Brothers of women with polycystic ovary syndrome: a new group with high risk for type 2 diabetes mellitus and cardiovascular disease

Polycystic ovary syndrome [PCOS] is common endocrinal disorder which is highly inherited and characterized by many metabolic abnormalities. We hypothesized that male relatives of PCOS women would also have metabolic abnormalities. Thus, our aim was to assess insulin sensitivity and metabolic parameters in brothers of women with PCOS and male control individuals. 30 brothers of women with PCOS and 20 male healthy control subjects were included in the study. Brothers and control were subjected to complete medical evaluation with stress on anthropometric measurements, fasting insulin, homeostasis assessment model [HOMA-IR], lipids, plasminogen activator inhibitor-1 [PAI-1], C-reactive protein [CRP] and androgens. Brothers and control individuals were similar as regard to age, MBI, WHR and blood pressure. However, brothers were insulin resistant and had dyslipidemia and dyscoagulability [HOMA-IR, P=0.043, TC P=0.001, LDL-C P=0.002, HDL-C P=0.03, TG P=0.048, PAI-1 P=0.002, CRP P=0.046]. Also HOMA-IR, was correlated significantly with BMI p<0.001, WHR P<0.001, PAI-1 P<0.001, CRP P<0.01, TG, P<0.001, LDL-C P=0.02, HDL-C P=0.019]. Brothers of women with PCOS have a metabolic phenotype consisting of dyslipidemia, insulin resistance, dysmgulability and carry an increased risk of cardiovascular disease [CVD] and type 2 diabetes mellitus [type 2 DM]. Given the high prevalence of PCOS, brothers may represent an important new risk factor for CVD in men and should be considered a well identified group for primary preventive measures

Homocysteine in type 2 diabetes mellitus: relation to diabetic vascular complications

Hyperhomocysteinemia has recently been recognized as an independent risk factor for cardiovascular disease. Diabetes mellitus [DM] is know to increase the risk of atherosclerotic vascular diseases. Insulin resistance syndrome is characterized by clustering of cardiovascular risk factors like hyperinsulinemia, hypertension .etc, that has been hypothesized to play an important role in atherosclerosis. The reason for the high susceptibility of diabetic patients to atherosclerosis remain incompletely understood. Plasma homocysteine [HCY] status in diabetics is still a matter of controversy. The aim of our work .was to study plasma level of HCY in type 2 diabetic patients and to study the relation of plasma HCY level to different diabetic vascular complications. The study included 40 patients with type 2 [DM] [aged 52.9 +/- 6.3 years]. and 25 apparently healthy controls matched in age and sex with the patients. Both groups were evaluated thoroughly and the following parameters were assessed, fasting blood post prandial blood glucose [PPBG], uric acid, serum creatinine, lipid fasting plasma insulin [FPI], homeostasis model assessment of insulin resistance [HOMA-IR] and plasma HCY level. Our study revealed significant increase in systolic blood pressure [SBP], diastolic blood pressure [DBP], FBG, PPBG, plasma cholesterol, triglycerides [TG] and low density lipoprotein cholesterol [LDL-c] but significant decrease in high density lipoprotein cholesterol [HDL-c] in diabetic patients vs control group. We found also significant increase in plasma HCY, FPI and HOMA-IR in diabetic patients vs control group, all [p<0,001].Thestudy also showed highly significant increase in plasma HCY in patients with macrovascular complications vs those with microvascular complications [31 +/- 1.69 vs 22.3 +/- 226, p<0.001]. In patients with type 2 DM there were significant positive correlation between HCY level and age, SBP, DBP, FBG, PPBG, serum creatinine, total cholesterol TG, LDL-c, FPI, proteinuria and HOMA-IR but significant negative correlation with HDL-c [all p<0.001]. From this study, it is concluded that hyperhomocysteinemia is present in type 2 DM especially in patients with concomitant macrovascular complications, and it can be considered as a definite risk factor for vascular complications in those patients

Health assessment for chronic liver disease

Assessment of health related quality of life [HRQOL] is not routinely reported in the literature on chronic liver disease [CLD]. Few studies have examined quality of life [QOL] in those patients despite its significant functional impact. The aim of this work is to evaluate HRQOL in patients with chronic liver disease and to examine the correlation between chronic liver disease questionnaire [CLDQ] and the severity of liver disease, and their impact on the well being of these patients with the chronic illness. Subject and methods:-Th study included 75 patients having CLD [aged 45.18 +/- 6.5 years 40 male and 35 female] and 20 apparently healthy subjects as a control group [aged 42.11 +/- 5.2 ,12 male and 8 female]. Both groups were evaluated thoroughly and were asked to complete the CLD] questionnaire which is designed to assess HRQOL in CLD patients. We found significant impairment of HRQOL in patients versus controls. The study also showed significant decrease in HRQOL in patients with higher Child Pugh [CP] class. We also found significant impairment in HRQOL in patients more than 50 years old compared to those younger than 50 years for all grades of CP classification. The study also revealed significant-ye correlation between HRQOL and clinical manifestation of liver decompensation, bilirubin and prothrombin time. There was significant+ve correlation between HRQOL And plasma albumin. As regard hepatic transaminases we found significant ve correlation between AST and worry domain and significant-ve correlation between ALT and activity domain of CLD questionnaire. From the previous results, it appears that chronic liver diseases substantially reduce HRQOL. Further, this impairment increases with disease severity. The ability of the CLDQ to detect associations with disease severity and its applicability to all types of liver diseases that it can be an additional, important outcome in clinical trials designed suggest to evaluate health changes due to disease progression and provide therapeutic measures suitable for patients

Subclinical hypothyrodism, is it mild thyroid failure to treat or acompansated state?

Subclinical hypothyroidism "SCH" affects of general 5-15% of general population, however the need of lifelong L-thyroxin "LT4" therapy is still controversial. As the serum lipids and myocardium are main targets of thyroid hormone action, we investigate whether SCH induces serum lipids and cardiovascular alterations and we evaluate the effect of L-T4 replacement therapy on clinical symptoms, serum lipids and echocardiographic parameters in patients with SCH. We studied 20 premenopausal women with subclinical hypothyroidism with age ranging from 18-45 years and 20 premenopausal euthyroid women as control group matched to SCH patients for age and body mass index [BMI]. Patients were randomly classified into two sub-group each included 10 women, one group received L-T4 therapy and the other group receive placebo for the same period. All were subjected to through clinical assessment, assessment of tissues hypothyroidism using zulewski Score, serum total cholesterol [TC] law density lipoprotein cholesterol "LDL-C", high density lipoprotein cholesterol "HDL-C" and triglycerides "TG" also echocardiography 2D, M-Mode and Doppler study. Our study revealed significant elevation of total cholesterol and LDL-C in SCH patients than control and after L-T4 therapy, there was significant improvement of both clinical score and serum lipids. Also SCH patients had significantly higher isovolumetric relaxation time "IVRT' and peak A value than control moreover preejection period "PEP" as well as PEP/ET were significantly longer in patients than controls and these changes fully reversed after L-T4 therapy. SCH patients has negative clinical metabolic and echocardiographic effects and these negative effects are fully reversible after LT4 therapy. Therefore subclinical hypothyroidism is better considered a condition of minimal tissues hypothyroidism than a compensated state. Indeed, L-T4 replacement therapy should be advised for these patients with the aim to prevent both the progression to frank hypothyroidism and the development of clinically significant myocardial dysfunction

Serum levels of interleukin-10 and interleukin- 12 in chronic hepatitis C

Background and Objective: it is still unclear whether Thl /Th2 cytokines are involved in the pathogenesis of hepatocellular injury of hepatitis C infection. We therefore examined serum levels of IL-10 and IL-12 in chronic liver disease patients, whereas IL-12 represents Thl cytokine and IL-10 represents Th2 cytokine

Methods: serum levels of LL-10 and IL-12 were measured in 54 patients including 30 with chronic hepatitis [CH] and 24 with liver cirrhosis [LC] in comparison with 20 normal individuals, by an enzyme-linked immunosorbent assay

Results: serum level of IL-10 was significantly higher in chronic hepatitis and LC than in controls [89.6 +/- 56.58 pg/ml ad 1 73.38 +/- 67.71 pg/ml Vs 36.35 +/- 16.04 pg/ml, respectively, P<0.001, each]. It was significantly higher in LC than in CH [p<0.001] Serum level of IL-12 was significantly higher in CH and LC than in controls [325.03 +/- 132.75 pg/ml. 349.01 +/- 204.32 pg/ml Vs 184.15 +/- 122.16, P<0.001 and P<0.01, respectively]

Conclusion: the results of the present study suggest that Th1 /Th2 type cytokines are changed in association with progression of chronic liver disease type related to HCV infection