Comparative Determination of Mitochondrial Biomarkers and Their Relationship With Insulin Resistance in Type 2 Diabetic Patients: An Observational Cross-Sectional Study.

INTRODUCTION: Data suggest malfunctioning mitochondria reduce oxidation and adenosine triphosphate (ATP) production, disrupting insulin signalling. Cytochrome c (CC), acylcarnitine (AC) and citrate synthase (CS) are essential components of the mitochondria machinery and can be used as reliable biomarkers of mitochondrial dysfunction. This study aimed to determine whether mitochondrial biomarkers (AC, CS and CC) are altered in individuals with type 2 diabetes mellitus (T2DM) and to examine the association between these biomarkers and insulin resistance. METHODOLOGY: A cross-sectional observational study that recruited 170 participants (88 with T2DM and 82 without DM) was conducted. Blood samples were collected from the recruits and analysed for levels of fasting glucose (FBG), AC, CS, CC, insulin, total cholesterol, triglycerides (TG), glycated haemoglobin (HbA1c) and magnesium. Blood pressure (BP) and anthropometric characteristics of participants were also taken. Appropriate formulas were used to determine %body fat, body mass index (BMI), waist-to-hip ratio (WHR), the homeostatic model assessment for insulin resistance (HOMA-IR) and insulin sensitivity (HOMA-ß). RESULTS: Patients with T2DM had higher levels of CC, %body fat, FBG, TG, HbA1c, BMI and HOMA-IR than controls (p < 0.05, respectively). Results showed a significant relationship between circulating CC levels versus HOMA-ß (r = -0.40, p = 0.001), CS (r = -0.70, p = 0.001) and AC (r = -0.72, p = 0.001) levels in patients with T2DM. The adjusted odds increased in the T2DM patients for VLDL (OR = 6.66, p = 0.002), HbA1c (OR = 6.50, p = 0.001), FPG (OR = 3.17, p = 0.001), TG (OR = 2.36, p = 0.010), being female (OR = 2.09, p = 0.020) and CC (OR = 1.14, p = 0.016). CONCLUSION: Overall, alterations in mitochondrial biomarkers, measured by AC, CC and CS, were observed in people with T2DM and showed a direct relationship with insulin resistance. These findings are potentially significant in Africa, although additional confirmation from a larger cohort is necessary.

Levels of anti-insulin antibodies in diabetic retinopathy patients: an observational cross-sectional study.

Aim: This study evaluated the levels of anti-insulin antibodies (AIAs) and the influence of some antidiabetic medications on AIA in diabetes mellitus (DM) patients with retinopathy. Patient & methods: An observational cross-sectional study. Results: A lower titer of AIA IgG was observed in the diabetic retinopathy (DR) and DM-only study categories compared with the control group [DR = 86 (5-560), DM-only = 50 (5-500), versus control = 200 (7-565); p = 0.017]. Taking nifedipine and metformin were negatively correlated (r = -0.32, p = 0.04) with the levels of AIA IgE in the DR group. Conclusion: A decreased titer of circulating AIAs was observed in the DR study category, suggesting that AIA may not contribute to the pathogenesis of DR.

Diabetic retinopathy (DR) is the main reason people lose their sight in countries with few resources. Anti-insulin antibodies, or AIAs, help the body fight off infections and may play a role in the development of DR. The study looked at how much AIA was in DR patients and how some diabetes drugs affected AIA levels. There was a negative link between nifedipine and one AIA (IgE) in people with DR, but a positive link between metformin and another AIA (IgG). AIA levels were lower in the DR study group, which suggests that AIA may not cause DR.

Diagnostic utility of selected faecal biochemical parameters in the determination of acute diarrhoea and associated defecation stooling characteristics in dogs: An observational study.

Diarrhoea, which is a clinical manifestation of various illnesses, is frequently observed in dogs. Regrettably, many dog owners find it difficult to provide comprehensive case histories, primarily because of limited interaction with their canine companions. This study aimed to evaluate the potential of faecal biochemical analytes in detecting and characterizing acute diarrhoea in dogs. Sixty-two domestic dogs were selected using the proportionate stratified sample technique. A structured questionnaire was used to collect demographic and clinical data. Faecal stool specimens from the dogs were obtained using the colon flush technique. The specimens were taken through biochemical analysis to determine urea, creatinine, total bilirubin, total cholesterol, triglycerides, gamma-glutamyl transferase and uric acid levels. Results showed a significant association between the diarrhoea status of the participants and their age, weight, breed, body size, source of last diet, period of inappetence, and other gastrointestinal signs (p < 0.050, respectively). Dogs that had not eaten in at least three days were five times more likely (p < 0.05) to have diarrhoea. Furthermore, miniature breeds were about six times more likely to develop diarrhoea (p < 0.05). Of the seven selected biochemical parameters, total faecal cholesterol was the most predictive index in diagnosing acute diarrhoea in dogs, with a likelihood ratio of 6.5, and it was the most accurate in predicting defecation stooling frequency and texture. In summary, in situations of inadequate case histories, measuring total faecal cholesterol could assist veterinarians in detecting diarrhoea and predicting its faecal stooling texture and frequency in dogs.

Blood C-peptide concentration as a proxy marker of cardiovascular disease: An observational cross-sectional study.

Background and Aims: Cardiovascular diseases (CVDs) are among the leading causes of disability and early death in sub-Saharan Africa. Most of the current blood tests for CVD diagnosis involve performing about three test profiles; often at additional cost to patients. C-peptide, a cleavage product of proinsulin, is a promising marker that has the potential to serve as a proxy marker for diagnosing CVDs in resource-poor settings. Methodology: The study was an observational cross-sectional one and involved 127 consenting persons diagnosed with CVD and 127 individuals without CVD. The socio-demographic and clinical characteristics of participants were obtained. Blood levels of C-peptide, fasting plasma glucose (FPG), total creatinine kinase (CK), creatine kinase myocardial bound (CKMB), lactate dehydrogenase (LDH), propeptide of brain natriuretic peptide (PBNP), Troponin T, lipids, and biomarkers of kidney and liver function were analyzed using ELISA and an automated analyzer. Insulin resistance was computed using the modified homeostatic model assessment (HOMA-IR). Results: The CVD Group had significantly higher levels of C-peptide, CK, CKMB, troponin T, PBNP, FPG, HOMA-IR, and several selected kidney, liver, and lipid parameters compared to the non-CVD Group (p < 0.05 for all). Troponin T recorded a positive correlation (r = 0.34, p < 0.001) with C-peptide among the CVD Group. The sensitivity and specificity of C-peptide in identifying CVD were 96.1% and 91.3% respectively (area under the curve = 0.938, p < 0.001). Conclusion: C-peptide levels were higher in the CVD Group and appeared to be a valuable (high sensitivity and specificity) biomarker in detecting CVD.

Effect of circulating ceramides on adiposity and insulin resistance in patients with type 2 diabetes: An observational cross-sectional study.

INTRODUCTION: Insulin resistance (IR) is one of the common chronic metabolic disorders in Africa and elsewhere. Accumulation of lipids in the body may be due to an imbalance in the metabolism of lipids, glucose and proteins. Ceramides are a sphingolipid class of lipids that are biologically active and vital in the production of more complex lipids. Circulating ceramides are thought to have a role in the development of obesity-related IR, although the precise involvement remains unclear. AIM: To investigate the impact of circulating ceramide on IR and body adiposity in people with and without type 2 diabetes mellitus (T2DM). METHODOLOGY: The study was observational and cross-sectional. There were a total of 84 volunteers with T2DM and 75 nondiabetics (control). The participants' ages, body mass indexes (BMI), waist circumferences, and blood pressure (BP) were among the clinical parameters assessed. Ceramide levels, fasting plasma glucose (FPG), lipids, basal insulin levels and glycated haemoglobin (HbA1c) were also measured. Additionally, the homeostatic model assessment for IR (HOMA-IR) and beta cell function (HOMA-ß) were computed. RESULTS: T2DM and control participants had different mean values for anthropometric parameters, BP, FPG, HbA1c, lipids, insulin, HOMA-IR, HOMA-ß and ceramide levels (p < .05 for all). HOMA-IR, HOMA-ß and cardiovascular risk were significant correlates with ceramide levels in the T2DM group (r = 0.24; -0.34; 0.24, p < .05, respectively). Further, FPG (OR = 1.83, p = .01) and ceramide (OR = 1.05, p = .01) levels were significant predictors of IR in the case group. CONCLUSION: Patients with T2DM exhibited high ceramide concentrations, which, when combined with high FPG, were associated with IR. The consequences of circulating ceramides in health and disease; however, merit further research.

Serum leptin levels in patients with chronic kidney disease and hypertensive heart disease: An observational cross-sectional study.

Background and Aim: Adipocytes secrete a peptide hormone called leptin, which plays a crucial role in controlling appetite and energy expenditure. Alterations in leptin concentrations are associated with CKD-related cardiovascular problems such as hypertensive heart disease (HHD). Despite the link, data on the precise function of leptin in people with CKD and HHD is scant. Methods: An observational cross-sectional study involving a total of 108 participants (72 CKD patients with HHD and 36 healthy controls). Their demographic and anthropometric information was collected using a standardized questionnaire. Certain clinical measures such as blood pressure and body mass index (BMI) were assessed. Fasting blood samples were analyzed for levels of plasma glucose (FPG), lipids, creatinine, and leptin. Data were analyzed with SPSS v23. Results: Leptin, FPG, creatinine and triglyceride levels were all significantly higher in CKD patients with HHD compared to controls (p < 0.01 for all). Furthermore, advanced CKD status (being in stage 5), having a 6-year diagnosis of HHD, being female, having a higher BMI, and elevation in levels of HDL and FPG contributed significantly to the variance in serum leptin levels in the case group (ß = 0.37, 0.22, 0.19, 0.18, 0.27, 0.28; p < 0.05 for all). In the control group, the female gender had the biggest unique effect on circulating leptin levels, followed by BMI and eGFR (ß = 0.71, 0.34, -0.22; p < 0.01 for all). Conclusion: Patients with CKD who also had HHD reported considerably higher circulating leptin levels. Significantly higher blood leptin levels were shown to be associated with CKD stage 5 in the case group. These results are consistent with the role of leptin in the metabolic complexity seen in CKD patients. There needs to be more research into treatments that aim to lower leptin levels in CKD patients with HHD.

NTCP gene polymorphisms and hepatitis B virus infection status in a Ghanaian population.

BACKGROUND: SLC10A1 gene codes NTCP, a receptor through which the hepatitis B virus (HBV) gets access into hepatocytes - a stage of the viral cycle necessary for replication. Polymorphism variants of SLC10A1 play roles in HBV infection, viral clearance, treatment outcome, and complications, in diverse ethnic groups and countries. However, no such study has been conducted in the Ghanaian population, a country with HBV endemicity. Therefore, an exploratory study was conducted to investigate the presence of three (3) single nucleotide polymorphisms (SNPs) in the SLC10A1 gene (rs2296651, rs61745930, and rs4646287) and assessed the risk of HBV infection among the Ghanaian population. METHOD: Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to determine the presence of the SNPs among 292 participants comprising 146 HBV infected persons as case-subjects and 146 HBV non-infected persons as control-subjects. RESULTS: The minor allele frequency (T) of rs2296651 was present in a significantly high proportion of cases compared with the control group (11.6% vs. 3.1%, p < 0.0001). The homozygote recessive variant of rs61745930 was present in 2.7% of the control group and 5.5% of the case group. Moreover, the minor allele frequencies of rs4646287 were 9.3 and 8.2% among the control and the case group, respectively (p = 0.767). Under the dominant (CC) genetic model of inheritance, rs2296651 was found to be protective of HBV infection [OR = 0.18 (0.07-0.44)], whereas under the co-dominant and additive model, rs2296651 was a potential risk factor for HBV infection [OR = 5.2 (95%CI: 2.1-12.8); 3.5 (95%CI: 1.6-7.6], respectively. Variants of rs61745930 and rs4646287 were not associated with HBV infection (p > 0.05). Polymorphisms in SLC10A1, however, did not show any significant association with HBV infectivity (p > 0.05). CONCLUSION: The study highlights some polymorphism proof that variants rs2296651, rs61745930, and rs4646287 exist in HBV-infected individuals in Ghana. Although variant rs2296651 was found to be associated with HBV infection, this association warrants more studies. Polymorphisms in SLC10A1 were not associated with HBV infectivity among the Ghanaian population. Further investigation is warranted to assess the offensive role of the relationship between rs2296651 and HBV infectivity.

Dyslipidaemia is common among patients with type 2 diabetes: a cross-sectional study at Tema Port Clinic.

OBJECTIVE: This study aimed to evaluate dyslipidemia in Ghanaian subjects with type 2 diabetes. RESULTS: Hundred individuals with type 2 diabetes and 61 apparently healthy controls participated. The prevalence of hypercholesterolemia among persons with type 2 diabetes was 53%. Blood pressure, fasting blood glucose (FBG), triglyceride (TG), low-density lipoproteins (LDL) and alanine transaminase (ALT) levels were higher in persons with type 2 diabetes compared with the control group (p < 0.01). Positive correlations were found within persons with type 2 diabetes for triglyceride vs FBG; ALT vs age and aspartate transaminase (AST) vs TG (p < 0.05 respectively). This study demonstrated hyperlipidemia and poor liver health in persons with type 2 diabetes.

Haptoglobin phenotypes with weak antioxidant capacity increase risk factors of cardiovascular disease in Ghanaian HIV-infected patients on highly active antiretroviral therapy.

OBJECTIVE: Highly active antiretroviral therapy (HAART) has considerably reduced HIV/AIDS-related morbidity and mortality; however, the therapy has been associated with the development of cardiovascular disease (CVD), and genetic predisposition factors may aggravate disease outcome. This study was aimed at investigating the relationship between haptoglobin phenotypes and risk factors of CVD in HIV patients. METHODS: A total of 105 HIV sero-positive patients on HAART and 75 HIV-infected HAART-naïve individuals were enrolled in the study. Socio-demographics and clinical characteristics of the participants were obtained using a well-structured questionnaire. Lipid profile, lactate dehydrogenase (LDH) and haptoglobin (Hp) phenotypes were analysed from serum whiles haemoglobin (Hb) level, CD4+ cell count and HIV viral RNA load were determined using whole blood. RESULTS: Atherogenic index of plasma (AIP) was significantly higher in patients on HAART than the naïve group (P < 0.05). Age, BMI, visceral fat, systolic blood pressure LDH and lipid variables strongly and positively correlated with AIP (P < 0.05), with the exception of HDL-c (P < 0.001) which showed a negative correlation. HAART was associated with hypertension (χ2  = 4.33, P = 0.037), hypercholesterolaemia (χ2  = 10.99, P < 0.001), elevated LDL-c (χ2 = 10.30, P < 0.001) and decreased HDL-c (χ2  = 3.87, P = 0.09). Hp2-2 and Hp0 collectively was strongly associated with hypertension (OR = 2.54, P = 0.011), obesity (OR = 5.97, P < 0.001) and hypercholesterolaemia (OR = 2.99, P < 0.001). CONCLUSION: HIV/AIDS patients on HAART expressing Hp phenotypes with weak antioxidant capacity have an increased risk of developing CVD.

OBJECTIF: La thérapie antirétrovirale hautement active (HAART) a considérablement réduit la morbidité et la mortalité liées au VIH/SIDA; cependant, le traitement a été associé au développement de maladie cardiovasculaire (MCV) et des facteurs de prédisposition génétique pourraient aggraver l'évolution de la maladie. Cette étude visait à étudier la relation entre les phénotypes de l'haptoglobine et les facteurs de risque de MCV chez les patients VIH. MÉTHODES: Un total de 105 patients VIH positifs sous HAART et 75 personnes infectés par le VIH mais naïfs au HAART ont été recrutés pour l'étude. Les caractéristiques sociodémographiques et cliniques des participants ont été obtenues à l'aide d'un questionnaire bien structuré. Le profil lipidique, les phénotypes de la lactate déshydrogénase (LDH) et de l' haptoglobine (Hp) ont été analysés à partir du sérum tandis que le taux d'hémoglobine (Hb), la numération des cellules CD4+ et la charge d'ARN viral du VIH ont été déterminés en utilisant du sang total. RÉSULTATS: L'indice athérogène du plasma (IAP) était significativement plus élevé chez les patients sous HAART que chez le groupe naïf (p <0,05). Les variables âge, IMC, graisse viscérale, tension artérielle systolique, LDH et lipides étaient fortement et positivement corrélées à l'IAP (p < 0,05), à l'exception du HDL-c (p < 0,001) qui présentait une corrélation négative. L'HAART a été associée à l'hypertension (χ2 = 4,33; p = 0,037), l'hypercholestérolémie (χ2 = 10,99; p <0,001), une LDL-c élevée (χ2 = 10,30; p <0,001) et une diminution de HDL-c (χ2 = 3,87; p = 0,09). Ensemble, Hp2-2 et Hp0 étaient fortement associés à l'hypertension (OR = 2,54; p = 0,011), à l'obésité (OR = 5,97; p <0,001) et à l'hypercholestérolémie (OR = 2,99; p <0,001). CONCLUSION: Les patients VIH/SIDA sous HAART exprimant des phénotypes Hp à faible capacité antioxydante ont un risque accru de développer une maladie cardiovasculaire.

Lower circulating kisspeptin and primary hypogonadism in men with type 2 diabetes.

INTRODUCTION: Kisspeptin influence on male androgens is partially understood. We aimed to evaluate serum concentrations of kisspeptin among Ghanaian men with type 2 diabetes and to identify related factors that may contribute to altering circulating kisspeptin. METHODS: A cross-sectional, observational study. Sixty persons with type 2 diabetes and 60 nondiabetic controls were included in this study. Blood pressure, body mass index (BMI), kisspeptin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (T), glucose (FBG), glycated haemoglobin (HbA1c) and lipid levels were assessed. RESULTS: Type 2 diabetic men had lower kisspeptin and T concentrations than controls (P = 0.001 for both). Levels of LH and FSH were, respectively, higher in diabetic men compared with their control counterparts (P = 0.003; P = 0.017). There were negative associations within the diabetic group for kisspeptin vs age (r = -0.590, P = 0.0001) and kisspeptin vs BMI (r = -0.389, P = 0.002). Positive associations were also found within the diabetic group for kisspeptin vs T (r = 0.531, P = 0.001), kisspeptin vs LH (r = 0.423, P = 0.001) and kisspeptin vs FSH (r = 0.366, P = 0.004). Lower T (OR = 1.473, P = 0.003) and advancing age (OR = 0.890, P = 0.004) contributed to decreased kisspeptin levels among Ghanaian males with type 2 diabetes. CONCLUSION: Our data demonstrate that circulating kisspeptin and T concentrations are lower among men with type 2 diabetes and highlight the importance of considering kisspeptin concentrations in the management of hypogonadism and type 2 diabetes.

Impact of exercise intensity on oxidative stress and selected metabolic markers in young adults in Ghana.

OBJECTIVE: This study aimed to evaluate the effect of different levels of exercise on markers of oxidative stress and selected metabolic parameters in Ghanaian young adults. RESULTS: Significant increases in a marker of oxidative stress malondialdehyde and antioxidants such as superoxide dismutase and uric acid were observed in the exercisers compared with the inactive group (p < 0.05). Total cholesterol and high density lipoprotein levels were significantly different (p < 0.05) between the two groups. Positive associations between exercise intensity, antioxidant concentration and malondialdehyde were observed within the exercise group for vigorous exercise with regards to uric acid, superoxide dismutase and malondialdehyde (r = 0.512, p = 0.004; r = 0.810, p = 0.001; r = 0.715, p = 0.001) respectively and moderate exercise vs malondialdehyde (r = 0.841, p = 0.001) compared to the inactive group. Exercise participants performed more vigorous exercise (p < 0.001), moderate exercise (p < 0.001) and more walking (p < 0.001) compared with the inactive group while the inactive group exhibited more sitting (p < 0.001). The study provides a first report on the risk associated with increase in oxidative stress and the importance of walking as a health promotion intervention among young Ghanaian adults.

Altered immunoglobulins (A and G) in Ghanaian patients with type 2 diabetes.

OBJECTIVES: Elevated immunoglobulin levels have been strongly linked to the development and progression of inflammatory disorders such as type 2 diabetes and obesity. This study aimed to evaluate circulating immunoglobulin levels and to identify other metabolic factors that influence humoral immune response among Ghanaian subjects with type 2 diabetes. METHODS: A comparative cross-sectional study conducted at the National Diabetes Management and Research Center, Accra. Eighty persons with type 2 diabetes were age-matched with 78 controls. Immunoglobulin A, immunoglobulin G and immunoglobulin M; interleukin 6; fasting blood glucose; glycated hemoglobin; and lipid parameter concentrations were measured. Blood pressure, anthropometry and body composition indices were also assessed. RESULTS: Median immunoglobulin A and immunoglobulin G (g/L) levels were higher in the case group compared with controls (0.89 vs 0.74, p = 0.043; 7.58 vs 7.29, p < 0.001). Immunoglobulin G, immunoglobulin A and interleukin 6 levels in the case cohort, respectively, associated weakly with fasting blood glucose (r = 0.252, p = 0.001; r = 0.170, p = 0.031; r = 0.296, p = 0.001). There were positive correlations within the control group for immunoglobulin A versus interleukin 6 (r = 0.366, p = 0.001) and within the case group for glycated hemoglobin versus interleukin 6 (r = 0.190, p = 0.020). CONCLUSION: Our data suggest that humoral immune response is altered in subjects with type 2 diabetes and that serum immunoglobulin levels could serve as useful biomarkers in the investigation and management of diabetes mellitus.

Lipid associated antioxidants: arylesterase and paraoxonase-1 in benign prostatic hyperplasia treatment-naïve patients.

BACKGROUND: Oxidative stress and antioxidants have been implicated in many diseases including prostate cancer and benign prostatic hyperplasia (BPH). Lipid peroxidation contributes to oxidative stress. However, new and emerging antioxidants such as paraoxonase 1 (PON1) and arylesterase (ARE) associated with lipoprotein peroxidation have not been examined in BPH patients. PON1 and ARE, a high-density lipoprotein (HDL) cholesterol-bound enzyme system of antioxidants, protect low-density lipoprotein (LDL) cholesterol and HDL from oxidation by hydrolysis. The study primarily determined paraoxonase (PON1) and ARE activities in BPH treatment-naïve patients. MATERIALS AND METHODS: Sixty newly diagnosed patients (treatment-naïve) alongside 30 apparently healthy controls were recruited. Blood examinations included lipid profile (total cholesterol, triglycerides, LDL, HDL), glutathione peroxidase, PON1, ARE, and prostate specific antigen (PSA).Prostate volume and International Prostate Symptoms Score (IPSS) were determined. RESULTS: PSA was significantly different between patient and control groups (P < 0.0001). Total cholesterol, triglycerides, and LDL were significantly higher in the patient group (P = 0.002, P < 0.001, P = 0.003, respectively). Glutathione peroxidase was very low in the patient group compared to the control group (5.65 ± 2.30 ng/mL and 17.43 ± 10.98 ng/mL, respectively). Although PON1 was higher in the patient group (50.22 ± 19.68/61.30 ± 29.55 ng/mL; P > 0.05), ARE was significantly lower in the patient group (61.31 ± 21.76/49.30 ± 19.82 ng/mL; P = 0.0098). No correlation was established between antioxidants and the lipid profile except for the LDL and PON1 patient group (r = 0.1486, P = 0.0374). Similarly, a weak correlation was also established between PSA and LDL in the patient group (r = -0.275, P = 0.033). PON1/HDL ratio was not significantly different. However, the ARE/HDL ratio was significantly lower in the patient group (P < 0.0001). CONCLUSION: These results signify the presence of a higher lipoprotein peroxidation activity and lower lipid-associated antioxidant activity in the patient group. The ARE/HDL ratio is a better indicator of the HDL associated antioxidant than the PON1/HDL ratio or the individual antioxidants (PON1 and ARE) as reported by others.

Adipocytokines in obese Ghanaian subjects with or without type 2 diabetes.

OBJECTIVE: This study aimed to evaluate serum leptin and high sensitivity C-reactive protein (hsCRP) concentrations in obese Ghanaians with or without type 2 diabetes and to find out the extent to which their levels are influenced by underlying disorders. RESULTS: Obese subjects with type 2 diabetes had lower leptin but higher hsCRP levels compared with obese non-diabetic controls. There were negative correlations within the control group for glucose vs % muscle mass (r = - 0.378, p = 0.016), leptin vs % muscle mass (r = - 0.555, p = 0.001) and within the obese diabetic group for leptin vs % muscle mass (r = - 0.602, p = 0.001). Obese persons without diabetes were about three times more likely to have higher leptin levels compared with their obese diabetic counterparts (Odds ratio = 3.315, p < 0.001). Obese females independently had a tenfold increase in leptin levels compared with obese males.

Adiposity and hyperleptinemia during the first trimester among pregnant women with preeclampsia.

BACKGROUND: Leptin levels start increasing from the early stages of pregnancy, irrespective of the maternal body mass index. Leptin levels are increased in pregnant women with preeclampsia (PE) and may precede the clinical onset of the disease, with peaks occurring around 28 weeks of gestation. This study was aimed at determining whether serum leptin concentration and body fat percentage are significantly altered during the first trimester in pregnancies that subsequently develop PE and whether such changes are useful in predicting the disease. MATERIALS AND METHODS: This was a prospective longitudinal study conducted among pregnant women in Ho municipality. A cohort of 314 pregnant women was monitored from the first antenatal visit to delivery period at the Volta Regional Hospital, Ho, Ghana. Maternal serum leptin and lipid profile were analyzed and body fat percentage determined during first trimester. Body mass index was also calculated. RESULTS: First trimester serum leptin level (P<0.0001) and body fat percentage (P<0.0001) were significantly higher in those who developed PE than those who did not; while triglycerides (P=0.8600), total cholesterol (P=0.5620), high-density lipoprotein (P=0.5880), low-density lipoprotein (P=0.4870) and very low-density lipoprotein (P=0.6540) did not show any significant difference between those with PE and those without PE. CONCLUSION: Leptin levels are increased significantly during the first trimester of pregnancy in obese women with PE, and these increases precede the onset of PE.

Circulating angiogenic factors in diabetes patients in a tertiary hospital in Ghana.

BACKGROUND: Impaired angiogenesis is amongst the underlining mechanisms of organ damage in diabetes and hypertensive patients. In diabetes and hypertensive patients without proteinuria and overt CVDs, we studied the levels of angiogenic growth factors, angiopoietin (Ang)-1, Ang-2 and vascular endothelial growth factor (VEGF), and the relationship between these angiogenic growth factors and renal function, measured as estimated glomerular filtration rate (eGFR). METHOD: In a case control design, 107 type 2 diabetes (T2DM) patients and 93 non-diabetes controls were recruited into the study. Levels of plasma glucose, lipids, creatinine and angiogenic growth factors; Ang-1, Ang-2 and VEGF measured from fasting blood samples. Estimated glomerular filtration rate (eGFR) was computed using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) algorithm and eGFR < 60 ml/min/1.73 m2 was considered to be low. Multivariable logistic regression was used to assess the odds of change in angiogenic growth factors among patients with diabetes and hypertension, and patients with low eGFR, compared to those without these conditions. RESULTS: In a total of 200 participants with 49 % females and mean age of 54.1 ± 10.2 years, 22.7 % of T2DM patients and 13.3 % of non-diabetes participant had low eGFR. The levels of Ang-1 and Ang-2 were highest in hypertensive T2DM patients, followed by patients with either T2DM or hypertension alone, with the controls having the lowest levels. The odds of change in circulating Ang-2 levels increased in patients with both diabetes and hypertension [11.76 (7.97-16.63), p < 0.01] compared to patients with either diabetes [5.45 (3.31-9.71), p = 0.02] or hypertension [5.45 (3.31-9.71), p = 0.02] alone. Compared to those with normal eGFR, the odds of change in serum Ang-2 levels were increased in patients with low eGFR in both the crude [1.26 (1.08-2.110), p = 0.023] and adjusted [1.14 (1.03-2.34), p = 0.043] regression models. CONCLUSION: In our study population, having diabetes and hypertension increased the levels of Ang-1 and Ang-2. Also, low eGFR status was associated with increased levels of Ang-2 after adjustment for other risk factors.

Urinary Lysosomal Enzyme Activities and Albuminuria in Ghanaian Patients with Type 2 Diabetes Mellitus.

Renal tubular lysosomal enzyme activities like alanine aminopeptidase (AAP) and N-acetyl-ß-D-glucosaminidase (NAG) have been shown to increase in patients developing diabetic nephropathy and nephrosclerosis. This study aimed to determine the activities of N-acetyl-ß-D-glucosaminidase and alanine aminopeptidase and albumin concentration in urine samples of patients with type 2 diabetes. One hundred and thirty (65 type 2 diabetic and 65 nondiabetic) subjects participated in this study. Blood samples were drawn for measurements of fasting blood glucose, albumin (Alb), lipids, and creatinine (Cr). Early morning spot urine samples were also collected for activities of alanine aminopeptidase (AAP), N-acetyl-ß-D-glucosaminidase (NAG), and concentration of albumin (U-Alb) and creatinine (U-Cr). Both NAG/Cr and AAP/Cr were significantly increased in diabetic subjects compared to controls (p < 0.001). There was positive correlation between NAG/Cr and Alb/Cr (r = 0.49, p < 0.001) and between NAG/Cr and serum creatinine (r = 0.441, p < 0.001). A negative correlation was found between NAG/Cr and eGFR (r = -0.432, p < 0.05). 9.3% and 12% of diabetics with normoalbuminuria had elevated levels of AAP/Cr and NAG/Cr, respectively. We conclude that measuring the urinary enzymes activities (NAG/Cr and AAP/Cr) could be useful as a biomarker of early renal involvement in diabetic complications.

Shift work and the risk of cardiovascular disease among workers in cocoa processing company, Tema.

OBJECTIVE: Shift work has been implicated in cardiovascular disease (CVD), a major cause of death globally. The aim of this study was to evaluate the risk of developing CVD in shift work. DESIGN: A cross-sectional study involving secondary analysis of shift and non-shift work from an industry in Ghana. PARTICIPANTS: Two hundred (113 shift and 87 non-shift) consecutive workers who consented were recruited into the study. A structured questionnaire was administered to deduce information on participant's age, alcohol consumption pattern, smoking habits, history of diabetes, stroke and hypertension. RESULTS: Shift workers were found to be associated with higher body mass index (26.9 ± 4.6 vs 25.2 ± 3.3, p = 0.013); fasting blood glucose (5.9 ± 1.8 vs 5.3 ± 0.8, p ≤ 0.0001); glycated haemoglobin (4.9 ± 0.9 vs 4.2 ± 0.8, p ≤ 0.0001); high sensitivity C-reactive protein (2.5 ± 1.1 vs 1.8 ± 1.1, p < 0.0001); total cholesterol (5.9 ± 1.3 vs 5.2 ± 1.7, p = 0.002); triglycerides (1.3 ± 0.8 vs 1.1 ± 0.6, p = 0.015) and LDL cholesterol (3.6 ± 0.9 vs 3.2 ± 1.3, p = 0.04) than controls. Shift work however, had no associations with HDL-cholesterol. CONCLUSION: It can be concluded that shift work is associated with risk factors of CVD.

Obesity and Testosterone Levels in Ghanaian Men With Type 2 Diabetes.

Testosterone plays a vital role in obesity, glucose homeostasis, and lipid metabolism. The aim of this study was to investigate androgen levels and its association with obesity in Ghanaian men with type 2 diabetes. The study showed that serum total and free testosterone concentrations were lower in male patients with type 2 diabetes and that obesity was strongly associated with low levels of total and free testosterone in Ghanaian men with type 2 diabetes.

Characterisation of the insulinotropic activity of an aqueous extract of Gymnema sylvestre in mouse beta-cells and human islets of Langerhans.

Leaves of the Gymnema sylvestre (GS) plant have been used to treat diabetes mellitus for millennia, but the previously documented insulin secretagogue effects of GS extracts in vitro may be non-physiological through damage to the beta-cells. We have now examined the effects of a novel GS extract (termed OSA) on insulin secretion from the MIN6 beta-cell line and isolated human islets of Langerhans. Insulin secretion from MIN6 cells was stimulated by OSA in a concentration-dependent manner, with low concentrations (0.06-0.25 mg/ml) having no deleterious effects on MIN6 cell viability, while higher concentrations (> or = 0.5 mg/ml) caused increased Trypan blue uptake. OSA increased beta-cell Ca2+ levels, an effect that was mediated by Ca2+ influx through voltage-operated calcium channels. OSA also reversibly stimulated insulin secretion from isolated human islets and its insulin secretagogue effects in MIN6 cells and human islets were partially dependent on the presence of extracellular Ca2+. These data indicate that low concentrations of the GS isolate OSA stimulate insulin secretion in vitro, at least in part as a consequence of Ca2+ influx, without compromising beta-cell viability. Identification of the component of the OSA extract that stimulates regulated insulin exocytosis, and further investigation of its mode(s) of action, may provide promising lead targets for Type 2 diabetes therapy.