Pub Date : 1900-01-01DOI: 10.4103/ejode.ejode_3_18
El-Sayed El-Meghawry, K. Elfayoumy, Mahmoud S Berengy, T. Emran
Introduction Hepatitis C virus (HCV) infection is known to be associated with insulin resistance (IR). The latter occurs early in the course of the disease and adversely affect it. The mechanism of this association seems to be different from that occurring in the metabolic syndrome. The aim of the study was to test this relationship in non-diabetic patients with early cirrhosis who are not fulfilling the criteria of metabolic syndrome. Patients and methods This cross-sectional study, included 100 patients with Child A cirrhosis induced by HCV. The patients were subjected to clinical, laboratory, ultrasonographic, and endoscopic evaluation. On the basis of homeostasis model assessment for insulin resistance (HOMA-IR) categorization, the patients were divided into two groups, with and without IR. Results A total of 63 patients had a higher HOMA-IR score, hence assigned as group 1, with significant elevation of liver enzymes, less albumin levels and more esophageal varices than in group 2. In a cohort of patients previously eradicated from the virus, HOMA-IR is lower than the non-treated patients. Conclusion Even in the absence of diabetes and metabolic syndrome, IR is evident in nearly two-thirds of patients having early HCV-induced cirrhosis. This link is associated with more inflammation of the liver and more drawbacks on the portal circulation. Sustained clearance of the virus improves insulin sensitivity.
{"title":"Insulin resistance and hepatitis C infection: a bidirectional relationship independent of diabetes and metabolic syndrome","authors":"El-Sayed El-Meghawry, K. Elfayoumy, Mahmoud S Berengy, T. Emran","doi":"10.4103/ejode.ejode_3_18","DOIUrl":"https://doi.org/10.4103/ejode.ejode_3_18","url":null,"abstract":"Introduction Hepatitis C virus (HCV) infection is known to be associated with insulin resistance (IR). The latter occurs early in the course of the disease and adversely affect it. The mechanism of this association seems to be different from that occurring in the metabolic syndrome. The aim of the study was to test this relationship in non-diabetic patients with early cirrhosis who are not fulfilling the criteria of metabolic syndrome. Patients and methods This cross-sectional study, included 100 patients with Child A cirrhosis induced by HCV. The patients were subjected to clinical, laboratory, ultrasonographic, and endoscopic evaluation. On the basis of homeostasis model assessment for insulin resistance (HOMA-IR) categorization, the patients were divided into two groups, with and without IR. Results A total of 63 patients had a higher HOMA-IR score, hence assigned as group 1, with significant elevation of liver enzymes, less albumin levels and more esophageal varices than in group 2. In a cohort of patients previously eradicated from the virus, HOMA-IR is lower than the non-treated patients. Conclusion Even in the absence of diabetes and metabolic syndrome, IR is evident in nearly two-thirds of patients having early HCV-induced cirrhosis. This link is associated with more inflammation of the liver and more drawbacks on the portal circulation. Sustained clearance of the virus improves insulin sensitivity.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"91 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":"126309299","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: 10.4103/2356-8062.197571
M. Tayel, A. Elzawawy, Mohamed Said, E. Soliman, M. Mohamed
Introduction Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disorder that may affect multiple organ systems. Vitamin D levels and its role in lupus inflammation is still a matter of debate. Objective The aim of this study was to assess the role of calcium homeostasis and vitamin D deficiency in premenopausal SLE patients and its relation with disease activity. Patients and methods We assessed serum 25-hydroxyvitamin D [25(OH)D] level in 60 (SLE) patients and 20 age and sex-matched healthy controls. We also assessed different clinical, immunological, and laboratory disease parameters in SLE patients − namely, erythrocyte sedimentation rate, C-reactive protein, antinuclear antibody, antidouble stranded DNA, C3, and C4–and disease activity score using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score. We correlated serum 25(OH)D with disease activity and different environmental parameters that might affect 25(OH)D level. Results A significantly lower 25(OH)D level was found in SLE patients compared with controls (P=0.033). Serum 25(OH)D was inversely correlated to SLEDAI score (P=0.043), antidouble stranded DNA (P<0.001), and erythrocyte sedimentation rate (P<0.001), but directly correlated to C3 and C4 levels (P=0.029). There was an inverse correlation between vitamin D supplementation and SLEDAI score (MCP=0.030), but there was no significant correlation with both calcium supplementation (P=0.861) and ionized calcium (P=0.681). Conclusion Vitamin D insufficiency and deficiency is highly prevalent in SLE patients than in healthy controls, and is prevalent among SLE patients with higher disease activity, which suggests an important role of vitamin D3 in the pathogenesis of SLE disease activity and flares. The therapeutic effect of vitamin D in SLE should be further assessed in interventional studies.
{"title":"A study on the role of calcium homeostasis and vitamin D deficiency in premenopausal systemic lupus erythematosus patients and its relation with disease activity","authors":"M. Tayel, A. Elzawawy, Mohamed Said, E. Soliman, M. Mohamed","doi":"10.4103/2356-8062.197571","DOIUrl":"https://doi.org/10.4103/2356-8062.197571","url":null,"abstract":"Introduction Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disorder that may affect multiple organ systems. Vitamin D levels and its role in lupus inflammation is still a matter of debate. Objective The aim of this study was to assess the role of calcium homeostasis and vitamin D deficiency in premenopausal SLE patients and its relation with disease activity. Patients and methods We assessed serum 25-hydroxyvitamin D [25(OH)D] level in 60 (SLE) patients and 20 age and sex-matched healthy controls. We also assessed different clinical, immunological, and laboratory disease parameters in SLE patients − namely, erythrocyte sedimentation rate, C-reactive protein, antinuclear antibody, antidouble stranded DNA, C3, and C4–and disease activity score using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score. We correlated serum 25(OH)D with disease activity and different environmental parameters that might affect 25(OH)D level. Results A significantly lower 25(OH)D level was found in SLE patients compared with controls (P=0.033). Serum 25(OH)D was inversely correlated to SLEDAI score (P=0.043), antidouble stranded DNA (P<0.001), and erythrocyte sedimentation rate (P<0.001), but directly correlated to C3 and C4 levels (P=0.029). There was an inverse correlation between vitamin D supplementation and SLEDAI score (MCP=0.030), but there was no significant correlation with both calcium supplementation (P=0.861) and ionized calcium (P=0.681). Conclusion Vitamin D insufficiency and deficiency is highly prevalent in SLE patients than in healthy controls, and is prevalent among SLE patients with higher disease activity, which suggests an important role of vitamin D3 in the pathogenesis of SLE disease activity and flares. The therapeutic effect of vitamin D in SLE should be further assessed in interventional studies.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"28 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":"114572467","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: 10.4103/2356-8062.159981
M. Abd El-kader, Eman A Al-Gohary, M. El-sawy, Ammar Neanaa
Introduction Chronic kidney disease (CKD) is a worldwide disease that is classified into five stages according to the glomerular filtration rate and presents through a variety of symptoms and signs. Anemia is one of the first signs of kidney dysfunction. The most common causes of anemia in CKD are erythropoietin (EPO) hormone deficiency and iron deficiency. Anemia and hyporesponsiveness to erythropoietin-stimulating agents (ESAs) are commonly observed in CKD patients and are associated with increased morbidity, mortality, and a significant healthcare economic burden. Although testosterone deficiency is a prevalent condition in men with CKD, it has so far received relatively little attention in practice. Testosterone stimulates erythropoiesis through the production of hematopoietic growth factors and possible improvement of iron bioavailability. Aim The aim of this study was to evaluate serum testosterone levels in patients on maintenance hemodialysis (MHD) and correlate its level with anemia and response to ESAs therapy. Patients and methods This study included 40 male patients from dialysis units, where they were divided equally into group A, group taking ESAs, and group B, group not taking ESAs (EPO-naive group). Another 20 men were included in group C (control group). All groups were subjected to a full assessment of history, full clinical examination, and laboratory investigations to exclude all possible causes of anemia. Results This study showed that in group A, 75% of the participants were anemic, whereas in group B, 100% of the participants were anemic, with a higher degree of anemia. The testosterone level was slightly higher in group B than group A; despite being within the normal range, it was relatively deficient on the basis of the age of the participants in the control group. Conclusion Testosterone deficiency is a prevalent condition in CKD that starts at an earlier age than the normal population. It is an evident independent cause of anemia in EPO-naive CKD patients and is a possible cause of resistance of ESAs in CKD patients; still, the most important causes of anemia in CKD are EPO and iron deficiency.
{"title":"Study evaluating testosterone deficiency as a cause of anemia and reduced responsiveness to erythropoiesis-stimulating agents in men on maintenance hemodialysis","authors":"M. Abd El-kader, Eman A Al-Gohary, M. El-sawy, Ammar Neanaa","doi":"10.4103/2356-8062.159981","DOIUrl":"https://doi.org/10.4103/2356-8062.159981","url":null,"abstract":"Introduction Chronic kidney disease (CKD) is a worldwide disease that is classified into five stages according to the glomerular filtration rate and presents through a variety of symptoms and signs. Anemia is one of the first signs of kidney dysfunction. The most common causes of anemia in CKD are erythropoietin (EPO) hormone deficiency and iron deficiency. Anemia and hyporesponsiveness to erythropoietin-stimulating agents (ESAs) are commonly observed in CKD patients and are associated with increased morbidity, mortality, and a significant healthcare economic burden. Although testosterone deficiency is a prevalent condition in men with CKD, it has so far received relatively little attention in practice. Testosterone stimulates erythropoiesis through the production of hematopoietic growth factors and possible improvement of iron bioavailability. Aim The aim of this study was to evaluate serum testosterone levels in patients on maintenance hemodialysis (MHD) and correlate its level with anemia and response to ESAs therapy. Patients and methods This study included 40 male patients from dialysis units, where they were divided equally into group A, group taking ESAs, and group B, group not taking ESAs (EPO-naive group). Another 20 men were included in group C (control group). All groups were subjected to a full assessment of history, full clinical examination, and laboratory investigations to exclude all possible causes of anemia. Results This study showed that in group A, 75% of the participants were anemic, whereas in group B, 100% of the participants were anemic, with a higher degree of anemia. The testosterone level was slightly higher in group B than group A; despite being within the normal range, it was relatively deficient on the basis of the age of the participants in the control group. Conclusion Testosterone deficiency is a prevalent condition in CKD that starts at an earlier age than the normal population. It is an evident independent cause of anemia in EPO-naive CKD patients and is a possible cause of resistance of ESAs in CKD patients; still, the most important causes of anemia in CKD are EPO and iron deficiency.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"72 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":"125137001","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: 10.4103/2356-8062.197588
Magdy Zohairy, A. Raya, A. Deghady, M. Amer
Background Rheumatoid arthritis (RA) is a chronic systemic inflammatory disorder thought to be autoimmune in nature and predominately affects synovial joints. Interleukin-33 (IL-33) is a newly reported cytokine of the IL-1 family. Aim of the work The aim of this study was to assess the role of IL-33 in the pathogenesis of RA. Patients and methods Group A included 30 adult patients with RA; all cases were diagnosed according to the American College of Rheumatology criteria for RA. Group B included 20 healthy adult persons (age and sex matched) who comprised the control group. The serum IL-33 levels were examined by using the enzyme-linked immunosorbent assay for 30 patients with RA and 20 healthy individuals. Disease activity was assessed according to disease activity score 28–C-reactive protein (CRP) scale. Results IL-33 was increased in all RA patients compared with controls. IL-33 was highly correlated to erythrocyte sedimentation rate, CRP, rheumatoid factor, anti-cyclic citrullinated peptide, and disease activity score 28–CRP score. Therefore, IL-33 most probably has a significant role to play in the pathogenesis of RA. Conclusion IL-33 most probably has a significant role in the pathogenesis of RA. IL-33 serum levels paralleled the severity of the disease subset. Understanding the functions of IL-33 is important for the development of new therapeutic approaches including IL-33 inhibitors as a therapeutic target.
{"title":"Interleukin-33 as a marker for disease activity in rheumatoid arthritis","authors":"Magdy Zohairy, A. Raya, A. Deghady, M. Amer","doi":"10.4103/2356-8062.197588","DOIUrl":"https://doi.org/10.4103/2356-8062.197588","url":null,"abstract":"Background Rheumatoid arthritis (RA) is a chronic systemic inflammatory disorder thought to be autoimmune in nature and predominately affects synovial joints. Interleukin-33 (IL-33) is a newly reported cytokine of the IL-1 family. Aim of the work The aim of this study was to assess the role of IL-33 in the pathogenesis of RA. Patients and methods Group A included 30 adult patients with RA; all cases were diagnosed according to the American College of Rheumatology criteria for RA. Group B included 20 healthy adult persons (age and sex matched) who comprised the control group. The serum IL-33 levels were examined by using the enzyme-linked immunosorbent assay for 30 patients with RA and 20 healthy individuals. Disease activity was assessed according to disease activity score 28–C-reactive protein (CRP) scale. Results IL-33 was increased in all RA patients compared with controls. IL-33 was highly correlated to erythrocyte sedimentation rate, CRP, rheumatoid factor, anti-cyclic citrullinated peptide, and disease activity score 28–CRP score. Therefore, IL-33 most probably has a significant role to play in the pathogenesis of RA. Conclusion IL-33 most probably has a significant role in the pathogenesis of RA. IL-33 serum levels paralleled the severity of the disease subset. Understanding the functions of IL-33 is important for the development of new therapeutic approaches including IL-33 inhibitors as a therapeutic target.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"4 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":"116836298","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: 10.4103/2356-8062.159992
S. Gomaa, Tamer Abou Youssif, Mostafa Elmissery, S. Elgendy
Background Prostate cancer is a common malignancy ranked as the second most common cause of cancer and the fifth cause of cancer-related mortality worldwide. The association between obesity and prostate cancer remains poorly understood, but evidence suggests that obesity may adversely affect the risk of developing high-grade disease. Adipokines may contribute toward the molecular basis for a link between obesity and prostate cancer. Several studies have shown the role of visfatin in different cancers including astrocytomas, myeloma, and male oral squamous cell; gastric, endometrial, hepatocellular, and colorectal carcinomas; and invasive breast cancer. Objective In the present study, we attempted to investigate whether a high serum level of visfatin is a good biomarker associated with prostate cancer, especially high-grade cancer, and in obese patients; then, it could be used as a biomarker for the detection of prostate cancer and to determine its aggressiveness. Participants and method The present study included 89 individuals divided as follows: 15 age-matched volunteers, control group (group I), 36 patients diagnosed with benign prostatic hyperplasia (BPH group) (group II), and 38 patients diagnosed with prostate cancer (PC group) (group III). Results There was a statistically significant increase in serum visfatin level in PC patients (group III) compared with both the controls (group I) and patients with BPH (group II) (P < 0.001, P < 0.001, respectively). In PC patients, the median value of serum visfatin was 55.36 ng/ml (44.32-94.02), whereas it was 12.06 ng/ml (10.36-17.74) in the BPH group and 14.89 ng/ml (10.68-18.62) in the control group. BMI, visfatin, and prostatic-specific antigen were found to be the major significant determinants of the tumor grade (Gleason score) of PC (with a 95% confidence interval 0.096-0.233, P < 0.001; 0.083-0.016, P = 0.005; and 0.001-0.019, P = 0.033, respectively). Conclusion In this study, we found a significant positive association between serum visfatin and PC, especially in obese individuals, and we suggest that visfatin could be used as a new promising biomarker for PC; further investigations are warranted to confirm its role in the diagnosis of PC and to assess its aggressiveness.
前列腺癌是一种常见的恶性肿瘤，是世界上第二大常见的癌症原因和第五大癌症相关死亡原因。肥胖和前列腺癌之间的关系尚不清楚，但有证据表明，肥胖可能会对发展为高级疾病的风险产生不利影响。脂肪因子可能是肥胖和前列腺癌之间联系的分子基础。几项研究表明，visfatin在不同癌症中的作用，包括星形细胞瘤、骨髓瘤和男性口腔鳞状细胞癌;胃癌、子宫内膜癌、肝细胞癌和结直肠癌;以及浸润性乳腺癌。目的:在本研究中，我们试图探讨高血清visfatin水平是否与前列腺癌(特别是高级别癌症)和肥胖患者相关的良好生物标志物;然后，它可以用作检测前列腺癌的生物标志物，并确定其侵袭性。本研究共纳入89人，分为以下几组:年龄匹配的志愿者15名，对照组(I组)，良性前列腺增生组(BPH组)36名(II组)，前列腺癌组(PC组)38名(III组)。结果PC组(III组)血清visfatin水平与对照组(I组)和前列腺增生组(II组)比较，差异均有统计学意义(P < 0.001, P < 0.001)。PC患者血清visfatin中值为55.36 ng/ml(44.32-94.02)，而BPH组为12.06 ng/ml(10.36-17.74)，对照组为14.89 ng/ml(10.68-18.62)。BMI、visfatin和前列腺特异性抗原是前列腺癌肿瘤分级(Gleason评分)的主要决定因素(95%可信区间为0.096 ~ 0.233,P < 0.001;0.083 ~ 0.016, p = 0.005;0.001 ~ 0.019, P = 0.033)。结论在本研究中，我们发现血清visfatin与PC呈显著正相关，特别是在肥胖人群中，我们认为visfatin可以作为一种新的有前景的PC生物标志物;有必要进一步研究以确认其在PC诊断中的作用并评估其侵袭性。
{"title":"Clinical significance of serum adipokine visfatin/eNampt in relation to prostate cancer detection and aggressiveness","authors":"S. Gomaa, Tamer Abou Youssif, Mostafa Elmissery, S. Elgendy","doi":"10.4103/2356-8062.159992","DOIUrl":"https://doi.org/10.4103/2356-8062.159992","url":null,"abstract":"Background Prostate cancer is a common malignancy ranked as the second most common cause of cancer and the fifth cause of cancer-related mortality worldwide. The association between obesity and prostate cancer remains poorly understood, but evidence suggests that obesity may adversely affect the risk of developing high-grade disease. Adipokines may contribute toward the molecular basis for a link between obesity and prostate cancer. Several studies have shown the role of visfatin in different cancers including astrocytomas, myeloma, and male oral squamous cell; gastric, endometrial, hepatocellular, and colorectal carcinomas; and invasive breast cancer. Objective In the present study, we attempted to investigate whether a high serum level of visfatin is a good biomarker associated with prostate cancer, especially high-grade cancer, and in obese patients; then, it could be used as a biomarker for the detection of prostate cancer and to determine its aggressiveness. Participants and method The present study included 89 individuals divided as follows: 15 age-matched volunteers, control group (group I), 36 patients diagnosed with benign prostatic hyperplasia (BPH group) (group II), and 38 patients diagnosed with prostate cancer (PC group) (group III). Results There was a statistically significant increase in serum visfatin level in PC patients (group III) compared with both the controls (group I) and patients with BPH (group II) (P < 0.001, P < 0.001, respectively). In PC patients, the median value of serum visfatin was 55.36 ng/ml (44.32-94.02), whereas it was 12.06 ng/ml (10.36-17.74) in the BPH group and 14.89 ng/ml (10.68-18.62) in the control group. BMI, visfatin, and prostatic-specific antigen were found to be the major significant determinants of the tumor grade (Gleason score) of PC (with a 95% confidence interval 0.096-0.233, P < 0.001; 0.083-0.016, P = 0.005; and 0.001-0.019, P = 0.033, respectively). Conclusion In this study, we found a significant positive association between serum visfatin and PC, especially in obese individuals, and we suggest that visfatin could be used as a new promising biomarker for PC; further investigations are warranted to confirm its role in the diagnosis of PC and to assess its aggressiveness.","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":"128932795","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: 10.4103/2356-8062.184395
Y. Khaled, L. Rashed
Background Chemerin, a newly discovered adipokine, highly expressed in obese and insulin resistant patients may provide a link between chronic inflammation and metabolic syndrome. Aim Was to evaluate serum chemerin levels in diabetic nephropathy patients and to evaluate the susceptibility between rs17173608 chemerin gene polymorphism and diabetic nephropathy risk in Egyptian patients. Materials and methods Study was conducted on 105 patients having type 2 diabetes and twenty adult healthy matched controls. Patients were divided into three groups according to urinary albumin excretion (UAE), macroalbuminuric (UAE<300mg/24h), microalbuminurua (30
{"title":"Serum chemerin levels and chemerin rs17173608 genotypes in the susceptibility of diabetic nephropathy in Egyptian diabetic patients","authors":"Y. Khaled, L. Rashed","doi":"10.4103/2356-8062.184395","DOIUrl":"https://doi.org/10.4103/2356-8062.184395","url":null,"abstract":"Background Chemerin, a newly discovered adipokine, highly expressed in obese and insulin resistant patients may provide a link between chronic inflammation and metabolic syndrome. Aim Was to evaluate serum chemerin levels in diabetic nephropathy patients and to evaluate the susceptibility between rs17173608 chemerin gene polymorphism and diabetic nephropathy risk in Egyptian patients. Materials and methods Study was conducted on 105 patients having type 2 diabetes and twenty adult healthy matched controls. Patients were divided into three groups according to urinary albumin excretion (UAE), macroalbuminuric (UAE<300mg/24h), microalbuminurua (30<UAE< 300mg/24h) and normoalbuminuric (UAE<30mg/24h).Serum chemerin levels were measured to all patients and controls by enzyme linked immunosorbent assay.Tetra-amplification refractory mutation system-PCR was performed to detect gene polymorphism. Results Serum chemerin level was significantly elevated in diabetic patients compared to controls. There is significant increase in serum chemerin levels among diabetic subgroups, significantly higher in diabetic patients with macroalbuminuria than in patients with microalbuminuria (P < 0.001) and normoalbuminuria (P = 0.0001). Also it shows highly significant elevation in diabetics with microalbuminuria than in normoalbuminuria (P = 0.0001).Our findings showed a significant association between GT genotypes (OR: 2.95,95% CI = 1.06 to 8.1; P = 0.03 and diabetic patients with macroalbuminuria. In the dominant effect of the G allele (comparison between TG+GG and TT), TG+ GG genotypes were associated with the risk of diabetic macroalbuminuria (OR: 2.8, 95%CI = 1.08to 7.5; P = 0.03). The G allele is dominant and increased the risk of diabetic macroalbuminuria as compared to the T allele (OR = 2.8, 95% CI = 1.01to7.1, P = 0.03). Conclusion Elevated serum chemerin could be marker of diabetic nephropathy and chemerin gene rs17173608 polymorphism is associated with susceptibility of diabetic nephropathy.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"206 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":"123379072","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: 10.4103/2356-8062.184399
N. Samir, M. Yehia, E. Maha, N. Doreen, Y. I. Eiman
Context Obesity and asthma are major public health problems affecting large numbers of population across the world. Obesity induces some physiological and metabolic changes, which are associated with the development of asthma. Inflammation in adipose tissue could lead to airway inflammation causing asthma in the setting of obesity. Aim The aim of this study was to compare the serum level of adiponectin and inflammatory markers [tumor necrosis factor α and C-reactive protein (CRP)] in obese asthmatic patients versus nonobese asthmatic patients compared with a third control group of healthy individuals of the same age and sex. Settings and design The study included two patient groups, and a third one served as a control group. The study was carried out in the Pulmonology and Internal Medicine Departments and Outpatient Clinics in Alexandria Main University Hospital. Materials and methods Anthropometric measurements (BMI, waist circumference, and waist to hip ratio) were obtained. Serum adiponectin, tumor necrosis factor α, and CRP levels were measured. Routine laboratory investigations, lipid profile, and blood glucose tests were performed in all studied groups. Results The mean serum level of CRP was more elevated in the obese patients in comparison with the control group (P = 0.002) and was also elevated in the normal weight asthmatic patients in comparison with the control group (P < 0.001). The mean adiponectin serum level was significantly lower in obese asthmatic patients than in normal weight asthmatic patients, and significantly lower in nonobese asthmatic patients in comparison with controls (P < 0.001 for each). Conclusion Prevention of obesity may be the most beneficial therapy for the obesity–asthma phenotype, and modulating adiponectin may open a unique and innovative approach toward managing asthma.
{"title":"Evaluation of inflammatory markers in relation to serum level of adiponectin in obese asthmatic patients","authors":"N. Samir, M. Yehia, E. Maha, N. Doreen, Y. I. Eiman","doi":"10.4103/2356-8062.184399","DOIUrl":"https://doi.org/10.4103/2356-8062.184399","url":null,"abstract":"Context Obesity and asthma are major public health problems affecting large numbers of population across the world. Obesity induces some physiological and metabolic changes, which are associated with the development of asthma. Inflammation in adipose tissue could lead to airway inflammation causing asthma in the setting of obesity. Aim The aim of this study was to compare the serum level of adiponectin and inflammatory markers [tumor necrosis factor α and C-reactive protein (CRP)] in obese asthmatic patients versus nonobese asthmatic patients compared with a third control group of healthy individuals of the same age and sex. Settings and design The study included two patient groups, and a third one served as a control group. The study was carried out in the Pulmonology and Internal Medicine Departments and Outpatient Clinics in Alexandria Main University Hospital. Materials and methods Anthropometric measurements (BMI, waist circumference, and waist to hip ratio) were obtained. Serum adiponectin, tumor necrosis factor α, and CRP levels were measured. Routine laboratory investigations, lipid profile, and blood glucose tests were performed in all studied groups. Results The mean serum level of CRP was more elevated in the obese patients in comparison with the control group (P = 0.002) and was also elevated in the normal weight asthmatic patients in comparison with the control group (P < 0.001). The mean adiponectin serum level was significantly lower in obese asthmatic patients than in normal weight asthmatic patients, and significantly lower in nonobese asthmatic patients in comparison with controls (P < 0.001 for each). Conclusion Prevention of obesity may be the most beneficial therapy for the obesity–asthma phenotype, and modulating adiponectin may open a unique and innovative approach toward managing asthma.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"29 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":"129567510","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_28_16
S. Elhini, R. Matta, Nossa Eledawi, Lamia Hamdi
Objective Thyroid dysfunction (TD) is a risk factor for coronary heart disease (CHD) events. We study the prevalence and predictors of TD and its impact on characteristics, cardiac function, and ischemic severity of patients with manifest CHD. Patients and methods A total of 200 patients 6–12 months after acute coronary syndrome had at least one vessel − significant stenotic coronary artery lesion. Before elective angiography, patients underwent anthropometric measurement, routine biochemical assay, thyroid hormones, and thyroid peroxidase antibody. Results The prevalence of TD was 17.5%: 12% for hypothyroidism (9.5% subclinical, 2.5% overt) and 5.5% for hyperthyroidism (2.5% subclinical, 3% overt). Compared with the euthyroid group, the hypothyroid group had a significantly higher age, BMI, diastolic blood pressure (BP), atherogic lipid profile, and impaired cardiac functions and higher pulmonary artery systolic pressure (PASP), and the hyperthyroid group had significantly higher systolic BP, ejection fraction (EF), and PASP and significantly lower diastolic BP and lipid profile. Independent predictors for hypothyroidism were age, bradycardia, increased BMI, lower EF, diastolic dysfunction, and atherogenic lipid profile, whereas increased PASP was an independent predictor for hyperthyroidism. Thyroid-stimulating hormone (TSH) was positively correlated and both free triiodothyronine and free thyroxine were negatively correlated to BP, BMI, lipid profile, impaired EF, and coronary atherosclerosis severity. TSH and free thyroxine were positively correlated to PASP, which increased significantly through hypothyroidism to hyperthyroidism. TSH and free triiodothyronine were independent predictors of severity of CHD. Conclusion Age, obesity, impaired cardiac function, and atherogenic lipid profile are predictors of hypothyroidism, and PASP is the predictor of hyperthyroidism among manifest CHD. Thyroid hormones are predictors of severity of coronary atherosclerosis and correlated to cardiac functions and PASP.
{"title":"Impact and predictors of thyroid dysfunction among patients with stenotic coronary artery lesion during late postacute coronary syndrome","authors":"S. Elhini, R. Matta, Nossa Eledawi, Lamia Hamdi","doi":"10.4103/ejode.ejode_28_16","DOIUrl":"https://doi.org/10.4103/ejode.ejode_28_16","url":null,"abstract":"Objective Thyroid dysfunction (TD) is a risk factor for coronary heart disease (CHD) events. We study the prevalence and predictors of TD and its impact on characteristics, cardiac function, and ischemic severity of patients with manifest CHD. Patients and methods A total of 200 patients 6–12 months after acute coronary syndrome had at least one vessel − significant stenotic coronary artery lesion. Before elective angiography, patients underwent anthropometric measurement, routine biochemical assay, thyroid hormones, and thyroid peroxidase antibody. Results The prevalence of TD was 17.5%: 12% for hypothyroidism (9.5% subclinical, 2.5% overt) and 5.5% for hyperthyroidism (2.5% subclinical, 3% overt). Compared with the euthyroid group, the hypothyroid group had a significantly higher age, BMI, diastolic blood pressure (BP), atherogic lipid profile, and impaired cardiac functions and higher pulmonary artery systolic pressure (PASP), and the hyperthyroid group had significantly higher systolic BP, ejection fraction (EF), and PASP and significantly lower diastolic BP and lipid profile. Independent predictors for hypothyroidism were age, bradycardia, increased BMI, lower EF, diastolic dysfunction, and atherogenic lipid profile, whereas increased PASP was an independent predictor for hyperthyroidism. Thyroid-stimulating hormone (TSH) was positively correlated and both free triiodothyronine and free thyroxine were negatively correlated to BP, BMI, lipid profile, impaired EF, and coronary atherosclerosis severity. TSH and free thyroxine were positively correlated to PASP, which increased significantly through hypothyroidism to hyperthyroidism. TSH and free triiodothyronine were independent predictors of severity of CHD. Conclusion Age, obesity, impaired cardiac function, and atherogenic lipid profile are predictors of hypothyroidism, and PASP is the predictor of hyperthyroidism among manifest CHD. Thyroid hormones are predictors of severity of coronary atherosclerosis and correlated to cardiac functions and PASP.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"84 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":"130322370","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: 10.4103/2356-8062.200938
Mohamed Atta, N. Abdalla, A. Ibrahim
Introduction The prevalence of obesity has increased dramatically over the last decade. The first sign of renal injury is microalbuminuria or frank proteinuria. The prevalence of microalbuminuria was positively increased with the increasing waist-to-hip ratio in nonhypertensive individuals. Adiponectin plays a role in the suppression of metabolic derangements that may result in diabetes, obesity, and nonalcoholic fatty liver disease and an independent risk factor for metabolic syndrome. Aim The aim of the study was to evaluate the relationship between obesity, adiponectin level, and microalbuminuria in obese nondiabetic nonhypertensive individuals. Patients and methods This study included 70 individuals who were divided into two groups according to their BMI: the obese group (group I), which included 50 people with BMI at least 30 kg/m2, and the control group (group II), which included 20 lean persons with BMI from 18.5 to 24.9 kg/m2. The study excluded patients with diabetes, hypertension, and chronic kidney disease. The following laboratory investigations were carried out on all subjects: serum glucose level, kidney function tests, and serum adiponectin level. Spot urine samples were collected for complete urinanalysis and tested for microalbuminuria and albumin/creatinine ratio (ACR). Results ACR showed significant increase in the obese group than in the nonobese group, but serum adiponectin showed significantly lower level in the obese group than in the nonobese group. Within the obese group a significant positive correlation was found between ACR and BMI and waist-to-hip ratio, whereas a significant negative correlation was found between ACR and serum adiponectin. Also, within the obese group a significant negative correlation was found between serum adiponectin level and ACR and BMI. Discussion and conclusion Through this study we have confirmed the association of microalbuminuria, obesity, and serum adiponectin. Our study supports the hypothesis that obesity is associated with microalbuminuria in obese people free from diabetes, hypertension, and chronic kidney disease.
{"title":"Microalbuminuria and adiponectin in obese nondiabetic nonhypertensive people","authors":"Mohamed Atta, N. Abdalla, A. Ibrahim","doi":"10.4103/2356-8062.200938","DOIUrl":"https://doi.org/10.4103/2356-8062.200938","url":null,"abstract":"Introduction The prevalence of obesity has increased dramatically over the last decade. The first sign of renal injury is microalbuminuria or frank proteinuria. The prevalence of microalbuminuria was positively increased with the increasing waist-to-hip ratio in nonhypertensive individuals. Adiponectin plays a role in the suppression of metabolic derangements that may result in diabetes, obesity, and nonalcoholic fatty liver disease and an independent risk factor for metabolic syndrome. Aim The aim of the study was to evaluate the relationship between obesity, adiponectin level, and microalbuminuria in obese nondiabetic nonhypertensive individuals. Patients and methods This study included 70 individuals who were divided into two groups according to their BMI: the obese group (group I), which included 50 people with BMI at least 30 kg/m2, and the control group (group II), which included 20 lean persons with BMI from 18.5 to 24.9 kg/m2. The study excluded patients with diabetes, hypertension, and chronic kidney disease. The following laboratory investigations were carried out on all subjects: serum glucose level, kidney function tests, and serum adiponectin level. Spot urine samples were collected for complete urinanalysis and tested for microalbuminuria and albumin/creatinine ratio (ACR). Results ACR showed significant increase in the obese group than in the nonobese group, but serum adiponectin showed significantly lower level in the obese group than in the nonobese group. Within the obese group a significant positive correlation was found between ACR and BMI and waist-to-hip ratio, whereas a significant negative correlation was found between ACR and serum adiponectin. Also, within the obese group a significant negative correlation was found between serum adiponectin level and ACR and BMI. Discussion and conclusion Through this study we have confirmed the association of microalbuminuria, obesity, and serum adiponectin. Our study supports the hypothesis that obesity is associated with microalbuminuria in obese people free from diabetes, hypertension, and chronic kidney disease.","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":"125180370","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: 10.4103/2356-8062.205205
Alaa E Dawood, M. Abdelraof, Yasser El ghobashy
Background Diabetic nephropathy (DN) is the leading cause of renal failure. Diabetic patients with microalbuminuria typically progress to proteinuria and overt DN. Similar to other microvascular complications of diabetes, there are strong associations between glucose control (as measured using HbA1c) and the risk of developing DN. Apelin (APLN), a peptide first isolated from bovine stomach tissue extracts, is the endogenous ligand for the G-protein-coupled APJ receptor that is expressed at the surface of some cell types. APLN and APJ are widely expressed in homogenates from animal organs in a pattern shared with angiotensinogen and the angiotensin receptor. APLN is widely distributed in the central nervous system and periphery, especially in the heart, kidney, lung, and mammary glands. The APLN–APJ system may be involved in the pathogenesis of DN, which may play a renoprotective role partially by antagonizing the angiotensin II–ATIR pathway. Aim The aim of this study was to investigate the relation between serum APLN and different grades of DN in type 2 diabetic patients. Patients and methods This study was conducted on 150 diabetic patients and 20 controls selected from the inpatient department and outpatient clinics of the Internal Medicine Department in Menoufia University Hospital. The selected participants were divided into four groups: group 1 included 20 healthy controls; group 2 included 50 type 2 diabetes mellitus (T2DM) patients with normoalbuminuria; group 3 included 50 T2DM patients with microalbuminuria; and group 4 included 50 T2DM patients with macroalbuminuria. Members of the study groups were subjected to thorough history taking with special emphasis on age, sex, and duration of diabetes mellitus. Investigations included liver profile, complete blood count, fasting and 2 h postprandial plasma glucose, glycosylated hemoglobin (HbA1c), complete urine analysis, kidney function tests (blood urea nitrogen and serum creatinine), urine albumin/creatinine ratio, estimated glomerular filtration rate, and serum APLN. Results Serum APLN was significantly higher in group 4 compared with the other groups, in group 3 compared with groups 1 and 2, and in group 2 compared with group 1. There was a significant positive correlation between serum APLN and serum creatinine, urine albumin/creatinine ratio, and HbA1c. Further, there was a significant negative correlation between serum APLN and estimated glomerular filtration rate in the studied diabetic patients. There was no correlation between serum APLN and BMI in diabetic patients. Conclusion From this study, we can conclude that serum APLN is significantly higher in patients with DN compared with diabetic patients without nephropathy, and there is a positive correlation between serum apelin and the degree of DN. Thus, APLN may play an important role in the development of DN.
{"title":"The relationship between serum apelin level and different grades of diabetic nephropathy in type 2 diabetic patients","authors":"Alaa E Dawood, M. Abdelraof, Yasser El ghobashy","doi":"10.4103/2356-8062.205205","DOIUrl":"https://doi.org/10.4103/2356-8062.205205","url":null,"abstract":"Background Diabetic nephropathy (DN) is the leading cause of renal failure. Diabetic patients with microalbuminuria typically progress to proteinuria and overt DN. Similar to other microvascular complications of diabetes, there are strong associations between glucose control (as measured using HbA1c) and the risk of developing DN. Apelin (APLN), a peptide first isolated from bovine stomach tissue extracts, is the endogenous ligand for the G-protein-coupled APJ receptor that is expressed at the surface of some cell types. APLN and APJ are widely expressed in homogenates from animal organs in a pattern shared with angiotensinogen and the angiotensin receptor. APLN is widely distributed in the central nervous system and periphery, especially in the heart, kidney, lung, and mammary glands. The APLN–APJ system may be involved in the pathogenesis of DN, which may play a renoprotective role partially by antagonizing the angiotensin II–ATIR pathway. Aim The aim of this study was to investigate the relation between serum APLN and different grades of DN in type 2 diabetic patients. Patients and methods This study was conducted on 150 diabetic patients and 20 controls selected from the inpatient department and outpatient clinics of the Internal Medicine Department in Menoufia University Hospital. The selected participants were divided into four groups: group 1 included 20 healthy controls; group 2 included 50 type 2 diabetes mellitus (T2DM) patients with normoalbuminuria; group 3 included 50 T2DM patients with microalbuminuria; and group 4 included 50 T2DM patients with macroalbuminuria. Members of the study groups were subjected to thorough history taking with special emphasis on age, sex, and duration of diabetes mellitus. Investigations included liver profile, complete blood count, fasting and 2 h postprandial plasma glucose, glycosylated hemoglobin (HbA1c), complete urine analysis, kidney function tests (blood urea nitrogen and serum creatinine), urine albumin/creatinine ratio, estimated glomerular filtration rate, and serum APLN. Results Serum APLN was significantly higher in group 4 compared with the other groups, in group 3 compared with groups 1 and 2, and in group 2 compared with group 1. There was a significant positive correlation between serum APLN and serum creatinine, urine albumin/creatinine ratio, and HbA1c. Further, there was a significant negative correlation between serum APLN and estimated glomerular filtration rate in the studied diabetic patients. There was no correlation between serum APLN and BMI in diabetic patients. Conclusion From this study, we can conclude that serum APLN is significantly higher in patients with DN compared with diabetic patients without nephropathy, and there is a positive correlation between serum apelin and the degree of DN. Thus, APLN may play an important role in the development of DN.","PeriodicalId":260758,"journal":{"name":"Egyptian Journal of Obesity, Diabetes and Endocrinology","volume":"42 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":"134304846","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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