Association of Genetic polymorphisms of EDN1 gene and Endothelin-1 level in patients with type 2 diabetes mellitus in the Jordanian population.

Endothelin-1 (ET-1) is one of the most potent vasoconstrictors, encoded by the endothelin-1 (EDN1) gene. It has been shown to play an important role in different diseases including Diabetes Mellitus (DM). Various single nucleotide polymorphisms (SNPs) in the EDN1 gene are related to microvascular complications of type 2 diabetes mellitus (T2DM) such as retinopathy, neuropathy and nephropathy. This study aims to determine the association between two selected EDN1 gene polymorphisms (rs2071942 G > A, rs5370 G > T) and T2DM in the Jordanian population, also to measure the level of ET-1 in T2DM. The samples were collected from the National Center of Diabetes, Endocrinology, and Genetics- Amman, Jordan, including 97 patients with T2DM and 80 healthy individuals. PCR-RFLP was used for SNPs genotyping. ET-1 level was determined using IQELISA kits. The univariate analysis for both SNPs didn't show statistically significant differences in the genotype or allele frequencies among T2DM cases as well as in controls. The same results were obtained regarding ET-1 concentration. The subgroup analysis by sex showed that the genotype and allelic frequencies of rs5370, rs2071942 G/A polymorphisms were not significantly different in males and females. Multivariate Analysis adjusted for various confounders didn't express statistical significance difference for occurrences of both SNPs. However, height and gender showed to be significant risk factors for occurrences of heterozygote alleles in both SNPs. On the other hand, the duration of diabetes has appeared to be related to the recessive allele in rs5370.

Prevalence of fatty liver disease and its associated factors among Jordanian patients with type 2 diabetes mellitus: A cross-sectional study.

BACKGROUND: Diabetes mellitus (DM) is a well-known risk factor for Non-alcoholic fatty liver disease (NAFLD). Patients with type 2 DM (T2DM) who have NAFLD are at a higher risk of developing advanced stages of liver disease, including fibrosis, cirrhosis, and hepatocellular carcinoma compared to non-diabetic patients. This study aimed to estimate the prevalence of NAFLD among patients with T2DM, using hepatic ultrasonographic changes combined with derangement of hepatic transaminases level. MATERIALS AND METHODS: This cross-sectional study was conducted at the National Center for Diabetes, Endocrinology and Genetics (NCDEG) in Amman, Jordan. A total of 408 patients with T2DM and 90 non-diabetic subjects were included in this study. Body mass index (BMI), waist circumference, glycosylated hemoglobin (HbA1c), lipid parameters and abdominal ultrasonography were measured. RESULTS: Using the ultrasonographic criteria for the diagnosis of NAFLD, the prevalence of NAFLD was 80.4 % and 53.3 % among diabetic and non-diabetic participants, respectively. Among the diabetic participants, 25 %, 40.4 %, and 15 % had mild, moderate, and severe grades of steatosis, respectively. On the other hand, 24.4 %, 21.1 %, and 7.8 % of the non-diabetic participants had mild, moderate, and severe grades of steatosis, respectively. Diabetic patients between 25 and 45 years of age, patients with overweight or obesity, patients with increased waist circumference were significantly at higher risk of having NAFLD. High TG, lower HDL, elevated AST and ALT, and using sulfonylureas and metformin versus using metformin only were significantly associated with increased odds of having NAFLD. CONCLUSIONS: NAFLD is highly prevalent among patients with T2DM. Overweight or obesity, abnormal cholesterol levels and treatment with sulfonylureas were significantly associated with NAFLD.

Effect of gonadotropin-releasing hormone analogue on final adult height among Jordanian children with precocious puberty.

OBJECTIVES: To study the effect of gonadotropin-releasing hormone analogue (GnRHa) on final adult height (FAH) among Jordanian children with central precocious puberty (CPP). Methods: It is a retrospective historical cohort study. We assessed the FAH and height gain in 43 children with CPP (39 females and 4 males) who received GnRHa and 13 children with CPP (11 females and 2 males) who did not receive GnRHa and achieved FAH between 2004 and 2014. Final adult height was compared to target height (TH) and mid- parental height (MPH) in both groups. Results: In GnRHa treated females, the FAH was 158.5±6.6 cm compared to 151.2±8.4 cm in the untreated females (p=0.004). Height gain was 2.9±8.5 cm in the treated females compared to -3.8±7.7 cm in the untreated group (p=0.022). In GnRHa treated females, FAH was found to be closer to TH (p=0.01) and MPH (p=0.01) in comparison to untreated females. Conclusion: Gonadotropin-releasing hormone  analogue is effective in increasing FAH in Jordanian children with CPP, particularly those with advanced bone age.

The prevalence of Hypogonadism among diabetic and non-diabetic men in Jordan.

OBJECTIVE: Determine the prevalence of hypogonadism among diabetic and non-diabetic men in Jordan. RESEARCH DESIGN AND METHODS: A cross-sectional study of 1717 men (1089 participants with type 2 diabetes and 628 non-diabetic subjects). Both groups were inquired to answer the Androgen Deficiency for aging male (ADAM) questionnaire. Early morning Total testosterone, prolactin, sex hormone binding globulin, follicle stimulating hormone, leutinizing hormone, HbA1c and fasting blood sugar were measured. Hypogonadism was defined as total testosterone <3 ng/ml and calculated free testosterone <5 ng/dl. RESULTS: The prevalence of Hypogonadism among all study participants was 18.5%. The prevalence of Hypogonadism in diabetic and non-diabetic men was 24.3% and 8.3%, respectively. The mean (SD) total testosterone concentration of diabetic and non-diabetic men was 3.78 ng/ml (1.7) and 4.92 ng/ml (2.5), respectively (P- value <0.005). In response to (ADAM) questionnaire, 19.8% of diabetics and 3% of the non-diabetics had symptomatic androgen deficiency (P value <0.005). Hypogonadism and symptomatic androgen deficiency were negatively and significantly related to diabetes, monthly income and age (P value <0.005). CONCLUSION: Hypogonadism is a prevalent disorder among Jordanian diabetic population. Symptoms of androgen deficiency should be corroborated with testosterone level to establish a multidisciplinary approach for management of hypogonadism.

Pituitary enlargement in patients with primary hypothyroidism.

OBJECTIVE: To assesses the frequency and degree of pituitary hyperplasia in patients with primary hypothyroidism, the association of pituitary enlargement with disease severity, and the response to treatment. METHODS: Between April 2002 and August 2004 at the National Center for Diabetes, Endocrinology and Genetics in Amman, Jordan, 53 patients (49 female and 4 male subjects) with primary hypothyroidism and serum thyrotropin (thyroid-stimulating hormone or TSH) levels of > or = 50 microIU/mL were encountered. Initial and follow-up investigations included thyroid function tests, serum prolactin levels, and magnetic resonance imaging (MRI) of the pituitary. Visual field examination was requested for all patients with pituitary enlargement (and adequately completed in 24). RESULTS: Pituitary enlargement on MRI was found in 37 of the 53 patients (70%), with 31 of the 37 patients (84%) having TSH levels of > or = 100 microIU/mL. After thyroxine treatment, 85% of the patients with pituitary enlargement who underwent a follow-up MRI showed a decrease in size of the gland. About half of the patients were referred to our facility with the diagnosis of hypothyroidism; presenting features in the rest of the patients included galactorrhea, menstrual irregularities, learning disability, short stature, precocious puberty, ovarian hyperstimulation syndrome, headaches, visual field defects, and dry ichthyotic skin. CONCLUSION: The association between pituitary gland enlargement and primary hypothyroidism should be kept in mind when pituitary hyperplasia is detected on MRI, before unwarranted and drastic interventions are initiated.