Reference intervals for serum cystatin C and serum creatinine in an adult sub-Saharan African population.

BACKGROUND: Serum cystatin C (SCysC) and serum creatinine (SCr) are two biomarkers used in common practice to estimate the glomerular filtration rate (GFR). For SCysC and SCr to be used in a given population, normal values need to be determined to better assess patients. This study aimed to determine SCysC and SCr reference intervals (RIs) in a Cameroonian adult population and factors susceptible of influencing them. METHODS: We carried-out a cross-sectional study from November 2016 to May 2017 in Yaoundé, Cameroon. Participants were Cameroonians aged 18 years and above, residing inside the country and found in good health at study inclusion. SCysC and SCr were determined by particle-enhanced turbidimetric immunoassay standardized against the ERM-DA471/IFCC reference material and by the IDMS reference modified Jaffe kinetic method, respectively. RIs were determined using the 2.5th and 97.5th percentiles and their respective 90% confidence intervals (CIs). The quantile regression served to identify potential factors likely influencing SCysC and SCr values. RESULTS: We included 381 subjects comprising 49.1% females.. RIs for SCysC varied between 0.57 (90%CI: 0.50-0.60) and 1.03 mg/L (90%CI: 1.00-1.10) for females, and from 0.70 (90%CI: 0.60-0.70) to 1.10 mg/L (90%CI: 1.10-1.20) for males. Concerning SCr, its RIs ranged from 0.58 (90%CI: 0.54-0.61) to 1.08 mg/dL (90%CI: 1.02-1.21) for females, and from 0.74 (90%CI: 0.70-0.80) to 1.36 mg/dL (90%CI: 1.30-1.45) for males. Men had significantly higher SCysC and SCr values than women (p <  0.001). Likewise, subjects aged 50 years and above had higher SCysC values in comparison to younger age groups (p <  0.001), which was not the case for SCr values (p = 0.491). Moreover, there was a positive and significant correlation between SCysC and SCr in women (ρ = 0.55, p < 0.001), in men (ρ = 0.39, p < 0.001) and globally (ρ = 0.58; p < 0.001). Furthermore, the sex influenced both biomarkers' values across all quantile regression models while age and body surface area (BSA) influenced them inconsistently. CONCLUSION: This study has determined serum cystatin C and serum creatinine reference intervals in an adult Cameroonian population, whose interpretations might take into account the patient's sex and to a certain extent, his/her age and/or BSA.

Prevalence and characteristics of metabolic syndrome in gout patients in a hospital setting in sub-Saharan Africa.

BACKGROUND: Evidence from epidemiological studies suggests an important association between gout and the metabolic syndrome (MetS). However, to the best of our knowledge, prevalence of metabolic syndrome in gout has not been reported in sub-Saharan African (SSA) settings. OBJECTIVES: The aim of this study was to determine the prevalence and characteristics of MetS in gout in a SSA population. METHOD: After prior ethical clearance, we carried out a cross-sectional study involving gout patients in a referral hospital in Douala-Cameroon. Metabolic syndrome was defined using International Diabetes Foundation criteria. Associations between variables were assessed using logistic regression.p <  0.05 was considered significant. RESULTS: On 174 gout patients (48.3% females) who consented to participate in the study, the median (IQR) age was 55.00 (14.25) years, and the median (IQR) duration of gout was 7.5 (10.0) years. Prevalence of metabolic syndrome was 54.6% (95% CI: 47.9%-62.8%). One hundred and forty-seven (84.5%) participants had central obesity, 62 (35.6%) raised triglycerides, 79 (45.4%) reduced HDL-C, 129 (74.1%) raised blood pressure, and 85 (48.9%) had raised fasting plasma glucose. On logistic regression analyses, gout patients with metabolic syndrome significantly had a higher body mass index (OR: 1.09, 95% CI: 1.02-1.17), and higher levels of serum uric acid (OR: 1.02, 95% CI: 1.01-1.04). CONCLUSIONS: About 1 out of every 2 gout patients in this population have metabolic syndrome. These gout patients with metabolic syndrome significantly have a higher body mass index, and higher levels of serum uric acid. Cohort studies are required to clearly establish the direction of the relationship between gout and metabolic syndrome.

Metabolic effects of Foofoo corn on healthy volunteers: influence of some traditional Cameroonian sauces.

BACKGROUND: Little data to guide diet prescription exists about the foods most frequently consumed in Africa. Moreover, the sauce accompanying a meal can significantly alter the metabolic effects of food. Our work was to study the influence of sauces on the metabolic effects of foofoo corn (Zea mays), one of the most commonly consumed foods in several countries in sub-Saharan Africa with a wide range of sauces. METHODS: Our study population consisted of ten healthy volunteers (five men, five women), aged from 21 to 28 years, with mean BMI of 23.9 (SD 1.9) kg/m2. The study involved seven visits of three hours each, conducted every 2 days, including one devoted to the oral glucose tolerance test (OGTT) and six visits to the consumption of each of 6 meals tested, standardized to 75 g of carbohydrate intake. Blood samples were collected at 0, 15, 30, 60, 90, 120 and 180 min after consumption of meals for blood glucose and triglycerides levels. The glucose area under the curve of each tested meal, was used to calculate its glycemic index, using the OGTT as the reference. The accompanying sauces tested with foofoo corn were: okra sauce (Abelmoschus esculentus), the so-called yellow sauce (Elaeis guinensis), the pistachio sauce (Pistacia vera), the nkui (Triumpheta pentandra), ndolé (Vernonia amygdalima) and cabbage (Brassica oleracea). RESULTS: All meals had generally a low glycemic index, with a maximum of 22.59 % for okra and cabbage, followed by ndolè (20.18 %), the yellow sauce (13.10 %), pistachio sauce (11.60 %), and nkui (5.27 %). There was a difference in the effects of the diets on triglyceride levels only at 180 min (p = 0.03). CONCLUSION: Whatever the accompanying sauce, foofoo corn has a low glycemic index. Some sauces, such as nkui give it a very low glycemic index and may be of great interest in diet prescription for patients with various metabolic disorders such as diabetes and obesity.