Impaired fasting glucose in Omani adults with no family history of type 2 diabetes

The aim of this study was to estimate the prevalence of impaired fasting glucose [IFG] among Omani adults with no family history [FH] of diabetes and to investigate the factors behind the risk of developing type 2 diabetes [T2D], while excluding a FH of diabetes. A total of 1,182 Omani adults, aged >40 years, visited the Family Medicine and Community Health Clinic at Sultan Qaboos University Hospital, Oman, on days other than the Diabetes Clinic days, from July 2010 to July 2011. The subjects were interviewed and asked if they had T2D or a FH of T2D. Only 191 [16%] reported no personal history of T2D or FH of the disease. Of these, anthropometric and biochemical data was complete in 159 subjects. Of these a total of 42 [26%] had IFG according to the American Diabetes Association criteria. Body mass index, fasting insulin, haemoglobin A[1c] and blood pressure [BP], were significantly higher among individuals with IFG [P <0.01, P <0.05, P <0.01 and P <0.01, respectively]. In addition, fasting insulin, BP and serum lipid profile were correlated with obesity indices [P <0.05]. Obesity indices were strongly associated with the risk of IFG among Omanis, with waist circumference being the strongest predictor. Despite claiming no FH of diabetes, a large number of Omani adults in this study had a high risk of developing diabetes. This is possibly due to environmental factors and endogamy. The high prevalence of obesity combined with genetically susceptible individuals is a warning that diabetes could be a future epidemic in Oman

Reference values for arterial stiffness indices in an Omani Arab population

To determine the reference values of arterial stiffness indices, particularly augmentation index [AIx] and pulse wave velocity [PWV] using applanation tonometry in a healthy Omani Arab population. This prospective study was carried out in the Department of Clinical Physiology, Sultan Qaboos University Hospital, Muscat, Oman over a 2-year period from June 2011 to June 2013. The central AIx, aortic PWV [AoPWV], and central pulse pressure [CPP] were recorded from 120 healthy subjects recruited randomly from a normal population using a SphygmoCor device. The 2.5[th] and 97.5[th] percentiles were used to determine the reference ranges for men and women separately. Analyses were performed using univariate statistics. The mean age of the cohort was 38 years for men, and 35 years for women, with the ages ranging from 20-53 years. The overall mean central AIx was 13 +/- 11%, and for AoPWV was 6.7 +/- 1.6 m/s. The central AIx was higher in women [17 versus 10%; p<0.001], whereas the AoPWV was higher in men [7.1 versus 6.3 m/s; p=0.003]. Subjects were categorized according to the gender and age decade, and reference values for CPP, central AIx, and AoPWV were obtained. This study reports the reference values for arterial stiffness indices from an Omani Arab population; the results of which should be interpreted in the context of its limitations

audit of the sleep medicine service in Oman

To audit the sleep service at Sultan Qaboos University Hospital [SQUH], Muscat, Oman, and to explore deficiencies to introduce new measures of improvement. Polysomnography [PSG] reports and SQUH medical records of all patients who underwent sleep studies from January 1995 to December 2006 in the sleep laboratory at SQUH were reviewed and analyzed. Out of a total of 1042 sleep studies conducted in the specified period, 768 PSG recordings were valid for analysis. The audit showed that the Otolaryngology Department was the main referring specialty for PSG [43%]. Snoring was the main symptom for 33% of the subjects referred, but suspicion of obstructive sleep apnea was the main reason for referral [38%]. Three quarters of the patients were males who were also younger, and with lower body mass index compared to females [p=0.0001 for all]. Despite large number of patients with an apnea-hypopnea index of >15 [n=261], only 94 [36%] patients received continuous positive airway pressure titrations and treatment. The sleep medicine service in SQUH provided the basic service, and raised the awareness of the importance of this specialty. However, substantial effort is required to bring it to international standards

Screening of patients with snoring and obstructive sleep opnoea using heart rate variability indices

Snoring and obstructive sleep apnea [OSA] are common disorders. Snoring associated with excessive daytime sleepiness is the most prevalent symptoms of OSA. Heart rate variability [HRV] is altered in patients with OSA and the degree of alteration may be linked to the severity of OSA. Alterations in HRV in 24 hour tachograms have recently been used in screening OSA patients. Autonomic components causing HRV can be reliably studied using spectral analysis techniques involving fast Fourier transformation [FFT]. Twenty-three subjects, 13 with severe OSA and 10 controls matched for age and body mass index, were selected from patients who had undergone polysomnography [PSG] for snoring at Sultan Qaboos University Hospital, Oman. A 24- hour electrocardiogram [ECG] Holter recording was done at home, starting at 10am. Spectral analysis of ECG from sleep Holter and PSG recordings was analysed using fast Fourier transformation [FFT]. The ECG RR intervals of snorers with OSA were significantly shorter than in snorers without OSA [p <0.01]. The low frequency [LF] spectral densities of HRV from polysomnography and Holter were significantly higher in OSA patients than in snorers, [p < 0.0001]. The power spectral density of the high frequency bands was similar in the two groups. The overnight ECG Holter accurately identified all 13 snorers with severe OSA. The spectral power of the LF band obtained using FFT of sleep HRV from Holter tachograms may be a useful and cost effective test in identifying snorers with severe OSA

Genotypes and allele frequencies of angiotensin converting enzyme [ACE] insertion/deletion polymorphism among Omanis

To describe the angiotensin converting enzyme [ACE] genotype frequencies among Omani Arabs. A polymerase chain reaction [PCR] test, based on separation of different size DNA fragments, was developed to test the presence or absence [polymorphism] of a small DNA deletion in the ACE gene. The subjects were 124 Omani Arab students of Sultan Qaboos University, Muscat. The frequency of the I allele was 0.29, while that of the D allele was 0.71. The gene frequency distribution did not deviate from Hardy-Weinberg equilibrium. The frequency of D allele among Omanis is similar to that among other Arabs and Africans, but differs significantly from that among the Japanese and Chinese

Assessment of aerobic fitness and its correlates in Omani adolescents using the 2o-metre shuttle run test. A pilot study

To assess aerobic fitness in male and female adolescents using the multistage ŸcŸa-metre shuttle run test and correlate it with selected fitness variables. The subjects comprised 83 girls and 64 boys aged 15-16 years, randomly selected from two segregated government schools in Muscat. After the pupils filled in a short questionnaire on their personal leisure time activities of the preceding week, their heights and weights were measured. Aerobic fitness was assessed by estimating each pupil's minimal oxygen uptake levels [VO[2max]] using the multistage 20-metre shuttle running test [20-MST]. Boys spent more time than girls on leisure physical activities, television, computer and video games and the Internet. The estimated VO[2max] in both boys and girls showed high correlation with their weekly physical activities. The time spent on television and computer negatively correlated with VO[2max] in girls but not in boys. Girls had higher body mass index [BMI] and less VO[2max] compared to boys; BMI showed a negative correlation with VO[2max] in girls but not in boys. Aerobic fitness in this sample was higher in boys than in girls and was strongly influenced by weekly physical activities in both genders. The 20-MST has proved a simple and inexpensive field test for aerobic fitness that could be implemented on a wide scale

Exaggerated blood pressure reactivity in the offspring of first-cousin hypertensive parents

To study blood pressure and blood pressure reactivity in young offspring of normotensive or hypertensive parents who are consanguineous [first cousins] or are not blood-related. Blood pressure, heart rate and body mass index [BMI] were measured in 9-10 year-old male offspring of 19 pairs of first-cousins normotensive, 16 pairs of first-cousin hypertensive and 12 pairs of non-blood-related hypertensive parents. The offspring of first-cousin hypertensive parents exhibited the greatest systolic and diastolic blood pressure reactivity to their first casual blood pressure measurement, while the offspring of first-cousin normotensive parents showed the least reactivity. The offspring of the hypertensive parents who were not blood-related showed an intermediate reactivity. Basal systolic blood pressure [SBP] was also highest in the offspring of first-cousin hypertensive parents, and their basal diastolic blood pressure [DBP] was higher than that in offspring of first-cousin normotensive parents. The augmented blood pressure response in the offspring of hypertensive parents may have prognostic implications and serve as an important and significant indicator of predisposition to hypertension later in life