Plasma fibrinogen and its correlates in adult Saudi population

To determine plasma fibrinogen and its correlates in the adult Saudi population and to investigate hyperfibrinogenemia as a possible risk factor for cardiovascular diseases [CVD]. A cross-sectional survey was designed and carried out through multi-stage stratified cluster random sampling of every third house in 6 heterogeneously populated districts of Riyadh, Kingdom of Saudi Arabia, during the period 1999 to 2002. Demographic and clinical data of 2263 adult Saudi subjects, consisting of 1934 [85.5%] men and 329 [14.5%] women, was collected through a standard questionnaire. Body mass index [BMI], blood pressure [BP] and history of smoking were recorded. Plasma fibrinogen, total serum cholesterol, triglycerides, high density lipoproteins [HDL] and blood sugar were determined in fasting blood samples. The majority [84.6%] of the subjects were between 20-50 years of age. The mean plasma fibrinogen was 336 +/- 115 mg/dl, and was increasing with age both in men and women. The mean +/- SD fibrinogen in women [357 +/- 118 mg/dl] was significantly higher [p value of 0.03] than men [332 +/- 114 mg/dl]. Hyperfibrinogenemia [>400 mg/dl] was indicated in 554 [24.6%] of the total subjects. Among hyperfibrinogenemic Saudi adults, the prevalence of hypercholesterolemia was 14.3%, hypertriglyceridemia 24%, obesity 26.3%, systolic/diastolic hypertension 11.5% and 11% and hyperglycemia 26% [in women only]. A reciprocal relation was observed between HDL and plasm fibrinogen. Significant positive correlation was seen between fibrinogen and BMI, systolic and diastolic BP and total cholesterol. There was no significant difference in the distribution of plasma fibrinogen between smokers and non-smokers [p value of 0.864]. The difference in the magnitude of metabolic as well as modifiable CVD risk factors between smokers and non-smokers was not significant, except serum triglyceride which was significantly higher in smokers than non-smokers [p value of 0.020]. A significant positive correlation was observed between hyperfibrinogenemia and obesity, systolic/diastolic hypertension and hypercholesterolemia. Our results thus support the earlier reports that hyperfibrinogenemia is a potential CVD risk factor. Unlike other reports, we could not find any correlation between smoking and plasma fibrinogen in our studied subjects. The value of hyperfibrinogenemia as a definite risk factor for CVD has to be quantified in future case-control studies comparing its significance between CVD subjects and normal controls

role of C.T. in Takayasu's disease: a case report and review of the literature

An aortogram and CT scan were performed on a sixteen year old African girl with a clinical diagnosis of Takayasu's arteritis. The aortogram revealed narrowing of the middle part of the descending aorta, the main branches of aortic arch and the mid-third portion of abdominal aorta with complete obstruction of the left renal artery. CT scan confirmed the angiographic findings of the thoracic aorta and it's main branches, but in addition, it showed thickening and increased density of the wall of the involved arteries and also revealed that the wall of the normal-looking lumen of the aorta on the angiogram was also thickened and dense. The same changes were noted in the wall of the SVC and the intrahepatic portion of IVC. Our patient showed a good clinical response to steroid therapy. Yet the follow-up CT, about 9 months after steroid therapy, revealed no reduction in the degree of thickness of the wall of the aorta although there had been an increase in peri-aortic infiltration around the aortic arch. It is suggested that CT scan could be used as a non-invasive technique in the follow-up of the case and to assess the response to treatment