Insulin resistance, the metabolic syndrome and global right and left myocardial performance index

Cardiovascular dysmetabolic syndrome [CDS], dysmetabolic syndrome, syndrome X, DROP syndrome [dyslipidemia, insulin resistance [IR], obesity, and high blood pressure] and IR syndrome are all synonymies for the syndrome characterized by four critical elements: atherogenic dyshpidemia, IR, central obesity, and high blood pressure. The aim of the study was to describe the global right and left myocardial function, in patients with metabolic syndrome [MS], defined according to the criteria proposed by NCEP-ATP III. A descriptive, cross-sectional, hospital based study in which, 730 patients, mean age [54 years + 6], [430 men and 300 women] who attended Suez Canal university [SCU] outpatient, clinic of cardiology and diabetes were screened for CDS criteria of whom 150 were diagnosed [63 men and 87 women]. Those who met the dysmetabolic syndrome criteria were subjected to careful history taking, blood pressure measurement anthropometric measures [Height and weight, body mass index, waist circumference], ECG and blood samples: [Na and K, Fasting blood sugar [FBS], fasting plasma insulin [FPI] [normal values from 5-15 micro IU/ml], serum creatinine [S.Cr.], serum uric acid and Lipids were measured. HOMA-IR was assessed according to the level of FBS and which was measured with electrochemiluminescence immunoassay method Serum intact pro-insulin was measured by using a highly specific solid phase enzyme linked immunosorbant assay based on sandwich principle. All participants were subjected to full echocardiographic study including right and left ventricular diastolic and systolic ftmction, and the combined index of myocardial performance [Tei index = IRT + ICT/ET]. Most of parameters of insulin resistance [IR] were higher in females than males, fasting plasma insulin, PPBS and HOMA-IR [27 vs. 21 micro IU/mL]. [162 vs. 151 mg/dl], and [10 vs. 8.5] respectively, [P value < 0.05]. In addition, waist circumference and BMI were higher in females than males, [130 vs. 127 cm] and [44 vs. 39 kg/m2] respectively, [P value < 0.05]. HDL were higher in females than males [43 vs. 39 mg/dl] respectively, with statistical significant difference [P value < 0.05]. Total body obesity [[BMI] and central obesity [waist circumference] had a statistically significant direct correlation relation with fasting plasma insulin, HOMA-IR, HDL, TG, FBS and PPBS. Central obesity alone had a statistically significant direct correlation relation with serum uric acid. Participants with the MS had greater left ventricular [LV] dimension, mass, and relative wall thickness, and left atrial diameter [all p < 0.01]. and a higher prevalence of LV hypertrophy [p <0.001], with lower ejection fraction [p <0.05], and mitral E/A ratio [p < 0.05] than participants who did not have the MS. Regarding the left ventricular global function there was significant difference between the groups. On the other hand there is non significant difference regarding right ventricular function between them. HOMA-IR was a predictor of incident global myocardial left ventricular dysfunction. The metabolic syndrome is associated with a global left rather than right ventricular dysfunction and HOMA-IR is a predictor. There is a pressing need for a national preventive program to combat obesity, diabetes and related comorbidities by general practitioners and diabetologists

effect of human umbilical cord blood stem cells on liver regenerative activity in mice

Liver fibrosis is seen as scar formation and considered as a sign of hepatic injury in many chronic liver diseases. Currently there is no effective treatment available. Human umbilical cord blood [HUCB] contains stem / progenitor cells, which can differentiate into a variety of cell types. They can differentiate into hepatocytes in vitro and in vivo and can ameliorate fives: The aim of this study was to evaluate the effect of HUCB stem cells on fibrosis formation induced by carbon tetrachloride [CC14] and on liver function in mice. Hepatic fibrosis was induced by CC14. HLCB stem cells were infused systemically through the tail vein immediately [group 1] or after one week of receiving CC14 [group 2]. Group 3 received only CC14. Administration of CC14 was continued for 10 weeks in G1, G2 and G3, while group 4 [control mice] received only saline infusion for 10 weeks. After that blood from all groups was collected for assessment of the liver function, then all mice were sacrificed under anesthesia, and the liver was taken for histopathological examination. It was found that the level of alanine aminotransferase [ALT] in mice treated with stem cells alter CC14 administration was significantly lower while s. albumin was significantly higher compared to group 3 animals who received CC14 without stem cell treatment [P=0.001], whereas serum total and direct bilirubin levels were similar among all groups. Histological examination revealed that hepatic damage was less in the stem cell treated mice [G1 and G2] than in the non treated group [as regards the liver cell changes, portal tract inflammation, piecemeal necrosis, portal tract fibrosis and bridging fibrosis]. The results were statistically significant. However, liver inflammation and fibrosis were more in mice treated after 1 week than in immediately treated mice. The results suggest that HUCB stem cells can improve liver function and ameliorate liver fibrosis in mice