Olusegun A. Mojiminiyi

Comparative analysis of the effects of hubble‐bubble (Sheesha) and cigarette smoking on respiratory and metabolic parameters in hubble‐bubble and cigarette smokers

Objectives and background:  Hazard of smoking tobacco is believed to be minimized by smoking hubble‐bubble (HB) instead of cigarettes. Our aims were to (i) develop an assay for estimating nicotine and cotinine; and (ii) evaluate the effect of smoking on respiratory and metabolic parameters in cigarette and HB smokers.

Association of C-reactive protein with coronary heart disease risk factors in patients with type 2 diabetes mellitus

The assessment of markers of systemic inflammation, such as C-reactive protein (CRP) and interleukin 6 (IL6), could be used to identify persons at high risk of coronary heart disease (CHD). This study evaluates the relationship of CRP and IL6 with CHD risk factors in patients with type 2 diabetes mellitus (DM) with CHD and age and sex matched type 2 DM controls without CHD. CRP, IL-6, total plasma homocysteine (tHcy), lipoprotein (a) [Lp(a)] and sialic acid (SA) were determined in 55 type 2 diabetic patients with CHD and 51 age- and sex-matched type 2 diabetic controls without CHD. Multivariate and logistic regression analyses were used to relate these markers with CHD risk factors. CRP (P=0.02) and tHcy (P=0.03) were significantly higher in patients with CHD compared with the control group even after correction for age and sex. IL6, Lp(a), SA and lipid parameters were not significantly different between the two groups of patients. After adjustment for potential confounders, the odds ratio (OR) for elevated CRP was 2.00 (95% confidence interval [CI], 1.12-3.58) (P=0.02) but the OR for IL6 was 3.41 95% CI, 0.70-17.17 (P=0.14). Partial correlation analyses of CRP and IL6 with other variables showed significant correlation of CRP with tHcy, and SA in patients with CHD only. Our results support the inclusion of CRP (high-sensitivity assay), in the risk assessment of diabetic subjects.

Plasma leptin concentration in patients with Type 2 diabetes: relationship to cardiovascular disease risk factors and insulin resistance

Aims  The aim of this study was to evaluate the relationship of obesity, leptin, insulin resistance and C‐reactive protein (CRP) with coronary heart disease (CHD) risk factors in patients with Type 2 diabetes mellitus (DM) with CHD compared with those with Type 2 DM without CHD.

Evaluation of cystatin C and β-2 microglobulin as markers of renal function in patients with type 2 diabetes mellitus

BACKGROUND Despite recent studies showing that serum cystatin C (CC) is a better marker for GFR than the ubiquitously used serum creatinine, its clinical utility remains under evaluation. METHODS To evaluate their usefulness in patients with type 2 diabetes mellitus (DM), serum concentrations of CC, beta-2 microglobulin (B2M) and creatinine were measured in 105 (38 males, 67 females) Kuwaiti patients with type 2 DM. The results were compared with creatinine clearance (Ccr), which was measured (mCcr) and estimated (eCcr) with the Cockroft-Gault formula, and correlated with 24-h urine protein and early morning urine albumin/creatinine excretion ratio. RESULTS In patients with eCcr and mCcr results (n=51), eCcr and mCcr showed significant correlation with each other (rs=.86, P<.0001) with no significant difference between the two. In all patients (n=105), CC and B2M showed significant correlation with each other (rs=.82, P<.0001) and with serum creatinine concentration (rs=.77 and.84, respectively, P<.0001). Serum CC, B2M and creatinine showed significant (P<.001) inverse correlation with eCcr (rs=-.63, -.61 and -.76, respectively). Partial correlations after correcting for age and sex improved the correlation of serum creatinine with eCcr (r=-.81, P<.0001), but there was no significant change in the correlations of CC and B2M with eCcr (r=-.65, P<.0001 and r=-.62, P<.0001, respectively). Receiver operating characteristic (ROC) plots for serum CC, B2M and creatinine for detection of changes in the eCcr showed that the area under the ROC curve+/-S.E. is 0.897+/-0.119 for CC, 0.871+/-0.091 for B2M and 0.785+/-0.087 for serum creatinine. There was no statistically significant difference between the areas under the curve (AUC) for serum creatinine and CC (P=.07) and B2M (P=.12). CC had the highest sensitivity for detection of eCcr (<60 ml/min/1.73 m(2)) at routinely used cutoff values. CC was also the best discriminator when patients with normoalbuminuria were compared with patients with microalbuminuria. CONCLUSION Although there is no significant difference in the overall diagnostic accuracies of CC, B2M and creatinine for the detection of changes in the GFR, CC is the most sensitive marker at routinely used cutoff values and would be more clinically useful than B2M or serum creatinine in diabetic patients.

Allopurinol provides long-term protection for experimentally induced testicular torsion in a rabbit model

To assess the effect of five antioxidants on exocrine function of rabbit testes retained in situ for 24 h and 3 months after experimental torsion.

Relation of serum total sialic acid concentrations with diabetic complications and cardiovascular risk factors in Kuwaiti Type 2 diabetic patients

Serum total sialic acid is a marker of the acute phase response. Elevated levels have also been associated with cardiovascular disease in the general Caucasian population and especially in Type 2 diabetic subjects. The purpose of this study was to estimate serum total sialic acid concentrations among Kuwaiti Type 2 diabetic subjects and to investigate its association with macro and microvascular diabetes-related complications in that population. Serum total sialic acid levels were estimated by an enzymatic spectro-photometric assay in two groups of subjects: (i) 358 Kuwaiti Type 2 diabetics (156 men and 202 women) referred for their annual evaluation to the specialised diabetic clinic at the main university teaching hospital in Kuwait, and (ii) 47 healthy age and sex matched non-diabetic Kuwaiti control population (13 men and 34 women). Serum sialic acid levels were significantly higher (P<0.001) among the diabetic patients (mean+/-S.D.) (81.2+/-13.2 mg/dl) compared to the non-diabetic controls (66.9+/-11.0 mg/dl). Kuwaiti diabetic women had significantly higher concentrations compared to diabetic men (85.2+/-12.1 vs. 75.9+/-13.0 mg/dl, P<0.001). Among the controls there was no significant gender difference in sialic acid levels of women, (68.3+/-11.6 mg/dl) versus men (63.2+/-8.2 mg/dl). The gender difference in the diabetic patients was unrelated to the degree of obesity. Significant correlations were found between serum total sialic acid concentrations and such cardiovascular risk factors as plasma levels of apolipoprotein B, low density lipoprotein cholesterol, triglycerides and uric acid in the diabetic subjects. Furthermore, there was a significant elevation in serum total sialic acid concentrations with increasing urinary albumin excretion, P<0.001, but not with retinopathy or neuropathy.

Homocysteine and endogenous markers of renal function in type 2 diabetic patients without coronary heart disease.

The aim of this study was to assess parameters of renal function and other determinants of plasma homocysteine in type 2 diabetic patients without coronary heart disease (CHD). Fasting plasma homocysteine, serum cystatin C and serum creatinine were determined in 183 (75 men, 108 women) Type 2 diabetic patients without clinical evidence of CHD. Creatinine clearance was calculated and parameters such as blood pressure, body mass index (BMI), and glycated haemoglobin (HbA(1c)) were assessed. The urine albumin:creatinine ratio was used to classify patients as normo-, micro- or macroalbuminuric. One hundred and ten patients were normoalbuminuric, 67 patients were microalbuminuric and six patients were macroalbuminuric. There was no statistically significant difference in plasma homocysteine concentration between patients with normoalbuminuria and microalbuminuria. There was a trend towards increasing plasma homocysteine with decreasing glomerular filtration rate (GFR) (r=-0.46; P<0.0001). There was statistically significant correlation between plasma homocysteine and age (r=0.37), serum cystatin C (r=0.47), and serum creatinine (r=0.56). Plasma homocysteine concentration was significantly higher in patients with BMI<30 kg/m(2) and showed significant inverse correlation with weight (r=-0.16; P=0.03) and body mass index (r=-0.24; P=0.001). Homocysteine and serum creatinine were significantly higher in males than females and higher in smokers than non smokers but was not associated with glycemic control and duration of diabetes. In conclusion, elevated homocysteine concentration in patients with type 2 DM without CHD is related to age, gender, smoking, BMI and GFR. Follow up studies will provide further information on the association between hyperhomocysteinemia and the development of cardiovascular disease.

Determinants of glycated LDL levels in nondiabetic and diabetic hyperlipidaemic patients in Kuwait

BACKGROUND Glycation and oxidative modification of lipoproteins enhance the uptake of these lipids by macrophages in the early stages of atherogenesis. Measurement of blood levels of modified LDL particles could thus constitute another useful modality in identifying subjects at high risk of coronary atherosclerosis (CHD). OBJECTIVE To measure the glycated LDL level and assess its associations with other metabolic parameters in diabetic and nondiabetic hyperlipidaemic subjects attending a Lipid Clinic in Kuwait. SUBJECTS AND METHODS One hundred thirty-three hyperlipidaemic (HL) (72 nondiabetic (ND); 61 diabetic (D)) patients and 42 healthy control (HC) subjects had their fasting serum samples analyzed for glucose, total cholesterol (TC), triglycerides (TG), urate, HDL, LDL (by routine autoanalyzer methods), apolipoproteins A1 and B (by nephelometry), fructosamine (by spectrophotometry) and glycated LDL (gLDL) by ELISA. RESULTS The serum gLDL level was significantly higher in HL [D+ND] than in HC (p<0.001). Within the HL group, the DHL patients had higher levels than the NDHL [p<0.001]. These differences were maintained when the gLDL level was also expressed as a percentage of the apo B concentration. The gLDL level correlated positively (p<0.01) with those of glucose, TC, TG and LDL and negatively with HDL (p<0.05) in all the subjects as a whole, healthy and hyperlipidaemia [HC+HL]. In the HL (D+ND) group as a whole, gLDL correlated significantly only with glucose [p<0.01]. In group DHL, however, gLDL correlated significantly with glucose, fructosamine and LDL [all p<0.05]. As expected, fructosamine levels were highest in the DHL group. The significant correlations established between fructosamine and the different analytes measured in the different subject groups were essentially similar to those observed for gLDL, except for the finding of persistent significant negative correlations of fructosamine with LDL in all the subject groups. CONCLUSIONS (i) Serum gLDL levels are increased in hyperlipidaemic patients and are further increased with diabetes, suggesting that the significant glycation of LDL occurs in all hyperlipidaemic patients irrespective of their glycaemic status. (ii) The significant correlation of gLDL with glucose and fructosamine in diabetic patients would suggest its potential utility as another index of medium term glycaemic control. (iii) gLDL is easily measurable and its values could provide additional information in ascertaining an individuals aggregate CHD risk.

Effect of homeostasis model assessment computational method on the definition and associations of insulin resistance.

Abstract Background: Homeostasis model assessment (HOMA) is a surrogate index widely used to study the role of insulin sensitivity or resistance in associated disease states. However, reported values for the definition of insulin resistance (the top 25% of the distribution in non-diabetic subjects) vary widely. This study evaluates the effect of HOMA computational methods [original HOMA model formula (HOMA1) and online calculator computer model (HOMA2)] on the associations and cut-off limits for insulin resistance. Methods: Anthropometric measurements, fasting adiponectin, leptin, leptin receptor, insulin, glucose, high-sensitivity C-reactive protein and a lipid profile were measured in type 2 diabetic patients (n=226) and their normoglycemic first degree relatives (n=319). HOMA1 and HOMA2 were used to estimate insulin resistance, β-cell function and insulin sensitivity. Subjects were classified as metabolic syndrome positive or negative (International Diabetes Federation criteria). Bland-Altmann analysis was used to evaluate agreement between the computational methods. Univariate and multivariate logistic regression analyses were used to relate the HOMA computational methods with metabolic variables and metabolic syndrome status. Results: The two computational methods had different cut-offs for the definition of insulin resistance: HOMA1 formula ≥2.5; HOMA2 calculator ≥1.4. Correlations of the two HOMA computational methods with anthropometric and metabolic variables showed some degree of variation. The odds ratios of the associations with the metabolic syndrome for the HOMA1 formula and HOMA2 calculator computational methods were 2.04 and 1.43, respectively. Receiver operating characteristic analysis for diagnosis of the metabolic syndrome showed that areas under the receiver operating characteristic curves for the HOMA1 formula and HOMA2 calculator computational methods were 0.741 and 0.680, respectively. Conclusions: The HOMA computational method is a significant determinant of the associations and classification of insulin resistance. Clin Chem Lab Med 2010;48:1629–34.

Age-specific reference levels of serum prostate-specific antigen and prostate volume in healthy Arab men

To determine age‐specific reference ranges for serum prostate‐specific antigen (PSA) concentration and prostate volumes in a population of healthy Arab men.