Genome-wide association study identifies novel type II diabetes risk loci in Jordan subpopulations.

The prevalence of Type II Diabetes (T2D) has been increasing and has become a disease of significant public health burden in Jordan. None of the previous genome-wide association studies (GWAS) have specifically investigated the Middle East populations. The Circassian and Chechen communities in Jordan represent unique populations that are genetically distinct from the Arab population and other populations in the Caucasus. Prevalence of T2D is very high in both the Circassian and Chechen communities in Jordan despite low obesity prevalence. We conducted GWAS on T2D in these two populations and further performed meta-analysis of the results. We identified a novel T2D locus at chr20p12.2 at genome-wide significance (rs6134031, P = 1.12 × 10-8) and we replicated the results in the Wellcome Trust Case Control Consortium (WTCCC) dataset. Another locus at chr12q24.31 is associated with T2D at suggestive significance level (top SNP rs4758690, P = 4.20 × 10-5) and it is a robust eQTL for the gene, MLXIP (P = 1.10 × 10-14), and is significantly associated with methylation level in MLXIP, the functions of which involves cellular glucose response. Therefore, in this first GWAS of T2D in Jordan subpopulations, we identified novel and unique susceptibility loci which may help inform the genetic underpinnings of T2D in other populations.

The metabolic syndrome among patients undergoing cardiac catheterization in Jordan.

This study was conducted to determine the prevalence of the metabolic syndrome (MeS) and its associated factors among patients undergoing cardiac catheterization in north Jordan. A cross-sectional study was conducted among patients who underwent cardiac catheterization at King Abdullah University Hospital in north Jordan. Data from 360 patients were collected through personal interview, medical records, and anthropometric measurements. MeS was defined using National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and International Diabetes Federation (IDF) criteria. The prevalence of MeS among patients undergoing cardiac catheterization in north Jordan was 64.7% according to NCEP ATP III criteria and 76.7% according to IDF criteria. About 96.7% of the participants had at least 1 metabolic abnormality. Sex, body mass index, and family history of cardiovascular disease were the only variables significantly associated with MeS. The prevalence of MeS among patients undergoing cardiac catheterization in north Jordan is considerably high, especially among women.

The standard clinical smell testing protocol of the National Center for Diabetes, Endocrinology and Genetics in Amman, Jordan: JOR test.

OBJECTIVE: The aim of this study was the development of a simple clinical smell test that can be applied in Jordan and its validation against one of the standard tests, the University of Pennsylvania Smell Test (UPSIT, Sensonics Inc, Haddon Heights, NJ). DESIGN: A prospective validation study of a locally designed smell test was done. SETTING: The study was conducted at the National Center for Diabetes, Endocrinology and Metabolism in Amman, Jordan. PARTICIPANTS: Fifty subjects were recruited to participate in this study. Twenty-five were normal healthy individuals, and 25 were patients with Kallmann syndrome. INTERVENTION AND MAIN OUTCOME MEASURES: All 50 participants underwent 2 tests, the UPSIT and the locally designed test (JOR test). The scores of all patients in both tests were compared. Test-retest reliability was determined in the same 50 subjects. All patients completed the study. RESULTS: Subjects who scored within normal limits on the UPSIT scored 8 to 10 on the JOR test, and people who were abnormal on the UPSIT scored between 0 and 5 on the JOR test. The correlation between the scores of both tests was almost perfect (r = 0.984, P = .000). When both tests were classified as normal and abnormal, there was a complete agreement (kappa statistic = 1). Both sensitivity and specificity were 100%. CONCLUSION: Given its highly significant correspondence to the UPSIT and the odor thresholds of Jordanians, our test proved valid and useful as a cross-cultural clinical test of olfactory function. In addition, it is an inexpensive, rapid test. Unfortunately, the data lacked persons with moderate impairment of smell. Therefore, the new test may not be used to assess this category of patients.

High prevalence of the metabolic syndrome among Northern Jordanians.

BACKGROUND: The prevalence of the metabolic syndrome is rapidly increasing with a considerable ethnic variation within and across populations. This study was conducted to estimate the prevalence of the metabolic syndrome and its individual components using Adult Treatment Panel III (ATP III) criteria among Northern Jordanians. METHODS: Data were analyzed from a cross-sectional study that included a random sample of 1121 northern Jordanians aged 25 years and above. The metabolic syndrome was defined by ATP III criteria. RESULTS: The age-adjusted prevalence of the metabolic syndrome was 36.3% (95% CI 33.6-39.0%) (28.7% among men and 40.9% among women). The prevalence increased significantly with age in men and women. The prevalence of the metabolic syndrome was significantly higher in women than in men in age groups of 40-49 and 60 years and above. Low HDL cholesterol was the most common abnormality in men (62.7%), and abdominal obesity was the most common abnormality in women (69.1%). CONCLUSIONS: Prevalence of the metabolic syndrome in North Jordan is considerably higher than in developed countries and other Arab populations. An integrated approach is needed for the prevention and treatment of the metabolic syndrome.

Sexual dysfunction among Jordanian men with diabetes.

OBJECTIVE: To estimate the prevalence and severity of erectile dysfunction (ED) and its correlations among Jordanian men with diabetes. METHODS: We conducted this study at the National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan, between January and August 2004. The study included 988 married diabetic men. Patients were interviewed by one of our medical staff based on a health care questionnaire and an Arabic translation of the 15-item International Index of Erectile Function. Scores of the questions in each of the 5 sexual function domains were summed up. Dysfunction was categorized as absent, mild, moderate or severe. RESULTS: The overall prevalence of ED was 62%; and we found that 30.3% had severe ED. The prevalence increased with age from 26.5% (13 out of 49) of patients <40 years of age to 91% (87 out of 96) in the age group > or = 70 years. Severity of ED increased with age as well. Multivariate logistic regression analysis identified age, glycemic control, hypertension, coronary artery disease, retinopathy and neuropathy as independent risk factors of ED. Among patients with ED, 7% reported having treatment for ED. CONCLUSION: Prevalence of ED among Jordanian diabetic patients is high. It increases with age and poor glycemic control. Other independent risk factors include: hypertension, coronary artery disease, retinopathy and neuropathy.

Thyroid dysfunction in patients with type 2 diabetes mellitus in Jordan.

OBJECTIVE: To investigate the prevalence of thyroid dysfunction and autoimmunity in type 2 diabetic patients. METHODS: The study was conducted at the National Center for Diabetes, Endocrinology and Genetics, Jordan University Hospital, Amman, Jordan, between March 2000 and September 2000. A group of 908 type 2 diabetic patients (T2DM) were recruited in the study and underwent investigations for thyroid functions; free thyroxine (FT4), free tri-iodothyronine (FT3) and thyroid stimulating hormone (TSH). Six hundred had performed thyroid autoantibodies, thyroid peroxidase antibodies (TPOab) or antimicrosomal antibodies (AMA) and thyroglobulin antibodies (Tgab). They were compared with 304 non-diabetics, of those 282 had performed thyroid antibodies. RESULTS: Fifty-three (5.9%) of diabetic patients were known to have thyroid disease. As a direct result of screening, new thyroid disease cases were diagnosed in 6.6% of the patients. Thus, the overall prevalence of thyroid disease was found to be 12.5%. The most common was subclinical hypothyroidism (4.1%). In the control group, the prevalence of thyroid disease was 6.6%. The most common was subclinical hypothyroidism (5%). There was a significant difference between diabetics and control subjects p=0.0064. Positive TPOab was found in 8.3% of T2DM patients (N=600) versus 10.3% in the control group (N=282) p=0.412. Positivity for both TPOab and Tgab was found to be 2.5% of T2DM versus 6% of the control subjects p=0.0155. CONCLUSION: This study suggests that diabetic patients should be screened for asymptomatic thyroid dysfunction.

Epidemiology and management of hypertension among Bedouins in Northern Jordan.

OBJECTIVE: To estimate the magnitude of hypertension, and its levels of awareness and control of hypertension among a community of Jordanian aborigines in Northern Jordan; and to compare the study findings with findings from other Jordanian communities. METHODS: A systematic sample of 50% of all households of Qafqafa, Northern Jordan was selected and all members of the selected households were included in the study at Qafqafa Health Center, Qafqafa, Jordan. A structured questionnaire was administered to all study participants and measurement of blood pressure was performed according to a preset criteria. Data on 366 subjects included in the sample were collected during the months of April and May 2002. RESULTS: A total of 40 subjects or 10.9% were suffering from hypertension. Prevalence rate of hypertension was significantly lower than the 16.1% and 16.3% prevalence rates reported from other more modernized Jordanian communities. Logistic regression analysis indicated that hypertension was positively associated with masculinity, age, illiteracy, obesity, and with positive family history of hypertension. No association was detected between hypertension and each of smoking, Diabetes mellitus, and total serum cholesterol. This study showed that one-half (47.5%) of hypertensives were unaware of their diagnosis and more than one-half (57.1%) of those aware of their diagnosis did not achieve control of their hypertension. CONCLUSION: Population of the study community has significantly lower levels of hypertension than both semi-urban and recently urbanized Jordanian communities, and much of the rise in blood pressure levels is attributed to environmental factors. Moreover, hypertension management programs in Jordan are far below the optimal standards.