Association of vitamin D and insulin resistance among the adults with newly detected prediabetes attending in a tertiary care hospital of Bangladesh

Several studies have found an inverse association between vitamin D level and insulin resistance (IR) causing prediabetes and diabetes. So the current study was done to find out the association between serum vitamin D level and IR among adults with prediabetes. This cross-sectional study was carried out in 140 newly detected adults with prediabetes according to ADA 2018 criteria. The 25(OH) D cutoffs to define deficiency and insufficiency were used according to Endocrine Society (USA) criteria, measurement of vitamin D & insulin (fasting) was done by chemiluminescent microparticle immunoassay (CMIA). Data were analyzed using SPSS (version 22.0) and presented as table and figure. P-value ≤0.05 was considered significant. In this study, most of the population was 30 years and above (73%). The Male-female ratio was 1:7, the majority of participants came from urban areas (81%) and it was observed that there was an increasing trend of insulin resistance across increasing severity of vitamin D deficiency though it was not statistically significant (p= 0.74). In conclusion, vitamin-D deficiency/insuffi- ciency is common among individuals with prediabetes in our country, but there were no associ- ation had been found between vitamin D and insulin resistance in individuals with prediabetes BSMMU J 2021; 14(4): 157-16

Vitamin D supplementation on prediabetic adults with vitamin D deficiency: a double-blind placebo-controlled randomized clinical trial

Hypovitaminosis D (<20 ng/mL) is thought to increase insulin resistance and meta-inflammation contributing to the pathogenesis of diabetes mellitus (DM). Correcting vitamin D deficiency in people with prediabetes might halt its progression to DM. The aim of this study was to examine the effect of vitamin D supplementation on insulin resistance, glycemic status, and inflammation in prediabetic adults with vitamin D deficiency. This doubleblind randomized placebo-controlled trial was done among 27 newly detected prediabetic adults with hypovitaminosis D randomly assigned to 60,000 IU of vitamin D weekly for eight weeks followed by monthly for the next four months or placebo along with lifestyle modification in both groups [vitamin D (n= 14) vs. Placebo (n=13). They were comparable in terms of sex, age and borlymass index. Glycemic status, fasting plasma glucose (FPG) and Hemoglobin A1C (HbA1C), insulin resistance (homeostasis model assessment of insulin resistance (HOMA-IR) and inflammatory marker high sensitivity C reactive protein (hs-CRP) were measured at baseline and after six months of intervention. Vitamin D levels (ng/mL) increased in both groups from baseline (vitamin D vs. placebo: 12.2±5.9 vs. 3.9±3.5, mean±SD). FPG (mmol/L) significantly decreased in the Vitamin D group (before vs. after: 5.9±0.6 vs. 5.5±0.7, P=0.016, mean±SD), whereas HbA1C (%) and hs- CRP (mg/L) significantly increased in the placebo group (before vs. after- HbA1C: 5.8±0.3 vs. 6.0±0.4, P<0.001; hs-CRP: 5.0±4.4 vs. 5.6±4.9, P=0.039, mean±SD). Percent changes in glycemic status, HOMA-IR, and hs-CRP were statistically similar between the groups. Our study failed to demonstrate the positive effects of vitamin D supplementation on reducing glucose, insulin resistance, or inflammatory marker in prediabetic adult patients with hypovitaminosis D. BSMMU J 2022; 15(3): 167-17

Effect of Ramadan Fasting on Anthropometric Measures and Metabolic Profiles among Type 2 Diabetic Subjects

Background: Fasting from dawn to dusk during the month of Holy Ramadan is obligatory for all healthy adult Muslims. Individuals are exempted from fasting if they are suffering from an illness that could be adversely affected by fasting. Although The Quran exempts sick people from fasting, many Muslim diabetic patients may not perceive themselves as sick and are keenly interested to fast. But they fast without proper medical guidance exposing themselves to certain risks as a direct consequence of fasting. So we designed this study to assess the impact of fasting during Ramadan and to evaluate the effects of fasting on their biochemical profiles in patients with diabetes. Objective: The objective of this study was to investigate whether Ramadan fasting has any effect on body weight, blood pressure, fasting glucose, HbA1C, serum lipids, serum creatinine among type 2 diabetic patients. Materials and Methods: Fifty two stable outpatients with type 2 diabetes with intention to fast were studied in the month of Ramadan 1434 Hijri calendar year (11th July to 9th August, 2013) at two points of time: one week before Ramadan (visit 1) and within last 3 days before the end of Ramadan (visit 2). During each visit the height, body weight and blood pressure were recorded. Blood samples were collected for fasting glucose, HbA1C, total cholesterol, triglyceride, high density and low density lipoprotein cholesterol and creatinine. Data were analyzed by Student’s paired t-test using SPSS system and results were expressed as mean ± SD. Probability values were considered to be significant if it was less than 0.05. Results: There were 30 (62.8%) males and 22 (37.2%) females with a mean age of 54.7 ± 11.55 (range 35–80) years and mean duration of diabetes was 5.5 ± 5.2 years (range 9 months–18 years). In this study mean weight of the patients decreased significantly from 60.5 ± 12.6 kg to 58.5 ± 11.3 kg (p<0.001). Blood pressure reduced but not significantly. Fasting blood glucose showed significant reduction from 10.7 ± 4.2 to 8.9 ± 3.7 mmol/L (p=0.002) at the end of the study though HbA1C showed no significant change. Lipid profile and serum creatinine values did not show any significant change. Conclusion: The effects of fasting during Ramadan on stable diabetic patients are minimal. So, stable diabetic patients can fast during Ramadan without significant detrimental effects

Thyroid hormone profile in apparently healthy pregnant women attending in a tertiary care hospital of Bangladesh

Background: Thyroid dysfunction is not uncommon in pregnancy. It should be evaluated for better outcome of pregnancy. Objective: To observe the thyroid hormone profile in apparently euthyroid pregnant women of any trimester. Methods: This cross-sectional study investigated 350 pregnant women irrespective of gestational age [(age 24±4, m±SDyr; 1st trimester = 101, 2nd trimester=111, 3rd trimester=138) for thyroid stimulating hormone (TSH) and for free thyroxine (FT4)] to assess their thyroid function during pregnancy following the criteria of American Thyroid Association (ATA). Results: Most of the mothers were housewifes (93.1 %, 326/350) of whom 46.6% were primigravida. About 63% mother had associated goiter, 58% (204/350) were euthyroid and 41 % (142/350) were subclinical hypothyroid (SCH). Frequency of goiter (63% vs. 62%, euthyroid vs. dysfunction) was not significantly different between dysfunction and normal groups. FT4 significantly correlated with gestational age (r= - 0.131, p=0.014) and TSH level (r= - 0.612, p< 0.001). Conclusion: It is concluded that many of the apparently euthyroid pregnant mother have dysfunction as defined by ATA reference ranges for TSH and FT4. Simple screening for thyroid function may have greater implication for better pregnancy outcome

Thyroid hormone profile in apparently healthy pregnant women attending in a tertiary care hospital of Bangladesh

Background: Thyroid dysfunction is not uncommon in pregnancy. It should be evaluated for better outcome of pregnancy.Objective: To observe the thyroid hormone profile in apparently euthyroid pregnant women of any trimester. Methods: This cross-sectional study investigated 350 pregnant women irrespective of gestational age [(age 24±4, m±SDyr; 1st trimester = 101, 2nd trimester=111, 3rd trimester=138) for thyroid stimulating hormone (TSH) and for free thyroxine (FT4)] to assess their thyroid function during pregnancy following the criteria of American Thyroid Association (ATA).Results: Most of the mothers were housewifes (93.1 %, 326/350) of whom 46.6% were primigravida. About 63% mother had associated goiter, 58% (204/350) were euthyroid and 41 % (142/350) were subclinical hypothyroid (SCH). Frequency of goiter (63% vs. 62%, euthyroid vs. dysfunction) was not significantly different between dysfunction and normal groups. FT4 significantly correlated with gestational age (r= - 0.131, p=0.014) and TSH level (r= - 0.612, p&lt; 0.001).Conclusion: It is concluded that many of the apparently euthyroid pregnant mother have dysfunction as defined by ATA reference ranges for TSH and FT4. Simple screening for thyroid function may have greater implication for better pregnancy outcome

Thyroid hormone profile in apparently healthy pregnant women attending in a tertiary care hospital of Bangladesh

Background: Thyroid dysfunction is not uncommon in pregnancy. It should be evaluated for better outcome of pregnancy.Objective: To observe the thyroid hormone profile in apparently euthyroid pregnant women of any trimester. Methods: This cross-sectional study investigated 350 pregnant women irrespective of gestational age [(age 24±4, m±SDyr; 1st trimester = 101, 2nd trimester=111, 3rd trimester=138) for thyroid stimulating hormone (TSH) and for free thyroxine (FT4)] to assess their thyroid function during pregnancy following the criteria of American Thyroid Association (ATA).Results: Most of the mothers were housewifes (93.1 %, 326/350) of whom 46.6% were primigravida. About 63% mother had associated goiter, 58% (204/350) were euthyroid and 41 % (142/350) were subclinical hypothyroid (SCH). Frequency of goiter (63% vs. 62%, euthyroid vs. dysfunction) was not significantly different between dysfunction and normal groups. FT4 significantly correlated with gestational age (r= - 0.131, p=0.014) and TSH level (r= - 0.612, p&lt; 0.001).Conclusion: It is concluded that many of the apparently euthyroid pregnant mother have dysfunction as defined by ATA reference ranges for TSH and FT4. Simple screening for thyroid function may have greater implication for better pregnancy outcome

Iodine nutrition status in clinically euthyroid pregnant women attending in BSMMU

Background: Iodine deficiency disorders (IDD) are common nutritional problem globally. All groups of people are affected by it, but the pregnant women and their neonates are most vulnerable.Objectives: This study was carried out to see the iodine status of pregnant women using median urinary iodine concentration (MUI) as a measure of outcome. Methods: This cross sectional observational study assessed the MUI in casual urine samples from 225 pregnant women (75 pregnants from each trimester) and 75 non-pregnant healthy controls. The urinary iodine content was estimated in urine sample using the method of Dunn et al. with the modification of Sandell &amp; Kolthoff (wet digestion method).Results: Median value of urinary iodine in pregnant women was 48.21Ug/L compared to 52.2

Iodine nutrition status in clinically euthyroid pregnant women attending in BSMMU

Background: Iodine deficiency disorders (IDD) are common nutritional problem globally. All groups of people are affected by it, but the pregnant women and their neonates are most vulnerable. Objectives: This study was carried out to see the iodine status of pregnant women using median urinary iodine concentration (MUI) as a measure of outcome. Methods: This cross sectional observational study assessed the MUI in casual urine samples from 225 pregnant women (75 pregnants from each trimester) and 75 non-pregnant healthy controls. The urinary iodine content was estimated in urine sample using the method of Dunn et al. with the modification of Sandell & Kolthoff (wet digestion method). Results: Median value of urinary iodine in pregnant women was 48.21Ug/L compared to 52.2

Increased frequency of positive antithyroid antibody in nodular goiter

Background: Nodular goiter is mostly a benign thyroid tumor. A change of frequency of nodular goiter in areas with sufficient iodine intake has been documented in several reports. However, contrary to common belief it may also be associated with autoimmunity is being observed recently by many investigators.Objectives: To observe association between thyroid autoimmunity and nodular goiter. Methods: This cross sectional study included two hundred cases and one hundred controls. Clinically suspected nodular thyroid patients were confirmed by USG. Selection of healthy control was done after exclusion of nodule clinically and by USG. Data were collected through a structured questionnaire.Results: Frequency of positive anti-thyroid antibodies was significantly higher in nodular goiter cases, when anti-TPO and anti-TG considered together (42.5% vs. 25.0%; ?2=8.792, p=0.003) as well as individually (anti-TPO: 37.0% vs. 20.0%; ?2=8.955, p=0.004 and anti-TG: 31.0% vs. 9.0%; ?2=17.861, p&lt;0.001) in the patients with nodular goiter than that of control. Conversely, there was no statistical difference between STN and MNG for antibody status when considered together (41.lvs. 42.5%; ?2=0.093; p=0.769) or separately (for anti-TPO: 34.2% vs. 38.6%; ?2=0.374, p=0.648 and anti TG: 27.4% vs. 33.1%; ?2=0.698, p=0.431). Also there was no statistical disparity for frequency of positivity of the two antibodies in STN (p=0.359) and MNG (p=0.167).Conclusion: Significant number of nodular goiter cases was positive for anti-thyroid antibodies