Gut microbiota analyses of Saudi populations for type 2 diabetes-related phenotypes reveals significant association.

BACKGROUND: Large-scale gut microbiome sequencing has revealed key links between microbiome dysfunction and metabolic diseases such as type 2 diabetes (T2D). To date, these efforts have largely focused on Western populations, with few studies assessing T2D microbiota associations in Middle Eastern communities where T2D prevalence is now over 20%. We analyzed the composition of stool 16S rRNA from 461 T2D and 119 non-T2D participants from the Eastern Province of Saudi Arabia. We quantified the abundance of microbial communities to examine any significant differences between subpopulations of samples based on diabetes status and glucose level. RESULTS: In this study we performed the largest microbiome study ever conducted in Saudi Arabia, as well as the first-ever characterization of gut microbiota T2D versus non-T2D in this population. We observed overall positive enrichment within diabetics compared to healthy individuals and amongst diabetic participants; those with high glucose levels exhibited slightly more positive enrichment compared to those at lower risk of fasting hyperglycemia. In particular, the genus Firmicutes was upregulated in diabetic individuals compared to non-diabetic individuals, and T2D was associated with an elevated Firmicutes/Bacteroidetes ratio, consistent with previous findings. CONCLUSION: Based on diabetes status and glucose levels of Saudi participants, relatively stable differences in stool composition were perceived by differential abundance and alpha diversity measures. However, community level differences are evident in the Saudi population between T2D and non-T2D individuals, and diversity patterns appear to vary from well-characterized microbiota from Western cohorts. Comparing overlapping and varying patterns in gut microbiota with other studies is critical to assessing novel treatment options in light of a rapidly growing T2D health epidemic in the region. As a rapidly emerging chronic condition in Saudi Arabia and the Middle East, T2D burdens have grown more quickly and affect larger proportions of the population than any other global region, making a regional reference T2D-microbiome dataset critical to understanding the nuances of disease development on a global scale.

Favorable impact of Nigella sativa seeds on lipid profile in type 2 diabetic patients.

BACKGROUND AND AIM: The atherogenic pattern of dyslipidemia associated with type 2 diabetes mellitus (DM) has been increasingly discussed. We have recently reported a hypoglycemic effect of Nigella sativa (NS) seeds in patients with type 2 DM. In this study we sought to assess the impact of NS seeds on lipid profile in type 2 diabetic patients. PATIENTS AND METHOD: A total of 94 patients with type 2 DM were recruited and divided into 3 dose groups. Capsules containing NS were administered orally in a dose of 1, 2, and 3 g/day for 12 weeks. All patients were subjected to measurement of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c) before treatment and 4, 8, and 12 weeks thereafter. RESULTS: Patients receiving 1 g/day NS seeds for 12 weeks (group 1) showed nonsignificant changes in all the parameters except for a significant increase in HDL-c after 4 weeks of treatment. However, patients ingested 2 g/day NS displayed a significant decline in TC, TG, and LDL-c, and a significant elevation in HDL-c/LDL-c, compared with their baseline data and to group 1 patients. Increasing NS dose to 3 g/day failed to show any increase in the hypolipdemic effect produced by the 2 g/day dose. CONCLUSION: NS supplementation at a dose of 2 g/day for 12 weeks may improve the dyslipidemia associated with type 2 diabetic patients. Therefore, NS is a potential protective natural agent against atherosclerosis and cardiovascular complications in these patients.

Modified Alvarado score for acute appendicitis in overweight patients.

OBJECTIVE: To find out the efficacy of Modified Alvarado (MA) scoring system in diagnosis of acute appendicitis in the overweight patients. METHODS: All the patients with suspected acute appendicitis admitted in the surgical department at King Fahad Hospital, Hofuf, Al-Hassa, during the period from September 2004 to December 2006 were included in the study. Patients with score of 7 or more of modified Alvarado score were included, patients with score of 6 or less were excluded. All patients underwent diagnostic laparoscopy, and the diagnosis was confirmed by histopathological examination. RESULTS: There was total of 228 patients. Twenty -four percent were overweight and 12% patients were obese. Sixty percent of the patients had confirmed diagnosis of acute appendicitis. CONCLUSION: Modified Alvarado scoring system is an easy method for diagnosis for acute appendicitis. It can be used as complementary aid for supporting the diagnosis of acute appendicitis in overweight and obese patients.

Morbidity patterns among king faisal university students, Al hassa, kingdom of saudi arabia.

OBJECTIVES: To explore the prevalent morbidity problems among students at King Faisal University. To identify the nature of referred cases and assess the efficiency of the referral system. SUBJECTS AND METHODS: This was a retrospective, records-based descriptive study, involving the examination of the health records of students at King Faisal University, who attended the Medical Center for Primary Health Care services in a five-year period. A pre-tested compilation sheet was used for data collection. RESULTS: Out of 2472 consultations, about 58 % of the diagnosed morbidity conditions were of infectious nature, mostly affecting the respiratory (62%), dental (14%), gastrointestinal (7%), and skin infections (5 %), with more prevalence among males. The non-infectious morbidity conditions were recorded more among females and included muscle and joints problems (16 %), allergic conditions (15 %), gastrointestinal (8 %), and trauma (5 %). Some of the encountered morbidity demonstrated seasonal variation. Case referrals were about 6 %, more in the non-infectious conditions, with a deficient feedback system. CONCLUSION: Quality improvement of the medical records and the establishment of a proper referral system are necessary. Health education on preventable morbid conditions should be organized and implemented.

Leptin levels in normal weight and obese saudi adults.

OBJECTIVE: The purpose of the study was to measure serum leptin in normal weight and obese individuals, and assess its relation to anthropometric measures and metabolic indices. METHODS: The study was conducted at King Fahd Hospital of the University, Saudi Arabia, from January 2003 to June 2004. Subjects included in the study were all non-diabetic normotensive adults. Variables measured were body mass index (BMI), waist to hip ratio (WHR), blood pressure, serum leptin, insulin, glucose, and lipids. RESULTS: Included were 43 non-obese subjects (20 men and 23 women) with the mean age of 25.8 + SD 5.3 y for men and 23.9 + SD 1.9 y for women and their mean BMI was 23.1 ± 1.4 for men and 23.0 ± 1.8 for women. Serum leptin was significantly higher in women 8.8 + SEM 2.10 than men 2.2 + SEM 0.26 ng /ml.Also included were 46 obese subjects (25 men and 21 women) with a mean age of 29.4 + SD 7.6 y for men and 28.8 + SD 6.2 y for women and a mean BMI of 35.5 ± 5.7 for men and 35.6 ± 4.4 for women. Serum leptin was significantly higher in women 23.0 + SEM 3.98, than men 12.5 + SEM 2.24 ng /ml. Serum leptin was significantly higher in obese men and women compared to non-obese subjects. Serum leptin significantly, and positively correlated with BMI (r 0.440), hip circumference (r 0.425), serum insulin (r 0.334), and HOMA IR (r 0.334).There was no correlation with mean age, mean systolic BP, mean diastolic BP, or WHR. CONCLUSIONS: Serum leptin increased with obesity, and was higher in women than men, both lean and obese. Serum leptin correlated positively with BMI and hip circumference. Though, correlation between leptin and insulin resistance was found, they probably reflect two different metabolic compartments.

Frequency of methylenetetrahydrofolate reductase C677T polymorphism in patients with cardiovascular disease in Eastern Saudi Arabia.

OBJECTIVE: Homozygosity for the C677T mutation in the gene of the thermolabile enzyme 5,10 methylenetetrahydrofolate reductase (MTHFR) associates with reduced enzyme activity, leading to mild hyperhomocysteinemia. We now know that an elevated level of homocysteine is an important risk factor for cardiovascular disease (CVD). The objective of this study was to determine the prevalence of the C677T mutation in Saudi patients diagnosed with CVD. METHODS: Over a period of 2 years (2003-2004) in a case control study, we determined the prevalence of the C677T mutation in 83 CVD patients and in 40 age and gender-matched controls in the Eastern Province of Saudi Arabia. We determined the MTHFR genotype by restriction fragment length polymorphism and allele specific hybridization procedures. RESULTS: The CVD group showed over representation of the C677T allele frequencies (20.5%) compared with unaffected controls (15%) (p=0.3). Furthermore, the genotypic data indicated that the prevalence of homozygosity for the C677T mutation was dramatically higher in the CVD patients (10.8%) when compared with normal (0%) (p=0.058). CONCLUSION: These results suggest that the MTHFR C677T variant mildly influences CVD. However, we require further investigation in large independent samples.

Electives during medical internship.

OBJECTIVE: The purpose of the study was to find out the reasons for selecting elective rotations during a rotating medical internship. METHODS: One hundred and seventy-eight medical interns in the College of Medicine, King Faisal University, Dammam, Kingdom of Saudi Arabia during the period March 2001 to August 2002 completed a questionnaire for their selection reasons with responses on a scale of 1-5. RESULTS: The study comprised 60% males and 98.3% Saudis. The most frequently chosen electives are dermatology 28.1%, radiology 20.8%, anesthesia 9.6% and otorhinolaryngology (ear, nose and throat [ENT]) 9%. Significantly, more males (89.2%) chose radiology rotation and more females (75%) chose ENT rotation. The leading reasons to choose an elective rotation are: 1. to gain broad medical training and education, 2. to assist in choice of future specialty, and 3. being relevant to future specialty. The mean score for ENT and dermatology is higher than radiology and anesthesia for the response "to participate in medical practice in different institute", while dermatology is higher than anesthesia for the response "to help getting acceptance for job in the same institute", and radiology is higher than ENT and anesthesia for the response "it has infrequent or no night duties". CONCLUSION: The reasons chosen reflect the educational value of the electives and their important role in choosing future career. Dermatology and radiology rotations are most popular electives, with additional though different reasons.