Total and LDL combined vitamin E concentrations in plasma patient with non insulin dependent diabetes mellitus

Patients with diabetes mellitus are susceptible to oxidant-antioxidant imbalance. Diabetic complications such as nephropathy, neuropathy and retinopathy increase 'this susceptibility. Other traditional atherogenic risk factors such as hypertension, cigarette smoking and dyslipidemia can also induce oxidant stress. It is possible that the existence of two or more of the atherogenic risk factors may enhance oxidant-antioxidant imbalance. However, this proposal has not been fully studied. Aim: To determine plasma vitamin E concentrations, both total and the fraction within LDL particles in patients with sole noninsulin-dependent diabetes mellitus [N-1DDM] or N1DDM associated with one or more of the other risk factors of atherosclerosis. This study was conducted on 60 patients with NIDDM [32 males and 28 females]. They were classified into four groups: [1] sole diabetic [n=20], [2] diabetic-hypertensive [n=10], [3] cigarette smoking diabetic [n=10] and [4] diabetic with multiple atherogenic risk factors [n=20]. Also, twenty clinically healthy individuals were investigated as a control group. Vitamin E was measured by high performance liquid chromatography [HPLC] while a plasma thiobarbituric acid reactive substance [malondialde-hyde] was determined colorimetrically. Plasma total vitamin E [VE] and vitamin E in LDL [VE-LDL] concentrations were significantly decreased while plasma malondialdehyde [MDA] levels were significantly increased in sole N1DDM, diabetic hypertensive, smoking diabetic and diabetic with multiple atherogenic risk factors groups in comparison to the corresponding values of the control group. These changes were noted more frequently and more severely in patients with multiple risk factors than those with single DM or DM with another risk factor. In these groups, vitamin E content in HDL showed significant negative correlation with LDL-C concentrations and significant positive correlation with HDL-C concentrations. Multiple regression analysis showed that vitamin E in HDL particles was an independent risk factor for coronary heart disease. The subnormal vitamin E content in LDL panicles may be a result of enhanced LDL oxidation in patients

Serum leptin levels in patients with systemic lupus erythematosus and rheumatoid arthritis

Background: Leptin is a cytokine-like peptide produced mostly by adipose tissue and regulating food intake, basal metabolism and the B- oxidation of fatty acids. It has recently been recognized as a modulator of inflammatory and immune responses, with a possible significant role in the pathogenesis of several autoimmune diseases

Objective: to evaluate the serum leptin levels in patients with systemic Lupus erythematosus [SLE] and rheumatoid arthritis [RA], and its relation to disease activity and systemic complications of each disease

Subjects and Methods: Leptin was measured in the serum of 20 patients with SLE and 20 patients with RA and in 10 healthy control subjects of similar body mass index [BMI]. Each group of SLE and RA patients were subdivided into two subgroups according to disease activity. Clinical characteristics and disease activity score for both SLE and RA patients were assessed. Serum leptin levels [ng/dl] were measured using enzymelinked immunosorbent assay [ELISA]

Results: Both patients with SLE and RA had significantly higher leptin levels than healthy control subjects [38.27 +/- 27.66, 27.73 + 14.58 and 2.73 +/- 0.85 ng/dl respectively; P < 0.0001]. Patients with active SLE showed significantly higher leptin levels in comparison to inactive group [51.57 +/- 35.47 versus 26.62 +/- 10.92 ng/dl; P < 0.0001]. While as, there were no significant difference in serum leptin levels between active and inactive groups of RA patients. Moreover, significant positive correlation was detected between serum leptin levels and degree of proteinuria in lupus nephritis patients. However, no relation could be detected between serum leptin and any of the clinical or laboratory parameters in patients with rheumatoid arthritis

Conclusion: Serum leptin levels significantly increases in both SLE and RA patients, and related to markers of disease activity in SLE but not in RA patients. Moreover, increased serum leptin levels were found to be related to degree of proteinuria in SLE patients. These results suggest that leptin could play a role in the pathogenesis of inflammatory phenomenon and disease activity in patients with systemic lupus erythematosus. While as, the precise role of leptin in rheumatoid arthritis patients remains uncertain, thus further studies including serum and synovial leptin in RA patients are recommended

Bone mineral density and rheumatoid arthritis

Background: rheumatoid arthritis [RA] is one of the causes of secondary osteoporosis. Several studies showed that patients with R4 have number of risk factors for osteoporosis such as decreased physical activity, duration of disease, steroid use, and disease activity

Objective: to evaluate the bone mineral density in patients with rheumatoid arthritis considering the demographic characteristics of patients, disease activity and different modalities of drug therapy

Setting: department of Medicine, Mansoura Faculty of Medicine, Mansoura

Patients and Methods: the study comprised 87 patients with rheumatoid arthritis and 40 healthy control. All patients had reports about degree of physical activity, smoking habits, daily intake of milk products and history of fractures. Disease activity of RA was considered. All patients and control had BMD evaluated with DEXA

Results: BMD was significantly lower for women with RA compared with males with RA [0.359 +/- 6.89 versus 0.451 +/- 4.06] and in postmenopausal compared with premenopausal women with RA [0.325 +/- 7.57 versus 0.421 +/- 5.66]. Age and cigarette smoking negatively correlated with BMD while daily intake of milk products and daily physical activity showed positive correlation with BMD. All markers of disease activity were negatively correlated with BMD. As regards the drug therapy, BMD did not significantly dipper between treated groups. BMD was reduced in RA patients with history of fracture than in patients without history of fracture, [0.351 +/- 7.25 versus 0.37 +/- 5.38] however, these differences were not statistically significant

Conclusion: BMD loss is greater in RA patients than in sex and age-matched healthy controls. Age, disease activity and lack of physical activity or inadequate intake of milk products are markers to patients at increased risk of osteoporosis