The Association between Lifestyle Factors and COVID-19: Findings from Qatar Biobank.

Coronavirus Disease 2019 (COVID-19) manifestations range from mild to severe life-threatening symptoms, including death. COVID-19 susceptibility has been associated with various factors, but studies in Qatar are limited. The objective of this study was to investigate the correlation between COVID-19 susceptibility and various sociodemographic and lifestyle factors, including age, gender, body mass index, smoking status, education level, dietary patterns, supplement usage, physical activity, a history of bariatric surgery, diabetes, and hypertension. We utilized logistic regression to analyze these associations, using the data of 10,000 adult participants, aged from 18 to 79, from Qatar Biobank. In total, 10.5% (n = 1045) of the participants had COVID-19. Compared to non-smokers, current and ex-smokers had lower odds of having COVID-19 (odds ratio [OR] = 0.55; 95% CI: 0.44-0.68 and OR = 0.70; 95% CI: 0.57-0.86, respectively). Vitamin D supplement use was associated with an 18% reduction in the likelihood of contracting COVID-19 (OR = 0.82; 95% CI: 0.69-0.97). Obesity (BMI ≥ 30 kg/m2), a history of bariatric surgery, and higher adherence to the modern dietary pattern-characterized by the consumption of foods high in saturated fat and refined carbohydrates-were positively associated with COVID-19. Our findings indicate that adopting a healthy lifestyle may be helpful in the prevention of COVID-19 infection.

Glucose-6-phosphate dehydrogenase deficiency and neonatal indirect hyperbilirubinemia: a retrospective cohort study among 40,305 consecutively born babies.

BACKGROUND AND OBJECTIVE: Glucose-6-phosphate dehydrogenase deficiency (G6PDD) being highly prevalent in the Middle East, the primary objective was to estimate the incidence of neonatal jaundice among G6PD-deficient neonates and to explore its association with various risk factors. METHODS: This retrospective cohort study includes 7 years data of neonates diagnosed with G6PDD between 1st January 2015, and 30 September 2022, from Al Wakra Hospital, HMC Qatar. RESULTS: Among the 40,305 total births, 1013 had G6PDD with an incidence of 2.51%. Of all the G6PDD babies, 24.6% (249/1013) received phototherapy and three babies required exchange transfusion. Statistically significant associations were noted between the need for phototherapy and gestational age, gestational age groups, birth weight, and birth weight groups, but logistic regression analysis showed significant association for phototherapy only with the gestational age group. CONCLUSION: Universal screening and proper follow-up is essential for G6PDD as it plays crucial role in neonatal jaundice.

Determinants of healthful eating and physical activity among adolescents and young adults with type 1 diabetes in Qatar: A qualitative study.

BACKGROUND: In Qatar, as in the rest of the world, the sharp rise in the prevalence of type 1 diabetes (T1D) is a leading cause for concern, in terms associated with morbidity, mortality, and increasing health costs. Besides adhering to medication, the outcome of diabetes management is also dependent on patient adherence to the variable self-care behaviors including healthful eating (HE) and physical activity (PA). Yet, dietary intake and PA in adolescents and young adults (AYAs) with T1D are known to fall short of recommended guidelines. The aim of this study was to develop an in-depth understanding of the behavioral determinants of HE and PA adherence among Arab AYAs within the age range of 17-24 years with T1D attending Hamad General Hospital. METHODS: Semi-structured, face-to-face individual interviews were conducted with 20 participants. Interviews were based on an integrative health behavior change model, the I-Change model (ICM). All interviews were audio-recorded, transcribed verbatim, and analyzed using the framework method. RESULTS: More participants reported non-adherence than adherence. Several motivational determinants of adherence to HE and PA were identified. The majority of participants were cognizant of their own behaviors towards HE and PA. Yet, some did not link low adherence to HE and PA with increased risks of health problems resulting from T1D. Facilitators to adherence were identified as being convinced of the advantages of HE and PA, having support and high self-efficacy, a high level of intention, and a good health care system. CONCLUSION: The suboptimal adherence in AYAs to HE and PA needs more attention. Supportive actions are needed to encourage adherence to a healthy lifestyle to achieve benefits in terms of glycemic control and overall health outcomes, with a special focus on adolescents. Interventions are needed to foster motivation by addressing the relevant determinants in order to promote adherence to these two behaviors in AYAs with T1D.

Association of vitamin D2 and D3 with type 2 diabetes complications.

AIMS: Vitamin D measurement is a composite of vitamin D2 (25(OH)D2) and D3 (25(OH)D3) levels, and its deficiency is associated with the development of type 2 diabetes (T2DM) and diabetic complications; vitamin D deficiency may be treated with vitamin D2 supplements. This study was undertaken to determine if vitamin D2 and D3 levels differed between those with and without T2DM in this Middle Eastern population, and the relationship between diabetic microvascular complications and vitamin D2 and vitamin D3 levels in subjects with T2DM. METHODS: Four hundred ninety-six Qatari subjects, 274 with and 222 without T2DM participated in the study. Plasma levels of total vitamin D2 and D3 were measured by LC-MS/MS analysis. RESULTS: All subjects were taking vitamin D2 and none were taking D3 supplements. Vitamin D2 levels were higher in diabetics, particularly in females, and higher levels were associated with hypertension and dyslipidemia in the diabetic subjects (p < 0.001), but were not related to diabetic retinopathy or nephropathy. Vitamin D3 levels measured in the same subjects were lower in diabetics, particularly in females (p < 0.001), were unrelated to dyslipidemia or hypertension, but were associated with retinopathy (p < 0.014). Neither vitamin D2 nor vitamin D3 were associated with neuropathy. For those subjects with hypertension, dyslipidemia, retinopathy or neuropathy, comparison of highest with lowest tertiles for vitamin D2 and vitamin D3 showed no difference. CONCLUSIONS: In this Qatari cohort, vitamin D2 was associated with hypertension and dyslipidemia, whilst vitamin D3 levels were associated with diabetic retinopathy. Vitamin D2 levels were higher, whilst vitamin D3 were lower in diabetics and females, likely due to ingestion of vitamin D2 supplements.

Serum vitamin D concentrations are inversely related to prevalence of metabolic syndrome in Qatari women.

Hypovitaminosis D has reached epidemic proportions in Qatar. Vitamin D is linked to several cardiometabolic diseases such as metabolic syndrome (MetSyn), diabetes, and atherosclerosis. It is not known if vitamin D status is linked to cardiometabolic risk factors in Qatari women. Therefore, a relationship between serum 25-hydroxyvitmain D [25(OH)D] concentrations and MetSyn was investigated in Qatari women using the Qatar Biobank database. Study sample consisted of 700 women, aged 20-80 years old. A multivariate-adjusted logistic regression was used to determine relation between serum 25(OH)D and MetSyn prevalence. Multivariate linear regression was performed to determine the association between serum 25(OH)D and markers of MetSyn. Prevalences of MetSyn in the first (≈32%), second (≈27%), and third (≈28%) serum 25(OH)D quartiles were significantly higher compared to fourth serum 25(OH)D quartile (≈17.5%) (p < .035). The likelihood of having MetSyn was significantly higher in the first serum 25(OH)D quartile (OR, 1.92; 95% CI, 1.06, 3.49) compared to the fourth serum 25(OH)D quartile (p < .001) in multivariate-adjusted analysis. No relationship was observed between serum 25(OH)D and waist circumference, blood pressure, glycated hemoglobin (HbA1C), blood glucose, HDL-cholesterol, and serum triglycerides. This study showed an inverse relationship between prevalence of MetSyn and serum 25(OH)D in Qatari women. Given the widespread prevalence of vitamin D deficiency in Qatar, consideration should be given to vitamin D fortification of some selected staple foods and through targeted supplementation of vitamin D in those who are at risk for cardiometabolic diseases.

Knowledge and intake of folic acid among teachers of childbearing age in the State of Qatar: a cross-sectional study.

OBJECTIVES: To assess the knowledge and intake of folic acid among teachers of childbearing age and to identify barriers to folic acid intake. SETTING: Governmental schools, which included 14 primary models, 29 primary, 14 preparatory and 16 secondary schools. The proportion of teachers in each stratum was then determined, and a stratified random sampling design had been used with proportional allocation. STUDY DESIGN: Cross-sectional study PARTICIPANTS: A total of 406 non-pregnant teachers of childbearing age enrolled in the study. A validated questionnaire in the Arabic language was used. RESULTS: The overall response rate was 98%. About 34.6% reported the optimal period in which they should take folic acid, 28.3% reported the correct intake duration and only 29.5% could name food rich in folic acid. Friends and healthcare providers were the main sources of information for the participants; however, 44% said that they did not receive enough information from their healthcare providers. CONCLUSION: There is a lack of knowledge and poor intake of folic acid among the participants. In particular, they lacked information about the appropriate time to start folic acid supplementations, the duration of intake and the folic acid-rich food. The most common reason being the limited advice given by their healthcare providers.Awareness campaigns are recommended to emphasise the role of healthcare providers in counselling women about the proper use of folic acid before pregnancy.

The effect of different forms of dysglycemia during pregnancy on maternal and fetal outcomes in treated women and comparison with large cohort studies.

AIMS OF THE STUDY: We describe the impact of different forms of dysglycemia on maternal and neonatal health. This research is a part of the PEARL-Peristat Maternal and newborn registry, funded by Qatar National Research Fund (QNRF) Doha, Qatar. METHODS: A population-based retrospective data analysis of 12,255 women with singleton pregnancies screened during the year 2016-2017, of which 3,027 women were identified with gestation diabetes mellitus (GDM) during pregnancy and 233 were diabetic before pregnancy. Data on maternal outcome was collected from the PEARL-Peristat Maternal and newborn registry. RESULTS: The prevalence of GDM and diabetes mellitus (DM) was 24.7 % and 1.9%, respectively. 55% of DM, 38% of GDM and 25.6% of controls were obese (p<0.001). 71% of pregnant women with DM and 57.8% of those with GDM were older than 30 years versus 44.2% of controls. Pregnant women with DM or GDM had higher prevalence of hypertension versus normal controls (9.9%, 5.5% and 3.5%, respectively; p<0.001). Among women with vaginal deliveries, the proportion of women with induction of labor was significantly higher in the DM and GDM compared to control subjects (33.9%, 26.5% and 12.4%, respectively; p<0.001). The number of women who underwent Cesarean section was significantly higher in the DM and GDM groups versus normal controls (51.9%, 36.8%, and 28.5%, respectively; p<0.001).  Preterm delivery was significantly higher in women with DM and GDM (13.7% and 9%, respectively versus normal women (6.4%); p<0.001). Babies of DM and GDM had significantly higher occurrence of respiratory distress (RDS) or transient tachypnea (TTS): 9% and 5.8 % versus normal controls (4.8%). Macrosomia was more prevalent in babies of DM (6.4%) and GDM (6.8%) compared to controls (5%) (p: <0.001). Significant hypoglycemic episodes occurred more frequently in babies of DM and GDM women (11.2% and 3%, respectively) versus controls (0.6%) (p: <0.001. Infants of DM and GDM mothers required more treatments of phototherapy (9.4% and 8.9%, respectively) versus those born to normal women (7.2%) (p: 0.006). The prevalence of congenital anomalies and neonatal death did not differ between the groups. CONCLUSIONS: Despite the improvement in the prenatal diagnosis and management of dysglycemia, there is still a higher prevalence of prematurity, macrosomia, and hypoglycemia in infants of mothers with DM and GDM. Measurements to reduce obesity and control dysglycemia in women during the childbearing period are highly required to prevent the still higher morbidity during pregnancy.

Identification of carbapenem-resistant Pseudomonas aeruginosa in selected hospitals of the Gulf Cooperation Council States: dominance of high-risk clones in the region.

PURPOSE: The molecular epidemiology and resistance mechanisms of carbapenem-resistant Pseudomonas aeruginosa (CRPA) were determined in hospitals in the countries of the Gulf Cooperation Council (GCC), namely, Saudi Arabia, the United Arab Emirates, Oman, Qatar, Bahrain and Kuwait. METHODOLOGY: Isolates were screened for common carbapenem-resistance genes by PCR. Relatedness between isolates was assessed using previously described genotyping methods: an informative-single nucleotide polymorphism MassARRAY iPLEX assay (iPLEX20SNP) and the enterobacterial repetitive intergenic consensus (ERIC)-PCR assay, with selected isolates being subjected to multilocus sequence typing (MLST). Ninety-five non-repetitive isolates that were found to be resistant to carbapenems were subjected to further investigation.Results/Key findings. The most prevalent carbapenemase-encoding gene, blaVIM-type, was found in 37/95 (39 %) isolates, while only 1 isolate (from UAE) was found to have blaIMP-type. None of the CRPA were found to have blaNDM-type or blaKPC-type. We found a total of 14 sequence type (ST) clusters, with 4 of these clusters being observed in more than 1 country. Several clusters belonged to the previously recognized internationally disseminated high-risk clones ST357, ST235, ST111, ST233 and ST654. We also found the less predominant ST316, ST308 and ST823 clones, and novel MLST types (ST2010, ST2011, ST2012 and ST2013), in our collection. CONCLUSION: Overall our data show that 'high-risk' CRPA clones are now detected in the region and highlight the need for strategies to limit further spread of such organisms, including enhanced surveillance, infection control precautions and further promotion of antibiotic stewardship programmes.

Evolution of 29 Anthropometric, Nutritional, and Cardiometabolic Parameters Among Morbidly Obese Adolescents 2 Years Post Sleeve Gastrectomy.

BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is a popular treatment for adolescent morbid obesity. Research on LSG outcomes among adolescents assessed a narrow range of anthropometric, nutritional, or cardiometabolic parameters, leading to an incomplete picture of these changes. We examined a wide variety of anthropometric, nutritional, and cardiometabolic parameters among adolescents before and after LSG. METHODS: We retrospectively reviewed medical charts of all obese adolescents who underwent LSG at Hamad Medical Corporation, Qatar, between January 2011 and June 2015 (N = 102). We assessed preoperative levels and postoperative changes in 4 anthropometric, 15 nutritional, and 10 cardiometabolic parameters. RESULTS: The study sample comprised 79 patients with complete information (36 males, mean age 15.99 ± 1.1 years). At a mean of 24.2 months post-LSG, we observed (1) significantly reduced mean weight and body mass index by 51.82 ± 28.1 kg and 17 ± 6.24 kg/m2, respectively; (2) the highest prevalence of post-LSG deficiencies pertained to vitamin D, albumin, and ferritin (89.3, 38, and 33.3%, respectively); (3) low hemoglobin levels (29.3%) only in females; (4) trace elements were not deficient; (4) significant reductions in percentage of adolescents with elevated low-density lipoprotein (from 66.1 to 38.9%), alanine aminotransferase (from 45.3 to 10.9%), and aspartate aminotransferase (from 24.1 to 8.6%) levels; (5) 100% remission of prediabetes cases; and (6) 80% remission of type 2 diabetes cases. CONCLUSIONS: LSG achieved significant weight loss and improvement of cardiometabolic risk factors among adolescents. However, the slight worsening of preexisting nutritional deficiencies warrants careful preoperative surveillance and appropriate postoperative nutritional supplementation.

Vitamin D deficiency among the elderly: insights from Qatar.

OBJECTIVES: Vitamin D (VitD) deficiency is associated with comorbidities in the elderly. The present study investigates the prevalence of VitD deficiency among the elderly in Qatar. RESEARCH DESIGN AND METHODS: A retrospective study conducted between April 2010 and April 2012 that involved chart reviews. All elderly patients of age ≥65 years in geriatrics facilities including Rumailah hospital, skilled nursing facility and home healthcare services in Qatar were included in the study. MEASUREMENTS: Patient characteristics and outcomes were analyzed and compared according to the severity of VitD deficiency. Correlation of VitD with comorbidities was analyzed. Mean follow-up period was 6 months. RESULTS: A total of 889 patients were enrolled; the majority (66%) were females and the mean age was 75 ± 8.7 years. Patient comorbidities included hypertension (76.5%), diabetes mellitus (63%), dyslipidemia, (47.5%), dementia (26%) coronary artery disease (24%) and cerebrovascular accident (24%). The mean baseline serum VitD level was 24.4 ± 13.5 ng/ml; 72% of patients had VitD deficiency: mild (31%), moderate (30%) and severe (11%). Patients with severe VitD deficiency had significantly higher HbA1c levels compared with patients with optimal VitD (P = 0.03). High density lipoprotein (HDL-C) levels were significantly lower in severe VitD deficiency patients compared with optimal VitD patients (P = 0.04). There was a positive correlation between HDL-C and VitD level (r = 0.17, P = 0.001), whereas HbA1c levels showed negative correlation with VitD (r = -0.15, P = 0.009). CONCLUSIONS: A high prevalence of VitD deficiency (72%) was observed among the elderly in Qatar. Lower VitD was associated with higher HbA1c and lower HDL-C levels. Further studies are warranted to evaluate whether VitD supplementation controls diabetes mellitus (DM) and low HDL-C levels among the elderly.

The role of vitamin D deficiency and osteoporosis in breast cancer.

AIM: Epidemiological studies suggest an association between vitamin D and calcium intake and breast cancer. The aim of this study was to determine the association of breast cancer with vitamin D deficiency and osteoporosis according to menopausal status and to examine vitamin D and bone mineral density (BMD) levels in breast cancer patients. METHODS: This was an observational cohort hospital-based study. It included 635 patients with breast cancer. Socio-demographic information, type of consanguinity, menopause status, medical history, lifestyle habits, dietary intake, BMD measurements and vitamin D levels were collected. Descriptive and univariate analyses were performed. RESULTS: Of the studied patients, 36.1% were Qataris, 63.9% non-Qatari Arabs, 40% premenopausal women, 20.9% university graduates and 37.2% housewives. Overall, 31.8% of breast cancer women were affected with osteopenia/osteoporosis. Vitamin D deficiency (10.7% vs. 7.9%) and severe vitamin D insufficiency (39.2% vs. 32.5%) were higher in postmenopausal women than premenopausal women (P < 0.001). Low physical activity (< 30 min/day) was observed among vitamin D deficient (46.8%) and osteoporotic (45%) women. Dietary intake of vitamin D was significantly lower in vitamin D deficient women; these included dairy products (33.1%), milk (38.6%), seafood (39.6%), (P < 0.001) and for osteoporotic women, dairy products (46%), calcium (21.3%), milk (36.1%), yoghurt (37.6%), cheese (37.6%) and sea food (34.7%) (P < 0.001). CONCLUSION: The present study findings revealed a high prevalence of vitamin D deficiency and osteoporosis in breast cancer patients. Also, the dietary intake of vitamin D and calcium was significantly lower in breast cancer women.

Assessment of the 10-year risk of coronary heart disease events for Qatar Petroleum's firefighters and non-firefighter staff in Qatar.

Coronary heart disease is a major public health problem worldwide and firefighters may be at particular occupational risk. In a cross-sectional study in Ras Laffan Industrial City, Qatar, we assessed the 10-year risk of coronary heart disease events for 369 Qatar Petroleum staff at their periodic medical examination. The subjects of the study (all males) were divided into firefighters and non-firefighters groups. Based on the Framingham risk score calculations, 69.9% of the subjects were categorized as low risk, 27.1% as intermediate risk and 2.9% as high risk. None of the firefighters was categorized as high risk, 15.5% were intermediate and the rest were low risk. In the whole group, low high-density lipoprotein cholesterol was the most prevalent risk factor (68.8%), followed by hypertension (32.0%) and smoking (15.4%). The mean risk of developing coronary heart disease in firefighters [6.5% (SD 3.7%)] was significantly lower than in non-firefighters 19.5% (SD 6.5%)].

Vitamin D status in health care professionals in Qatar.

OBJECTIVE: To investigate the prevalence of vitamin D deficiency among health care professionals working at Hamad Medical Corporation in Doha, Qatar. METHODS: Between 15th January 2007 and 15th January 2008, 340 healthy volunteers were included in this study. Each subject completed a diary to determine the duration of sunlight exposure, and vitamin D supplements. Serum levels of 25-hydroxyvitamin D (25OHD), parathyroid hormone (PTH), calcium, phosphorus, alkaline phosphatase, total protein, and albumin were obtained. Those with abnormal results were called for counselling. RESULTS: The mean overall vitamin D level was 11.7 ng/ml. It was lower in females (10.3 ng/ml) than in males (13.7 ng/ml). Ninety-seven percent of all participants had a mean level <30 ng/ml. Eighty-seven percent had a mean level of <20 ng/ml. CONCLUSION: We concluded that the prevalence of vitamin D deficiency among health care professionals in Qatar is very high.

Vitamin D deficiency in healthy children in a sunny country: associated factors.

OBJECTIVE: The objective of the present study was to determine the factors associated with low concentrations of 25-hydroxy vitamin D (vitamin D deficiency) in healthy children in Qatar. DESIGN: The survey was a cross-sectional study conducted at the Primary Health Care Clinics over the period from August 2007 to March 2008. Subjects The study was carried out among healthy Qatari nationals, male and female, aged below 16 years. A random sample of 650 healthy subjects who visited the Primary Health Care Centers for any reason other than acute or chronic disease were approached and 458 subjects gave consent; a response rate of 70.5%. METHODS: Face-to-face interviews were based on a questionnaire that included variables such as socio-demographic information, assessment of non-dietary covariates, assessment of dietary intake, vitamin D intake, type of feeding, clinical manifestations and laboratory investigations. The subjects' health status was assessed by medical conditions, family history, body mass index, past or present clinical manifestations, 25-hydroxy vitamin D, calcium, alkaline phosphates, phosphorus, HbA1C, Parathyroid Hormone (PTH), magnesium and creatinine analysis. RESULTS: The study revealed that vitamin D deficiency was highly prevalent in Qatari adolescents (11-16 years old; 61.6%), followed by the 5-10 year olds (28.9%) and those below 5 years old (9.5%). Vitamin D deficiency increased with age and there was a significant difference between vitamin D-deficient and normal children in their age groups (P =0.013). The body mass index was significantly lower in vitamin D-deficient children (19.6+/-3.6; P =0.019). A family history of vitamin D deficiency was more frequent in children with vitamin D deficiency (33.7%) than in normal children (24.5%). Most of the vitamin D-deficient children had no physical activity (60.6%) and no exposure to sunlight (57.5%). There was a significant difference between both groups in terms of family history of vitamin D deficiency, physical activity, exposure to sunlight and duration of time spent outside under the sun (P <0.05). The mean values of vitamin D serum concentration, calcium, alkaline phosphates, and phosphorus were very low in vitamin D-deficient children. Vitamin D-deficient children had a very poor diet for vitamin D (cod liver oil, 56.5%; milk fortified with vitamin D, 27.3%; fortified food, 24.1%; and seafood, 5.7%) compared with normal children. Fractures (P =0.006), delayed milestones (P =0.013), rickets (P =0.017) and gastroenteritis (P =0.020) were significantly higher in vitamin D-deficient children. CONCLUSION: The study findings revealed that Qatari children are at high risk for vitamin D deficiency. Lack of exposure to sunlight, outdoor activities under the sun, and physical activity and vitamin D intake are the main associated factors for vitamin D deficiency in the young population of Qatar. Breast-fed infants need to take vitamin D supplements for a longer period.

High prevalence of vitamin D deficiency in type 1 diabetes mellitus and healthy children.

Epidemiological studies suggest a link between vitamin D deficiency in early life and the later onset of type 1 diabetes. The aim of this matched case-control study was to find the association between vitamin D and T1DM then to study the difference in the level of vitamin D in T1DM and healthy subjects, and to determine the associated environmental risk factors in young Qatari population. The study was carried out among T1DM children and healthy subjects below 16 years at the pediatric endocrinology outpatient clinics of the Hamad General Hospital and the Primary Health care Clinics (PHCs). The survey was conducted over a period from 6 August to 25 December 2007. The subjects were Qatari nationals male and female aged below 16 years. The study is based on matching by age, gender and ethnicity of 170 cases with those of 170 controls. Face-to-face interviews were based on a questionnaire that included variables such as socio-demographic information, assessment of non-dietary covariates, assessment of dietary intake, vitamin D intake, type of feeding, clinical manifestations and laboratory investigations. Their health status was assessed by medical conditions, family history, BMI, past or present clinical manifestations, 25 (OH)D, Calcium, alkaline phosphatase, phosphorus, HbA1C, PTH, Mg and creatinine analysis. The study revealed that vitamin D deficiency was considerably higher in T1DM children (90.6%) compared to non-diabetic children (85.3%). There was a significant difference found in the mean value of vitamin D between T1DM and non-diabetic children (P = 0.009). There were statistically significant differences between type 1 diabetic and healthy subjects with respect to the occupation of parents (P < 0.001) and consanguinity rate (P < 0.047). Family history of vitamin D deficiency was considerably higher among T1DM children (35.3%) with a significant difference between diabetic and non-diabetic children (22.9) (P < 0.012). Vitamin D supplement with breast milk was very poor in diabetic children (37.4%) compared to non-diabetic children (47.7%). Majority of the studied subjects were breast-fed children (95.1% of diabetic children and 97.2% of healthy children). Multivariate logistic regression analysis revealed that fathers and mothers occupation, family history of DM, physical activity, low duration of time under sun light, breast feeding less than 6 months and low vitamin D level were considered as the main factors associated with the T1DM. In conclusion, the present study revealed that vitamin D deficiency was higher in T1DM children compared to non-diabetic. Moreover, vitamin D deficiency was common in Qatari young population. Vitamin D intake was very poor in children and it shows that supplementing infants with vitamin D might be a safe and effective strategy for reducing the risk of T1DM.

Impact of lifestyle and dietary habits on hypovitaminosis D in type 1 diabetes mellitus and healthy children from Qatar, a sun-rich country.

BACKGROUND: There are no population-based studies that have examined the association between vitamin D and type 1 diabetes mellitus (T1DM) and the role of lifestyle habits and dietary factors in young children in the Arabian Gulf and Middle East region. Little data on the intake of these nutrients in Mediterranean countries exist, and predictors of their suboptimal intake are not well defined. OBJECTIVE: The objective of this study was to determine the association between vitamin D status and T1DM and assess the impact of lifestyle and dietary habits on hypovitaminosis D in the young population of the State of Qatar. A matched case-control study was carried out among T1DM children and healthy subjects <16 years of age at the pediatric endocrinology outpatient clinics of the Hamad General Hospital and the primary health care clinics center. The survey was conducted over a period from 6 August to 25 December 2007. The sample included 170 cases and 170 controls matched by age, gender and ethnicity. METHODS: Face to face interviews were based on a questionnaire that included variables such as sociodemographic information, assessment of non-dietary covariates, assessment of dietary intake including vitamin D, type of feeding, clinical manifestations and laboratory investigations. Their health status was assessed by medical conditions, family history, body mass index, past or present clinical manifestations, serum 25(OH) vitamin D, calcium, alkaline phosphates, phosphorus, hemoglobin A1C, parathyroid hormone, magnesium and creatinine analysis. RESULTS: The study revealed that the incidence of severe vitamin D deficiency was considerably higher in T1DM (28.8%) compared with healthy children (17.1%). Although the mean serum level of vitamin D was significantly lower in T1DM children (15.80+/-9.23 ng/ml), compared with nondiabetic children (18.45+/-9.56 ng/ml), both groups belonged to the mild-moderate vitamin D deficiency category. A family history of vitamin D deficiency (35.3%; p=0.012) and diabetes mellitus (56.5%; p<0.001) was significantly higher in diabetic children. More than half of the diabetic (67.1%) and healthy children (51.2%) had no physical activity in their daily life. Both groups (65.9 vs. 62.9%) had very limited exposure to sunlight. Vitamin D supplement intake was very poor in diabetic children compared with healthy children; 60% of diabetic and 40.6% of healthy children never had any vitamin D supplement. The study revealed that vitamin D serum concentration, phosphorus, hemoglobin A1C, magnesium and creatinine show statistically significant differences between T1DM and healthy control subjects. A significant difference was noted between diabetic and healthy children for fractures (p=0.005), weakness (p=0.001) and gastroenteritis (p=0.025). CONCLUSIONS: The present study revealed that vitamin D deficiency is a common problem in Qatari children, but the incidence of vitamin D deficiency becomes very severe in T1DM children, compared with healthy children. This suggests that there is an association between vitamin D deficiency and T1DM. The data show that vitamin D status is dependent on sunshine exposure and dietary vitamin D intake. The results suggest the necessity of nutrition education to promote healthy eating habits among adolescents and their parents.

Pet ownership: its effect on allergy and respiratory symptoms.

BACKGROUND: Studies have shown that pets are very important sensitizing agents in patients with asthma. Respiratory disorders such as asthma and allergic rhinitis are common in the State of Qatar. OBJECTIVE: The aim of the present study was to determine whether exposure to pets and domestic animals plays a significant role in the development of asthma and allergic rhinitis among Qatari population. DESIGN: A hospital-based prospective descriptive study conducted. SETTING: Allergy Laboratory at the Hamad General Hospital and Hamad Medical Corporation, State of Qatar. PATIENTS: Adult patients over 12 years of age diagnosed with bronchial asthma and/or allergic rhintis who were referred for allergy skin prick test. 1106 adult patients recruited with respiratory diseases of suspected allergic origin who attended Allergy Clinic at the Hamad General Hospital, during three years from January 2001 to April 2003. Total of 1106 whom 607 were females (54.9 %) and 499 were males (45.1%) and their mean was age 30 years (12-48). METHODS: Skin Prick Test (SPT) was performed on 1106 patients for common allergens whom the blood sample was taken for measuring total IgE concentration. RESULTS: There were 1106 patients studied and 496 patients (44.9%) had positive and 610 (55.1%) had negative skin prick tests. Out of 1106 patients, 311 patients (28.1%) had asthma; 503 patients had allergic rhinitis (45.5%) and 87 patients (7.8%) had skin allerg. Three hundred and forty (340/1106=30.7%) of the 1006 subjects studied had at least one animal at home, and the remaining 69.3% had never had pets in the home. A further 12% reported having had pets in the past, but not anymore. Cats (26.7%), goats (15%) and birds (14.7%), animals were the most common present within the house and was the most frequently seen pet types when compared to other pet types. The risk of having asthma (RR: 1.29; 95% CI: 1.07-1.55; p=0.008), allergic rhinitis (RR: 1.48; 95% CI: 1.24-1.77; p<0.0001) and eczema (RR: 3.56; 95% CI:1.24-1.77; p<0.0001) was significantly higher in subjects with animals than in patients without. CONCLUSION: In the present study, the prevalence of asthma, rhinitis, and skin allergy was significantly more common in families with animals than in those without.

The pattern of indoor and outdoor respiratory allergens in asthmatic adult patients in a humid and desert newly developed country.

BACKGROUND: Studies have shown that allergens are very important sensitizing agents in patients with asthma. Respiratory disorders such as asthma and allergic rhinitis are common in the State of Qatar. OBJECTIVE: To characterize the most frequent indoor and outdoor respiratory allergens involved in bronchial asthma and allergic rhinitis in the State of Qatar. DESIGN: A hospital-based prospective study conducted. SETTING: Allergy Laboratory at the Hamad General Hospital and Hamad Medical Corporation, Doha, State of Qatar. PATIENTS: Adult patients over 12 years of age diagnosed with bronchial asthma and/or allergic rhinitis who were referred for allergy skin pick test. 1106 adult patients recruited with respiratory diseases of suspected allergic origin who attended Allergy Clinic at the Hamad General Hospital, during three years from January 2001 to April 2003. Total of 1106 whom 607 were females (54.9%) and 499 were males (45.1%) and their mean was age 30 years (12-48). METHODS: Skin Prick Test [SPT] was performed on 1106 patients for common allergens whom The blood sample was taken for measuring specific IgE concentration. RESULTS: There were 1106 patients studied and 569 patients (51.4%) had positive skin prick test. All patients expressed clinical allergy, 464 patients (52%) had asthma and rhinitis, 286 patients (32%) had rhinitis alone and 137 patients (15%) had asthma alone. The population sample had a higher prevalence of diagnosed asthma among females (32.7%) than in males (29.8%) and also skin conditions such as eczema, pruritus, and urticaria higher in females (9.1%%) than males (7.0%). Similarly, males had higher prevalence of allergic rhinitis (86.0%) than in females. There were 318 (55.9%) patients whose asthma developed before they were 10 years old. The percentage of asthmatic patients with a positive family history of asthma was 44%. The most common allergens detected in order of frequency were Dermatophagoides Pteronyssimus (Der p l) in 248 patients (41.6%), Dermatophagoides Farinae (Der f l) in 220 patients (36.9%), Cockroach allergen (Bla g l) in 192 patients (32.2%). The study showed that females are more exposed to pollen, grasses and tress, but males are mostly exposed to mites and insects. Furthermore, Molds and Yeast were common among males. CONCLUSION: In conclusion, the frequency of indoor and outdoor allergens in state of Qatar, based on skin prick test study showed the dominance of house dust mites, pollen, grasses which are more or less same to other countries with similar and even with different climate. Reduced exposure to these agents will help control raising severity of these disease.