Relationship between age and serum lipids in malnourished and well-fed pre-school children in Zaria, Nigeria.

OBJECTIVE: The objective of this study was to evaluate the relationship between age and serum total cholesterol (TC) and triglyceride (TG) in malnourished and well-fed pre-school Nigerian children in Zaria, northern Nigeria. MATERIALS AND METHODS: Serum total cholesterol (TC) and TG concentrations were measured in 115 malnourished and 115 age- and gender-matched well-fed children aged one (1)-three (3) years. These consisted of 25, 30, 30 and 30 children with kwashiorkor, marasmic-kwashiorkor, marasmus and underweight, respectively with their corresponding age- and gender-matched well-fed children. There were 60 males and 55 females each of malnourished and well-fed children. Concentrations of TC and TG were measured by enzymatic colorimetric method using reagent kits supplied by HUMAN, Gesel Für Biochemical Und Diagnostica mbH (Wiesbaden, Germany). RESULTS: There was no correlation between age and serum TC in malnourished children (r = 0.0101, p = 0.9250), while the correlation was negative and significant in well-fed children (r = 0.3599, p = 0.3110). Similarly, there was no correlation between age and serum TG in malnourished chidren (r = 0.0605, p = 0.4623) but negative and significant correlation in well-fed children (r = 0.3210, p = 0.0001). CONCLUSION: The findings of this study demonstrate that in well-fed pre-school children, serum lipids decrease with advancing age and that this pattern was abolished in malnourished children. This contribution should be noted and considered when interpreting serum lipid results in children.

Serum lipid profile in malnourished Nigerian children in Zaria.

BACKGROUND/OBJECTIVE: There is paucity of data on the pattern of serum lipids in malnourished children in Zaria. Most of the reported studies were carried out in southern part of Nigeria. The overall objective of this study was therefore to measure serum lipids in children with PEM in Zaria with the view to recommending its use in them. SUBJECTS, MATERIALS AND METHODS: Serum lipids were measured in 115 children presenting with PEM and 115 age- and sex-matched well nourished controls aged 6-36 months .The malnourished children consisted of 25, 30, 30 and 30 children with kwashiorkor, marasmic-kwashiorkor, marasmus and underweight respectively. There were 60 males and 55 females. Serum total cholesterol(TC),high density lipoprotein cholesterol (HDL-C) and triglyceride(TG) were measured by enzymatic colorimetric methods of serum low density lipoprotein cholesterol(LDL-C) and very low density lipoprotein cholesterol(VLDL-C) were estimated using Friedewald formula. RESULTS: Serum TC, LDL-C and HDL-C levels were significantly lower (p<0.01, p<0.05 and p<0.001 respectively), while the ratio TC/HDL-C was significantly higher (p<0.001) in children with PEM than in their well-nourished counterparts. Concentrations of serum TG and VLDL-C were apparently but not significantly lower in children with PEM than in well-fed children (p>0.05).Serum levels of TC, LDL-C and HDL-C were significantly higher (p<0.001, p<0.001 and p<0.01 respectively) in oedematous PEM patients than in their non-oedematous counterparts. Serum TG and VLDL-C values were apparently but not significantly higher in oedematous PEM patients than in non-oedematous ones. CONCLUSION: There was a significant reduction in serum lipid concentrations in children with PEM. The study therefore suggests that measurement of serum lipids could be of importance in the assessment of childhood malnutrition.

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.

Evaluation of serum lipid profile of under-five Nigerian children.

BACKGROUND: Serum lipid profile assay forms one of the special investigations in most chemical pathology laboratories worldwide. Several studies in children from different countries have shown that serum lipids exhibit age and geographical pattern of variation prior to puberty. This study was conducted to evaluate serum lipid profile in Nigerian children aged 6 to 36 months. METHODS: A total of 115 randomly selected apparently healthy children were studied. These consisted of 38, 40 and 37 children in groups I (6 to 12 months), II (13 to 24 months) and III (25 to 36 months) respectively. There were 60 male and 55 female children. Serum concentrations of total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglyceride (TG) were measured by enzymatic colorimetric method using reagent kits supplied by Human, Gesel Für Biochemica Und Diagnostica mbH (Wiesbaden, Germany). Serum low density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL-C) were subsequently estimated using Friedewald formula. RESULTS: The reference ranges and (Mean +/- SEM) of serum TC, LDL-C, HDL-C, TG, VLDL-C and TC/HDL-C for the total group of children were 1.55-5.42(2.89 +/- 0.12), 0.50-3.29(1.28 +/- 0.15), 0.45-2.77(1.12 +/- 0.14). 0.93-3.43(0.79 +/- 0.14), 0.17-0.72(0.35 +/- 0.14) mmol/L and 1.01-4.74(2.19 +/- 0.13) respectively. There were no sex differences in all these parameters. Serum levels of TC, LDL-C, HDL-C and TC/HDL-C in the 3 age groups were also statistically similar (p > 0.05). Concentrations of TG and VLDL-C were lower (p < 0.001) in group II than in I. These values were also significantly lower (p < 0.02) in group III than in I. Serum TG and VLDL-C in groups II and III were statistically comparable (p > 0.05). CONCLUSION: Serum concentrations of TC, TG and VLDL-C decrease with advancing age, with more marked decrease between first and second years of life. We hereby recommend that the reference values established in this study be utilized for the interpretation of serum lipid results in pre-school children in Nigerian hospitals and possibly elsewhere in Africa.

Serum fructosamine in the assessment of glycaemic status in patients with sickle cell anaemia.

AIM: To assess the usefulness of fructosamine in evaluating the glycaemic status in patients with sickle cell anaemia. METHOD: Serum fructosamine, glucose, albumin and bilirubin were measured in one hundred and fifty patients with sickle cell anaemia (HbSS), fifty poorly controlled diabetics and one hundred healthy control subjects. Fructosamine was assayed using the method of Johnson et al. RESULTS: None of the HbSS patients had hyperglycaemia. Serum fructosamine was significantly higher in the poorly controlled Diabetics compared to the HbSS patients and the Controls. The mean serum albumin levels were within the laboratory's reference interval in the three groups of subjects studied. There was no significant correlation between fructosamine and normal serum albumin in the three groups of subjects. Moderately raised serum bilirubin concentrations in the HbSS patients did not cause any significant interference in the assay of fructosamine in the patients. CONCLUSION: Serum fructosamine could be reliably employed as a measure of glycaemic status of patients with sickle cell anaemia with moderate hyperbilirubinaemia.

Reference interval of serum heat-stable alkaline phosphatase activity in pregnant women in Zaria.

UNLABELLED: The study was designed to establish a reference interval for serum heat-stable ALP activity in pregnancy, which is not available in this environment. MATERIALS AND METHODS: One hundred (100) apparently healthy pregnant women in their third (3rd) trimester who were attending the antenatal clinic (ANC) of Ahmadu Bello University Teaching Hospital (ABUTH), Zaria were recruited for the study. The serum heat-stable ALP activity was measured using the 4-nitrophenyl phosphate (4-NPP) method introduced in 1946 by Bessey, Lowry and Brock. RESULTS: The reference interval for the serum heat-stable ALP activity was found to be 24-161 IU/L. This was similar to some earlier reports elsewhere. CONCLUSION: The finding will help in the evaluation/diagnosis of patients with placental insufficiency.

Anaemia and iron status of symptom-free adult males in northern Nigeria.

The prevalence of anaemia and iron deficiency have been evaluated in 276 symptom-free male inhabitants of northern Nigeria. One hundred and eighteen were classified as non-elite and 158 as elite. Twenty-six of the elite had a high consumption of alcohol, and have been considered as a separate sub-group. Measurements included haemoglobin (Hb), serum iron (SI), total iron-binding capacity (TIBC), free erythrocyte protoporphyrin (FEP) and serum ferritin (SF). The prevalence of anaemia (Hb less than 13.0 g dl-1) was considerably higher in non-elite (35.6%) than in 132 non-alcohol drinking elites (7.0%), while none of the alcohol drinkers was anaemic. The geometric mean SF was 54.6 micrograms l-1 in the non-elites, 100.6 micrograms l-1 in the non-drinking elites and 149.3 micrograms l-1 in the alcohol-drinkers. Iron deficiency [at least two of transferrin saturation (TS) less than or equal to 20%, FEP greater than or equal to 70 micrograms dl-1 and SF less than or equal to 30 micrograms l-1] was diagnosed in 15.3% of the non-elites and in only 1.3% of the elites. Iron deficiency in the non-elites probably resulted from poor availability of iron from the local staples guinea corn (Sorghum spp.) and millet (Pennisetum spp.), with chronic haemorrhage due to helminthic infestations contributing in some. Evidence of iron overload (TS greater than 90%, SF greater than 600 micrograms l-1 was found in two of the drinkers, one of whom had a history of prolonged consumption of burukutu, a beer locally brewed from cereals.

Anaemia and iron status of pregnant and non-pregnant women in the guinea savanna of Nigeria.

Haemoglobin concentration, serum iron, iron binding capacity, transferrin saturation, free erythrocyte protoporphyrin and serum ferritin (SF) were measured in 66 elite non-pregnant and 95 pregnant (27 elite and 68 non-elite) Nigerian women at Zaria, in the guinea savanna. Anaemia (as defined) was observed in 46% non-pregnant, 37% pregnant elite and 52% pregnant non-elite women. Iron deficiency (as defined) was diagnosed in 54, 30 and 25%, respectively. The mean SF in pregnant elite (28.9 micrograms l-1 was lower, but not significantly, than in pregnant non-elite women (33.6 micrograms l-1, either because of less inflammatory disease or because of more iron deficiency. The prevalence of anaemia tended to fall with increasing parity, being 52% in primigravidae and 40% in grande-multigravidae; this was probably due to greater risk of malaria-induced anaemia in primigravidae. In contrast, prevalence of iron deficiency increased with parity, being 18 and 35%, respectively, in primigravidae and grande-multigravidae. Anaemia and iron deficiency were seen most frequently in the third trimester. Pregnant women in the north of Nigeria require iron supplements irrespective of socioeconomic status or maternal parity.

Glycosylated haemoglobin (HbA1) for diabetic control in Africans; preliminary findings with the microcolumn technique.

Glycosylated haemoglobin (HbA1) was determined by a microcolumn technique using Biorex 70 resin in normal Nigerians and in patients with diabetes, iron deficiency anaemia, sickle cell disease and renal failure. Mean %HbA1 was 10.0 +/- 1.9% in controls which is higher than levels reported in Caucasians. HbAS but not HbSS had a reducing effect on the %HbA1 which was also found elevated in iron deficiency anaemia and diabetes mellitus. Factors peculiar to tropical medical practice affecting glycosylated haemoglobin must be appreciated and further investigated to assess the usefulness of HbA1 determination in the long term control of diabetes mellitus.