Determination of Serum Thyroglobulin Concentration in Simple Diffuse Goiter Patients with Known Iodine Status

Background: Thyroglobulin (TG) seems to be a valuable indicator of thyroid function and iodine nutrition status. Aim of the study: The aim of the study was to observe the relationship between serum thyroglobulin and urinary iodine (UI) in simple diffuse goiter patients.Methods:This cross-sectional observational study was conducted at the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. The study duration was 2 years, starting from May 2014 to March 2016. Total 87 patients with simple diffuse goiter attending the OPD Department of Endocrinology of BSMMU had been recruited as study population. A purposive sampling technique was followed for sample selection.Results:Serum thyroglobulin (ng/mL, mean盨D and median) was lowest in the age group 12-16 years (6.0�5, 5.16 ng/mL) followed by age>31 years (8.8�1, 6.16 ng/mL), whereas other age groups showed level around 13.0 and 10.0 ng/mL (p= 0.520). Mean (盨D) Urinary Iodine was not statistically different among age groups (347.4� 226.5 vs. 337.08�8.9 vs. 300.5� 95.37 vs. 337.7� 225.42 vs. 278.3� 105.7, 礸/L; F 0.451, p=0.771) while median values were 325.26 vs. 355.68 vs. 325.80 vs. 338.86 and 300.90 礸/L respectively. Neither thyroglobulin (5.76�72 vs. 11.60� 13.50; 3.47 vs. 8.9 ng/mL, m盨D and median; p=0.294) nor Urinary Iodine (373.5� 44.5 vs. 317.2� 180.32; 378.1 vs. 308.9 礸/L, m盨D and median; p=0.450) were statistically different between the gender groups. Similarly, thyroglobulin and Urinary Iodine were also statistically similar for grade-1 and grade-2 goiter (thyroglobulin: 6.79�33 vs. 11.67�.69 and 6.74 vs. 8.02 ng/mL, m盨D and median, p=0.319; Urinary Iodine: 361.33� 51.60 vs. 317.09� 182.44, 362.69 vs. 305.35 礸/L, m盨D and median, p=0.498).Conclusion:Thyroglobulin seems to have an inverse association in iodine deficiency state and positive association in over sufficient state with UI. There was no statistically significant difference of TG concentration between males and females nor between Grade-1 and Grade-2 goiter.

Serum Zinc Level in Persons with Prediabetes and it’s Relation with Glycemic Status Attending Tertiary Care Hospital in Bangladesh

Background: Type 2 diabetes mellitus is becoming one of themajor health problems worldwide. Especially in South EastAsia, type 2 diabetes has gained critical significance. Asprediabetes prevalence is increasing worldwide, it has becomean important concern to prevent diabetes at an early stage inBangladesh.Objectives: Estimation of serum zinc level and establishmentof its relation with glycemic status in individuals with prediabetes.Materials and Methods: This cross-sectional studyencompassed 126 (age: 35.09±9.96 years, mean ± SD; Sex:16/110, M/F) subjects with prediabetes and 126(age:29.08±9.28 years, mean ± SD; Sex: 22/104, M/F) healthynondiabetic controls from the out-patient department ofEndocrinology, BSMMU consecutively. Serum zinc wasmeasured by using Atomic Absorption Spectrophotometry.Height, weight, waist circumference, acanthosis nigricans,hypertension, SGPT& serum creatinine were recorded asconfounding variables.Results: Serum zinc level in persons with prediabetes waslower than that in control (0.76±0.01 vs. 0.78±0.01mg/L,M±SEM, p=0.28). There was statistically significant differencefor zinc level in gender groups (M vs. F: 0.84±0.02 vs.0.75±0.01 mg/L, M±SEM, p<0.001) and monthly family incomegroups (p=0.02). Also zinc level was statistically similar amongglycemic status groups apart from zinc level in between controland combined glucose intolerance (CGI) groups (control vs.CGT: 0.78±0.01 vs. 0.72±0.02mg/L, M±SEM, p=0.03). Amongcases comparisons between groups with or without risk factorslike: smoking (0.72±0.03 vs. 0.76±0.10 mg/L, p=0.42),smokeless tobacco (0.73±0.03 vs. 0.76±0.01mg/L, p=0.46),hypertension (0.80±0.03 vs. 0.75±0.01 mg/L, p= 0.14), familyhistory of DM (0.75±0.02 vs. 0.77±0.02mg/L, p=0.52), familyhistory of CVD (0.74±0.02vs.0.77±0.01mg/L,p=0.28), overweight (0.76±0.01 vs.0.74±0.05mg/L, P=0.59), waistcircumference (0.75±0.01 vs. 0.79±0.04mg/L, p=0.40) andacanthosis nigricans (0.75±0.02 vs. 0.76±0.02mg/L, p=0.70),showed no statistically significant difference. None of thevariables like age (r= -0.02, p=0.19), BMI (r= 0.14, p=0.12),FPG (r= -0.05, p=0.60) and PG 2h after 75g glucose (r=0.10,p=0.28), HbA1c (r=0.04, p=0.64), serum creatinine (r=0.01,p=0.87) showed significant relationship with the level of zincexcept SGPT which showed significant relation with zincamong cases (r= 0.28, p=0.002) and among all participants(r=0.17, p=0.008) but not in control group (r=0.07, p=0.43).Conclusion: It is concluded that persons with prediabetes hadserum zinc level within normal limit and there was found nostatistically significant relationship between HbA1c and zinc

Urinary iodine status and thyroid dysfunction: a Bangladesh perspective.

Iodine deficiency is endemic in Bangladesh. Compulsory iodization of table salt was introduced since 1993 to prevent and improve thyroid disorders in the country. Urinary iodine status, thyroid function and antithyroid antibodies were studied in 397 newly diagnosed thyroid patients and 94 age-sex matched controls. Among thyroid patients, 96 were hyperthyroid, 185 euthyroid and 116 hypothyroid. Mean and median urinary iodine were higher (p=0.075) in thyroid patients (26.13+/-0.91 and 23.03) than controls (22.65+/-1.47 and 18.59); in hyperthyroid and euthyroid than hypothyroid (p=0.020); in multinodular (28.08+/-2.80 and 26.94) and diffuse (27.35+/-1.19 and 26.71) goitre than uninodular (23.91+/-2.37 and 19.14) and nongoitrous (NG, 21.5+/-2.05 and 18.27) (p=0.098) patients but no sex difference (p=0.466). Antimicrosomal (26.7%) and antithyroglobulin (34%) antibodies were more frequently positive among thyroid patients than controls (6.4% and 12.8% respectively) (p=0.00002 and p=0.00005 respectively). Antibody positivity was higher in diffuse (82/228) and multinodular (20/47) goitre than nongoitrous (20/56) and uninodular (13/66) goitre (p=0.046) as well as in hypothyroid (55.2%) and hyperthyroid (36.5%) than euthyroid (19.5%) patients (P<0.001). Urinary iodine correlated neither with antimicrosomal (thyroid patients: p=0.597 and control: p=0.112) nor with antithyroglobulin (thyroid patients: p=0.388 and control: p=0.195) antibody. Thyroid autoimmunity and dysfunction seems common; and interaction of salt iodization with iodine status and thyroid disorders may be important in Bangladesh.

Predominance of the DEN-3 genotype during the recent dengue outbreak in Bangladesh.

A recent outbreak of dengue in Bangladesh was marked by many fatal complications. As clinical virulence varies among the genotypes of dengue virus, a study was conducted to investigate the molecular genotypes of dengue in Bangladesh. Reverse transcription polymerase chain reaction was used to determine viral genotypes using oligonucleotide generic primers that produce a 511 bp product. The resulting product was typed by nested PCR with strain-specific primers, yielding 482 (DEN-1), 119 (DEN-2), 290 (DEN-3) and 392 (DEN-4), visualized on UV transilluminator after electrophoresis on 2% agarose gel stained with ethidium bromide. Of 45 clinically diagnosed dengue patients (mean age 28 years; male/female 30/15), 19 (42.2%) had detectable viral RNA in their blood. However, during the first 5 days of fever in 30 patients, the frequency was 60% (18/30), implying that the sooner serum is drawn after the fever, the greater the chances of detecting viral RNA. DEN-3 was detected in all except 2 patients who were infected with DEN-2. DEN-2 (two cases) and DEN-4 (one case) were present as co-infections with DEN-3. All of the patients presented with fever, anorexia and vomiting; many had headache and general body ache; a few had a rash. About a quarter had suffered episodes of bleeding, while ascites, pleural effusion and CNS symptoms were found in a few patients Patients positive for viral RNA were also positive for anti-dengue IgM (p=0.007) in subsequent sampling. The study suggests the predominance of DEN-3 infection with occasional co-infection with other types, during the recent outbreak of dengue in Bangladesh.

Chronic carriers of hepatitis B virus in Bangladesh: a comparative analysis of HBV-DNA, HBeAg/anti-HBe, and liver function tests.

Serological markers of hepatitis B virus (HBV), liver function tests and quantitative estimation of HBV-DNA are important in the assessment of the state of infection and prognosis following treatment for hepatitis B. This study aimed to determine whether low-cost assays, eg hepatitis B e antigen (HBeAg) and liver function tests, could be used for the assessment of infectivity as an alternative to HBV-DNA estimation. We tested 125 hepatitis B carriers for HBeAg, antibody to HBeAg (anti-HBe), and serum HBV-DNA; we also carried out a range of standard liver function tests. Seventy-three subjects were positive and 52 were negative for HBeAg. Of the HBeAg positive cases, 3 were also positive for anti-HBe; of the HBeAg negative cases, 5 were also negative for anti-HBe. Of these 8 cases, 7 had no detectable HBV-DNA. Most of the HBeAg positive but anti-HBe negative subjects were positive for HBV-DNA (74.3%; 52/ 70) whereas most of the HBeAg negative and anti-HBe positive subjects (93.6%; 44/47) were also negative for HBV-DNA. Of 56 HBV-DNA positive individuals, alanine transaminase (ALT) was found to be raised in 69.6% (p=0.066) and aspartate transaminase (AST) was raised in 66.1% (p=0.011), while 67.9% had normal alkaline phosphatase (ALP) (p=0.054). HBeAg (p=0.018) and raised ALT (p=0.008) were found to be independent predictors for HBV-DNA positivity among HBV carriers. This study suggests that HBeAg positive and anti-HBe negative hepatitis B carriers with raised ALT and AST are likely to be positive for HBV-DNA; the combination of routine serology and biochemical tests may be considered as an alternative to HBV-DNA in evaluating the state of chronic HBV infection. However, HBV-DNA should be specifically assessed if discordance is observed between seromarkers and transaminases.