ABSTRACT
To assess the plasma levels and relations of adipocytokines and biochemical bone markers in type 2 diabetes mellitus [T2DM] Saudi males with insulin resistance. This case-control study included 80 overweight/obese males with T2DM on oral anti-diabetic medications recruited from the diabetic center and 40 healthy lean males of matched age. Measurements included fasting plasma glucose [FBG], fasting plasma insulin, serum calcium [Ca[2 +]], HbA1c, plasma adiponectin and resistin, serum bone-specific alkaline phosphatase [B-ALP], plasma osteocalcin [OC], and plasma osteoprotegerin [OPG]. Waist and hip circumferences were measured. Body mass index, waist/hip ratio [WHR], and insulin resistance [HOMA-IR] were calculated. Compared to the control group, diabetic patients showed significantly both lower adiponectin [p = 0.000] and Ca[2 +] [p = 0.000] but significantly higher resistin [p = 0.000], OC [p = 0.000], B-ALP level [p = 0.000] and OPG [p = 0.000]. After multivariate adjustment in diabetic patients, resistin predicted OC, [beta = -0.30, p = 0.005], WC and resistin predicted Ca[2+] [beta = -0.34, p = 0.035 and beta = -0.25,p = 0.033], adiponectin and resistin predicted B-ALP, [beta = -0.35, p = 0.010 and beta = 0.35, p = 0.004], and FBG, HOMA-IR and age predicted OPG, [beta = -0.66, p = 0.010, beta = 0.58, p = 0.024 and beta = 0.27, p = 0.031 respectively]. Also, FBG, WHR and HOMA-IR predicted adiponectin [beta = -0.79, p = 0.001, beta = -0.60, p = 0.001 and beta = 0.80, p = 0.001 respectively], while OC and OPG predicted HbA1c [beta = -0.32, p = 0.007 and beta = 0.28, p = 0.016 respectively]. Uncontrolled T2DM Saudi males with insulin resistance have abnormal bone markers with unfavorable levels of adipocytokines. Strong associations between bone markers, adipocytokines, insulin resistance and metabolic control may suggest interaction in multiple direction feedback loops exacerbating hyperglycemia
ABSTRACT
Lack of coronary artery disease [CAD] risk factors [RFs] knowledge and orientation among physicians would indicate a defect in their attitude towards primary preventive strategies. To assess the prevalence and the awareness of self-reported major and life-style CAD risk factors among physicians working in Medina, Saudi Arabia. A cross-sectional survey was conducted from May 2008 to January 2009 to screen a stratified random sample of 209 physicians aged 41.8 +/- 9.1 years. Using a p re-coded questionnaire, the prevalence and awareness of CAD major and life-style RFs were self-reported by the participants. Life-style RFs were more prevalent than major RFs among physicians [86% Vs 48.8%], 41.2% of the physicians were having combined RFs increasing their future risk of CAD. Female physicians lost their gender protection despite being significantly younger than males [39.9 +/- 8.1 Vs 42.6 +/- 9.4 years, p < 0.00], however they had longer duration of diabetes [6.7 +/- 6.4 vs 5.6 +/- 4.3 years, p < 0.000] and hypertension [8.5 +/- 6.8 Vs 7.98 +/- 7] years, p < 0.00]. Less than 10% of physicians were unaware of their serum lipids with no gender difference. Physicians were likely to be aware of their serum lipids if they had hypertension [p = 0.3] or family history of diabetes [p = 0.04]. While physicians who were unaware of their serum lipids tend to consume more dairy products [P = 0.02]. Life-style RFs are prevalent among physicians working in Medina together with substantial unawareness of their lipid profile this indicates a need for increasing their awareness about lipid screening programs and initiating healthy lifestyle modifications as essential primary preventive strategies to minimize their future risk of CAD