Homocysteine and hematological indices in hemodialysis patients

Objectives: To explore the relationship between homocysteine and various hematological indices in hemodialysis patients. Patients and Methods: This case-control study comprised 60 hemodialysis patients and 60 healthy controls matched for gender and age. Hemodialysis duration was 3.2±2.9 year at frequency of 2.6±0.6/week. Hypertension and diabetes were the most common self-reported disorders among the hemodialysis patients. Results: Serum homocysteine was significantly higher in hemodialysis patients than in controls (50.8±9.7 vs. 13.1±3.7 μmol/l, P= 0.000). White blood cell (WBC) and platelet (PLT) counts were significantly higher in hemodialysis patients than in controls [(7.18±2.37 x109/L and 266.3±111.9 x109/L vs 5.95±1.37 x109/L and 222.0±54.1 x109/L) with P= 0.017 and P= 0.045, respectively]. In contrast, red blood cell (RBC), hemoglobin, and hematocrit were significantly lower in hemodialysis patients (3.1±0.5 x1012/L, 8.9±1.5 gm/dl and 26.3±4.6%) than in controls (4.0±0.4 x1012/L, 12.8±1.6 gm/dl and 45.0±4.6%) with P= 0.000. Prothrombin time (PT) and international normalized ratio (INR) were significantly higher in hemodialysis patients compared to controls (16±3 sec and 1±0 vs. 14±0 sec and 1.0±0.1, P= 0.000), whereas activated partial thromboplastin time (APTT) was significantly decreased in hemodialysis patients (25±5 vs 33±2 sec, P= 0.000). Homocysteine correlated directly with WBC count (r= 0.338, P= 0.008) and PLT count (r= 0.369, P= 0.000) whereas inverse correlations were found between homocysteine and RBC count (r=-0.648, P= 0.000), hemoglobin (r=-0.733, P= 0.000) and hematocrit (r=-0.836

AssAssessment of Helicobacter Pylori Infection as Risk Factor for Type 2 Diabetes Mellitus in Gaza Strip

Background: Diabetes mellitus is a multifactorial disorder characterized by disturbance in carbohydrates, lipids and proteins metabolism. It constitutes one of the tenth leading causes of death in Gaza strip with mortality rate of 8.5 per 100,000 population in the year 2010. Helicobacter pylori (H. pylori) infection is believed to be associated with Type 2 diabetes mellitus. Objective: To assess the H. pylori infection as a risk factor for type 2 diabetes mellitus in Gaza strip. Materials and methods: This case-control study comprised 90 type 2 diabetic patients (Cases: 45 males and 45 females) and 90 healthy controls (45 males and 45 females). Questionnaire interview was applied. Blood samples were collected, processed and analyzed. Serum H. pylori IgG, glucose, insulin, cholesterol, triglycerides, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), aspartate aminotransferase (AST), alanine aminotransferase (ALT), urea and creatinine were determined. Blood glycated hemoglobin (HbA1c) was measured. White blood cell (WBC), red blood cell (RBC), hemoglobin (Hb) and platelet (PLT) were determined. Data were analyzed using SPSS version 18.0. Results: Type 2 diabetes was more prevalent among families with low income as well as among individuals with family history of the disease. More than half of the cases had diabetes since less than 5 years and most of them followed diet. The main self-reported complications were retinopathy, neuropathy and cardiovascular diseases. In addition, the prevalence of gastritis and peptic ulcer was significantly higher among cases compared to controls. Blood HbA1c and serum glucose and insulin levels was significantly higher in cases compared to controls (8.2±1.7%, 153.7±53.0 mg/dl and 11.6±9.6 mlU/ml vs 5.2±0.7%, 87.0±12.3 mg/dl and 6.8±5.1 mlU/ml, respectively, P=0.000). Serum cholesterol and triglycerides were significantly higher in cases (201.4±43.3 and 203.8±97.7 mg/dl) than controls (189.0±37.9 and 153.1±45.7 mg/dl, P=0.042 and P=0.000, respectively). Serum AST and ALT activities were significantly higher in cases compared to controls (36.3±4.7 and 42.4±5.0 U/L vs 16.9±6.0 and 17.8±8.7 U/L, respectively, P=0.000). Serum urea and creatinine were also found to be significantly higher in cases (47.0±5.3 and 1.06±0.21 mg/dl vs 31.5±11.8 and 0.88±0.22, mg/dl, respectively, P=0.000). White blood cell and PLT counts were significantly increased in cases compared to controls (8.0±1.9 and 262.3±61.3×109/L vs 7.0±1.4 and 224.8±43.4×109/L, respectively, P=0.000) whereas RBC count and Hb content did not show significant differences between cases and controls. The prevalence of H. pylori among diabetic patients 65 (72.2%) was significantly higher than controls 33 (36.7%) with P=0.000. Infection with H. pylori was significantly higher in diabetic males than diabetic females (P=0.034). When related to H. pylori, blood HbA1c levels were significantly higher in positive than in negative cases (8.4±1.8 vs 7.6±1.5, P=0.042). Serum cholesterol, triglycerides and LDL-C levels were significantly increased in H. pylori positive cases than in negative cases (216.4±42.5, 190.1±91.9 and 139.8±42.6 mg/dl, vs 195.6±42.6, 164.5±61.2 and 115.4±40.2 mg/dl, P=0.041, P=0.033 and P=0.013, respectivily), whereas HDL-C level was significantly lower in positive cases (37.5±6.9 vs 41.1±8.8 mg/dl, P=0.040). The activity of serum ALT and the concentration of urea were significantly increased in H. pylori positive cases compared to negative cases (43.1±4.9 U/L and 41.1±10.9 mg/dl vs 40.8±4.8 U/L and 37.0±12.8 mg/dl, P=0.049 and P=0.022, respectivily). The WBC count was also singnificantly elvated in H. pylori positive cases (8.1±1.8 vs 7.2±1.5 ×109/L, P=0.038)