Non-alcoholic fatty liver disease and associated factors among type 2 diabetic patients in southwest Ethiopia

Background: Non-alcoholic Fatty Liver Disease (NAFLD) among type 2 diabetic patients is completely ignored in developing regions like Africa paving the way for public health and economic burden in the region. Therefore, the main objective of this research was to evaluate non-alcoholic fatty liver disease and associatedfactors among type 2 diabetic patients in Southwestern Ethiopia attending Diabetic Clinic of Jimma University Specialized Hospital (JUSH).Methods: Facility based cross-sectional study design was used. Anthropometry, fatty liver (using utrasonography), liver enzymes, and lipid profiles were measured among type 2 diabetic patients who fulfilled the inclusion criteria. Socio-demographic and clinical characteristics were assessed using standard questionnaires.Results: Ninety-six (96) type 2 diabetic patients were enrolled and non-alcoholic fatty liver disease prevalence was 73%. Of nonalcoholic fatty Liver disease documented patients, 35.4%, 31.3% and 6.3% exhibited mild, moderate and severe fatty liver diseases, respectively. Alanine aminotransferase (p ≤0.001), Triacyglycerol (p ≤0.001), total bilirubin (p ≤0.05), direct bilirubin (p ≤0.05) and diabetic duration (p ≤0.01) were significantly associated with nonalcoholic fatty liver disease among type 2 diabetic patients. The Aspartate aminotransferase/ Alanine aminotransferase ratio among non alcoholic fatty liver disease patients was greater than one.Conclusions: The magnitude of non-alcoholic fatty liver disease is high among study groups and it needs urgent action by healthcare systems. Therefore, targeted treatment approach inclusive of non-alcoholic fatty liver disease should be designed.Keywords: Africa, Ethiopia, Nonalcoholic Fatty Liver Disease, Type 2 DM, Liver Enzymes, Lipid Profil

Nutritional iron deficiency anemia: magnitude and its predictors among school age children, southwest Ethiopia: a community based cross-sectional study.

BackgroundIron deficiency anemia (IDA) is a global public health problem among school age children, which retards psychomotor development and impairs cognitive performance. There is limited data on prevalence and risk factors for IDA.ObjectiveThe aim of this study was to determine the prevalence, severity, and predictors of nutritional IDA in school age children in Southwest Ethiopia.MethodologyA community based cross-sectional study was conducted in Jimma Town, Southwest Ethiopia from April to July 2013. A total of 616 school children aged 6 to 12 years were included in the study using multistage sampling technique. A structured questionnaire was used to collect sociodemographic data. Five milliliter venous blood was collected from each child for hematological examinations. Anemia was defined as a hemoglobin level lower than 11.5 g/dl and 12 g/dl for age group of 5-11 years and 12-15 years, respectively. Iron deficiency anemia was defined when serum iron and ferritin levels are below 10 µmol/l and 15 µg/dl, respectively. Moreover, fresh stool specimen was collected for diagnosis of intestinal parasitic infection. Stained thick and thin blood films were examined for detection of Plasmodium infection and study of red blood cell morphology. Dietary patterns of the study subjects were assessed using food frequency questionnaire and anthropometric measurements were done. Data were analyzed using SPSS V-20.0 for windows.ResultOverall, prevalence of anemia was 43.7%, and that of IDA was 37.4%. Not-consuming protein source foods [AOR = 2.30, 95%CI(1.04,5.14)], not-consuming dairy products [AOR = 1.83, 95%CI(1.14,5.14)], not-consuming discretionary calories [AOR = 2.77, 95%CI(1.42,5.40)], low family income [AOR = 6.14, 95%CI(2.90,12.9)] and intestinal parasitic infections [AOR = 1.45, 95%CI(1.23, 5. 27)] were predictors of IDA.ConclusionIron deficiency anemia is a moderate public health problem in the study site. Dietary deficiencies and intestinal parasitic infections were predictors of IDA. Therefore, emphasis should be given to the strategies for the prevention of risk factors for IDA

Correction: Nutritional Iron Deficiency Anemia: Magnitude and Its Predictors among School Age Children, Southwest Ethiopia: A Community Based Cross-Sectional Study.

[This corrects the article DOI: 10.1371/journal.pone.0114059.]

Nutritional iron deficiency anemia: magnitude and its predictors among school age children, southwest Ethiopia: a community based cross-sectional study.

Iron deficiency anemia (IDA) is a global public health problem among school age children, which retards psychomotor development and impairs cognitive performance. There is limited data on prevalence and risk factors for IDA.The aim of this study was to determine the prevalence, severity, and predictors of nutritional IDA in school age children in Southwest Ethiopia.A community based cross-sectional study was conducted in Jimma Town, Southwest Ethiopia from April to July 2013. A total of 616 school children aged 6 to 12 years were included in the study using multistage sampling technique. A structured questionnaire was used to collect sociodemographic data. Five milliliter venous blood was collected from each child for hematological examinations. Anemia was defined as a hemoglobin level lower than 11.5 g/dl and 12 g/dl for age group of 5-11 years and 12-15 years, respectively. Iron deficiency anemia was defined when serum iron and ferritin levels are below 10 µmol/l and 15 µg/dl, respectively. Moreover, fresh stool specimen was collected for diagnosis of intestinal parasitic infection. Stained thick and thin blood films were examined for detection of Plasmodium infection and study of red blood cell morphology. Dietary patterns of the study subjects were assessed using food frequency questionnaire and anthropometric measurements were done. Data were analyzed using SPSS V-20.0 for windows.Overall, prevalence of anemia was 43.7%, and that of IDA was 37.4%. Not-consuming protein source foods [AOR = 2.30, 95%CI(1.04,5.14)], not-consuming dairy products [AOR = 1.83, 95%CI(1.14,5.14)], not-consuming discretionary calories [AOR = 2.77, 95%CI(1.42,5.40)], low family income [AOR = 6.14, 95%CI(2.90,12.9)] and intestinal parasitic infections [AOR = 1.45, 95%CI(1.23, 5. 27)] were predictors of IDA.Iron deficiency anemia is a moderate public health problem in the study site. Dietary deficiencies and intestinal parasitic infections were predictors of IDA. Therefore, emphasis should be given to the strategies for the prevention of risk factors for IDA

Burden and associated factors of anemia among pregnant women attending antenatal care in southern Ethiopia: cross sectional study

Abstract Background Anemia is a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient to meet physiologic needs, which varies by age, sex, altitude, smoking, and pregnancy status. The study aim is to determine the prevalence and factors associated with anemia among pregnant women attending a hospital in southern Ethiopia using a structured interview administered questionnaire. Methods Facility-based cross-sectional study was conducted from March 01–April 30 2015 at Butajira General Hospital, Ethiopia. A total of 217 women responded to the questionnaire and provided blood and stool samples for analysis. Data were analyzed using Statistical packages for social sciences version 20 for windows. Result and conclusions The overall burden of anemia in this study was 27.6%. Residence, ANC follow up, history of excess menstrual bleeding and interpregnancy interval were statistically associated with anemia among the pregnant women. Therefore, working in the identified gaps could reduce the current burden of anemia among pregnant women in the study area

Association of trace metal elements with lipid profiles in type 2 diabetes mellitus patients: a cross sectional study

Abstract Background It is well known that dyslipidemia and chronic hyperglycemia increase the onset of diabetes and diabetic complication. The aim of this study is to see the association of trace metals elements and lipid profile among type 2 diabetes mellitus patients. Methods The study was conducted on 214 type 2 diabetic patients at Jimma University Specialized Hospital, Jimma, Ethiopia. All the eligible study participants responded to the structured interviewer administered questionnaire and fasting venous blood was drawn for biochemical analysis. Trace metal elements (zinc(Zn+2), magnesium(Mg+2), chromium(Cr+3), calcium(Ca+2), phosphorus(Po4 −3), manganese(Mn+2), copper(Cu+2), and iron(Fe+3)) and lipid profiles (total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein (HDL-C), and triglycerides (TG)) were measured by atomic absorption spectrophotometry and enzymatic determination method respectively. Data were analyzed by SPSS version 24 software for windows. Bonferroni correction for multiple statistical comparisons was used and a p-value less than 0.01 were accepted as a level of significance. Result The mean age of study participants was 42.95(±12.6) with an average of 5.83(±3.1) years being diagnosed with diabetes mellitus. The BMI of female (27.1(±4.9)) was significantly higher than male (25.21(±4.2)). BMI shows positive and significant (p < 0.01) association with lipid profiles (TC, LDL-C, and TG) among type 2 diabetic patients in the liner regression model. In addition, WH-R was positively associated with TG. In Pearson partial correlation adjusted for sex and age, Za+2 shown to have statistically significant and negative correlations with TC, LDL-C and with TG. Mg+2 and Cr+2 negatively and significantly correlated with the lipid profile TC and LDL-C. Ca+2 negatively correlated with TC and TG. Po−3 4 positively correlated with HDL-C; iron negatively correlated with TC. However, in the liner regression model, only calcium positively and significantly (Beta = −0.21, p < 0.01) associated with TG. Conclusion In the current study, a negative correlation was observed between trace metal elements (Zn+2, Mg+2, Cr+3, Ca+2 and Fe+3) and lipid profile (TC, LDL-C and TG) among type 2 diabetes mellitus patients. In addition, Ca+2 observed to be associated with TG. Future studies are highly advised to uncover the bidirectional association between trace metal element and dyslipidemia in diabetic patients

Patient Awareness, Prevalence, and Risk Factors of Chronic Kidney Disease among Diabetes Mellitus and Hypertensive Patients at Jimma University Medical Center, Ethiopia

Background. There is an alarming rise of chronic kidney disease (CKD) prevalence globally, which is associated with significant morbidity and mortality necessitating special attention as one of the major public health problems. The burden of CKD disproportionately impacts low-income countries like Ethiopia where hypertension and diabetes mellitus, the two most important risk factors for CKD growth rate, are greatest. Objective. The aim of this study is to assess patient awareness, prevalence, and risk factors of chronic kidney disease among hypertensive and diabetes mellitus patients. Methods. Hospital based cross-sectional study design was conducted at Jimma University Medical Center among adult (≥18 years) hypertensive and diabetes mellitus patients. Informed written consent was obtained from each participant and data was collected by interview and chart review; blood and urine samples were collected for CKD screening. Glomerular filtration rate (GFR) was estimated from serum creatinine using CKD epidemiology collaboration (CKD-EPI) equation, and CKD was defined using estimated GFR (e-GFR) and albuminuria. Multivariate logistic regression was used to identify independent predictors of CKD and p-value 150 mg/dl, long duration of hypertension, ACEIs nonusers, and poor knowledge about CKD

Class 3 PI3K coactivates the circadian clock to promote rhythmic de novo purine synthesis

Metabolic demands fluctuate rhythmically and rely on coordination between the circadian clock and nutrient-sensing signalling pathways, yet mechanisms of their interaction remain not fully understood. Surprisingly, we find that class 3 phosphatidylinositol-3-kinase (PI3K), known best for its essential role as a lipid kinase in endocytosis and lysosomal degradation by autophagy, has an overlooked nuclear function in gene transcription as a coactivator of the heterodimeric transcription factor and circadian driver Bmal1-Clock. Canonical pro-catabolic functions of class 3 PI3K in trafficking rely on the indispensable complex between the lipid kinase Vps34 and regulatory subunit Vps15. We demonstrate that although both subunits of class 3 PI3K interact with RNA polymerase II and co-localize with active transcription sites, exclusive loss of Vps15 in cells blunts the transcriptional activity of Bmal1-Clock. Thus, we establish non-redundancy between nuclear Vps34 and Vps15, reflected by the persistent nuclear pool of Vps15 in Vps34-depleted cells and the ability of Vps15 to coactivate Bmal1-Clock independently of its complex with Vps34. In physiology we find that Vps15 is required for metabolic rhythmicity in liver and, unexpectedly, it promotes pro-anabolic de novo purine nucleotide synthesis. We show that Vps15 activates the transcription of Ppat, a key enzyme for the production of inosine monophosphate, a central metabolic intermediate for purine synthesis. Finally, we demonstrate that in fasting, which represses clock transcriptional activity, Vps15 levels are decreased on the promoters of Bmal1 targets, Nr1d1 and Ppat. Our findings open avenues for establishing the complexity for nuclear class 3 PI3K signalling for temporal regulation of energy homeostasis