Arjumand S. Warsy

A comparative study of prevalence of overweight and obesity in children in different provinces of Saudi Arabia.

The aim of this study was to determine the prevalence of overweight and obesity in Saudi children from different provinces of the country and in different age groups. A total of 12,701 children (6,281 boys and 6,420 girls) with ages ranging from 1 to 18 years were enrolled during a household screening programme in different provinces of Saudi Arabia and height and weight were recorded. Body Mass Index (BMI) was calculated and applying age and sex specific cut-off points for BMI the children were grouped into overweight and obese. The overall prevalence of overweight was 10.68 and 12.7 per cent and that of obesity was 5.98 and 6.74 per cent in the boys and girls, respectively. In the different provinces the prevalence of overweight ranged from 8.8 to 27.4 per cent and from 9.3 to 27.6 per cent and obesity ranged from 4.7 to 10.4 per cent and from 4.3 to 13.8 per cent in the boys and girls, respectively. Prevalence of overweight and obesity was also calculated after grouping the children into 17 groups according to age. It is concluded that overweight and obesity occur in all provinces of Saudi Arabia although at a variable prevalence. In general, girls have a higher prevalence of both overweight and obesity compared with boys. Eastern province children have the highest prevalence and the Southern province children have the lowest prevalence of overweight and obesity. When grouped according to age, overweight and obesity tend to increase with age. Suggestions are made to prevent overweight and obesity development in Saudi children.

THE PREVALENCE OF OBESITY AND OVERWEIGHT IN 1-18-YEAR-OLD SAUDI CHILDREN

OBJECTIVES The aim of this study was to review the prevalence of overweight and obesity in Saudi children with ages ranging up to 18 years. SUBJECTS AND METHODS The study was a cross-sectional national epidemiological household survey, and the study group included 12071 children (boys 6281; girls 6420), with ages ranging from 1-18 years. Their height and weight were measured and body mass index (BMI) was calculated. The study group was classified as obese or overweight, using age- and sex-specific cut-off points for BMI for determining overweight and obesity in children. RESULTS The overall prevalence of overweight was 10.7% and 12.7% in the boys and girls, respectively, and obesity was 6.0% and 6.74% in the two groups, respectively. The children were grouped according to the province to which they belonged, and prevalence of obesity and overweight were calculated for each province. The highest frequency was in the Eastern Province, while the lowest was in the Southern Province. The children were further grouped into 1-6, 6-12 and 12-18-year-olds and prevalence of obesity and overweight was calculated. In addition, at yearly intervals, the prevalence of obesity and overweight was calculated. Among the boys and girls, the maximum prevalence of obesity was in the 2-3 year-olds. A decrease in prevalence was found in both males and females up to the age group of 8-13 years, and then the prevalence increased again up to the 18 years age. CONCLUSION This epidemiological household survey shows the overweight and obesity trends in Saudi children based on the international sex-specific cut-off points for BMI. It also shows a variable prevalence in different age groups until after 13 years, when the prevalence rate increases.

The Frequency of 14 β-Thalassemia Mutations in the Arab Populations

The β-thalassemias are a heterogeneous group with respect to molecular pathogenesis, and different populations and ethnic groups differ with respect to the predominating mutations. This variable spectrum of β-thalassemia mutations has resulted in extensive studies in each population and ethnic group to identify the major mutations. In this study we investigated the prevalence of 14 mutations in 253 β-thalassemia patients drawn from eight Arab countries (i.e. Jordan, Egypt, Syria, Lebanon, Yemen, and Saudi Arabia), living in Saudi Arabia and attending Ministry of Health hospitals. The mutations investigated included IVS-l-110 (G→A), IVS-ll-1 (G→A), IVS-l-5 (G→C), codon 39 (C→T), IVS-l-1 (G→A), frameshift at codons 8/9 (+G), frameshift at codons 41/42 (-TTCT), codon 15 (TGG→TAG), IVS-l-6 (T→C), frameshift at codon 16 (-C), IVS-ll-745 (C→G), codon 6 (-A), IVS-I, 3′ end (-25 bp), and Cap +1 (A→C). The most frequently encountered mutations were IVS-l-110 and IVS-ll-1 which were identified in the population of ...

Frequency of Glucose-6-phosphate Dehydrogenase, Pyruvate Kinase and Hexokinase Deficiency in the Saudi Population

The frequencies of glucose-6-phosphate dehydrogenase (G-6-PD), pyruvate kinase (PK) and hexokinase (HK) deficiency were determined in different regions of Saudi Arabia. G-6-PD deficiency was found to range from 0.045 to 0.220 for the male and 0.020 to 0.125 for the female population. The highest frequencies were found to exist in the regions which are endemic to malarial parasite and have high frequencies of sickle cell and thalassaemia genes. Partial deficiencies of PK and HK were encountered in each region, however, no case of complete deficiency of these enzymes was identified. Further investigations are in progress to determine the clinical manifestations of enzyme deficiencies in the Saudi population.

Nitric oxide production is enhanced in patients with heat stroke

Objective: To determine whether nitric oxide (NO) production is increased in heat stroke (HS) patients. Design: A prospective analysis of nitrite and nitrate (NO·2/NO3) levels in ten HS patients was performed at the HS center in Makkah, Saudi Arabia. Methods: Plasma (NO·2/NO3) levels were determined spectrophotometrically before cooling (0 time), and at 6, 12, and 24 h post-cooling. Results: The mean level of NO in the ten HS victims before cooling was significantly higher than in eight control patients (35.6 ± 37.0 vs 3.0 ± 4.2 μmol/l; p < 0.01). The levels were higher in non-survivors than in survivors. NO also correlated positively with the Acute Physiology and Chronic Health Evaluation II score (r = 0.72, p < 0.018). There was no correlation between the NO level before cooling and blood pressure, rectal temperature, or cooling time. Conclusion: HS is associated with excessive NO production, the magnitude of which is proportional to the severity of illness. NO may be an important mediator and integral part of the pathophysiological processes resulting in HS and may be a central factor linking the neurological and cardiovascular abnormalities observed in HS.

Sickle cell disease in Middle East Arab countries

The sickle cell (HbS) gene occurs at a variable frequency in the Middle Eastern Arab countries, with characteristic distribution patterns and representing an overall picture of blood genetic disorders in the region. The origin of the gene has been debated, but studies using β-globin gene haplotypes have ascertained that there were multiple origins for HbS. In some regions the HbS gene is common and exhibits polymorphism, while the reverse is true in others. A common causative factor for the high prevalence and maintenance of HbS and thalassaemia genes is malaria endemicity. The HbS gene also co-exists with other haemoglobin variants and thalassaemia genes and the resulting clinical state is referred to as sickle cell disease (SCD). In the Middle Eastern Arab countries, the clinical picture of SCD expresses two distinct forms, the benign and the severe forms, which are related to two distinct β-globin gene haplotypes. These are referred to as the Saudi-Indian and the Benin haplotypes, respectively. In a majority of the Middle Eastern Arab countries the HbS is linked to the Saudi-Indian haplotype, while in others it is linked to the Benin haplotype. This review outlines the frequency, distribution, clinical feature, management and prevention as well as gene interactions of the HbS genes with other haemoglobin disorders in the Middle Eastern Arab countries.

Normal reference values for hematological parameters, red cell indices, HB A2 and HB F from early childhood through adolescence in Saudis.

BACKGROUND Values of hematological parameters are affected by factors such as age, sex, ethnic background and social, nutritional and environmental factors. The objective of this study was to determine the values of hematological parameters, red cell indices and Hb A2 and Hb F levels in normal Saudi children, living in the Central Province of Saudi Arabia. MATERIALS AND METHODS The study was carried out on 1526 apparently healthy children, with ages ranging from 1-15 years, and selected during a household screening program. Hematological parameters, red cell indices, and hemoglobin types (Hb A2 and Hb F) were estimated, and the children were divided into 15 groups depending on the age. Male and female children were separated, and the mean and standard deviation of each parameter was calculated for each age group. RESULTS No significant differences were observed in the red cell count in the male and female children. White blood cells gradually decreased from 2 years onwards, while hemoglobin and hematocrit levels increased significantly from 2 to 15 years. Mean cell volume and mean cell hemoglobin also showed slight increases, while mean cell hemoglobin concentration remained more or less constant. Hemoglobin A2 and Hb F showed slight but nonsignificant fluctuations. Comparison of the results with those reported in the literature shows that Saudi children have some values similar to Caucasians, while others have values which are intermediate between Caucasians and African children. CONCLUSION The values reported in this study can be used as normal reference values for Saudi children and adolescents.

In silico analysis of single nucleotide polymorphism (SNPs) in human β-globin gene.

Single amino acid substitutions in the globin chain are the most common forms of genetic variations that produce hemoglobinopathies- the most widespread inherited disorders worldwide. Several hemoglobinopathies result from homozygosity or compound heterozygosity to beta-globin (HBB) gene mutations, such as that producing sickle cell hemoglobin (HbS), HbC, HbD and HbE. Several of these mutations are deleterious and result in moderate to severe hemolytic anemia, with associated complications, requiring lifelong care and management. Even though many hemoglobinopathies result from single amino acid changes producing similar structural abnormalities, there are functional differences in the generated variants. Using in silico methods, we examined the genetic variations that can alter the expression and function of the HBB gene. Using a sequence homology-based Sorting Intolerant from Tolerant (SIFT) server we have searched for the SNPs, which showed that 200 (80%) non-synonymous polymorphism were found to be deleterious. The structure-based method via PolyPhen server indicated that 135 (40%) non-synonymous polymorphism may modify protein function and structure. The Pupa Suite software showed that the SNPs will have a phenotypic consequence on the structure and function of the altered protein. Structure analysis was performed on the key mutations that occur in the native protein coded by the HBB gene that causes hemoglobinopathies such as: HbC (E→K), HbD (E→Q), HbE (E→K) and HbS (E→V). Atomic Non-Local Environment Assessment (ANOLEA), Yet Another Scientific Artificial Reality Application (YASARA), CHARMM-GUI webserver for macromolecular dynamics and mechanics, and Normal Mode Analysis, Deformation and Refinement (NOMAD-Ref) of Gromacs server were used to perform molecular dynamics simulations and energy minimization calculations on β-Chain residue of the HBB gene before and after mutation. Furthermore, in the native and altered protein models, amino acid residues were determined and secondary structures were observed for solvent accessibility to confirm the protein stability. The functional study in this investigation may be a good model for additional future studies.

Sickle Cell Gene in the Population of Saudi Arabia

A comprehensive screening program was initiated in Saudi Arabia in 1982 to determine the frequency of the sickle cell (Hb S) gene in the different regions of Saudi Arabia. Over a period of 10 years 30,055 samples were collected from 36 areas in the five provinces of Saudi Arabia; these were screened using electrophoretic techniques in alkaline and acid pH for the presence of Hb S in heterozygous and homozygous states. The overall prevalence of Hb AS was 7.36% and Hb SS was 1.06%, giving an Hb S gene frequency of 0.047. The results from the different regions were separated and the prevalence of Hb AS and Hb SS and Hb S gene frequencies were calculated in each province and each region. The prevalence of Hb AS and Hb SS cases ranged from O to 25.88% and O to 5.27%, respectively. No case of Hb AS or Hb SS were identified in certain areas of the central province (Al-Russ, Al-Unaiza, Al-Mesnab and Bkaria) and northern province (Qurayat and Al-Jouf). In the southern province both Hb S homozygotes and heterozygotes were encountered in all regions except Farasan Island. In all other regions the Hb S gene was encountered, but at a variable frequency. Applying Hardy-Weinberg equilibrium it was observed that in the majority of the regions the observed Hb S homozygotes were significantly higher compared to the number expected (p < 0.0001). This was believed to be due to bias as the samples were collected in the hospital. The Hb S gene frequency in the different regions ranged from 0 to 0.17 when the frequency was calculated on the basis of both Hb AS and Hb. SS cases, and 0 to 0.13 if the gene frequency was calculated after eliminating the Hb SS cases. A close correlation was observed between the Hb S gene frequency and malaria endemicity. This study shows that the Hb S gene occurs frequently in several regions of Saudi Arabia and there is an urgent need to implement control and prevention programs to reduce the number of Hb S homozygous cases.

Glucose-6-Phosphate Dehydrogenase Deficiency in Saudi Arabia

This paper reports the frequency of glucose-6-phosphate dehydrogenase (G6PD) deficiency in the male and female population of Al-Ula in the northwestern province of Saudi Arabia. The frequency of G6PD