Energy Metabolism in Residents in the Low- and Moderate Altitude Regions of Central Asia with MAFLD and Type 2 Diabetes Mellitus.

The knowledge about the features of energy metabolism in MAFLD in the population living at different climatic and geographic heights is lacking. The goal of this study is to explore the biochemical parameters of blood and erythrocyte energy consumption in patients with MAFLD with and without DM2 living in the low- and moderate-altitude regions of Central Asia. Our study was carried out on patients living in low-altitude mountains: Bishkek, altitude=750-800 m; n=67 (MAFLD with DM 2: n=24; MAFLD without DM2: n=25; control: n=18), and At-Bashy District, Naryn Region, altitude=2046-2300 m; n=58 (MAFLD with DM2: n=28; MAFLD without DM2: n=18; control: n=12). Non-alcoholic fatty liver disease was diagnosed according to history, laboratory tests, liver ultrasound, and exclusion of other liver diseases. The level of liver fibrosis was determined using the FIB-4 score. Blood adenosine 5'-triphosphate (ATP) was determined using the CellTiter-Glo method. Healthy residents living in moderate altitudes have significantly higher levels of cytosolic ATP in their blood (p+≤+0.05) than residents living in low mountains. MAFLD is characterized by an increase in the level of ATP concentration in their blood. ATP concentration decreased significantly in patients with MAFLD with DM2 living in moderate-altitude in comparison to those living in low-altitude mountains. The results suggest that chronic altitude hypoxia leads to a breakdown in adaptive mechanisms of energy metabolism of ATP in patients with MAFLD with type 2 DM.

The current salt iodization strategy in Kyrgyzstan ensures sufficient iodine nutrition among school-age children but not pregnant women.

OBJECTIVE: Although goitre and cretinism were brought under control in Kyrgyzstan during the 1960s by centrally directed iodized salt supplies, iodine-deficiency disorders (IDD) had made a comeback when the USSR broke up in 1991. Upon independence, Kyrgyzstan started developing its own salt processing industry and by 2001 the Government enacted a law on IDD elimination, mandating universal salt iodization (USI) at 25-55 mg/kg. The present study aimed to evaluate the effectiveness of the USI strategy on the iodine consumption, iodine status and burden of IDD in the population of Kyrgyzstan. DESIGN: A national, population-representative survey during autumn 2007 collected household salt and urine samples of school-age children and pregnant women for quantitative iodine measurements. Thyroid volume was measured by ultrasound. RESULTS: The median iodine content in household salt was 11.2 mg/kg; 97.9 % of salt samples were iodized, but only 39.5 % had >or=15 mg iodine/kg. The median urinary iodine concentration (UIC) of 114 microg/l in children did not differ from the UIC of 111 microg/l in pregnant women. Thyroid volume in pregnant women increased with the duration of pregnancy. Strong relationships existed between salt iodine levels and the UIC values in children and women. CONCLUSIONS: The iodine nutrition status of the Kyrgyz population is highly responsive to household salt iodization. Although the results in children suggest adequate iodine nutrition, the iodine consumption among pregnant women did not assure their dietary requirements. In-depth analysis of the survey data suggest that excess iodine intake is not likely to become a public health concern in Kyrgyzstan when the salt supply meets agreed standards.