John Ayodele Olaniyi

Metabolic alterations in different stages of hypertension in an apparently healthy nigerian population.

Metabolic syndrome (MS) amplifies hypertension (HTN) associated with increased risk of cardiovascular disease (CVD). MS components and other CVD risk measures were investigated in different stages of hypertension. 534 apparently healthy Nigerian traders aged 18–105 years were participants of a cohort study. The International Diabetes Federation (2005) and the National High Blood Pressure Education Program Coordinating Committee criteria were used for MS and HTN classifications, respectively. Anthropometric indices were obtained by standard methods. Levels of fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDLC) were determined by enzymatic methods, while low-density lipoprotein cholesterol (LDLC) was calculated. Data analysed statistically were significant at P < 0.05. 143 (26.8%), 197 (36.9%), and 194 (36.3%) of the traders had normotension, pre-HTN and HTN (stages 1 and 2), respectively. All indices tested except HDLC were significantly different among BP groups (P < 0.05). Waist to hip (WHR) and waist to height (WHT) ratios were significantly different between HTN groups (P < 0.05). HTN was associated with MS and female gender (P < 0.05). Metabolic alterations and significant HTN were observed. Treatment of the individual components of the syndrome and improvement of modifiable metabolic factors may be necessary to reduce MS and high BP.

Serum Copeptin and Cortisol Do Not Accurately Predict Sickle Cell Anaemia Vaso-Occlusive Crisis as C-Reactive Protein

Objective This study assessed the diagnostic performance and prognostic properties of C-reactive protein (CRP), copeptin and cortisol in individuals with sickle cell anaemia (SCA). Design Prospective case-control study Methods Sixty consecutive SCA subjects (18–40 years) comprising 30 subjects in the steady state and 30 subjects in vaso-occlusive crisis (VOC) were recruited into this study. Thirty (30) apparently healthy individuals with HbAA genotype served as controls. ELISA was used for the determination of serum levels of copeptin, CRP and cortisol. Data obtained were statistically analyzed using the Student’s t-test and Mann Whitney U as appropriate and P<0.05 was considered significant. Results SCA subjects in VOC had significantly lower copeptin level and significantly higher CRP level compared with controls. However, serum levels of copeptin, cortisol and CRP were significantly higher in SCA subjects in VOC compared with SCA subjects in steady state. Furthermore, CRP had the widest Area under the ROC curve (AUROC) than copeptin and cortisol. No significant difference was observed in the levels of copeptin, CRP and cortisol when SCA subjects in VOC who were hospitalized for less ≤5 days were compared with subjects who had longer stays. Conclusion It could be concluded that C-reactive protein has a superior diagnostic performance for vaso-occlusive crisis in individuals with sickle cell anaemia and that C-reactive protein, cortisol and copeptin are not good prognostic markers in SCA subjects in vaso-occlusive crisis.

Impact of dietary intervention on selected biochemical indices of inflammation and oxidative stress in Nigerians with metabolic syndrome: a pilot study.

ABSTRACT Aim: This study assessed the impact of dietary modification on cardiometabolic, inflammatory and oxidative stress indices in Nigerians with metabolic syndrome (MS). Subjects and Methods: Sixty participants with MS were selected using the International Diabetes Federation criteria from a cohort participating in “Risk Assessment of Type 2 diabetes mellitus and Dementia in Nigerians with Metabolic Syndrome” study. The subjects were seen by a Dietitian and the approximate percentages of total calories from total protein, total fat, polyunsaturated fat, and carbohydrate were calculated from dietary history and pegged at 20%, 30%, 14% and 50% respectively. To ensure compliance, each participant was seen monthly (for 6 months) by the Dietitian. Glucose and lipid profile were determined using enzymatic methods. Serum activities of superoxide dismutase (SOD), catalase (CAT), Myeloperoxidase (MPO) and levels of nitric oxide (NO), malondialdehyde (MDA), hydrogen peroxide (H

Indices of Metabolic Syndrome in 534 Apparently Healthy Nigerian Traders

Background: Metabolic Syndrome (MS) increases the risk of developing type-2 diabetes (DM2) and cardiovascular diseases (CVD) and it is thought to be prevalent in Nigeria. This study aims at determining the prevalence of MS and its component risk factors among apparently healthy traders in a local market in Ibadan, Nigeria. Methods: 534 apparently healthy traders from a local market in Bodija, Ibadan, Nigeria aged (18–105) years with neither DM2 nor CVD were participants of a cohort study on risk assessment of type 2 diabetes and dementia in Nigerians with metabolic syndrome. The International Diabetes Federation (2005) and the World Health Organisation (1998) criteria were used for MS and BMI respectively. Anthropometric indices (weight, height, body mass index (BMI), percentage body fat (PBF), waist and hip circumferences (WC & HC) and their ratio (WHR), waist circumference to height ratio (WHT)) and blood pressure (BP) were obtained by standard methods. Blood samples (6 ml) were obtained for the determination of glucose (FPG), total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C) by enzymatic methods while low density lipoprotein cholesterol (LDL-C) was calculated. Descriptive statistics, Chi-square test and ANOVA were among the analyses conducted. Results: 301 (56.4%) of traders studied were overweight (176, 33.0%) or obese (125, 23.4%) while 17 (3.4%) and 125 (40.4%) were underweight and normal weight respectively. The prevalence of MS and obesity were 87 (16.3%) and 125 (23.4%) respectively. There was significant association between obesity and MS (p < 0.05). Both MS and obesity were significantly associated with gender (p < 0.05). The prevalence of MS and obesity was higher in female (20.9%; 31.0%) than male traders (6.5%; 7.1%) respectively. The prevalence of MS increased from normal weight (8.3%) to overweight (18.8%) to obesity (28.8%). There were significantly higher differences in age, BP(systolic and diastolic), weight, BMI, WC, HC, WHT, WHR, and PBF but lower difference in height when overweight/obese groups were compared with normal weight group (p < 0.05). TC and LDL-C were significantly higher in only obese than normal weight traders. However, FPG, TG and HDL-C were similar in all groups (p > 0.05). Conclusion: There is high prevalence of MS and obesity among Nigerian traders. Female gender, hypercholesterolemia, hypertension, increasing age, general and abdominal obesity appear to be important metabolic risk factors of CVD and not DM2 among Nigerian traders. Health care strategies for effective modulation of diet and lifestyle are needed urgently. In addition, screening programs for indices of MS in all Nigerians irrespective of BMI could be considered.

PREVALENT COMPONENTS OF METABOLIC SYNDROME AND THEIR CORRELATES IN APPARENTLY HEALTHY INDIVIDUALS IN SUB-SAHARAN AFRICA

Aim: To assess the prevalent components of metabolic syndrome (MSC) and their related determinants of lipid metabolism in the Nigerian for early diagnosis, prevention

Preliminary Evaluation of a Point-of-Care Testing Device (SickleSCAN™) in Screening for Sickle Cell Disease

Abstract Sickle cell disease affects about 150,000 births annually in Nigeria. Early diagnosis is hampered by factors such as centralized and urban localization of laboratories, high cost of diagnostic equipment and inadequate skilled manpower to operate them. The need for a low-cost, portable, easy-to-use diagnostic test for sickle cell disease is critical, especially in resource-poor countries. In this study, we evaluated the performance characteristics of a novel point-of-care testing device (SickleSCAN™), and its acceptability and feasibility, as a possible screening tool for sickle cell disease. In the first phase, we assessed the performance characteristics of SickleSCAN™ by evaluating 57 subjects comprising both children and adults attending a primary health center, for Hb SS (βS/βS; HBB: c.20A>T), Hb SC (βS/βC; HBB: c.19G>A) and Hb AS (βA/βS) using SickleSCAN™, cellulose acetate electrophoresis (CAE) and high performance liquid chromatography (HPLC). Performance characteristics such as diagnostic sensitivity and specificity were compared to HPLC as a standard method. We subsequently undertook a second phase wherein the acceptability and feasibility of the device for sickle cell disease screening, was evaluated using semi-structured and structured questionnaires among 197 healthcare personnel and 221 subjects, respectively. Sickle cell disease was carried by 3.4% of the subjects. The diagnostic sensitivity, specificity and test efficiency of SickleSCAN™ for sickle cell disease (Hb SS and Hb SC), were 100.0, 98.2 and 98.2%, respectively. Findings from this study showed SickleSCAN™ to be a viable screening tool that can easily be applied in community-based screening for early diagnosis of sickle cell disease with little expertise and low cost.

Defective lipid metabolism in sickle cell anaemia subjects in vaso-occlusive crisis

Background: Abnormal lipid homeostasis has been reported in sickle cell anaemia (SCA) as well as in other haematological disorders. However, there is little information on the lipid profile of SCA subjects in vaso-occlusive crisis (VOC). This study determined the lipid profile of adult SCA subjects in VOC and in steady state (SSCA). Materials and Methods: Fifty-eight (58) adults with HbSS (30 in steady state and 28 in vaso-occlusive crisis) and 24 age-matched healthy individuals with HbAA genotype were recruited into this study. Standard methods were used for the determination of blood pressure (BP), packed cell volume (PCV), total white blood cell count (WBC) and haemoglobin phenotype. After an overnight fast, 5 ml of venous blood was obtained from each SSCA and the controls while samples were collected upon admission in the VOC group. Plasma lipid profile was determined using enzymatic method. Differences between two groups were determined using independent Students t-test or Man-Whitney U as appropriate. P-values less than 0.05 were considered significant. Results: Plasma total cholesterol (TC) and high density lipoprotein (HDL) were significantly lower while the ratio of triglyceride (TG) to HDL (TG/HDL) was significantly higher in SSCA compared with the controls. Low density lipoprotein (LDL) and TC were significantly lower in SCA subjects in VOC compared with controls. However, TC, TG, LDL and TG/HDL were significantly lower while HDL was significantly higher in VOC compared with SSCA. Conclusion: Sickle cell anaemia subjects have defective fasting lipid metabolism which becomes pronounced with VOC.

Serum Iron Status and Haematological Profiles in Adult Nigerian Sickle Cell Anaemia Patients

Background: Sickle cell anaemia (SCA) patients are prone to require long-term frequent blood transfusion because of chronic haemolysis and overlapping hyper-haemolysis. Hence, they become vulnerable to iron overload and its complications. On the other hand, iron deficiency has been documented among un-transfused SCA cases. Thus, there is a need to effectively and efficiently determine iron status of SCA patients. Objective: We investigated whether adult SCA patients in steady state (SSt) or those with vaso-occlusive crisis (VOC) have significantly different iron status viz-a-viz Serum Iron (SI), Serum Ferritin (SF), Total Iron Binding Capacity (TIBC), Transferrin (TRF), percentage TFS and haematological parameters when compared with age and sexmatched controls. Materials and Methods: Ninety subjects, comprising 30 SCA patients in SSt, 30 SCA patients with VOC and 30 HbAA, ethnicity, age and sex-matched controls (NC), were consecutively recruited. Serum samples were analysed for SF, TRF and TIBC using

A Multi-centre Survey of Acceptability of Newborn Screening for Sickle Cell Disease in Nigeria

Background Sickle cell disease (SCD) is a major genetic disease that manifests early in life and may lead to significant morbidities. One of the health care services that have been effective in reducing the burden of SCD in developed countries is newborn screening (NBS) followed by pneumococcal vaccines, penicillin prophylaxis, and hydroxyurea treatment. Yet, in sub-Saharan African countries, where about 75% of annual affected babies worldwide are born, NBS programmes are largely unavailable. It is not clear whether this is due to technical challenges associated with setting up such programmes, or significant cultural and social barriers to its acceptance in such settings. Objective Our aim was to ascertain the attitudes to and acceptability of NBS in Nigeria among various socio-demographic groups including health professionals, undergraduate students, parents of children with SCD and SCD patients. Methods Data on socio-demographic characteristics, knowledge of SCD and attitude towards NBS were collected using a semi-structured pre-tested questionnaire from April to July 2014 across 15 health institutions and university campuses in Nigeria. Data were collected from 1,301 respondents across Nigeria. Results There was good knowledge of SCD as an inherited blood disorder. Although 86% of respondents (n = 1,119) supported NBS, there was a statistically significant relationship between support for NBS and age (p = 003), educational status (p = 000) and religion (p = 000). Conclusion This study suggests that there is a good acceptability of NBS across Nigeria. The main barriers to its use are likely to be financial and practical, rather than social or cultural.