Measurement of vitamin D and cathelicidin (LL-37) levels in patients of psoriasis with co-morbidities.

BACKGROUND: During the last decade, a lot of co-morbidities (diabetes, obesity, heart disease, etc.) have been described to be associated with psoriasis, but the exact link at the molecular level is not well-known. Researchers have shown molecular level changes in vitamin D pathway and its relationship to cathelicidin. AIMS: To estimate the levels of cathelicidin (LL-37), and vitamin D in psoriasis patients with co-morbidities, and compare them with matched healthy controls. METHODS: One hundred consecutive patients with stable plaque psoriasis (psoriasis area and severity index ≥10) with no systemic treatment in the past 3 months were investigated for the serum levels of vitamin D and LL-37, and compared with equal number of matched healthy volunteers. RESULTS: The serum vitamin D levels were significantly lower in patients. Furthermore, the levels of serum LL-37 were significantly high. CONCLUSION: Our study showed that the low serum levels of vitamin D, and higher blood levels of cathelicidin could form a molecular level clue in the pathogenesis of psoriasis patients, who are more likely to develop co-morbidities.

Does insulin resistance in type 2 diabetes alter vitamin D status?

AIMS: Data on changes of vitamin D due to insulin resistance are conflicting. We assessed vitamin D concentrations and parameters of glycemia and mineral homeostasis in patients with insulin resistant type 2 diabetes and in matched normal controls. METHODS: Sixty-nine patients with type 2 diabetes and 60 matched normal control subjects were studied. After an overnight fast, blood was collected for measuring the parameters of glycemia (glucose, insulin and HbA1c), mineral profile (corrected calcium, phosphate and alkaline phosphatase), total 25(OH) vitamin D and parathyroid hormone (PTH) levels. RESULTS: Patients had significantly elevated fasting glucose (P=0.0001), insulin (P=0.0003) and HbA1c (P=0.0005) than the controls had. They had significantly raised calculated insulin resistance compared with control subjects (P=0.0001). Patients and controls had similar levels of serum corrected calcium and ALP, whereas serum phosphate was significantly lower in the patients compared with controls (P=0.001). Patients and controls had similar levels of 25(OH)D, but the levels of 25(OH)D in both were in the deficiency range. Intact PTH was similar in the patients and controls. Levels of 25(OH)D did not demonstrate any relation with fasting insulin, insulin resistance, or HbA1c, but correlated negatively with intact PTH (r=-0.4, P=0.02). CONCLUSION: This study demonstrated prevalent vitamin D deficiency in insulin resistant type 2 diabetic and normal subjects. Insulin resistance did not influence the status of vitamin D.

Prevalence of low bone mass in postmenopausal Kuwaiti women residents in the largest province of Kuwait.

UNLABELLED: We measured bone mineral density (BMD) in Kuwaiti women residents in the largest province of Kuwait state to highlight the BMD changes with each age, in particular when they reach the postmenopausal stage. Healthy Kuwaiti females between the ages of 10 and 89 years, who were residents in the largest province of Kuwait, were included in the study. After measurements of their height and weight, their bone mineral density of L2-L4 lumbar spine and femur (neck and total) was measured using dual-energy X-ray absorptiometry. Out of the studied 903 female subjects, 811 fulfilled the inclusion criteria. Their mean ± SEM age and body mass index (BMI) were respectively 47 ± 1 years and 30.8 ± 0.2 kg/m(2). Out of these 811 subjects, 454 were postmenopausal, and their age and BMI were 55.0 ± 0.3 years and 32.0 ± 0.3 kg/m(2), respectively. We have demonstrated that osteoporotic BMD of the spine and femur neck occurred in 20.2 and 12.5 % of postmenopausal Kuwaiti females, whereas osteopenic BMD of the spine and femur neck was observed at a frequency of 35.4 and 42.8 % of women, respectively. When the subjects were subdivided as per BMI, it was notable that overweight and obese had significantly higher BMD than normal weight postmenopausal women. BMD of the spine, femur neck, and femur total demonstrated significant positive correlations with body weight and BMI, whereas they demonstrated significant negative correlations with age. Low BMD of the femur neck and spine, reflected by the combination of osteopenia and osteoporosis, seemed to occur in more than half (55.3-55.6 %) of postmenopausal Kuwaiti women. OBJECTIVES: Most of the studies on assessment of prevalence of low bone mass were focused in Caucasian population. Data on subjects of the Mediterranean area are limited. We measured bone mineral density (BMD) in Kuwaiti women residents in the largest province of Kuwait state to highlight the BMD changes with each age, in particular when they reach the postmenopausal stage. SUBJECTS AND METHODS: Kuwaiti female subjects of different age groups between 10 and 89 years, who were residents in the largest province of Kuwait (Hawalli), were included in the study. They were included if they had been healthy over the last 12 months, had no past history of bone disease, and are not taking any prescription medication that may affect bone density. Their bone mineral density of L2-L4 lumbar spine and femur (neck and total) was measured using dual-energy X-ray absorptiometry. RESULTS: Out of the studied 903 female subjects, 811 fulfilled the inclusion criteria and were included in the study. Their mean ± SEM age and body mass index (BMI) were respectively 47 ± 1 years and 30.8 ± 0.2 kg/m(2). Out of these 811 subjects, 454 were postmenopausal, and their age and BMI were 55.0 ± 0.3 years and 32.0 ± 0.3 kg/m(2), respectively. We have demonstrated that osteoporotic BMD of the spine and femur neck occurred in 20.2 and 12.5 % of postmenopausal Kuwaiti females, respectively, whereas osteopenic BMD of the spine and femur neck was observed at a frequency of 35.4 and 42.8 % of women. When subjects were subdivided as per BMI, it was notable that overweight and obese postmenopausal women had significantly higher BMD of lumbar spine, femur neck, and femur total than normal weight postmenopausal women. Bone mineral densities of the spine, femur neck, and femur total demonstrated significant positive correlations with body weight and BMI, whereas they demonstrated significant negative correlations with age. CONCLUSION: Low BMD of the femur neck and spine, reflected by the combination of osteopenia and osteoporosis, seemed to occur in more than half (55.3-55.6 %) of postmenopausal Kuwaiti women residents at the largest province of Kuwait.

Photoprotection and vitamin D status: a study on awareness, knowledge and attitude towards sun protection in general population from Kuwait, and its relation with vitamin D levels.

BACKGROUND: The primary cause of skin cancers is exposure to ultraviolet (UV) radiation. And, for decades sun protection has been promoted in various public health education campaigns. Recently, however, vitamin D deficiency has been related to increased risk of skin cancers. And, skin being the primary site for the synthesis of active form of vitamin D, excessive sun protection could lead to vitamin D-deficient states. But, the results have so far been conflicting. AIMS: To study the level of awareness, knowledge and attitude of representative groups from the general population from Kuwait towards sun protection. And, also study the correlation of the level of sun protective measures used and vitamin D levels in these groups. METHODS: The study constituted of two main parts. First part comprised a questionnaire-based survey of representative group of people aged 18 and above to assess their knowledge, awareness and attitude towards sun protection. The second part consisted of measuring serum vitamin D levels in 150 volunteers amongst the responders of the questionnaire, who had been regularly using sunscreens for at least 2 years and compare to the levels seen in 150 age and sex-matched responders of similar skin phototypes, who had never used sunscreens. RESULTS: Out of the total of 1044 responders, 80% of them had adequate knowledge of the beneficial and harmful effects of sun exposure, and had been using sunscreens regularly, and adopting other sun protective measures in their daily life. The levels of vitamin D were found to be deficient in both sunscreen users and those who had never used sunscreens. The difference between the two groups was statistically insignificant (60.67% vs 54.67%; P value>0.001). CONCLUSION: Population at large seems to be adequately informed about the beneficial and deleterious effects of sun exposure. Vitamin D levels are deficient in majority of our people, and there is a need to do larger surveys covering all parts of the country and give supplemental doses of vitamin D to those found deficient.