ABSTRACT
Metabolic Syndrome (MS), which affects 33.1% of Nigerians, predisposing them to cardiovascular disease (CVD) risk, has been associated with the female gender. The cardioprotective effect of oestradiol against CVD is now controversial and was investigated in premenopausal with MS (PRMMS) and postmenopausal women with MS (POMMS). A total of 191 women (44 PRMMS, 126 POMMS and 21 premenopausal women without MS (PRM) (controls) with mean (s.d) age of 40.0 (6.9), 57.0 (8.8), 29.0 (6.8) years were participants of this study. Demography, blood pressure (BP), anthropometry, hormones, fasting plasma glucose (FPG) and lipids were obtained by standard methods. Data were significant at (P<.05). Age, parity, all anthropometric measures, FPG, leptin, ET ratio and FSH were significantly higher while HDLC, testosterone and prolactin were significantly lower in PRMMS compared with controls (P<.03). In comparison of POMMS with PRMMS, age, parity, WHR, systolic BP, TG, FSH and LH were significantly higher while body weight, HC, and leptin were lower in POMMS compared with PRMMS (P<.05). DBP positively predicted oestradiol in PRM only (P=.044) while oestradiol positively predicted testosterone in PRMMS only (P<.001). In POMMS only, DBP positively predicted testosterone; testosterone, ET ratio and FSH positively predicted oestradiol while LDLC and oestradiol positively predicted the ET ratio (P<.03). Metabolic syndrome may predispose both pre and postmenopausal women to the risk cardiovascular disease and type 2 diabetes mellitus. Oestradiol may protect against cardiovascular diseases in women without metabolic syndrome only.
ABSTRACT
Aim: To determine indices of insulin sensitivity and oral disposition index (DIo) derived from 30 min of glucose challenge in adults with sickle cell anaemia; a group in whom there is chronic inflammation. Study Design: Case-controlled study. Place of Study: Department of Chemical Pathology and Department of Haematology, University of Ibadan/University College Hospital, Ibadan, Nigeria. Methodology: Twenty five (25) adults with sickle cell anaemia (SCA) in steady state and 25 age, sex and body mass index (BMI) matched healthy individuals with HbAA genotype were recruited into this study. After an overnight fast of about 10 hr, 5 ml of venous blood was obtained from each participant for the determination of plasma glucose and serum insulin. Thereafter, each subject underwent a 75-g oral glucosetolerance test and at 30min, 5ml of venous blood was obtained for the determination of plasma glucose and serum insulin. Serum insulin was determined using ELISA while the plasma glucose was estimated using glucose oxidase method and indices of insulin sensitivity and β-cell function were calculated appropriately. Differences between variables with Gaussian distribution were determined using independent Student’s t-test while Mann-Whitney U was used for the non-Gaussian variables. P-values less than 0.05 were considered significant. Results: The mean fasting plasma glucose (FPG) was within the normal limit but was significantly lower in subjects with SCA compared with controls. All other indices of insulin sensitivity (insulinogenic index, fasting insulin resistance index, modified Matsuda index of insulin sensitivity and insulin secretion/insulin resistance index) and oral disposition index (DIo) were similar in both groups. Conclusion: It could be concluded from this study that SCA subjects have a similar insulin sensitivity status with HbAA subjects. This suggests that SCA subjects might not be more predisposed to the development of type 2 diabetes mellitus than those with HbAA despite the chronic inflammation associated with the former.
ABSTRACT
Background: Sickle cell anaemia (SCA) patients are prone to require long-term frequent blood transfusion because of chronic haemolysis and overlapping hyper-haemolysis. Hence, they become vulnerable to iron overload and its complications. On the other hand, iron deficiency has been documented among un-transfused SCA cases. Thus, there is a need to effectively and efficiently determine iron status of SCA patients. Objective: We investigated whether adult SCA patients in steady state (SSt) or those with vaso-occlusive crisis (VOC) have significantly different iron status viz-a-viz Serum Iron (SI), Serum Ferritin (SF), Total Iron Binding Capacity (TIBC), Transferrin (TRF), percentage TFS and haematological parameters when compared with age and sex-matched controls. Materials and Methods: Ninety subjects, comprising 30 SCA patients in SSt, 30 SCA patients with VOC and 30 HbAA, ethnicity, age and sex-matched controls (NC), were consecutively recruited. Serum samples were analysed for SF, TRF and TIBC using ‘WATER’ HPLC 616 and 626; SI was determined using the Atomic Absorption Spectroscopic (AAS) method. Haematological parameters were determined using a Sysmex Kx21 auto-analyser. Results: The SCA groups (VOC and SSt) had significantly lower SI, SF, TRF and TIBC compared to the control group. The VOC group had a significantly lower mean ferritin level but higher SI, TRF and percentage TFS levels compared to SSt group. The MCV, MCH (in SSt group) were significantly lower while MCHC was significantly higher in the SCA groups compared to the NC group. Using the normal ranges for all parameters, all parameters were within normal for the controls while TIBC was below normal and percentage TFS was higher in SCA groups. Percentage TFS was significantly higher in VOC compared to SSt group. Conclusions: The study reported lower SI and TRF, lower MCV and MCH, below normal TIBC, within normal Ferritin but elevated WBC and platelet counts, elevated percentage TFS (more elevated in VOC than SSt) and higher MCHC in SCA patients. The use of percentage TFS as a marker of VOC is suggested.
ABSTRACT
Aim: To assess the prevalent components of metabolic syndrome (MSC) and their related determinants of lipid metabolism in the Nigerian for early diagnosis, prevention and management of the metabolic syndrome (MS) and its associated diseases. Study Design: Cohort study. Place and Duration of Study: Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan between March and August 2010. Methodology: 534 apparently healthy Nigerian traders aged 18–105 years were participants of a cohort study. The IDF (2005) criteria was used for MS diagnosis. Anthropometric indices and blood pressure (BP) were obtained by standard methods. Fasting plasma glucose, total cholesterol (TC), triglycerides (TG) and high density lipoprotein cholesterol (HDLC) were determined by enzymatic methods while low density lipoprotein cholesterol (LDLC) was calculated. Data analysed were statistically significant at P<0.05. Results: 60.1% of traders had 2 and 3MSC. 0.6%, 1.1% and 9.6% of traders had all 5MSC, ≥3MSC without elevated waist circumference (WC) and zero MSC respectively. Elevated WC, reduced HDLC and high BP were more frequent MSC representing 70.2%, 63.1% and 47.9% while FPG and TG were less frequent representing 11.2% and 2.2% of traders respectively. This pattern was similar in MS and non-MS groups. 25.3% of males and only 2.2% of females had no MSC. Reduced HDLC and elevated WC were the most frequent MSC in males and females respectively. All metabolic risk factors (MRF) except TC were significantly different in comparison between MS and non-MS groups as well as among traders with 0-5 MSC. WHR was the only parameter that correlated significantly with all MRF. Conclusion: Elevated waist circumference, reduced high density lipoprotein cholesterol, and high blood pressure may be prevalent metabolic syndrome components and important in managing metabolic syndrome in Nigeria. Regional specific cut-offs for these components for the African population is needed.
ABSTRACT
Aims: To compare the mean levels of plasma total Homocysteine (tHct), Meth ylm alonic ac id ( MMA), vitamin B12, folate and haematological parameters(PCV, WBC, Platelet counts, MCV, MCH, MCHC) among adult SCA patients in steady state (SS), SCA in (VOC) and age and sex matched controls in order to determine significant differences. Study Design: Case-control study. Place and Duration of Study: Department of Haematology and Department of Chemical Pathology, University College Hospital, Ibadan, Nigeria between March 2012 and July 2012. Methodology: We included 60 SCA patients (30 in VOC, 30 in Steady State; and 30 age and sex matched controls. Plasma tHct, MMA, folate and vitamin B12 were assessed using HPLC and haematological parameters were determined using haematological autoanalyzer (Syxmex Kx21). Results: The mean plasma tHct, MMA, vitamin B12 of SCA patients (VOC and SS) were significantly lower (p=0.000) compared to control population but the mean folate levels were comparable (p=0.085). The SCA (in VOC) had significantly lower (p=0.000) MMA and folate levels compared to SS group but the SS group had significantly lower (p=0.001) tHct level compared to VOC group. While the PCV, Hgb, MCV, and MCH were significantly lower; the WBC, platelet count and the MCH were significantly elevated in SCA patients compared to controls. Conclusion: A larger, better controlled, multicenter study is required to confirm lower tHct and MMA found in SCA groups compared to control group and higher tHct in SCA (VOC) but higher MMA level in SCA (SS) when VOC and SS groups were compared. The haematological parameters in SCA groups were not in keeping with macrocytic anaemia but were indicative of chronic haemolytic and inflammatory process.