Gamma glutamyl transferases in association with cardiovascular risk scores in non-diabetic hypertensive Cameroonians: preliminary data from HYRICCA study.

OBJECTIVE: The usefulness of gamma glutamyl transferase (GGT) as biomarker of cardiovascular risk (CVR) remains unexplored in sub-Saharan Africans. To evaluate their relevance on CVR assessment in non-diabetic hypertensive Cameroonians. This was a prospective cross-sectional study on non-diabetic hypertensive adults aged 57.7 ± 10 years (62% female), without evidence of acute or chronic liver disease, in which we assessed GGT levels and correlates it with validated CVR biomarkers, CVR scores (WHO risk score, Framingham 2008, ASCVD 2013, EuroSCORE 2003, and Reynolds score), and plasma atherogenic index (PAI). RESULTS: We found a positive but weak association between GGT and PAI on linear regression [0.004 (0.001; 0.007); p = 0.021], which was dependent of triglycerides levels (r = 0.17; p = 0.03). We did not find a significant association between GGT levels and the results of the CVR scores studied; Although being related to atherogenic risk, as reported in literature in non-sub-Saharan Africans, GGTs would be of little value for CVR assessment in our population.

Procalcitonin levels in children affected by severe malaria compared to those with uncomplicated malaria in the absence of bacterial infection: a cross-sectional study.

BACKGROUND: Procalcitonin is an inflammatory marker strongly associated with the presence of bacterial infection. It has been considered raised in severe malaria infection as opposed to uncomplicated malaria. There are suggestions that it may be raised only when there is concomitant unnoticeable bacterial infection during a malaria crisis. We aimed to assess the difference in plasma procalcitonin levels between children affected by severe and uncomplicated malaria. METHODS: We assessed plasma procalcitonin levels in 83 children diagnosed with malaria with no clinical and biological evidence of concomitant bacterial infection. Severity of malaria was established using WHO guidelines. Procalcitonin was determined using the ELISA method. Non-parametric Mann-Whitney U test was used to compare medians across the 2 groups. Statistical significance was set for all p values < 0.05. RESULTS: Of the 83 participants, 28 had uncomplicated malaria, and 55 had severe malaria. PCT levels were obtained in 24 and 40 subjects of each group, respectively, and were similar in both groups; [2.76 (2.52-2.93) vs 2.74 (2.52-2.98) ng/ml, p = 0.916]. The parasite density was lower in the uncomplicated malaria group than in the severe malaria group, but not statistically significant; [22,192 (9110-44 654) vs 31 684 (13 960-73 500) parasites/µl, p = 0.178]. There was no correlation between the parasite density in the general study population and PCT levels (r = 0.072, p = 0.572). CONCLUSION: In the absence of overt bacterial infection, procalcitonin levels are not different between children affected with uncomplicated malaria and those with severe malaria. Therefore, bacterial infection should be thoroughly checked for in children with raised serum procalcitonin diagnosed with severe malaria.

Relationship between periodontal diseases and newly-diagnosed metabolic syndrome components in a sub-Saharan population: a cross sectional study.

BACKGROUND: Oral health is a frequently ignored aspect of global health in sub-Saharan patients. Periodontitis, a very frequent oral disease has been proven to be associated to development of the metabolic syndrome. This study aims to evaluate the relationship between periodontal disease and metabolic syndrome components in a sub-Saharan population. METHODS: We performed a cross sectional study in 3 Yaounde hospitals. Consenting adults aged 21 years and above were recruited. Participants who presented with a tooth loss of at least 50% or any condition which could alter values of biological and periodontal parameters (tobacco smoking, pregnancy, chronic kidney disease, cancer) were excluded. Metabolic syndrome elements (glycaemia, arterial pressure, HDL cholesterol, abdominal circumference, triglycerides) and periodontal variables were recorded (plaque and gingival index of Silness and Loe, periodontal pocket depth and clinical attachment loss). These variables were compared using Fisher's exact Test and odds ratio calculated with 95% confidence intervals. RESULTS: The prevalence of periodontitis and metabolic syndrome were 43.4% and 10.8% respectively. Age (37.75 ± 13.25, P < 0.001) and poor accessory brushing methods were associated risk factors for development of periodontal disease. Sub-Saharan sindividuals with periodontitis had increased odds of having obesity (OR 11.1 [95% CI 3.97-31.03], P < 0.001) and low HDL (OR 4.58 [95% CI 1.79-11.70], P = 0.001) CONCLUSION: Our findings suggest an association between periodontal disease and metabolic syndrome in Sub-Saharan subjects. Increasing age and poor accessory brushing methods are associated risk indicators.

Atherogenic index of plasma and risk of cardiovascular disease among Cameroonian postmenopausal women.

BACKGROUND: The paucity of data regarding the relationship between atherogenic index of plasma (AIP) and risk of cardiovascular disease (CVD) in postmenopausal women living in sub-Saharan Africa prompted us to conduct this study which aimed at assessing the interplay between AIP and risk of CVD among Cameroonian postmenopausal women. METHODS: This was a cross-sectional study conducted among 108 postmenopausal women in Yaoundé, Cameroon. Risk of CVD was calculated using the Framingham risk score, (FRS), and the AIP was derived as log (triglycerides/high-density lipoproteins cholesterol). RESULTS: Mean age of participants equaled 56.4 ± 6.9 years. AIP values ranged from -0.40 to 0.85 with a mean of 0.21 ± 0.27. There was a positive and significant correlation between AIP and body mass index (r = 0.234; p = 0.015), systolic blood pressure (r = 0.350; p < 0.001), diastolic blood pressure (r = 0.365; p < 0.001), fasting plasma glucose (r = 0.314; p = 0.001), uric acid (r = 0.374; p < 0.001), and total cholesterol (r = 0.374; p < 0.001), but not with age (r = -0.104; p = 0.284). The FRS varied between 1.2 % and >30 % with a mean of 13.4 ± 8.7 %. In univariable model, AIP significantly influenced the risk of CVD (ß = 11.94; p < 0.001; R(2) = 0.136). But in the multivariable model, after adjusting for confounders, AIP did not impact the risk of CVD anymore (adjusted ß = 1.98; p = 0.487; R(2) = 0.486). CONCLUSION: AIP may not be an independent factor impacting the risk of CVD among Cameroonian postmenopausal women. More studies are needed to better elucidate the interaction between AIP and risk of CVD in our setting.

Afrostyrax lepidophyllus extracts exhibit in vitro free radical scavenging, antioxidant potential and protective properties against liver enzymes ion mediated oxidative damage.

BACKGROUND: Several studies described the phytochemical constituents of plants in relation with the free radical scavenging property and inhibition of lipid peroxidation. This study investigated the in vitro antioxidant property, and the protective effects of ethanolic and aqueous ethanol extract of the leaves and barks of Afrostyrax lepidophyllus (Huaceae) against ion mediated oxidative damages. METHODS: Four extracts (ethanol and aqueous-ethanol) from the leaves and barks of A. lepidophyllus were used in this study. The total phenols content, the antiradical and antioxidant properties were determined using standard colorimetric methods. RESULTS: The plant extracts had a significant scavenging potential on the 2,2-diphenyl-1-picrylhydrazyl (DPPH), hydroxyl (OH), nitrite oxide (NO) and 2,2-azinobis (3-ethylbenzthiazoline)-6-sulfonic acid (ABTS) radicals with the IC50 varied between 47 and 200 µg/mL depending on the part of plant and the type of extract. The ethanol extract of A. lepidophyllus bark (GEE) showed the highest polyphenolic (35.33 ± 0.29) and flavonoid (12.00 ± 0.14) content. All the tested extracts demonstrated a high protective potential with the increased of superoxide dismutase, catalase and peroxidase activities. CONCLUSION: Afrostyrax lepidophyllus extracts exhibited higher antioxidant potential and significant protective potential on liver enzymes.

Hyperlactatemia in a group of HIV patients living in Yaounde-Cameroon.

BACKGROUND AND AIM: Prolonged exposure to highly active antiretroviral therapy (HAART) is associated with adverse effects such as hyperlactatemia. We determined the prevalence and risk factors for developing hyperlactatemia among human immunodeficiency virus (HIV)-infected cameroonians on antiretroviral therapy (ART). METHODS: We conducted a cross-sectional study from January to April 2012 involving 91 HIV-infected patients receiving ART for at least 12 months and 30 HIV-infected patients who have never received ART (ART-naïve patients). Plasma lactate levels were determined after at least 12 hours of overnight fasting and hyperlactatemia defined as lactate concentrations ≥ 3 mmol/L. The prevalence of hyperlactatemia was determined and the risk factors were analyzed by a multivariate logistic regression model. RESULTS: The mean lactataemia was significantly higher in the group of HIV patients currently taking ART than in the ART-naïve one (2.3 ± 1.3 and 1.7 ± 0.7 mmol/L respectively, p = 0.002). Patients on first line ART regimens had significantly higher lactatemia than those on second line regimens (2.5 ± 1.5 and 1.9 ± 0.7 mmol/L respectively, p = 0.014). The prevalence of hyperlactatemia in HIV patients receiving ART and in ART-naïve HIV patients was respectively 18.7 and 6.7% (p = 0.095). ART-exposure (adjusted odds ratio (aOR) 5.44, 95% confidence interval (CI) 1.06 - 27.84; p = 0.042) and being on a first line regimen (aOR 16.22, 95% CI 1.57 - 167.91; p = 0.019) were independent strong predictors of hyperlactatemia. CONCLUSION: Hyperlactatemia was not rare in our study population. Being on a first line regimen constitutes an important risk factor for developing hyperlactatemia. Measurement of plasma lactate may be useful in optimizing the management of HIV-positive persons on ART.

Syzyguim guineense Extracts Show Antioxidant Activities and Beneficial Activities on Oxidative Stress Induced by Ferric Chloride in the Liver Homogenate.

The aim of this study was to determine the in vitro antioxidant activity, free radical scavenging property and the beneficial effects of extracts of various parts of Syzygium guineense in reducing oxidative stress damage in the liver. The effects of extracts on free radicals were determined on radicals DPPH, ABTS, NO and OH followed by the antioxidant properties using Ferric Reducing Antioxidant Power assay (FRAP) and hosphomolybdenum (PPMB). The phytochemical screening of these extracts was performed by determination of the phenolic content. The oxidative damage inhibition in the liver was determined by measuring malondialdehyde (MDA) as well as the activity of the antioxidant enzymes superoxide dismutase (SOD), catalase (CAT) and peroxidase. Overall, the bark extract of the ethanol/water or methanol showed the highest radical scavenging activities against DPPH, ABTS and OH radicals compared to the other extracts. This extract also contained the highest phenolic content implying the potential contribution of phenolic compounds towards the antioxidant activities. However, the methanol extract of the root demonstrated the highest protective effects of SOD and CAT against ferric chloride while the hydro-ethanol extract of the leaves exhibited the highest inhibitory effects on lipid peroxidation. These findings suggest that antioxidant properties of S. guineense extracts could be attributed to phenolic compounds revealed by phytochemical studies. Thus, the present results indicate clearly that the extracts of S. guineense possess antioxidant properties and could serve as free radical inhibitors or scavengers, acting possibly as primary antioxidants. The antioxidant properties of the bark extract may thus sustain its various biological activities.

Phenolic Content of Hypodaphnis Zenkeri and Its Antioxidant Effects against Fenton Reactions' Mediated Oxidative Injuries on Liver Homogenate.

Under oxidative stress conditions, endogenous antioxidant defenses are unable to completely inactivate the free radicals generated by an excessive production of reactive oxygen species (ROS). This state causes serious cell damage leading to a variety of human diseases. Natural antioxidants can protect cells against oxidative stress. Hypaodaphnis zenkeri (H. zenkiri) is a plant consumed as a spice in the Cameroonian diet, and its bark has been used in traditional medicine for the treatment of several diseases. The present study aims at investigating the antioxidant activity, which includes free radical scavenging and protective properties of an extract from H. Zenkiri against oxidative damage on a liver homogenate. The free radical assays determined the scavenging activities of 2,2-diphenyl-1-picrylhydrazyl (DPPH), hydroxyl (OH), nitrite oxide (NO) and 2,2-azinobis(3-ethylbenzthiazoline)-6-sulfonic acid (ABTS) radicals and the enzymes, whose protection was to be considered in the liver homogenate, including superoxide dismutase, catalase, and peroxidase. The antioxidative activities were studied using the ferric reducing antioxidant power (FRAP), reductive activity, and phosphomolybdenum antioxidant power (PAP) methods. In addition, the phenolic contents of the extracts were examined. The results showed that these extracts demonstrated significant scavenging properties and antioxidant activities, with the hydro-ethanolic extract of the bark of H. zenkeri (EEH) being the most potent. This extract had the highest total polyphenol (21.77 ± 0.05 mg caffeic acid (CAE)/g dried extract (DE)) and flavonoids (3.34 ± 0.13 mg quercetin (QE)/g dried extract) content. The same extract had significantly greater protective effects on enzyme activities compared to other extracts. The high performance liquied chromatography (HPLC) profile showed higher levels of caffeic acid, OH-tyrosol acid, and rutin in the leaves compared to the bark of H. zenkeri. In conclusion, the ethanolic and hydro-ethanolic extracts of the bark and leaves from H. zenkeri showed an antioxidant and protective potential against oxidative damage.