Thyroid functions in pregnant women with gestational hypertension

Background: In normal pregnancy, changes in thyroid function are well acknowledged; however, information about thyroid function in gestational hypertension [GH] is scanty. Hypertensive disorders complicating pregnancy are common and contribute greatly to prenatal and maternal morbidity and mortality in the developing countries. The aim of this study was to investigate thyroid functions in pregnant women with gestational hypertension

Methods: This was a case-control study evaluated maternal thyroid hormonal status in 78 [62 hypertensive and 16 normotensive] women with pregnancy of >20 weeks to term, referred to Jinnah Hospital, Lahore. Thyrotropin [TSH], Total thyroxine [tT4] and Total triiodothyronine [tT3] were assayed with ELISA

Results: Serum TSH and tT3 were significantly higher in hypertensive pregnant [HP] compared to normotensive pregnant women [p=0.002, p=0.039 respectively]. Mean serum TSH was 3.28+/-0.29 microIU/ml in normotensive pregnant subjects and 6.71+/-1.06 microIU/ml in HP subjects, whereas mean serum tT3 in normotensive subjects was 1.22+/-0.03 etag/ml and 1.31+/-0.21 etag/ml in the HP subjects. There were no significant differences in serum tT4 levels of the subjects

Conclusion: Mean serum TSH and tT3 levels were significantly increased without concomitant changes in tT4 in HP compared to normal pregnant women. Raised TSH and tT3 levels might be associated with a risk for occurrence of gestational hypertension

Significant high lipid profile in pre-hypertensive subjects as compare to stage 1 and stage 2 of hypertensive subjects

To analyze the differences in lipid profile in various categories of hypertension in our local population. Cross Sectional Study. This study was conducted at Amin Hayat Memorial Trust for diabetes and Hypertension, Lahore and Punjab Institute of Cardiology [PIC], Lahore from Dec. 2005 to May 2007. A total of 510 subjects of either sex were screened during a cross-sectional study. Biochemical assessment includes the determination of TC [Total Cholesterol], LDL-C [Low Density Lipoprotein Cholesterol], HDL-C [High Density Lipoprotein Cholesterol], and TG [Triglycerides], which were measured by using commercially available kits using Hitachi 902 photometer. vLDL and LDL-C/HDL-C ratio was calculated by using formula. Abnormal lipid profile was observed in 59% of the study population. Around 75% of prehypertensive subjects had abnormal lipid profile as compare to stage 1 and stage 2 of hypenension. Beside prevalence significant high levels of TC, LDL-L, and LDL-C/HDL-C were also observed in prehypertensive group. Females had significantly high levels of TC, HDL-C and LDL-C/HDL-C compared to males. A high prevalence of dyslipidemia was observed in all stages of hypertension; however, prehypertensive group had significant high levels of lipid profile and smoking and family history also predispose to high blood pressure

Insulin resistance, liver enzymes and the metabolic syndrome

The objective of the study was to test the hypothesis that enzymes conventionally associated with liver dysfunction [alkaline phosphatase, aspartate aminotransferase, alanine arninotransferase] may predict diabetes. Three hundred type-2 diabetics were selected from Diabetic clinic and one hundred and fifty non-diabetes control from population. Biochemical testing of fasting and 2 hours serum insulin, renal, liver functions and protein was measured by using standard method and instruments. Insulin resistance was calculated using the homeostasis model assessment for insulin resistance [HOMA-IR] method. Statistical analysis of samples and control subjects were done by using SPSS-13. At baseline all three enzymes were related to most of the features of the metabolic syndrome. Serum alkaline phosphatase levels as well as serum transaminases also showed a statistical significant difference at P<0.05. The HOMA-IR in the type-2 diabetic group was significantly greater than that of the control group [mean +/- SD 3.84 +/- 2.3 vs. 1.62 +/- 0.79 units [P<0.05]. Serum total proteins and albumin significantly reduced in type-2 diabetic subjects. Mild elevations in liver enzymes and decreased levels in serum proteins are associated with features of the metabolic syndrome

C-reactive protein levels in type-2 diabetes mellitus amongst the local population

The objective of this study was to assess the levels of C-reactive protein in type-2 diabetes mellitus patients in the local population. Serum samples of patients of sixty type-2 diabetes mellitus and thirty healthy subjects acting as control of same age and sex matched were included from the general community, ensuring similarities of their basic confounding factors. Duration of type-2 diabetes of these subjects was also recorded. Sera were stored at-80°C till analysis. Estimation of CRP was done by a microplate immunoenzymometric assay. HbAlc levels in blood were done by using a commercial kit. Baseline values for HbAlc and CRP were assayed in the diabetic as well as control samples. CRP levels in serum were significantly higher among diabetic participants compared to the control subjects [P<0.05]. Among diabetic participants, higher levels of HbAlc were associated with higher level of CRP. CRP levels during different duration of type-2 diabetes were 3.4 +/- 1.35 micro g/ml in type-2 diabetics and 1.37 +/- 1.10 micro g/ml in control subjects having duration less than one year [P<0.05] similarly, 1-5 years 6-10 years and 11-15 years of duration had levels 4.90 +/- 1.57 micro g/ml, 4.60 +/- 1.90 micro g/ml and 4.42 +/- 1.20 micro g/ml respectively in type-2 diabetics and control subjects had 1.85 +/- 1 .20 micro g/ml, 1.40 +/- 1 .70 micro g/ml and 1.22 +/- 1.10 micro g/ml respectively. Diabetes having 16-20 years duration showed a non significant behavior. Our findings show that patients having type 2 diabetes had higher CRP levels in serum compared to the control subjects. Duration of disease and HbAlc levels showed statistical significant differences

Insulin resistance and cardiovascular risks in type-2 diabetic population

To determine the presence of diabetes mellitus and other conventional coronary heart disease risk factors such as hypertension, hyperlipidemia and sedentary lifestyles in patients with acute coronary events in Pakistani population. This study included 300 type-2 diabetic patients selected from diabetic clinic of PMRC Research Centre Fatima Jinnah Medical College and Sir Ganga Ram Hospital Lahore with insulin resistant type-2 diabetics, unstable angina or myocardial infarction [MI]. One hundred and fifty control subjects without diabetes, myocardial or other coronary artery disease were also included in this study. Out of all patients 41.66% were female while 58.34% males and duration of diabetes was 0-3 years in 8% cases. Frequency of cardiovascular complications in type-2 diabetics were noted in 40.66% having hypertension, angina pectoris in 12.33%, congestive cardiac failure in 2% and MI in 2% cases. Location and extension of MI and myocardial enzymes did not differ between diabetics and non-diabetic patients. Age, duration of diabetes and HbA1c levels, did not differ between diabetic patients with or without MI. Hypertension and current smoking was significantly higher in patients with MI compared to patients with unstable angina [P< 0.05]. Serum TG, HDL-C, LDL-C and total cholesterol level did not differ between patients with MI and unstable angina. In this study insulin resistant type-2 diabetic patients have at least one of conventional cardiac risk factors. Diabetes and hypertension are leading risk factors, which may directly or indirectly interfere and predict more serious complications of coronary heart disease

Some chemical constituents of accessory sex organs in different functional states of endocrine pancreas in male rats

Chemical constituents of functional importance as acid phosphatase, alkaline phosphatase, citric acid, ascorbic acid, zinc and fructose from accessary sex organs of rats were observed in normal, prolonged alloxan diabetic and orally glibenclamide treated prolonged diabetic rats. Diabetes mellitus when persisted for longer time caused gross atrophy of accessory sex glands and glibenclamide treatment did not improve the glandular weight and morphology. Acid phosphate and citric acid concentration increased in untreated diabetic animals and was found further elevated in the diabetic treated with glibenclamide. Alkaline phosphatase and ascorbic acid concentrations, however, decreased on glibenclamide administration. The glandular zinc concentration remained unchanged in all the experimental groups. The fructose showed a non-significant increase in the accessory sex glands of untreated diabetic rats