Prevalence of obesity and ethno-geographic variation in body sizes of Nigerians with type 2 diabetes mellitus - a multi-centre study

BACKGROUND: Excess weight gain is common in people with type 2 diabetes mellitus (DM) but little is known about its ethno-geographic variation among the Nigerian populace. We aimed to report the prevalence and regional variation of overweight/obesity among subjects with type 2 DM in all the six geo-political regions of Nigeria.METHOD: Basic demographic and anthropometric data were consecutively collected from patients with type 2 DM attending out-patient clinics of seven designated teaching hospitals in the six geographic regions of the country using a pre-agreed method of measurement of anthropometry including waist circumference. The study was hospital-based descriptive cross-sectional in design. Body Mass Index (BMI) was categorised using the WHO criteria. Based on recommendations of the International Diabetes Federation (IDF) cut-off values for waist circumference, values >94 cm and > 80 cm were taken as abnormal for men and women respectively.RESULTS: A total of 709 subjects with DM comprising 378 (53.3%) females and 331 (46.7%) males (female: male ratio 1:1.14) with an overall mean age (SD) of 51.9 (13.9) years were evaluated. The prevalence of excess body weight among Nigerian subjects with type 2 DM was: peripheral (417 or 58.8%) and abdominal obesity (449 or 63.3%). Also, there was a significant wide variation in excess weight gain (both peripheral and central) across ethno-geographic regions (p=0.001) and between both sexes (p=0.001). In both peripheral and abdominal obesities, whether intra or inter centres, the female subjects with type 2 DM demonstrated relatively higher proportions of anthropometric measures. Generally, subjects from south-south and south-east Nigeria had higher BMI and abdominal obesity compared to those from south-west who had the lowest. The female subjects with type 2 DM were heavier peripherally and centrally compared to their male counterparts.CONCLUSION: The prevalence of peripheral and central obesity among Nigerians living with type 2 DM (especially the female subjects) is unacceptably high. Additionally, there is a wide variation in the proportion and absolute values of both peripheral and central obesity across different parts of Nigeria.KEY WORDS: Obesity, Prevalence, Ethno-Geographic Variation, Nigerians, Type 2 Diabetes Mellitu

APOE E4 is associated with impaired self-declared cognition but not disease risk or age of onset in Nigerians with Parkinson's disease

The relationship between APOE polymorphisms and Parkinson's disease (PD) in black Africans has not been previously investigated. We evaluated the association between APOE polymorphic variability and self-declared cognition in 1100 Nigerians with PD and 1097 age-matched healthy controls. Cognition in PD was assessed using the single item cognition question (item 1.1) of the MDS-UPDRS. APOE genotype and allele frequencies did not differ between PD and controls (p > 0.05). No allelic or genotypic association was observed between APOE and age at onset of PD. In PD, APOE ε4/ε4 conferred a two-fold risk of cognitive impairment compared to one or no ε4 (HR: 2.09 (95% CI: 1.13-3.89; p = 0.02)), while APOE ε2 was associated with modest protection against cognitive impairment (HR: 0.41 (95% CI 0.19-0.99, p = 0.02)). Of 773 PD with motor phenotype and APOE characterized, tremor-dominant (TD) phenotype predominated significantly in ε2 carriers (87/135, 64.4%) compared to 22.2% in persons with postural instability/gait difficulty (PIGD) (30/135) and 13.3% in indeterminate (ID) (18/135, 13.3%) (p = 0.037). Although the frequency of the TD phenotype was highest in homozygous ε2 carriers (85.7%), the distribution of motor phenotypes across the six genotypes did not differ significantly (p = 0.18). Altogether, our findings support previous studies in other ethnicities, implying a role for APOE ε4 and ε2 as risk and protective factors, respectively, for cognitive impairment in PD

Recent Development In The Management Of Diabetes Mellitus

No AbstractNigerian Journal of Clinical Practice Vol. 10 (4) 2007 pp. 335-34

Clinicopathological evaluation of Newcastle disease virus vaccination using gums from Cedrela odorata and Khaya senegalensis as delivery agents in challenged chickens

Following previous studies on delivery potential and immune response of chickens given Newcastle disease vaccine with gums, this study was conducted to evaluate the protective ability of vaccines delivered with plant gums against clinicopathological features of Newcastle disease (ND). Processed gums from incised trunks of Cedrela odorata and Khaya senegalensis trees were combined with ND vaccine in ratio 2:2:1 and administered at 21 days to white leghorn cockerels after weaning of maternal antibodies. The birds were grouped into gum-vaccine-oral (GVOR), vaccine-oral (VOR), gum-vaccine-ocular (GVOC), vaccine-ocular (VOC), gum-oral (GOR), gum-ocular (GOC), no-gum-no-vaccine/challenged (NGNV/C), no-gum-no-vaccine/unchallenged (NGNV/U). Vaccination was boosted with the same preparation at day 42 while birds were challenged with live ND virus (KUDU strain) at day 84. Clinical signs (Dullness, Diarrhoea, Paralysis, Torticollis) Post infection (Pi), terminal weakness, gross and histology lesions were scored on a severity scale from absent (0-), mild (1+) to moderate (2+) and severe (3+). Scores were assigned a quantitative score of 0, 10, 20, 30 respectively. Clinical signs scores for the 5 week Pi were subjected to Friedman test to assess the significance of severity among the groups. The test was significant at 1% significance level which implies that the clinical signs ranked highest in the NGNV/C, followed by the Gum alone groups, the vaccine alone groups and the gum-vaccine groups irrespective of route. Moribund birds subsequently euthanized were seen in the GOR and GOC group at 21% each and at 57% in NGNV/C group alone. No signs were seen in the NVNG/U group. Grossly, mild to moderate lesions were seen in all groups except GVOR and NGNV/U. At histology, pulmonary congestion, acute pneumonia, cecal tonsilar haemorrhages, gliosis and neuronophagia were present at different proportions in all groups except the GVOR and NGNV/U. Overall, lesion severity was least in the gum-vaccine groups while the oral groups had less lesion score compared to the ocular. From this study, phytogenic mucoadhesives polymers used hold immense potential as a delivery agent capable of improving protection against clinicopathologic features of Newcastle disease in previously vaccinated birds. Keywords: Vaccines, Chickens, Mucoadhesives, Gums, Newcastle disease, Patholog

The Nigeria Parkinson Disease Registry: Process, Profile, and Prospects of a Collaborative Project

BACKGROUND: Clinical disease registries are useful for quality improvement in care, benchmarking standards, and facilitating research. Collaborative networks established thence can enhance national and international studies by generating more robust samples and credible data and promote knowledge sharing and capacity building. This report describes the methodology, baseline data, and prospects of the Nigeria Parkinson Disease Registry. METHODS: This national registry was established in November 2016. Ethics approval was obtained for all sites. Basic anonymized data for consecutive cases fulfilling the United Kingdom Parkinson's Disease Brain Bank criteria (except the exclusion criterion of affected family members) are registered by participating neurologists via a secure registry website (www.parkinsonnigeria.com) using a minimal common data capture format. RESULTS: The registry had captured 578 participants from 5 of 6 geopolitical zones in Nigeria by July 2019 (72.5% men). Mean age at onset was 60.3 ± 10.7 years; median disease duration (interquartile range) was 36 months (18–60.5 months). Young‐onset disease (<50 years) represented 15.2%. A family history was documented in 4.5% and 7.8% with age at onset <50 and ≥ 50, respectively. The most frequent initial symptom was tremor (45.3%). At inclusion, 93.4% were on treatment (54.5% on levodopa monotherapy). Per‐capita direct cost for the registry was $3.37. CONCLUSIONS: This is the first published national Parkinson's disease registry in sub‐Saharan Africa. The registry will serve as a platform for development of multipronged evidence‐based policies and initiatives to improve quality of care of Parkinson's disease and research engagement in Nigeria