Metabolic syndrome and its components among HIV/AIDS patients on Antiretroviral Therapy and ART-Naïve Patients at the University of Calabar Teaching Hospital, Calabar, Nigeria

Background: Although an increasing access to ART in sub-Saharan Africa has made it possible for HIV/AIDS patients to live longer, clinicians managing such patients are faced with the challenge of drug-related metabolic complications. Methods: A cross -sectional study was carried out at the University of Calabar Teaching Hospital, Nigeria, on three groups of participants; namely HIV patients on ART, ART-naïve patients and HIV negative subjects (n =75). Demographic and anthropometric data were collected using a well-structured questionnaire while biochemical parameters were measured using colorimetric methods. Results: The highest prevalence of MS was associated with the HIV/AIDS patients on ART (i.e. 32.0 %, and 50.3% for NCEP-ATP III and IDF criteria respectively). Patients on ART had significant increases (p< 0.05) in waist to hip ratio, FPG, serum TG and LDL-c; and a significantly higher (p< 0.05) prevalence of hypertension, diabetes, low HDL-c and hypertriglyceridemia compared to the ART-naïve patients. Low serum HDL-c was the most prevalent form of dyslipidemia in all three groups and the most prevalent component of MS in HIV patients. Conclusion: ART increases the risk of MS and CVD. HIV/AIDS patients on ART should be advised on lifestyle modifications and undertake regular assessment of their cardiovascular risk factors

Assessment of Health Risk Associated with Heavy Metal Contamination of Edible Vegetables in Cement Contaminated Area

Aim: Heavy metal (HM) content of some vegetables in the vicinity of a cement factory can be a useful index for assessment of HM contamination of the environment associated with cement production. Study Design: This cross sectional study was conducted at the United Cement Company at Mfamosing, Akamkpa local government area, Cross River State, Nigeria between February to November 2016. Methods: One hundred and forty edible vegetables of Telfairia occidentalis (fluted pumpkin), Vernonia amygdalina (bitter leaf), Amaranthus viriditis (green leaf), Talinum triangulare (water leaf), Lavantheca africanum, Heinsia crinata and Gnatum africana were collected at varying distances and directions from the cement factory site and an area remote to the site serving as control. The lead (Pb), copper (Cu), manganese (Mn), iron (Fe), cadmium (Cd), selenium (Se), chromium (Cr), zinc (Zn) and arsenic (As) content of the vegetable samples were determined using atomic absorption spectrophotometry. Data were analyzed using analysis of variance at P = .05. Results: The Pb, Cu, Mn, Fe, Cd, Se and Zn content of vegetables in all the locations studied were within the safe limits except for Cr and As levels of some vegetables from location closest to the factory which were higher than the safe limits. The HM content of all vegetables from location closest to the factory were significantly higher than those from other locations (P <0.001). The hazard quotient (HQ) of all HM in all the vegetables were <1 except for Mn in T. occidentalis which was >1. The hazard index (ƩHQ) for all HM in all the vegetables were >1. Conclusion: Cement production is associated with chromium and arsenic contamination of edible vegetables and increase in hazard index of HM levels in vegetables closest to the factory which may be implicated in increased risk for development of deleterious health consequences to consumers.

Glycemic control, micronutrients and some metabolic enzyme activity in type 2 diabetes.

Background: Alterations in the metabolism of some essential micronutrients and activities of some metabolic enzymes have been reported in diabetes mellitus. These changes have been attributed to hyperglycemia and increased protein glycosylation associated with diabetes and seems to be more pronounced in poor glycemic states. The influence of glycemic control on serum levels of calcium (Ca), Iron (Fe), phosphorus (P), vitamin C, and lactate dehydrogenase (LDH) and amylase activity in type 2 diabetes were determined in this study. Methods: Fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), serum calcium (Ca), Iron (Fe), phosphorus (P), vitamin C, LDH and amylase activity were determined in fifty type 2 diabetic subjects aged between 40-70 years and fifty age matched apparently healthy non-diabetic subjects in Calabar, Nigeria using colorimetric methods. Socio-demographic characteristics, anthropometric indices (body mass indices (BMI), waist to hip ratio (WHR)) and blood pressure were determined using standard methods. Data was analyzed using t-test, ANOVA and Pearson correlation analysis at p = 0.05. Results: The FPG, HbA1c, serum vitamin C, Iron and calcium levels were significantly higher and serum phosphorus lower in diabetics than in non-diabetics. Diabetics with poor glycemic control (HbA1c >8.0%) have higher serum calcium and LDH activity compared to those with good glycemic control (HbA1c <8.0%). Conclusions: Diabetes may alter the metabolism of vitamin C, Iron, calcium and phosphorus while poor glycemic control may be associated with changes in calcium and LDH activity.

Adiponectin and cardiovascular risk factors in relation with glycemic control in type 2 diabetics.

Background: Adiponectin has been associated with insulin resistance and dyslipidemia in Type 2 diabetes, though the mechanism of association is still uncertain. The adiponectin levels and lipid profile in relation to glycemic control were investigated in type 2 diabetics. Methods: Forty two diabetic subjects (35-64 years) and 33 age-matched non-diabetic subjects were recruited into this case control study. Socio-demographic characteristics, anthropometric indices and blood pressure were obtained. Total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein, (HDL), fasting plasma glucose (FPG), and glycated hemoglobin (HbA1c) were estimated using colorimetric methods, atherogenic index (AI) was calculated, while serum adiponectin was determined by ELISA method. Results: Adiponectin levels of type 2 diabetics were not significantly different from the non-diabetics studied (p>0.05). Higher TG levels were observed in diabetics with poor glycemic control compared with those with good glycemic control (p<0.05). Hypertensive diabetics have higher TC and lower HDL-C levels compared with non hypertensive diabetics (p<0.05). Adiponectin correlated positively with HDL-C (r = 0.739, p = 0.01) and negatively with AI (r = -0.539, p = 0.001) only in the non diabetic group. No significant differences were observed in the adiponectin levels in relation with gender, duration of diabetes and glycemic state (p>0.05). Conclusion: Type 2 diabetics do not have lower adiponectin levels. Gender, duration of diabetes and glycemic control does not seem to exert any influence on adiponectin levels in type 2 diabetes. Adiponectin may be associated with reduced risk of atherosclerosis through its effects on HDL cholesterol metabolism.