Serum interleukin-10 and interleukin-6 levels in obese women with metabolic syndrome

Obesity, especially visceral obesity, may play a role in the pathophysiology of the metabolic syndrome, and is clearly linked to insulin resistance and increased risk for developing cardiovascular diseases. The metabolic syndrome is characterized by the occurrence of visceral obesity, dyslipidemia [especially high levels of triglycerides and low levels of high density lipoprotein cholesterol], hyperglycemia and hypertension. Although circulating levels of pro-inflammatory cytokines as interleukin-6 [IL-6] and tumor necrosis factor-alpha [TNF-alpha] as well as other markers of inflammation as C-reactive protein [CRP] have been shown to be elevated in obesity, nothing is known about the role of anti-inflammatory cytokines. So, this study was conducted to determine interleukin-10 [IL-10] levels in obese women with or without metabolic syndrome. This study included 3 groups of women, 20 obese women without metabolic syndrome, 20 obese women with metabolic syndrome and 15 normal lean women as a control group. The study showed that CRP levels were significantly elevated in obese women with metabolic syndrome compared with those without metabolic syndrome, and also CRP levels were significantly elevated in obese women with or without metabolic syndrome compared with lean women. IL-6 levels were significantly increased in obese women compared with lean subjects but no significant difference was found between obese women with or without metabolic syndrome. IL-10 levels were significantly increased in obese women with or without metabolic syndrome compared with lean women. Moreover, IL-10 levels were significantly lower in obese women with metabolic syndrome compared with obese women without metabolic syndrome

Thyroid functions in obese type 2 diabetes mellitus

Type 1 diabetes mellitus may be associated with autoimmune thyroid diseases like Grave's disease and Hashimoto's thyroiditis. Type 2 diabetes mellitus is usually associated with obesity and other features of the metabolic syndrome like hypertension, hyperlipidemia, and insulin and leptin resistance. It is reported that high body mass index is associated with decrease total and free thyroxine levels and increased thyroid stimulating hormone. Some reports found that leptin is needed to maintain thyrotropin regulating hormone expression in the hypothalamus. This stimulatory effect of leptin on thyroid hormones production may be blunted in obese diabetics due to leptin resistance seen in these patients. The aim of this work was to study thyroid functions in obese type 2 diabetes mellitus and to find out any relation between thyroid hormones and leptin. This study included 4 groups of subjects, aging from 35 to 60 years. The first group included 10 healthy lean subjects as a control group. The second group included 20 obese non diabetic subjects. The third group included 20 obese diabetic patients and the fourth group included 20 lean diabetic patients. This study showed significant decreased free triiodothyronine and free thyroxine levels in obese subjects [diabetic and non diabetic] [p < 0.05]. Also thyroid stimulating hormone levels were significantly higher in obese subjects [diabetic and non diabetic] compared to the control persons [p < 0.05]. Thyroid stimulating hormone levels were significantly elevated in obese diabetic compared to lean diabetics [p < 0.05]. Significantly elevated leptin and insulin levels were found in obese subjects [diabetics and non diabetics], who have decreased thyroid hormones levels compared to lean subjects. Significant negative correlations were found between free triiodothyroniue or free thyroxine and body mass index, age, insulin and leptin

Combined approach for management of diabetic foot ulcer

Diabetic foot ulcers occur as a result of peripheral neuropathy, microvascular and macrovascular arterial disease, suboptimal glycemic control and foot infections. Peripheral neuropathy has the greatest risk of foot ulceration. In fact, every year 5 percent of diabetic patients develop foot ulcers and 1 percent requires amputation. Combined approach for management of diabetic foot ulcers in the form of strict diabetic control, correction of associated diabetic complications, such as neuropathy and/or angiopathy, hyperlipidemia, and infection, surgical intervention in the form of ulcer cleaning, debridment, dressing and skin coverage with the suitable mean, with the aid of physical therapy in the form of electric stimulation and low power laser irradiation has been reported to achieve the shortest and the maximum success of diabetic foot ulcers management. Low power laser irradiation has been reported to cause biological effects on tissue healing by increasing production of collagen by fibroblasts and stimulation of keratinocyte activity and microcirculation with increase of lymphatic drainage. Electric stimulation increases tissue collagenase, enhance vascularization, regional blood flow and tissue oxygen levels; also increase macrophage migration to the site of ulcer. In this study 20 diabetic patients with foot ulcers were Selected from general medicine, surgery departments and out patient diabetes clinic in Matareya Teaching Hospital. All patients were subjected to history taking with special emphasis on duration of diabetes, presence or absence of neuropathy and/or angiopathy. Physical examination included neurological and vascular examination as well. Local examination of the foot included: circumference and depth of ulcer, and measurement of foot oedema. Investigations included: Laboratory investigations [fasting and 2 hours post-prandial blood sugar, glycated haemoglobin, lipid profile, liver and kidney functions]. Electrodiagnostic tests included: nerve conduction study [motor and sensory before and after treatment] was carried out for common peroneal and posterior tibial nerve. Six patients were subjected to surgical procedures for coverage of their ulcers and the rest of the patients were managed conservatively medically together with laser irradiation and electric stimulation. The mean of total surface area of ulcer before treatment was 20 +/- 12.9 cm[2]. While the depth was 2.09 +/- 1.09 mm and after treatment both were zero [complete healing]. Mean duration of healing was 4.7 +/- 2.75 months. Statistical significant improvement of laboratory investigations was recorded after three months of treatment. Statistical significant improvement in edema, sense of pain and nerve conduction velocity [motor and sensory] of common peroneal and posterior tibial nerve was evident after treatment. Good results were obtained by work of Combined team including physician for meticulous control of blood glucose, hyperlipidemia, control of infection and other associated complications of diabetes mellitus, surgeon for ulcer debridment and doing skin flap for necessary cases, clinical pathologist for the laboratory investigations; physiatrist to evaluate the neurophysiological function of motor and sensory components of both common peroneal and posterior tibial nerves before and after treatment. Physiotherapist for local evaluation of ulcers [area and depth], edema and sense of pain and application of the physical therapy program in the form of laser irradiation and faradic stimulation sessions

Plasma homocysteine levels in cerbrovascular strokes

Seventy adult subjects were included in this study and subdivided into four groups: The first group included 10 healthy lean subjects as a control group, the second group included 20 patients with high risk factors as diabetes mellitus, hypertension, hypercholesterolemia and/or smoking, the third group included 20 patients with cerebrovascular stroke and having one or more of the risk factors, while the fourth group included 20 patients with stroke having none of the above-mentioned risk factors. This study showed that homocysteine was significantly elevated in the three different groups of patients compared with the control group. Although homocysteine levels were higher in both groups of patients with stroke compared with the non- stroke patients with risk factors, the difference was not statistically significant. Also, this study showed that there were significant elevated levels of cholesterol, triglycerides, fasting blood glucose and glycated hemoglobin in both groups of patients with risk factors compared with the control group or the group of patients with stroke, but without having risk factors other than hyper homocysteine. In addition, the study showed that there was a significant positive correlation between homocysteine and age, body mass index [BMI], blood glucose, glycated hemoglobin, total cholesterol and low lipoprotein cholesterol