Leptin, osteocalcin, and bone mineral density in post-hepatitic liver cirrhosis

The pathophysiology of osteoporosis complicating chronic liver disease is unknown. Some studies have found leptin to be a potent inhibitor of bone formation. The aim of this study is to investigate the relationship between leptin, osteocalcin and bone mineral density [BMD] in liver cirrhosis. Sixty patients with post-hepatitic liver cirrhosis were classified into three groups: group I, 20 pre-menopausal females; group II, 20 post-menopausal females; and group III, 20 males. In addition, 21 age- and sex-matched healthy subjects [seven for each group] were included as control subjects. Patients were classified according to Child-Pugh classification into grade A [n = 0], grade B [n = 38] and grade C [n = 22]. Serum osteocalcin, leptin and parathyroid hormone [PTH], in addition to liver functions test, hepatitis B surface antigen [HBsAg], anti-hepatitis C virus [HCV], serum phosphorus and calcium were measured. Bone mineral density [BMD] was measured by calcaneal ultrasound. Leptin was elevated in all groups [I, II and III] when compared with their control groups [p < 0.01, p < 0.001 and p < 0.01, respectively]. Further, it was high in female groups [I and II] compared to males [group III], [p < 0.01 each]. BMD and serum osteocalcin decreased in each group compared with the respective control [p < 0.001; p < 0.01 in group I, p < 0.05; p < 0.001 in group II and p < 0.001; p < 0.001 in group III, respectively]. In the Child-Pugh grade C group, BMD and osteocalcin were low [p < 0.001, p < 0.05, respectively], while serum leptin was elevated [p < 0.05], when compared with grade B group. Leptin correlated negatively with serum osteocalcin [r = -0.553; p < 0.001], BMD [r = -0.229; p < 0.05], albumin [r = -0.449; p < 0.001] and albumin/globulin [A/G] ratio [r = -0.661; p < 0.001], while positively correlated with both aspartate transaminase [AST] [r = 0.462; p < 0.001], and alanine transaminase [ALT] [r = 0.483; p < 0.001]. Osteocalcin negatively correlated with intact iPTH [r = -0.370, p < 0.001], while positively correlated with BMD [r = 0.418; p < 0.001], albumin [r = 0.659; p < 0.001] and A/G ratio [r = 0.444; p < 0.001]. Serum leptin was elevated in cirrhotic patients and may have a role in the pathogenesis of osteoporosis in liver cirrhosis

study of sexual and reproductive dysfunctions in juvenile onset diabetic men

Diabetes affects an increasingly large number of young men of reproductive age To determine fertility status and to evaluate semen parameters and sexual dysfunction in men having juvenile onset diabetes comparing them to fertile controls. 73 male patients having juvenile onset diabetes mellitus. The study included clinical evaluation, erectile capacity scoring with IIEF-5 score, urine analysis after masturbation, conventional semen analysis and sperm hypoosmotic swelling test of 73 diabetic men and 33 fertile controls. Comparison between diabetic patients and fertile controls in conventional sperm parameters and hypoosmotic sperm swelling percentage [HOS%]. Additionally, assessment of prevalence of infertility, erectile and ejaculatory dysfunction in diabetic patients. There was a significant decrease in percentage of normal sperm morphology among diabetic patients [41.37 +/- 12. 38] than controls [57.27 +/- 8.11] [P < 0.001]. Percentage of progressive sperm motility was significantly lower in diabetic patients [33.42 +/- 13.38] than controls [54.84 +/- 5.92] [P < 0.001]. There was a significant decrease in sperm HOS% among diabetic patients [62.55 +/- 11.69] in comparison to controls [77.36 +/- 8.23] [P < 0.001]. There was no significant difference in sperm concentration [in million sperm/ml] between diabetic patients [69.75 +/- 62.11] and controls [74.55 +/- 50.78]. Similar results were obtained on comparing between fertile and infertile diabetics. Prevalence of infertility was 40%, erectile dysfunction [ED] was 75%, premature ejaculation was 31% and partial retrograde ejaculation was 5%. Diabetic patients had significantly lower normal sperm morphology, progressive sperm motility and hypoosmotic sperm swelling percentages. They had higher round cell number. They also had increased prevalence of infertility, erectile and ejaculatory dysfunctions

Human muscle sarcocystosis in relation to non specific rheumatic diseases and rheumatoid arthritis

Human muscle sarcocystosis is a parasitic infestation acquired by ingestion of the sporocysts of the sarcocystis species. Sarcocystis antibodies were said to be encountered in patients with connective or mixed connective tissue disorders. Parasitological etiology of musculoskeletal disorders may help to modify the line of treatment of these patients. This study was performed on 22 non specific rheumatic patients, 21 rheumatoid arthritic [RA] patients and 10 apparently healthy persons as controls. Using the sarcocystis fusiformis antigen [Ag.], serum samples of the patients were tested for the presence of sarcocystis species antibodies using the Westren Blot technique. Of the 22 patients of the first group, 14 were positive [63.7%], of the 21 patients of the second group 5 were positive [23.8%]. They deducted several band ranges from 15-116 KD. Most of these samples had eosinophilia ranging from 7-20%. None of the control group serum reacted against sarcocystis Ag. Statistically the difference between the two groups was significant [P <0.04]. Sarcocystis infection may be an important cause of the non specific rheumatic diseases associated with myositis. Diagnosis and treatment of such a frequent infestation in carefully chosen cases would relieve them from prolonged intake of antirheumatics and their side effects

use of gated cardiac single photon emission computed tomography [SPECT] in healthy smokers

As cigarette smoking is a major cardiovascular risk factor, this study was designed to find the effect of chronic cigarette smoking on cardiovascular system of apparently healthy subjects by using gated SPECT. This study included 20 healthy young males heavy smokers with smoking index 379 +/- 193.4. Also 10 age and sex matched non smokers volunteers served as controls. Smokers and non smokers persons were subjected to complete history taking, thorough clinical examination, X-ray chest, resting ECG and resting echocardiography to exclude any abnormalities. In addition the following laboratory investigations were done; blood urea, serum creatinine, serum glucose, lipogram and C-reactive protein. Also, stress gated cardiac SPECT using Tc99m MIBI was performed for all subjects. Mean values of serum cholesterol and LDL-c were significantly higher in smokers than non smokers [p <0.001, p <0.05 respectively]. Mean values of HDL-c were significantly lower in smokers than controls [p<0.05]. The percentages of positive CRP were significantly higher in smokers versus non smokers [p<0.05]. The mean values of EF% and SV were insignificantly lower in smokers versus controls at post-stress SPECT. Also, 50% of smokers had diminished myocardial perfusion versus 0% of non smokers [p<0.01] at post stress SPECT. There were also abnormal wall motion and thickness at post stress SPECT. Cigarette smoking is a major risk factor for atherosclerosis in young adult male. Post stress cardiac SPECT may be useful for early detection of cardiovascular events of smoking

Soluble adhesion molecules for prediction of cardiac dysfunction in chronic renal failure patients

Beside cell-bound adhesion molecules, which are of fundamental importance to a large number of physiological and pathological processes, soluble forms of adhesion molecules have been detected in the circulating blood in recent years. Circulating soluble adhesion molecules appear to be biologically active, and raised levels have been reported in a variety of disorders. In the present study, we measure the serum levels of the soluble [s] molecules included vascular cell adhesion molecule 1 [sVCAM- 1] and sE-selectin in 26 patients on chronic hemodialysis [HD], 16 undialyzed patients with chronic renal failure [CRF], and 10 healthy controls having a similar mean and distribution of ages. The presence of hypoalbuminemia, inflammation [C-reactive protein,CRP] and dyslipidemia were assessed together with echocardiographic evaluation of cardiac dimensions, systolic and diastolic function in all studied groups. sVCAM-1 was found to be elevated in patients with chronic hemodialysis and undialyzed CRF [P < 0.001 each] compared with the controls but levels did not differ between both groups of patients. sE-selectin was also raised in both groups of CRF patients compared with controls [P < 0.001 each] with higher significant level in the undialyzed group [P < 0.05] compared with HD group. Both adhesion molecules are correlated positively to each other [r = 816, P<0.001]. The presence of hypoalbuminemia, inflammation, dyslipidemia together with left ventricular hypertrophy [LVH] and low ratio of E/A peak early LV filling velocity [E] /peak atrial filling velocity [A] by echocardiography were associated with higher sVCAM-1 and sE-selectin than in CRF patients without these findings. Both sVCAM and sE-selectin correlated significantly positive with CRP [P<0.01, P<0.001 respectively], left ventricular mass index [LVMI] [P<0.001, P<0.05 respectively], and significantly negative with high-density lipoprotein [HDL] [P<0.001 each], serum albumin levels [P<0.001 each] and with E/A ratio [P<0.001 each]. Elevated serum concentrations of soluble adhesion molecules [sVCAM-l and sE-selectin] are found in undialyzed and chronic hemodialysis patients who are malnourished inflamed, dyslipidemic and have echo findings of cardiac diastolic dysfunction and LVH