Low indices of overweight and obesity are associated with cardiometabolic diseases among adult Filipinos in a rural community / Journal of the ASEAN Federation of Endocrine Societies

@#<p style="text-align: justify;"><strong>OBJECTIVES:</strong> To determine cut-off levels of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) for overweight/obesity associated with cardiometabolic diseases (CMDs) among adult Filipinos in a rural community.<br /><strong>METHODOLOGY:</strong> This community-based cross-sectional observational study utilized data from our Phase II of Diabetes Self-Management Education Program in San Juan, Batangas, Philippines. It included 332 Filipino adults with no known illnesses and residing for at least 6 months in the rural communities. Optimal cut-offs were determined by the intersection of sensitivity and specificity curves of having at least 1 or 2 CMDs.<br /><strong>RESULTS:</strong> The study population included 332 participants (72.3% females). Mean BMI, WC and WHR were 23.5 kg/m2, 79.5 cm and 0.87 respectively. Twenty eight percent, 11.1%, 78.3% and 85.8% of the participants have hypertension, diabetes, dyslipidemia, and at least 1 CMD respectively. The optimal cut-off for overweight/obesity and central obesity in males and females are BMI of 24 and 23 kg/m2, WC of 84 and 77 cm, and WHR 0.91 and 0.85 respectively.<br /><strong>CONCLUSION:</strong> Similar to other Asian countries, cut-off levels for overweight, obesity, and central obesity associated with CMDs are lower than the currently recommended cut-offs among Filipino adults in rural communities, particularly for WC in both sexes.</p>

Filipino normative data for thyroid ultrasonography: Correlates with weight, height and gender but not urinary iodine levels

OBJECTIVE: To establish a normal range of values for thyroid volume among adult Filipinos and to correlate thyroid dimensions with age, sex, weight, height, and urinary iodine.METHODS: This is a cross-sectional study conducted at the University of the Philippines-Philippine General Hospital. Out of 212 health personnel screened, 169 were included based on the following exclusion criteria: goiter stage Ib to III as defined by WHO, hyperthyroid or hypothyroid, hospitalization within the past month, chronic renal disease, chronic alcohol intake, more than 4 pack years of smoking, and abnormal laboratory profile. Laboratory parameters included FT3, FT4, TSH, creatinine, anti-thyroglobulin, anti-thyroid peroxidase, 24-hr urinary iodine , and thyroid ultrasonography. There were 55 males and 114 females with a mean age of 38.98 +/- 11.21 years old, mean weight of 59.84 +/- 11.91 kg.RESULTS: The size of the right lobe ranged from 3.58-5.09 x 1.15-1.89 x 1.01-1.90 cm (LxWxD) while the left lobe ranged from 3.62-5.01 x 1.15-1.93 x 1.03-1.84, comparable with established values in literature. Using Hotelling's T-squared, male sex was associated with a larger thyroid dimension, (p-value CONCLUSIONS: The normative thyroid dimensions established among Filipino adults were comparable with the accepted reference values. Thyroid dimensions were significantly correlated with weight, height, and sex but not with urinary iodide levels.

A case of noonan syndrome associated with nephrotic syndrome, pituitary mass and pes varus

We report a case of a Filipino male diagnosed with Noonan syndrome on the basis of facial dysmorphism, chest deformity, short stature, mental and skeletal retardation, pulmonic stenosis and hypogonadism. In addition, he has three clinical features which are not known to be associated with the syndrome and are perhaps being reported for the first time:structurally normal kidneys with nephrotic syndrome, pituitary macroadenoma and pes varus.

Angiotensin I-converting enzyme gene polymorphism and diabetic nephropathy in Filipino type 2 diabetes mellitus patients / Journal of the ASEAN Federation of Endocrine Societies

Objective. Previous studies have demonstrated the role of genetic susceptibility in the pathogenesis of diabetic nephropathy. The study aimed to determine the frequencies of angiotensin I-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism in a pilot population of Filipino type 2 diabetic patients and normal controls. Methods. An analysis of the ACE gene polymorphism was performed in 42 diabetic patients with and without nephropathy, and 24 normal controls. The analysis was done using polymerase chain reaction, restriction enzyme digestion, and gel electrophoresis techniques to determine the polymorphism (II, DD or ID). Independent T-tests and chi-square tests were used to compare clinical characteristics, and logistic regression analysis was done to determine odds ratio for development of nephropathy. Results. The ID polymorphism of the ACE gene was more frequent (52.4%) in patients with diabetic nephropathy (n=21). In those without nephropathy (n=21), II was more common (61.9%). ID was the more frequent genotype in the normal controls (n=24) (58.3%). The odds of developing diabetic nephropathy were increased by 4.8 times in those with ID polymorphism, and 2.9 times in those with DD. Conclusion. The D allele was more common in patients with diabetic nephropathy, similar to the observation in South Indian patients. Since the study involved only a small pilot group, studies on a larger population is needed to establish the hypothesized role of the D allele in susceptibility to diabetic nephropathy in Filipinos.

Prevalence of undiagnosed autoimmune thyroid disease and thyroid dysfunction in Filipino patients with autoimmune rheumatic disorders / Journal of the ASEAN Federation of Endocrine Societies

OBJECTIVES:(1) To determine the prevalence of autoimmune thyroid disease among patients with autoimmune rheumatic disorders seen at the Philippine General Hospital. (2) To determine clinical features that are associated with the occurrence of autoimmune thyroid disease in these patient.METHODOLOGY:This is a cross sectional analytical study that included 155 adult Filipinos diagnosed with an autoimmune rheumatic disorder. Clinical characteristics were recorded. Serum thyrotropin, thyroxine, triiodothyronine, anti-thyroid peroxidase antibody, anti-thyroglobulin antibody and urinary iodide excretion were determined. The prevalence of autoimmune thyroid disease was computed. Associations between clinical factors and autoimmune thyroid disease were determined.RESULTS:Overall 21.94% of the population had autoimmune thyroid disease. There was significant association between duration of the autoimmune rheumatic disorder and autoimmune thyroid disease (p-= 0.018). No significant association was noted with the other clinical factors although there was an almost significant association observed for the presence of goiter (p=0.054).CONCLUSION:Autoimmune thyroid disease commonly occurs in patients with autoimmune rheumatic disorders. As such, it is important to consider screening these patients for the coexistence of thyroid disease to help prevent the complications associated with thyroid dysfunction and avoid adding up to the morbidity of the existing autoimmune rheumatic disorder.

Impact of waist circumference measurement variation on the diagnosis of metabolic syndrome

INTRODUCTION: While waist circumference (WC) is widely used as an index for visceral fat accumulation and purportedly the primary pathology responsible for the metabolic syndrome (MS), its proposed cut-off value varies depending on the disparate diagnostic criteria used as well as on the gender, race and ethnic group being evaluated. Due to the strong association between MS and central obesity, waist circumference should be incorporated into the routine physical exam when assessing cardiovascular disease and diabetes risk. Currently however, there is no standard location for the measurement of WC. On literature review, we found no scientific rationale for preferring any one WC site to the others hence, this study.OBJECTIVE: This study aims to (1) determine waist circumference measurement var iat ions among MS patients, (2005 NCEP-ATP III/AHA/NHLB criteria), at three levels: (A) umbilical level, (B) midline level (between the inferior margin of the ribs and the superior border of the iliac crest) and (C) level of the superior border of the iliac crest.RESEARCH DESIGN AND METHODS: Across - sectional analytical study among adult patients, aged 40 to 69 years, diagnosed with MS using 2005 NCEP-ATP III/AHA/ NHLB criteria seen at the Philippine General Hospital, as part of the Asia-Oceania Survey on Metabolic Syndrome and Diabetes initiated by the Japan Diabetes Society.RESULTS: A total of 187 MS individuals were included in the study (56% females). Both males and females were obese stage 1 (25.5 kg/m2 and 26.7 kg/m2 respectively). The mean WC measurements at level A in men was 92.9 cm (81.36 - 104.44 cm) and 93.83 cm (83.4 - 104.26 cm) in women; at level B, the mean WC in men was 90.73 cm (75.49 - 105.97 cm) and 91.51 cm (80.62 - 102.4 cm) in women; and at level C, the mean WC in men was 93.5 cm (81.97 - 105.03 cm) and 95.12 cm (85.11 - 105.13 cm) in women. Results showed that WC measurements at three levels did not significantly differ among MS patients when stratified to age and sex. However, when waist circumference was measured at three levels among all patients with MS, there was significant difference in WC taken at level B and level C (Sig = 0.009). Waist circumference at level A was similar and less variable to WC level B than WC at levelC.CONCLUSIONS: Among patients with MS as defined by NCEPATP III/AHA/NHLB criteria, waist circumference at level B (midpoint level between the lower ribs and superior border of the iliac crest) was smaller than waist circumference at level A (umbilical level) and smaller than level C (superior border of the iliac crest) (WCB