Lorenzo Gordon

Lipid profile of type 2 diabetic and hypertensive patients in the Jamaican population

Aims: Previous studies have shown that diabetes mellitus (DM) increases the risk of cardiovascular diseases in females to a greater extent than in males. In this cross-sectional study, we evaluated the lipid profiles of type 2 diabetic males and females. Materials and Methods: The study included 107 type 2 diabetic patients (41 males and 66 females), and 122 hypertensive type 2 diabetic patients (39 males and 83 females), aged 15 years and older. Total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C), very low density lipoprotein-cholesterol (VLDL-C) and high density lipoprotein-cholesterol (HDL-C) concentrations were assayed for each group using standard biochemical methods. Results: The mean TC, TG, VLDL-C, HDL-C and LDL-C concentrations, TG/HDL and LDL/HDL ratios were higher in type 2 diabetic and hypertensive type 2 diabetic patients compared with non-diabetic, and hypertensive non-diabetic control subjects, although these were not significant (P > 0.05). Hypertensive type 2 diabetic females had significantly higher serum TC (7.42 ± 1.63 mmol/L) than hypertensive non-diabetic males (5.76±1.57 mmol/L; P < 0.05). All the other lipid and lipoprotein parameters except HDL-C were non-significantly higher in females with type 2 DM and those with hypertension and type 2 DM, compared with type 2 diabetic and hypertensive type 2 diabetic males, respectively (P > 0.05). Conclusion: This study demonstrated that dyslipidemia exists in our type 2 diabetic population with greater TC in hypertensive type 2 diabetic females compared with hypertensive type 2 diabetic males. This suggests that hypertensive type 2 diabetic females are exposed more profoundly to risk factors including atherogenic dyslipidemia compared with males.

Effect of yoga exercise therapy on oxidative stress indicators with end-stage renal disease on hemodialysis.

Background: Oxidative stress promotes endothelial dysfunction and atherosclerosis in chronic renal disease. Objectives: This study investigated the impact of Hatha yoga on oxidative stress indicators and oxidant status, in patients with end-stage renal disease (ESRD) on hemodialysis. Design: This prospective randomized study consisted of 33 ESRD patients in the Hatha yoga exercise group who were matched with 35 ESRD patients in the control group. Outcome Measures: The oxidative stress indicators (malondialdehyde - MDA, protein oxidation - POX, phospholipase A2 - PLA2 activity) and the oxidative status (superoxide dismutase (SOD) and catalase activities) were determined in the blood samples taken at the pre-hemodialysis treatment, at baseline (0 months) and after four months. Results: In patients in the Hatha yoga exercise group, lipid peroxidation, as indicated by MDA decreased by 4.0% after four months (P = 0.096). There was also a significant reduction in the activity of PLA from 2.68 ± 0.02 IU / L to 2.34 IU / L (− 12.7%; P = 0.010) and POX from 2.28 ± 0.02 nmol / mg to 2.22 ± 0.01 nmol / mg (− 22.6%; P = 0.0001). The activity of SOD significantly increased from 12.91 ± 0.17 U / L to 13.54 ± 0.15 U / L (4.65%; P = 0.0001) and catalase from 79.83 ± 0.63 U / L to 80.54 ± 0.80 U / L (0.90%; P = 0.0001). There was a significant correlation between the pre-hemodialysis oxidative stress parameters at the zero month and after four months for the activities of PLA (r = 0.440), catalase (r = 0.872), and SOD (r = 0.775). Conclusions: These findings suggest that the Hatha yoga exercise has therapeutic, preventative, and protective effects in ESRD subjects, by decreasing oxidative stress.

Serum creatine kinase and lactate dehydrogenase activities in patients with thyroid disorders.

BACKGROUND AND OBJECTIVES There is the recognition of a pattern of elevations of serum enzymes in hyperthyroid and hypothyroid patients. The aims of this study were to determine the activities of serum creatine kinase (CK) and lactate deydrogenase (LDH) in thyroid disorders, and to evaluate the relationship between CK, LDH and FT4, and TSH levels. MATERIALS AND METHODS In this retrospective study, thyroid function tests, serum CK and LDH activities were obtained from the medical records of newly diagnosed hyperthyroid and hypothyroid patients attending the Endocrinology Clinic at the University Hospital of the West Indies from 2005- 2009. RESULTS Elevation of CK activity was found in 5 patients (28%, 5/18) with overt hypothyroidism and in 12 patients (24.0%, 12/50) with subclinical hypothyroidism. The mean CK activity in subclinical hypothyroid patients was 179.80 ± 125.68 U/L compared with 389.901 ± 381.20 U/L in overt hypothyroid patients. The elevation of LDH activity was found in 6 patients (33.3%, 6/18) with overt hypothyroidism and in 37 patients (74.0%, 37/50) with subclinical hypothyroidism. In the hypothyroid patients, a positive correlation was found between CK activity and TSH (r = 0.292, P = 0.015), and a negative correlation between CK activity and FT4 (r = - 0.325, P = 0.007); and between FT4 and TSH (r = - 0.371, P = 0.002). CONCLUSION The significant elevation in serum CK and LDH activities indicates that these can be used as parameters for screening hypothyroid patients but not hyperthyroid patients.

Effect of exercise therapy on lipid parameters in patients with end-stage renal disease on hemodialysis

Background: Dyslipidemia has been established as a well-known traditional risk factor for cardiovascular disease in chronic kidney disease patients. Aim: This study investigated the impact of Hatha yoga exercise on lipid parameters in patients with end-stage renal disease (ESRD) on hemodialysis. Materials and Methods: This prospective randomized study consisted of 33 ESRD patients in the Hatha yoga exercise group that was matched with 35 ESRD patients in the control group. Serum total cholesterol, triglycerides, low-density lipoprotein (LDL)-cholesterol, and high-density lipoprotein (HDL)-cholesterol were determined at baseline (0 month) and after 4 months. Results: Comparing values after 4 months versus baseline in the prehemodialysis Hatha yoga exercise group, there was found a significant decrease in total cholesterol from 5.126 ± 0.092 mmol/l to 4.891 ± 0.072 mmol/l (-4.58%; P = 0.0001), triglycerides from 2.699 ± 0.078 mmol/l to 2.530 ± 0.063 mmol/l (-6.26%; P = 0.0001), LDL-cholesterol from 2.729 ± 0.083 mmol/l to 2.420 ± 0.066 mmol/l (-11.32%; P = 0.0001), and total cholesterol/HDL-cholesterol ratio from 5.593 ± 0.119 mmol/l to 4.907 ± 0.116 mmol/l (-12.26%; P = 0.047). For patients in the Hatha yoga exercise group, 51.5% had normal total cholesterol at 0 month while 70.0% had normal total cholesterol (P < 0.05) after 4 four months and 54.5% of patients had normal LDL-cholesterol at 0 month while 84.9% had normal LDL-cholesterol after 4 months (P < 0.05). Conclusion: These findings suggest that Hatha yoga exercise has preventive and beneficial effects and may be a safe therapeutic modality in ESRD patients.

Dyslipidaemia in hypertensive obese type 2 diabetic patients in Jamaica

Introduction Hypertension and obesity are common problems among diabetic patients accelerating progression of vascular diabetic complications. Materials and methods A two-stage stratified random sampling design was used, and individuals aged 15 years and over were interviewed. This cross-sectional study evaluated lipid abnormalities of 117 obese type 2 diabetic patients (28 males and 89 females), and 56 hypertensive obese type 2 diabetic patients (22 males and 34 females). Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), very-low-density lipoprotein cholesterol (VLDL-C) and high-density lipoprotein cholesterol (HDL-C) concentrations were assayed using standard biochemical methods. Results Hypertensive obese type 2 diabetic females had significantly higher mean serum concentrations of TC (p = 0.043), TG (p = 0.046), LDL-C (p= 0.040), TC/HDL-C ratio (p = 0.001) and LDL-C/HDL-C ratio (p = 0.003) compared with hypertensive obese non-diabetic females. Similar results were found in hypertensive obese type 2 diabetic males compared with hypertensive obese non-diabetic males. Hypertensive obese type 2 diabetic females had significantly higher serum TC, TG and TC/HDL-C ratio (p < 0.05) than hypertensive obese type 2 diabetic males. Hypertensive obese type 2 diabetic females had significantly higher mean serum concentrations of TG (p = 0.03) and TC (p = 0.01) than obese type 2 diabetic females. There was a significant association between blood glucose and LDL-C concentrations in type 2 diabetic subjects (r = 0.36; p< 0.05). Conclusion Obese hypertensive type 2 diabetic females are exposed more profoundly to risk factors including atherogenic dyslipidaemia compared with males.

LIPID PROFILE AND CLINICAL CHARACTERISTICS OF WOMEN WITH GESTATIONAL DIABETES MELLITUS AND PREECLAMPSIA

Lipid Profile and Clinical Characteristics of Women with Gestational Diabetes Mellitus and Preeclampsia Gestational diabetes mellitus (GDM) is associated with increased risk of pregnancy-induced hypertension and other maternal and foetal complications of pregnancy. The aims of the study were to evaluate the serum lipid profile of women with GDM, and determine the number of women with GDM who have preeclampsia (PE). A retrospective study of 84 women with GDM and 90 pregnant women with normal glucose tolerance (controls) was conducted. Women with GDM had significantly higher parity (p=0.047), total cholesterol (p=0.039) and triglycerides (p=0.033), but non-significantly lower HDL-cholesterol (p=0.086) when compared to controls. Systolic blood pressure was significantly elevated in women with GDM coupled with PE (GDM-PE; p=0.015), the mean birth weight of infants born to women with GDM-PE was significantly lower than that of women with only GDM (p=0.025). Women with GDM-PE had significantly higher triglycerides (p=0.020), had to be more multi-gravida (p=0.047) with significantly elevated VLDL-cholesterol (p=0.037) when compared with women with only GDM. 11.9% of women with GDM had PE. On the basis of these findings, it can be concluded that GDM is associated with hyperlipidaemia as evident by the significantly elevated total cholesterol and triglyceride concentrations. Women with dyslipidaemia and GDM are at risk of developing preeclampsia. It is imperative that blood lipids be evaluated in women with GDM during antenatal care as it would be helpful in the early detection and treatment of PE. Lipidski Profil I Kliničke Karakteristike Žena SA Gestacionim Dijabetes Melitusom I Preeklampsijom Gestacioni dijabetes melitus (GDM) povezan je sa povećanim rizikom od hipertenzije izazvane trudnoćom i drugih komplikacija trudnoće kod majke i fetusa. Ciljevi studije bili su da se odredi lipidski profil žena sa GDM, i utvrdi broj žena sa GDM koje imaju PE. Sprovedena je retrospektivna studija 84 žene sa GDM i 90 trudnica sa normalnom tolerancijom glukoze (kontrola). Žene sa GDM imale su značajno povišen paritet (p=0,047), ukupni holesterol (p=0,039) i trigliceride (p=0,033), ali i neznačajno niži HDL-holesterol (p=0,086) u poređenju sa kontrolom. Sistolni krvni pritisak bio je značajno povišen kod žena sa GDM u kombinaciji sa PE (GDM-PE; p=0,015), a prosečna težina novorođenčadi koju su rodile žene sa GDM-PE bila je značajno niža nego kod žena sa GDM (p=0,025). Žene sa GDM-PE imale su značajno povišene trigliceride (p=0,020), i sklonije su većem broju trudnoća (p=0,047) uz značajno povišen VLDL-holesterol (p=0,037), u poređenju sa ženama samo sa GDM. 11,9% žena sa GDM imalo je PE. Na osnovu tih nalaza može se zaključiti da je GDM povezan sa hiperlipidemijom, što se vidi iz značajno povišenih ukupnih koncentracija holesterola i triglicerida. Kod žena sa dislipidemijom i GDM postoji rizik od razvoja preeklampsije. Veoma je važno određivati lipide u krvi žena sa GDM u okviru prenatalne zaštite jer to pomaže ranom otkrivanju i lečenju PE.

The Use of Soluble Transferrin Receptor in the Detection of rHuEPO Abuse in Sports

Erythropoietin (EPO) increases the number of circulating erythrocytes and muscle oxygenation. The recombinant forms of EPO have indiscriminately been used by athletes, mainly in endurance sports to increase their erythrocytes concentration, thus generating a better delivery of oxygen to the muscle tissue. The administration of recombinant human erythropoietin (rHuEPO) except for therapeutic use was prohibited by the International Olympic Committee (IOC) and its unauthorized use considered as doping. In the last few years, a number of studies using parameters indicative of accelerated erythropoiesis have investigated a number of indirect methods for the detection of rHuEPO abuse. No single indirect marker has been found that can satisfactorily demonstrated rHuEPO misuse. Soluble transferrin receptor (sTfR) is a new marker of iron status and erythropoietic activity. It has been included in multivariable blood testing models for the detection of performance enhancing EPO abuse in sports. Indirect markers of altered erythropoiesis give reliable evidence of current or discontinued rHuEPO usage. This review describes the physical, biological and pharmacokinetic properties of endogenous EPO and its recombinant form. It also discusses the available strategies for the detection of rHuEPO abuse in sports, involving the use of sTfR concentration directly or in mathematical multivariate models.