Ayman A. Zayed

Smokers' hair: Does smoking cause premature hair graying?

Aims: To determine if there is a significant association between premature hair graying and cigarette smoking. Materials and Methods: A cross-sectional observational study was conducted in a nonclinical setting on 207 participants on August 24 until 25, 2010. Participants were classified into two groups [premature hair graying (PHG) and normal hair graying]. PHG was defined as the first appearance of gray hair before the age of 30. Data were collected using an interview questionnaire and measurements of body mass index, waist circumference, fasting blood glucose and blood pressure. Collected data were statistically analyzed using SPSS 16, Chicago, IL. Results: Of the 207 subjects, 104 (50.2%) had first appearance of gray hair before the age of 30 (PHG group) while the other 103 (49.8%) were considered normal hair graying group. The prevalence of smokers in the “PHG” group was higher (40.2% vs. 24.7%, P = 0.031). Smokers had earlier onset of hair graying (smokers: 31 (7.4) vs. nonsmokers: 34 (8.6), P = 0.034). Using multiple logistic regression with conditional likelihood, smokers were two and half times (95% CI: 1.5-4.6) more prone to develop PHG. Conclusion: This study suggests that there is a significant relation (with adjusted odds ratio of two and half) between onset of gray hair before the age of 30 and cigarette smoking.

The prevalence of isolated growth hormone deficiency among children of short stature in Jordan and its relationship with consanguinity

The prevalence of isolated growth hormone deficiency (IGHD) among short‐statured children in Jordan, where consanguineous marriage (CM) is common, is unknown. No studies have investigated the relationship between degrees of consanguinity and IGHD. This study aimed to determine the prevalence of IGHD among short‐statured children referred to a university hospital in Jordan and its relationship with different degrees of consanguinity.

The correlation between plasma levels of oxytocin and betatrophin in non-diabetic and diabetic metabolic syndrome patients: A cross sectional study from Jordan

BACKGROUND Oxytocin (OXT) is a neurohypophyseal hormone that has been recently shown to possess a number of beneficial effects in diabetes and obesity. Betatrophin is a protein expressed in fat and liver that regulates lipid metabolism and promotes pancreatic β-cell proliferation. It is not investigated yet whether OXT and betatrophin levels correlate in metabolic syndrome (MS) or diabetes patients. METHODS The aim was to assess correlations between plasma betatrophin and OXT levels in MS-diabetic or prediabetic (N=89) as compared to MS-non-diabetic (N=69) patients. Competitive binding ELISA was used to evaluate betatrophin and OXT plasma concentrations. Correlations of the above biomarkers and patient clinical characteristics were also detected. RESULTS As compared to the control MS participants (0.32±0.25ng/mL); betatrophin plasma levels were increased (P<0.001) in the MS-pre/T2DM patients (1.23±0.68ng/mL). On the contrary, OXT concentrations were decreased (P<0.001) in the MS-pre/T2DM patients (1222.46±514.55pg/mL) as compared to the MS control subjects (2323.42±848.68pg/mL). OXT concentration correlated negatively (r=-0.492, P<0.001), while HbA1c and FPG correlated positively with betatrophin plasma levels (P<0.001), but were inversely correlated with OXT levels (P<0.001) in the total sample. CONCLUSION Betatrophin levels are increased, while OXT levels are decreased in MS-pre/T2DM. We found an inverse correlation between the levels of the two biomarkers in addition to correlation between their levels and the degree of glycemic control.

SERUM LEVELS OF CARCINOEMBRYONIC ANTIGEN IN PATIENTS WITH TYPE 2 DIABETES

OBJECTIVE To investigate whether serum carcinoembryonic antigen (CEA) levels are associated with type 2 diabetes mellitus (T2DM) and glycated hemoglobin (HbA1c). METHODS A comparative, cross-sectional, observational study was conducted at Jordan University Hospital, Amman, Jordan, on 282 adult subjects from March 2012 to June 2015. Subjects were classified into 2 groups: T2DM subjects (n = 168) and a healthy comparison group (n = 114). Subjects with any condition known to be associated with elevated CEA levels were excluded. HbA1c and serum CEA levels were measured, and body mass index (BMI) was determined. RESULTS Subjects with T2DM had significantly higher mean serum CEA than controls (2.4 ± 1.5 vs. 1.5 ± 1.2 ng/mL, P<.0001). Sex did not correlate with CEA levels, while age (Spearmans rho [ρ] = 0.18, P = .002) and HbA1c (ρ = 0.56, P<.0001) did; however, age no longer correlated after correcting for diabetic status. HbA1c was the only variable shown to correlate with CEA in a stepwise linear regression (r = 0 .37, P<.001). CONCLUSION We observed a statistically significant association between elevated CEA and T2DM, despite average CEA values for both groups being within the reference range. In addition, serum CEA levels correlated positively with HbA1c values. ABBREVIATIONS ADA = American Diabetes Association BMI = body mass index CA 19-9 = carbohydrate antigen 19-9 CEA = carcinoembryonic antigen CRP = C-reactive protein DM = diabetes mellitus HbA1c = glycated hemoglobin JUH = Jordan University Hospital T2DM = type 2 diabetes mellitus ρ = Spearmans correlation coefficient.

Should food intake and circadian rhythm be considered when measuring serum calcitonin level

OBJECTIVE To investigate the relationship between both food intake and circadian rhythmicity and serum calcitonin in the same individuals. METHODS Eighteen healthy subjects, 10 males and 8 females, aged 22 to 24 years, were recruited. Serum calcitonin level was measured three times: at 0800 after a 9-hour overnight fast, at 0900 postprandially, and at 1700 after another 9-hour fast. The same protocol was repeated once. RESULTS The mean calcitonin levels (at 0800) were 3.92 pg/mL (SD, 2.5 pg/mL) on Day 1 and 3.52 pg/mL (SD, 2.1 pg/mL) on Day 2. Mean postprandial calcitonin (at 0900) was 9.46 pg/mL (SD, 8.6 pg/mL) on Day 1 and 9.91 pg/mL (SD, 6.9 pg/mL) on Day 2. Mean fasting calcitonin in the evening (at 1700) was 6.74 pg/mL (SD, 4.73 pg/mL) on Day 1 and 6.49 pg/mL (SD, 3.57 pg/mL) on Day 2. There was no significant difference in the mean calcitonin level on days 1 and 2 for any of the three time points examined. Statistically significant differences were found between postprandial and evening calcitonin levels and the fasting levels on Day 1 (P = .018 and .015, respectively) and Day 2 (P = .001 and .0009, respectively). CONCLUSION These results suggest that serum calcitonin level is significantly influenced by food intake in healthy young subjects and reveal a circadian rhythm, with increased calcitonin level during the afternoon. The timing of blood sampling relative to meals should be integrated into clinical practice and research settings involving serum calcitonin measurements.

Predetermined Anti-Diabetic Drug Regimen Adjustments during Ramadan Fasting: An Observational Study of Safety

Background Many Muslim type 2 diabetes mellitus (T2DM) patients choose to fast the month of Ramadan despite the possible adverse health effects brought about by the change in dietary habits, among other things. Clinical data regarding the safety of multi-drug regimens during fasting are particularly scarce. The aim of the study was to evaluate the safety of a drug protocol devised by the authors to accommodate Ramadans dietary changes, involving dose adjustments of four anti-diabetic drug regimens in T2DM patients fasting Ramadan. Methods In this prospective, observational, open-label study, 301 T2DM patients who wished to fast Ramadan were followed during Ramadan and the preceding month. The incidence of hypoglycemia, diabetic ketoacidosis (DKA) and non-ketotic hyperosmolar state (NKHS) was monitored. Patients were classified into four groups: A group (those taking metformin, sulfonylurea and insulin [n=33]); B group (metformin and sulfonylurea [n=89]); C group (metformin and insulin [n=96]); and D group (premixed 70/30, glargine or regular insulin [n=82]). During Ramadan, drug doses were adjusted as percentages of their pre-Ramadan values: 75% for sulfonylureas, 75% for glargine, 75% for premixed insulin 70/30 in two doses, and 75% for regular insulin. Metformin was adjusted to a twice-daily regimen. Results No cases of DKA or NKHS were reported. Hypoglycemia occurred at a lower rate than pre-Ramadan values in groups C, and D; and a similar rate in groups A, and B. Conclusion The data suggested that using the above protocol to adjust the doses of anti-diabetic drugs is safe in T2DM patients in regards to hypoglycemia, DKA, and NKHS.