Study of small intestinal structural and functional changes in patients with diabetes mellitus

Small intestinal structural and functional changes were studied in 20 IDDM patients, 20 NIDDM patients and 10 normal controls. Diarrhea was the most common gastrointestinal symptom, affecting 55% of patients of IDDM group and 40% of patients of NIDDM group. Manifestations of autonomic neuropathy were present in 55% of IDDM group and 40% of NIDDM group, and a statistically significant association was found between the presence of autonomic manifestations and the presence of diarrhea and constipation. D-xylose absorption excretion was normal in 75% of patients of each diabetic group and was reduced in the remaining 25% of patients. Histopathological examination of the jejunal mucosa showed villi of normal shape in all patients who had normal D-xylose excretion, and were abnormally clubbed and stunted with decreased cryptovillous ratio and increased goblet cells in all patients with reduced D-xylose excretion. Histochemical examination showed that alkaline phosphatase and succinic dehydrogenase activity were reduced in all patients with abnormal villi and reduced D-xylose excretion, and were dependent on the control status of diabetes mellitus in patients with normal villi, with significant increase in alkaline phosphatase activity and decrease in succinic dehydrogenase activity in uncontrolled cases

Evaluation of zinc status as a liver function test in patients with schistosomal hepatic fibrosis

The association between schistosomiasis and Zinc [Zn] deficiency had been attributed to many causes including malabsorption, hepatic malfunction or reduction in its binding proteins [albumin and a[2] rnacroglobulins]. The present work aimed at the study of the relation between zinc status and the functional reserve capacity of the liver in patients with schistosomal hepatic fibrosis. For this purpose the study included 60 subjects; 15 healthy persons as a control group and 45 patients with schistosomal hepatic fibrosis divided into three equal groups [A, B and C] according to the severity of their liver affection using modified child's classification. It was found that zinc levels in plasma, polymorphonuclear leukocytes and erythrocytes are significantly low in all Schistosomal patients as compared to the control group and usually the more severe the dysfunction is, the more the Zn deficiency. This indicates Zn depletion in both extra and intracellular compartments can be mainly explained by the defective synthesis of plasma proteins by the liver, mainly albumin and a2 macroglobulins that act as carriers of Plasma Zn. However, the hyperzincuria found in these patients may share in the chronic Zn deficiency and it is mostly due to increased diffusible fraction of Zn as a result of hypoalbuminemia