Prabin Gyawali

Oxidative stress and antioxidant defense in oral lichen planus and oral lichenoid reaction

Abstract Background. Oral Lichen Planus (OLP) is an inflammatory disease of unknown etiology while Oral Lichenoid Reaction (OLR) is a condition mimicking OLP. As these conditions are exposed to oxidative stress, they could release reactive oxygen species (ROS) which are implicated in the pathogenesis of a plethora of inflammatory conditions to lethal diseases. We evaluated and compared the levels of a series of oxidative stress markers in patients with OLP and OLR with that of normal controls and tried to identify the role of these oxidative stress markers in these conditions. Methods. Protein thiol oxidation, malondialdehyde (MDA) and total antioxidant activity were estimated in both the groups (OLP and OLR) and compared with that of normal subjects. Results. There were significantly lower levels of serum protein thiols in OLP (p < 0.005) while in patients with OLR the difference was not statistically significant (p < 0.489) when compared with controls. Serum MDA levels were significantly higher in OLP (p < 0.001) and OLR (p < 0.001) than in controls. However, there was no significant difference in serum MDA levels between OLP and OLR patients (p >0.05), but with a significant difference in serum thiol levels between the two (p < 0.047). Total antioxidant levels were lower in OLP (p < 0.016) and OLR (p < 0.017) when compared to normal subjects, while between the study group total antioxidant levels were not significantly different (p < 0.632). Conclusions. The findings from the present study demonstrate involvement of ROS in the pathogenesis of OLP and OLR, though both these disease conditions have a different clinical course.

Pattern of Thyroid Dysfunction in Patients with Metabolic Syndrome and Its Relationship with Components of Metabolic Syndrome

Background Thyroid dysfunction (TD) and metabolic syndrome (MetS) are known risk factors for atherosclerotic cardiovascular disease (ASCVD). TD is risk factor for ASCVD mediated by the effects of thyroid hormones on lipid metabolism and blood pressure hence the components of MetS. It is possible that coexistence of these two disease entities and unrecognized TD in patients with MetS might substantially increase ASCVD risk. Moreover, little is known about the relationship between TD and the components of MetS. Thus, the purpose of this study was to evaluate the pattern of TD in patients with MetS and its relationship with components of the MetS. Methods A total of 358 previously diagnosed patients with MetS were recruited in the study. The thyroid function test parameters were measured to classify TD at Dhulikhel Hospital-Kathmandu University Hospital, Dhulikhel, Nepal. Statistical analyses were performed using SPSS version 16.0 to evaluate pattern and relationship. Results The overall prevalence of TD in patients with MetS was 31.84% with high prevalence of subclinical hypothyroidism (29.32%). We found no evidence of a relationship between TD and components of MetS, although there was significant difference in waist circumference between four groups of TD. Conclusion Patients with MetS had subclinical hypothyroidism greatly. Although there was no evidence of any relationship between thyroid status and all components of MetS, TD should be taken into account when evaluating and treating patients with MetS to reduce the impending risk.

Assessment of frequency of micronucleated exfoliated buccal cells in relation to oxidative stress in oral lichen planus in coastal Karnataka, India

Objective To assess the frequency of micronucleus in exfoliated buccal mucosa cells of patients with oral lichen planus (OLP) in relation to free radical toxicity since OLP is considered to be a precancerous lesion.

Cross-sectional and longitudinal determinants of serum sex hormone binding globulin (SHBG) in a cohort of community-dwelling men

Despite its widespread clinical use, there is little data available from population-based studies on the determinants of serum sex hormone binding globulin (SHBG). We aimed to examine multifactorial determinants of circulating SHBG levels in community-dwelling men. Study participants comprised randomly selected 35–80 y.o. men (n = 2563) prospectively-followed for 5 years (n = 2038) in the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study. After excluding men with illness or medications known to affect SHBG (n = 172), data from 1786 men were available at baseline, and 1476 at follow-up. The relationship between baseline body composition (DXA), serum glucose, insulin, triglycerides, thyroxine (fT4), sex steroids (total testosterone (TT), oestradiol (E2)), and pro-inflammatory cytokines and serum SHBG level at both baseline & follow-up was determined by linear and penalized logistic regression models adjusting for age, lifestyle & demographic, body composition, metabolic, and hormonal factors. Restricted cubic spline analyses was also conducted to capture possible non-linear relationships. At baseline there were positive cross-sectional associations between age (β = 0.409, p<0.001), TT (β = 0.560, p<0.001), fT4 (β = 0.067, p = 0.019) and SHBG, and negative associations between triglycerides (β = -0.112, p<0.001), abdominal fat mass (β = -0.068, p = 0.032) and E2 (β = -0.058, p = 0.050) and SHBG. In longitudinal analysis the positive determinants of SHBG at 4.9 years were age (β = 0.406, p = <0.001), TT (β = 0.461, p = <0.001), and fT4 (β = 0.040, p = 0.034) and negative determinants were triglycerides (β = -0.065, p = 0.027) and abdominal fat mass (β = -0.078, p = 0.032). Taken together these data suggest low SHBG is a marker of abdominal obesity and increased serum triglycerides, conditions which are known to have been associated with low testosterone and low T4.

PS 11-50 GLYCATED HEMOGLOBIN: PREDICTOR OF DYSLIPIDEMIA AND ATHEROGENICITY IN DIABETES MELLITUS

Background: Cardiovascular disease (CVD) is the major cause of morbidity/mortality in diabetes. Type 2 diabetes has an increased prevalence of lipid abnormalities contributing to their high risk of CVD. Individuals with coexisting diabetes and dyslipidemia are often soft targets for CVD and deaths. A timely intervention to normalize circulating lipids has shown to reduce cardiovascular complications and mortality. Glycosylated hemoglobin (HbA1c) is routinely used as a marker to indicate long-term glycemic control. The atherogenic index of plasma (AIP) [a logarithmic transformation of the ratio of the molar triglyceride (TAG) concentration and high density lipoprotein cholesterol (HDL)], Risk ratio (RR) [Total Cholesterol(TC)/ HDL] & Non HDL-cholesterol (NHC) [TC-HDL] have recently been proposed as a predictive marker for plasma atherogenicity. This study intends to evaluate the diagnostic value of HbA1c in predicting diabetic dyslipidemia and atherogenisity. Methods: A total of 1217 diagnosed type II diabetic patients, who attended Tribhuvan University Teaching Hospital, Kathmandu, Nepal between January 2013 and November 2014 were recruited in the study. Fasting venous blood samples were collected. The whole blood and sera were analyzed for HbA1c, fasting blood glucose (FBG) and lipid profile panel test. Diabetes and dyslipidemia were defined as per American diabetes association criteria and National Cholesterol Education Programme (NCEP) Adult Treatment Panel (ATP) III guidelines respectively. RR, NHC and AIP were calculated. The statistical analysis was done by SPSS statistical package version 17.0. Results: HbA1c showed direct correlation with FPG, Triacylglycerol (TAG) & Low density lipoprotein (LDL) while there was inverse correlation with HDL. Statistically significant ’p’ values (<0.05) were obtained for FPG, TAG and LDL. Closer associations were found between HbA1c and NHC and AIP than lipids alone. Conclusion: These findings indicate that HbA1c can provide valuable supplementary information about cardiac risk besides its primary role in monitoring long-term glycemic control.