Complement and immunoglobulin levels in Ilorin Nigeria, and environ.

The levels of complement components C3 and C4 were determined in EDTA (ethylene-diamine-tetra-acetic acid) plasma of 106 apparently healthy people aged 11-50 years, and in 23 paired maternal and cord plasma in Ilorin. The immunoglobulins G,A and M concentrations of these paired samples were also assayed. Furthermore, serum IgG, IgA and IgM levels were quantitated in 501 apparently healthy residents of Ilorin (1-84 years old, n = 313) and its suburban community, Shao (11-80 years old, n = 188). Generally, there were no significant sex-related differences in C3 and C4 values, but these values increased steadily with age. C3 and C4 levels in cord plasma were high, representing 73% and 88% of adult levels respectively. Maternal levels of these complement components were higher (P < 0.02) than values obtained in non-pregnant females of comparable age. Immunoglobulin G values obtained for maternal and cord samples compare well with figures reported previously from other centres in Nigeria. Only 1 of 23 IgA and 2 of 23 IgM samples showed detectable values of these immunoglobulins in cord blood. The mean concentrations of immunoglobulins obtained were similar for IgG and lower for IgA and IgM in Ilorin, but higher for IgG and lower for IgA and IgM in Shao, when compared with data reported from Enugu and Zaria--both in Nigeria. Shao showed significantly higher mean level of IgG but similar levels of IgA and IgM to values obtained in Ilorin. Generally, IgG and IgA concentrations rose gradually up to age group 31-40 and 41-50 years respectively; and then declined. (ABSTRACT TRUNCATED AT 250 WORDS)

Urinary magnesium excretion in steady-state sickle cell anaemia.

Previous reports indicate that individuals with sickle cell anaemia may be magnesium deficient. The role of renal excretion of magnesium in the pathogenesis of this low magnesium status was investigated in 25 patients with sickle cell anaemia (sicklers) in the steady state and in 25 age- and sex-matched controls with haemoglobin genotype AA. The clearance, excretion fraction and excretion rates of magnesium were enhanced in the sicklers. These patients also had significantly lower erythrocyte and plasma magnesium concentrations than the controls. However expressed, urinary magnesium showed a significant positive correlation with plasma magnesium and a weak negative correlation with erythrocyte magnesium. Furthermore, a significant negative correlation was observed between erythrocyte and plasma magnesium in the sicklers. These results suggest that urinary disposal of magnesium in rates and amounts inappropriate to the body stores of the cation may be one of the mechanisms accounting for hypomagnesaemia and low erythrocyte magnesium content in patients with sickle cell anaemia.

Maintenance of normouricaemia during adolescence in sickle-cell anaemia.

Aspects of uric acid metabolism were investigated during adolescence in 122 patients with sickle-cell anaemia in the steady state and 52 matched controls with normal haemoglobin AA. Plasma urate concentrations were significantly lower (P less than 0.02) in male patients than in male controls. No significant differences were observed between either female patients and female controls or total patient group and total control group. Further study in subgroups of the subjects showed that all indices of urinary urate excretion in male patients were significantly increased over male controls or female patients. The increases in these indices in female patients over female controls were not statistically significant. Significant inverse correlations were also found between plasma urate and either renal urate clearance (r = -0.483, P less than 0.02) or fractional urate excretion (r = -0.398, P less than 0.05) in the patients. These findings indicate that patients with sickle-cell anaemia maintain normouricaemia during adolescence by increasing renal urate disposal. This process appears to be more efficient in the male patients.

Erythrocyte and plasma magnesium in sickle-cell anaemia.

Erythrocyte and plasma magnesium concentrations were measured in 168 subjects. Eighty three of the subjects were sickle-cell anaemia patients (sicklers) with haemoglobin genotype HbSS, and in the steady state; 30 were subjects who had the sickle-cell trait (HbAS), and 55 were subjects with the normal haemoglobin genotype HbAA. All the subjects were aged between 10 and 16 years. The sicklers had significantly lower erythrocyte (P less than 0.01) concentrations when compared with the normal subjects or subjects with the sickle-cell trait. Erythrocyte and plasma magnesium concentrations in subject with the sickle-cell trait were not significantly different from the corresponding values in the normal subjects. A significant negative correlation (r = -0.2661, P less than 0.02) was observed between erythrocyte magnesium and plasma magnesium in the sicklers only. However, magnesium concentrations in erythrocyte and plasma were not related to age, sex and physical stature in the three study groups. These results suggest that sickle-cell anaemia patients may be magnesium deficient.

Plasma magnesium and retinopathy in black African diabetics.

Observations in Caucasian diabetics have linked hypomagnesaemia as being an additional risk factor for the development of retinopathy which is a major microvascular complication of diabetes mellitus. We estimated fasting plasma magnesium concentrations in 82 non-insulin-dependent Nigerian diabetics with normal renal function and 48 healthy subjects. The diabetic patients were divided into two subgroups according to the presence (n = 25) or absence (n = 57) of retinopathy. Both diabetic subgroups were comparable regarding their metabolic control, body mass index and duration of diabetes. Hypomagnesaemia was observed in the diabetic patients as a whole and in the diabetic subgroups with and without retinopathy; however these levels were not of statistical significance when compared to healthy controls. Furthermore, when the two diabetic subgroups were compared, no significant differences were observed in the magnesium concentrations. Our data suggests that hypomagnesaemia may not be associated with the occurrence of retinopathy in black African diabetics.

Renal excretion of magnesium and calcium in diabetes mellitus.

Renal excretion of magnesium and calcium was investigated in a group of Nigerian diabetic patients. Urinary excretion rates, clearances and excretion fractions of magnesium and calcium were significantly increased in the diabetic group compared with controls. Urinary excretion rate of sodium was also significantly increased in the diabetics. Furthermore, significant positive correlations were observed between magnesium and calcium with respect to their urinary excretion rates, clearances and excretion fractions in the diabetic patients. The results of this study suggest that the renal tubular reabsorption of magnesium and calcium is reduced in diabetic patients resulting in increased urinary losses of the two divalent cations. Moreover, the renal excretion of magnesium remains intimately related to that of calcium in the diabetic state.

Erythrocyte and plasma magnesium status in Nigerians with diabetes mellitus.

Erythrocyte and fasting plasma magnesium were assayed by a dyebinding colorimetric method using the metallochromic dye, Calmagite, in 51 diabetic Nigerians and 25 controls. Erythrocyte magnesium concentrations were similar in the diabetics and the controls. Fasting plasma magnesium concentrations were significantly lower only in insulin-treated diabetics as compared to controls. No significant correlations were observed between fasting plasma glucose concentrations and either plasma or erythrocyte magnesium concentrations in the diabetic groups. Also, no significant correlation was found between erythrocyte magnesium and plasma magnesium concentrations. However, erythrocyte magnesium concentrations were directly related to age while plasma magnesium concentrations were directly related to duration of diabetes in all diabetics. Erythrocyte and plasma magnesium concentrations were not significantly affected by sex and degree of plasma glucose control. These results suggest that insulin-treated black African diabetics may develop hypomagnesaemia which is not associated with depletion of the erythrocyte content of magnesium.

Assessment of fetal maturity in Nigeria by amniotic fluid analysis.

Seven different tests of amniotic fluid have been evaluated for assessment of gestational age. Statistical correlation of the lecithin/sphingomyelin (L/S) ratio with gestational age was positive and significant (P less than 0.001). The Nile blue hydrochloride staining test was very reliable in predicting fetal maturity: in all cases where there was at least 15% of orange-staining cells, the age of the fetus was 37 weeks or more. The reliability of this test was greatly improved when combined with the amniotic fluid L/S ratio, and the result of Clements' "shake test", especially when the creatinine value was also greater than 176 mumol/1. Changes in the levels of amniotic fluid urea, uric acid and total protein were not sufficiently consistent to be of value in assessing fetal maturity. Where facilities for ultrasound are not available, these simple tests can be very helpful in the determination of fetal maturity and in the prevention of accidental delivery of immature fetuses.

Biochemical changes of normal pregnancy and puerperium in Lagos, Nigeria.

A cross-sectional study is presented of biochemical changes in the third trimester of normal pregnancy and puerperium during the wet season in the tropical climate of Lagos, Nigeria. These changes are less marked in first than in subsequent pregnancies, and although qualitatively similar, in some respects they differ from those observed in the temperate climatic zone. The indications are that quantitative differences may exist which could be relevant to the management of pregnancy in the tropics.

Serum albumin level in an urban Nigerian population.

1. Serum albumin levels have been estimated in healthy adult Nigerians. The average level of albumin was 41.4 g/l and there was no sex difference, but the findings differed from that of a previous survey in Ibadan. The importance of serum albumin measurement in relation to the socio-economic and dietary habits of the population has been reviewed. 2. It is concluded that socio-economic, dietary and cultural changes associated with Western education could be responsible for the increased level of serum albumin in this healthy population. 3. It is suggested that similar surveys should be done by locally-practising chemical pathologists.

Biochemical changes in prolonged labour in the tropics.

Serum electrolytes, creatinine, urea and urine osmolality were estimated in 25 healthy pregnant women at term, 25 women in early normal labour, and 25 healthy parturients in prolonged labour. A statistically significant fall in serum potassium was found in early labour with a further significant fall in prolonged labour. Bicarbonate changes followed the same pattern of a progressive fall. Sodium fell slowly, reaching significant levels only in prolonged labour and chloride fell even more slowly. There was a conspicuous or significant rise in serum urea with a smaller, not significant rise in creatinine. The rapid insensible loss of water in tropical areas was reflected in the rise in serum urea while homeostatic mechanisms maintained a slower fall in sodium and chloride by renal conservation.