Vitamin D status in type 2 diabetic patients and its association with glycemic control, lipids and microalbuminuria: a pilot study

The objective of the present study was to determine the vitamin D status of type 2 diabetic patients and correlate the levels with glycemic control, lipids and microalbuminuria. A pilot study was conducted on 192 randomly selected type 2 diabetic patients of both sexes from different ethnic backgrounds, in the age group of 35-65 years, with or without hypertension and dyslipidemia, who attended the medical OPD at GMC Hospital Ajman from January to April 2013. A questionnaire was used to obtain sociodemographic and clinical details about the patients. American Diabetic Association Criteria [2013] were used for diagnosis. Patients were classified into three groups according to their total vitamin D status: deficient [10- < 20 ng/mL], insufficient [20-30 ng/mL], Sufficient [optimum >3050 ng/mL]. Fasting blood specimens were analysed for glucose, total vitamin D, calcium, phosphorus, lipoproteins and HbA1C levels in addition to routine kidney functions using Cobas 601 analyzer [Roche]. Morning urine specimens were analyzed for Urinary Albumin Excretion Rate [UAER] using DCA 2000 analyzer [Bayer] employing Turbidimetric Inhibition Immunoassay. UAER between 30-300 microg/mg creatinine was described as microalbuminuria. Vitamin D deficiency and insufficiency was found among 96.8% of type 2 diabetic patients. Serum calcium and phosphorus levels and routine kidney function tests were normal. Plasma glucose, lipoprotein and HbA1C levels were significantly elevated [p < 0.05] in patients with raised UAER compared to patients with normal UAER. HbA1C and LDLc showed a negative correlation with vitamin D levels. The presence of elevated UAER, HbA1C and LDLc levels in type 2 diabetic patients with low vitamin D levels suggest the role of vitamin D deficiency in the pathogenesis of type 2 diabetes mellitus and its complications. The results of the pilot study will be used in carrying out our study on large cohort of type 2 diabetics and identify the role of vitamin D deficiency in its pathogenesis and complications. In the meantime, it is suggested that proper exposure to sun in addition to regular intake of vitamin D and calcium may delay the development of type 2 diabetes and its complications

Subclinical hypothyroidism in patients attending GMC hospital and its association with lipid disorders - a preliminary study

Subclinical hypothyroidism is a state characterized by mild elevations in Thyroid Stimulating Hormone [TSH] in patients without known thyroid disease. Clinical importance and therapy for subclinical hypothyroidism are subjects of both debate and research. To study the lipid disorders in patients with subclinical hypothyroidism referred from the Department of Internal Medicine, GMC Hospital and Research Centre, Ajman, UAE. Subjects referred to the laboratory for thyroid profiles between January and December 2009 were divided into three groups; Euthyroid [EUT], Subclinical Hypothyroid [SCH] and Overt Hypothyroid [OVH] based on TSH values 4 /= 10 mIU/ mL respectively. patients with diabetes, cardiovascular disease, dyslipidemia or on treatment for thyroid disorders were excluded. Serum lipid profiles of the subjects were investigated. PASW 18 software was used for analysis. One way ANOVA and Duncan multiple comparison tests were used to find the significance. of the 1234 subjects studied, 953 were females [77%] and 281 males [23%]. Mean age for the female subjects was 33+/- 10 years and for the male subjects 38 +/- 11 years. 95.5% were in the 19-59 year age group. 77 subjects [6.2%] were found to be SCH. Mean +/- SD total Cholesterol values were 223 +/- 33, 225 +/- 28, 253 +/- 35, LDL cholesterol values were 120 +/- 22, 130 +/- 21, 123 +/- 17 and Triglyceride levels were 99 +/- 21, 90 +/- 14, 130 +/- 45 mg/dl in the EUT, SCH and the OVH groups respectively. While there was no significant difference between the EUT and SCH group in the total Cholesterol and Triglyceride values, they were significantly different from the OVH group [p<0.05]. There were no differences in LDL cholesterol between the groups or lipid parameters between the genders. 6.2% of the patients referred were found to be SCH. There were no significant differences between the lipid parameters of EUT and SCH patients. OVH patients showed significantly higher total cholesterol and triglyceride levels in blood

Male infertility and its association with metabolic syndrome and hypogonadism

Hormonal profile alteration is seen in men with metabolic syndrome. Obese men have elevated levels of estrone and estradiol and there is also an attenuation of the pulse amplitude of luteinizing hormone [LH] which leads to a reduction of testicular production of testosterone. This study was conducted to assess the sperm morphology, prevalence of metabolic syndrome and association between gonadal hormones and parameters of metabolic syndrome among men diagnosed with infertility. Out of 434 men referred to the laboratory of Gulf Medical College Hospital and Research Centre, Ajman, UAE, 184 were diagnosed as infertile based on seminal parameters. Prevalence of metabolic syndrome and gonadal hormonal level among these infertile men were also studied. Data were analyzed with PASW 18 software and student t-test used for the significance. Mean age of the men referred for seminal analysis was 33 +/- 7.2 years. Forty two percent of the men were found to be infertile based on seminal parameters. Majority had total forward progression abnormality followed by abnormalities of head, tail and neck. Prevalence of metabolic syndrome among these men was found to be 19%. FSH and LH levels were significantly lower and prolactin levels were significantly higher [p<0.01] in men with metabolic syndrome. Estradiol and total testosterone levels showed no difference. High prevalence of metabolic syndrome was found among men diagnosed with infertility. Significant hypogonadism was found associated with metabolic syndrome among these men

Plasma homocysteine and other biochemical parameters in gestational Diabetes Mellitus

Gestational Diabetes Mellitus [GDM] is characterized by glucose intolerance that is first diagnosed during pregnancy. Insulin resistance is the hallmark of gestational diabetes, little is known about the other metabolic changes taking place. Plasma homocysteine [Hcy] levels have been reported associated with cardiovascular disease and osteoporosis. Elevated Hcy levels are associated with pregnancy complications and adverse pregnancy outcomes. The objective of the present study was to compare plasma levels of Homocysteine and other biochemical parameters in women diagnosed with GDM attending Gulf Medical College Hospital with that in normal pregnant women. Prospective study of pregnant women GDM [N = 26] was confirmed by the oral glucose tolerance test. Normal pregnant women served as control group [N = 36]. Fasting plasma Glucose [mg/dL] level and Body mass index [kg/m[2]] of the GDM group was significantly higher compared to the control group. serum total cholesterol level was found to be significantly higher [P<0.00] in GDM [230.77 +/- 27.21 mg /dL] compared to contral [181.53 +/- 17.09]. Serum Triacylglycerol, Uric acid and Creatinine were also significantly elevated [P < 0.001] in the GDM group compared to control even though all values lay within the normal reference ranges. Hcy level in GDM was significantly higher [19.073 +/- 3.61 micro mol/L] compared to controls [8.322 +/- 1.94], P<0.001. Homocysteine, Cholesterol, Triacylglycerol, Uric acid and Creatinine levels were significantly elevated in GDM compared to normal pregnant women. Hcy correlated strongly with the fasting glucose levels [Pearson correlation, r = 0.9]

Biochemical parameters in women with polycystic ovary syndrome

Polycystic ovary syndrome [PCOS] is a common endocrine disorder affecting 5 -10% of women and is the major cause of anovulatory infertility. Prevalence varies among populations based on genetic and environmental factors. Etiology of PCOS remains unknown but Hyperandrogenism and Insulin resistance have both been associated with PCOS. The objective of the present study was to measure plasma levels of Homocysteine and other biochemical parameters in women diagnosed with PCOS attending Gulf Medical College Hospital [GMCH], Ajman. Young women between 18 and 35 years of age, diagnosed with PCOS [N =37], not on any treatment, attending GMCH were included in the study. Biochemical parameters were measured using standard procedures. Laboratory normal reference ranges were used for comparison. 54% of the women with PCOS were overweight or obese according to the BMI and 51% had a waist circumference >88cm. Fasting and postprandial Glucose and Insulin levels and HOMA-IR were within the normal reference ranges indicating that no Insulin resistance was seen in these women. 40% of the women had a serum total Cholesterol level above 200 mg/dL. LDL Cholesterol was above and HDL cholesterol lower than the desirable value. Serum Triacylglycerol was within the normal reference range. Serum Testosterone, Estradiol, Prolactin TSH and plasma Homocysteine were found to be within the normal reference ranges. Homocysteine levels correlated with Testosterone, total Cholesterol and LDL cholesterol levels. Body mass index was high in 54% of the women. No Insulin resistance was seen in these patients. Hormone levels and Homocysteine were within the normal reference ranges. Dyslipidemia was observed. These findings differ from reports in literature where Insulin resistance, Hyperandrogenism and high Homocysteine levels have been associated with PCOS

role of immunoglobulins and complements in immunity against hydatis disease in Libyans

The serum immunoglobulins [IgG. IgM, IgA, IgE] and [C3, C4] levels were investigated in 45 [17 male and 28 female] Libyan patients with hydatid disease confirmed [age: 19-70 years; mean age: 44 years]. Twenty six healthy Libyans, age and sex matched, were also included in the study as control subjects. Of these 45 patients 34 had hepatic [76%]. 5 had pulmonary [11%] and 6 had multiple [hepatic, pulmonary and intestinal] [13%] lesions. The study showed that patients with hydatid disease had significantly higher total IgG [P<0.05], Igm [P<0.02] and IgE [P<0.01] levels as compared to control. Further statistical analyses for linear, exponential and geometrical correlations revealed that IgG had significant linear correlation with anti-echinococcus antibody titre [AEAT] [r=0.9214, t=5.7392, p<0.01]. Interestingly, IgE exhibited more significant exponential correlation [r=0.9309, t=5.7011, p<0.01] than geometrical correlation [r=0.8402], t=3.4643, p<0.02] with AEAT. These observations suggested than the host's immune response did occur concomitant with the existence and fluorishment of the hydatid cyst. The various possibilities as to how this can happen have been discussed

Clinical, biochemical and hematological features of an outbreak of human brucellosis in Benghazi

During the outbreak of human brucellosis in Benghazi, Libya, in June-September 1987, haematological and biochemical parameters were analysed in 18 Libyan patients [age: 16:60 years; sex: 10 male, 8 female]. Since leukopenia with relative lymphocytosis was present in 5/18 [28%] patients only, it was not considered as a general rule for diagnosis of acute brucellosis. The ESR was raised in 14/18 [78%] patients which is generally a feature of acute brucellosis. Although biochemical analyses showed in some cases moderate elevation of serum ALT [8/18], AST [7/18], ALP [2/18] and LDH [5/18], serum ALT, AST and LDH were markedly elevated in only 5/18 [28%], 6/18 [33%] and 3/16 [18%] patients respectively. The implications of these findings and methods of choice for quick confirmed diagnosis of acute brucellosis as a possible cause for pyrexia of unknown origin are discussed