Effect of glycemic control and dyslipidemia on plasma vascular endothelial growth factor and pigment epithelium-derived factor in diabetic retinopathy patients in Northern Nigeria.

OBJECTIVES: The disruption of the reciprocal regulation between vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF) has been associated with the pathogenesis of diabetic retinopathy (DR). This study assessed the levels of VEGF, PEDF, indices of glycemia, and lipid profile in diabetic patients with retinopathy. METHODS: One hundred fifty participants comprised 50 type 2 diabetic patients with DR, 50 without DR and 50 non-diabetic normotensive controls, aged 30-80 years, were randomly recruited for this case-control study. The study was carried out from November 2017 to December 2018. VEGF, PEDF, glycated hemoglobin (HbA1c), fasting plasma glucose, and lipid profile were determined using standard methods. Blood pressures (BP) and anthropometric indices were measured. Chi-squared test of independence, analysis of variance, and Pearson's correlation were used to analyze data. Statistical significance was set at P < 0.05 and 95% confidence interval. RESULTS: Both diabetic groups had significantly higher (P = 0.001) systolic and diastolic BP, VEGF, PEDF, HbA1c, fasting plasma glucose, triglycerides, total, high-density lipoprotein-cholesterol (HDL-C), and low-density lipoprotein-cholesterol (LDL-C) levels and significantly lower (P = 0.005) VEGF/PEDF than the controls. However, the diabetics with retinopathy had significantly higher (P = 0.001) HDL-C, LDL-C, VEGF, and PEDF levels compared to the diabetics without retinopathy. There were no significant differences (P > 0.05) in the levels of VEGF, PEDF, and VEGF/PEDF in both groups of diabetics that had good glycemic control and poor glycemic control. There was also no significant difference (P > 0.05) in the levels of VEGF and PEDF between the dyslipidemic and non-dyslipidemic subjects in both diabetic groups. CONCLUSION: DR is associated with higher levels of VEGF and PEDF while good glycemic control and dyslipidemia seem not to have a profound effect on VEGF and PEDF levels in diabetics with or without DR. Higher PEDF levels are associated with higher atherogenic risk in the diabetics with retinopathy.

Impact of Androgen Deprivation on Oxidative Stress and Antioxidant Status in Nigerian Patients With Prostate Cancer Undergoing Androgen Deprivation Therapy.

PURPOSE: Prostate cancer (CaP) incidence and mortality rate are increasing in Africa. Some have linked oxidative stress with the pathogenesis of cancer. This study assessed the levels of malondialdehyde (MDA), nitric oxide (NO), total plasma peroxide (TPP), and total antioxidant capacity (TAC) in Nigerian patients with CaP. PATIENTS AND METHODS: One hundred twenty patients with CaP and 100 apparently healthy controls were consecutively recruited into this case-control study. The patients with CaP were divided into treatment-naïve and androgen deprivation therapy (ADT)-treated groups. Anthropometric indices were measured, and MDA, NO, TAC, and TPP were assayed by colorimetric methods. The t test and analysis of variance were used in analysis of data; statistical significance was set at P < .05, and 95% CIs were reported. RESULTS: The patients with CaP had significantly higher waist-hip ratios and NO (P = .0001), TPP (P = .001), oxidative stress index (OSI; P = .003), and MDA values (P = .002) than controls. The treatment-naive patients with CaP had significantly higher waist-hip ratios (P = .011) and TPP (P = .013), MDA (P = .011), and NO values (P = .0001) and lower TAC values (P = .013) compared with the controls. The ADT-treated patients had higher waist-hip ratios (P = .0001) and TPP (P = .005), OSI (P = .005), MDA (P = .011), and NO values (P = .0001) than the controls. However, the treatment-naive patients had significantly higher NO values (P = .05) only compared with the ADT-treated patients. There was a significantly positive correlation between MDA and duration of treatment (r = 0.280, P = .018) in ADT-treated patients with CaP. CONCLUSION: This study demonstrated that patients with CaP have higher levels of TPP, MDA, and NO and lower levels of TAC compared with men without CaP. In addition, even in patients with CaP undergoing treatment, TPP and MDA levels remained high.

Seminal Oxidative Stress Markers, Calcium, Magnesium, and Semen Profile of Infertile Diabetic and Nondiabetic Nigerian Men.

CONTEXT: Oxidative stress, vitamin, and macroelement deficiencies have been implicated in male infertility. It is unknown if diabetes mellitus with its attendant increased oxidative stress makes the seminal quality of the diabetic infertile men worse compared to their nondiabetic counterparts. AIMS: The study investigated semen parameters, seminal plasma calcium, magnesium, Vitamins C and E, and total antioxidant capacity (TAC) in diabetic and nondiabetic infertile men. SETTINGS AND DESIGN: This was a cross-sectional study involving 30 infertile men with type 2 diabetes, 30 infertile nondiabetic men and 30 fertile men. SUBJECTS AND METHODS: Fasting plasma glucose, glycated hemoglobin, seminal plasma calcium, magnesium, TAC, Vitamin C, Vitamin E, semen analysis, and cultures carried out using the standard procedures. STATISTICAL ANALYSIS USED: Data were analyzed by the analysis of variance and Student's t-test; the level of significance was set at P < 0.05. RESULTS: Both infertile groups had significantly lower (P < 0.0001) sperm count, percentage motility, TAC, Vitamin E and C, magnesium and calcium when compared to the fertile group. However, there was no statistically significant difference (P > 0.05) in the mean values of these parameters among the two infertile groups. The infertile men had a significantly higher (P = 0.034) frequency of bacterial isolates compared to the fertile men. Staphylococcus aureus was the most frequent organism isolated. CONCLUSIONS: Seminal calcium, magnesium, TAC, and Vitamin E and C were lower in both infertile diabetic and nondiabetic men as compared to that of fertile men, but the levels of these analytes were comparable in the infertile diabetic and nondiabetic men.

Fertility hormones and vitamin E in active and passive adult male smokers in Calabar, Nigeria.

Smoking is an extremely lethal act and is associated with many illnesses. Lately, major concerns that passive smokers face the same health risks as (if not higher than) active smokers have been raised. Some studies have shown that active smoking is associated with low serum levels of vitamins and testosterone. Are these facts also valid in passive smokers? This study investigated the levels of cotinine, testosterone, follicle stimulating (FSH), Luteinizing Hormone (LH), prolactin and vitamin E in male active smokers and compare these with male passive smokers. Serum levels of cotinine, testosterone, FSH, LH, prolactin and vitamin E were determined in 60 cigarette smokers, 60 passive smokers and 60 non-smokers recruited from Calabar metropolis. The hormones were assayed using ELISA and Vitamin E using high performance liquid chromatography. Socio-demographic and anthropometric indices were obtained and data analyzed using PAWstatistic 18. Cotinine levels were significantly (p<0.05) higher in active smokers than in passive smokers and controls. Vitamin E and testosterone were significantly lower in both active (p<0.05) and passive smokers (p<0.05) when compared to non-smokers. The FSH of the active smokers was significantly higher (p = 0.034) than that of the controls while the passive smokers had the highest LH values (p = 0.0001). However, there were no significant variations in the prolactin levels among the three groups. Both passive and active smoking depletes serum vitamins E and lowers testosterone levels. Lower serum vitamin E is pointer to increased oxidative stress which in conjunction with lower testosterone levels may lead to increased incidence of infertility in both active and passive male smokers.

Cardiovascular Disease Risk Factors: How Relevant in African Men With Prostate Cancer Receiving Androgen-Deprivation Therapy?

PURPOSE: Cardiovascular disease risk factors have been associated with androgen-deprivation therapy (ADT) in white and Hispanic populations. It is therefore relevant to determine if there exists a relationship between these parameters in the African population. PATIENTS AND METHODS: The design of the study was cross sectional. Prostate-specific antigen concentration, waist circumference, body mass index (BMI), lipid profile, glucose level, and insulin level were determined in 153 patients with prostate cancer and 80 controls. The patients with prostate cancer were divided into subgroups of treatment-naïve patients and those receiving ADT. RESULTS: Mean total cholesterol (P = .010), LDL cholesterol (P = .021), BMI (P = .001), and waist circumference (P = .029) values were significantly higher in patients treated with ADT when compared with treatment-naïve patients. In patients treated with ADT for up to 1 year, only mean BMI was significantly higher than in treatment-naïve patients, whereas those treated with ADT for more than 1 year had significantly higher mean BMI, waist circumference, total cholesterol, and LDL cholesterol values when compared with treatment-naïve patients. There were no significant differences in insulin or glucose levels. Those undergoing hormone manipulation after orchiectomy had fewer cardiovascular risk factors compared with those undergoing hormone manipulation alone. CONCLUSION: This study shows that ADT results in elevated total cholesterol, LDL cholesterol, BMI, and waist circumference values, all of which are risk factors of cardiovascular disease. Screening for cardiovascular risk factors should be included in treatment plans for patients with prostate cancer.

Thyroid hormones and prolactin levels in infertile women in southern Nigeria.

INTRODUCTION: Human infertility is a complex global health problem. It has multiple social consequences which are especially profound for thyroid hormones in infertility with the aim of determining the degree of association of thyroid hormones with hyperprolactinemia in our population. MATERIALS AND METHODS: The serum levels of prolactin, T3, T4 and TSH were determined in 90 hyperprolactinemic infertile women, 90 normoprolactinemic infertile women and 50 fertile women. The hormones were assayed using Enzyme Linked Immunosorbent Assay kits. STATISTICAL ANALYSIS: Analysis of variance and Pearson's correlation were used to analyze the data, with the significant p-level set at 0.05. RESULTS: A significantly higher mean serum prolactin and TSH were observed among the infertile groups compared to the fertile controls (p<0.05). The mean serum T3 and T4 were significantly lower in the hyperprolactinemic infertile women compared to the fertile controls (p<0.05). The mean TSH and T3 of normoprolactinemic infertile women and controls were comparable (p>0.05). However, the mean T4 was significantly lower in normoprolactinemic infertile women compared to the fertile controls (p<0.05). In all the groups, TSH correlated inversely with T3 and T4, while T3 correlated positively with T4. It was only in the control group that prolactin correlated positively and significantly with TSH. CONCLUSION: It is therefore concluded that hyperprolactinemia with thyroid dysfunction may be a major contributory hormonal factor in infertility among infertile women and as such, estimation of prolactin, T3, T4 and TSH should be included in the workup for infertile women especially those with hyperprolactinaemia.