Lower Levels of Serum Adiponectin and the T Allele of rs1501299 of the ADIPOQ Gene Are Protective against Polycystic Ovarian Syndrome in Jordan / 가정의학회지

BACKGROUND: Polycystic ovary syndrome (PCOS) is a common reproductive disorder. Obesity, which is linked with lower adiponectin levels, increases a woman's risk of developing PCOS; however, the association between adiponectin and PCOS is controversial. Adiponectin levels could be affected by single nucleotide polymorphisms (SNPs) in the ADIPOQ gene. This study aimed to test the relationship between serum adiponectin and PCOS in Jordan and the association between the rs2241766, rs1501299, and rs266729 SNPs in the ADIPOQ gene and PCOS. METHODS: One hundred and fifty-four women with PCOS and 149 age- and body mass index–matched normally menstruating controls were recruited. Serum adiponectin levels were measured using enzyme-linked immunosorbent assay. Genotyping was performed using polymerase chain reaction–restriction fragment length polymorphism analysis. RESULTS: Serum adiponectin levels were significantly lower (P=0.0064) in PCOS women and rs1501299 (+276 G/T) genotype distributions were significantly different (P=0.01) between them and normally menstruating women. Multivariate analysis revealed that adiponectin levels remained significantly lower in PCOS women (P=0.001; odds ratio [OR], 0.9; 95% confidence interval [CI], 0.84–0.96). The GT genotype of rs1501299 increased the risk of PCOS (P < 0.001; OR, 5.46; 95% CI, 2.42–12.33) and increased the risk of PCOS by three-fold (P < 0.001; OR, 3.00; 95% CI, 1.36–6.60) relative to the TT genotype. The GG genotype increased the risk of PCOS as well (P < 0.001; OR, 3:00; 95% CI, 1.36–6.60). CONCLUSION: PCOS is associated with lower serum adiponectin levels independent of age and body mass index. The T allele of the rs1501299 (+276 G/T) SNP of the ADIPOQ gene protects against PCOS.

Sonographic assessment of kidney length in Jordanian children: results from a tertiary hospital in the north of the kingdom

Objective: To provide a reliable and practical reference for normal standard kidney length values in Jordanian children using ultrasound according to age, height, and weight, and to assess the comparability of our standards to those from previous studies

Materials and Methods: The kidneys of 331 children [156 males, 175 females] ages between newborns and 14 years of age, who had diseases unrelated to the urinary tract were prospectively examined by ultrasound. All the examined kidneys were normal in size, shape, and position. The length of the kidneys were correlated with the age, weight, and height of the patients, and was compared to previous studies published in the literature

Results: There was no significant statistical difference between the length of the right kidney and the left kidney, and no difference between boys and girls [P>0.05]. There was good correlation between the length of the kidneys and the somatic parameters of the patients. Also, there was agreement between the kidney length in our study to those from previous international studies

Conclusions: A reliable and practical reference for normal standard kidney length values in Jordanian children is provided, which is in concordance with previously published data

Prevalence of low testosterone levels in men with type 2 diabetes mellitus: a cross-sectional study

A high prevalence of low serum testosterone [LST] in men with type 2 diabetes have been reported worldwide. The aim of this study was to determine the prevalence and associated factors of LST in men with type 2 diabetes. This was a cross-sectional study, conducted among 1,089 men [aged 30-70 years] with type 2 diabetes who consecutively attended a major diabetes center in Amman, Jordan, between August 2008 and February 2009. The patients' demographic characteristics were collected using a prestructured questionnaire. Duration of diabetes, smoking habits, presence of retinopathy, neuropathy, and nephropathy were collected from the medical records. All participants were asked to complete the Androgen Deficiency in Ageing Male [ADAM] questionnaire. Venous blood sample was collected to test for total testosterone [TT], free testosterone [FT], sex hormone binding globulin [SHBG], follicle-stimulating hormone [FSH], luteinizing hormone [LH], prolactin [PRL], serum lipids, and glycosylated hemoglobin [HbA1c]. LST was defined as TT <3 ng/ml. Overall, 36.5% of patients with diabetes had TT level <3 ng/ml and 29% had symptoms of androgen deficiency. Of those with serum testosterone level <3 ng/ml, 80.2% had symptoms of androgen deficiency, 16.9% had primary hypogonadism [HG], and 83.1% had secondary HG. Univariate analysis showed a significant relationship between age, income, education, body mass index [BMI], smoking, duration of diabetes, diabetic nephropathy, diabetic neuropathy, and HbA1c. Multivariate logistic regression analysis indicated age, income, BMI, and diabetic neuropathy as the independent risk factors of LST. The prevalence of LST among men with type 2 diabetes is high. Age, income, BMI, and diabetic neuropathy were found to be the independent risk factors for LST

Prevalence of diabetic foot ulcer and its associated risk factors among diabetic patients in Jordan

The objectives of this study were to assess the prevalence of diabetic foot ulcers and their risk factors among patients attending the National Center for Diabetes, Endocrinology, and Genetics [Amman, Jordan]. A systematic random sample of 1,000 diabetic patients was selected from patients attending the diabetes clinic at the National Center for Diabetes, Endocrinology, and Genetics [Amman, Jordan]. Vascular, neurological, musculoskeletal, and ulcer risk categories were all assessed. There were 49% males in the sample. The mean age of the sample was 52 years, and the mean duration of diabetes was 9.7 years. Diabetic foot ulcer prevalence was 4.6%, sensory neuropathy 14.9%, lower limb ischemia 7.5%, and amputation 1.7%. Ulceration was associated mainly with the male gender, neuropathy, and increased duration of diabetes. Future efforts should be directed toward educating both healthcare professionals and patients about proper foot care. Community based studies are also necessary to determine the actual prevalence of diabetic foot complications

Effects of perinatal risk factors on common neonatal respiratory morbidities beyond 36 weeks of gestation

To assess the incidence of respiratory morbidity [RM] in all single live neonates born >36 weeks of gestation, and the effects of perinatal characteristics on these morbidities. This is a prospective hospital based study covering a 12-month period. The study took place at the Department of Pediatrics, Jordan University Hospital, Amman, Jordan, between January and December 2009. The effects of different perinatal characteristics on RM including transient tachypnea of the newborn [TTN] and respiratory distress syndrome [RDS] were analyzed. A total of 2282 newborns were included. One thousand two hundred and seventy-six [55.9%] of the newborns were delivered by vaginal delivery and 1,006 [44%] by cesarean section [CS] [24.5% by emergency CS and 19.5% by elective CS]. Respiratory morbidity was reported in 3.7%. The incidence of TTN was 2.9% and RDS was 0.7%. Elective CS was found to be a risk factor for RM development when the gestational age was <39 weeks. Maternal hypertension and diabetes mellitus, and the absence of labor were independent risk factors for RM. The emergency CS and large for gestational age babies were risk factors for TTN, while male gender and GA <37[o+6] weeks were risk factor for RDS. The collaborative obstetric and neonatology responsibility helps to identify the risk factors for adverse respiratory outcome when considering the time and mode of delivery. The pregnant mother should be informed regarding this possibility if delivery by elective CS is performed before the 39[o+6] weeks of gestation

Relationship between 25-hydroxyvitamin D and metabolic syndrome among Jordanian adults

Evidence of the association between 25-hydroxyvitamin D (25(OH)D) and metabolic syndrome (MeS) remains uncertain and incongruent. This study aimed to determine the association between 25(OH)D and MeS among Jordanian adults. A complex multistage sampling technique was used to select a national population-based household sample. The present report deals exclusively with adults aged > 18 years who had complete information on all components of MeS (n = 3,234). A structured questionnaire was used to collect all relevant information. Anthropometric, clinical, and laboratory measurements were obtained. MeS was defined according to the International Diabetes Federation (IDF) definition. Of the total, 42.0% had MeS and 31.7% had 25(OH)D < 30 ng/ml. In a stratified analysis, the prevalence of MeS did not differ significantly between subjects with low and normal 25(OH)D levels for men and women in all age groups. In the multivariate analysis, the odds of MeS were not significantly different between subjects with low and normal 25(OH)D levels (OR = 0.85, 95% CI: 0.70, 1.05, P-value = 0.133). The association between 25(OH)D and MeS remained non-significant when 25(OH)D was analyzed as a continuous variable (OR = 1.004, 95% CI; 1.000, 1.008, P = 0.057) and when analyzed based on quartiles. None of the individual components of MeS were significantly associated with 25(OH)D level. This study does not provide evidence to support the association between 25(OH)D level and MeS or its individual components. Prospective studies are necessary to better determine the roles of 25(OH)D levels in the etiology of MeS.

Factors associated with sexual dysfunction in Jordanian women and their sexual attitudes

Female sexual dysfunction [FSD] is defined as disorders of libido, arousal, and orgasm, as well as sexual pain, that leads to personal distress or interpersonal difficulties. Social aspects of FSD have been understudied. The aim of this study was to explore the social aspects of FSD and sexual attitudes of Jordanian women. Six hundred thirteen married females were studied between October 2006 and August 2007 at the National Center for Diabetes, Endocrinology and Genetics [NCDEG], Amman, Jordan. Females were interviewed using a special questionnaire that was suitable to our culture and added to the Arabic translation of the Female Sexual Function Index [FSFI] Questionnaire. Older age was associated with a decreased total FSD index and its domain scores. Women with obesity were more likely to have impaired arousability and impaired capability of reaching orgasm. About 58.5% of women reported that they prepared themselves if they had sexual desire and 68.2% reported wearing special attire for this purpose. Only 37.2% of women could ask their husband for a special excitement. FSD is prevalent in Jordan. Its social aspects are understudied and need more research in the future

Intracytoplasmic sperm injection after total conventional in-vitro fertilization failure

This study assessed the value of delayed intracytoplasmic sperm injection after failure of initial in-vitro fertilization in patients with normal seminology. A case series analysis was conducted on 82 couples who underwent delayed intracytoplasmic sperm injection after failure of initial in-vitro fertilization at Fakeeh Hospital, Jeddah, Kingdom of Saudi Arabia between January 1995 and January 2001. Seventy-eight couples had 616 unfertilized metaphase II mature oocytes after initial in-vitro fertilization. Second day "rescue" reinsemination by intracytoplasmic sperm injection [ICSI] resulted in 174 embryos that were suitable for transfer. This resulted in 4 clinical pregnancies [5.1% per started rescue ICSI cycle]. The limited success rate in this study provides confirmatory data that rescue ICSI is not an efficient adjuvant laboratory procedure