Pattern of serum lipid profile of type 2 diabetes patients in a tertiary hospital in Nigeria

Background: Diabetes mellitus is a metabolic disorder characterised by chronic hyperglycemia and disturbances of carbohydrate, lipid and protein metabolism. Diabetic patients have an increased risk of developing dyslipidemia with various lipid abnormalities which makes them prone to develop cardiovascular disease. The aim of the study is to determine the patterns of lipid profile in patients with Type 2 diabetes mellitus.Methods: Lipid profile data for a total of 104 known type 2 DM patients from the medical outpatient clinic were collected. The profile of the study sample was analysed for dyslipidemia using the ATP III classification. Data obtained were analysed using Analyse-it v3.0 statistical software for Microsoft Excel.Results: This study showed that there were more females 53.8% than males 46.2% with type 2 diabetes mellitus with the mean age of 52.5±11.9 years. The pattern of dyslipidaemia revealed elevated LDL 51.9%, TG 37.5%, TC 36.5% and low HDL 27.9%. We had more patients who were overweight 33.7% than obese 32.7%.Conclusions: It was observed from the study that a significant number of diabetic patients have dyslipidaemia and most common lipid abnormalities are elevated LDL, triglyceride and low HDL

Prevalence of metabolic syndrome and associated factors among human immunodeficiency virus patients on highly active antiretroviral therapy in North central Nigeria

Background: Metabolic syndrome (MS) is a complex disorder defined by cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus. The Use of Highly active antiretroviral therapy in HIV patients is associated with metabolic syndrome which increases the risk of cardiovascular disease (CVD). The aim of the study was to determine the prevalence of MS among HAART treated HIV patients and HAART naïve patients.Methods: This was a cross-sectional study that evaluated 581 (396 females, 184 males) consenting HIV patents in the hospital. Clinical characteristics, anthropometry, blood pressure, lipid profile, fasting blood glucose, fasting plasma insulin, CD4 cell counts and viral load were determined using appropriate standard techniques. MS was defined using International Diabetes Federation (IDF) cut-off values.Results: The overall prevalence of MS was 10.7%, with more females 52 (13.1%) than males 10 (5.4%), p=0.005. MS in patients on HAART was 58 (15.1%) and HAART naive 4 (2.0%). Overall, waist circumference, BMI, systolic blood pressure (BP), diastolic blood pressure (BP), triglycerides and fasting blood glucose were 82.7±11.5, 22.7±, 120.6±17.6, 77.5±10.6, 1.1±0.7 and 5.1±1.9 respectively. Patients with MS had significantly higher (p<0.05) waist circumference (94.1 vs 81.3 cm), BMI (24.8 vs 22.5 kg/m2), systolic BP (135.4 vs 118.8 mmHg), diastolic BP (86.2 vs 76.5 mmHg), triglycerides (1.3 vs 1.0 mmol/l) and fasting blood glucose (6.3 vs 4.9 mmol/l).  Insulin resistance (IR) was higher in patients with MS 11.8(7.9) compared with patients without MS 5.5 (6.8) p=0.02.Conclusions: Prevalence of metabolic syndrome in this study was lower than that reported in previous works, the prevalence is much higher in the HAART treated patients. The risk of MS were high triglycerides, hypertension and abnormal fasting blood glucose. There was significant association with the traditional risk factors, age, female gender and HIV duration.

Prevalence and determinants of glucose intolerance among HIV/AIDS patients in north-central Nigeria

Background: The advent of potent antiviral drugs has revolutionalised the clinical course of HIV / AIDS resulting in increased survival and improved quality of life. Metabolic derangements in HIV infected patients are becoming more common probably due to this increased survival from the use of HAART. There is limited data on the occurrence of glucose intolerance among HIV patients in Nigeria.Objective: To determine the prevalence of glucose intolerance and associated risk factors in HIV/AIDS patients.Methods: Consenting adult HIV patients at the HIV clinic of the Jos University Teaching Hospital (JUTH), Jos , Nigeria were evaluated were evaluated for the presence of glucose intolerance using a 75g oral glucose tolerance test (OGTT). There clinical characteristics, anthropometry, CD4 cell counts and viral load were determined using appropriate standard techniques. Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance (IGT), and Diabetes Mellitus (DM) were defined based on the American Diabetes Association (ADA) cut-off values.Results: Of the 584 patients studied, 384 (130 males and 251 females) with mean±SD age of 38±15 years were HAARTtreated; while 200 (61 males and 139 females) with mean±SD age of 33±17 years were HAART-naive. Overall, the prevalence of GI was 40.4% (IFG) 19.5%, IGT 11.5% and DM 9.4%. The prevalence of IFG (27.1%) and DM (11.2%) in HAART - treated patients were observed and those in HAART-naive patients were (IFG 5.0%,DM 6.0%), p&lt;0.005. IGT was more prevalent in HAART-naive than in HAART-treated patients (19.5%, and 7.3% respectively), p&lt;0.05. The proportions of patients with GI were higher in overweight and obese HAART-treated patients with moderate CD4 cell count (200-500 x106 cell/L); while in the HAART-naive patients, GI was more prevalent in underweight subjects with CD4 cell count (&lt;200 x 106 cell/L). The Determinants of GI were age, increasing BMI, low CD4 cell count, metabolic syndrome and HAART treatment duration. The independent predictors of glucose intolerance in HIV / AIDS patients were low CD4 cell count and prolonged HAART treatment duration.Conclusion: The prevalence of GI among HIV/AIDS patients in North-Central Nigeria is high. Treatment with HAART and low CD4 cell count are strong determinants of glucose intolerance in our HIV / AIDS patients. Regular screening for glucose intolerance among our HIV / AIDS patients is recommended.Keywords: HIV, Glucose Intolerance, Prevalence, North-Central Nigeri

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

Abdominal obesity as a risk factor for stroke in Abuja, Nigeria

Background: Obesity in Africa has remained a public health concern, which is been fueled by urbanization and its attendant lifestyle changes which includes less energy demanding jobs, sedentary lifestyle and adopting detrimental western eating habits. There are well established risk factors for stroke, however the association of obesity with that of stroke is less clear.Methods: This study was designed to determine whether abdominal obesity is independently associated with an increased risk of ischaemic stroke. It is a case control study of 113 patients in which structured questionnaire was administered to consecutive patients admitted into the medical wards. The controls were matched for age and sex from a database with participants of the population-based cohort study. Statistical analysis of data was performed using SAS software (SAS Institute) 9.4.Results: In the study 85% of the patients had hypertension, 50.5% had hypercholesterolemia and 33.6% had diabetes. The BMI was normal for most of the cases (23.3% vs. 76.7% p&lt;0.0001) while the WHR was increased for most of the cases (70.9% vs. 29.1% p&lt;0.0001). The statistical significance shows that WHR was more sensitive in assessing obesity than BMI. The logistic regression analysis, in model 1 unadjusted and model 2 adjusted for sex and age, BMI showed a positive association with risk of stroke (OR 1.10; 95% CI, 1.04-1.17; p=0.002) this association lost its significance in model 3 after adjusting for diabetes, hypertension and hypercholesterolemia (OR 1.04; 95% CI, 0.96-1.13; p=0.3751). The results of logistic regression analysis for WHR for model 1, model 2 and model 3 did not show any significance before and after adjustment.Conclusions: Abdominal obesity may increase the risk of ischemic stroke through conventional vascular risk factors, but not as an independent risk factor

MAPT allele and haplotype frequencies in Nigerian Africans: Population distribution and association with Parkinson's disease risk and age at onset

INTRODUCTION: The association between MAPT and PD risk may be subject to ethnic variability even within populations of similar geographical origin. Data on MAPT haplotype frequencies, and its association with PD risk in black Africans are lacking. We aimed to determine the frequencies of MAPT haplotypes and their role as risk factors for PD and age at onset in Nigerians. METHODS: The haplotype and genotype frequencies of MAPT rs1052553 were analysed in 907 individuals with PD and 1022 age-matched healthy controls from the Nigeria Parkinson's Disease Research network cohort. Clinical data related to PD included age at study, age at onset (AAO), and disease duration. RESULTS: The frequency of the H1 haplotype was 98.7% in PD, and 99.1% in controls (p = 0.19). The H2 haplotype was present in - 1.3% of PD and 0.9% of controls (p = 0.24). The most frequent MAPT genotype was H1H1 (PD - 97.5%, controls - 98.2%). The H1 haplotype was not associated with PD risk after accounting for gender and AAO (Odds ratio for H1/H1 vs H1/H2 and H2/H2: 0.68 (95% CI:0.39-1.28); p = 0.23). CONCLUSIONS: Our findings support previous studies that report a low frequency of the MAPT H2 haplotype in black ancestry Africans but document its occurrence in Nigerians. The MAPT H1 haplotype was not associated with an increased risk or age at onset of PD in this cohort

Identification of genetic risk loci and causal insights associated with Parkinson's disease in African and African admixed populations: a genome-wide association study

BACKGROUND: An understanding of the genetic mechanisms underlying diseases in ancestrally diverse populations is an important step towards development of targeted treatments. Research in African and African admixed populations can enable mapping of complex traits, because of their genetic diversity, extensive population substructure, and distinct linkage disequilibrium patterns. We aimed to do a comprehensive genome-wide assessment in African and African admixed individuals to better understand the genetic architecture of Parkinson's disease in these underserved populations. METHODS: We performed a genome-wide association study (GWAS) in people of African and African admixed ancestry with and without Parkinson's disease. Individuals were included from several cohorts that were available as a part of the Global Parkinson's Genetics Program, the International Parkinson's Disease Genomics Consortium Africa, and 23andMe. A diagnosis of Parkinson's disease was confirmed clinically by a movement disorder specialist for every individual in each cohort, except for 23andMe, in which it was self-reported based on clinical diagnosis. We characterised ancestry-specific risk, differential haplotype structure and admixture, coding and structural genetic variation, and enzymatic activity. FINDINGS: We included 197 918 individuals (1488 cases and 196 430 controls) in our genome-wide analysis. We identified a novel common risk factor for Parkinson's disease (overall meta-analysis odds ratio for risk of Parkinson's disease 1·58 [95% CI 1·37-1·80], p=2·397 × 10-14) and age at onset at the GBA1 locus, rs3115534-G (age at onset β=-2·00 [SE=0·57], p=0·0005, for African ancestry; and β=-4·15 [0·58], p=0·015, for African admixed ancestry), which was rare in non-African or non-African admixed populations. Downstream short-read and long-read whole-genome sequencing analyses did not reveal any coding or structural variant underlying the GWAS signal. The identified signal seems to be associated with decreased glucocerebrosidase activity. INTERPRETATION: Our study identified a novel genetic risk factor in GBA1 in people of African ancestry, which has not been seen in European populations, and it could be a major mechanistic basis of Parkinson's disease in African populations. This population-specific variant exerts substantial risk on Parkinson's disease as compared with common variation identified through GWAS and it was found to be present in 39% of the cases assessed in this study. This finding highlights the importance of understanding ancestry-specific genetic risk in complex diseases, a particularly crucial point as the Parkinson's disease field moves towards targeted treatments in clinical trials. The distinctive genetics of African populations highlights the need for equitable inclusion of ancestrally diverse groups in future trials, which will be a valuable step towards gaining insights into novel genetic determinants underlying the causes of Parkinson's disease. This finding opens new avenues towards RNA-based and other therapeutic strategies aimed at reducing lifetime risk of Parkinson's disease. FUNDING: The Global Parkinson's Genetics Program, which is funded by the Aligning Science Across Parkinson's initiative, and The Michael J Fox Foundation for Parkinson's Research