Study of gut microbiome in Egyptian patients with autoimmune thyroid diseases.

BACKGROUND: Hashimoto's thyroiditis (HT) and Graves' disease (GD) are the most prevalent forms of autoimmune thyroid disorders (ATD). A pathogenic link with gut microbial dysbiosis has been described in different autoimmune disorders but not yet fully elucidated in patients with ATD. AIM OF THE WORK: The present study aimed to elucidate changes in gut microbiome in Egyptian patients with ATD. PATIENTS AND METHODS: The gut bacterial composition of 20 patients with ATD and 30 age, sex, and BMI-matched healthy subjects as controls was analysed using Quantitative SYBR Green Real-Time PCR technique targeting 16S rRNA of selected bacterial genera and/or species. RESULTS: Compared with controls; the Firmictus/Bacteroidetes ratio (known to be representative for healthy status) was significantly decreased in patients with ATD (P < .001), without a significant difference between GD and HT patients. Also, the relative abundance of beneficial bacteria associated with the gut barrier and anti-inflammatory state; A. mucinophilia, Bifidobacterium, Lactobacillus, and F. prausnitzii, were decreased in ATD patients. TRAb in GD patients and anti-TPO in HT patients showed a significant positive correlation with Bacteroidetes (P = .001) and (P = .018), respectively. CONCLUSION: Egyptian patients with ATD show dysbiosis of the gut microbiome that can be related to the pathogenesis of ATD. This hopefully points to the potential therapeutic benefits of manipulating the composition of the gut microbiome in the management or even protection from ATD.

Type 2 Diabetes Mellitus non-surgical remission: A possible mission.

BACKGROUND: Remission of Type 2 Diabetes Mellitus (DM) has been observed throughout the last few years, yet factors associated with remission through non-surgical approaches are still unclear. So, the factors associated with type 2 DM remission were investigated. METHODS: Out 670 patients, 63 patients gained non-surgical remission of type 2 DM (defined according to ADA criteria), and 396 patients served as control matched for age, sex, and BMI. The records of patients who attended Alexandria University Students Hospital between the years 2015 and 2018 were reviewed retrospectively. The collected data at first visit and 1 year after remission were history, examination, HbA1c %, oral glucose tolerance test & fasting blood glucose and lipid profile and type of treatment. RESULTS: 75% of patients were females with mean age 51.5 ±â€¯11.34 years. The mean duration of treatment till remission was 26.4 ±â€¯33.1 months. One year after remission HbA1c & BMI were significantly decreased (P = 0.001, 0.03; respectively). However, cox proportional hazards model & ROC curve analysis showed that age < 50 years, female sex, short duration of diabetes < 5.2 years, intial HbA1c < 8.5%, HDL > 45.6 mg/dl, and initial intervention with lifestyle modification, 2000 mg metformin and 100 mg vildagliptin are the factors associated with remission. CONCLUSION: Our mission in type 2 DM female patients < 50 years with short duration of disease < 5.2 years, initial HbA1c < 8.5% and HDL > 45.6 mg/dl, is to achieve diabetes remission by intensive life style modification with daily metformin and vildagliptin.

Serum leptin in male hypothyroid prediabetic patients: Association with cardiovascular risk.

INTRODUCTION: Hyperliptenemia is a risk factor for coronary heart disease (CHD). Hypothyroidism and prediabetes confer an increased cardiovascular risk. Few studies have addressed the role of leptin in hypothyroid prediabetic patients and its effect on CHD risk factors. OBJECTIVE: The aim of this study was to detect serum levels of leptin in hypothyroid prediabetic patients and their relationship with risk factors for CHD. PATIENTS AND METHODS: The study included three groups; group A included 120 hypothyroid male patients with normal glucose tolerance, group B included 120 hypothyroid male patients with prediabetes, and group C included 120 healthy individuals matched for age and sex as a control group. All groups were subjected to assessment of history, clinical examination, and laboratory investigations including fasting and 2 h postprandial blood glucose, serum total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), free T3, free T4, thyroid-stimulating hormone, and fasting serum leptin. RESULTS: Serum leptin was significantly higher in groups A and B compared with group C (P=0.0001), whereas there was no significant difference in serum leptin between groups A and B. In comparison with group A, the patients in group B had significantly higher serum TC (P=0.02), LDL (P=0.04), and lower serum HDL (P=0.02). In group B, serum leptin correlated positively with serum TC (P=0.0001), TG (P=0.041), and LDL (P=0.036), and negatively with serum HDL (P=0.039). CONCLUSION: Hypothyroidism is associated with high serum leptin independent of prediabetic state. Serum leptin in hypothyroid prediabetic patients showed a direct relationship with some primary markers of metabolic syndrome; thus, leptin may predict the development of CHD in those patients.