174G>C interleukin-6 gene polymorphism in Tunisian patients with coronary artery disease

A state of low-grade inflammation accompanies the pathogenesis of atherosclerotic events. Interleukin-6 [IL-6] is a pleotropic pro-inflammatory cytokine that modulates the development of acute coronary syndromes [ACSs], partly by destabilizing coronary atherosclerotic plaques. We have examined the contribution of the -174G>C IL-6 promoter variant on the risk of coronary artery disease [CAD] among Tunisians. Study subjects included 418 CAD patients and 406 age-and sex-matched controls. IL-6 genotyping was done by PCR-restriction fragment length polymorphism. The frequency of the -174C allele [mutant] was lower in Tunisians than in Europeans, and the distribution of -174 G>C genotypes was similar between CAD patients and control subjects. Moreover, compared to GG genotype carriers, -174C allele carriage did not increase the CAD relative risk [odds ratio and 95% confidence interval=1.09 and 0.80-1.49], which remained nonsignificant after adjusting for traditional risk factors for CAD [age, smoking, hypertension, diabetes and obesity]. The -174G>C IL-6 promoter variant is not associated with an increased risk of CAD among Tunisians

Hyperhomocysteinemia, C677T MTHFR polymorphism and ischemic stroke in Tunisian patients

Hyperhomocysteinaemia has been identified as a strong risk factor for ischemic stroke [IS]. A point mutation in methylene tetrahydrofolate reductase [MTHFR C677T] has been associated with increased plasma homocysteine [Hcy] levels. This preliminary study aimed to investigate whether hyperhomocysteinaemia and/or MTHFR C677T mutation are associated with ischemic stroke. A case-control study including 50 consecutive patients with confirmed IS and 97 controls was performed. Fasting plasma homocysteine levels, MTHFR C677T genotypes were assessed. Other factors such as hypertension, obesity, dyslipidemia, diabetes mellitus, recurrent stroke tobacco and alcohol were investigated. Mean plasma homocysteine levels were significantly higher in IS patients than in controls [15.83 +/- 10.60] micro mol/L vs 13,78 +/- 6.29 micro mol/L, p=0.04], while no association of MTHFR C677T variant was observed even with homocysteine. The risk to develop ischemic stroke in hyperhomocysteinemic subjects was 2.4 times more than in subjects with normal Hcy levels [OR= 2.4; 95% CI: 1.13-5.06; p<0.05]. Our findings suggest that high levels of homocysteine but not MTHFR C677T polymorphism represent risk factors for arterial ischemic stroke in Tunisian subjects

[Acquired isolated factor VII deficiency and bronchogenic carcinoma. a case report]

An acquired factor VII deficiency was identified in a 63-year-old man with bronchogenic carcinoma. Initial studies indicated a normal activated partial thromboplastin time and a prolonged prothrombin time. The factor VII level was 6%. No evidence of a factor VII inhibitor or inactivator was demonstrable. However, on account of the initial normal laboratory test of emostases, the partial correction of the prothrombin time with 50% normal plasma in vitro and the family history, the congenital deficiency in factor VII was ruled out. Whatever the mechanism involved, this factor VII deficiency was related to malignancy

[Homocysteinaemia and degenerative complications in non insulin dependent diabetes mellitus]

Type 2 diabetes mellitus [non insulin-dependent diabetes mellitus: NIDDM] is known to be associated with degenerative complications. Although, the pathophysiology of such complications is well known, the role of homocysteine [Hey] is still discussed.The aim of the present study was to evaluate the relationship between the homocysteine levels and the NIDDM related complications in a group of NIDDM patients. Our study population consisted of 41 NIDDM patients including 13 subjects [G1] without complications [group controls], 17 patients [G2] with microangiopathy and 11 patients [G3] with coronary deficiency. Plasmatic homocysteine, glycemia, glycated haemoglobin [HbAIC] and lipid parameters were assessed in all patients. Our results showed that mean levels of plasmatic homocysteine were within the normal range [10.4 +/- 3.3 micro mol/l, 9.9 +/- 5.5 micro mol/l and 14.8 +/- 10.4 micro mol/l in G1, G2 and G3 respectively]. Nevertheless, moderate hyperhomocysteinaemia was found in 36% in the coronary group [G3], 17.3% in patients with microangiopathy [G2] and 7.7% in controls.These preliminary results showed that cardiovascular complications in NIDDM patients may be related to high levels of homocysteine