Micronutrient status and its effect on glycaemic indices in type 2 diabetics with foot ulcer in Ibadan, Nigeria.

BACKGROUND: Micronutrients are required by organisms in trace concentrations sufficient to maintain homeostasis. Deficiency of these elements could result in different medical and metabolic abnormalities. There are limited data on micronutrient status in type 2 diabetics with foot ulcer (DM+FU). Premised on this, this study investigated micronutrient levels of DM+FU and examined their effects on glycaemic indices. METHODS: One hundred and twenty participants, comprising seventy DM+FU and fifty non-diabetic participants (controls) aged 40-60 years, were recruited for the study. Ten millilitres of fasting blood samples were collected from each participant after obtaining their consent and levels of vitamin C, vitamin E, copper, selenium, zinc, FPG and HbAlc were measured. The data were analyzed using 't'- test and Pearson's correlation coefficients. Statistical significant was considered at p<0.05. RESULTS: FPG and HbAlc were significantly higher in DM+FU (12.98±0.43 mmol/l; 8.63±0.24 %) than in controls (5.09±0.08 mmol/l; 4.08±0.11 %). Vitamin C (3.7610.43 vs. 5.57±0.43 ptmol/l; p=0.003), vitamin E (19.57±1.01 vs. 25.57±0.27 pLimol/l; p=0.000) and selenium (0.48±0.01 vs. 0.81±0.04 srmol/l; p=0.000) were substantially lower in DM+FU compared with controls. However, no significant changes were observed when levels of copper and zinc were compared in all participants. Data revealed inverse associations between micronutrients and glycaemic indices (vitamin C/ FPG: (r= 0.250, p=0.037); Cu/HbA Ic: (r= 0.131, p=0.365)). CONCLUSIONS: Diabetics with foot ulcer were observed to be deficient in selenium, vitamin C and vitamin E. Therefore, type 2 diabetics with foot ulcer should be advised and encouraged to take more of leafy green vegetables and unsweetened fruits.

An investigation of the prevalence of iron overload in Nigerian women.

BACKGROUND: Iron overload has been recognized to be a risk factor for numerous acute and chronic illnesses. It is generally assumed to be rare and acknowledgment of iron toxicity is difficult for some nutritional scientists, clinicians and laypersons. There is also a heightened interest to raise body iron through universal iron "fortified" foods. OBJECTIVE: This study investigated the need to examine the policy of unselective iron supplementation in a sub-Saharan African community. METHODS: This is a descriptive study carried out on 98 apparently healthy women attending a Papanicolaou (PAP) smear clinic for routine cervical cancer screening. Information on demographic data and diet were obtained with structured questionnaires and serum samples were analyzed for serum iron (SI) and total iron binding capacity (TIBC) which were used to derive the values for tranferrin saturation (TS%). Iron overload was defined by tranferrin saturation greater than 50%. RESULTS: The prevalence of iron overload was 8.2% in women aged 26-71 years. Skilled workers constituted 44.9% of the population while semi-skilled and housewives were 50% and 5.1% respectively. Eighty four percent of the women had been on iron vitamin supplement at one time or the other. Mild anaemia was present in 25% of the women with iron overload. The prevalence of iron overload between women who were actively reproducing and those who were not was not statistically different. CONCLUSIONS: Iron overload is common, therefore, iron studies may be included in routine investigation and selective iron supplementation should be encouraged. Moreso, iron loading anaemia should be ruled out in patients with anaemia before prescribing iron therapy.

Depressed antioxidant status in pregnant women on iron supplements: pathologic and clinical correlates.

Iron (Fe) remains a commonly prescribed supplement in pregnancy. Its possible pathologic potential is either uncommonly considered or ignored. We determined the antioxidant status in pregnant women with and without Fe supplements. Fifty-eight apparently healthy pregnant women on Fe supplements were selected for the study from the antenatal clinic of the University College Hospital, Ibadan, Nigeria. Fifty-five aged matched pregnant women who were not on Fe from various parishes of the Christ Apostolic Church, Ibadan (non-drug using Christian sect) were randomly selected as controls. Both groups were classified according to the trimesters of pregnancy. The gestational age in both pregnant women on Fe supplements and non-supplement pregnant women was similar. Fruit and vegetables consumption was higher in the supplement than in the non-supplement group (57.2% vs. 37.3%). Anthropometric indices, weight, height, and BMI, were also similar. But while the weight of the Fe supplement group decreased by nearly 3% in the third trimester, it increased by over 10% (p < 0.00) in the non-supplement group in the same period. Serum Fe level was significantly higher in the supplement than the non-supplement group (p < 0.001). In contrast, the levels of the antioxidants, ascorbic acid, copper (Cu), zinc (Zn), and bilirubin were all significantly decreased (p < 0.05, p < 0.001, p < 0.05, and p < 0.05, respectively). Uric acid level though also lower in the supplement group did not reach statistical significance (p > 0.05), while vitamin E was similar in both groups. There was relative stability of all antioxidants except uric acid, which declined from the first to the last trimester in the non-supplement group. The significantly higher Fe level in the second trimester was sustained in the third trimester though to a lesser degree (p < 0.05) and associated with significant decreases in the following antioxidant levels in the supplement group, ascorbic acid, bilirubin, Cu, and Zn (p < 0.02, p < 0.02, p < 0.02, and p < 0.001, respectively). Uric acid and vitamin E though lower in the supplement group were not significantly different. Remarkably, percentage changes between the first and third trimesters revealed that serum Fe increased by over 116% in the Fe supplement group, while it only increased by over 50% in the non-supplement group. This was associated with 23.50% decrease in ascorbate level (p < 0.003) in the supplement group, while it decreased by only 3.70% in the non-supplement group (p > 0.05). Again vitamin E decreased by 17.22% in the supplement group, while it decreased by only 7.30% in the non-supplement group during the period. Uric acid and bilirubin levels decreased by similar proportions during the period, while Zn decreased by 18.55% in the supplement group and by 14.86% in the non-supplement group. In contrast Cu increased by 7.20% in the supplement group, while it increased by only 2.96 in the non-supplement group. Additionally, all the antioxidants in the supplement group except vitamin E, viz, ascorbic acid, bilirubin, Cu, uric acid, and Zn, were significantly inversely correlated with serum Fe level (r - 0.299, p < 0.05, r - 0.278, p < 0.05, r - 0.383, p < 0.05, and r - 0.0369, p < 0.05). These data imply markedly depressed antioxidant status in the Fe supplement pregnant group with attendant oxidative stress (most probably pro-oxidant Fe-induced). This is associated with molecular and cellular damage as well as a number of pathologic and clinical correlates that underlie the exacerbation of morbidity and mortality in maternal and child populations, particularly in the developing countries. This appears to call for serious caution and prior evaluation of antioxidant and Fe status and during the use of Fe supplements in pregnancy for monitoring and prognostic purposes and to avert or ameliorate oxidative stress-induced pathologies in maternal and fetal systems.

Effects of methionine containing paracetamol formulation on serum vitamins and trace elements in male rats.

Methionine is an effective antidote in the treatment of paracetamol-induced toxicity but at large doses it has been reported to induce or aggravate a number of pathological conditions. It also alters plasma levels of many vital elements and molecules. This study was designed to identify if the alteration observed for antioxidant vitamins and minerals especially at sub-toxic and toxic levels of exposure in our earlier study of 24-hour exposure period may warrant trace elements supplementation. This was investigated by carrying out a 48-hour study to test the ability of a living organism to restore homeostasis of these vital molecules and elements. The levels of antioxidant minerals and vitamins were estimated in the serum samples obtained from adult male Wistar rats exposed to paracetamol tablets. At 100 mg\kg BW (body weight) vitamin A, niacin, riboflavin, selenium and manganese were not significantly different from the control group. Moreover at 350 mg\kg, all these indices except zinc were not significantly different in the exposed group compared with controls whereas at 1000 mg\kg level of exposure manganese, selenium and vitamin E were not significantly decreased at the end of 48 hours of exposure but copper, niacin and vitamin A were significantly increased in the exposed group compared with the controls. These results suggest that with time the body may be capable of bringing about restoration of the levels of some of these elements\vitamins. This was more evident at 350 mg\kg level of exposure than a higher dose of 1000 mg\kg level.

Industrialization and the increasing risk of genome instability in developing countries: nutrigenomics as a promising antidote.

Increased reliance on chemicals in the industrializing developing countries places new demands on them, as they have limited resources to adequately regulate exposure to these chemicals. Majority of the chemicals cause mutation in DNA among others. The consequences of increased exposure to chemicals on the genome and their mitigation by Nutrigenomics, a science concerned with the prevention of genome damage by nutritional factors is poorly recognized in these countries. Growing evidence indicates that genome instability in the absence of overt exposure to genotoxicants is a sensitive marker of nutritional deficiency. Therefore, the increasing prevalence of chemicals in these countries which contribute to genome disturbances and the widespread nutritional deficiency, at least double the risk of genome instability.Environmental pollutants such polychlorobiphenyls, metal fumes, and fly ash, common in these countries are known to increase urinary level of 8-hydroxy deoxyguanosine (8-OHdG), a marker of oxidative DNA damage, precursor of genome instability.Increasing evidence emphasizes the importance of zinc in both genetic stability and function. Zinc deficiency has been linked with oxidative stress, DNA damage and impairment of repair mechanisms as well as risk of cancer. Zinc plays an important role in vitamin A metabolism from which the retinoids are derived. Zinc is also an important component of the p53 protein, a DNA damage sensor which prevents genetic lesions contributing to genome instability.Zinc deficiency ranks among the top 10 leading causes of death in developing countries. A large proportion of the population in these countries ingests less than 50% of the RDA for Zn.This makes this genome protective nutrient among others grossly inadequate. Folate now also recognized for its role in genome stability, is among the nutrients frequently cited as critical to genome stability. Folate deficiency of sub- clinical degree is common. Reduced folate intake causes as much genome damage as that induced by exposure to a high dose of ionizing radiation. Even moderate folate deficiency causes very severe damage to the genome in the general population. All these accentuate the susceptibility of populations in these nations to environmental toxic assault requiring preventive measures employing the science of Nutrigenomics, probably augmented with adaptive response pathways such as the Nrf2 signaling pathway. Human populations in developing countries are increasingly exposed to a diverse array of industrial chemicals, which adversely modify the genome, the precursor of many diseases especially cancer. Nutrigenomics encompasses nutritional factors that protect the genome from damage and is a promising new field that can be exploited, perhaps augmented with the Nrf2 signaling pathway with international collaboration in these nations as an antidote to chemical-induced genome instability.

Dose-dependent changes in some haematological parameters during short-term administration of Hibiscus sabdariffa Calyx aqueous extract (Zobo) in Wistar albino rats.

The extract of Hibiscus Sabdariffa L. (MALVACEAE) is popularly consumed and assumed to have haematological benefits, but no scientific investigations are known in the literature to have been conducted to corroborate this claim. The present study was therefore conducted to evaluate the effects of Hibiscus Sabdariffa L. Calyx extract on some haematological parameters (Haemoglobin, haematocrit, total white blood cells and differentials) in rats, with a view to determining its medicinal usefulness in the treatment of anaemia. Proximate analysis on dry matter basis, and mineral clement analysis were carried out on dried calyx of Hibiscus Sabdariffa L. Different doses of aqueous extract of Hibiscus Sabdariffa L calyx extract (200 - 1000 mg/ kg body wt.) were administered orally by intra Ocsophageal cannulation to four groups of six animals (rats) per group for 14 days. Venous blood samples were collected from each animal in all the groups including the control group on days 0 and 14 of the experiment for haematological investigations. Paired stat analysis of day 0 and day 14 results was done for each group using student's T-test. Proximate and mineral analysis of dry calyx confirmed the presence of some nutrients, e.g. protein, mineral elements (potassium) and Vitamin C in the calyx. After 14 days of the extract administration, significant elevations were observed in haematocrit (P = 0.03) and haemoglobin (P = 0.004) in the groups of animals given doses of 200 mg and 400 mg per kg (P < 0.05) while the groups given high doses revealed significant reductions (P 0.031) in the haematocrit but not in haemoglobin. This study suggests that, aqueous extract of Hibiscus Sabdariffa L. calyx used in this experiment had beneficial effects on the red cells at low doses (200 mg-400 mg/kg) which may not be sustained at higher doses. However, the long-term effects and the possible mechanism (s) of action of the extract should be studied before a recommendation could be made.

Amelioration of carbon tetrachloride-induced hepatotoxicity by terpenoid extract from leaves of Vernonia amydgalina.

Sesquiterpene lactone extract from the leaves of Vernonia amygdalina was tested for antihepatotoxic activity. Adult male rats were selected for the study. One group of rats was treated with toxic doses of carbon tetrachloride (CCl4) the second group was pretreated with known concentration of terpenoid extract from leaves of V. amygdalina. One hour prior to receiving toxic doses of CCl4, Kolaviron, a biflavonoid extract of the seeds of Garcina kola was used as a positive control. Serum enzymes, alanine amino transferase (ALT), ornithine carbamoyl transferase (OCT) that are known to be very sensitive to cytotoxic hepatic injury, and aspertate amino transferase (AST) that is particularly sensitive to carbon tetrachloride poisoning, were measured as indices of hepatotoxicity. The results obtained showed that there were reduction in the activities of serum ALT, AST and OCT from 20.57 +/- 5.59, 10.46 +/- 6.71 and 184.8 +/- 10.45 in animals treated with toxic doses of CCl4 to 3.40 +/- 0.10, 3.95 +/- 0.15 and 1293 +/- 12.10 in animal pretreated with terpenoid extract before CCl4 intoxication, representing 83.5%, 62.3%, and 30% decrease respectively. These decreases were statistically significant (P < 0.001, P < 0.05, P < 0.001 respectively). From these results, it is concluded that sesquiterpene lactone extract from the leaves of V. amygdalina like kolaviron, a biflavonoid extract from the seeds of G. kola has antihepatotoxic activity in CCl4-induced hepatic damage in rats.