Screening and Evaluation of Deleterious SNPs in APOE Gene of Alzheimer's Disease

Introduction. Apolipoprotein E (APOE) is an important risk factor for Alzheimer's disease (AD) and is present in 30–50% of patients who develop late-onset AD. Several single-nucleotide polymorphisms (SNPs) are present in APOE gene which act as the biomarkers for exploring the genetic basis of this disease. The objective of this study is to identify deleterious nsSNPs associated with APOE gene. Methods. The SNPs were retrieved from dbSNP. Using I-Mutant, protein stability change was calculated. The potentially functional nonsynonymous (ns) SNPs and their effect on protein was predicted by PolyPhen and SIFT, respectively. FASTSNP was used for functional analysis and estimation of risk score. The functional impact on the APOE protein was evaluated by using Swiss PDB viewer and NOMAD-Ref server. Results. Six nsSNPs were found to be least stable by I-Mutant 2.0 with DDG value of >−1.0. Four nsSNPs showed a highly deleterious tolerance index score of 0.00. Nine nsSNPs were found to be probably damaging with position-specific independent counts (PSICs) score of ≥2.0. Seven nsSNPs were found to be highly polymorphic with a risk score of 3-4. The total energies and root-mean-square deviation (RMSD) values were higher for three mutant-type structures compared to the native modeled structure. Conclusion. We concluded that three nsSNPs, namely, rs11542041, rs11542040, and rs11542034, to be potentially functional polymorphic

The Use of The Mini Nutritional Assessment To Assess The Nutritional Status of Elderly Subjects Living In The Riyadh Nursing Home

Objective: To evaluate the nutritional status of elderly in the Riyadh nursing home, using the mini nutritional assessment (MNA) test. Methods: All elderly residents (n=74) in the Riyadh nursing home were included in the study. Body mass index (BMI), mid-arm circumference (MAC) and calf circumference (CC) were measured. The MNA, specifically design for elderly subjects, was used in the study to determine the nutritional status. Results: Twenty seven percent and 43% of elderly subjects were found to be malnourished and at risk of being malnourished, respectively. The means for the BMI, MAC and CC were about 24 kg/m2, 26 cm and 29.5 cm, respectively. Elderly people, who were classified as malnourished, according to the MNA, had the lowest BMI, MAC and CC. When the score of the MNA was based on the diagnosis of the elderly, the results show that elderly with more than one main diagnosis had the lowest score. Conclusion: Based on the score of the MNA test, more than one fourth of the subjects were malnourished. Most of the subjects were consuming three whole meals and more than two serving of fruit and vegetables per day. It seems that food intake, in the nursing home, was satisfactory, among the subjects. Despite that, the percentage of malnourished subjects reached 27%. The results of the MNA test indicated the necessity of performing national nutritional assessment, for this vulnerable group of people, in other nursing homes and in the community

GLIM Criteria for Assessment of Malnutrition in Saudi Patients with Type 2 Diabetes

The Global Leadership Initiative on Malnutrition (GLIM) is a new approach established for the assessment of malnutrition. This study aimed to validate the GLIM for the diagnosis of malnutrition in patients with type 2 diabetes mellitus (T2DM) in Saudi Arabia, using the Subjective Global Assessment (SGA) as a reference. In addition, the association between the GLIM criteria and vascular complications in those patients was examined. A cross-sectional study was conducted on 101 patients with T2DM. The level of agreement between the GLIM and SGA tools was calculated using the kappa coefficient (κ). A receiver operating characteristic curve was used to determine the sensitivity and specificity of the GLIM. In addition, binary logistic regression was performed to investigate the association between each GLIM criterion and T2DM vascular complications. According to both the GLIM and the SGA, malnutrition was found in 15.8% and 17.8% of patients, respectively. The GLIM criteria achieved a very good level of accuracy (AUC = 0.877). The agreement between the tools was substantial (κ = 0.778). The ‘disease/inflammation’ criterion of the GLIM was significantly associated with macrovascular complications. To conclude, the GLIM criteria for diagnosis of malnutrition presented satisfactory levels of validity, and as such are acceptable for assessing the nutritional status of patients with T2DM

Body composition analysis by bioelectrical impedance and its relationship with nutritional status in older adults: a cross-sectional descriptive study

Currently, in the Kingdom of Saudi Arabia (KSA), adults aged ≥ 60 years make up approximately 6% of the total population, and this is predicted to reach around 23% by the year 2050 (1). The expected changes in the age distribution of the population will increase the incidence and prevalence of many chronic diseases (2,3),which are known to occur more commonly in the Saudi older age group (4-6). A poor diet, in addition to sedentary lifestyle and genetics, plays a crucial role in the increased prevalence of many chronic diseases (7,8). For example, the prevalence of obesity, diabetes, dyslipidemia and hypertension in the KSA, which are known risk factors of cardiovascular disease, a major cause of death in the KSA, have reached 49.6%, 25.1%, 32.1% and 30.3%, respectively (9). With ageing, there is a loss of lean body mass (mainly skeletal muscle), an increase in fat mass (10) and a decrease in resting energy expenditure (11). With the loss of muscle comes a loss of strength, and, consequently, older adults may become less active, which contributes to further loss of muscle. On the other hand, national surveys conducted in the KSA show that overweight and obesity have reached high rates in the adult population (12-14), which indicates that KSA is now facing a serious obesity-prevalence crisis. There has, however, been less focus on lean mass, and its functional significance, in the older Saudi population. Therefore, the current study aimed to assess body composition and the relationship between body composition and nutritional status in community dwelling older adults attending primary health care centers (PHCCs) in Riyadh city, KS

Normative data for handgrip strength in Saudi older adults visiting primary health care centers

Background and objective: handgrip strength (HGS) plays a vital role as a predictor of adverse health outcomes. Several studies have established HGS norms by age, sex, hand, occupation, culture or disability in different countries and for children in Saudi Arabia. However standardized values for Saudi older adults has not been reported yet. Therefore, the current study was aimed to establish normative data for HGS in Saudi older adults visiting primary health care centers (PHCCs). Material and Method: in this descriptive cross-sectional study, HGS in kilograms was measured using a hydraulic hand dynamometer in Saudi older adults (n=2045) aged ≥60 years 27 visiting 15 PHCCs selected randomly from the five geographical regions of Riyadh, Saudi Arabia between January 2015 and April 2017. The average mean from three successive trials, standard deviations, and 95% confidence intervals presented for the left and right hands of men and women in six age groups (60–64, 65–69, 70–74, 75-79, 80-84, and 85+ years). The analyses were performedusing the ANOVA test for all the age groups and to determine whether any differences exist between them. Results: the average mean HGS was significantly (p<0.0001) differ by the left and right hands of men and women in six age groups. Discussion: The current study presents specific norms for HGS in Saudi older adults by age, sex, and hand. Further studies are required to examine the utility of these norms for prediction of morbidity and mortality in this populatio

Association of malnutrition in peritoneal dialysis patients of Saudi Arabia

Malnutrition is highly prevalent in dialysis patients, and a major contributor to morbidity and mortality. We have investigated the inter-relationship between malnutrition and its impact on morbidity and mortality in peritoneal dialysis (PD) patients. We enrolled 60 PD patients, and measured C-reactive protein (CRP) and various nutritional markers, including pre-albumin. Patients were classified into two groups according to the albumin level since albumin is a good marker of nutrition condition: Group I (n = 32) patients with normal albumin (NAP) where the albumin level was above or equal to 35 g/L and Group II (n = 28) patients with low albumin level (LAP) less than 35 g/L. The level (mean ± SD) of blood urea nitrogen was significantly high (p < 0.05) in NAP group (19.9 ± 5.76 mmol/L) compared with LAP group (15.9 ± 6.32 mmol/L). Data showed that, the mean of creatinine was significantly high (p < 0.01) in NAP group (921 μmol/L) compared with LAP group (584 μmol/L) (Table 2). There was a trend toward association of elevated CRP with all-cause mortality in PD patients. It is useful to incorporate albumin and CRP in the regular assessment of PD patients, whose survival may be improved by better management of malnutrition