Abdulaziz Al-Othman

Modest reversal of metabolic syndrome manifestations with vitamin D status correction: a 12-month prospective study.

Numerous cross-sectional studies have noted significant negative associations between circulating levels of 25-hydroxyvitamin D and cardiometabolic risk factors, highlighting potential extraskeletal functions of this sterol hormone. Prospective studies, however, have been limited; and hence, no cause-and-effect relations can be inferred. This study aims to determine whether vitamin D status correction can reverse already established manifestations of the metabolic syndrome (MetS). A total of 59 adult nondiabetic, overweight, and obese Saudis (31 male, 28 female) were prospectively enrolled in this 1-year interventional study. Anthropometry and biochemical evaluation were performed, including determination of serum 25-hydroxyvitamin D, calcium, and phosphorous concentrations, as well as fasting blood glucose and lipid profile. Subjects were advised to regularly expose themselves to sunlight and increase intake of vitamin D-rich foods. All measurements were repeated 6 and 12 months later. At the initial baseline visit, the prevalence of both low high-density lipoprotein cholesterol and hypertension was significantly increased among patients with 25-vitamin D deficiency (P < .05), even after adjusting for sex and body mass index. Overall prevalence of MetS patients by the modified National Health and Nutrition Examination Survey Adult Treatment Panel III definition decreased from 25.2% to 13.0%; and this was largely due to a parallel decrease in the prevalence of low high-density lipoprotein cholesterol, triglycerides, and hypertension. Optimization of vitamin D status through sun exposure and increased intake of a vitamin D-rich diet can lead to an improved cardiometabolic profile, offering a promising nonpharmacologic approach in the prevention of MetS manifestations.

Vitamin D supplementation as an adjuvant therapy for patients with T2DM: an 18-month prospective interventional study

BackgroundVitamin D deficiency has been associated with impaired human insulin action, suggesting a role in the pathogenesis of diabetes mellitus type 2 (T2DM). In this prospective interventional study we investigated the effects of vitamin D3 supplementation on the metabolic profiles of Saudi T2DM subjects pre- and post-vitamin D supplementation over an 18-month period.MethodsT2DM Saudi subjects (men, N = 34: Age: 56.6 ± 8.7 yr, BMI, 29.1 ± 3.3 kg/m2; women, N = 58: Age: 51.2 ± 10.6 yr, BMI 34.3 ± 4.9 kg/m2;) were recruited and given 2000 IU vitamin D3 daily for 18 months. Anthropometrics and fasting blood were collected (0, 6, 12, 18 months) to monitor serum 25-hydroxyvitamin D using specific ELISA, and to determine metabolic profiles by standard methods.ResultsIn all subjects there was a significant increase in mean 25-hydroxyvitamin D levels from baseline (32.2 ± 1.5 nmol/L) to 18 months (54.7 ± 1.5 nmol/L; p  < 0.001), as well as serum calcium (baseline = 2.3 ± 0.23 mmol/L vs. 18 months = 2.6 ± 0.1 mmol/L; p = 0.003). A significant decrease in LDL- (baseline = 4.4 ± 0.8 mmol/L vs. 18 months = 3.6 ± 0.8 mmol/L, p  < 0.001] and total cholesterol (baseline = 5.4 ± 0.2 mmol/L vs. 18 months = 4.9 ± 0.3 mmol/L, p < 0.001) were noted, as well as a significant improvement in HOMA-β function ( p  = 0.002). Majority of the improvements elicited were more prominent in women than men.ConclusionIn the Saudi T2DM population receiving oral Vitamin D3 supplementation (2000 IU/day), circulating 25-hydroxyvitamin D levels remained below normal 18 months after the onset of treatment. Yet, this “suboptimal” supplementation significantly improved lipid profile with a favorable change in HDL/LDL ratio, and HOMA-β function, which were more pronounced in T2DM females.

Effect of physical activity and sun exposure on vitamin D status of Saudi children and adolescents

BackgroundAccumulating evidence suggests an increased prevalence of vitamin D deficiency in the Middle East. In this context, we aimed to determine whether the prevalence of vitamin D deficiency is related to degree of physical activity and sun exposure among apparently healthy Saudi children and adolescents, a little studied population.MethodsA total of 331 Saudi children aged 6–17 years (153 boys and 178 girls) were included in this cross sectional study. Levels of physical activity and sun exposure were determined using a standard questionnaire. Anthropometry, serum calcium and 25-(OH) vitamin D were analyzed.ResultsAll subjects were vitamin D deficient, the majority being moderately deficient (71.6%). Age was the single most significant predictor affecting 25 (OH) Vitamin D levels, explaining 21% of the variance perceived (p = 1.68 x 10-14). Age-matched comparisons revealed that for groups having the same amount of sun exposure, those with moderate or are physically active will have higher levels of vitamin D status, though levels in across groups remained deficient.ConclusionVitamin D deficiency is common among Saudi children and adolescents, and is influenced by both sun exposure and physical activity. Promotion of an active outdoor lifestyle among Saudi children in both homes and schools may counteract the vitamin D deficiency epidemic in this vulnerable population. Vitamin D supplementation is suggested in all groups, including those with the highest sun exposure and physical activity.

Hypovitaminosis D associations with adverse metabolic parameters are accentuated in patients with Type 2 diabetes mellitus: A body mass index-independent role of adiponectin?

Background: Hypovitaminosis D has been associated with an increased prevalence of Type 2 diabetes mellitus (DMT2) and metabolic syndrome manifestations. The purpose of this study was to examine the association between 25-hydroxy-vitamin D (25-OH-VitD) levels and indices of insulin resistance (IR), including adipocytokines, in a Saudi population with or without DMT2. Subjects and methods: A total of 266 subjects (153 DMT2 and 113 healthy controls) aged 26–80 yr were randomly selected from the existing Biomarkers Screening in Riyadh Program (RIYADH Cohort). Subjects were assessed clinically, anthropometry was performed, morning blood chemistries, including fasting glucose (FG), triglycerides, total cholesterol, LDL cholesterol (LDL-C), and HDL cholesterol were obtained. Homeostasis model assessment of IR (HOMA-IR) was calculated, and serum 25-OH-VitD, leptin, adiponectin, resistin, insulin, high sensitivity CRP (hsCRP), and tumor necrosis factor α concentrations were measured using specific assays. Results: In DMT2 subjects, negative correlations between 25-OH-vitD and body mass index (BMI), FG, insulin, HOMA-IR, cholesterol, LDL-C, and hsCRP were observed, while a positive correlation between 25-OH-VitD and adiponectin was detected. The later remained significant after controlling for BMI. Interestingly, only weak and nonsignificant associations between 25-OH-VitD and metabolic parameters were observed in the control group, whereas, when the entire population was examined, negative correlations were evident primarily between 25-OH-VitD and FG, HOMA-IR, total cholesterol, LDL-C. These associations remained significant after controlling for BMI. Conclusions: These results suggest that hypovitaminosis D associations with metabolic disturbances are accentuated in DMT2. The BMI-independent positive correlation between 25-OH-VitD and adiponectin suggests a potential role for this adipocytokine as a link between 25-OH-VitD and IR in patients with DMT2.

Increased vitamin D supplementation recommended during summer season in the gulf region: a counterintuitive seasonal effect in vitamin D levels in adult, overweight and obese Middle Eastern residents

Purpose  Seasonal variations in circulating vitamin D levels provide vital information as to the most appropriate time to either start or increase vitamin D supplementation to maintain optimal vitamin D levels. In this follow‐up study, we determined seasonal differences in serum 25(OH)‐vitamin D (25(OH)D) levels, as well as parallel changes in metabolic parameters, in a cohort of adult, overweight and obese Saudis.

Pistagremic acid, a glucosidase inhibitor from Pistacia integerrima.

Pistacia integerrima Stewart in traditionally used as folk remedy for various pathological conditions including diabetes. In order to identify the bioactive compound responsible for its folk use in diabetes, a phytochemical and biological study was conducted. Pistagremic acid (PA) was isolated from the dried galls extract of P. integerrima. Strong α-glucosidase inhibitory potential of PA was predicted using its molecular docking simulations against yeast α-glucosidase as a therapeutic target. Significant experimental α-glucosidase inhibitory activity of PA confirmed the computational predictions. PA showed potent enzyme inhibitory activity both against yeast (IC(50): 89.12±0.12μM) and rat intestinal (IC(50): 62.47±0.09μM) α-glucosidases. Interestingly, acarbose was found to be more than 12 times more potent an inhibitor against mammalian (rat intestinal) enzyme (having IC(50) value 62.47±0.09μM), as compared to the microbial (yeast) enzyme (with IC(50) value 780.21μM). Molecular binding mode was explored via molecular docking simulations, which revealed hydrogen bonding interactions between PA and important amino acid residues (Asp60, Arg69 and Asp 70 (3.11Å)), surrounding the catalytic site of the α-glucosidase. These interactions could be mainly responsible for their role in potent inhibitory activity of PA. PA has a strong potential to be further investigated as a new lead compound for better management of diabetes.

Protection of α-tocopherol and selenium against acute effects of malathion on liver and kidney of rats

Protection from effects of the organophosphate insecticide, malathion on the liver and kidney of male Wistar albino rats by α-tocopherol and selenium was investigated. Significantly greater (P<0.01 ) mean concentrations of malondialdehyde (MDA) and lesser concentrations (P<0.01) of reduced glutathione (GSH) and tissues total proteins were observed in liver and kidney of rats exposed to malathion. Activities of the antioxidant enzymes, superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) were less in livers and kidneys of rats exposed to malathion. These effects caused by exposure to malathion were reversed when rats were subsequently treated orally with 100 mg/kg b.w. tocopherol and/or 0.1 mg selenium/kg b.w. Both tocopherol and selenium (Se) reduced the concentration of MDA, and increased concentration of total proteins and reduced glutathione and mean activities of SOD, CAT and GPx, to levels that were not significantly different from unexposed, control rats, previous to exposure to malathion. Selenium was significantly ( P<0.05) more effective at recovering activities of SOD and GPx in liver and kidney of malathion treated rats than was αtocopherol, whereas, α-tocopherol was significantly ( P<0.05) more effective at recovering activities of CAT in liver and kidney than was Se. Both α-tocopherol and Se were effective in alleviating oxidative damage in liver and kidney of rats caused by malathion.

Hypovitaminosis D and cardiometabolic risk factors among non-obese youth

Hypovitaminosis D and increased cardiometabolic risk have been well established in adults. This study aims to determine whether or not vitamin D also influences cardiometabolic risk in children and adolescents. To test this hypothesis, we recruited 186 boys (mean age 12.4 ± 3.7 years) and 114 girls (11.6 ± 3.7) in a cross-sectional observational study. Anthropometrics were obtained and morning fasting blood samples were collected. Serum glucose and lipid profile were determined using routine methods. Serum 25-hydroxyvitamin D was quantified using an enzyme-linked immunosorbent assay. In our population, approximately 10% of subjects had severe 25-hydroxyvitamin D deficiency (< 12.5 nmol/L), while 50% of the boys and 40% of the girls had mild vitamin D deficiency (12.5–24.9 nmol/L). Circulating 25-hydroxyvitamin D concentrations were inversely correlated with age, body mass index (BMI), blood pressure, waist and hip circumferences and serum triglyceride concentrations, and positively associated with HDL-cholesterol. Age and systolic blood pressure were significant predictors of 25-hydroxyvitamin D, explaining about 30% of the variance (p = 0.0005). In conclusion, significant associations between serum 25-hydroxyvitamin D and cardiometabolic parameters support promising cardioprotective benefits from vitamin D sufficiency at an early age. Follow-up with prospective clinical intervention studies are needed to validate this hypothesis.

Flood hazards in an urbanizing watershed in Riyadh, Saudi Arabia

Riyadh, the capital of the Kingdom of Saudi Arabia, has experienced unusual levels of urbanization in the past few decades, making it one of the fastest growing cities in the world. This paper examines flood hazards in the rapidly urbanizing catchment of Al-Aysen in Riyadh. Remote sensing and geographic information system techniques were employed to obtain and prepare input data for hydrologic and hydraulic models, with the former based on the very popular curve number approach. Due to the limited nature of the rainfall data, observations from two rain gauges in the vicinity of the catchment were used to estimate design storms. The hydrologic model was run in a semi-distributed mode by dividing the catchment into many sub-catchments. The impact of urbanization on run-off volume and peak discharge resulting from different storms was investigated, with various urbanization scenarios simulated. Flood hazard zones and affected streets were also identified through hydrologic/hydraulic model simulation. The mismatch between administrative and catchment boundaries can create problems in flood risk management for similar cities since hydrologic processes and flood hazards are based on the hydrologic connectivity. Since flooding events impact the road network and create driving hazards, governmental decision-makers must take the necessary precautions to protect drivers in these situations.

Selected Dietary Nutrients and the Prevalence of Metabolic Syndrome in Adult Males and Females in Saudi Arabia: A Pilot Study

During the last decade, the rapid economic development in Saudi Arabia resulted in an unbalanced dietary intake pattern within the general population. Consequently, metabolic syndrome was also documented to be highly prevalent in the Middle-East region. We aimed to examine the relationship between selected dietary nutrient intakes and the prevalence of metabolic syndrome in the general adult population of Riyadh, Saudi Arabia. In this cross-sectional study, 185 adult Saudis aged 19 to 60 years (87 males and 98 females (mean age 35.6 ± 13.2 and 37.6 ± 11.7 years, respectively)) were included. The criteria for metabolic syndrome were based on the International Diabetes Foundation (IDF) criteria, and the dietary food intake was assessed by two 24-h dietary recall methods. The odd ratios (ORs) of metabolic syndrome risk across quartiles of selected dietary nutrients were significantly lower for carbohydrates and proteins, as well as for vitamins A, C, E and K, calcium, zinc and magnesium (p < 0.05 for all) in the female group with metabolic syndrome than those without. The pattern of daily dietary intake of selected nutrients among the general population of Saudi Arabia raises concern, and this dietary imbalance could increase the risk of metabolic syndrome, particularly in adult Saudi females.