role of autoantibody and antioxidant enzymes in patients with type 1 diabetes

To determine autoantibodies and antioxidant enzymes as well as the correlation between them. This study included 80 individuals, 40 patients with type 1 diabetes and 40 healthy individuals without diabetes [as a control group]. The study was carried out during the period from December 2010 to the end of December 2012 at Al-Tahreer General Hospital, Al-Basra Maternity and Pediatric Hospital, and Al-Sader Teaching Hospital. Laboratory investigations were performed to estimate glutamic acid decarboxylase antibody [GADA] and islet cell antigen-2 antibody [IA-2A] by enzyme-linked immunosorbent assay [ELISA], antioxidant enzymes [glutathione peroxidase [GPX] and superoxide dismutase [SOD]], and glycosylated hemoglobin [HbA1c] [as a marker of glycemic control] for these patient and control groups. The high prevalence of GADA and IA-2A had been demonstrated among patients with type 1 diabetes, which was significantly higher [P < 0.001] [72.5%] in comparison to 0% in the control group. These results are suggestive of the autoimmune characteristic of type 1 diabetes. The age of onset of type 1 diabetes is found to affect the frequency of these autoantibodies. The frequency was significantly higher in patients who developed the disease in early childhood [91.7% for GADA and 58.3% for IA-2A] in comparison with those who developed the disease later on [40% for GADA and 20% for IA-2A]; this probably occurred due to genetic and non-genetic factors. Although the statistical analysis of the correlation between gender and autoantibodies showed no significant difference, female patients with type 1 diabetes were found to be more affected than male patients. The frequency of these autoantibodies was found to decrease as the duration of type 1 diabetes increased. The prevalence of GADA and IA-2A in patients with duration of disease less than 5 years was 78.3% and 43.5%, respectively, and began to decrease to 0% for GADA and IA-2A in those with disease duration more than 12 years. These results are attributed to the depletion of islet cell autoantibodies with time. Additionally, HbA1c levels were significantly higher in islet cell autoantibodies-positive patients than in islet cell autoantibodies-negative patients [P < 0.001]. The difficulty in achieving glycemic control despite oral hypoglycemic drug and insulin therapy is attributed to the fact that the pathogenesis of disease in developing type 1 diabetes and latent autoimmune diabetes [LADA] in adults is due to beta-cell destruction rather than insulin resistance as in classical type 2 diabetes. The mean activity of both antioxidant enzymes [SOD and GPX] in red blood cells [RBCs] was significantly lower than the control [P < 0.001]. Also the lower mean activity of both antioxidant enzymes [SOD and GPX] in RBCs showed a higher significant value in patients who had uncontrolled diabetes [HbA1c level > 8%] [P < 0.001]. Patients with LADA who were tested positive for GAD and IA-2A showed a significant decrease in the mean activity of SOD and GPX in comparison to patients with type 2 diabetes who were tested negative to autoantibodies; most of the patients with LADA also had a higher HbA1c level > 8% [P< 0.001]. There is a strong evidence of the role of autoimmunity in the pathogenesis of type 1 diabetes. The oxidative stress SOD and GPX are depleted as well. The correlation reflects the more oxidative stress with poor diabetic patients may progress the complications

Evaluation of lipid and lipoprotein profile in patients with insulin dependent diabetes mellitus

Dyslipoproteinaemia is one of the several risk factors linked to diabetic complications. To determine the changes in lipid and lipoprotein profile in patients with insulin dependent diabetes mellitus [IDDM]. Sixty-four IDDM patients [28 males and 36 females] and 120 control subjects [35 males and 85 females] were included in this prospective study. In patients and controls, serum concentrations of glucose [fasting blood sugar [FBS]], total cholesterol [TC], high density lipoprotein-cholesterol [HDL-C], low density lipoprotein-cholesterol [LDL-C], triglyceride [TG], and very low density lipoprotein- cholesterol [VLDL-C] were measured. In patients with IDDM,TC [p 0.01] LDL-C TG, VLDL-C serum levels [P< 0.05] and LDL-C / HDL-C ratio [P< 0.001] were significantly higher, and serum HDL-C level [P < 0.001] was significantly lower in comparison to control subjects. In males, serum HDL-C concentration [P< 0.05] was significantly lower in IDDM patients compared to controls, whereas, no significant differences seen in TC,LDL-C, TG,VLDL-C and LDL-C /HDL-C ratio among patients and control subjects [P> 0.05]. In females, IDDM patients have significantly higher serum levels of TC,TG [P< 0.05], VLDL-C [P< 0.05], LDL-C [p 0.01] and LDL-C/ HDL-C ratio [P< 0.001], and significantly lower serum HDL-C level [P< 0.001] compared to controls. IDDM patients are at a greater risk of dyslipidemia than normal individuals, and females are more prone than males, and hence, would be more susceptible to atherosclerosis and coronary artery disease [CAD]

Hyponatremia in children with acute central nervous system diseases

Hyponatremia is a common electrolyte disturbance and its potential neurological sequelae make its differential diagnosis mandatory before any therapeutic intervention. The study was conducted to estimate the frequency of hyponatremia among children hospitalized with acute cerebral insult and to look for the possible causes of hyponatremia. Prospective case-control study. Basrah maternity and children hospital. Case-control study performed on 150 children [87 boys and 63 girls], during 9 months [from the first of October 2003 till the end of June 2004]. Their ages ranged from 2-108 months. Seventy five of them presented with acute central nervous system [CNS] manifestations, while the rest were considered as control. Serum sodium, potassium, glucose and urea nitrogen were estimated and serum osmolality was calculated. In addition, urinary sodium, potassium, glucose, urea and creatinine determination was done, and urine osmolality was calculated. Eight of 75 pediatric patients [10.7%] with acute CNS diseases had hyponatremia syndrome, 3 of which were diagnosed with inappropriate antidiuretic hormone secretion. Another 2 patients showed signs of dehydration and evidence of cerebral salt wasting. In the remaining 3 patients the clinical and laboratory data were insufficient for further classification. The highest percentage of hyponatremia [3 out of 6 patients; 50%] was found in patients with intracranial diseases. Four out of 38 patients [15.5%] presented with CNS infections. Mean serum levels of glucose, sodium and osmolality were significantly lower in all patients with acute CNS diseases compared with the control, while urinary urea and osmolality levels were significantly higher in those patients as compared with the control group. The study showed that there was a significant decrease in the mean serum level of glucose, sodium and osmolality in hyponatremic patients compared to non-hyponatremic patients. There was also a significant increase in urine sodium/creatinine ratio, urea, and osmolality in hyponatremic patients compared to non-hyponatremic patients. The study has demonstrated that serum urea was significantly higher in patients with cerebral salt wasting compared to those with syndrome of inappropriate antidiuretic hormone secretion. In addition to that, the 3 groups of hyponatremia have significant differences in the mean urine sodium, urea, osmolality and serum osmolality. From this study, we may conclude that hyponatremia is not uncommon in patients with acute central nervous system [CNS] insults. Serum sodium should be routinely monitored in these patients to enable early diagnosis and treatment of hyponatremia

Cardiovascular risk factors among college students

Cardiovascular diseases [CVD] are the leading causes of death worldwide. Their incidence particularly coronary heart diseases [CHD] are increasing among young adult. Few data exist on the prevalence of risk factors in young adult college students. To determine the prevalence of CVD risk factors among young adult college students. Two Hundred and thirty-two questionnaires covering socio-economic aspects, physical activity, diet, smoking, personality, and parental history of CHD death were reviewed. In addition, clinical examination, biochemical analysis of lipid profile were done. All were students asymptomatic for CVD, 36 [15.5%] were smokers, 92 [39.6%] consumed mostly fatty diet, 17 [7.3%] were obese. 22 [9.5%] were physically inactive, 24 [10.3%] had positive parental history of CHD death, 49 [21.1%] had type A personality, 5 [2.2%] had diabetes mellitus, 13 [5.6%] had systolic blood pressure > 140 mmHg, and 20 [8.6%] had diastolic blood pressure > 90 mmHg. The prevalence of smoking and physical inactivity was significantly higher among men than women. While obesity and parental history of CHD death were significantly more prevalent among older age group [> 30years] than in younger age group [<30 years]. High serum cholesterol level was prevalent in 17 [7.3%], low level of HDL-C in12 [5.2%], high levels of LDL-C in 11 [4.7%], and high triglycerides level in5 [2.2]. Low level of apo A was prevalent in 28 [16.2%] of men and 9 [15.3%] of women, while high level of apo B was prevalent in 12 [6.9%] of men compared to 2 [3.4%] of women. The prevalence of abnormal levels of HDLC, TC/DL and LDL/HDL ratios were significantly higher among older age group [>/= 30years] than in younger subjects [<30 years]. No significant difference in the prevalence of lipid risk factors was noted between men and women. Many CVD risk factors were prevalent among apparently healthy young college students. Those young adult people may be more at risk from subsequent CVD than was expected

Lipid profile changes in hyperthyroidism

The change in serum concentrations of total cholesterol [TC], low density lipoprotein-cholesterol [LDL-C], high density lipoprotein-cholesterol [HDL-C], and triglycerides [TG] were investigated in 119 patients with hyperthyroidism [22 males and 97 females] from Barsrah, Iraq. The results were compared with that of 132 euthyroid controls [22 males and 110 females]. Serum TC concentration was significantly lower in hyperthyroid male [P<0.01] and female [P<0.001] patients as compared with controls. Also, the serum concentration of HDL-C was significantly lower in male [P<0.001] and female [P<0.001] patients with hyperthyroidism than in controls. The serum concentrations of LDL-C and TG were lower among hyperthyroid patients in comparison with controls. However, this difference was only significant for females [P<0.05] for LDL-C and [P<0.01] for TG, whereas it was not significant for males [P<0.05]. The metabolic effects of thyroid dysfunction on lipid metabolism were discussed

Serum bilirubin levels in neonates and children from Basrah

Serum bilirubin levels were estimated in normal healthy newborns [199]; full term babies [70] aged between 24 and 120 hours and 199 children aged between 1 month and 15 years. The mean [and standard deviation] of cord blood serum bilirubin was 1.3 [0.54] mg/dL. Serum bilirubin from full term babies and children was 4.68 [2.0] mg/dL and 0.71 [0.34] mg/dL respectively. There was no significant differences between males and females in all age groups, except in full term babies at the fifth day of life [p = 0.01]. These data could be used as initial values for the concentration of serum total bilirubin in Iraqi newborns, infants and children