Plasma Zinc Levels in Patients with Chronic Leg Ulcers at University College Hospital, Ibadan, Nigeria.

BACKGROUND: Chronic leg ulcers are defects in the skin below the level of knee persisting for more than six weeks and shows no tendency to heal after three or more months. Zinc is a necessary component of several DNA & RNA polymerases and transferases essential for cell proliferation. Zinc deficiency is known to retard wound healing by preventing cellular mitosis and disturbance of fibroblast function and collagen synthesis. This study compares zinc levels in patients with chronic leg ulcers with apparently healthy individuals. METHODS: Five milliliters of venous blood samples was taken from twelve patients with chronic leg ulcers. Five milliliters of venous blood samples was also taken from a control group, who do not have chronic leg ulcers, but are matched with the cases in age (± 5 yr), sex, socioeconomic status and body mass index (± 3 kg/m2). Plasma zinc levels was determined by atomic absorption spectrophotometry. Principal exposure include the socio-demographic characteristics of patients, duration of symptoms before presentation, signs of ulcer-site, number, size, depth, base, edge, presence of discharge, enlarged lymph nodes and local neurovascular integrity. The outcome variables include plasma levels of biochemical markers measured -Zinc, serum albumin, total protein. RESULTS: The plasma zinc levels was significantly lower (P<0.01) in patients with chronic leg ulcer (92.808±16.689 µg/dl) as compared with control subjects (109.413 ± 9.304 µg/dl). There was no statistical difference in albumin and protein levels in both groups. CONCLUSION: Patients with chronic leg ulcers have significantly lower plasma zinc levels than apparently healthy individuals.

Relationship between selected micronutrient deficiencies and oxidative stress biomarkers in diabetes mellitus patients with foot ulcers in Ibadan, Nigeria

Background/aim: Micronutrients are indispensable in the prevention of diseases and maintenance of good health. Their deficiencies have been implicated in several diseases associated with oxidative stress (OS). This study aimed at investigating the levels of some vitamins and minerals in association with OS markers in diabetic foot ulcer (DFU) patients in Ibadan, Oyo State, Nigeria. Materials and methods: Seventy DFU patients and 50 apparently healthy volunteers (controls) were recruited for the study. Blood samples of 10 mL were collected after a 10-h overnight fast from each participant after obtaining their consent. Levels of oxidative stress biomarkers such as lipid peroxide (LPO), 8-hydroxyl-2?-deoxyguanosine (8-OHdG), total antioxidant status (TAS), superoxide dismutase (SOD), and glutathione peroxidase (GPx) and micronutrients such as vitamin C, vitamin E, copper, selenium, and zinc were determined. Results: Significant increases in the levels of LPO and 8-OHdG and GPx activity were found in DFU patients compared to controls (P < 0.001). Significant decreases in vitamin C (P = 0.003), selenium, vitamin E, and TAS concentrations were detected between DFU patients and controls (P < 0.001). However, nonsignificant decreases in SOD activity and copper and zinc levels were observed when DFU patients and controls were compared (P > 0.05). Vitamin C was significantly positively correlated with GPx and selenium was significantly negatively correlated with 8-OHdG in the DFU group. However, nonsignificant correlations were observed between other micronutrients and oxidative stress biomarkers of both the DFU and control groups. Conclusion: Diabetes mellitus patients with foot ulcers may require micronutrient supplementation for proper control and maintenance of oxidant/antioxidant homeostasis.

Relationship between Plasma Aldosterone Levels and Left Ventricular Mass in Hypertensive Africans.

Background. Hypertension is the most common cardiovascular disease worldwide and is a major cause of morbidity and mortality. Studies have suggested that the activity of the renin-angiotensin-aldosterone system play a major role in the target organ damage such as left ventricular hypertrophy occuring in hypertension. We sought to determine the relationship between plasma aldosterone and left ventricular mass in untreated African hypertensives. Methods. We recruited 82 newly diagnosed and untreated hypertensives and 51 normal controls. Measurements obtained included echocardiographic LV mass index, plasma aldosterone and renin. Results. The hypertensive subjects had lower renin levels (21.03[6.974] versus 26.66[7.592] ng.mL(-1), P = 0.0013), higher LV mass index (52.56[14.483] versus 42.02[8.315] g.m(-2.7) P < 0.0001) when compared with the controls. There were no univariate associations between LV mass index and plasma aldosterone (r = 0.0179, P = 0.57) and between LV mass index and plasma renin (r = 0.0887, P = 0.61). In a multivariate model involving LV mass index and age, sex, body mass index (BMI), plasma aldosterone, plasma renin and systolic blood pressure (SBP), only age (P = 0.008), BMI (P = 0.046), and SBP (P = 0.001) were independently associated with the LV mass index. Conclusions. In this group of hypertensive Africans, there is no independent association of plasma aldosterone with LV mass. The height of the blood pressure, the body mass index and the age of the subjects determined the LV mass.

Plasma catecholamines in Nigerians with primary hypertension.

BACKGROUND: Hypertension is the most common cardiovascular disease worldwide and is a major cause of morbidity and mortality. Increased adrenergic activity is thought to play a major role in the initiation and progression of the hypertensive state. Hypertension is more severe in Blacks when compared with White patients. Much of the evidence for the increased adrenergic activity is from studies in predominantly White participants. This study aims to evaluate the adrenergic system in Black Nigerian hypertensives by measuring their plasma catecholamines. METHODS: Eighty-two newly diagnosed hypertensives and 51 normal controls were recruited for the study. Blood was obtained from the participants after an overnight fast. Also, a 24-hr urine collection was obtained. Levels of plasma noradrenaline, adrenaline, renin, angiotensin converting enzyme (ACE), atrial natriuretic peptide (ANP), aldosterone and insulin levels were determined using HPLC. Fasting plasma glucose was also determined. RESULTS: Plasma noradrenaline level was higher while plasma adrenaline level was lower in the hypertensives. The hypertensives also had lower levels of plasma renin, ACE, and ANP. Systolic blood pressure negatively correlated with plasma adrenaline (r = -0.29, P < .001) and positively correlated with plasma noradrenaline (r = 0.31, P < .001). Renin and ANP also correlated negatively with blood pressure (r = -0.22, P = .012 and r = -0.34, P < .0001 respectively). CONCLUSIONS: Black Nigerian hypertensives demonstrate elevated levels of plasma noradrenaline when compared with normal controls. This is consistent with the hypothesis of the hyperadrenergic state in hypertension. Further studies are needed to relate the hyperadrenergic state to the racial differences in the severity of hypertension.

Oral glucose tolerance testing outcomes among women at high risk for gestational diabetes mellitus.

AIMS: This study aimed to determine the prevalence and relationships with known risk factors of gestational diabetes mellitus (GDM) at University College Hospital, Ibadan, Nigeria. METHODS: Records of all women referred for oral glucose tolerance testing at the metabolic research unit of the Hospital over a 2 year period were reviewed. Diagnosis of GDM was made in accordance with WHO criteria. GDM diagnosis was classified as early and late based on a gestational age <24 weeks and >24 weeks respectively. Body mass index (BMI) measurements were performed for women who presented in the first trimester. Various statistical tools including student t test and Pearson's coefficient of correlation were used. RESULTS: A total of 765 records were reviewed. The crude prevalence rate was 13.9%. The prevalence rate among women in the first trimester was highest at 17.4% although most of the diagnoses were made in the third trimester (55.7%). A positive family history and a family history of GDM were associated significantly with a higher fasting and 2 h post-load glucose values, irrespective of current GDM diagnosis. The most consistent associations with a diagnosis of GDM were a positive family history and a history of GDM. Age above 30 years at oral glucose testing also showed significant association. There was no BMI threshold associated with a significant risk of GDM for those women presenting in the first trimester. CONCLUSIONS: GDM is a common metabolic condition in Nigeria. Onset before the 24th week of pregnancy is not uncommon.

Antioxidant and oxidative stress status in type 2 diabetes and diabetic foot ulcer.

OBJECTIVE: Oxidative stress (OS) has been implicated in the aetiology and progression of diabetic complications including diabetic foot ulcer. In this study, the levels of lipid peroxides (LPO) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) as well as the enzymatic antioxidant activities of superoxide dismutase (SOD) and glutathione peroxidase (GPx) in type 2 diabetes mellitus and diabetic foot ulcer subjects were assessed and compared with apparently healthy normal subjects to understand the involvement of OS in the subjects. METHOD: The above-mentioned OS markers were measured in 50 subjects for each of the following groups: type 2 diabetes mellitus (DM), diabetic foot ulcer (DF) and non-diabetic control (NC). RESULTS: Significant elevated values of LPO (39.86%) and 8-OHdG (45.53%) were found in DM subjects compared with the NC subjects. This increase in both parameters was greater for DF subjects: 80.23% and 53.91% respectively. SOD activities were significantly reduced in DM (14.82%) and DF (4.09%) subjects in contrast with elevated activities of GPx observed in DM (21.87%) and DF (20.94%) subjects. Glycated haemoglobin/fasting plasma glucose (HbA1c/FPG) correlated positively with LPO, 8-OHdG and GPx, whereas a negative correlation was observed for SOD. CONCLUSION: Increased oxidation subsequent to diabetic conditions induces an over-expression of GPx activity suggesting a compensatory mechanism by the body to prevent further tissue damage in the subjects.