ABSTRACT
To determine the frequency of occurrence of hypoadrenalism in patients with human immunodeficiency virus [HIV] infection and document the clinical correlates of hypoadrenalism for this group of patients. A descriptive study was carried out on 66 hospitalized HIV patients in a semi-urban setting of South Africa. Hypoadrenalism was diagnosed based on a basal cortisol level of less than 400 nmol/l with or without overt signs and symptoms. Clinical and biochemical parameters of hypoadrenalism were compared between subjects with suboptimal and normal cortisol levels. Statistical analysis included Student's t test, ?[2] and Pearson's correlation coefficient tests. The prevalence of hypoadrenalism was 27% with a high occurrence of contributory factors [cytomegalovirus infection in 100% and tuberculosis in 68.2% of the study subjects]. Typical features of hypoadrenalism included: hyponatremia, 19.6%; hyperkalemia, 6.1%; mucosal hyperpigmentation, 12%, and loss of axillary hair, 15%. Comparison of clinical and biochemical parameters of hypoadrenalism did not show a correlation between CD4 count and cortisol levels [r = 0.1 and p = 0.3]. The prevalence of hypoadrenalism in our patients with HIV infection was high and the clinical features were comparable in subjects with normal and subnormal cortisol levels
ABSTRACT
Diabetes mellitus has been associated with increased risk of oxidative stress. There is limited information on the significance of an early marker of oxidative stress which can reflect the total antioxidative activity, especially in poorly controlled diabetes mellitus. The aim of this study was to establish association of glycaemic control determinants and total antioxidant activity and also to evaluate the frequency of occurrence of reduced antioxidant activity in poorly controlled glycaemia. This was a cross sectional study carried over three months. The study population consisted of two hundred type 2 diabetes mellitus patients attending the diabetic clinics of Lagos State University Teaching Hospital, Ikeja and General Hospital, Gbagada. These categories of patients were males and females between the ages of 40 and 60 years. Glycaemic control was assessed using fasting plasma glucose, fructosamine and glycosylated haemoglobin. Biochemical parameters were compared using students't test, Pearson's correlation coefficient and analysis of variance. This study demonstrated reduced total antioxidant activity in Nigerian diabetics in comparison with control subjects [p < 0.05] and was observed to be much lower in complicated diabetes mellitus patients. Consistent negative association of total antioxidant activity with short, medium and long term glycaemic control determinants fasting plasma glucos "r = -0.43, p = 0.001", fructosamine "r = -0.42, p = 0.002" and glycosylated haemoglobin "r = - 0.35, p = 0.030" was observed. The clinical usefulness of total antioxidant activity as a surrogate marker of glycaemic control is shown. This may be useful in the early detection of diabetic complications. Significant reduction of total antioxidant activity especially among diabetics with complications suggests a possible role of this in the pathogenesis of diabetic complications