Prevalence and related factors of asymptomatic hyperglycemia among Kurd in Duhok, Iraq

Detection of the unknown cases of diabetes mellitus and its related risk factors is of great medical and public health interest. To estimate the prevalence of and the environmental risk factors associated with asymptomatic hyperglycemia in apparently healthy adults of the general population of Duhok city, northern Iraq. This is a cross sectional survey conducted on a representative sample of the population of Duhok city. The target population for this study were relatives of patients seen at surgical outpatient Clinics located in Azadi Teaching Hospital during one year period, out of the 5,302 contacted healthy adult subjects, 941 [17.9%] were inclusive. The prevalence of previously undiagnosed diabetes mellitus was 10.9% and impaired glucose homeostasis [impaired glucose tolerance and impaired fasting glucose] was 14.3%. A large proportion of subjects had increased body weight [69.2%], sedentary lifestyle [67.7%], married [83.6%], and illiterate [66.5%] and nearly one third [33.0%] had positive family history of diabetes mellitus. The prevalence rate of glucose intolerance was higher in subjects with overweight and obese [52.1%], positive family history of diabetes mellitus [36.1%], no physical activity [32.5%], low educational level [29.95], and married [28.9%] versus normal weight [9.3%], negative family history of diabetes mellitus [19.9%], physical activity [10.2%], high educational level [19.2%] and unmarried [6.5%] respectively [p<0.01] for all parameters. Data of this study has highlighted the risk factors and draws attention to the need for large-scale screening, followed up by appropriate management measures

[Evaluation of zinc status in patients with metabolic syndrome]

This preliminary study is an attempt to controls and to assess zinc status in a sample of metabolic syndrome patients in comparison with those of apparently healthy controls and to ascertain the relationship between zinc and metabolic syndrome features. Collection of data was carried out during the period April 2006 till January 2007, at the Medical Consultation Department, Baghdad Teaching Hospital in the Medical City, Baghdad, Iraq. In the first part of the study [a case-control study], the metabolic syndrome group, 100 metabolic syndrome patients who were chosen from patients with cardiovascular disease attending the medical examination during the period of the study. The control group includes 90 subjects who were selected from the workers of the same hospital. In the second part of the study [single blind with intervention study], metabolic syndrome patients [24 patients] divided into two groups, the first group included 12 patients supplemented with oral zinc [30 mg/day] for 50 days, and second group included 12 patients given placebo and designed as a control group. General information for each subject was obtained by questionnaire designed for the study. Waist circumference, blood pressure estimation, fasting serum glucose, triglycerides, high density lipoprotein cholesterol, zinc and urinary zinc/g creatinine were estimated for each subject. The first part of the study shows that the mean value for serum zinc level was significantly lower in metabolic syndrome patients than healthy controls [83.1 +/- 18.3 micro g/dl Vs 87.7 +/- 11.1 micro g/dl, p<0.05]. The mean urinary zinc levels, corrected for creatinine, were higher in metabolic syndrome patients than in controls [p<0.01] and increased linearly with the increasing number of metabolic syndrome components [r=0.252, p<0.05]. The prevalence of marginal zinc deficiency was significantly higher in metabolic syndrome group than in controls [24.0% Vs 14.4%, p<0.05]. The prevalence of raised fasting serum glucose, triglycerides and reduced high density lipoprotein cholesterol was higher in the metabolic syndrome group with low serum zinc [Zn< 70.0 micro g/dl] compared to zinc sufficient group [Zn> 70.0 micro g/dl] by 5.7%, 2 0.6% and 10.3% respectively. The second part of the study showed that the mean value of triglycerides of the zinc-supplemented group decreased at the end of 50 days by 6.2%, whereas the mean value of high density lipoprotein cholesterol increased by 13.6%. Marginal zinc deficiencies have been observed in the subjects study with a higher prevalence in metabolic syndrome group. The measured zinc status is associated with the features of metabolic syndrome

frequency of 2 hours post glucose load hyperglycemia in subjects with normal fasting glucose

The prevalence of impaired glucose tolerance [IGT] and previously undiagnosed diabetes mellitus [PU-DM] in variety of ethnic group has been well documented. Limited information, however, is available about the presence in Iraqi population. The aim of this study is to investigate the prevalence of the glucose intolerance and undiagnosed diabetes among healthy adult population. A total of 918 members of the general population of Baghdad city were studied. They presented different age groups [ranging from 20 to 60 years]. All subjects were in good health, and had normal fasting serum glucose levels [<6.1 mmol/L]. For assessment of hyperglycemia, all subjects underwent an oral glucose tolerance test. Among 918 subjects [401 males and 517 females], 19.0% males and 16.8% females had IGT. The prevalence of PU-DM was 1.2% for males and 5.6% for females. The prevalence increased with age in both genders. IGT and PU-DM were more commonly seen in obese subjects than in normal weight subjects [IGT: 24.5% vs 11.9%] and [PU-DM: 6.3% vs 1.9%]. This report on the IGT and PU-DM from Baghdad population showed a high prevalence of these disorders

Anemia among adolescents

To determine the prevalence of anemia in a group of apparently healthy school adolescents selected from 2 distinct socio-economic areas [SEAs] in Baghdad; and to assess the importance of diet and some other factors which could be relevant in the epidemiology of anemia in adolescents. A random sample of 1051 adolescents were included in the present study, 46% of them [487 adolescents] were from Al-Mansoor area for high socio-economic area [HSEA] and 54% of them [564 adolescents] were from Al-Horya area for low socio-economic area [LSEA] in Baghdad, Iraq. Collection of data was carried out during the period between November 1996 until the end of April 1997. Hemoglobin concentration and packed cell volume levels were determined. Dietary intake of iron, calories, protein and Vitamin C were estimated. The prevalence of anemia among adolescents in HSEA was 12.9% compared with 17.6% in LSEA. Hemoglobin concentration in males was significantly correlated with age and dietary iron intake while in females it was correlated significantly with years of education of father and mother, number of pads and age at menarche. Anemia among adolescents was found to be a health problem of moderate severity

Serum sialic acid and glycosaminoglycans in patients with rheumatoid arthritis

Serum levels of sialic acid [SA], serum glycosaminoglycans [GAGs] and urinary excretion of glycosaminoglycans were analyzed in 76 patients suffering from rheumatoid arthritis [RA]. The values were compared with those of 69 normal healthy controls. Other related parameters of disease activity were also analyzed, i.e, serum rheumatoid factor [RF], C-reactive protein [C-RF], ceruloplasmin [CF],hemoglobin [Hb] and erythrocyte sedimentation rate [ESR]. There was a significant elevation in the serum SA and urinary GAGs levels of the RS patients compared to control subjects, while no such elevations in serum GAGs were noticed. Serum SA levels were significantly correlated with disease activity. This suggests that serum SA levels can be used as an additional parameter to assess disease activity in RA patients

Serum lipids in stroke patients

Total cholesterol [TC], high denity Iipoprotein cholesterol [HDL-C], low density lipoprotein cholesterol] [LDL-C], triglycerides [TG], apoprotein A [APO-A-l] and apo protein B [APO-B] were determined in sera of 97 stroke patients and 51 healthy subjects of comparable age and sex as a control group. In stroke patients the concentration of total cholesterol, low density lipoprotein cholesterol and apoprotein B increased significantly compared to control subjects, whereas high density lipoprotein cholesterol and apoprotein A significantly decreased. These findings that such patients are at a high risk for atherosclerosis which forms an important underlying factor in stroke

Copper in rheumatoid arthritis: the relationship to disease activity

A prospective study to detect the role of copper [Cu] in rheumatoid arthritis [RA] and its relation to disease activity was conducted in 185 rheumatoid arthritic patients with various states of disease activity. The results clearly demonstrated that plasma CU [but not erythrocyte Cu] had a direct relation to disease activity. It also suggested that plasma Cu might provide an additional and useful laboratory test for the assessment of disease activity in RA

Comparison of serum zinc level in healthy Iraqi children and patients with acrodermatitis enteropathica

This study was conducted to establish reference values of serum zinc [S Zn] in Iraqi children [108 healthy infants and children of different age groups] for comparison of the results obtained for eleven patients with Acrodermatitis-enteropathica [AEP]. The value of S Zn in healthy subjects was found to be significantly lower during the first. year of life than in other age groups. Patients with AEP also had a significant low S Zn level. The clinical manifestations in these patients were as follow Dermatitis was present in 100%, loss of hair, diarrhea and family history of death were found in 63.6%, 27.2% and 27.2% respectively

incidence of monoclonal gammopathy in medical city hospital patients

The Incidence of monoclonal proteins and their Significance among hospital patients were investigated. During eight months period out of 6060 serum protein electrophoresis performed in Medieal city Laboratory, monoclonal proteins were demonstrated in the sera of 45 patients only, corresponding to a frequancy of 0.74 per cent.Those 45 patients were studied regarding to clinical, radiological and laboratory investigatlons in an attempt to reach a final diagnosis. Of 45 patients 25 [55.5%] had plasma cell dyscrasia, 12 [26.7%] had malignant lymphoma, leukemias or carcinomas, 8 [17.8%] had inflammatory conditions and other miscellaneous associated conditions. The patients with multiple myeloma were more than half of the cases, and with immunoglobulin class of IgG and IgA only. In general, the incidence of monoclonal proteins in our patients population is lower than previously reported

Lipid profile study in subjects and patients with ischemic heart disease

This study was conducted to obtain knowledge on the status of the plasma lipid fractions in normal subjects and in patients with ischemic heart disease [IHD]. Thirty one normal volunteers and 104 consecutive patients with ischemic heart disease were included in the study. The values in normal subjects were: Total serum cholesterol [T.Ch] 215 +/- 44 mg/ 100 ml, low density lipoprotein cholesterol [LDL-C] 139 +/- 40 mg/100 ml and triglyceride [TG] 130 +/- 56 mg/100 ml. These data were significantly lower than the values in patients with IHD: T. ch 236 +/- 43 mg/ 100 ml, LDL-C 155 +/- 45 mg/ 100 ml and TG 189 +/- 86 mg/ 100 ml. The high density lipoprotein cholesterol [HDL-C] in normal subjects was significantly higher [49 +/- 11 mg/100 ml] than patients with IHD [44 +/- 10 mg/ 100 ml]. The T.ch/HDL-C and the LDL-C/HDL-C were significantly lower in normal subjects than in patients with IHD. The values of the lipid fractions in normal subjects which included the T.Ch, LDL-C and HDL-C were similar to the values reported from Iraq, the United State of America, North and South Europe. However, the serum TG level was significantly higher in the American population

adverse health effects of direct and indirect exposure to lead among battery factory workers

The advers health effects of direct and indirect exposure to lead were investigated among 387 battery factory workers. The workers were divided into three groups according to the exposure level. Group I, directly exposed workers. Group Il, indirectly exposed workers and Group Ill office workers. A higher average blood lead level [Pb-B] was noticed among directly exposed workers [P <0.001]. An opposite behaviour was observed for Delta-aminolevulenic acid dehydratase [ALAD] average [P<0.01]. The majority of the workers had shown a combination of symptoms. The most dominant symptoms were easy fatigability [35.4%], joint pain [20.6%], anaemia [16.5%], constipation [10.8%] and abdominal colic [10.0%]. None of the workers had blue gum line. Higher or. prevalence, ice of easy fatigability and anaemia were found among the directly exposed workers as compared to the other groups

Lead exposure among the general population

The degree of lead exposure among the general population of Baghdad city was investigated in 1044 subjects [530 children and 514 adults] from different areas of the city. The mean values of blood lead level [Pb-B] and Delta- aminolevulinic acid dehydratase [ALAD]activity [biological indicator of lead absorption] were 14.1 +/- 4.2 ug/100ml and 190 +/- 40 unit/ml RBc respectively. Values of less than 30 ug lead/100ml blood [Australian level of concern] were reported in 99.1% of children and in 98% of the adult group. A significant increase was recorded in blood lead [P<0.01] of the adult group in comparison to the children group. There was a statistically significant difference in pb-B level by sex, cigarette smoking and alcohol drinking. Exposure of the general population of Baghdad city to lead is still within the recommended acceptable limit