Biochemical reference values in elderly black subjects

Biochemical reference values for the black age group of ≥ 65 years were determined from the black urban population of the Orange Free State. Biochemical investigations performed were those included in the Sequential Multiple Analyser Computer profile because it includes the 20 most requested clinical chemistry investigations. Most of the reference values corresponded to values for the same age groups in the Western world. There was no age-related rise in the alkaline phosphatase values, which suggested absence of occult Paget's disease. Reference values for serum total protein and globulin were found to be higher than values derived from elderly white groups

Selected risk factors for coronary heart disease in male scholars from the major South African population groups

A num.ber of risk factors for coronary heart disease (CHD) in 7 groups of South African male scholars aged between 15 and 20 years were surveyed. Selection of the groups was based on socioeconomic status and comprised urban and rural blacks, Indians of higher and lower socio-economic status, coloureds of higher and lower socio-economic status, and middle-class whites. Both Indian groups, both coloured groups and the whites had a much greater prevalence and severity of CHD risk factors than the two black groups. This held for total cholesterol, low-density lipoprotein cholesterol (LDLC), high-density lipoprotein cholesterol (HDLC), the HDLC/LDLC ratio, apolipoprotein B, apolipoprotein A-I, insulin, fibrinogen and mass. One exception was lipoprotein a, levels of which were higher in both black groups. In general the CHD risk factor profile was worse in the higher socio-economic groups, and it also tended to be worse in urban than in rural blacks. These findings stress the need to reduce CHD risk factors in our developed populations and to prevent their emergence in our developing peoples

A 6-month trial of simvastatin (HMG-CoA reductase inhibitor) in the treatment of hypercholesterolaemia

The aim of this study was to evaluate the long-term efficacy and tolerability of the 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor simvastatin, over a 24week period. Patients (108) with primary hypercholesterolaemia were clinically, haematologically and biochemically evaluated and established on a cholesterol-lowering diet. After a wash-out period free from other lipid-lowering drugs and a baseline period on placebo of 1 month each, 10 mg simvastatin was introduced at night. The dose was increased to 20 mg and 40 mg at 6 and 12 weeks' follow-up respectively if the total cholesterol (TC) level was still above 5,17 mmolll. Follow-up took place every 6 weeks and included lipid, haematological, biochemical and clinical evaluation. A full ophthalmological evaluation was conducted at baseline and at 24 weeks' follow-up.Overall the TC level was reduced below the baseline level by 34,3% at week 18 of follow-up and 32,5% at week 24. Patients with higher initial TC levels showed greater TC lowering in response to simvastatin than did those with lower initial TC levels. A group of 45 patients was followed up for an additional 12 weeks after the end of the trial and maintained TC reductions similar to those at the end of the trial.Fourteen patients experienced adverse effects which were thought to be drug-related. One patient was withdrawn from the trial after developing conjunctivitis that proved to be related to the use of simvastatin. The rest of the adverse experiences were not severe enough to terminate the use of simvastatin and included gastro-intestinal tract symptoms, dizziness, conjunctivitis, pruritus and the aggravation of  eczema. Aspartate aminotransferase, alanine aminotransferase and creatine kinase values were raised in a significant number of patients but no patient was withdrawn from the trial. A dose of 40 mg simvastatin was associated with a rise in the abovementioned enzymes more often than were lower doses

Simvastatin in non-insulin-dependent diabetic patients with hypercholesterolaemia

ArticleThe original publication is available at http://www.samj.org.zaThe objective of this study was to evaluate the lipid-lowering effect of simvastatin in non-insulin-dependent diabetes mellitus (NIDDM) patients with hypercholesterolaemia while possible clinical and biochemical adverse effects were monitored for. Forty-three NIDDM patients with hypercholesterolaemia (total cholesterol ≥6,5 mmol/l) used simvastatin after a detailed clinical laboratory evaluation as well as a 4-week wash-out period and a 4-week placebo baseline period. Simvastatin treatment was initiated with a 10 mg dose for 6 weeks; this was increased to 20 mg and 40 mg at 12 and 18 weeks of follow-up respectively if the total cholesterol level had not decreased to below 5,17 mmol/l. Patients were placed on a lipid-lowering diet and continued to take any regular non-lipid lowering medication throughout the trial; side-effects were monitored at 6-week intervals until patients had taken simvastatin for 24 weeks. The mean total cholesterol level was reduced by 22,2% at the first follow-up visit, and by 24,2%, 23,3% and 28,5% at the second, third and fourth follow-up visits respectively compared with baseline levels. A dose of 10 mg simvastatin brought about a reduction in total cholesterol similar to those found with higher doses. The mean triglyceride level was reduced by 20,9% with 20 mg simvastatin. The high-density lipoprotein cholesterol level was not altered significantly and neither was the control of diabetes. Clinical adverse experiences thought to be caused by simvastatin were abdominal discomfort and nausea, exfoliative dermatitis, tinnitus and light-headedness as well as dry, irritated eyes. Levels of the enzymes aspartate aminotransferase, alanine aminotransferase and creatinine kinase were raised in 5, 6 and 5 patients respectively. Simvastatin in doses of 10 mg or 20 mg daily reduces total cholesterol and triglyceride levels effectively in NIDDM patients with hypercholesterolaemia.Publisher’s versio

Folate status, homocysteine metabolism, and methylenetetrahydrofolate reductase genotype in rural South African blacks with a history of pregnancy complicated by neural tube defects.

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