RESUMO
BACKGROUND: While several type 2 diabetes mellitus (T2DM) susceptibility loci identified through genome-wide association studies (GWAS) have been replicated in many populations, their association in Arabs has not been reported. For this reason, the present study looked at the contribution of ENNP1 (rs1044498), IGF2BP2 (rs1470579), KCNJ11 (rs5219), MLXIPL (rs7800944), PPARγ (rs1801282), SLC30A8 (rs13266634) and TCF7L2 (rs7903146) SNPs to the risk of T2DM in Lebanese and Tunisian Arabs. METHODS: Study subjects (case/controls) were Lebanese (751/918) and Tunisians (1470/838). Genotyping was carried out by the allelic discrimination method. RESULTS: In Lebanese and Tunisians, neither ENNP1 nor MLXIPL was associated with T2DM, whereas TCF7L2 was significantly associated with an increased risk of T2DM in both the Lebanese [P < 0.001; OR (95% CI): 1.38 (1.20-1.59)] and Tunisians [P < 0.001; OR (95% CI): 1.36 (1.18-1.56)]. Differential associations of IGF2BP2, KCNJ11, PPARγ and SLC30A8 with T2DM were noted in the two populations. IGF2BP2 [P = 1.3 × 10(-5); OR (95% CI): 1.66 (1.42-1.94)] and PPARγ [P = 0.005; OR (95% CI): 1.41 (1.10-1.80)] were associated with T2DM in the Lebanese, but not Tunisians, while KCNJ11 [P = 8.0 × 10(-4); OR (95% CI): 1.27 (1.09-1.47)] and SLC30A8 [P = 1.6 × 10(-5); OR (95% CI): 1.37 (1.15-1.62)] were associated with T2DM in the Tunisians, but not Lebanese, after adjusting for gender and body mass index. CONCLUSION: T2DM susceptibility loci SNPs identified through GWAS showed differential associations with T2DM in two Arab populations, thus further confirming the ethnic contributions of these variants to T2DM susceptibility.
Assuntos
Árabes/genética , Diabetes Mellitus Tipo 2/genética , Polimorfismo de Nucleotídeo Único , Fatores de Transcrição de Zíper de Leucina e Hélice-Alça-Hélix Básicos/genética , Índice de Massa Corporal , Proteínas de Transporte de Cátions/genética , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etnologia , Feminino , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Genótipo , Hemoglobinas Glicadas/metabolismo , Humanos , Líbano/epidemiologia , Líbano/etnologia , Masculino , Pessoa de Meia-Idade , PPAR gama/genética , Diester Fosfórico Hidrolases/genética , Canais de Potássio Corretores do Fluxo de Internalização/genética , Pirofosfatases/genética , Proteínas de Ligação a RNA/genética , Proteína 2 Semelhante ao Fator 7 de Transcrição/genética , Tunísia/epidemiologia , Tunísia/etnologiaRESUMO
AIM: Factor V Leiden (R506Q) mutation is the most commonly observed inherited genetic abnormality related to vein thrombosis. Lebanon has one of the highest frequencies of this mutation in the world with a prevalence of 14.4% in the general population. The aim of this study is to define risk factors including inherited genetic abnormalities among Lebanese patients with lower extremity deep vein thrombosis. We report the clinical outcome of patients with thrombophilia. METHODS: From January 1998 to January 2008, 162 patients (61 males and 101 females) were diagnosed with lower extremity deep vein thrombosis. Mean age was 61 years (range: 21 to 95 years). RESULTS: The most frequent risk factors for vein thrombosis were surgery, advanced age, obesity, and cancer. Twenty-five patients had thrombophilia, 16 patients had factor V Leiden (R506Q) mutation, and seven patients had MTHFR C677T mutation. Ninety-two percent of patients screened for thrombophilia were positive. Screening was requested in young patients (16), patients with recurrent (11), spontaneous (8), and extensive (5) venous thrombosis, familial history (5), pregnancy (4), estroprogestative treatment (3), and air travel (1). Nine patients had one, 11 patients had two, and five had three of these conditions. Follow-up (6 to 120 months) of these 25 patients treated with antivitamin K did not reveal recurrences or complications related to venous thromboembolism. CONCLUSION: Factor V Leiden mutation followed by MTHFR mutation are the most commonly observed genetic abnormalities in these series. Defining risk factors and screening for thrombophilia when indicated reduce recurrence rate and complications. Recommendations for thrombophilia screening will be proposed.
Assuntos
Extremidade Inferior/irrigação sanguínea , Trombofilia/complicações , Trombose Venosa/etiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/uso terapêutico , Povo Asiático/genética , Fator V/genética , Feminino , Frequência do Gene , Predisposição Genética para Doença , Humanos , Incidência , Líbano , Masculino , Programas de Rastreamento/métodos , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Pessoa de Meia-Idade , Mutação , Neoplasias/complicações , Obesidade/complicações , Recidiva , Medição de Risco , Fatores de Risco , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Trombofilia/diagnóstico , Trombofilia/tratamento farmacológico , Trombofilia/etnologia , Trombofilia/genética , Resultado do Tratamento , Trombose Venosa/tratamento farmacológico , Trombose Venosa/etnologia , Trombose Venosa/genética , Vitamina K/antagonistas & inibidores , Adulto JovemAssuntos
Árabes/genética , Polimorfismo de Nucleotídeo Único , Trombofilia/etnologia , Fator V/genética , Feminino , Predisposição Genética para Doença/etnologia , Genótipo , Humanos , Masculino , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Epidemiologia Molecular , Protrombina/genética , Trombofilia/genéticaAssuntos
Ciclosporina/uso terapêutico , Transplante de Rim/imunologia , Tacrolimo/uso terapêutico , Adulto , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados , Soro Antilinfocitário/uso terapêutico , Glicemia/metabolismo , Cadáver , Daclizumabe , Quimioterapia Combinada , Feminino , Seguimentos , Rejeição de Enxerto/epidemiologia , Teste de Histocompatibilidade , Humanos , Imunoglobulina G/uso terapêutico , Imunossupressores/uso terapêutico , Lipídeos/sangue , Doadores Vivos , Masculino , Pessoa de Meia-Idade , Doadores de TecidosRESUMO
Chronic hepatitis C virus (HCV) infection in many individuals is asymptomatic and the prevalence of antibodies to hepatitis C virus (anti-HCV) among blood donors in Lebanon is scarce. This study aimed to address the prevalence of anti-HCV in 8700 blood donors, the data obtained was compared to other world regions. Between 1997 and 2000, 8700 blood donors were screened for the presence of anti-HCV in their sera. Initially reactive specimens were retested in duplicate, and repeatedly positive samples were subsequently retested by a third generation microplate enzyme immunoassay. Of the 8700 blood donors screened, 51 were confirmed positive for anti-HCV, giving a prevalence rate of 0.6%. While there was no difference in anti-HCV prevalence in relation to age or gender, higher rates were seen in non-Lebanese compared to Lebanese subjects (6.17% vs. 0.48%, P < 0.001). None of the anti-HCV positive individuals had an identifiable risk factor for contracting HCV (intravenous drug user, prior transfusion, etc.), and their transaminases were comparable to anti-HCV-negative donors, suggesting that HCV-positive donors were asymptomatic. These results demonstrate low prevalence of anti-HCV among Lebanese blood donors, which was comparable to those established for Western countries.
Assuntos
Doadores de Sangue , Anticorpos Anti-Hepatite C/sangue , Adolescente , Adulto , Doadores de Sangue/estatística & dados numéricos , Feminino , Hepatite C/diagnóstico , Hepatite C/prevenção & controle , Hepatite C/transmissão , Humanos , Técnicas Imunoenzimáticas , Líbano/epidemiologia , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos , Topografia Médica , Transaminases/sangueRESUMO
BACKGROUND: Human papillomavirus (HPV) is the most significant cause of cervical cancer. In view of the number of drawbacks associated with endocervical sampling, the gold standard for HPV detection, this study examined the utility and specificity of vaginal sampling as an alternative for endocervical sampling for the routine detection of HPV. CASE STUDY: The study comprised 51 women who tested positive and 54 women who tested negative for endocervical HPV by polymerase chain reaction (PCR), confirmed by histopathology. At the time of specimen collection, both (speculum-assisted) endocervical and vaginal (no speculum) scrapings were isolated from HPV-positive and negative women, and HPV DNA was assessed by PCR using the MY09/MY11 primer system; HPV type was identified by hybridization of PCR products with type-specific biotinylated DNA probes. Each participant served as her own control. HPV was detected in vaginal and cervical scrapes from all HPV-positive but not HPV-negative women. In HPV-positive women the same HPV type was found in vaginal and endocervical scrapings (positive predictive value = 1.0). CONCLUSION: Correlation between vaginal and endocervical sampling methods was excellent in detecting the presence of HPV DNA and for identifying distinct HPV genotypes. Utilization of vaginal testing for routine HPV detection, and for the long-term follow-up of persistent HPV infection, is therefore recommended.
Assuntos
Colo do Útero/patologia , Colo do Útero/virologia , DNA Viral/análise , Papillomaviridae/genética , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/patologia , Infecções por Papillomavirus/virologia , Infecções Tumorais por Vírus/patologia , Infecções Tumorais por Vírus/virologia , Vagina/patologia , Vagina/virologia , Esfregaço Vaginal , Actinas/análise , Actinas/genética , Adulto , Estudos de Viabilidade , Feminino , Humanos , Pessoa de Meia-Idade , Infecções por Papillomavirus/genética , Reação em Cadeia da Polimerase , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Infecções Tumorais por Vírus/genéticaRESUMO
Insofar as chronic hepatitis C virus (HCV) infection in many individuals is asymptomatic, and as the prevalence of antibodies to hepatitis C virus (anti-HCV) among blood donors in Lebanon is scarce, this study addressed the prevalence of anti-HCV in 5,115 blood donors. Data obtained were compared to other world regions. Of the blood donors screened, 57 were initially tested positive or doubtful for anti-HCV Ab. Subsequent testing by two-third generation enzyme immunoassays confirmed that, of the 57 initially tested positive/doubtful, only 18 were positive for anti-HCV giving a prevalence rate of 0.4%. While there was no difference in HCV prevalence with respect to age or gender, a higher rate was seen in non-Lebanese compared to Lebanese subjects (3.4% vs 0.3%, P < 0.001). These results demonstrate a low prevalence of HCV infection among Lebanese blood donors, which was comparable to those established for western countries.
Assuntos
Doadores de Sangue , Hepatite C/epidemiologia , Adolescente , Adulto , Feminino , Anticorpos Anti-Hepatite C/sangue , Humanos , Técnicas Imunoenzimáticas , Líbano/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Topografia MédicaRESUMO
BACKGROUND: A specific point G-A transition at nucleotide position 1691 in the factor V (FV) gene, FV-Leiden, was associated with increased risk of venous thromboembolism (VTE). Insofar as the association of FV-Leiden with coronary artery disease (CAD) remains poorly defined, the aim of this study was to determine the prevalence of FV-Leiden in a sample of 68 VTE patients, 69 CAD patients, and 192 randomly selected healthy subjects. METHODS: Total genomic DNA was extracted from the peripheral blood of study subjects and was used for PCR analysis. The presence (or absence) of FV-Leiden was assessed by PCR using primers flanking the mutant site (nt 1691), followed by hybridization with wild-type ('G') and mutant ('A') biotinylated DNA probes; detection was by DNA enzyme immunoassay (DEIA). RESULTS: While the prevalence of FV-Leiden in CAD patients was not statistically different from that of healthy subjects (14.5 % vs. 15.1 %; P=0.890, odds ratio 0.95; 95 % confidence interval 0.43--2.06), a significant increase in FV-Leiden prevalence was seen in VTE patients (70.6 % in VTE patients; P<0.001, odds ratio 13.4, 95 % confidence interval 6.9--25.8). Of the 48 VTE patients who tested positive for FV-Leiden, 42 were heterozygotes (G/A), while 6 were homozygotes (A/A) (allele frequency 0.397). All 10 CAD patients positive for FV-Leiden were heterozygote carriers (allele frequency 0.072). While gender was not a factor in FV-Leiden expression, higher prevalence in FV-Leiden was seen in younger (< or =45 years) VTE patients (38/51 vs. 10/17). CONCLUSION: FV-Leiden is a major inherited risk factor for VTE, with a peak incidence in younger patients, but does not appear to play any role in CAD pathogenesis in the population studied.
Assuntos
Resistência à Proteína C Ativada/complicações , Doença das Coronárias/epidemiologia , Fator V/genética , Trombofilia/genética , Trombose Venosa/epidemiologia , Resistência à Proteína C Ativada/genética , Adolescente , Adulto , Distribuição por Idade , Idoso , Criança , Pré-Escolar , Doença das Coronárias/genética , Feminino , Frequência do Gene , Predisposição Genética para Doença , Genótipo , Humanos , Líbano/epidemiologia , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Fatores de Risco , Trombose Venosa/etiologia , Trombose Venosa/genéticaRESUMO
BACKGROUND: Health care workers are at risk of contracting hepatitis C virus (HCV) infection more than the general population, and chronic HCV infection may be asymptomatic. Therefore, the purpose of this study was to determine the seroprevalence of HCV among health care workers at St Georges-Orthodox Hospital, the first study done for a major teaching hospital in Lebanon. METHODS: Health care personnel at St Georges-Orthodox Hospital, Beirut, were offered anonymous testing for anti-HCV antibody. Seroprevalence rates of health care personnel were compared with the rates of blood donors screened during the same year. RESULTS: Of the 502 persons screened, 13 (2.60%) initially tested either positive or doubtful-positive by the SM-HCV rapid test; 2 (0.4%) were confirmed positive by 2 commercial enzyme-linked immunosorbent assay kits and reverse transcriptase-polymerase chain reaction. This prevalence rate was comparable with the rate obtained for blood donors (n = 600) during the same period. CONCLUSION: The seroprevalence of HCV infection among health care workers at St Georges-Orthodox Hospital was similar to the rate observed in local blood donors, which suggests that the occupational risk of HCV infection was low.
Assuntos
Anticorpos Anti-Hepatite C/sangue , Hepatite C/epidemiologia , Doenças Profissionais/epidemiologia , Recursos Humanos em Hospital/estatística & dados numéricos , Adulto , Ensaio de Imunoadsorção Enzimática , Feminino , Hepatite C/sangue , Humanos , Líbano/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/sangue , Exposição Ocupacional , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Estudos SoroepidemiológicosRESUMO
BACKGROUND: Certain types of human papillomavirus (HPV) are associated with cervical intraepithelial neoplasia (CIN) and invasive cervical carcinoma. The study addressed the expression and detection of HPV genotypes in cervical and vaginal specimens of women with normal and abnormal cytology by polymerase chain reaction (PCR), each woman serving as her own control. METHODS: Study participants (127) were subgrouped into CIN-positive and CIN-negative, based on cytology screening, and endocervical and vaginal scrapes were collected by a gynecologist and placed immediately in saline. HPV DNA was assessed by PCR, and HPV genotypes were determined by hybridization of PCR products with type-specific biotinylated probes. RESULTS: Of the 127 participants, 55 tested positive and 72 tested negative for HPV DNA. While there was no difference between the two groups with regards to age or to number of pregnancies, higher numbers of smokers and of women with multiple sexual partners and abnormal cytology were seen in the HPV-positive group (P < 0.001). HPV DNA was detected in the vaginal scrapes of all HPV-positive, but in none of the HPV-negative women (sensitivity and specificity = 1.0). Furthermore, the HPV genotype was the same in vaginal and endocervical specimens in all the HPV-positive women. CONCLUSION: HPV detection by PCR, using endocervical or vaginal sampling, is a sensitive and highly specific test for the identification of HPV infection, in particular in women with cytomorphologically normal cervices.
Assuntos
Colo do Útero/virologia , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/diagnóstico , Vagina/virologia , Adulto , DNA Viral/análise , Feminino , Genótipo , Humanos , Pessoa de Meia-Idade , Infecções por Papillomavirus/virologia , Sensibilidade e Especificidade , Infecções Tumorais por Vírus/virologia , Neoplasias do Colo do Útero/virologia , Esfregaço Vaginal/instrumentação , Esfregaço Vaginal/métodos , Displasia do Colo do Útero/virologiaRESUMO
The aim of this study was to assess the validity and usefulness of vaginal scrapes in detecting cervical human papillomavirus (HPV) DNA by the polymerase chain reaction (PCR). The study group comprised 23 women tested positive and 28 women tested negative for cervical HPV DNA by PCR, and confirmed by histopathology. At the time of specimen collection, both vaginal and endocervical scrapes were taken from these women, and tested for HPV DNA by PCR, using MY09/MY11 primer system. HPV genotypes were analyzed by hybridizing PCR products with HPV type-specific biotinylated probes. HPV DNA was detected in both vaginal and cervical scrapes from the HPV-positive, but not from HPV-negative group. In the HPV-positive group, the same HPV type was found in vaginal and endocervical scrapes, giving a positive predictive value of 1.0. The results indicate that HPV types can be detected in vaginal scrapes, and recommend utilization of the less invasive vaginal testing for the routine detection of HPV DNA.
Assuntos
DNA Viral/análise , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/virologia , Infecções Tumorais por Vírus/virologia , Vagina/virologia , Adulto , Colo do Útero/virologia , Sondas de DNA , Feminino , Genótipo , Humanos , Papillomaviridae/genética , Reação em Cadeia da Polimerase , Reprodutibilidade dos TestesRESUMO
Resistance to activated protein C (APC) degradation caused by a specific point mutation in the factor V (FV) gene, FV:R506Q or FV-Leiden, which replaces Arg506 with Gln at the APC cleavage site within the FV gene, is the most prevalent inherited caused of venous thrombosis. Recent reports suggested that the prevalence of FV-Leiden is high among Caucasians, and very low among non-Caucasians, thereby suggesting that FV-Leiden has originated as a single event in a primary focus. Insofar as FV-Leiden is associated with increased risk of thromboembolic diseases, coupled with its selective worldwide distribution, the aim of this study was to determine the prevalence of FV-Leiden in Lebanon and compare it with those of other countries of Caucasian and non-Caucasian origin. FV-Leiden was determined by PCR, followed by hybridization with specific wild-type and mutant DNA probes. By screening 174 healthy Lebanese subjects, 25 were shown to carry the FV-Leiden mutation, giving an allele frequency of 7.4% and an overall prevalence rate of 14.4%. Of the 25 FV-Leiden carriers, 24 were in the heterozygous state while one was in the homozygous states. No statistical difference in the FV-Leiden prevalence was noted with respect to age, gender, or sect. In addition to Lebanon, which had the highest prevalence rate reported thus far (14.4%), a high prevalence of FV-Leiden was reported for Syria (13.6%), Greece-Cyprus (13.4%), and Jordan (12.3%), an indication that the Eastern Mediterranean is the primary focus of FV-Leiden mutation. The high prevalence of FV-Leiden in Lebanon suggests that screening for this mutation must be considered for those with a family history, and/or those with additional risk factors for venous thrombosis.
Assuntos
Fator V/genética , Frequência do Gene , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Chipre/epidemiologia , Feminino , Predisposição Genética para Doença , Grécia/epidemiologia , Heterozigoto , Humanos , Jordânia/epidemiologia , Líbano/epidemiologia , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Síria/epidemiologia , Tromboembolia/genéticaAssuntos
Fator V/genética , Adulto , Feminino , Testes Genéticos , Humanos , Líbano , Masculino , Mutação Puntual , PrevalênciaAssuntos
Glucocorticoides/farmacologia , Rejeição de Enxerto/metabolismo , Fator de Crescimento Transformador beta/biossíntese , Divisão Celular/efeitos dos fármacos , Rejeição de Enxerto/tratamento farmacológico , Humanos , Ativação Linfocitária/efeitos dos fármacos , RNA Mensageiro/biossíntese , Células Th2/efeitos dos fármacos , Células Th2/imunologia , Fator de Crescimento Transformador beta/genéticaRESUMO
One hundred Lebanese volunteers blood donors were tested for the qualitative detection of antibodies against hepatitis E virus (HEV) by an immunoenzymatic method. The results showed 4% of positivity. This figure allows us to confirm the presence of infection due to HEV in Lebanon. More studies on a larger panel are necessary to confirm this result. This study leads us to suspect an HEV infection in front of an acute non A, non B, non C hepatitis even if the patients have not lived in an endemic area.