The relationship between vitamin D deficiency and NAFLD in sample of Egyptian type 2 diabetic patients

Background: vitamin D deficiency has a strong association with insulin resistance and NAFLD.Objective: to assess vitamin D levels in patients having type2 diabetes with NAFLD and to study its relationship withinsulin resistance. Patients and methods: a case­control study conducted on 50 subjects who were divided into 2 groups: 35 patients having T2DM and NAFLD (group 1) and 15 healthy subjects served as control (group 2). Fasting plasma glucose (FBG), 2 hour post prandial (2hrpp), and fasting plasma insulin (FPI) were measured with calculation of HOMA-IR. Fasting lipids, Hb A1c, calcium, phosphorus, urea, creatinine, serum alanine aminotranseferase (ALT), aspartate aminotransaminase (AST) were also measured. BMI was calculated, serum 25 (OH)D was measured with ELISA and abdominal ultrasonography was done for all participant. Results: the study showed lower level of vitamin D in patients with T2DM and NAFLD 10.6 (5.5-21.3) as compared to control group 31 (27-39.7). While non-significant difference was found between male and female regarding 25(OH) D level and HOMA-IR. There was significant negative correlation between vitamin D level and HOMA-IR. Conclusion: Vitamin D level was associated with presence of NAFLD. There was strong relation between vitamin D level and insulin resistance as vitamin D deficiency was associated with higher levels of HOMA-IR. Obesity may be related to low vitamin D level, but no difference in VD level between males and females was found

Evaluation of adipocyte function in women with polycystic ovaries

Background: Leptin acts mostly as a signaling factor from adipose tissue to central nervous system regulating food intake. Adiponectin and Resistin produced by adipose cells may have a role in preventing the development of insulin resistance. Polycystic ovary syndrome [PCOS] is characterized by insulin resistance and 50% of women affected are obese

Aim of work: To study adipo-cytokines secretion in women with Polycystic Ovary Syndrome and correlate results with insulin resistance

Subjects and Methods: Thirty-two women with PCOS and matched controls were studied; three adipocytokines were measured compared with controls. Diagnosis of PCOS based on the classic criteria of hyperandrogenism and chronic anovulation. PCOS patients mean age was 26.2+/-1 years and Body Mass Index [BMI] mean was 28.7+/-0.7. years Controls of 20 women mean age 25.1+/-0.7 yrs and mean BMI 28.5+/-0.5. Normal ovulation was assessed by serum progesterone [20nM/l] on days 22-23 of menstrual cycle. Controls and PCOS were subdivided into groups of normal weight [BMI 25]; overweight [BMI 25-30], and obese [BMI 30]. Fasting blood samples used during the follicular phase [08:00-09:00 hr] for measurements of LH, FSH, insulin, glucose, leptin, adiponectin, and resistin using RIAs and EIAs. Insulin resistance was calculated by the quantitative insulin-sensitivity check index [QUICKI]

Results: PCOS women had increased insulin level [19.2 +/- 1.1] [P= 0.01] also a lower QUICKI values than controls [19 +/- 0.5] [P= 0.00], but obese women had a greater degree of insulin resistance. The entire PCOS group had lower levels of adiponectin [8.2 +/- 0.6] [P= 0.05] and higher levels of resistin [6.1 +/- 0.4] [P= 0.05] while leptin levels were not significantly different than controls. Leptin was only significantly higher in the obese group [BMI 30] compared with normal. However, adiponectin correlated only with BMI [r 0.58, P=0.05] but not with insulin [r 0.03] nor with QUICKI [r 0.02], and resistin did not correlate with any of these parameters. Leptin maintains its correlations with BMI, insulin and QUICKI [r=0.72, 0.54 and 0.63, P= 0.01, =0.05 and =0.01 respectively]

Conclusion: Circulating adipo-cytokine levels were different resulting in higher leptin and lower adiponectin, being the most marked change, shows similar levels with no marked change of resistin with increasing BMI. These alterations may due to altered adipose tissue function in women with PCOS, which occurs even with normal BMI

Anthropometry and breast cancer risk

There is a growing interest on the relation of anthropometry and breast cancer. The main objective of this study was to clarify this relation, taking into account the influence of menopausal status and the implication of lipoproteins and estrogen levels. A hospital based, age matched, case-control study was conducted on a total sample of 164 women [80 cases and 84 controls]. Cases were found to have significantly greater body weight and body mass index [BMI] and to be of long stature than their controls. A clear direct trend of increasing odds ratios for postmenopausal breast cancer risk as weight and BMI increased was observed, while a risk reduction with increasing weight and BMI was noticed for pre-menopausal women. A significant trend of positive association between height and breast cancer risk was demonstrated for both pre-and post-menopausal women; but it was more pronounced for post-menopausal cancer. Abdominal adiposity was also found to be associated with an increased risk of pre-and post-menopausal breast cancer. Additionally, it was ascertained that as BMI elevated, estrogen levels had decreased in pre-menopausal women; but increased in post-menopausal [P>0.05]. High Density Lipoprotein [HDL] also decreased with increasing BMI in pre-menopausal[P>0.05]; while both Low Density Lipoprotein[LDL]and triglyceride levels were increased as BMI increased in pre-and post-menopausal women. It appears that women who heed public health messages to maintain a healthy weight will lower their breast cancer risk