Gender disparity in prevalence and risk factors of chronic Kidney disease among patients with type 2 diabetes in Northeastern Nigeria.

Diabetes mellitus is a metabolic disorder that is responsible for up to 5% of premature deaths worldwide. Diabetic kidney disease is the leading cause of end-stage renal disease. This study aims to evaluate gender disparity in prevalence and risk factors of diabetic kidney disease in northeastern Nigeria. Methodology: The study population consisted of adult patients with type 2 diabetesrecruited consecutively at the diabetes clinic of the University of Maiduguri Teaching Hospital, Maiduguri. Socio-demographic and anthropometric variables including age, sex, weight, height, BMI, as well as laboratory parameters, were obtained from each patient. Glomerular filtration rate was derived from the CKD-EPI formula using serum creatinine. Results: Two hundred and sixty-one adult patients with type 2 diabetes were recruited consecutively from the Diabetes outpatient clinic of the University of Maiduguri Teaching Hospital, Maiduguri. There were 167(64%) females and 94(36%) males. The mean ages of males and females were 51.10±12.23 years and 48.76±11.00 years, respectively (p= 0.115). The mean duration of diabetes was similar between males and females (7.24±7.18 vs 6.87±6.02 years, p= 0.652). Females had a higher BMI 2 2 compared with males (28.49±6.27Kg/M2 vs 26.41±4.86Kg/M2 p= 0.003). Fasting blood glucose, Low- density lipoprotein cholesterol and PCV were more deranged in females than among males (9.53±4.72 mmol/L vs 11.10±5.97mmol/L p= 0.020; 2.84±1.03mmol/L vs 3.19±1.03mmol/L p=0.009; 34.49±5.33% vs 33.11±4.54% p= 0.026). Out of the study population, 83(74.1%) females had renal dysfunction compared with 29(25.9%) males. The risk factors for progressive kidney disease among female patients were age >45 years (Exp (B) 1.799, 95% CI= 1.165-3.805) and systolic blood pressure >140mmHg (Exp (B)= 1.592, 95% CI= 0.772- 3.284). Conclusion: Diabetic kidney disease among our cohorts with type 2 diabetes was more prevalent among females compared with males and the risk factors associated with this disparity were older age, high BMI, poor glycaemic control, low PCV and elevated LDL cholesterol

Standardization of Aspergillus IgG diagnostic cutoff in Nigerians

BACKGROUND AND OBJECTIVES: Commercial Aspergillus IgG antibody assays have become pivotal in the current diagnosis of chronic pulmonary aspergillosis (CPA). However, diagnostic cutoffs have been found to vary from manufactures' recommendations in different settings. This study aimed to establish the Aspergillus IgG reference range among Nigerians and determine a diagnostic cutoff for CPA.METHODS: Sera from 519 prospectively recruited healthy blood donors and 39 previously confirmed cases of CPA were analysed for Aspergillus IgG levels using the Bordier test kit (Bordier Affinity Products SA, Crissier, Switzerland). Accuracy versus cutoff profile and receiver operating characteristics (ROC) curve were analysed for both CPA cases and controls using the R-Studio (2020), (Window desktop, version 4.0.2 software with R packages "nnet" and "ROCR").RESULTS: Among healthy blood donors, 141 (27.2%) were aged 16-25 years with median (interquartile range, IQR) of 22 (20-24) years; 304 (58.6%) were aged 26-40 years with median (IQR) of 32 (29-36) years; while 74 (14.2%) were aged 41-60 years with median (IQR) of 46 (44-49.75). Median IgG level in respective age groups were 0.069 (0.009-0.181), 0.044 (0.014-0.202) and 0.056 (0.01-0.265) with no significant difference found in the three age categories (p = 0.69). The overall diagnostic cutoff for the diagnosis of CPA was 0.821 with an accuracy of 97.1% and area under the curve (AUC) = 0.986.CONCLUSION: The optimal diagnostic cutoff for diagnosing CPA in Nigerians using the Bordier kit was 0.821 which is lower than the manufacturer's recommended cutoff of 1.0. The determination of this cutoff among Nigerians will significantly enhance accurate identification of CPA and assessment of its true burden in Nigeria.</p