Blood Lead Levels in Occupationally Exposed Workers Involved in Battery Factories of Delhi-NCR Region: Effect on Vitamin D and Calcium Metabolism.

Workers involved in battery manufacturing or recycling factories are occupationally exposed to high concentrations of lead. In humans, lead can cause a wide range of biological effects depending upon the level and duration of exposure. The purpose of this study was to find out the blood lead levels (BLL) in occupationally exposed workers involved in battery industry in Delhi NCR region and to study whether lead affected the vitamin D (vit D) and calcium metabolism. For this study 100 occupationally lead-exposed battery workers (LEBW) and 100 non-lead exposed controls (NLEC) were recruited. BLL were measured using inductively coupled plasma optical emission spectrometer (ICP-OES) technique while ELISA was performed to quantify the serum vit D levels in the study subjects. Routine biochemical parameters were measured by chemistry autoanalyzers. Statistical analysis was done using appropriate statistical tools. Results showed that BLL were significantly higher in LEBW as compared to NLEC (p < 0.0001). Serum vitamin D, calcium and phosphorus levels were significantly decreased in battery workers as compared to controls (p < 0.005). Spearman's rank correlation analysis showed significant negative correlation of BLL with serum Vitamin D and calcium levels. Significant positive correlation was observed between BLL and duration of lead exposure. Weak negative correlation was also observed between BLL and vit D even after adjusting for smoking status. In conclusion, this study demonstrated that higher BLL significantly alters the vit D and calcium metabolism.

Type-2 diabetes mellitus with or without metabolic syndrome and their associated critical factors: A study from Northern India.

Background: Diabetes mellitus is associated with carbohydrate, lipid and protein metabolism abnormalities. Uncontrolled hyperglycaemia can result in dysfunction of various organs such as eyes, kidneys, nerves, and heart and blood vessels leading to long-term complications like nephropathy, neuropathy, retinopathy, stroke and ischaemia. The main objective of the study was to identify critical factors in Type 2 diabetes mellitus (Type 2 DM) with metabolic syndrome (mets) compared with Type 2 DM without mets and their association in the development of Type 2 DM to Type 2 DM with mets and cardiovascular complications. This can aid in improving the clinical management and the consequences of the disease. Materials and Methods: The present study was conducted in the Department of Biochemistry, a tertiary care centre in Northern India. All patients who were aged between 35 and 65 years of age were enrolled. Enrolled subjects were divided into three groups, Group I: 50 healthy people; Group II: 50 Type 2 DM without mets; and Group III: 50 Type 2 DM with mets. These patients were subjected to Anthropometric and biochemical parameter assessment. Results: On comparing Group III with control and Group II significant difference was observed in these parameters, that is, elevated TGs (P = 0.001), reduced high-density lipoprotein (HDL) level (P = 0.001), elevated high-sensitivity C-reactive protein (hs-CRP) (0.011), high serum insulin fasting (P = 0.010), weight (P = 0.021), waist circumference (P = 0.001) and BMI (P = 0.001). In the control group, head circumference was significantly lower compared to Group II (P = 0.001) and Group III (P = 0.001). Conclusion: On the basis of observed observation, it has been suggested that low enzymatic activity with poor glycaemic control may further progress Type 2 DM into Type 2 DM with metabolic syndrome and cardiovascular complications. High hs-CRP concentration and high fasting insulin can be independent predictor of cardiovascular complications.

Exploring the link between leptin levels and metabolic syndrome in elderly Indian patients: Implications for family medicine and primary care practices.

Background: The metabolic syndrome (MetS), according to the Adult Treatment Panel III of the National Cholesterol Education Programme, is a collection of metabolic abnormalities that includes one, two, or all three of the following traits: obesity in the abdomen, dyslipidemia, hypertension, fasting blood sugar, or insulin resistance. This study's aim was to assess the relationship between fasting serum leptin and MetS in elderly adults with T2DM in the Northern Indian population. Material and Methods: The following information was collected from all the participants: (1) anthropometric data, (2) biochemical data, and (3) a lifestyle questionnaire on sociodemographic data, dietary practices, smoking, and alcohol intake to identify their risk factors for diabetes mellitus, CVD, and hypertension. Results: A total of 36 older participants (56.30%) had a history of hypertension, while 29 elderly participants (44.61%) had diabetes mellitus. A total of 32 elderly participants (49.2%) had MetS, and this group had higher serum leptin (P 0.003), body weight (P = 0.019), BMI (P 0.001), waist circumference (P 0.001), CRP (P = 0.021), insulin (P = 0.001), and HOMA-IR (P = 0.003) values as well as higher percentages of females (P = 0.001), and those with type 2 diabetes mellitus (P = 0.002) and hypertension (P = 0.039) than those in the non-MetS group. Conclusion: In older persons with T2DM, our study discovered a favorable correlation between serum leptin and MetS. It can act as a standalone indicator of MetS, offering a way to spot populations at risk for associated consequences and enabling early intervention.

Primary care perspectives on leptin and adiponectin in north Indian families with metabolic syndrome.

Background: Urbanization, sedentary lifestyles, and dietary changes have all contributed to an increase in the prevalence of metabolic syndrome (MetS) in Indian populations during the past 10 years. Numerous markers have been investigated to determine if a person is at risk for developing MetS, with the bulk of them having to do with adipose tissue. Recently, adiponectin and leptin, two biomarkers with a high correlation to cardiometabolic health or disease, are of particular interest. Methods: In the general population of India, 100 persons were included. Body mass index (BMI), waist circumference, systolic and diastolic blood pressure, fasting blood glucose, plasma lipids, adiponectin, leptin, insulin, and the homeostasis model were measured to assess insulin resistance. We used binary logistic regression analysis to determine the connection between the researched factors and MetS and Spearman's analyses to evaluate correlations. Results: In all, 200 participants (100 men and 100 women) were enrolled in the study. Men's and women's median ages were 53 and 48, respectively (P < 0.05). Men had significantly greater WHR, SBP, and DBP (P < 0.05, respectively). Women had significantly higher levels of triglycerides, LDL, insulin, adiponectin, leptin, and HOMA-IR (P < 0.05, respectively). Leptin-to-adiponectin ratio was significantly and positively correlated with BMI (r = 0.597, P < 0.001), waist circumference (r = 0.576, P < 0.001), triglycerides (r = 0.190, P = 0.001), insulin levels (r = 0.329, P < 0.000), and HOMA-IR (r = 0.301, P < 0.000). Conclusion: In this study, higher levels of LAR, together with higher levels of leptin and lower levels of adiponectin, were found to be significantly linked with MetS. To properly determine whether LAR can be a predictor of MetS, independent of confounding factors, research with adequate design must be conducted.

Role of Pro-BNP in predicting outcome in acute heart failure patient presenting to a medical emergency: An observational study from North India.

Background: Acute heart failure (AHF) is a clinical syndrome defined as the new onset or acutely decompensated heart failure (ADHF) leading to signs and symptoms of heart failure (HF). The critical cut-off values for these biomarkers that suggest high mortality are not clearly defined in previous studies. More studies are required to better understand the correlation of Pro- BNP and its association with HF. The primary objective is to study the role of Pro-BNP and critical factors in predicting outcomes in AHF patients presenting to a medical emergency. Materials and Methods: The data from the patients presented with symptoms of HF in the Department of Medical Emergency at our hospital were recorded and analysed. AHF is a clinical syndrome defined as the new onset or ADHF leading to signs and symptoms of HF, as based on the European Society of Cardiology. Results: The present study highlights the various risk factors of AHF in patients and their association with mortality. In the present study, mortality in patients with very high Pro-BNP levels ≥2000 pg/ml was significantly higher than in patients with moderately elevated Pro-BNP. The patients who survived after 5 days of hospitalization had Pro-BNP levels ≤2000 pg/ml, suggesting that very high Pro-BNP levels ≥2000 pg/ml are associated with fatal outcomes. Conclusion: To conclude, diabetes and sepsis are critical factors for the hospitalization and mortality of patients with AHF in northern India. Very high Pro-BNP levels ≥2000 pg/ml in patients with AHF requiring hospitalization and associated with fatal outcomes.

Comparative evaluation of INF-γ as an immunological healing marker based on anti-tubercular treatment among diabetic and non-diabetic pulmonary tuberculosis patients.

OBJECTIVES: Tuberculosis is an infectious airborne disease caused by Mycobacterium tuberculosis. Pulmonary tuberculosis is the ninth most frequent complication of diabetes mellitus. The co-existence of TB and DM in patient causes severe TB symptoms, modify radiological findings, slower response to treatment outcomes and prognosis. IFN-γ is the key cytokine which play role in the protective immune response against mycobacterium infection. The main function of IFN-γ is macrophage activation which is able to exert its microbicidal functions. Estimation and comparison of pre and post treatment serum IFN-γ among pulmonary tuberculosis among diabetic and non-diabetic patients. METHODS: The study was conducted in the Departments of Biochemistry and Pulmonary Medicine, FMHS, SGT University, Budhera, Gurugram and District TB Centre, Gurugram, Haryana, India. In this study, 100 newly diagnosed PTB patients without diabetes mellitus and 100 newly diagnosed PTB patients with diabetes mellitus (PTB-DM) above 15 years of age were included after obtaining written consent. 5 mL venous blood was collected from patients of pre and post anti-tubercular treatment. The level of IFN-γ was measured by ELISA method. RESULTS: The circulating level of IFN-γ in PTB patients was significantly decreased in post-treatment (25.53 ± 6.12 pg/mL) compared to pre-treatment (58.76 ± 16.02 pg/mL) with t-value 32.03 and p-value <0.001. The circulating level of IFN-γ in PTB-DM patients was significantly decreased in post treatment (29.11 ± 7.41 pg/mL) compared to pre-treatment (44.14 ± 10.85 pg/mL) with t-value 31.35 and p-value <0.001. In the present study, level of IFN-γ in pre-treatment PTB patients (58.76 ± 16.02 pg/mL) was significantly raised compared to PTB-DM patients (44.14 ± 10.85 pg/mL) with t-value 7.55 and p-value <0.001. However, level of IFN-γ in post-treatment PTB patients (25.53 ± 6.12 pg/mL) was significantly low compared to PTB-DM patients (29.11 ± 7.41 pg/mL) with t-value 3.71 and p-value <0.001. CONCLUSIONS: The decreased level of IFN-γ in post-treatment compared to pre-treatment in both PTB and PTB-DM patients had shown efficacy of anti-tubercular treatment. However, the post treatment level of IFN-γ was high in PTB-DM patients compared to PTB patients which verified that effect of ATT was low in PTB-DM.