Leptin and uric acid as predictors of metabolic syndrome in jordanian adults

BACKGROUND/OBJECTIVES: Metabolic syndrome (MetS) is a set of interrelated metabolic risk factors that increase the risk of cardiovascular morbidity and mortality. Studies regarding the specificity and sensitivity of serum levels of leptin and uric acid as predictors of MetS are limited. The aim of this study was to evaluate the serum levels of leptin and uric acid in terms of their specificity and sensitivity as predictors of MetS in the studied Jordanian group. SUBJECTS/METHODS: In this cross sectional study, 630 adult subjects (308 men and 322 women) were recruited from the King Hussein Medical Center (Amman, Jordan). The diagnosis of MetS was made according to the 2005 International Diabetes Federation criteria. Receiver operating characteristic curves were used to determine the efficacy of serum levels of leptin and uric acid as predictors of MetS in the studied Jordanian group. RESULTS: Study results showed that for identification of subjects with MetS risk, area under the curve (AUC) for leptin was 0.721 and 0.683 in men and women, respectively. Serum uric acid levels in men showed no significant association with any MetS risk factors and no significant AUC, while uric acid AUC was 0.706 in women. CONCLUSION: Serum leptin levels can be useful biomarkers for evaluation of the risk of MetS independent of baseline obesity in both men and women. On the other hand, serum uric acid levels predicted the risk of MetS only in women.

Diabetes knowledge among patients with diabetes mellitus at King Hussein Hospital

To assess Diabetes Knowledge among patients with Diabetes mellitus at King Hussein Hospital. This study was conducted at King Hussein Hospital. Descriptive research design during the period between September 2010 to October 2010, was used to recruit a convenient sample of 100 hospitalized adult patients with Diabetes mellitus. Data was collected through face-to-face interview using the Brief Diabetes Knowledge Test [Fitzgerald et al, 1998]. This test is composed of 23 multiple choice questions that assess General Knowledge and Insulin Knowledge as well as Total score for Total knowledge. Simple descriptive statistics [frequency, mean, percentage] was used to describe the study variables One hundred diabetic patients participated in this study [50 men and 50 women]. Their age ranged from 19 to 86 years [mean +/- SD 57.8 +/- 10.9 years]. The majority [90%] were married. The overall scores of the total sample were low; Total knowledge was [49.8 +/- 13.4]; General Diabetes Knowledge was [54 +/- 14] and Insulin Knowledge was [43 +/- 19.6]. Men scored higher than women in the total Knowledge [52.9 vs. 46.7]; General Diabetes Knowledge [56.8 vs. 51.1]; and Insulin Knowledge [46.9 vs. 39.8]. Moreover, there were no differences found between patients with type 1 and type 2 Diabetes in study group. Diabetic patients in this study had Diabetes Knowledge deficit about their disease, which in turn will limit their involvement in the management of the disease

Impact of metabolic syndrome's components on the development of cardiovascular disease in a Jordanian cohort with metabolic syndrome

To assess the gender differences in the prevalence of diabetes, composite cardiovascular disease, and the components of metabolic syndrome [MS] in a Jordanian cohort with MS. Secondly, to evaluate the impact of number of MS components on prevalence of diabetes, ischemic heart disease [IHD], and stroke. We carried out a cohort study among participants who fulfilled the National Cholesterol Education Program [Adult Treatment Panel III] criteria for MS recruited from December 2006-2007 from Endocrine Outpatient Clinics of the King Hussein Medical Centre, Amman, and Prince Rashid Military Hospital, Irbid, Jordan. Patients were divided into groups according to gender, presence, or absence of diabetes, and were evaluated for MS components, presence of IHD, and stroke. Three hundred and fifty-seven patients 207 males and 150 females were included, type 2 diabetes was present in 226 [132 males] patients. No intergroup differences were found on waist circumference, systolic blood pressure, diastolic blood pressure, or fasting blood sugar. Female group was having a worst lipid profile, higher triglyceride levels and low high density lipoprotein. Metabolic syndrome components were more in males. Diabetic males have more composite cardiovascular disease [CCVD] [relative risk [RR]=1.88, 95% confidence interval: 1.01-3.59]. No difference in prevalence of CCVD between female subgroups neither between the 2 genders with MS. The prevalence of diabetes mellitus, IHD, and stroke increased with increasing number of MS components. Diabetes was the strongest predictor for development of CCVD [RR=1.8] and IHD [RR=2.18]. Females with MS have the worst lipid profile compared to the males, diabetic males have the worst CCVD end point. The prevalence of diabetes and IHD correlates with the number of MS components

Primary hyperparathyroidism. A rare cause of spinal cord compression

We report a case of a 62-year-old postmenopausal hypertensive lady who was treated for osteoporosis with calcium and Vitamin D. She presented with progressive lower limb weakness and paresthesia with sensory level at T4. Investigations revealed high parathyroid hormone 1152 ng/dl, calcium 10.9 mg/dl, and low phosphorus of 2.4 mg/dl after stopping calcium supplement. Chest x-ray showed an expansile mass lesion of the right 6th rib confirmed by chest CT. Thoracic MRI showed a mass lesion extending from the T3 vertebral body and compressing the spinal cord. There were multiple lytic lesions of the scalp, ribs, femur, and pelvis suggesting metastatic lesions. A neck ultrasound and SESTA MIBI parathyroid scan confirmed a right lower parathyroid adenoma. Excision biopsy of the rib lesion confirmed a vascular lesion with features of brown tumor BT. Decompression surgery of the thoracic spine was performed, and the histopathology confirmed BT. Two weeks later the patient underwent right parathyroidectomy that proved to be a parathyroid adenoma. She showed a remarkable improvement in her clinical condition and there were some regression of the bony lesions observed 12 months post parathyroidectomy. This case should alert physicians to the association of multiple brown tumors in PHPT and that the presentation may be an aggressive one mimicking metastasis, patients with osteoporosis warrant at least calcium profile to rule out a secondary cause

Hypothyroidism due to Hashimoto thyroiditis post struma ovarii excision

Struma ovarii is a rare ovarian teratoma that may produce hyperthyroidism. The association with Hashimoto thyroiditis HT, however is rare and has been reported in only one case. We report a case of HT following the resection of struma ovarii tumor, after which the patient became frankly, hypothyroid with elevated thyroid stimulating hormone and low thyroxin levels. Her thyroid peroxidase antibodies were positive. She improved after initiation of levothyroxine replacement therapy. We believe her euthyroid status preoperatively was due to thyroid hormone secretion by struma ovarii itself