Evaluation of polypeptide YY and ghrelin in complicated type 2 diabetic patients

The gut peptides polypeptide YY [PYY], [a potent satiety agent] and ghrelin [a potent hunger signal] are suggested to play a role in obesity. Obesity is commonly associated or complicated with hypertension [HT] and type 2 diabetes [T2D]. Thus, the current study aimed to: [i] estimate the fasting plasma levels of PYY and ghrelin in lean versus overweight subjects as well as overweight HT and T2D subjects, [ii] assess if PYY and ghrelin are affected by the glycemic state; and [iii] intercorrelate the levels of PYY and ghrehn considering insulin sensitivity, blood pressure values and lipid profile in HT and/or T2D subjects. Twelve lean healthy male subjects [group I] and fifty eight overweight, age and sex matched subjects [group II] were included in the present study. Group II [overweight group] was further sub classified into: [i] group IIa: normoglycemic normotensive subjects [n=14]; [ii] group IIb: T2D normotensive patients [n=18]; [iii] group IIc: normoglycemic HT patients [n=14]. Fasting plasma lipid profile, glucose [FG], insulin [Fl]. PYY, ghrelin and blood glycated hemoglobin A1C [HbA1C] were estimated. Insulin sensitivity was evaluated according to the homeostatic model assessment [HOMA] index. In the present study significantly lower mean plasma levels of both ghrelin and PYY were observed in all overweight groups versus the lean control group. The hypertensive and T2D groups, also, showed lower PYY and ghrelin levels compared to the over-weight normotensive normoglycemic group. Furthermore, in hypertension T2D group both present, both PYY and ghrelin levels showed further decrease. Ghrelin correlated positively with high density lipoprotein cholesterol, HDL-c [r=0.43, p<0.01]. Both ghrelin and PYY correlated negatively with BMI, FG, Fl, HbA1c, HOMA index, low density lipoprotein cholesterol [LDL-c] and mean arterial blood pressure [r=0.52, r=0.62, r=-0.73, r=-0.71, r=-0.76, r=-0.42, and r=-0.5. p<0.01 respectively for ghrelin: and r=-0.51, r=-0.61, r=-0.62, r=-0.39, and r=-0.48, p<0.05 respectively for PYY]. In controls, PYY and ghrelin were negatively correlated [r=-0.76, p<0.001]. However, in all groups of patients studied, they were positively correlated [r=0.64, p<0.001], Multiple regression analysis revealed that low ghrelin and PYY concentration were independently correlated to BMI [p=0.002, and p=0.009 respectively]. Low ghrelin was, also, independently correlated to FI [i.e., hyperinsulinemia] [p=0.04]. In the diabetic groups both PYY and ghrelun levels were lower in patients with poor glycemtc control versus controlled diabetics, as assessed byHbA1C. Thus, from the current study it could be concluded that low PYY and ghrelin levels may play a role in the pathogenesis of obesity, hypertension and T2D. Combination of a ghrelin antagonist [a hunger signal antagonist] and PYY [a satiety signal] is potentially and attractive therapeutic strategy for treatment of obesity and its complications

Basic fibrolast growth factor and vascular endothelial growth factor levels as pulmonary biomarkers of chronic obstructive pulmonary disease

There has been increasing interest in using pulmonary biomarkers to understand and monitor the inflammation in the respiratory tract of patients with chronic obstructive pulmonary disease [COPD]. The aim of this study is evaluating circulating basic fibroblast growth factor [bFGF] and vascular endothelial growth factor [VEGF] levels to determine the value of these growth factors as biomarkers of COPD and as indicators of severity of COPD in patients with chronic obstructive pulmonary disease in comparison to the inflammatory cytokines, C-reactive protein [CRP], tumor necrosis factor- alpha [TNF- alpha and interleukin-6 [IL-6]. Also, to determine if there is a correlation between circulating levels of VEGF and bFGF and pulmonary function [FEV1]. The study included 86 patients with chronic obstructive pulmonary disease [COPD], Besides 20 healthy, age matched males with normal pulmonary function were included as controls. The patients were divided into 5 stages according to lung function measured by spirometer [FEV1% predicted]. All patients were subjected to determination of FEV1 and determination of circulating bFGF, VEGF. TNF- alpha CRP and IL-6. The results showed that the concentration of circulating bFGF, VEGF, TNF- alpha, CRP and IL-6 were significantly higher in patients with CORD in comparison to the control group and their levels increased according to the stage of disease. There was a negative correlation between the blood levels of VEGF and bFGF with FEV1 in the different stages of COPD [p<0.05]. Also, there was a strong positive correlation between VEGF and bFGF [p<0.05]. In conclusion, bFGF and VEGF could play an important role in the pathogenesis of COPD and could be considered as a reliable and early biomarker in the diagnosis of COPD

Prognostic value of interleukin-6 [IL-6] and tumor necrosis factor-alpha [TNF-alpha] in Egyptian patients with breast cancer

The study was conducted on 41 females selected from National Cancer Institute, Cairo University, Surgery Department. The patients were divided into two groups. Group I included 21 clinically established breast cancer patients in early stage [I or II] and Group II included 20 clinically established breast cancer patients in late stage [III or IV]. Beside 20 healthy females were included as control group. The aim of the present work is to assess the prognostic value of pre and postoperative IL-6, TNF-alpha and to investigate the relationship between these parameters and the serum inflammatory parameter [ESR]. The results showed that non-significant changes were found in the serum levels of IL-6 and TNF-alpha in early cases before and after surgery when compared to control group, while ESR value was significantly increased before and after surgery [p<0.01] and [p<0.05] respectively. Both IL-6 and TNF-alpha showed non-significant changes on comparing early cases group before and after surgery, while ESR values showed a significant decrease after surgery [p<0.01]. In late cases, levels of IL-6, TNF-alpha and ESR were highly significantly increased before surgery, [,p<0.001] for all parameters when compared to the control group. After surgery, this increase was still highly significant for IL-6, TNF-alpha and ESR [p<0.001, <0.01, <0.01] respectively when compared to controls. Comparing, TNF-alpha and ESR before and after surgery in group II, our results showed significant decrease [p < 0.05] for both parameters. While IL-6 showed highly significant decrease [p<0.001]. In conclusion, the preoperative serum levels of IL-6, TNF-alpha, and ESR significantly increased with advanced stages of breast cancer. So, IL-6 and TNF-alpha may be considered as promising additive prognostic parameter for breast cancer

Biochemical assessment of E selectin and von willebrand factor as markers of atherosclerosis damage in Egyptian hypertensive patients

The aim of the present study was to evaluate levels of von Willebrand Factor and E-selectin in essentional hypertensive patients, before and after successful hypertension therapy, although correlated them with other traditional atherosclerosis risk factors [lipid parameters, blood pressure values and BMI] as well as an attempt to answer the question whether Von willebrand factor and E-selectin can be useful in predicting atherosclerosis in essential hypertensive patients. The study was conducted on 30 essential hypertensive patients before [GI] and after [GII] hypertensive therapy, in addition to 15 healthy age and sex matched normotensive adults as a control group. All members of the study were subjected to: Throughout clinical examination, Liver function tests. Kidney function tests. Determination of body mass index, Blood pressure measurements, in addition to evaluation of levels of fasting and post prandial blood sugar, total cholesterol, HDL-chole, LDL-chole, triglycerides, E-selectin in serum and plasma vonWillebrand Factor. The results of the study showed a significant elevation in serum cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides and plasma vonWillebrand Factor in GI [essential hypertensive patients before hypertension therapy] and GIl [essential hypertensive patients after hypertension therapy] as compared to control group. There was a significant reduction in the elevated parameters after 6 months ofantihypertension therapy. The plasma vWF level showed a positive significant correlation with body mass index [BMI] in all studied groups [GI, GII and C]. The levels of E-selectin showed a non significant in GI and GII as compared to control group. The plasma vWF, serum T.cholesterol, LDL-cholesterol. and triglycerides in essential hypertensive patients were higher than those in normotensive control. Also, plasma vonWillebrand Factor had a positive significant correlation with body mass index [BMI] in all studied groups [an important atherosclerotic risk factor], So, WFcould play some role in pathogenesis ofendothelial damage in essential hypertensive patients, it can be used as a complementry test with T.cholesterol, LDL-cholesterol and triglycerides to detecte essential hypertensive patients at risk of atherosclerosis.