-174G>C interleukin-6 gene polymorphism in Tunisian patients with coronary artery disease

<b>Background and Objectives :</b> A state of low-grade inflammation accompanies the pathogenesis of atherosclerotic events. Interleukin-6 (IL-6) is a pleotropic pro-inflammatory cytokine that modulates the development of acute coronary syndromes (ACSs), partly by destabilizing coronary atherosclerotic plaques. We have examined the contribution of the -174G&gt;C IL-6 promoter variant on the risk of coronary artery disease (CAD) among Tunisians. <b>Patients and Methods :</b> Study subjects included 418 CAD patients and 406 age- and sex-matched controls. IL-6 genotyping was done by PCR-restriction fragment length polymorphism. <b>Results</b> : The frequency of the -174C allele (mutant) was lower in Tunisians than in Europeans, and the distribution of -174 G&gt;C genotypes was similar between CAD patients and control subjects. Moreover, compared to GG genotype carriers, -174C allele carriage did not increase the CAD relative risk (odds ratio and 95&#x0025; confidence interval=1.09 and 0.80-1.49), which remained nonsignificant after adjusting for traditional risk factors for CAD (age, smoking, hypertension, diabetes and obesity). <b>Conclusion</b> : The -174G&gt;C IL-6 promoter variant is not associated with an increased risk of CAD among Tunisians

The Resolution of Obstructive Sleep Apnea in a Patient with Goiter after Total Thyroidectomy: A Case Report

Obstructive sleep apnea (OSA) may be linked to various factors that narrow the upper airways, such as obesity, adenotonsillar hypertrophy and craniofacial abnormalities. Hypothyroidism has also been described as a risk factor for OSA. However, the implication of goiter independently of thyroid function in the occurrence of OSA remains unclear. We present the case of a 66-year-old woman with a large compressive multinodular goiter for whom total thyroidectomy was indicated. During the preoperative assessment, the patient had a body mass index (BMI) of 37.8 kg/m2 with symptoms of OSA. Respiratory polygraphy confirmed the diagnosis of severe OSA (apnea–hypopnea index (AHI) = 32), and treatment with continuous positive airway pressure (CPAP) was initiated prior to thyroid surgery. Surprisingly, after total thyroidectomy, OSA symptoms disappeared, and the patient abandoned CPAP therapy. Subsequent respiratory polygraphy after thyroidectomy showed a decrease in AHI to a normal value (AHI < 5). Interestingly, there was no change in BMI or other factors explaining the resolution of OSA, except for thyroidectomy. This case report suggests that goiter can be considered a risk factor for OSA. However, prospective studies are needed to accurately assess the effects of goiter on the occurrence of OSA according to its dimensions and local extension

–308G&#62;A and –1031T&#62;C tumor necrosis factor gene polymorphisms in Tunisian patients with coronary artery disease

Background: Recent research has shown that inflammation plays a key role in coronary artery disease (CAD) and other manifestations of atherosclerosis. Several lines of evidence support a key role for tumor necrosis factor-α (TNF-α), a potent immunomodulator and pro-inflammatory cytokine, in the development of atherosclerosis and in complications of CAD. Methods: We investigated the possible association between CAD and the TNF gene promoter polymorphisms –308G&#62;A and –1031T&#62;C in a Tunisian population. We compared the distribution of these polymorphisms between 418 patients with CAD and 406 healthy controls using polymerase chain reaction restriction fragment length-polymorphism analysis. Results: The frequency of the TNF-α –308A allele in the control group was similar to that observed in CAD patients [p=0.78; odds ratio (OR)=1.15; 95% confidence interval (CI)=0.86–1.55], but higher than those described in other Europeans, such as in the French, Finnish and Spanish. Concerning the TNF-α –1031T/C polymorphism, the same distribution was observed between patients with CAD and controls (p=0.12; OR=1.27; 95% CI=0.94–1.72). In addition, the genotype and allele frequencies of control individuals were comparable to those previously reported in healthy Tunisian controls and other ethnic groups. Haplotype analysis (TNF-α –308G&#62;A and –1031T&#62;C) demonstrated no significant association between TNF haplotypes and CAD. Conclusions: We conclude that TNF promoter gene polymorphisms at position –308G&#62;A and –1031T&#62;C do not play a major role in the pathogenesis of CAD in the Tunisian population. Clin Chem Lab Med 2009;47:1247–51.Peer Reviewe