Anemia And It\u27s Associated Factors Among Adolescents in Kuwait

We estimated the prevalence of anemia among school children and investigated factors associated with this problem in Kuwait. A cross-sectional study was conducted on 1415 adolescents randomly selected from middle schools in Kuwait. Hemoglobin, iron, ferritin, folate and vitamin B-12, in addition to many other laboratory indicators, were measured in a venous blood sample. Data on risk factors for anemia were collected from parents and adolescents. Multiple logistic regression was used to investigate factors associated with anemia. The prevalence of anemia was 8.06% (95% CI: 6.69-9.60%), which was significantly higher among females compared to males (10.96% vs. 5.04%; p \u3c 0.001). Mean (SD) Hb level was 133.7 (9.89) g/L and 130.00 (10.48) g/L among males and females, respectively (p \u3c 0.001). The prevalence of mild, moderate and severe anemia was 5.94%, 1.91% and 0.21%, respectively. Gender, age, iron concentration and ferritin were associated with anemia in multivariable analysis. These data indicate that anemia among school children in Kuwait is of mild public health significance. Further reduction in anemia in school girls should focus on correcting iron deficiency. Surveillance systems for anemia may consider using a cut-off point that is specific for the method of blood sampling and the method of Hb measurement

Season of Birth and Sugary Beverages Are Predictors of Raven\u27s Standard Progressive Matrices Scores in Adolescents

To investigate factors associated with cognitive functioning in healthy adolescents, a school-based cross-sectional study was conducted on 1370 adolescents aged 11-16 years that were randomly selected from all governorates of Kuwait. Raven\u27s Standard Progressive Matrices (SPM), a non-verbal test of intelligence, was used to measure cognitive functioning of the study participants. Data on predictors of cognitive functioning were collected from parents and adolescents. Weight and height of the participants were measured in a standardized manner and blood samples were tested in an accredited laboratory under strict measures of quality control. In multivariable linear regression analysis, factors that showed significant association with the SPM score were gender (p=0.002), season of birth (p=0.009), place of residence (p\u3c0.001), father\u27s (p\u3c0.001) and mother\u27s (p=0.025) educational level, type of housing (p\u3c0.001), passive smoking at home (p=0.031), sleeping hours during weekends (p=0.017), students\u27 educational level (p\u3c0.001) and the frequency of consumption of sugary drinks (p\u3c0.001). The link between cognitive functioning and season of birth seems to be robust in various geographical locations including the Middle East. The association between sugary drinks and cognitive functioning highlights the importance of diet independently of obesity and support efforts to reduce consumption of sugary drinks among children

Clinical Applications of Adiponectin Measurements in Type 2 Diabetes Mellitus: Screening, Diagnosis, and Marker of Diabetes Control

Background. Adipose tissue-derived adiponectin has pleiotropic protective effects with suppression of inflammatory and metabolic derangements that may result in insulin resistance, metabolic syndrome, type 2 diabetes mellitus (T2DM), and cardiovascular disease. The aim of this study was to evaluate adiponectin as a diagnostic marker of T2DM and diabetes control. Methods. Fasting adiponectin, insulin, glucose, and HbA1c were determined in 376 patients with known T2DM and 575 subjects with undiagnosed diabetes but with family history of T2DM. Clinical and anthropometric data were recorded. Subjects were classified on the basis of degree of adiposity, insulin resistance (IR), and achievement of target HbA1c levels. Receiver operating characteristic (ROC) curve analysis was used to examine the diagnostic performance for undiagnosed DM. Results. In undiagnosed subjects, adiponectin was significantly lower in subjects with IR and diabetic subjects compared with those without. The area under the adiponectin ROC curve for diagnosis of DM was 0.740. In known T2DM subjects, those with good control had significantly higher adiponectin (8.6 versus 7.4 μg/mL) compared to subjects with poor control. Conclusions. Adiponectin levels are associated with better glycemic control and could be a useful adjunct for screening for IR and T2DM. Therapeutic measures that increase adiponectin levels might be valuable targets for improving diabetes control and decreasing complications

Vitamin D-Binding Protein Clearance Ratio Is Significantly Associated with Glycemic Status and Diabetes Complications in a Predominantly Vitamin D-Deficient Population

Introduction. Studies have shown increased urine excretion of vitamin D-binding protein (VDBP) in patients with diabetic nephropathy (DN) resulting from postulated mechanisms linked to renal tubular damage. In this study, we evaluate the utility of VDBP clearance ratio as a novel determinant of glycemic status, DN, and other diabetes-associated complications. Methods. Levels of vitamin D, HbA1c, serum, urine concentrations of VDBP, and creatinine were measured in 309 subjects. The ratio of urine microalbumin to creatinine was determined to categorize subjects as normoalbuminuric (NAO), microalbuminuric (MIA), and macroalbuminuric (MAA). The VDBP clearance ratio was calculated. Results. Mean VDBP clearance ratios in NAO, MIA, and MAA were 0.7, 4, and 15, respectively. Significant positive correlations of VDBP clearance ratio were found with age, WC, SBP, DBP, TG, glucose, HbA1c, urine VDBP, urine microalbumin, and urine microalbumin/creatinine, and a significant negative correlation was found with the steady-state estimate of beta cell function (B%). Receiver operating curve (ROC) analyses of the use of VDBP clearance ratio for detection of albumin status shows a value of 0.81 for the area under the curve. Conclusions. The strong associations of VDBP clearance ratio with glycemic control and diabetes-associated complications suggest that this index could play a wider role in detection and/or pathogenesis and complications of diabetes

Associations of TERC Single Nucleotide Polymorphisms with Human Leukocyte Telomere Length and the Risk of Type 2 Diabetes Mellitus

<div><p>Previous Studies have mapped putative loci that may probably regulate leukocyte telomere length (LTL). The strongest associations with LTL were reported for SNP rs12696304 and rs16847897 near the non-coding Ribose Nucleic Acid (RNA) molecule component (<i>TERC</i>) of telomerase enzyme on 3q26. It is unclear whether these identified loci coding functional components of telomerase, exert a similar effect on LTL in other populations or influence risk factors of Type 2 Diabetes Mellitus (T2DM). The present study was performed to: study the influence of <i>TERC</i> polymorphisms on LTL, human telomerase reverse transcriptase (hTERT), indices of obesity and explore the potential associations with T2DM. 225 T2DM patients and 245 age and sex matched controls were studied. Allelic Discrimination (AD) genotyping was utilized to determine <i>TERC</i> SNPs [rs12696304 and rs16847897]. hTERT, adiponectin, Insulin, Homeostasis Model Assessment (HOMA-IR), and LTL were measured. Body Mass Index (BMI) and waist circumference (WC) were recorded. [CC] genotype of rs16847897 was significantly associated with shorter LTL [OR = 1.6, p = 0.004], lower hTERT levels [OR = 0.4, p = 0.006], higher BMI [OR = 2.2, p = 0.006], larger WC [OR = 23.4, p = 0.007] and hypo-adiponectemia [OR = 0.6, p = 0.006]. [GG] genotype of rs12696304 was also significantly associated with shorter LTL [OR = 1.5, p = 0.004], lower hTERT [OR = 0.7, p = 0.006] but with larger WC[OR = 5.3, p = 0.004]. [CC] genotype of rs16847897 and [GG] genotype of rs12696304 together increased the risk of T2DM significantly [OR = 1.7, p = 0.004]. We provide insights connecting a structure that is critically involved in maintaining genomic stability with obesity and T2DM. Given the central role of telomere length in determining telomere function our findings may expand our understanding of the pathological mechanisms underlying age associated conditions such as T2DM.</p></div

ORs [95%CI] for associations of haplotypes with LTL, hTERT, anthropometric indices and metabolic factors of obesity.

<p>ORs [95%CI] for associations of haplotypes with LTL, hTERT, anthropometric indices and metabolic factors of obesity.</p

ORs [95CI] for associations of <i>TERC</i> SNPs rs16847897 and rs12696304 with LTL, hTERT, anthropometric indices and metabolic factors of obesity.

<p>ORs [95CI] for associations of <i>TERC</i> SNPs rs16847897 and rs12696304 with LTL, hTERT, anthropometric indices and metabolic factors of obesity.</p

Box plots show the distribution of Leukocyte Telomere Length [LTL].

<p>The horizontal line within the box corresponds to the median value. Vertical bars represent the values between 2.5^th to 97.5^th percentiles excluding outliers.</p

Complex interplay between TERC SNPs, short telomeres, telomerase and obesity related factors.

<p>Complex interplay between TERC SNPs, short telomeres, telomerase and obesity related factors.</p