Sex-related differential prevalence of central obesity in diabetes mellitus: a multi-centred survey in North-Central Nigeria

Contrary to the old dictum that central obesity is more common among men than women, recent reports have shown a gradual reversal of this trend, as suggested by some studies. Objective: To compare the prevalence of central obesity among men and women with Diabetes mellitus in NorthCentral Nigeria. Methods: This multi-centred, cross-sectional study was conducted across 20 hospitals in Abuja, Nasarawa State, and Niger State, involving 1040 participants. Some obesity indices (body mass index, waist circumference and waist-toheight ratio) were measured. Results: The prevalence of central obesity (waist circumference criterion) was significantly higher in the females compared to male participants (89.6% vs 51.6%, χ2 = 1231.37, p<0.001), similar to the prevalence determined by waistheight ratio criterion (female vs male, 88.8% vs 71.5%, χ2 = 58.83, p<0.001). Following correction for age, duration of diabetes mellitus, blood pressure, blood glucose, and glycated haemoglobin using logistic regression, female gender remained a significant determinant of central obesity (OR = 2.76, 95% CI 1.81-3.83, p = 0.004). Conclusion: The prevalence of central obesity was higher among women than men in a cross-section of patients with diabetes mellitus in North-Central Nigeria

Waist-height ratio: How well does it predict glucose intolerance and systemic hypertension?

AIM: The aim of this study is to assess whether WHtR is a better predictor of glucose intolerance and systemic hypertension than some other obesity indices. METHODS: This is a cross-sectional observational study among four hundred (4 0 0) participants in a Northern Nigerian population. Four (4) participants were eventually excluded due to incomplete data, therefore data from three hundred and ninety six (3 9 6) participants were used in the final analysis. The study assessed whether WHtR is a better predictor of glucose intolerance and systemic hypertension compared to some other obesity indices. Participants were recruited after due consent, then bio-data, blood pressure levels, and some anthropometric measurements were obtained. Subsequently, plasma glucose levels (fasting [FPG] and 2-hour post 75 g glucose load [2HrPPG]) were measured. Data was entered into Microsoft Excel, then analyzed using IBM SPSS version 23. RESULTS: Data from three hundred and ninety six (3 9 6) participants (4 excluded due to incomplete details) were analyzed. Logistic regression of obesity indices showed that WHtR was the best predictor of glucose intolerance with odds ratio (OD) of 20.74 (CI 2.80-155, p < 0.001), followed by WC with OD of 1.89 (CI 1.83-3.94, p < 0.001), then WHR with OD of 1.69 (CI 1.06-8.22, p = 0.009). The least but significant predictor of glucose intolerance was BMI with odds ratio of 1.12 (CI 1.06-3.18, p < 0.001). Furthermore, logistic regression of obesity indices showed that WHtR was the strongest predictor of systemic hypertension with OD of 2.32 (CI 4.85-14.96, p < 0.001), followed by BMI (OD 1.99, CI 1.96-2.05, p = 0.031), then WC (OD 1.95, CI 1.90-1.99, p = 0.020). The weakest predictor of systemic hypertension was WHR (OD 1.26, CI 0.04-1.88, p = 0.181). CONCLUSION: WHtR had the highest predictive power for both glucose intolerance and systemic hypertension compared to BMI, WC, and WHR.

Myasthenia gravis associated with autoimmune thyroid disease: a report of two patients.

Myasthenia gravis (MG) is an acquired autoimmune disorder causing skeletal muscle fatigue and weakness. This is a report of one woman and her daughter presenting with myasthenia and gravis and Grave's disease. It highlights possible hereditary component of this condition which has not been commonly reported in our setting.

Euthyroid Sick syndrome And Cardiac Failure In Zaria, Nigeria.

AIMS AND OBJECTIVES: The study was aimed at establishing the existence of sick euthyroid syndrome in our patients with cardiac failure and to find out whether the syndrome in the our patients has a peculiar pattern PATIENTS AND METHODS: Thirty subjects diagnosed with cardiac failure in NYHA class 3 and 4 were studied; they had clinical evaluation, electrocardiograph, chest radiograph and echocardiograph. The biochemical investigation included urea, electrolyte, and creatinine, thyroid function test (T3, T4 and TSH). Thirty individuals who served as control (age and sex matched) also had similar evaluation to the subjects. RESULTS: The subjects' ages ranging from 17 to 85 years and a mean of 51.0 +/- 15.8 years compared to controls with a mean age of 48.9 +/- 8.1 years (p < 0.1). Twenty-two and eight patients were in NYHA class3 and 4 respectively. The subjects had a lower mean T3 than controls of 1.42 +/- 0.07 ug/l and 2.3 +/- 1.0 ug/l respectively and p < 0.001. The mean T4 levels were higher in the subjects than controls (85.4 +/- 26 ug/l and 70.0 +/- 1.7 ug/l respectively and p < 0.001) but TSH levels were similar in the two groups. The subjects had higher mean values of LAD, aortic root diameter, IVSD, LVIDD, LVPW, EDV ESV, LVM and LVMI (p < 0.05). The LV ejection fraction and fractional shortening were lower in subjects than controls (p <0.01). Six, seventeen and seven subjects had diastolic, systolic and combined diastolic-systolic dysfunction on echocardiography respectively. There was a positive correlation between T3 with duration of cardiac failure and ejection fraction (p < 0.05). There was a negative correlation between T3 and LVM, LVMI, LVIDD, EDV, LAD and cardio-thoracic ratio. The levels of T4 showed a positive relationship with LAD and CTR. Partial correlation was statistically significant between T3 and duration of cardiac failure, duration of aetiology of cardiac failure and LVM. The various forms of cardiac failure (diastolic, systolic and combined diastolic-systolic dysfunction) showed no statistically significant difference in mean levels of T3, T4 and TSH. CONCLUSION: Euthyroid sick syndrome is also seen in Nigerians with cardiac failure as reported elsewhere and the levels of T3 seemed to be inversely proportional to LAD, CTR, LVIDD, LVM and LVMI. Serum T3 levels are also directly proportional to EF and FS. Low serum levels of T3 with normal T4 and TSH is associated with severe cardiac failure.