Effect of Adiposity and Type of Antipsychotic Medication on Plasma Levels of Resistin and Adiponectin in Patients with Major Mental Illnesses

Metabolic alteration is not uncommon in patients with major mental illnesses (MMI) and adipokines are thought to play some roles. Presently, the link between adiposity, adipokines release and MMI is still poorly understood. This study was carried out to determine the possible impact of central adiposity and type of antipsychotic medication on plasma levels of adiponectin and resistin in patients with MMI. Plasma levels of adiponectin and resistin were determined in ninety adults comprising 65 patients with MMI and 25 apparently healthy individuals, who served as controls. Anthropometry and blood pressure (BP) of the study participants were taken using standard methods. Anthropometric indices, BP and plasma level of adiponectin, but not resistin, were significantly higher in patients with MMI compared with the controls. The median plasma adiponectin level was significantly higher in patients with depression compared with patients with schizophrenia and the controls. However, the median plasma levels of adiponectin and resistin were insignificantly higher in patients with central obesity compared with patients without central obesity and in patients on atypical drugs compared with patients on typical drugs. Also, there was no significant difference in the median plasma levels of adiponectin and resistin in patients on clozapine or olanzapine compared with those on risperidone. It could be concluded from this study that patients with MMI have elevated level of adiponectin which does not appear to be influenced by central adiposity and type of antipsychotic medication

Assessment of serum Cystatin-C based eGFR equations and kidney dysfunction in patients with sickle cell anaemia: a single centre evaluation of cases and healthy controls

Background: Serum creatinine and its estimated glomerular filtration rate (eGFR) may be imprecise in assessing renal impairment of patients with sickle cell anaemia (SCA).Objective: To evaluate serum Cystatin-C and Cystatin-C eGF Requationsin the assessment of kidney dysfunction in Nigerians with SCA and controls.Design: A prospective, cross-sectional and case-control studySetting: The study was conducted at the haematology units of the Obafemi Awolowo University Teaching hospital complex, Ile-Ife and the Ring Road State Hospital, Ibadan in the South Western Nigeria,Subjects: The study participants included 46 sickle cell anaemia patients (HbSS) and 36 HbAA healthy controls in whiche GFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI, 2009 and 2012) equations for Creatinine, cystatin-C and Creatine and cystatin-C combined.Results: Mean serum cys-C was similar in patients and control group [0.29 (0.09) vs 0.26 (0.07) mg/L] while albuminuria occurred in 44.4% of patients only. Twice the number of patients with hyper filtration using CKD-EPI Cr equation was identified by CKD-EPI Cr-cys-C equation andnone by CKD-EPI cys-C. CKD-EPI cys-C identified more patients with eGFR 60 mL/min/1.73m2 than the creatinine based only and/or Cr-cys-C equations. Patients with CKD stage 3 were identified by CKD-EPI Cr and CKD-EPI cys-C at 2.2% and 8.7% respectively. Age 19 years, male sex, low eGFR and albuminuria were predictive of having high levels of serum cystatin C.Conclusion: Serum Cystatin C values appear lower for the sickled cell anaemia patients and healthy controls in the Nigerian population. Of the CKD-EPI equations, CKD-EPI cystatin-C equation best identified SCA patients with low eGFR (eGFR < 60 mL/min/1.73m2

Risk and prevalence of type 2 diabetes mellitus in patients with major mental health disorders

Background: The bi directional association between major mental health disorders (MMHD) and diabetes mellitus (DM) is well established. Presently, there is little information on the risk and prevalence of DM in Nigerians with MMHD.Objective: To determine the risk and prevalence of DM in Nigerians with MMHD.Design: Cross-sectional studySetting: New World Psychiatry Hospital, Ibadan, NigeriaSubjects: Plasma levels of glucose was determined after an overnight fast and at 120 minutes (2-h PG) of a standard 75-g oral glucose tolerance test in 124 patients with MMHD. Thereafter, normoglycaemia, pre-diabetes and diabetes were defined using the American Diabetes Association criteria. Also, the risk of developing DM within 10 years was assessed using the Finnish Diabetes Association DM Risk Assessment Form.Results: Seventy eight (62.9%), 37 (29.8%) and 9 (7.3%) of the patients had normoglycaemia, pre-diabetes and DM respectively. Only 2 patients had high diabetes risk score. There was progressive rise in 2-h PG level as the diabetes risk score increases. The mean 2-h PG was significantly higher in moderate-and-high risk group combined (MHR) compared with the low risk (LR) group. Also, the proportion of patients with pre-diabetes increased progressively from LR through MHR.Conclusion: Dysglycaemia is not a rare occurrence in Nigerians with MMHD and it appears to be more prevalent in them than in the Nigerian general population. Also, high diabetes risk score could be a strong indication for glucose tolerance testing

Changes in mediators of inflammation and pro-thrombosis after 12 months of dietary modification in adults with metabolic syndrome

Objective: This study evaluated the effects of a 12-month dietary modification on indices of inflammation and pro-thrombosis in adults with metabolic syndrome (MS).Materials and methods: This longitudinal study involved 252 adults with MS recruited from the Bodija market, Ibadan and its environs. Participants were placed on 20%, 30% and 50% calories obtained from protein, total fat and carbohydrate respectively and were followed up monthly for 12 months. Anthropometry and blood pressure were measured using standard methods. Fasting plasma glucose (FPG), total cholesterol (TC), triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), fibrinogen, plasminogen activator inhibitor-1 (PAI-1)], interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured using spectrophotometric methods and ELISA as appropriate. Data was analysed using ANCOVA, Student’s t-test, Mann-Whitney U and Wilcoxon signed-rank tests. P-values less than 0.05 were considered significant.Results: After 6 months of dietary modification, there was a significant reduction in waist circumference (WC), while the levels of HDL-C, fibrinogen and PAI-1 were significantly increased when compared with the corresponding baseline values. However, WC and fibrinogen reduced significantly, while HDL-C and IL-10 significantly increased after 12 months of dietary modification as compared with the respective baseline values.Conclusion: Long-term regular dietary modification may be beneficial in ameliorating inflammation and pro-thrombosis in metabolic syndrome.Keywords: Dietary modification, fibrinogen, interleukins, metabolic syndrome, plasminogen activator inhibito

Insulin sensitivity and mortality risk estimation in patients with type 2 diabetes mellitus

Background: There is at present the dearth of information on the possible contribution of insulin resistance to scores obtained from mortality risk estimation in patients with type 2 diabetes mellitus (T2DM).Aim: This study determined the mortality risk scores in patients with T2DM and its relationship with insulin resistance.Methods: Fasting plasma glucose, total cholesterol, high-density lipoprotein cholesterol (HDL), triglycerides, serum and urinary creatinine, glycated hemoglobin (HbA1c), serum insulin, and urinary albumin were determined in 111 T2DM patients. Thereafter, low-density lipoprotein cholesterol (LDL), quantitative insulin sensitivity check index (QUICKI), urinary albumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR) were calculated using the standard formula. Mortality risk was estimated using the validated Gargano mortality risk calculator with scores ≤0.67, 0.68–0.79, and ≥0.80 considered as low, intermediate, and high risks, respectively.Results: Of the total patients, 5 (4.5%), 28 (25.2%), and 78 (70.3%) patients had high, intermediate, and low mortality risk, respectively. There was no difference in the median QUICKI values when the three groups were compared. However, there was a significant elevation in the median eGFR in patients with high mortality risk compared with patients with low and intermediate mortality risks. Also, the median mortality risk score of patients with low insulin sensitivity (QUICKI ≤0.3) was similar to that obtained in patients with normal insulin sensitivity (QUICKI ≥0.31). No significant correlation was found between QUICKI and mortality risk scores.Conclusion: Insulin sensitivity status does not have a direct effect on scores obtained from the Gargano mortality risk prediction model.Keywords: Insulin resistance, mortality risk, type 2 diabetes mellitus, urinary albumin-to-creatinine rati

Complement factors in newly diagnosed Nigerian schizoprenic patients and those on antipsychotic therapy

The role of Complement factors in the pathogenesis of psychiatric disorders is enormous, but the data on levels and functions of complement factors in patients with schizophrenia are scanty and conflicting. To address this issue, levels of Complement regulators (C1 inhibitor and C3 activator) and complement factors (C1q, C3c, C4 and C5) were determined in the serum of newly diagnosed drug free schizophrenic patients, schizophrenic patients on medication and healthy subjects using immune-plates. C1q was significantly reduced in newly diagnosed schizophrenic patients or schizophrenic patients on medication compared with the controls. C3c was significantly reduced in newly diagnosed schizophrenic patients compared with controls or schizophrenic patients on medication. The levels of C3 activators, C1 inhibitors and C4 were similar in the two groups of schizophrenic patients compared with the controls. It may be concluded from this study that C1qis deficient in schizophrenic patients; and that C3c may differentiate newly diagnosed schizophrenia from schizophrenic patients on medication

Relationship between Fasting Plasma Glucose and Glycated Haemoglobin In Adult Diabetic Nigerians

The relationship between packed cell volume (PCV), fasting plasma glucose (FPG) and glycated haemoglobin (HbAI) was investigated in 40 diabetic patients (22 males and 18 females) and 20 apparently healthy controls (12 males and 18 females). Among the control subjects the FPG and HbA1 were significantly higher in the female than male subjects (P < 0.001). This gender differences was not found in diabetic patients (P < 0.05). While all the control subjects have FPG and HbA1 level within normal range (75- 115mg/dl and 5 – 8 %, respectively), 15 (38%) of the diabetic patients had FPG level within normal and only 5 (13%) had HbA1 level within the normal range. The FPG and HbA1 values were however, significantly higher in diabetic patients (139.34 ± 7.06 and 12.09 ± 2.80) than control subjects (76.40 ± 1.24 and 6.24 ± 0.51), respectively (P < 0.001). The PCV in controls correlated significantly with FPG and HbA1 (P < 0.001) while the FPG correlated significantly with HbA1 (P < 0.001). There was however only a significant correlation between FPG and HbA1 in the diabetic subjects. Bland Ahman graph shows a good agreement between FPG and HbA1, in both test and control subjects. These results show that PCV and gender factors have significant influence on FPG and HbA1 level in control subjects and were insignificant in diabetic patients. FPG and / or HbA1 are important and agreeable indices for assessment of glucose metabolism. Furthermore, there was an evidence of poor glycemic control in diabetic patients investigated in this study, probably due to poor compliance culture of the patients or inability to procure recommended drugs