Carotid doppler ultrasonography in patients with co-existing type 2 diabetes mellitus and hypertension in Nigeria

Background:The co-existence of diabetes mellitus (DM) and hypertension (HTN) has been rising globally with subclinical atherosclerotic complications. These vascular changes can be detected using carotid ultrasonography. Objectives: To determine and compare the carotid arterial structural wall changes and blood flow velocities of adults with co-existing DM and HTN with age-and sex-matched non-diabetic, non-hypertensive controls. Methods: A cross-sectional comparative study of 300 participants comprising 200 adults with co-existing DM and HTN and 100 age-and sex-matched controls was done. Their carotid arteries were examined bilaterally for plaques, carotid intima media thickness (CIMT) and flow velocities ­peak systolic velocity (PSV), end diastolic velocity (EDV), pulsatility index (PI) and resistive index (RI) using 4­12MHz linear array transducer. Visceral obesity and serum lipids were also assessed. Results: The mean age of the subjects was 56.13 ± 6.93 years; they comprised 38% males and 62% females. The subjects' CIMT was statistically significantly higher (p = 0.001) with a three-fold mean increase (45.5%) compared to the controls (13.7%). Lower flow velocities but higher indices were also observed in the subjects. Strong and significant correlations were observed between EDV and PI r =-0.663, p=>0.001), EDV and RI (r = -0.661, p=>0.001) and PI and RI (r =0.988, p= >0.001)among the subjects. Conclusion: Significant reduction in flow velocities with increased CIMT may be an early indication of subclinical atherosclerosis. Therefore, carotid ultrasonography should be mandatory in individuals at risk for early detection and possible prevention of atherosclerotic complications.

Vitamin D Levels and Insulin Resistance among Nigerian men with Type-2 Diabetes mellitus

Background: A number of studies have shown a high prevalence of insufficient vitamin D levels in humans in the North American, European and Asian regions. Various research works have also shown that low serum vitamin D levels play a major role in the pathogenesis of chronic, non-infective illnesses such as diabetes mellitus and cancer.Objective: This study was aimed at assessing the serum vitamin D status in relation to glucose homeostasis among men with Type-2 Diabetes mellitus and normal controls.Methods: This comparative cross-sectional study included 80 men with confirmed diagnosis of Type-2 diabetes mellitus and 49 normal adult male controls. Serum 25-hydroxy vitamin D, fasting serum C-peptide and fasting plasma glucose levels were measured in both study groups.Results: There was a significant difference between the mean serum 25-OH vitamin D levels among the cases (36.55ng/mL) and the controls (42.96ng/mL) (p = 0.001). All the four 25-OH vitamin D-deficient subjects had diabetes. In the diabetes group, 43.8% had a normal insulin resistance compared to 61.8% of the control group (p = 0.054). In the diabetes group, 73.8% had sufficient vitamin D, 21.2% had insufficient vitamin D and 5% had vitamin D deficiency. In the control group, there was a significant negative correlation between serum 25-OH vitamin D and BMI and fasting plasma glucose. The mean HOMA2IR value for the diabetes group (3.09) was higher than the value for the controls (2.40).Conclusion: The mean serum 25-OH vitamin D level in the diabetes group was lower than that of the control group hence, hypovitaminosis D may be a contributor to the onset of diabetes mellitus among Nigerian men

Plasma Micronutrients (magnesium, zinc, selenium) Status and Lipid Profile in Type II Diabetes Mellitus Patients in Sagamu, Southwestern Nigeria

Background: Diabetes mellitus (DM) is a group of metabolic disorders characterised by hyperglycemia with secondary derangements in micronutrient status. Various studies had given conflicting reports of increased or decreased levels of micronutrients in Type II DM.Objective: To measure the plasma micronutrient levels and lipid profile in adults with Type II DM.Method: Plasma magnesium, zinc and selenium levels were measured among 100 subjects comprising 50 people with DM (age range 36-70 years) and 50 control subjects without DM (age range 29-70 years). The anthropometric parameters were measured; fasting blood glucose, plasma cholesterol, triglycerides, and high-density lipoprotein cholesterol, micronutrients (magnesium, zinc and selenium) levels were also measured using standard methods.Result: There were statistically significant (p < 0.05) higher plasma glucose, blood pressure (systolic and diastolic), LDLC, and lower levels of plasma magnesium, zinc, selenium, HDLC levels among the patients with DM (cases) compared with the normal control subjects. No significant difference was observed in the plasma total cholesterol and triglyceride between the two groups. A significant negative correlation was found between the plasma levels of the trace metals (magnesium, zinc and selenium) and triglycerides (r = - 0.36, r = - 0.43, r = - 0.51 respectively).Conclusion: Plasma levels of magnesium, zinc and selenium are reduced in Type II DM with associated hyperglycaemia-driven dyslipidaemia

Association of Plasma Lead with Iron Indices and Complete Blood Count among Male Bricklayers in Ibadan, Oyo State.

Background: Analysis of cement dust by various investigators has revealed that its contents include mercury (Hg), copper (Cu), chromium (Cr), cadmium (Cd), Nickel (Ni), Manganese (Mn) and lead (Pb). Few studies done among cement factory workers in Nigeria showed conflicting results in haematological parameters which could not be related to any particular heavy metals. This necessitated the need for this study. Objective: This study aims to relate lead level with iron indices and complete blood count among bricklayers. Methods: Comparative cross sectional study among 45 bricklayers and 45 age and sex matched tailors. Questionnaire was administered to find out occupational practice. Plasma was analyzed for lead by Atomic Absorption spectrometer (AAS) while serum was analyzed for ferittin and iron by ELISA and photometric method respectively. Total Iron Binding Capacity (TIBC) and percentage Transferin saturation (%TFS) were derived by calculation while complete Blood Count (CBC) was determined using a Sysmex Kx21 auto-analyser. Results: Eighty seven percent of the bricklayers practice their profession without protective coverings. There was a significant increase in the plasma level of lead (p=.00) but decrease in ferrittin among bricklayers compared with controls (p=.00). Bricklayers with blood lead level above acceptable level (5 µg/dl) had significantly reduced ferittin (p=0.04). Conclusion: In this study showed a relatively lower serum ferritin level among bricklayers which was more pronounced with increasing lead level. This may suggest depletion of iron store with increasing lead level. The use of protective measures such as gloves, facemasks and protective garments when in contact with cement and regular medical checkups to prevent depletion of iron store and its consequences are hereby suggested.