Male sexual dysfunction, leptin, pituitary and gonadal hormones in Nigerian males with metabolic syndrome and type 2 diabetes mellitus

Background: Pituitary and gonadal dysfunctions resulting from increased adiposity leading to disturbances of sexual and reproductive functions have been reported in males with metabolic syndrome [MS] and type 2 diabetes mellitus [DM2]. The aim of this study was to evaluate sexual dysfunction, leptin, and reproductive hormones in Nigerian males with MS and DM2

Methods: Participants were 104 men [34 males with DM2, 17 men with MS and 53 men with normal body mass index [18.5-24.9 Kg/m[2]] without MS [controls]]. The International Diabetes Federation [2005] criteria were used for MS diagnosis. Reproductive history, anthropometry, blood pressure [BP] and 10 ml fasting blood samples were obtained by standard methods. Fasting plasma glucose, total cholesterol, triglycerides and high density lipoprotein cholesterol were determined by enzymatic methods while low density lipoprotein cholesterol was calculated. Leptin, follicle stimulating hormone [FSH], luteinising hormone [LH], prolactin, testosterone and oestrogen were determined by enzyme immunoassay [leptin by Diagnostic Automation, Inc.; others by Immunometrics [UK] Ltd.] while oestrogen-testosterone ratio was calculated. Data analyzed using ANOVA, Chi square and multiple regression were statistically significant at p<0.05

Results: Testosterone was significantly lower in MS than controls while oestradiol and ETR were significantly higher in MS compared with controls and DM2 group [p<0.05]. ETR significantly predicted testosterone in all groups [p<0.05]. Significantly lower libido was observed in men in MS than controls and DM2 groups [p<0.05]

Conclusion: Sexual and reproductive dysfunction may be related to increased conversion of testosterone to oestrogen in increased adipose mass in men with metabolic syndrome and type 2 diabetes mellitus

C1 Inhibitor, C3 activator, IgG, IgA, and IgM titers in Nigerian sickle cell disease patients with plasmodium falciparum

Sickle cell disease [HbSS] is a major health problem in Nigeria and malaria has been implicated as a leading cause of morbidity/mortality in sickle cell disease patients. Few reasons were put forward to explain the observed morbidity/mortality of HbSS subjects due to Plasmodium falciparum [P. falciparum] malaria. To determine the level of immunoglobulin classes [IgM, IgA, and IgG] and regulators of complement system [C1 inhibitor and C3 activator] in Nigerian HbSS patients with and without P. falciparum parasitemia. A total of 64 subjects were considered, including 10 HbSS genotypic subjects with P. falciparum parasitemia [HbSS+PfM], 18 HbAA genotypic subjects with P. falciparum parasitemia [HbAA+PfM], 20 HbSS without P. falciparum parasitemia [HbSS-PfM], and 16 HbAA genotypic subjects without P. falciparum parasitemia [HbAA-PfM]. IgM, IgA, IgG, C1 inhibitor, and C3 activator titers were quantified by single radial immunodiffusion method. The mean levels of IgG in HbSS+PfM [2373.90 +/- 1772.81mg/dl] and HbAA+PfM [1868.80 +/- 0.00mg/dl] were significantly higher compared with HbSS-PfM [644.55 +/- 171.15mg/dl] or HbAA-PfM [659.75 +/- 158.01mg/dl] patients. HbAA-PfM subjects had the lowest level of IgM [67.27 +/- 63.7mg/dl], though no significant difference was observed comparing mean levels of IgM between the four groups. IgA titer was significantly higher in HbSS-PfM patients [249.00 +/- 94.8mg/dl] compared with HbAA-PfM [p<0.05], HbAA+PfM [p<0.05], or HbSS+PfM [p<0.05]. The mean values of C1 inhibitor were lower in HbSS+PfM and HbAA+PfM compared with HbSS-PfM or HbAA-PfM. However, HbAA+PfM had a significantly lower value of C1 inhibitor compared with HbAA-PfM [p<0.01]. C3 activator was highest in HbSS-PfM [17.10 +/- 7.35mg/dl] and was significantly higher compared with HbSS+PfM [p<0.05]. Increased C1 inhibitor and decreased C3 activator in HbSS+PfM compared with HbAA+PfM shows that deranged regulation of complement factors may be responsible for increased susceptibility of HbSS to P. falciparum malaria

Immunoglobulin classes and nutritional factors in plasma and breast milk of lactating mothers in Nigeria

Breast milk is important for the overall well-being of infants. Although lactation is relatively robust in the face of poor nutrition, the implication of poor nutrition on non-nutritive factors in breast milk is inconclusive. This study was designed to find associations between nutritional and immune factors in maternal blood and breast milk with the aim to improve the needed public and individual strategies for a healthy infant. A cross sectional study was conducted on 61 lactating Nigerian women aged 23-40years within the first 3 months postpartum. Anthropometric measurements were obtained while nutritional factors [total protein, albumin] and immunoglobulin classes [IgG, A and M] were estimated by Biuret, Bromocresol green and single radial immunodiffusion methods respectively in maternal plasma and breast milk. Most [73.5%] of the lactating mothers had normal mean body mass index [i.e. not under weight nor obese] and the mean levels of plasma total protein, albumin, IgG, IgA and IgM were within normal reference ranges in these mothers. Nutritional and immunological indices increase in the plasma with length of lactation but decrease in breast milk with lactation. There were no correlation between BMI, plasma indices and milk indices in these lactating mothers. This study supports the superiority of colostrum over transitional or matured milk for the protection and nourishment of infants

Leucocyte migration and nitroblue tetrazolium assay in Nigerian children with bacteremia and malaria parasitemia.

The prevalence of malaria parasitemia, bacteremia, certain hematological parameters, leucocyte migration index and nitroblue tetrazolium dye reduction were determined in 147 Nigerian children (4.24+/-2.88 years of age). Sixty (40.8%), 28(19.1%) and 26(17.7%) had malaria parasitemia only, bacteremia only and both malaria parasitemia and bacteremia, respectively. Four genera of bacteria, i.e E. coli, Proteus, Staphylococcus and Salmonella, were detected in subjects with both malaria parasitemia and bacteremia. The 4 bacterial genera and Klebsiella were detected in subjects with bacterial infection only. P. falciparum (68%), P. malariae (25%) and P. ovale (7%) were the species of malaria parasites identified in our subjects. Bacteremia was most prevalent in subjects with hemoglobin AA (HbAA) (60.7%) followed by HbAC (21.45%). Packed cell volume (PCV) and Hb concentration were similar in all groups but mean counts of red blood cells (RBC) and white blood cells (WBC) were statistically significantly lower in subjects with malaria parasites only compared to the controls. Leucocyte migration was significantly reduced in children with bacteremia only or both malaria parasitemia and bacteremia compared to controls, while the nitroblue tetrazolium assay was significantly reduced in children with bacteremia only. It may be concluded that malaria parasitemia significantly affects both leucocyte migration and nitroblue tetrazolium assay.