TCF7L2 gene polymorphism as a risk for type 2 diabetes mellitus and diabetic microvascular complications.

BACKGROUND: Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic condition with various genetics and environmental influences that affects the capacity of the body to produce or use insulin resulting in hyperglycemia, which may lead to variable complications. It is one of the world's rising health problems. There is emerging evidence that some genetic polymorphisms can impact the risk of evolving T2DM. We try to determine the relationship of (rs7903146) variant of the Transcription factor 7-like 2 (TCF7L2) gene with T2DM and its microvascular complications. METHODS AND RESULTS: This case-control study included 180 subjects: 60 diabetic patients without complications, 60 diabetic patients with microvascular complications and 60 matched healthy controls. Genotypes of rs7903146 (C/T) SNP in the TCF7L2 gene were evaluated by real-time polymerase chain reaction via TaqMan allelic discrimination. Logistic regression was used to detect the most independent factor for development of diabetes and diabetic microvascular complications. Variant homozygous TT and heterozygous CT genotypes were significantly increased in diabetic without complications and diabetic with complications groups than controls (p = 0.003, 0.001) respectively. The T allele was more represented in both patient groups than controls with no significant difference between patient groups. TT genotype as well as T allele was significantly associated with increased T2DM risk. CONCLUSION: The T allele of rs7903146 polymorphism of TCF7L2 confers susceptibility to development of T2DM. However, no significant association was found for diabetic complications.

Mean Platelet Volume as a Fibrosis Marker in Patients with Chronic Hepatitis C

Background and study aim: Liver biopsy limitations push us to search for new non invasive methods to detect liver fibrosis such as serum markers. The aim of this study is to evaluate mean platelet volume (MPV) as a fibrosis marker in patient with chronic hepatitis C. Patients and methods: 150 patients diagnosed with chronic hepatitis C infection refereed to Tanta Fever Hospital in period from May 2013 to January 2014 and 20 healthy volunteers as a control were included. All of them were tested for Mean Platelet Volume (MPV) in comparison with who done liver biopsy as standard. Results: Statistically significant differences in MPV and Platelet Count were seen in patients with chronic hepatitis C (CHC) compared to healthy controls (MPV: 8.95 ± 1.39fL vs. 7.57 ± 0.68 fl, P-value = 0.043; PC 226.03 ±68.36 vs. 188.9±46.49, P-value = 0.02) Multi-variate Logistic regression analysis shows only 5 variables remained as independent risk factors for fibrosis progression: (MPV, Schistosomiasis, ALT, AST and Prothrombin time). AST (OR 1.11, 95% CI 1.02 to 1.21), ALT (OR 0.92, 95% CI 0.86 to 0.99), PT (OR 2.11, 95% CI 1.15 to 3.88), and MPV (OR 2.28, 95% CI 1.22 to 4.25). Cut-off values were calculated for diagnostic performance, and the cut-off value for MPV was 9.22 fl., sensitivity 75.5%, specificity 62%, PPV 40.3%, NPPV 93.4% and Accuracy rate 61.8%. Conclusion: We suggest that high MPV levels (especially those over 9.22 fl) may help to predict advanced fibrosis in patients with CHC. However, it should not be forgotten that MPV is not a specific marker for fibrosis, and the negative predictive rate seems more valuable to exclude a high fibrosis ratio in patients with CHC