Indices of Insulin Sensitivity and Oral Disposition Index in Adult Nigerians with Sickle Cell Anaemia: A Pilot Study.

Aim: To determine indices of insulin sensitivity and oral disposition index (DIo) derived from 30 min of glucose challenge in adults with sickle cell anaemia; a group in whom there is chronic inflammation. Study Design: Case-controlled study. Place of Study: Department of Chemical Pathology and Department of Haematology, University of Ibadan/University College Hospital, Ibadan, Nigeria. Methodology: Twenty five (25) adults with sickle cell anaemia (SCA) in steady state and 25 age, sex and body mass index (BMI) matched healthy individuals with HbAA genotype were recruited into this study. After an overnight fast of about 10 hr, 5 ml of venous blood was obtained from each participant for the determination of plasma glucose and serum insulin. Thereafter, each subject underwent a 75-g oral glucosetolerance test and at 30min, 5ml of venous blood was obtained for the determination of plasma glucose and serum insulin. Serum insulin was determined using ELISA while the plasma glucose was estimated using glucose oxidase method and indices of insulin sensitivity and β-cell function were calculated appropriately. Differences between variables with Gaussian distribution were determined using independent Student’s t-test while Mann-Whitney U was used for the non-Gaussian variables. P-values less than 0.05 were considered significant. Results: The mean fasting plasma glucose (FPG) was within the normal limit but was significantly lower in subjects with SCA compared with controls. All other indices of insulin sensitivity (insulinogenic index, fasting insulin resistance index, modified Matsuda index of insulin sensitivity and insulin secretion/insulin resistance index) and oral disposition index (DIo) were similar in both groups. Conclusion: It could be concluded from this study that SCA subjects have a similar insulin sensitivity status with HbAA subjects. This suggests that SCA subjects might not be more predisposed to the development of type 2 diabetes mellitus than those with HbAA despite the chronic inflammation associated with the former.

Prevalent Components of Metabolic Syndrome and Their Correlates in Apparently Healthy Individuals in Sub-saharan Africa.

Aim: To assess the prevalent components of metabolic syndrome (MSC) and their related determinants of lipid metabolism in the Nigerian for early diagnosis, prevention and management of the metabolic syndrome (MS) and its associated diseases. Study Design: Cohort study. Place and Duration of Study: Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan between March and August 2010. Methodology: 534 apparently healthy Nigerian traders aged 18–105 years were participants of a cohort study. The IDF (2005) criteria was used for MS diagnosis. Anthropometric indices and blood pressure (BP) were obtained by standard methods. Fasting plasma glucose, total cholesterol (TC), triglycerides (TG) and high density lipoprotein cholesterol (HDLC) were determined by enzymatic methods while low density lipoprotein cholesterol (LDLC) was calculated. Data analysed were statistically significant at P<0.05. Results: 60.1% of traders had 2 and 3MSC. 0.6%, 1.1% and 9.6% of traders had all 5MSC, ≥3MSC without elevated waist circumference (WC) and zero MSC respectively. Elevated WC, reduced HDLC and high BP were more frequent MSC representing 70.2%, 63.1% and 47.9% while FPG and TG were less frequent representing 11.2% and 2.2% of traders respectively. This pattern was similar in MS and non-MS groups. 25.3% of males and only 2.2% of females had no MSC. Reduced HDLC and elevated WC were the most frequent MSC in males and females respectively. All metabolic risk factors (MRF) except TC were significantly different in comparison between MS and non-MS groups as well as among traders with 0-5 MSC. WHR was the only parameter that correlated significantly with all MRF. Conclusion: Elevated waist circumference, reduced high density lipoprotein cholesterol, and high blood pressure may be prevalent metabolic syndrome components and important in managing metabolic syndrome in Nigeria. Regional specific cut-offs for these components for the African population is needed.

Biochemical Nutritional Parameters in Breast-Milk and Plasma of HIV Infected Lactating Nigerian Mothers on Anti-Retroviral Therapy

Undernourishment in HIV infected individuals exacerbates immunosuppression; acceleration of HIV replication and CD4 + T cell depletion. The production of human milk (lactogenesis) is dependent on factors in the blood therefore deranged blood parameters in HIV patients are expected to reflect in the components of breast milk. Study on effects of HIV infection on nutritional components of breast milk and plasma is scarce. This study assessed the impact which HIV infection might have on the nutritional quality of human breast milk and plasma by determining the levels of biochemical nutritional factors such as albumin; pre-albumin; transferrin and retinol binding in HIV infected lactating mothers (n=20) and HIV-negative lactating mothers (n=30) using immunoplates. The mean plasma level of albumin was significantly reduced in HIV infected lactating mothers (HIM) compared with HIV-negative lactating mothers (control). Breast milk transferrin was significantly increased in HIM compared with the control. It is concluded from this study that hypoalbuminaemia is a common feature in HIV-infected lactating mothers

Antioxidant Levels of Acute Leukaemia Patients in Nigeria

The incorporation of nutritional screening and comprehensive assessments of oxidative stress is increasingly recognised as imperative in the development of standards for quality care in oncology. This study evaluated the levels of nitric oxide (NO); some essential trace metals (Zn; Cu; Fe; and Se); superoxide dismutase (SOD) activity and malondialdehyde (MDA) in twenty five (25) patients with acute leukaemia and 25 apparently healthy controls. The mean levels of plasma Zinc (Zn); Iron (Fe) and Selenium (Se) were not significantly elevated (p 0.05) in leukaemia patients compared with controls. Also; slightly lower level of plasma Cu was observed in leukaemia patients compared with the controls. However; nitric oxide was significantly increased (p 0.05) in leukaemia patients compared with controls. The implication of the present finding is that intervention to increase antioxidant status in patients with Acute Lymphoblastic Leukaemia (ALL) should be considered