Genetic Association Between Insulin Resistance And Total Cholesterol In Type 2 Diabetes Mellitus - A Preliminary Observation

We investigated the degree of genetic association between insulin resistance (IR) with type 2 diabetes mellitus (DM) and abnormalities in lipid metabolism in 42 patients. IR was assessed by fasting insulin test (FI), McAuley (McA), HOMA and QUICKI methods. IR was detected in 34 (81%) patients by FI, McA and in 39 (93%) patients by HOMA and QUICKI. 26 (62%) patients had family history of DM and 23 (89%) of them displayed IR by FI & McA. 24 of them (92%) displayed IR by HOMA and QUICKI. Our results suggest that association between the family history of DM and IR were statistically significant by chi-square test (P<0.05). Further, 29 (69%) patients had elevated total cholesterol levels. Association between elevated total cholesterol and IR as assessed by FI test was also statistically significant (x2=4.6; p<0.05). Results of our study indicate the statistically significant genetic association of IR with abnormal cholesterol metabolism and family history of D

Effects of Deliberate Ingestion of Organophosphate or Paraquat on Brain Stem Auditory-Evoked Potentials

Organophosphate (OP) and paraquat (PQ) ingestion is a serious health problem. A common pathology behind OP or PQ poisoning is the generation of reactive oxygen species (ROS) which is known to cause ototoxicity. The aim of the study was to identify the effects of deliberate ingestion of OP or PQ on brain stem auditory-evoked potentials (BAEPs). Consecutive patients with deliberate self-poisoning with OP or PQ who were admitted to a secondary and a tertiary care hospital in the Southern province of Sri Lanka and matched controls were recruited. BAEPs were performed at 1 week (first assessment) and 6 weeks (second assessment) after the exposure. Interpeak latencies of I–III, III–V, and I–V were measured. There were 70 and 28 patients in the OP and PQ arms with the mean age of 32 ± 12 and 29 ± 12 years, respectively. There were 70 controls and their mean age was 33 ± 12 years. In OP and PQ poisoning, 53/70 and 18/28 came for the second assessment, respectively. The interpeak latency was not statistically different in the controls vs the first assessment, controls vs the second assessment, and the first vs the second assessment. There were no significant lesions in the auditory pathway in OP or PQ poisoned patients. The generation of ROS within the perilymphatic space following the ingestion of OP or PQ may not be sufficient to cause lesions in the auditory pathway. Further studies with the assessment of auditory threshold are needed

Urinary Biomarkers KIM-1 and NGAL for Detection of Chronic Kidney Disease of Uncertain Etiology (CKDu) among Agricultural Communities in Sri Lanka.

Chronic Kidney Disease of uncertain etiology (CKDu) is an emerging epidemic among farming communities in rural Sri Lanka. Victims do not exhibit common causative factors, however, histopathological studies revealed that CKDu is a tubulointerstitial disease. Urine albumin or albumin-creatinine ratio is still being used as a traditional diagnostic tool to identify CKDu, but accuracy and prevalence data generated are questionable. Urinary biomarkers have been used in similar nephropathy and are widely recognised for their sensitivity, specificity and accuracy in determining CKDu and early renal injury. However, these biomarkers have never been used in diagnosing CKDu in Sri Lanka. Male farmers (n = 1734) were recruited from 4 regions in Sri Lanka i.e. Matara and Nuwara Eliya (farming locations with no CKDu prevalence) and two CKDu emerging locations from Hambantota District in Southern Sri Lanka; Angunakolapelessa (EL1) and Bandagiriya (EL2). Albuminuria (ACR ≥ 30mg/g); serum creatinine based estimation of glomerular filtration rate (eGFR); creatinine normalized urinary kidney injury molecule (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) were measured. Fourteen new CKDu cases (18%) from EL1 and nine CKDu cases (9%) from EL2 were recognized for the first time from EL1, EL2 locations, which were previously considered as non-endemic of the disease and associated with persistent albuminuria (ACR ≥ 30mg/g Cr). No CKDu cases were identified in non-endemic study locations in Matara (CM) and Nuwara Eliya (CN). Analysis of urinary biomarkers showed urinary KIM-1 and NGAL were significantly higher in new CKDu cases in EL1 and EL2. However, we also reported significantly higher KIM-1 and NGAL in apparently healthy farmers in EL 1 and EL 2 with comparison to both control groups. These observations may indicate possible early renal damage in absence of persistent albuminuria and potential capabilities of urinary KIM-1 and NGAL in early detection of renal injury among farming communities in Southern Sri Lanka

Clinical characteristics of the study populations representing non-endemic locations in Matara (CM), Nuwara Eliya (CN) and CKDu emerging locations Angunakolapelessa (EL1) and Bandagiriya (EL2).

<p>Clinical characteristics of the study populations representing non-endemic locations in Matara (CM), Nuwara Eliya (CN) and CKDu emerging locations Angunakolapelessa (EL1) and Bandagiriya (EL2).</p

Flow chart representing study populations and study design in non-endemic control locations in Matara (CM), Nuwara Eliya (CN) and two farming locations (Agunukolapalassa—EL1 & Badagiriya—EL2).

<p>Flow chart representing study populations and study design in non-endemic control locations in Matara (CM), Nuwara Eliya (CN) and two farming locations (Agunukolapalassa—EL1 & Badagiriya—EL2).</p

Creatinine adjusted tubular markers (KIM-1 & NGAL) and clinical data in non-endemic controls (CM & CN) and two CKDu emerging locations (EL1 and EL2).

<p>EL1 and EL2 further divided as control subjects from the same locations (C-EL1 & C-EL2) and CKDu subjects (EL1-CKDu & EL2- CKDu). All variables are present as mean (SEM) and range.</p

Study locations of the current study (Agunukolapalassa; EL1, Badagiriya; EL2, Matara; CM) in Southern Province and Nuwara Eliya (CN) in Central Province represented with different climatic zones in Sri Lanka.

<p>Study locations of the current study (Agunukolapalassa; EL1, Badagiriya; EL2, Matara; CM) in Southern Province and Nuwara Eliya (CN) in Central Province represented with different climatic zones in Sri Lanka.</p

Baseline characteristics of the study populations representing non-endemic control groups (CM & CN), CKDu emerging locations Angunakolapelessa (EL1) and Bandagiriya (EL2).

<p>All variables are presented as % and numbers indicates medical conditions.</p

Association of albumin to creatinine ratio (ACR, mg/g Cr) with urinary KIM-1 (5A), estimated glomerular filtration rate (eGFR) (ml/min/1.73 m²) with urinary KIM-1 (5B), albumin to creatinine ratio (ACR, mg/g Cr) with urinary neutrophil gelatinase-associated lipocalin (5C) and estimated glomerular filtration rate (eGFR) (ml/min/1.73 m²) with urinary NGAL (5D) in the CKDu emerging locations EL1 and EL2.

<p>Association of albumin to creatinine ratio (ACR, mg/g Cr) with urinary KIM-1 (5A), estimated glomerular filtration rate (eGFR) (ml/min/1.73 m²) with urinary KIM-1 (5B), albumin to creatinine ratio (ACR, mg/g Cr) with urinary neutrophil gelatinase-associated lipocalin (5C) and estimated glomerular filtration rate (eGFR) (ml/min/1.73 m²) with urinary NGAL (5D) in the CKDu emerging locations EL1 and EL2.</p

Mean urinary NGAL (μg/g Cr) in the control groups (CM & CN), CKDu groups (EL1-CKDu & EL2-CKDu) with control groups from CKDu emerging locations (C-EL1 & C-El2).

<p>Mean urinary NGAL (μg/g Cr) in the control groups (CM & CN), CKDu groups (EL1-CKDu & EL2-CKDu) with control groups from CKDu emerging locations (C-EL1 & C-El2).</p