ABSTRACT
Within less than a quarter century diabetes has become a health problem in developing countries. In Africa this metabolic disorder is found in a wide variety of sometimes atypical forms. The purpose of this study was to highlight the special epidemiological features of medically diagnosed diabetes in Ivory Coast. Data from the files of 10320 African patients who presented at a major national outpatient care centre between January 1, 1991 and December 31, 2000 were compiled and analyzed. Findings showed that morbidity gradually increased from 30 to 49 years then stabilized from 50 to 69 years with a higher rate in males between 30 and 49 years. One of the five national ethnic groups appeared to be most affected and two appeared to be relatively unaffected. On the basis of several criteria, 5968 patients were classified as type 1 in 11.8% of cases, type 2 without excess body weight in 48.7% and type 2 with excess body weight in 39.5%. The second of these identified groups was characterized by intermediate-discovered glycaemia and older age at diagnosis. Epidemiological features included age of occurrence and higher morbidity in young male patients, probable higher premature mortality, likely links with socio-cultural environmental factors and existence of two type 2 subgroups. This profile underlines the challenges of screening, management and prevention of diabetes in Ivory Coast.
Subject(s)
Diabetes Mellitus/epidemiology , Adolescent , Adult , Age Factors , Aged , Child , Child, Preschool , Cote d'Ivoire/epidemiology , Diabetes Mellitus/prevention & control , Ethnicity , Female , Humans , Male , Middle Aged , Sex FactorsABSTRACT
INTRODUCTION: To appreciate vitamin B1 status in normal and pathophysiological states in local ivorian populations, a high-performance liquid chromatographic method for the simultaneous determination of thiamine and its phosphate esters: thiamine monophosphate and thiamine diphsophate or cocarboxylase in whole blood has been developed. METHODS: The method involves extraction with diethylether, followed by pre-column alkaline derivatization by bromide cyanogen. The extract was analysed by isocratic reversed-phase isocratic high performance liquid chromatography with fluorescent detection. System suitability tests were applied to assess the method's continuing suitability for use. The main tests of method validation: linearity, precision, accuracy and sensibility were applied to the analytical procedure. RESULTS: Thiamine and its esters were eluted within 10 minutes with a good resolution. System suitability tests showed that the chromatographic system was suitable for continuing use. Results of validation tests show the reliability of the method : linearity domain, satisfying precision and accuracy, detection limits between 0.067 pg/l et 0.92 pg/l (0.160 fmol/l et 1.822 fmol/l). CONCLUSION: The proposed method is suitable for determination of thiamine and its phosphate esters in whole blood.
Subject(s)
Chromatography, High Pressure Liquid , Thiamine/blood , Acid Anhydride Hydrolases/blood , Humans , Phosphoric Monoester Hydrolases/blood , Thiamine Pyrophosphate/bloodABSTRACT
Prospectively assessment of vitamin A supplemented during a follow-up of a protein-energy malnutrition rehabilitation included serum retinol, Retinol Binding Protein (RBP) and prealbumin (PA) determination. This study was conducted during one month on a group of 36 vitamin A (200,000 IU) supplemented malnourished children and 32 age-and sex-matched malnourished children receiving only a nutritional regimen. Determinations were carried out at days 0, 15 and 30. Protein marker concentrations increased steadily in supplemented children as compared to those in the untreated group (p < 0.05, Student's t test). On the other hand, serum concentrations of the two proteins progressively regained normal values in the vitamin A supplemented group. Data also showed that retinol supplementation in conjunction with an appropriate nutritional diet is effective in raising serum concentrations of vitamin A and its binding proteins to normal levels. Therefore, we concluded that the results of this study demonstrates the importance of vitamin A supplementation in the management of these deficiency states.
Subject(s)
Nutrition Disorders/diet therapy , Nutrition Disorders/drug therapy , Prealbumin/metabolism , Retinol-Binding Proteins/metabolism , Vitamin A/blood , Vitamin A/therapeutic use , Biomarkers/blood , Child, Preschool , Dietary Supplements , Female , Follow-Up Studies , Humans , Infant , Kwashiorkor/blood , Kwashiorkor/complications , Kwashiorkor/diet therapy , Kwashiorkor/drug therapy , Male , Nutrition Disorders/blood , Prealbumin/analysis , Protein-Energy Malnutrition/blood , Protein-Energy Malnutrition/complications , Protein-Energy Malnutrition/diet therapy , Protein-Energy Malnutrition/drug therapy , Retinol-Binding Proteins/analysis , Time FactorsABSTRACT
Prospectively assessment of nutritional status, besides anthropometric parameters measurements, included determination of the following plasma proteins: albumin, transferrin, retinol-binding protein and thyroxine-binding prealbumin, usually regarded as useful indices of protein depletion states. Patients' inflammatory or infectious diseases were investigated by measuring the two most reliable acute-phase reactants (orosomucoid and c-reactive protein). This study was conducted on a group of 56 pediatric patients malnourished and 54 age- and sex-matched healthy subjects as controls. Data showed a higher prevalence of inflammatory process during the course of malnutrition as revealed progressive but severe alteration of the Prognostic Inflammatory and Nutritional Index (PINI) or CRP x a1-GPA/Alb x TBPA. On the other hand, kwashiorkor and marasmus seemed to be a precipitating cause of infectious or/and inflammatory process. We, therefore, conclude that the PINI scoring system should be for the pediatricians, a sensitive and precious tool allowing the correct follow-up of inflammatory pole in nutritional disorders in developing countries.
