Liver cysts in Congolese patients with autosomal dominant polycystic kidney disease follow a family pattern

Background. It is now well established that at least two genes are associated with autosomal dominant polycystic kidney disease (ADPKD).Objective. To analyse the clinical expression of ADPKD in Congolese patients and to compare ADPKD expression between families.Methods. Following informed consent, ADPKD patients admitted to Brazzaville University Hospital (Congo) were reviewed and their relatives aged 20 years and older were screened by means of a clinical examination, abdominal ultrasound, urinalysis and determination of serum creatinine.Results. We found 7 patients with ADPKD, belonging to 7 distinct families, and identified 100 relatives of whom 50, aged from 20 to 68 years, were diagnosed as having ADPKD. Polycystic kidney disease was associated with polycystic liver in 4 families. In the remaining 3 families no liver cysts were found. No family had a mixture of members with kidney cysts only and members with kidney and liver cysts. This finding was age-independent.Conclusion. Liver cysts follow a family pattern in our ADPKD patients. We suggest that our patients may carry at least two different genes for ADPKD, one of which may be associated with renal cysts alone and other with both renal and liver cysts

Dépistage de l'artériopathie oblitérante des membres inférieurs chez les personnes âgées de 65 ans et plus à Brazzaville.

International audienc

Assessing clustering of metabolic syndrome components available at primary care for Bantu Africans using factor analysis in the general population

The original publication is available at http://www.biomedcentral.com/1756-0500/6/228Bibliography.ABSTRACT: To provide a step-by-step description of the application of factor analysis and interpretation of the results based on anthropometric parameters(body mass index or BMI and waist circumferenceor WC), blood pressure(BP), lipid-lipoprotein(triglycerides and HDL-C) and glucose among Bantu Africans with different numbers and cutoffs of components of metabolic syndrome(MS). This study was a cross-sectional, comparative, and correlational survey conducted between January and April 2005, in Kinshasa Hinterland, DRC. The clustering of cardiovascular risk factors was defined in all, MS group according to IDF(WC, BP, triglycerides, HDL-C, glucose), absence and presence of cardiometabolic risk(CDM) group(BMI,WC, BP, fasting glucose, and post-load glucose). RESULTS:Out of 977 participants, 17.4%( n = 170), 11%( n = 107), and 7.7%(n = 75) had type 2 diabetes mellitus(T2DM), MS, and CDM, respectively. Gender did not influence on all variables. Except BMI, levels of the rest variables were significantly higher in presence of T2DM than non-diabetics. There was a negative correlation between glucose types and BP in absence of CDM. In factor analysis for all, BP(factor 1) and triglycerides-HDL(factor 2) explained 55.4% of the total variance. In factor analysis for MS group, triglycerides-HDL-C(factor 1), BP(factor 2), and abdominal obesity-dysglycemia(factor 3) explained 75.1% of the total variance. In absence of CDM, glucose (factor 1) and obesity(factor 2) explained 48.1% of the total variance. In presence of CDM, 3 factors (factor 1 = glucose, factor 2 = BP, and factor 3 = obesity) explained 73.4% of the total variance. CONCLUSION: The MS pathogenesis may be more glucose-centered than abdominal obesity-centered in not considering lipid-lipoprotein , while BP and triglycerides-HDL-C could be the most strong predictors of MS in the general population. It should be specifically defined by ethnic cut-offs of waist circumference among Bantu Africans.Publishers' Versio

Aging, female sex, migration, elevated HDL-C, and inflammation are associated with prevalence of metabolic syndrome among African bank employees

Thierry Gombet,1 Benjamin Longo-Mbenza,2 Bertrand Ellenga-Mbolla,1 Meo Stephane Ikama,3 Etienne Mokondjimobe,4 Gisele Kimbally-Kaky,3 Jean-Louis Nkoua,31Emergency Department, University Hospital Center of Brazzaville, Brazzaville, Congo; 2Faculty of Health Sciences, Walter Sisulu University, Mthatha, Eastern Cape, South Africa; 3Department of Cardiology and Internal Medicine, University Hospital Center of Brazzaville, Brazzaville, Congo; 4Laboratory of Biochemistry and Pharmacology, Faculty of Health Sciences, Brazzaville, CongoBackground: The objective of this study was to compare four different criteria for diagnosing metabolic syndrome (MS) and to correlate sociodemographic data, liver enzymes, lipids, inflammation, and insulin resistance with MS definitions.Methods: This cross-sectional study included a random number of 126 African bank employees from Brazzaville, Congo.Results: The prevalence of MS varied according to the different definitions used: 4.8% under World Health Organization (WHO) criteria, 8.7% under the National Cholesterol Education Program Adult Treatment Panel III (NECP-ATPIII) criteria, 14.3% under the International Diabetes Federation (IDF) for Europe, and 15.9% by the IDF for Central Africa. According to the IDF, specific cutoff points for the erythrocyte sedimentation rate, ≥13 mm at first hour and ≥30 mm at second hour, defined MS for Central Africa. The best agreement was observed between the IDF for Europe and the IDF for Central Africa (Kappa = 0.938; P < 0.0001) criteria. The worst agreements were between the WHO and IDF for Central Africa (Kappa = 0.419; P < 0.0001) criteria and between the WHO and IDF for Europe (Kappa = 0.462; P < 0.0001) criteria. The NECP-ATPIII criteria did not agree with either the IDF for Europe or the IDF for Central Africa criteria. There was a significant relationship between female sex, aging, elevated liver enzymes, elevated phospholipids, high homeostasis model assessment of insulin resistance, and MS defined by the IDF for Central Africa.Conclusion: The IDF definition of the MS modified for Central Africa provides higher prevalence estimates of MS than the estimates based on the NECP-ATPIII and IDF for Europe criteria. Liver enzymes, phospholipids, and homeostasis model assessment of insulin resistance should be included in clinical practice to stratify cardiovascular disease risk among Africans.Keywords: metabolic syndrome, insulin resistance, inflammation, liver enzymes, atherosclerosis, sub-Saharan Africa&nbsp

Helicobacter pylori infection is identified as a cardiovascular risk factor in Central Africans

Benjamin Longo-Mbenza,1 Jacqueline Nkondi Nsenga,2 Etienne Mokondjimobe,3 Thierry Gombet,3 Itoua Ngaporo Assori,3 Jean Rosaire Ibara,3 Bertrand Ellenga-Mbolla,3 Dieudonné Ngoma Vangu,4 Simon Mbungu Fuele41Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa; 2Division of Gastroenterology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo; 3Faculty of Health Sciences, University of Marien Ngouabi, Brazzaville, Democratic Republic of the Congo; 4Biostatistics Unit, Lomo Medical Center, Limete, Kinshasa, Democratic Republic of the CongoBackground: Helicobacter pylori is now incriminated in the pathogenesis of atherosclerosis.Objective: To examine the importance of H. pylori infection as a cardiovascular disease (CVD) risk factor.Methods: Two hundred five patients (128 with H. pylori infection [HP-seropositive] and 77 without) had a baseline assessment for other potential CVD risk factors and were followed prospectively for 10 years (1999–2008). They were assessed on a monthly basis for the outcomes of carotid plaque, angina pectoris, myocardial infarction, and stroke. In the HP-seropositive group, male sex and quartile 4 for IgG anti-H. pylori antibodies (anti-HP Ab) were correlated with traditional CVD risk factors, stroke, myocardial infarction, and angina pectoris.Results: At the baseline assessment, the levels of carotid intima-media thickness, blood fibrinogen, total cholesterol, fasting plasma glucose, and uric acid were higher in H. pylori-infected patients than in the uninfected group. Serum HDL-cholesterol was significantly lower in the HP-seropositive group. Men had higher levels of IgG anti-HP Ab, waist circumference, blood pressure, uric acid, and total cholesterol than women. Within the HP-seropositive group, individuals in quartile 4 for IgG anti-HP Ab had higher rates of elevated fibrinogen, diabetes mellitus, low high-density lipoprotein cholesterol, arterial hypertension, and high total cholesterol than those in quartile 1. After adjusting for traditional CVD risk factors, H. pylori infection was the only independent predictor of incident carotid plaque (multivariate odds ratio [OR] = 2.3, 95% confidence interval [CI]: 1.2–7.2; P < 0.0001) and incident acute stroke (multivariate OR = 3.6, 95% CI: 1.4–8.2; P < 0.0001). Within the HP-seropositive group and after adjusting for traditional CVD risk factors, male sex was the only independent predictor of incident angina pectoris (multivariate OR = 3.5, 95% CI: 1.6–16; P < 0.0001), incident acute stroke (multivariate OR = 3.2, 95% CI: 1.4–28; P < 0.0001), and acute myocardial infarction (multivariate OR = 7.2, 95% CI: 3.1–18; P < 0.0001).Conclusion: Our study provides evidence for an association among known CVD risk factors, carotid plaque, stroke, and H. pylori infection. Among infected individuals, there is a significant association among severity of HP-seropositivity, male sex, and CVD. The eradication of H. pylori infection may therefore reduce the emerging burden of CVD in Africa.Keywords: Helicobacter pylori, stroke, myocardial infarction, cardiovascular disease, carotid plaque, African

Rates of untreated, treated, and controlled hypertension and relationships between blood pressure with other cardiovascular risk factors in Brazzaville (Republic of the Congo): May Measurement Month 2017-Sub-Saharan Africa.

Hypertension (HT) is a growing burden worldwide, leading to over 10 million deaths each year. In Brazzaville, the prevalence of HT was 32.5% in 2004. The mortality for stroke in 2008 and heart failure in 2013 were, respectively, 24% and 20.2%. May Measurement Month (MMM) is a global initiative initiated by the International Society of Hypertension aimed at raising awareness of HT and to act as a temporary solution to the lack of screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2017. Blood pressure (BP) measurement, the definition of HT and statistical analysis followed the standard MMM protocol. The screening was carried out in Brazzaville, and the screening sites were distributed in different districts of the city in public places and health facilities. A total of 3842 individuals were screened during MMM17. After multiple imputations, 1576 (41.0%) had HT. About 956 (29.7%) individuals not receiving anti-hypertensive medication, were hypertensive. Four hundred and nine (66.0%) individuals receiving anti-hypertensive medication, had uncontrolled BP. Systolic and diastolic BPs after adjustment for age and sex differed significantly in association with use of anti-hypertensive medication (P < 0.0001), previous stroke (P = 0.001 for systolic), and waist circumference (P < 0.0001). MMM17 was the largest BP screening campaign undertaken in Congo. Almost one-third of screenees had untreated HT, and two-thirds of treated hypertensives were not well controlled. These results suggest that opportunistic screening can identify significant numbers with raised BP