The effects of plasma chromium on lipid profile, glucose metabolism and cardiovascular risk in type 2 diabetes mellitus. A case - control study.

BACKGROUND: The study was aimed at determining the effect of plasma chromium concentration on the metabolism of glucose, and lipids and their subsequent cardiovascular risk in patients with type 2 diabetes in the Bolgatanga district of Ghana. MATERIAL AND METHODS: Fasting blood glucose and lipids profile were determined by enzymatic assay using the BT 5000® Random Access Chemistry Analyzer. Fasting serum insulin and High sensitive C-reactive protein were determined by ELISA, a solid phase direct sandwich immunoassay method. HOMA-IR, which is based on fasting blood sample for insulin and glucose concentrations measured in a single blood sample, was used to calculate insulin resistance. Plasma chromium was measured using an atomic Absorption Spectrometer. RESULTS: Patientswith diabeteshad significantly (p<0.0001) increased LDL, TC, TG, VLDL, insulin, CRP and HOMAIR and a significantly reduced plasma chromium (p<0.0001) (0.53± 0.02µg/l and 0.11±0.01µg/l control and case respectively). Low Cr (p ≤0.001) was associated with high blood pressure, obesity and lipid dysregulation. Plasma Cr significantly correlated negatively with blood pressure and LDL. CONCLUSION: Lower plasma Cr level was associated with hyperglycaemia, hyperinsulinemia, hypertension, insulin resistance and high inflammation marker HsCRP.

Placental peptides metabolism and maternal factors as predictors of risk of gestational diabetes in pregnant women. A case-control study.

BACKGROUND: Gestational diabetes is a risk factor for perinatal complications; include shoulder dystocia, birth injuries such as bone fractures and nerve palsies. It is associated with later development of type 2 diabetes, the risk of macrosomia and other long-term health effects of infants born to diabetic mothers. The study assesses placental peptides and maternal factors as potential predictors of gestational diabetes among pregnant women. MATERIAL AND METHODS: A total of 200 pregnant women were recruited for the study, 150 pregnant women without pre gestational diabetes including 50 women with low risk factors of diabetes as controls and 50 other pregnant women with pregestational diabetes as control. Fasting blood glucose and the lipid profile were determined by enzymatic methods using Envoy® 500 reagents (Vital Diagnostics, USA). Glycated haemoglobin was assessed using the Cation Exchange resin method. Leptin and the Human Placenta Lactogen were assayed using the Sandwich-ELISA technique. Beta chorionic gonadotrophin, insulin, progesterone and estradiol were determined using chemilumiscence imunoassay technique on MAGLUMI 600 analyzer. Anthropometry, including BMI and blood pressure were also measured. RESULTS: Fasting plasma glucose (FBG), insulin, insulin resistance, glycated haemoglobin and Human Placenta Lactogen(HPL)were significantly (p<0.0001) increased in the pregestational diabetic women whereas progesterone and estradiol were significantly decreased. In the second trimester however, there was no significant difference (p>0.05) in estradiol, insulin, insulin resistance and HPL between the pregnant women who developed gestational diabetes and those who did not. Leptin, progesterone and FBG were significantly increased in those who developed GDM. The risk of developing gestational diabetes increased with overweight (OR = 1.76, P = 0.370) and family history of diabetes (OR = 2.18, P = 0.282). CONCLUSION: Leptin, progesterone, estradiol estimated in this study were increased in the gestational diabetes mellitus women and fairly predicted gestational diabetes in the non-diabetics pregnant women. Obesity, aging and family history of diabetes were strongly predictive of gestational diabetes.