The Interplay between Zinc, Vitamin D and, IL-17 in Patients with Chronic Hepatitis C Liver Disease.

OBJECTIVES: To assess zinc (Zn) and vitamin D (Vit. D) status in chronic Hepatitis C virus- (HCV) infected patients and their relationship to interleukin- (IL-) 17 and disease severity and then investigate whether Zn and Vit. D3 modulate IL-17 expression in chronic HCV patients. METHODS: Seventy patients and fifty healthy subjects were investigated. Serum levels of Zn, Vit. D, and IL-17 were assessed in the patients group and subgroups. Patients lymphocytes were activated in vitro in the presence or absence of Zn or Vit. D3 and then intracellular IL-17 production was assessed using flow cytometry. RESULTS: Zn and Vit. D were significantly decreased in HCV patients. Increasing disease severity leads to more reduction in Zn level opposed by increasing IL-17 level. Zn potently reduced IL-17 production in a dose-related fashion; however it did not exert any toxic effects. Although Vit. D apparently increases IL17 expression, it is unclear whether it is due to its toxic effect on cell count or lack of definite association between Vit. D and both IL-17 and disease severity. CONCLUSIONS: This study demonstrates that Zn modulates IL-17 expression and provides a rationale for evaluating this compound as a supplementary agent in the treatment of chronic HCV.

Abdominal Aortic Diameter and the Risk for Asymptomatic Peripheral Arterial Disease in Patients with Type 2 Diabetes.

Peripheral arterial disease (PAD) is common among older people because it often results from atherosclerosis, which becomes more common with age. The disease is particularly common among people who have diabetes. Little information is available on the relation between abdominal aortic diameter and PAD in elderly patients with diabetes. This article studies the relationships between abdominal aortic diameter, PAD, and the cardiovascular risk factors in asymptomatic elderly patients suffering from type 2 diabetes mellitus. A case-control study was conducted on 90 participants aged 60 years and older divided into 60 cases (30 males and 30 females) and 30 age-matched healthy controls (15 males and 15 females). The relationships between the size of the abdominal aorta and ankle-brachial index (ABI), plasma cholesterol, triglycerides (TG), and high-sensitivity C-reactive protein were examined. Approximately, 15% of patients with diabetes had asymptomatic PAD. The patients with diabetes with PAD were of older age (70.4 ± 3.6 vs. 63.4 ± 3.9 years; p = 0.000), had larger abdominal aortic diameter (22.4 ± 3.08 vs. 18.7 ± 2 mm; p = 0.000), and higher CRP levels (8.3 ± 1.1 vs. 5.8 ± 2.2 mg/L; p = 0.002), while other variables revealed no significant difference. Abdominal aortic diameter correlated well with ABI measured by Doppler method in diabetic patients (r = - 0.471, p = 0.000). Older age and larger abdominal aorta are independent risk factors for asymptomatic PAD in the elderly with type 2 diabetes mellitus.

Serum visfatin levels in a group of Egyptian obese individuals.

Adipose tissue is an endocrine organ that secretes many adipokines. Visfatin is a relatively novel adipocytokine predominantly secreted from adipocytes and shows insulin mimetic properties. The aim of the study was to assess visfatin levels as well as its relation to selected anthropometric and biochemical parameters in adult obesity. The study included 46 adult obese subjects with body mass index of 52.9 +/- 9 kg/m2. In addition, the control group included 44 healthy individuals with matched age and sex and with BMI values of 23.1 +/- 1 kg/m2. Anthropometric measures included also the height, weight, waist and hip circumferences. Serum visfatin and fasting insulin were assessed using commercially available enzyme immunoassay kits. The insulin resistance index was estimated using the Homeostasis Model Assessment (HOMA). Other biochemical parameters assessed included fasting blood sugar, total serum cholesterol and triglycerides. Significant higher serum visfatin levels were found in obese subjects compared to controls (P<0.05). In addition, a statistically significant positive correlation was obtained between serum visfatin and each of BMI (P<0.05), waist circumference (P<0.001), hip circumference (P<0.001), as well as HOMA (P<0.05) in obese subjects unlike in control group. In conclusion, the observed visfatin increase in obesity together with its positive correlation to HOMA might be suggestive of a role in glucose homeostasis.

Effect of surgically-induced weight loss on inflammatory mediators and peripheral blood monocyte CD11b expression in morbid obesity.

Obesity is characterized by a state of chronic mild inflammation, with raised circulating levels of inflammatory markers. Expression and release of inflammation-related adipokines, generally, rise as adipose tissue expands. In the present study we evaluated the level of serum mediators concerned in inflammation and monocyte activation (TNF-alpha, hs-CRP, MCP-1) together with percentage of CD11-b expression on monocytes in a group of morbidly obese individuals (n = 20) before and (3-6 months) after restrictive surgery, and in 15 healthy normal weight individuals. Serum MCP-1, TNF-alpha and hs-CRP were assayed by enzymatic immunoassay, while the percentage of CD11b expression on monocytes was assayed by flow cytometry. The total lipid profile and random blood glucose levels were also assessed. Morbidly obese individuals ( before surgical weight loss) had significantly increased levels of MCP-1, TNF-alpha, hs-CRP, CD11b expression on monocytes as compared to controls (P < 0.01). Levels of MCP-1, TNF-alpha, hs-CRP were significantly decreased 3 to 6 months after restrictive surgery than before the operation (P < 0.01). hs-CRP, MCP-1 and TNF-alpha were positively correlated versus each other. TNF-alpha and hs-CRP also showed positive correlation with the body mass index. Our data suggested that the studied serum and monocyte parameters may link obesity with systemic inflammation and metabolic disorders. The interactions of MCP-1, CD11b and other inflammatory parameters might provide the basis for development of new therapies for this syndrome.