Medium-term carbohydrate tolerance improves and then deteriorates with advancing pregnancy in urban Nigerian women

Background: It has been reported that carbohydrate metabolism does not deteriorate in pregnancy in the African, an observation at variance with general teaching. Objective: To determine the effect of pregnancy on medium term carbohydrate metabolism Methods: Medium term carbohydrate metabolism was evaluated in pregnant and non-pregnant Nigerian women using changes in Glycoted Plasma Proteins (GPP) as a surrogate for medium-term carbohydrate metabolism. Study subjects included women in all three trimesters of pregnancy, a group of non-pregnant women with normal carbohydrate metabolism and another group of women with confirmed diabetes already on treatment but not pregnant. Fasting plasma glucose was determined by the glucose oxidase method while GPP was determined using a modification of the thiobarbituric method with correction for levels of total plasma proteins (TPP). Average values are presented as mean (SD) while relationship between variables were determined using Pearson product moment correlation coefficients. Significance of p values of determinations is set at

Subacute thyroiditis and HIV infection: Case report and literature review

This case report is on Subacute thyroiditis (SAT) with thyrotoxicosis in a 22year-old housewife . She had been married for 2years to a long-distance driver. She presented with a fever and neurological features which were followed by features of SAT such as pain and difficulty in swallowing, swelling of the anterior aspect of the neck, palpitations, shaking of the body, tenderness over the neck, coarse tremors of the hands and worsening of fever. She appeared depressed and was restless. The fever with the neurological features (lower motor neurone lesion of the facial nerve) suggested a form of viraemia, which could have been from any virus. HIV infection was confirmed in this patient but there was no weight loss, no diarrhoea nor lymphadenopathy. This suggests a probable viraemia of seroconversion of HIV infection. There were also no features of other infections or other diseases. This case report may suggest an aetiological association between HIV and subacute thyroiditis. However, HIV has not been reported before as an aetiology of subacute thyroiditis.Jos Journal of Medicine, Volume 7 No.

Prevalence of hypertension amongst persons with diabetes mellitus in Benin City, Nigeria

Objective: To determine the prevalence of hypertension amongst persons with diabetes mellitus (DM) in Benin city.Materials and Methods: Four hundred and fifty diabetic subjects were evaluated for hypertension by measuring their blood pressure using a sphygmomanometer at the diabetes clinics of the University of Benin Teaching Hospital and Central Hospital, both in Benin City, Nigeria. Other data obtained included age, sex, type of DM, weight, height, body mass index and waist hip ratio.Results: Two hundred and forty-four out of 450 subjects had hypertension, thus giving a prevalence rate of 54.2%. 124 males (50.8%) were hypertensive compared with 120 (49.2%) females, but this difference was not significant (χ2 = 0.1, df = 1, P > 0.05). Thirteen (22.4%) of the 58 Type 1 subjects had hypertension, while 231 (58.9%) of the Type 2 subjects had hypertension, and this difference was statistically significant (χ2 = 27, df = 1, P < 0.05).Conclusions: Hypertension is prevalent in persons with DM. Studies have shown that adequate control of the blood pressure reduces the microvascular and macrovascular complications of DM. DM care providers must prescribe appropriate antihypertensive therapy to control hypertension in persons with DM

Deriving an optimal threshold of waist circumference for detecting cardiometabolic risk in sub-Saharan Africa.

BACKGROUND: Waist circumference (WC) thresholds derived from western populations continue to be used in sub-Saharan Africa (SSA) despite increasing evidence of ethnic variation in the association between adiposity and cardiometabolic disease and availability of data from African populations. We aimed to derive a SSA-specific optimal WC cut-point for identifying individuals at increased cardiometabolic risk. METHODS: We used individual level cross-sectional data on 24 181 participants aged ⩾15 years from 17 studies conducted between 1990 and 2014 in eight countries in SSA. Receiver operating characteristic curves were used to derive optimal WC cut-points for detecting the presence of at least two components of metabolic syndrome (MS), excluding WC. RESULTS: The optimal WC cut-point was 81.2 cm (95% CI 78.5-83.8 cm) and 81.0 cm (95% CI 79.2-82.8 cm) for men and women, respectively, with comparable accuracy in men and women. Sensitivity was higher in women (64%, 95% CI 63-65) than in men (53%, 95% CI 51-55), and increased with the prevalence of obesity. Having WC above the derived cut-point was associated with a twofold probability of having at least two components of MS (age-adjusted odds ratio 2.6, 95% CI 2.4-2.9, for men and 2.2, 95% CI 2.0-2.3, for women). CONCLUSION: The optimal WC cut-point for identifying men at increased cardiometabolic risk is lower (⩾81.2 cm) than current guidelines (⩾94.0 cm) recommend, and similar to that in women in SSA. Prospective studies are needed to confirm these cut-points based on cardiometabolic outcomes.International Journal of Obesity advance online publication, 31 October 2017; doi:10.1038/ijo.2017.240

Deriving an optimal threshold of waist circumference for detecting cardiometabolic risk in sub-Saharan Africa

BACKGROUND: Waist circumference (WC) thresholds derived from western populations continue to be used in sub-Saharan Africa (SSA) despite increasing evidence of ethnic variation in the association between adiposity and cardiometabolic disease and availability of data from African populations. We aimed to derive a SSA-specific optimal WC cut-point for identifying individuals at increased cardiometabolic risk. METHODS: We used individual level cross-sectional data on 24 181 participants aged ⩾15 years from 17 studies conducted between 1990 and 2014 in eight countries in SSA. Receiver operating characteristic curves were used to derive optimal WC cutpoints for detecting the presence of at least two components of metabolic syndrome (MS), excluding WC. RESULTS: The optimal WC cut-point was 81.2 cm (95% CI 78.5–83.8 cm) and 81.0 cm (95% CI 79.2–82.8 cm) for men and women, respectively, with comparable accuracy in men and women. Sensitivity was higher in women (64%, 95% CI 63–65) than in men (53%, 95% CI 51–55), and increased with the prevalence of obesity. Having WC above the derived cut-point was associated with a twofold probability of having at least two components of MS (age-adjusted odds ratio 2.6, 95% CI 2.4–2.9, for men and 2.2, 95% CI 2.0–2.3, for women). CONCLUSION: The optimal WC cut-point for identifying men at increased cardiometabolic risk is lower (⩾81.2 cm) than current guidelines (⩾94.0 cm) recommend, and similar to that in women in SSA. Prospective studies are needed to confirm these cut-points based on cardiometabolic outcomes

A Comparison Of Anthropometric Measures (Body Mass Index) And Serum Lipids (Cholesterol And Triglycerides) In Normotensive And Hypertensive Type 2 Diabetics

Aims: A study was undertaken at the Jos University Teaching Hospital,to determine the effect of hypertension on the lipids of type 2 diabetics. Methods: Consecutive sex-marched and closely age-marched normotensive and hypertensive diabetics had their lipids and BMI compared. Results: Sixty-two pairs of patients were evaluated; 37.1% of the hypertensive diabetics had high fasting serum triglycerides compared to 24.2% of normotensive diabetics. 46.8% of normotensive diabetics had high fasting serum total cholesterol compared to 38.7% of hypertensive diabetics. Overall, more hypertensive diabetics had lipid disorder than normotensive diabetics. Hypertensive diabetics had a statistically significantly higher BMI than the normotensive diabetic patients. Conclusion: From the study, hypertension seems to increase the presence of lipid abnormality in diabetics. Increased BMI and hypertriglyceridaemia in hypertensive diabetics may suggest the presence of the metabolic syndrome (Syndrome X) in the hypertensive diabetics. Key words: Body mass index, Serum Lipid Hypertension Highland Medical Research Journal Vol. 3 (1) 2005: 1-

Body mass index and its effect on serum cortisol level

Introduction: Cortisol measurement is indicated in suspected over or underproduction of cortisol by the adrenal cortex. The finding of low cortisol can create concern and initiate further investigations for the exclusion of adrenal insufficiency. Cushing’s syndrome is frequently included in the differential diagnosis of obesity. Some literature describes reduced serum cortisol levels in obesity, however, this is not a well‑recognized phenomenon.Aim: The aim of this study was to determine the relationship between body mass index (BMI) and serum cortisol levels.Subjects, Materials and Methods: Seventy healthy participants agreed to take part in the study. The anthropometric measurements (weight, height, and waist and hip circumferences) were done. Exclusion criteria include those with a history of adrenal/pituitary disease or medications altering cortisol level. The basal cortisol (BC) sample was taken at 8 a.m. immediately before administration of an intravenous bolus injection of 250 μg adrenocorticotropic hormone (ACTH). BMI categories were defined as normal and high if BMI was 18.5-24.99 kg/m2 and ≥ 25 kg/m2, respectively.Results: Forty (57.1%) participants had normal BMI while 30 (42.9%) participants had BMI ≥ 25 kg/m2 (P = 0.053). The mean BC level was lower in participants with BMI ≥ 25 kg/m2 but not significant. There was a negative correlation between BMI and BC level (r = −0.205, P = 0.88) while a positive correlation existed between stimulated cortisol level and BMI (r = 0.009, P = 0.944).Conclusion: Persons with BMI above 25 kg/m2 had lower BC level though not statistically significant, the trend was noticed. Subjecting people whose BMI is above 25 kg/m2 to further stimulation with ACTH because of low BC is not advised because their response to ACTH stimulation was similar to those who have normal BMI.Key words: Adrenal gland, adrenocorticotropic hormone, body mass index, cortisol, obesit

Profile of antihypertensive use and hypertension control amongst persons with Diabetes Mellitus in Benin City

No Abstract. Nigerian Hospital Practice Vol. 2 (4) 2008: pp. 106-10

Anti-diabetic Agents and the Potentials for Reducing Cardiovascular Risks in Type-2 Diabetes Mellitus

Recent reports from Cardiovascular Outcome Trials (CVOTs) revealed that some newer anti-diabetic drugs impact Major Adverse Cardiovascular Events (MACE). These medications include the Sodium-Glucose Co-Transporter (SGLT2) inhibitors and the Glucagon-like Peptide-1 (GLP-1) receptor agonists. There is a need for a review of the mechanisms of action of these drugs, in addition to their glucose-lowering effects and CV benefits. This review paper aims to explore the cardio-protective effects and CV risks of anti-diabetic medications, their mechanisms of action and the CV benefits evidenced by CVOTs. Using internet search, with search items such as Type 2 Diabetes mellitus, cardiovascular risk factors, cardiovascular outcome trials, major adverse cardiovascular events, sodium-glucose transporter-2 inhibitors, glucagon-like peptide-1 receptor agonist, the Google Scholar, EMBASE, PubMed, Medline, Web MD, and Scopus were checked for various relevant published articles. Analyses of the results of multiple CVOTs from various parts of the world were considered. These CVOTs were reviewed to assess the role of anti-diabetic agents in reducing cardiovascular risk in patients with T2DM. The SGLT2 inhibitors and GLP1 agonists were found to be beneficial in lowering MACE when compared with placebo. This is in addition to their anti-hyperglycaemic benefits. In conclusion, SGLT2 inhibitors and GLP-1 agonists confer dramatic beneficial CV risk reduction on patients with T2DM, as shown by the various CVOTs. This is in addition to their anti-hyperglycaemic effects. This remarkable benefit justifies the need by various guidelines to adopt them as second line agents to metformin in managing patients with T2DM

Lipid Profile Pattern amongst Type 2 DM subjects with Erectile Dysfunction in Benin City, Nigeria

Objective:Dyslipidaemia in patientswith diabetesmellitus leads to atherosclerosis and this contributes to erectile dysfunction (ED). This study set out to characterize the lipid profile pattern in diabetic patients with erectile dysfunction.Subject andMethods:Aprospective, cross sectional study carried out at the diabetes clinic of the University of Benin Teaching Hospital. Forty diabetic subjects with erectile dysfunction and thirty-two diabetic subjects without erectile dysfunction who served as controls were recruited for the study. Data obtained include anthropometric indices and fasting serum lipids.Data was analyzed with SPSS version 10.Results: The prevalence of dyslipidaemia was 82.5%in the ED subjects and 68.7%in the control group and this difference was not statistically significant. The ED subjects had greater means of age, body mass index and waist hip ratio than the control group but this was not statistically significant. The mean values of the lipid profile was higher in the EDpatients except for the HDL cholesterol level. Elevated total cholesterolwas themost common abnormal lipid parameter,while elevated triglyceridewas the least common abnormal parameter seen in both groups.Conclusion: The prevalence of dyslipidaemia in diabetic subjects with erectile dysfunction is high. Efforts must be put in place to treat dyslipidaemia and other cardiovascular risk factors aggressively to prevent or ameliorate this complication.Niger Med J, Vol. 49, No. 4, Oct– Dec 2008, 81–83Keywords:Lipid profile, erectiledysfunction, diabetesmellitus, BeninCity