ABSTRACT
Fertility in the male is dependent on the proper production of sperm cells. This process, called spermatogenesis is very complex and involves the synchronization of numerous factors. The presence of pro-inflammatory cytokines, tumor necrosis factor- alpha [TNF-alpha], interleukin-1 alpha [IL-1 alpha] and interleukin 1 beta [IL-1 beta] cytokines in the male reproductive tract [testis, epididymis and sperm] may have certain physiological functions. However, when the levels of these cytokines are higher than normal, as seen in conditions of inflammation, they become very harmful to sperm production. Moreover, inflammation is also associated with oxidative stress and the latter is well known to impair sperm function. Epidemiological studies regarding male infertility have revealed that more and more infertile men suffer from acute or chronic inflammation of the genitourinary tract, which often occurs without any symptoms. The inflammatory reactions within the male genital tract are inevitably connected with oxidative stress. Oxidative stress, especially in sperm, is harmful because it damages sperm DNA and causes apoptosis in sperm. This article reviewed the suggested mechanisms and contribution of inflammation to male infertility. In addition, the review was further strengthened by discussing how inflammation affects both fertility and assisted reproductive technologies [ART]
ABSTRACT
Diabetes mellitus has been associated with increased risk of oxidative stress. There is limited information on the significance of an early marker of oxidative stress which can reflect the total antioxidative activity, especially in poorly controlled diabetes mellitus. The aim of this study was to establish association of glycaemic control determinants and total antioxidant activity and also to evaluate the frequency of occurrence of reduced antioxidant activity in poorly controlled glycaemia. This was a cross sectional study carried over three months. The study population consisted of two hundred type 2 diabetes mellitus patients attending the diabetic clinics of Lagos State University Teaching Hospital, Ikeja and General Hospital, Gbagada. These categories of patients were males and females between the ages of 40 and 60 years. Glycaemic control was assessed using fasting plasma glucose, fructosamine and glycosylated haemoglobin. Biochemical parameters were compared using students't test, Pearson's correlation coefficient and analysis of variance. This study demonstrated reduced total antioxidant activity in Nigerian diabetics in comparison with control subjects [p < 0.05] and was observed to be much lower in complicated diabetes mellitus patients. Consistent negative association of total antioxidant activity with short, medium and long term glycaemic control determinants fasting plasma glucos "r = -0.43, p = 0.001", fructosamine "r = -0.42, p = 0.002" and glycosylated haemoglobin "r = - 0.35, p = 0.030" was observed. The clinical usefulness of total antioxidant activity as a surrogate marker of glycaemic control is shown. This may be useful in the early detection of diabetic complications. Significant reduction of total antioxidant activity especially among diabetics with complications suggests a possible role of this in the pathogenesis of diabetic complications
ABSTRACT
To determine the frequency of hyperfibrinogenaemia, elevated C-reactive protein, hyperuricaemia and elevated lipoprotein A in a clinic population of patients with type 2 Diabetes mellitus [DM] compared with healthy controls; and determine the interrelationship between fasting plasma glucose levels and indices of long-term glycaemic control [fructosamine and glycosylated haemoglobin] in DM. Cross-sectional, analytical study. The study was conducted at the Lagos State University Teaching Hospital, Ikeja, from April to June 2009. A total of 200 patients with type 2 DM and 100 age and gender matched healthy controls were recruited for the study. Glycaemic control was assessed using fasting blood glucose, fructosamine and glycosylated haemoglobin levels. The non-traditional risk factors studied included C-reactive protein [CRP], Lipoprotein a [Lpa], serum uric acid [SUA], microalbuminuria and fibrinogen. Mann-whitney, chi-square and Pearson's correlation tests were used for analysis as applicable. Hyperfibrinoginaemia, elevated CRP, LPa, microalbuminuria and hyperuricaemia were present in 3.5%, 65%, 12%, 6% and 57% respectively in type 2 DM. The mean levels of these CV risk factors were significantly higher in subjects with type 2 DM than that of the control subject. There was a positive and significant correlation between HbA1c and FBS [r=0.46, p=0.0001] and HbA1c and fructosamine [r=0.49, p=0.0001]. All studied CVS risk factors were related to indices of glycaemic control which were found to be interrelated. Fasting blood glucose significantly correlated with both HbA1c and fructosamine but HbA1c showed better correlation to FPG than fructosamine [r=0.51 vs. 0.32]. Glycosylated haemoglobin and fasting plasma glucose but not fructosamine are significantly associated with microalbuminuria, fibrinogen SUA and CRP in type 2 DM. HbA1c was found to be better than fructosamine in monitoring overall long-term glycaemic control