Zahid Hassan

SPINK1 Is a Susceptibility Gene for Fibrocalculous Pancreatic Diabetes in Subjects from the Indian Subcontinent

Fibrocalculous pancreatic diabetes (FCPD) is a secondary cause of diabetes due to chronic pancreatitis. Since the N34S variant of the SPINK1 trypsin inhibitor gene has been found to partially account for genetic susceptibility to chronic pancreatitis, we used a family-based and case-control approach in two separate ethnic groups from the Indian subcontinent, to determine whether N34S was associated with susceptibility to FCPD. Clear excess transmission of SPINK1 N34S to the probands with FCPD in 69 Bangladeshi families was observed (P<.0001; 20 transmissions and 2 nontransmissions). In the total study group (Bangladeshi and southern Indian) the N34S variant was present in 33% of 180 subjects with FCPD, 4.4% of 861 nondiabetic subjects (odds ratio 10.8; P<.0001 compared with FCPD), 3.7% of 219 subjects with type 2 diabetes, and 10.6% of 354 subjects with early-onset diabetes (aged <30 years) (P=.02 compared with the ethnically matched control group). These results suggest that the N34S variant of SPINK1 is a susceptibility gene for FCPD in the Indian subcontinent, although, by itself, it is not sufficient to cause disease.

Pancreatitis in fibrocalculous pancreatic diabetes mellitus is not associated with common mutations in the trypsinogen gene

A distinct type of pancreatitis associated with diabetes, termed fibrocalculous pancreatic diabetes (FCPD), has been reported in tropical developing countries including Bangladesh. The molecular basis for autosomal dominant hereditary pancreatitis (HP) has recently been attributed to mutations in exons 2 and 3 of the trypsinogen gene. We have investigated the hypothesis that mutations in the aforementioned exons of this gene might also predispose to FCPD.

Anthropometric indices of obesity and type 2 diabetes in Bangladeshi population: Chandra Rural Diabetes Study (CRDS)

BACKGROUND Obesity is a risk factor for type 2 diabetes (DM); however, no study has specially assessed the anthropometric indices as predictors of diabetes in rural Bangladeshi population. OBJECTIVE To identify markers for diabetes through body mass index (BMI), waist circumference (WC), waist hip ratio (WHR) and waist height ratio (WHtR) and identify the optimal cut-off values suitable for Bangladeshi adult population. METHODS A total of 2293 subjects aged ≥20 years from rural Bangladesh were randomly recruited to participate in a population-based, cross sectional survey. Age adjusted data for anthropometric indices and diabetes risk were assessed and their relationships were examined. RESULTS Age adjusted prevalence of DM in men and women were 9.5% and 7.0%, respectively. Both men and women with DM had a higher rate of general obesity (defined by BMI) and central obesity (defined by WC, WHR and WHtR) than non-diabetic subjects. In both men and women the most sensitive indice was WHR for predicting DM. The appropriate cut-offs values for WHR to predict DM in men and women were 0.93 and 0.87, respectively. WC of 82 cm for both sexes was appropriate to predict DM. Those of BMI and WHtR were 21.2 kg/m2, 21.8 kg/m2 and 0.53, 0.54 in men and women, respectively. CONCLUSIONS Compared with BMI, measures of central obesity, WHR, WC, WHtR showed a better association with the risk of DM for both sexes in rural Bangladeshi population. Follow-up studies are needed for validifying these cut-offs values.

Gender differences in serum leptin concentrations from umbilical cord blood of newborn infants born to nondiabetic, gestational diabetic and type-2 diabetic mothers.

To investigate gender differences, if any, in leptin concentrations from umbilical cord blood of new born infants of mothers with type 2 diabetes mellitus (DM), gestational diabetes mellitus (GDM), and Non diabetic (ND) at delivery. Serum leptin concentrations were measured in 105 newborns (53 males and 52 females in the three groups). Blood was taken from the umbilical cord of the babies at delivery. Maternal anthropometric measurements were recorded within 48 hours after delivery. Pearson correlation coefficient was used to explore the relationship between serum leptin concentrations and anthropometric measures of the fetus and their mother. Both Serum leptin level and serum C-peptide was measured by chemiluminescence based ELISA. The median range of leptin concentration in cord blood was ND group: Male [13.91 (3.22 – 47.63)], Female [16.88 (2 – 43.65)]; GDM group: Male [32 (7 – 76.00)], Female [36.73 (4.80 – 81.20)]; DM group: Male [20.90 (2 –76.00)], Female [32 {2.58 – 80.67)]. Cord serum leptin levels correlated with birth weight(r=0.587, p=0.0001), ponderal index (PI) (r=.319, p=0.024)of the babies and body mass index (BMI) (r=−0.299, p=0.035) of their mothers but did not correlate with gestational age, cord serum C-peptide concentration or placental weight at delivery. Leptin concentrations were higher in the female fetus in comparison to the male fetus. Birth weight of the female fetuses were also higher than that of male fetus. We found that there are very strong associations between cord leptin concentrations at delivery and birth weight, ponderal index of the baby, body mass index of the mothers with Type 2 DM. We also found that high leptin levels could represent an important feedback modulator of substrate supply and subsequently for adipose tissue status during late gestation or adipose tissue is the major determinant of circulating leptin levels.

Serum glucose and insulin response to mango and papaya in type 2 diabetic subjects

Abstract To rank Bangladeshi Mango and Papaya in terms of their Glycemic Index (GI) and Insulinemic Index (II), which are useful measures of glucose and insulin responses to a dietary component, thirteen type 2 diabetic subjects consumed, under a cross-over design, equi-carbohydrate amounts of mango (250 g), papaya (602 g) and white bread (the reference food, 63 g). Blood sample was drawn 5 times between 0h and 3h. Serum C-peptide was measured to evaluate Insulinemic status. Mango and Papaya showed higher serum glucose responses compared to that of bread. The similar glycemic responses of Papaya and Mango were reflected in their GI values. Papaya showed higher insulin response compared to both Mango and Bread ( p