Pre-hypertension and hypertension in college students in Kuwait: a neglected issue.

OBJECTIVE: To determine the proportion of pre-hypertension and hypertension in college students in Kuwait and their related risk factors. MATERIALS AND METHODS: A total of 803, randomly selected students aged 17 to 23 years (346 male, 457 female) from different colleges in Kuwait, were included in the study between 2009 and 2010. Systolic and diastolic blood pressure measurements were taken by trained personnel. Pre-hypertension was defined as systolic pressure between 120 and 139 mm Hg or diastolic pressure between 80 and 89 mm Hg. Risk factor measurements that were determined, included smoking, body mass index (BMI), and family history of hypertension. Blood samples were collected and impaired glucose tolerance (IGT) and lipid profile levels were determined. RESULTS: There were no hypotensive students. Normotensives constituted 53.5% (n = 430), pre-hypertensives formed 39.5% (n = 317), and hypertensive students comprised of 7% (n = 56). The overall proportions of hypertension and pre-hypertension were higher among male students (85.7 and 64.4%) than female students (14.3 and 35.6%), respectively. Hypertensive and pre-hypertensive students versus normotensive students had significantly higher levels of BMI-based obesity, smoking, glycated hemoglobin (HbA1c), and IGT. Also, hypertensive and pre-hypertensive, compared to normotensive students, had significantly higher proportions (21.4, 18.3, and 4.0%, respectively) of risky high-density lipoprotein (HDL) level (< 1 mg / dL), cholesterol (7.1, 3.8, and 1.4%, respectively), and triglycerides (TG) (17.9, 9.1, and 7.9%, respectively) where p was< 0.001, 0.016, and 0.051, respectively. CONCLUSION: Hypertensive and pre-hypertensive students showed elevated levels of lipids and BMI-based obesity more than normotensive students. TG, HDL, HbA1c, and cholesterol appeared to influence pre-hypertension.

Association between apolipoprotein E-polymorphism and Ischemic heart disease patients with or without type 2 diabetes mellitus: a preliminary study in Kuwait.

BACKGROUND: We investigated the association between apolipoprotein E polymorphism and ischemic heart disease with or without type 2 diabetes in Kuwait and examined the impact of apolipoprotein E polymorphism in diabetic patients. METHODS: The present study was conducted from January 2005 to June 2006 in the Diabetic Clinic of Al-Amiri and Al-Sabah Hospitals in Kuwait City. Apolipoprotein E polymorphism was assessed in 250 subjects of which 83 were ischemic heart disease patients (41 diabetic and 42 non-diabetic) and 105 were diabetic patients without ischemic heart disease. Results were compared with 62 healthy controls. Apolipoprotein E polymorphisms were detected by polymerase chain reaction-restriction fragment length polymorphism. RESULTS: Apolipoprotein E3 allele was the most commonly occurring form. The frequency of apolipoprotein E4 was higher in ischemic heart disease patients with type 2 diabetes (39%) and the non-diabetic (31%) group, but lower in the diabetic (20%) and control groups (16%). CONCLUSION: Apolipoprotein E4 allele may be related to the development of ischemic heart disease in patients with or without type 2 diabetes in Kuwait.  However, future studies with larger population sizes are needed to establish such relationship.

Effect of 17beta-estradiol on insulin secretion and cytosolic calcium in Min6 mouse insulinoma cells and human islets of Langerhans.

OBJECTIVE: Female gonadal steroids can exert an insulinotropic effect in vivo. The objective of this study was to investigate the effects in vitro of 17-beta-estradiol (17beta-E2) on changes in cytosolic calcium ([Ca]i) and on insulin secretion from the MIN6 mouse insulinoma cell line and human primary islets of Langerhans. METHODS: Stimulus-induced changes in [Ca]i were measured in Fura-2-loaded cells by single cell microfluorimetry. The effects of 17beta-E2 on insulin secretion were measured in static incubation experiments, and the rate and pattern of secretory responses were studied in multi-channel perifusion experiments. RESULTS: 17Beta-E2 (1-100 nmol/L) enhanced basal (2 mmol/L glucose) insulin secretion but had no effect on secretory responses to 20 mmol/L glucose or to depolarizing stimuli (100 micromol/L tolbutamide, 20 mmol/L KCl). Approximately 60% of MIN6 cells responded to 17beta-E2 (1-100 nmol/L) with a small but sustained increase in [Ca]i, whereas 98% of MIN6 cells responded to tolbutamide (100 micromol/L). Similar effects were observed in experiments using human primary beta cells. In contrast, 17beta-E2 had no detectable effect on the increases in [Ca]i evoked by tolbutamide (100 micromol/L) or glucose (20 mmol/L). CONCLUSIONS: Our observations are consistent with a rapid effect of 17beta-E2 to depolarize beta cells leading to an influx of extracellular Ca and the initiation of insulin secretion by the consequent elevations in [Ca]i. We suggest that this may offer a mechanism through which circulating estradiol can influence beta-cell responsiveness to other signals.