (P=0.031). Thyroid profile showed no significant difference between patients with and without RA within the group of AITD. In that group, a positive correlation between titers of both RF and TPOAb was observed (r=0.474, P<0.001). The coexistence of RA with AITD was noticed to be associated with higher RF, C-reactive protein, and TPOAb titers as well as. the presence of type 2 diabetes mellitus, other AID and family history of RA. Conclusion RA is more prevalent in patients with AITD than the general population, and the underlying autoimmunity is likely to be the link. Our data highlight the importance of screening thyroid patients for RA especially if present with type 2 diabetes mellitus, another AID, or having a family history of RA.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"142 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132659064","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 : 1900-01-01DOI: 10.4103/2356-8062.205209
A. Wafa, M. El-Nahas, Azza Al Biaumy, Yara Mansour
Context Diabetic neuropathy is one of the commonest long-term complications of diabetes seen in routine healthcare and considered the most common cause of peripheral neuropathy in developed world. Aim The aim of our work was to measure advanced glycation endproducts (AGEs) and their receptors (RAGEs) in diabetic peripheral neuropathy (DPN), both painful and painless DPN. Patients and methods Our study was conducted on 50 type 2 diabetes mellitus patients with peripheral neuropathy, divided into two subgroups: the first group included 25 patients with painful DPN and the second group included 25 patients with painless DPN. Moreover, a third group included 20 diabetic patients without peripheral neuropathy, and a fourth group that included 20 healthy participants. All groups were subjected to full history taking and clinical examination, anthropometric parameters, the calculation of neuropathy disability score, and nerve conduction studies (peroneal, sural, and tibial nerves). Laboratory investigations included serum AGEs and RAGEs. Results Our study demonstrated that hemoglobin A1c, AGE, and RAGE showed statistically significant difference between the studied groups. Hemoglobin A1c was significantly high in both neuropathic and diabetic groups in comparison with control. Regarding AGE, it was statistically higher in neuropathic group than in control (P<0.011). On the contrary, RAGE was significantly higher in both neuropathic and diabetic groups rather than control (P<0.02). Although the neuropathic group has higher levels of AGE and RAGE than diabetic group, the difference was statistically nonsignificant. Significant difference was found between studied groups regarding nerve conduction studies of sural and tibial nerves. Statistically significant difference was found in the parameters of nerve conduction studies between neuropathic group and both non-neuropathic diabetic and control groups. Conclusion Our study concluded that AGE and RAGE are significantly higher in diabetic patients with neuropathy versus control, with more elevation in neuropathic group than in diabetic without neuropathy.
{"title":"Study of advanced glycation endproducts and their receptors in Egyptian type 2 diabetic individuals with peripheral neuropathy","authors":"A. Wafa, M. El-Nahas, Azza Al Biaumy, Yara Mansour","doi":"10.4103/2356-8062.205209","DOIUrl":"https://doi.org/10.4103/2356-8062.205209","url":null,"abstract":"Context Diabetic neuropathy is one of the commonest long-term complications of diabetes seen in routine healthcare and considered the most common cause of peripheral neuropathy in developed world. Aim The aim of our work was to measure advanced glycation endproducts (AGEs) and their receptors (RAGEs) in diabetic peripheral neuropathy (DPN), both painful and painless DPN. Patients and methods Our study was conducted on 50 type 2 diabetes mellitus patients with peripheral neuropathy, divided into two subgroups: the first group included 25 patients with painful DPN and the second group included 25 patients with painless DPN. Moreover, a third group included 20 diabetic patients without peripheral neuropathy, and a fourth group that included 20 healthy participants. All groups were subjected to full history taking and clinical examination, anthropometric parameters, the calculation of neuropathy disability score, and nerve conduction studies (peroneal, sural, and tibial nerves). Laboratory investigations included serum AGEs and RAGEs. Results Our study demonstrated that hemoglobin A1c, AGE, and RAGE showed statistically significant difference between the studied groups. Hemoglobin A1c was significantly high in both neuropathic and diabetic groups in comparison with control. Regarding AGE, it was statistically higher in neuropathic group than in control (P<0.011). On the contrary, RAGE was significantly higher in both neuropathic and diabetic groups rather than control (P<0.02). Although the neuropathic group has higher levels of AGE and RAGE than diabetic group, the difference was statistically nonsignificant. Significant difference was found between studied groups regarding nerve conduction studies of sural and tibial nerves. Statistically significant difference was found in the parameters of nerve conduction studies between neuropathic group and both non-neuropathic diabetic and control groups. Conclusion Our study concluded that AGE and RAGE are significantly higher in diabetic patients with neuropathy versus control, with more elevation in neuropathic group than in diabetic without neuropathy.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121970515","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 : 1900-01-01DOI: 10.4103/ejode.ejode_30_16
Sahar Elhini, R. Matta, M. Saad, H. Mostafa, Ahmed AbedelfadeeL
Introduction Fibroblast growth factor-21 (FGF21) regulates glucose and lipid metabolism and protects against atherosclerosis. Serum FGF21 levels were assessed in newly diagnosed, drug-naive patients with prediabetes (group 1, n=60) and diabetes mellitus type 2 (group 2, n=60), in addition to 40 healthy individuals (group 3, n=40). Results Serum FGF21 levels were significantly increased in groups 1 and 2 compared with group 3 (231.7±59.3 and 260.4±82.5 vs. 22.6±5.31 pg/dl, respectively; P<0.001 for both). Moreover, group 2 had statistically significantly higher FGF21 levels compared with group 1 (P=0.03). Receiver operating characteristic curve analysis identified FGF21 cutoff value of greater than 204 and 30 pg/ml for the diagnosis of diabetes mellitus type 2 and prediabetes, with an area under the curve 0.72 and 1, sensitivity of 82.5 and 100%, and specificity of 60 and 100%, respectively. Using univariate analysis, FGF21 was positively correlated with blood pressure, obesity (BMI and waist–hip ratio), glycemic (glucose and glycosylated hemoglobin) and insulin resistance (fasting insulin and homeostasis model assessment-insulin resistance) parameters, atherogenic lipid profile, liver enzymes, and cardiovascular disease risk score in group 1 and group 2. FGF21 correlated with albumin–creatinine ratio negatively in group 1 and positively in group 2. Independent predictors of FGF21 level were fasting glucose, insulin, and triglyceride in both patient groups. The independent predictors of FGF21 were obesity parameters in group 1 and albumin–creatinine ratio, age, and systolic blood pressure in group 2. Conclusion Among prediabetic patients, FGF21 is an excellent predictor and a novel linkage between metabolic parameters, circulatory system, and nephropathy.
{"title":"Fibroblast growth factor-21 is a novel linkage between metabolic parameters, cardiovascular risk, and nephropathy in prediabetes","authors":"Sahar Elhini, R. Matta, M. Saad, H. Mostafa, Ahmed AbedelfadeeL","doi":"10.4103/ejode.ejode_30_16","DOIUrl":"https://doi.org/10.4103/ejode.ejode_30_16","url":null,"abstract":"Introduction Fibroblast growth factor-21 (FGF21) regulates glucose and lipid metabolism and protects against atherosclerosis. Serum FGF21 levels were assessed in newly diagnosed, drug-naive patients with prediabetes (group 1, n=60) and diabetes mellitus type 2 (group 2, n=60), in addition to 40 healthy individuals (group 3, n=40). Results Serum FGF21 levels were significantly increased in groups 1 and 2 compared with group 3 (231.7±59.3 and 260.4±82.5 vs. 22.6±5.31 pg/dl, respectively; P<0.001 for both). Moreover, group 2 had statistically significantly higher FGF21 levels compared with group 1 (P=0.03). Receiver operating characteristic curve analysis identified FGF21 cutoff value of greater than 204 and 30 pg/ml for the diagnosis of diabetes mellitus type 2 and prediabetes, with an area under the curve 0.72 and 1, sensitivity of 82.5 and 100%, and specificity of 60 and 100%, respectively. Using univariate analysis, FGF21 was positively correlated with blood pressure, obesity (BMI and waist–hip ratio), glycemic (glucose and glycosylated hemoglobin) and insulin resistance (fasting insulin and homeostasis model assessment-insulin resistance) parameters, atherogenic lipid profile, liver enzymes, and cardiovascular disease risk score in group 1 and group 2. FGF21 correlated with albumin–creatinine ratio negatively in group 1 and positively in group 2. Independent predictors of FGF21 level were fasting glucose, insulin, and triglyceride in both patient groups. The independent predictors of FGF21 were obesity parameters in group 1 and albumin–creatinine ratio, age, and systolic blood pressure in group 2. Conclusion Among prediabetic patients, FGF21 is an excellent predictor and a novel linkage between metabolic parameters, circulatory system, and nephropathy.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"58 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120823886","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 : 1900-01-01DOI: 10.4103/2356-8062.159989
M. A. Abdel Khalek, Amal El-Barbary, A. Elsherbeny, Emad Abdel Abdel Hadi, Mona Balata, M. Hussein, R. Gaber, S. El-Gaaly
Introduction Type 2 diabetes mellitus (T2DM) is a group of pandemic debilitating metabolic diseases featuring chronic hyperglycemia that results from defective insulin secretion and/or insulin actions. Dame and Sutor reported that diabetic patients are prone to thrombocytosis through a complex interplay of mechanisms. Therefore, the aim of our work is to evaluate serum sclerostin levels in patients with T2DM and to analyze the relationships among sclerostin, bone mineral density (BMD), bone metabolism, and thrombocytosis. Objective This study aimed to evaluate serum sclerostin in T2DM and its correlations with bone metabolism and thrombocytosis. Patients and methods Fifty male T2DM patients were enrolled; they were divided into two groups according to existing thrombocytosis. Forty age-matched men were included as controls. Clinical tests of physical mobility, fasting blood glucose, glycated hemoglobin, calcium, creatinine, parathormone (PTH), 25-hydroxyvitamin D, bone-specific alkaline phosphatase (BALP), serum carboxy-terminal cross-linked telopeptide of type I collagen (sCTX-I), serum sclerostin, and BMD were performed. Results There were insignificant increases in BMD in diabetic patients versus controls. There were significantly lower levels of PTH, BALP, and sCTX-I in the diabetes mellitus (DM) patient groups compared with the controls (P < 0.001). Serum sclerostin levels were significantly higher in DM patients than the controls, with insignificantly higher sclerostin levels in group II. Serum sclerostin was correlated positively with disease duration and correlated negatively with PTH, BALP, and sCTX-I (P < 0.001). Conclusion Sclerostin plays a role in the pathogenesis of bone changes in T2DM. The interplay between vitamin D, PTH, and blood glucose highlights the possibility of an existing endocrine axis. Finally, the role of osteocytes in regulating hematopoiesis and association with DM and osteoporosis should be investigated further.
{"title":"Serum sclerostin levels in type 2 diabetes mellitus patients: possible correlations with bone metabolism parameters and thrombocytosis","authors":"M. A. Abdel Khalek, Amal El-Barbary, A. Elsherbeny, Emad Abdel Abdel Hadi, Mona Balata, M. Hussein, R. Gaber, S. El-Gaaly","doi":"10.4103/2356-8062.159989","DOIUrl":"https://doi.org/10.4103/2356-8062.159989","url":null,"abstract":"Introduction Type 2 diabetes mellitus (T2DM) is a group of pandemic debilitating metabolic diseases featuring chronic hyperglycemia that results from defective insulin secretion and/or insulin actions. Dame and Sutor reported that diabetic patients are prone to thrombocytosis through a complex interplay of mechanisms. Therefore, the aim of our work is to evaluate serum sclerostin levels in patients with T2DM and to analyze the relationships among sclerostin, bone mineral density (BMD), bone metabolism, and thrombocytosis. Objective This study aimed to evaluate serum sclerostin in T2DM and its correlations with bone metabolism and thrombocytosis. Patients and methods Fifty male T2DM patients were enrolled; they were divided into two groups according to existing thrombocytosis. Forty age-matched men were included as controls. Clinical tests of physical mobility, fasting blood glucose, glycated hemoglobin, calcium, creatinine, parathormone (PTH), 25-hydroxyvitamin D, bone-specific alkaline phosphatase (BALP), serum carboxy-terminal cross-linked telopeptide of type I collagen (sCTX-I), serum sclerostin, and BMD were performed. Results There were insignificant increases in BMD in diabetic patients versus controls. There were significantly lower levels of PTH, BALP, and sCTX-I in the diabetes mellitus (DM) patient groups compared with the controls (P < 0.001). Serum sclerostin levels were significantly higher in DM patients than the controls, with insignificantly higher sclerostin levels in group II. Serum sclerostin was correlated positively with disease duration and correlated negatively with PTH, BALP, and sCTX-I (P < 0.001). Conclusion Sclerostin plays a role in the pathogenesis of bone changes in T2DM. The interplay between vitamin D, PTH, and blood glucose highlights the possibility of an existing endocrine axis. Finally, the role of osteocytes in regulating hematopoiesis and association with DM and osteoporosis should be investigated further.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123411600","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 : 1900-01-01DOI: 10.4103/ejode.ejode_29_17
L. E. El Toony, W. Khalifa, Osama Ghazaly
Objective The aim was to evaluate the effectiveness of an individualized educational program in improving patient’s awareness, knowledge, and attitude and to assess its role in reducing the burden of gestational diabetes mellitus (GDM). Patients and methods A prospective study was conducted on women diagnosed to have GDM at 24–28 weeks of gestation according to The Diabetes In Pregnancy Study group India criteria 2015 (2 h blood glucose ≥140 mg/dl) between December 2015 and December 2016 who were enrolled into an individualized GDM educational program. A modified and shortened version of a validated questionnaire developed by Carolan and colleagues was tested before and after education to evaluate the feedback of education. Follow-up was every 2 weeks till labor to assess awareness together with both maternal and fetal outcomes. Results A total of 60 pregnant women diagnosed to have GDM were included. The questions that were answered correctly in the post-test by more than 50% of the participants fell into these categories: definition of GDM (100%), associated risk factors (75%), way of diagnosis (83.3%), management of GDM (71.7%), and postpartum follow-up (56.7%). As regards fetal and maternal outcome it was observed that both weight gain and glycemic control were better in the well-educated group versus other groups (P=0.02, 0.01, respectively). Conclusion Health education plays an important role in increasing patients awareness regarding the GDM risk and its proper management in order to reduce its complications both for the mother and the fetus.
{"title":"Assessing the effectiveness of an educational program for patients with gestational diabetes in Assiut University","authors":"L. E. El Toony, W. Khalifa, Osama Ghazaly","doi":"10.4103/ejode.ejode_29_17","DOIUrl":"https://doi.org/10.4103/ejode.ejode_29_17","url":null,"abstract":"Objective The aim was to evaluate the effectiveness of an individualized educational program in improving patient’s awareness, knowledge, and attitude and to assess its role in reducing the burden of gestational diabetes mellitus (GDM). Patients and methods A prospective study was conducted on women diagnosed to have GDM at 24–28 weeks of gestation according to The Diabetes In Pregnancy Study group India criteria 2015 (2 h blood glucose ≥140 mg/dl) between December 2015 and December 2016 who were enrolled into an individualized GDM educational program. A modified and shortened version of a validated questionnaire developed by Carolan and colleagues was tested before and after education to evaluate the feedback of education. Follow-up was every 2 weeks till labor to assess awareness together with both maternal and fetal outcomes. Results A total of 60 pregnant women diagnosed to have GDM were included. The questions that were answered correctly in the post-test by more than 50% of the participants fell into these categories: definition of GDM (100%), associated risk factors (75%), way of diagnosis (83.3%), management of GDM (71.7%), and postpartum follow-up (56.7%). As regards fetal and maternal outcome it was observed that both weight gain and glycemic control were better in the well-educated group versus other groups (P=0.02, 0.01, respectively). Conclusion Health education plays an important role in increasing patients awareness regarding the GDM risk and its proper management in order to reduce its complications both for the mother and the fetus.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114207685","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 : 1900-01-01DOI: 10.4103/2356-8062.184396
M. Abdelkader, A. Mansour, Heba S Elshaer, Amr K. Hussien
Background Acute kidney injury (AKI) is a major complication of sepsis in ICU patients. The overall incidence of AKI in ICU patients ranges from 20 to 50% with lower incidence seen in elective surgical patients and higher incidence in sepsis patients. AKI represents a significant risk factor for mortality and can be associated with mortality greater than 50%. The aim of this study was to investigate the role of angiopoietin-2 as a biomarker in sepsis induced AKI. Patients and methods The study was conducted on 60 participants (20 patients with septic AKI, 20 patients with sepsis only without AKI and 20 healthy volunteers as the control group). Serum angiopoietin-2 levels were assessed by the ELISA technique. Clinical, biochemical, and therapeutic data were collected. Results High levels of serum angiopoietin-2 were detected in patients with septic AKI. These levels were significantly higher in relation to septic patients with no AKI and the control group. There was a statistically significant positive correlation between serum angiopoietin-2 level in the septic AKI group and serum creatinine, white blood cell count, erythrocyte sedimentation rate, C-reactive protein, and there was a statistically significant negative correlation between serum angiopoietin-2 level in the septic AKI group and the estimated glomerular filtration rate. Conclusion Serum angiopoietin-2 levels were significantly positive in patients with septic AKI. Serum angiopoietin-2 may be used as a biomarker in sepsis induced AKI.
{"title":"The role of serum angiopoietin-2 as a biomarker in sepsis induced acute kidney injury","authors":"M. Abdelkader, A. Mansour, Heba S Elshaer, Amr K. Hussien","doi":"10.4103/2356-8062.184396","DOIUrl":"https://doi.org/10.4103/2356-8062.184396","url":null,"abstract":"Background Acute kidney injury (AKI) is a major complication of sepsis in ICU patients. The overall incidence of AKI in ICU patients ranges from 20 to 50% with lower incidence seen in elective surgical patients and higher incidence in sepsis patients. AKI represents a significant risk factor for mortality and can be associated with mortality greater than 50%. The aim of this study was to investigate the role of angiopoietin-2 as a biomarker in sepsis induced AKI. Patients and methods The study was conducted on 60 participants (20 patients with septic AKI, 20 patients with sepsis only without AKI and 20 healthy volunteers as the control group). Serum angiopoietin-2 levels were assessed by the ELISA technique. Clinical, biochemical, and therapeutic data were collected. Results High levels of serum angiopoietin-2 were detected in patients with septic AKI. These levels were significantly higher in relation to septic patients with no AKI and the control group. There was a statistically significant positive correlation between serum angiopoietin-2 level in the septic AKI group and serum creatinine, white blood cell count, erythrocyte sedimentation rate, C-reactive protein, and there was a statistically significant negative correlation between serum angiopoietin-2 level in the septic AKI group and the estimated glomerular filtration rate. Conclusion Serum angiopoietin-2 levels were significantly positive in patients with septic AKI. Serum angiopoietin-2 may be used as a biomarker in sepsis induced AKI.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"104 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122627415","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 : 1900-01-01DOI: 10.4103/2356-8062.178331
F. Bukhary, Yehia Z. Mahmoud, Ragaa Abdel-Shahid, H. Keryakos, L. Mohsen, Tamer T. Ismail, L. Hamdy
Introduction Several studies have shown high prevalence of osteoporosis and weight loss in patients with chronic obstructive pulmonary disease (COPD). Leptin regulates bone metabolism, body weight, and pulmonary artery pressure. The association of bone density and serum leptin with BODE score in moderate COPD patients is still unclear. Aim of the study The aim of the study was to explore the association of serum leptin with average bone attenuation assessed by routine chest MDCT, and their correlation with clinical and echocardiographic parameters. Patients and methods The study included 54 male patients with low BMI and moderate COPD severity. Patients were divided into two groups: those with COPD exacerbations (24 patients; group I) and those with stable COPD (30 patients, group II). Twenty male volunteers of matched age and BMI were included as controls (group III). Calculation of BMI and BODE score was done. Spirometry and echocardiography were performed in all participants. Average bone attenuation of the thoracic spine was estimated by MDCT. Serum leptin was estimated. Results Group I and group II had significantly lower bone attenuation and higher BODE index, pulmonary artery systolic pressure (PASP), and right ventricle diameter (RVD) as compared with healthy controls (P < 0.001). Serum leptin level and leptin/BMI ratio were significantly increased in group I than in other groups (P < 0.001). Group II had significantly lower serum leptin than did controls. Serum leptin correlated positively with age, BMI, COPD severity, and bone attenuation and showed significant negative correlation with BODE score and serum calcium in group II. Meanwhile; it showed significant positive correlation with BMI and PASP in group I. In the stable COPD group, PASP, RVD, BMI, and bone attenuation were independent predictors of serum leptin, whereas BODE score, FEV 1 , FEV 1 /FVC, PASP, RVD, BMI, and serum leptin were independent predictors of bone attenuation. Conclusion COPD patients with moderate severity and low BMI had increased circulating leptin and low calcium level during exacerbation. Serum leptin level correlated with bone attenuation in stable but not in exacerbation states.
{"title":"Serum leptin and multi-detector computed tomography (MDCT)-measured bone attenuation among low BMI male patients with moderate-severity chronic obstructive pulmonary disease in exacerbation and stable states","authors":"F. Bukhary, Yehia Z. Mahmoud, Ragaa Abdel-Shahid, H. Keryakos, L. Mohsen, Tamer T. Ismail, L. Hamdy","doi":"10.4103/2356-8062.178331","DOIUrl":"https://doi.org/10.4103/2356-8062.178331","url":null,"abstract":"Introduction Several studies have shown high prevalence of osteoporosis and weight loss in patients with chronic obstructive pulmonary disease (COPD). Leptin regulates bone metabolism, body weight, and pulmonary artery pressure. The association of bone density and serum leptin with BODE score in moderate COPD patients is still unclear. Aim of the study The aim of the study was to explore the association of serum leptin with average bone attenuation assessed by routine chest MDCT, and their correlation with clinical and echocardiographic parameters. Patients and methods The study included 54 male patients with low BMI and moderate COPD severity. Patients were divided into two groups: those with COPD exacerbations (24 patients; group I) and those with stable COPD (30 patients, group II). Twenty male volunteers of matched age and BMI were included as controls (group III). Calculation of BMI and BODE score was done. Spirometry and echocardiography were performed in all participants. Average bone attenuation of the thoracic spine was estimated by MDCT. Serum leptin was estimated. Results Group I and group II had significantly lower bone attenuation and higher BODE index, pulmonary artery systolic pressure (PASP), and right ventricle diameter (RVD) as compared with healthy controls (P < 0.001). Serum leptin level and leptin/BMI ratio were significantly increased in group I than in other groups (P < 0.001). Group II had significantly lower serum leptin than did controls. Serum leptin correlated positively with age, BMI, COPD severity, and bone attenuation and showed significant negative correlation with BODE score and serum calcium in group II. Meanwhile; it showed significant positive correlation with BMI and PASP in group I. In the stable COPD group, PASP, RVD, BMI, and bone attenuation were independent predictors of serum leptin, whereas BODE score, FEV 1 , FEV 1 /FVC, PASP, RVD, BMI, and serum leptin were independent predictors of bone attenuation. Conclusion COPD patients with moderate severity and low BMI had increased circulating leptin and low calcium level during exacerbation. Serum leptin level correlated with bone attenuation in stable but not in exacerbation states.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116515633","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 : 1900-01-01DOI: 10.4103/2356-8062.159984
Noha El-Sabbagh, Enas A. E. Shahin, Nany Abo El Makarem, R. Swelem, Shaymaa AbdElMoneim
Introduction Aging results in chronic low-grade inflammation that is associated with an increased risk for disease, poor physical functioning, and mortality. The biomarkers that are mostly related to inflammation such as tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) are created to stimulate and activate the immune system in response to inflammation. Strategies that reduce age-related inflammation may improve the quality of life in older adults. The benefits of regular exercise for the elderly are well established, whereas less is known on the impact of low-intensity resistance exercise on this chronic low-grade inflammation in the elderly. Aim of the study To study the level of TNF-α and CRP before and after programmed resistance exercise in Egyptian elderly individuals. Patients and methods Thirty healthy elderly individuals aged 60 years or older, of both sexes, participated in 4 weeks of resistance exercise training (RET). Circulating levels of TNF-α and CRP were measured before and after the exercise training. Results This study found that both inflammatory markers, TNF-α and CRP, were statistically significantly decreased (P = 0.036, 0.009), respectively, in comparison with the previous starting level measured before the exercise in the same individuals. Conclusion There was a negative correlation between TNF-α and CRP levels and the RET, which indicated that RET represents a low-cost strategy that may reduce age-related inflammation and may thus improve the quality of life in older adults.
{"title":"Study of the C-reactive protein and tumor necrosis factor-α levels in the elderly before and after resistance exercise training","authors":"Noha El-Sabbagh, Enas A. E. Shahin, Nany Abo El Makarem, R. Swelem, Shaymaa AbdElMoneim","doi":"10.4103/2356-8062.159984","DOIUrl":"https://doi.org/10.4103/2356-8062.159984","url":null,"abstract":"Introduction Aging results in chronic low-grade inflammation that is associated with an increased risk for disease, poor physical functioning, and mortality. The biomarkers that are mostly related to inflammation such as tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) are created to stimulate and activate the immune system in response to inflammation. Strategies that reduce age-related inflammation may improve the quality of life in older adults. The benefits of regular exercise for the elderly are well established, whereas less is known on the impact of low-intensity resistance exercise on this chronic low-grade inflammation in the elderly. Aim of the study To study the level of TNF-α and CRP before and after programmed resistance exercise in Egyptian elderly individuals. Patients and methods Thirty healthy elderly individuals aged 60 years or older, of both sexes, participated in 4 weeks of resistance exercise training (RET). Circulating levels of TNF-α and CRP were measured before and after the exercise training. Results This study found that both inflammatory markers, TNF-α and CRP, were statistically significantly decreased (P = 0.036, 0.009), respectively, in comparison with the previous starting level measured before the exercise in the same individuals. Conclusion There was a negative correlation between TNF-α and CRP levels and the RET, which indicated that RET represents a low-cost strategy that may reduce age-related inflammation and may thus improve the quality of life in older adults.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124016326","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 : 1900-01-01DOI: 10.4103/2356-8062.197589
M. Zeid, A. Deghady, Hesham Elsaygh, H. El Shaer, Rasha Gawish
Introduction Fibroblast growth factor 23 (FGF23) plays an important role in regulating phosphate and vitamin D homeostasis. Elevated levels of FGF23 are independently associated with mortality in patients with chronic kidney disease and End stage renal disease (ESRD). Whether FGF23 levels are elevated and associated with adverse outcomes in patients with acute kidney injury (AKI) has not been studied so far. Objective The aim of this study was to determine the relationship between FGF23 levels in patients with AKI and morbidity, mortality, and/or the need for renal replacement therapy. Patients and methods The study included two groups: group 1, which included 30 AKI patients from the general medical ward and ICUs [identified in accordance with the criteria established by Acute Kidney Injury Network (AKIN) grading of AKI]; and group 2, which included 30 healthy controls matched with the patients as regards age and sex. Plasma levels of C-terminal FGF23, 1,25-dihydroxy vitamin D [1,25(OH)2D], and intact parathyroid hormone (iPTH) were measured within 24 h of AKI onset and 5 days later. The composite end point was death or need for renal replacement therapy. Results FGF23 levels on day 1 were significantly higher among participants with AKI than among controls (mean level: 278.20 ± 220.58 vs. 14.60 ± 9 pg/ml). There was a statistically significant negative correlation between FGF23 and vitamin D on day 1, with a P-value of less than 0.023, whereas there was no statistically significant negative correlation between FGF23 and vitamin D on day 5, with a P-value of 0.102. There was a statistically significant positive correlation between FGF23 on day 1 and both Acute Physiology and Chronic Health Evaluation and Sequential Organ Failure Assessment scores, with a P-value of less than 0.001. FGF23 proved to be a good predictor of mortality (sensitivity: 100%, specificity: 85%) at a cutoff value of 280 pg/ml. Conclusion FGF23 levels are elevated in AKI patients and are associated with increased mortality. AKI is also associated with significant reduction in the level of 1,25(OH)2D and with significant elevation of PTH.
{"title":"Association of fibroblast growth factor 23, parathyroid hormone, and vitamin D with acute kidney injury","authors":"M. Zeid, A. Deghady, Hesham Elsaygh, H. El Shaer, Rasha Gawish","doi":"10.4103/2356-8062.197589","DOIUrl":"https://doi.org/10.4103/2356-8062.197589","url":null,"abstract":"Introduction Fibroblast growth factor 23 (FGF23) plays an important role in regulating phosphate and vitamin D homeostasis. Elevated levels of FGF23 are independently associated with mortality in patients with chronic kidney disease and End stage renal disease (ESRD). Whether FGF23 levels are elevated and associated with adverse outcomes in patients with acute kidney injury (AKI) has not been studied so far. Objective The aim of this study was to determine the relationship between FGF23 levels in patients with AKI and morbidity, mortality, and/or the need for renal replacement therapy. Patients and methods The study included two groups: group 1, which included 30 AKI patients from the general medical ward and ICUs [identified in accordance with the criteria established by Acute Kidney Injury Network (AKIN) grading of AKI]; and group 2, which included 30 healthy controls matched with the patients as regards age and sex. Plasma levels of C-terminal FGF23, 1,25-dihydroxy vitamin D [1,25(OH)2D], and intact parathyroid hormone (iPTH) were measured within 24 h of AKI onset and 5 days later. The composite end point was death or need for renal replacement therapy. Results FGF23 levels on day 1 were significantly higher among participants with AKI than among controls (mean level: 278.20 ± 220.58 vs. 14.60 ± 9 pg/ml). There was a statistically significant negative correlation between FGF23 and vitamin D on day 1, with a P-value of less than 0.023, whereas there was no statistically significant negative correlation between FGF23 and vitamin D on day 5, with a P-value of 0.102. There was a statistically significant positive correlation between FGF23 on day 1 and both Acute Physiology and Chronic Health Evaluation and Sequential Organ Failure Assessment scores, with a P-value of less than 0.001. FGF23 proved to be a good predictor of mortality (sensitivity: 100%, specificity: 85%) at a cutoff value of 280 pg/ml. Conclusion FGF23 levels are elevated in AKI patients and are associated with increased mortality. AKI is also associated with significant reduction in the level of 1,25(OH)2D and with significant elevation of PTH.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129593967","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 : 1900-01-01DOI: 10.4103/2356-8062.159997
Mohamed Ghitany, E. Soliman, M. Bondok, S. Elmaadawy
Background Autoimmune diseases are chronic conditions initiated by the loss of immunological tolerance to self-antigens; they represent a heterogeneous group of disorders that afflict specific target organs or multiple organ systems. Autoimmune thyroid disease (AITD) is a common organ-specific autoimmune disorder affecting mostly middle-aged women. AITD is a term that includes various clinical forms of autoimmune thyroiditis; among these diseases, Hashimoto′s thyroiditis and Graves′ disease are the two most common types and share many features immunologically. Rheumatoid arthritis (RA) is a chronic inflammatory disease that leads to severe disability and premature mortality. Given the same pathogenic mechanisms, autoimmune diseases tend to cluster together, and hence this study was designed to investigate the relationship between AITD and RA, particularly seropositive versus seronegative subtypes. Patients and methods The study included 70 patients with evidence of RA. Their diagnosis was based on the 2010 American College of Rheumatology (ACR)-EULAR classification criteria, and they were subclassified into two groups: group I, comprising 35 patients with seropositive RA (positive to one or both seromarkers), and group II, comprising 35 patients with seronegative RA (negative to both seromarkers). Twenty healthy age-matched and sex-matched controls constituted group III. All of the studied participants underwent detailed history-taking and physical examination, focusing on RA duration of illness, clinical features suggestive of thyroid dysfunction, and disease activity score (DAS28). We determined the complete blood count, erythrocyte sedimentation rate, C-reactive protein, urea, creatinine, alanine aminotransferase, aspartate aminotransferase, thyroid stimulating hormone (TSH), serum total T3 (TT3), serum total T4 (TT4), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), anti-thyroid peroxidase (anti-TPO), thyroglobulin Ab, and TSH receptor antibody (TRAb) levels, and also performed a neck ultrasound. Results It was found that erythrocyte sedimentation rate, C-reactive protein, RF, and anti-CCP were significantly higher in RA patients versus controls, particularly in seropositive versus seronegative patients. No significant difference was found between the studied groups as regards TSH, T3, and T4 levels; however, hypothyroidism was found to be more common than hyperthyroidism in RA patients (29 vs. 3% in group I and 9% in group II). Anti-TPO and antithyroglobulin were significantly higher in RA patients versus controls (P < 0.001) and specifically in seropositive (1301.9 ± 1716.0 and 1750.0 ± 1866.2, respectively) versus seronegative patients (799.4 ± 1597.7 and 898.1± 988.11, respectively). TRAbs were detectable in a small subset of RA patients (6% regardless of the serostatus) with significant difference between patients and controls (P = 0.006). Ultrasonographic features of thyroiditis were significantly evident in RA pati
{"title":"Autoimmune thyroid disorders in seropositive versus seronegative rheumatoid arthritis","authors":"Mohamed Ghitany, E. Soliman, M. Bondok, S. Elmaadawy","doi":"10.4103/2356-8062.159997","DOIUrl":"https://doi.org/10.4103/2356-8062.159997","url":null,"abstract":"Background Autoimmune diseases are chronic conditions initiated by the loss of immunological tolerance to self-antigens; they represent a heterogeneous group of disorders that afflict specific target organs or multiple organ systems. Autoimmune thyroid disease (AITD) is a common organ-specific autoimmune disorder affecting mostly middle-aged women. AITD is a term that includes various clinical forms of autoimmune thyroiditis; among these diseases, Hashimoto′s thyroiditis and Graves′ disease are the two most common types and share many features immunologically. Rheumatoid arthritis (RA) is a chronic inflammatory disease that leads to severe disability and premature mortality. Given the same pathogenic mechanisms, autoimmune diseases tend to cluster together, and hence this study was designed to investigate the relationship between AITD and RA, particularly seropositive versus seronegative subtypes. Patients and methods The study included 70 patients with evidence of RA. Their diagnosis was based on the 2010 American College of Rheumatology (ACR)-EULAR classification criteria, and they were subclassified into two groups: group I, comprising 35 patients with seropositive RA (positive to one or both seromarkers), and group II, comprising 35 patients with seronegative RA (negative to both seromarkers). Twenty healthy age-matched and sex-matched controls constituted group III. All of the studied participants underwent detailed history-taking and physical examination, focusing on RA duration of illness, clinical features suggestive of thyroid dysfunction, and disease activity score (DAS28). We determined the complete blood count, erythrocyte sedimentation rate, C-reactive protein, urea, creatinine, alanine aminotransferase, aspartate aminotransferase, thyroid stimulating hormone (TSH), serum total T3 (TT3), serum total T4 (TT4), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), anti-thyroid peroxidase (anti-TPO), thyroglobulin Ab, and TSH receptor antibody (TRAb) levels, and also performed a neck ultrasound. Results It was found that erythrocyte sedimentation rate, C-reactive protein, RF, and anti-CCP were significantly higher in RA patients versus controls, particularly in seropositive versus seronegative patients. No significant difference was found between the studied groups as regards TSH, T3, and T4 levels; however, hypothyroidism was found to be more common than hyperthyroidism in RA patients (29 vs. 3% in group I and 9% in group II). Anti-TPO and antithyroglobulin were significantly higher in RA patients versus controls (P < 0.001) and specifically in seropositive (1301.9 ± 1716.0 and 1750.0 ± 1866.2, respectively) versus seronegative patients (799.4 ± 1597.7 and 898.1± 988.11, respectively). TRAbs were detectable in a small subset of RA patients (6% regardless of the serostatus) with significant difference between patients and controls (P = 0.006). Ultrasonographic features of thyroiditis were significantly evident in RA pati","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130625936","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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