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1.
Artículo en Inglés | MEDLINE | ID: mdl-31680140

RESUMEN

CONTEXT: IGF1 receptor mutations (IGF1RM) are rare; however, patients exhibit pronounced growth retardation without catch-up. Although several case reports exist, a comprehensive statistical analysis investigating growth profile and benefit of recombinant growth hormone (rhGH) treatment is still missing. OBJECTIVE AND METHODS: Here, we compared IGF1RM carriers (n = 23) retrospectively regarding birth parameters, growth response to rhGH therapy, near final height and glucose/insulin homeostasis to treated children born small for gestational age (SGA) (n = 34). Additionally, health profiles of adult IGF1RM carriers were surveyed by a questionnaire. RESULTS: IGF1RM carriers were significantly smaller at rhGH initiation and had a diminished first-year response compared to SGA children (Δ height SDS: 0.29 vs. 0.65), resulting in a lower growth response under therapy. Interestingly, the number of poor therapy responders was three times higher for IGF1RM carriers than for SGA patients (53 % vs. 17 %). However, most IGF1RM good responders showed catch-up growth to the levels of SGA patients. Moreover, we observed no differences in HOMA-IR before treatment, but during treatment insulin resistance was significantly increased in IGF1RM carriers compared to SGA children. Analyses in adult mutation carriers indicated no increased occurrence of comorbidities later in life compared to SGA controls. CONCLUSION: In summary, IGF1RM carriers showed a more pronounced growth retardation and lower response to rhGH therapy compared to non-mutation carriers, with high individual variability. Therefore, a critical reevaluation of success should be performed periodically. In adulthood, we could not observe a significant influence of IGF1RM on metabolism and health of carriers.

2.
Endocr Pract ; 25(11): 1101-1108, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31241365

RESUMEN

Objective: The purpose of this study is to determine the prevalence of prediabetes/diabetes in Lebanese university students and to examine the relationship between both hemoglobin A1c (HbA1c) and blood pressure (BP) and gender, body mass index (BMI), study field, and lifestyle factors. Methods: This cross-sectional study was carried out at the Saint-Joseph University of Beirut. A total of 603 students aged 18 to 25 years were recruited from both the medical science campus (MSC) and the social science campus (SSC) between January, 2016, and May, 2018. Waist circumference (WC), BMI, and BP were determined for each student and HbA1c was measured using the Siemens vintage DCA device. Participants completed a self-administered questionnaire about their eating habits and level of physical activity. Results: The mean age of the population was 20.31 ± 1.76 years. The percentage of participants recruited from the MSC was 59.2%. The prevalence of prediabetes was 2.5%. Lower BMI, WC, and HbA1c values, and higher diastolic BP (DBP) were found in MSC students compared to SSC ones. HbA1c, systolic BP (SBP), and DBP were correlated with BMI (P = .02, P<.0001, and P = .017, respectively). HbA1c was not associated with eating habits or physical activity. DBP was inversely associated with physical activity (P = .002), while SBP was positively associated with fast food consumption (P = .003). Conclusion: The present study shows a low prevalence of prediabetes in Lebanese students. BMI and the study field are the main factors predicting HbA1c and BP. Further studies are needed to extrapolate our results to the overall young Lebanese population. Abbreviations: ADA = American Diabetes Association; BMI = body mass index; BP = blood pressure; DBP = diastolic blood pressure; HbA1c = hemoglobin A1c; HTN = hypertension; MSC = medical science campus; SBP = systolic blood pressure; SSC = social science campus; T2D = type 2 diabetes; US = United States; USJ = Saint-Joseph University; WC = waist circumference.


Asunto(s)
Estilo de Vida , Presión Sanguínea , Índice de Masa Corporal , Estudios Transversales , Diabetes Mellitus Tipo 2 , Hemoglobina A Glucada , Humanos , Hipertensión , Factores de Riesgo , Estudiantes , Circunferencia de la Cintura , Adulto Joven
3.
Lipids Health Dis ; 18(1): 48, 2019 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-30744653

RESUMEN

BACKGROUND: Few studies looked at the prevalence of dyslipidemia in pediatric Middle-Eastern countries. In addition, worldwide longitudinal changes of lipid profile is not well documented. The purpose of this study is to look at the longitudinal changes of lipid parameters in Lebanese school-age children. MATERIALS AND METHODS: A total of 97 subjects (41 girls and 56 boys) aged between 11 and 21 years were included in this study. The subjects were selected among 339 school-age children with a previous abnormal lipid profile who were recruited from 10 schools of varying socio-economic levels (SEL). A fasting lipid profile [total cholesterol (TC), triglycerides (TG) and HDL-cholesterol (HDL-C)] was performed. Non-HDL-cholesterol (Non-HDL-C) was calculated. Weight and height were measured under the same conditions, and BMI percentiles were calculated. A multivariate covariance analysis model (MANCOVA) was used with TG, HDL-C and non-HDL-C as dependent variables with additional post-MANCOVA F tests. RESULTS: The age of the current cohort is 16.5 ± 2.9 years with no significant difference according to gender. The current lipid profile was obtained 3.1 ± 0.7 years following the initial one, with 53.6% of the subjects having it normalized. TC, TG, and non-HDL-C decreased significantly over time in girls, while only TG decreased significantly in boys. No significant changes were observed for HDL-C. Using MANCOVA, a significant time by age interaction was observed (p < 0.0001), while gender, BMI and SEL were found not to be significant. Post-hoc F tests showed that the time by age interaction was driven by TG (p = 0.03) and non-HDL-C (p < 0.001), the larger effect being observed in younger children. CONCLUSION: A high proportion of school-age children normalize their abnormal lipid profile with time. Screening for lipid disorders could be postponed until post puberty age.


Asunto(s)
HDL-Colesterol/sangre , LDL-Colesterol/sangre , Dislipidemias/sangre , Triglicéridos/sangre , Adolescente , Estatura , Índice de Masa Corporal , Peso Corporal , Niño , Dislipidemias/diagnóstico , Dislipidemias/economía , Ayuno , Femenino , Humanos , Líbano , Estudios Longitudinales , Masculino , Análisis Multivariante , Factores Sexuales , Factores Socioeconómicos , Adulto Joven
4.
Arch Osteoporos ; 14(1): 9, 2019 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-30643980

RESUMEN

The purpose of this study is to establish the prevalence and determinants of fractures among 974 Lebanese schoolchildren aged 8-18. Fractures might be less common in the Lebanese pediatric population compared to western populations. Male gender and high SES are independent risk factors for fractures, while 25(OH)D and BMI have no impact. PURPOSE: To establish the prevalence of fractures among Lebanese schoolchildren and its relationship with age, gender, BMI, 25 hydroxyvitamin D (25(OH)D) levels, and socioeconomic status (SES). METHODS: In this cross-sectional study, 974 Lebanese schoolchildren aged 8-18 years old, mean age 13.37 ± 2.92 (508 boys and 466 girls), were recruited from 10 schools with different SES. For each participant, a questionnaire was used to collect data regarding history of fractures. Serum 25(OH)D was also measured. RESULTS: The prevalence of Lebanese children sustaining ≥ 1 fracture was 16.9% and was higher in boys compared to girls (22.2% vs 11.1%, p < 0.0001). A 71.3% of fractures were localized in the upper limbs and 20% of participants had at least one displaced fracture. Children who sustained a fracture had a non-significant higher BMI compared to those without (p = 0.096). The percentage of children with fractures was higher in children from high SES compared to those from middle and low SES (respectively 23.3% vs. 16.3% and 13.8%, p < 0.0001). Fractures occurred at a younger age in girls compared to boys, but this difference was non-significant (p = 0.13). 25(OH)D levels were significantly higher in children with fractures compared to those without (p = 0.017). Finally, female gender was protective against upper limb fractures (p = 0.009). In a logistic regression analysis, male gender and high SES were independently associated with fractures, while BMI and 25(OH)D were not. CONCLUSION: Our study demonstrates that the prevalence of fractures in the Lebanese pediatric population might be lower than western populations. It also confirms that male gender and high SES are independent risk factors for fractures, while 25(OH)D and BMI were not independently associated with fracture risk.

5.
Int J Endocrinol ; 2017: 6372964, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28250769

RESUMEN

The aims of this study are to establish reference values for TSH in Lebanese schoolchildren; to look at the relationship between TSH and age, gender, BMI, socioeconomic status (SES), and thyroid antibodies (TAb); and to investigate the prevalence of abnormal TAb in this population. 974 Lebanese schoolchildren aged 8-18 years were recruited from 10 schools of different SES. Third-generation TSH, TPO-Ab, and Tg-Ab measurements were performed using the IMMULITE chemiluminescent immunoassay. The mean TSH is 2.06 ± 1.05 µUI/ml. TSH values are inversely correlated with age (p < 0.0001), are higher in boys than in girls (resp., 2.14 ± 1.10 and 1.98 ± 0.99 µUI/ml, p = 0.017), and are positively correlated with BMI (p < 0.0001). They are also significantly higher in subjects from low-SES schools (p = 0.03) and in girls with positive TAb (p = 0.026). In boys, TSH is independently associated with age, BMI, and schools' SES (p = 0.01, p = 0.03, and p = 0.026, resp.) while in girls, the association is only significant for age and TAb (p = 0.0001 and p = 0.015, resp.). The prevalence of TAb is 4.3% (3% for TPO-Ab and 2.1% for Tg-Ab). Our results showed higher TSH values in the pediatric Lebanese population compared to western populations. TSH varies according to age, gender, BMI, and SES and is associated in girls with TAb.

6.
Endocr Pract ; 23(4): 391-398, 2017 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-28095043

RESUMEN

OBJECTIVE: The aims of our study were to establish reference values for insulin-like growth factor 1 (IGF-1) in Lebanese schoolchildren and to evaluate the relationship between IGF-1 and age, sex, body mass index (BMI), vitamin D, and ferritin. METHODS: This cross-sectional study included 952 Lebanese schoolchildren (495 boys and 457 girls) aged 8 to 18 years. Blood samples were taken from children attending 10 schools with different socio-economic status (SES). Chemiluminescent immunoassays were used for IGF-1, 25 hydroxyvitamin D (25(OH)D), testosterone, and ferritin measurements. RESULTS: The mean age was 13.46 ± 2.80 with no significant difference according to sex. IGF-1 was correlated with age in both sexes (P<.0001); it was higher in girls compared to boys (P = .007) and peaked at the ages of 14 and 12 for boys and girls, respectively. For each age group, the median IGF-1 value was higher compared to the values provided by the kit. IGF-1 was significantly correlated with BMI in boys (r = 0.16, P<.0001) but not girls. In both sexes, IGF-1 was inversely correlated with 25(OH)D and ferritin values. After adjustment for age, BMI, and height, the correlation between IGF-1 and 25(OH)D disappeared, whereas the relationship with ferritin persisted (P<.001 for boys, P = .002 for girls). For both sexes, multivariate regression analysis revealed independent associations between IGF-1 and height, Tanner stage, and ferritin. An association was also noted in boys for BMI and testosterone. CONCLUSION: Our results showed higher and earlier peak IGF-1 values in the pediatric Lebanese population compared to western populations. In addition, an independent inverse relationship was observed between IGF-1 and ferritin. Further studies are needed to identify the reason(s) underlying these results. ABBREVIATIONS: BMI = body mass index CRP = C-reactive protein CV = coefficient of variation GH = growth hormone IGF-1 = insulin-like growth factor 1 25(OH)D = 25 hydroxyvitamin D SES = socio-economic status TSH = thyroid-stimulating hormone.


Asunto(s)
Ferritinas/sangre , Factor I del Crecimiento Similar a la Insulina/metabolismo , Estudiantes , Vitamina D/sangre , Adolescente , Factores de Edad , Índice de Masa Corporal , Niño , Estudios Transversales , Femenino , Humanos , Líbano/epidemiología , Masculino , Instituciones Académicas/estadística & datos numéricos , Factores Sexuales , Estudiantes/estadística & datos numéricos
7.
Pharmacogenomics ; 17(15): 1675-1686, 2016 10.
Artículo en Inglés | MEDLINE | ID: mdl-27672714

RESUMEN

AIM: To explore the association between VDR polymorphisms and several cardiovascular risk factors and adiponectin. MATERIALS & METHODS: Three-hundred and sixty-nine healthy students were randomly selected. Five VDR polymorphisms were genotyped: BsmI rs1544410; Cdx2 rs11568820; ApaI rs7975232; TaqI rs731236 and FokI rs2228570. BMI, waist circumference (WC), blood pressure, lipid/glycemic profiles and adiponectin were assessed. RESULTS: In men, BsmI, ApaI and TaqI were associated with BMI and WC (p < 0.05). FokI was associated with triglycerides and high-density lipoprotein levels (p = 0.0036; p = 0.005) whereas BsmI and Cdx2 were associated with adiponectin levels (p = 0.026; p = 0.048). Associations disappeared after BMI and WC adjustments. In women, ApaI was associated with systolic blood pressure (p = 0.02). CONCLUSION: Our study demonstrated a gender-specific difference between VDR SNPs and various cardiovascular risk factors and adiponectin.


Asunto(s)
Adiponectina/sangre , Enfermedades Cardiovasculares/etiología , Polimorfismo de Nucleótido Simple , Receptores de Calcitriol/genética , Adulto , Índice de Masa Corporal , Femenino , Humanos , Lípidos/sangre , Masculino , Factores de Riesgo , Análisis de Secuencia de ADN , Vitamina D/análogos & derivados , Vitamina D/sangre
8.
J Clin Lipidol ; 10(2): 378-85, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27055969

RESUMEN

BACKGROUND: The prevalence of dyslipidelmia in pediatric Middle-Eastern populations is unknown. Our study aims to investigate the distribution and correlates of non-high-density lipoprotein cholesterol (non-HDL-C) and triglycerides among Lebanese school children. METHODS: A total of 969 subjects aged 8-18 years were included in the study (505 boys and 464 girls). Recruitment was done from 10 schools located in the Great Beirut and Mount-Lebanon areas. Non-fasting total cholesterol, triglycerides, and HDL-cholesterol (HDL-C) were measured. Non-HDL-C was calculated. Schools were categorized into 3 socioeconomic statuses (SESs; low, middle, and high). RESULTS: In the overall population, the prevalence of high non-HDL-C (>3.8 mmol/L), very high non-HDL-C (>4.9 mmol/L), and high triglycerides (>1.5 mmol/l) are respectively 9.2%, 1.24%, and 26.6%. There is no significant gender difference for non-HDL-C or triglycerides. Non-HDL-C and triglycerides are inversely correlated with age in girls (P < .0001 for both variables) but not in boys. They are also positively correlated with body mass index (BMI) in boys and girls (P < .0001 for all variables). There is no relationship between schools' socioeconomic process (SES) and non-HDL-C. However, triglycerides are higher in children from lower SES schools. After adjustment for age and body mass index (BMI), testosterone is inversely associated with triglycerides in boys (P < .0001). In a multivariate regression analysis, non-HDL-C is independently associated with age and BMI in girls (P < .0001 for both variables) but only with BMI in boys (P < .0001), whereas triglycerides are independently associated with BMI and schools' SES in both girls and boys. CONCLUSIONS: This study confirms, in our population, the association between obesity and both high non-HDL-C and triglycerides, and between high triglycerides and low SES.


Asunto(s)
Colesterol/sangre , Instituciones Académicas/estadística & datos numéricos , Triglicéridos/sangre , Adolescente , Distribución por Edad , Índice de Masa Corporal , Niño , Dislipidemias/sangre , Dislipidemias/epidemiología , Femenino , Humanos , Líbano/epidemiología , Masculino , Distribución por Sexo , Clase Social , Testosterona/sangre
9.
Bone ; 68: 142-5, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25180662

RESUMEN

INTRODUCTION: Hypophosphatemic rickets (HR) comprises a rare group of inherited diseases. Very recently, mutations in the dentin matrix protein 1 (DMP1) gene were identified in patients with an extremely rare autosomal recessive form of HR (ARHR). To date, very few cases of these mutations were reported. MATERIALS AND METHODS: A Lebanese consanguineous family with 2 affected sisters was studied. Patients aged 45 and 47years old presented with short stature, severe genu varum, cranial hyperostosis and a very high bone density that led to a diagnosis of a familial sclerosing bone dysplasia. Molecular analysis of known genes involved in osteopetrosis showed normal results. A combination of genotyping and exome sequencing was performed in order to elucidate the genetic basis of this pathology. RESULTS: Biochemical analysis was consistent with normal serum calcium and 1-25(OH)2D levels, low to normal serum phosphorus and elevated PTH values. Serum c-terminal FGF-23 was elevated in one of the two patients. A homozygous mutation disrupting the initiation codon of the DMP1 gene (OMIM 600980), NM_001079911.2: c.1A>G, p.Met1Val, was identified by exome sequencing and confirmed by Sanger sequencing. CONCLUSION: We report here a family of ARHR secondary to a DMP1 mutation located in the first coding exon of the gene. Our cases show that some ARHR cases may develop with age an unaccountable increase in bone density and bone overgrowth.


Asunto(s)
Exoma/genética , Proteínas de la Matriz Extracelular/genética , Osteocondrodisplasias/genética , Fosfoproteínas/genética , Adulto , Secuencia de Bases , Análisis Mutacional de ADN , Familia , Femenino , Humanos , Persona de Mediana Edad , Datos de Secuencia Molecular , Mutación/genética , Osteocondrodisplasias/sangre , Osteocondrodisplasias/diagnóstico por imagen , Osteocondrodisplasias/orina , Radiografía
10.
PLoS One ; 9(7): e100409, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25019163

RESUMEN

BACKGROUND: Low total testosterone (TT) and sex hormone-binding globulin (SHBG) concentrations have been associated with the metabolic syndrome (MetS) in men, but the reported strength of association varies considerably. OBJECTIVES: We aimed to investigate whether associations differ across specific subgroups (according to age and body mass index (BMI)) and individual MetS components. DATA SOURCES: Two previously published meta-analyses including an updated systematic search in PubMed and EMBASE. STUDY ELIGIBILITY CRITERIA: Cross-sectional or prospective observational studies with data on TT and/or SHBG concentrations in combination with MetS in men. METHODS: We conducted an individual participant data meta-analysis of 20 observational studies. Mixed effects models were used to assess cross-sectional and prospective associations of TT, SHBG and free testosterone (FT) with MetS and its individual components. Multivariable adjusted odds ratios (ORs) and hazard ratios (HRs) were calculated and effect modification by age and BMI was studied. RESULTS: Men with low concentrations of TT, SHBG or FT were more likely to have prevalent MetS (ORs per quartile decrease were 1.69 (95% CI 1.60-1.77), 1.73 (95% CI 1.62-1.85) and 1.46 (95% CI 1.36-1.57) for TT, SHBG and FT, respectively) and incident MetS (HRs per quartile decrease were 1.25 (95% CI 1.16-1.36), 1.44 (95% 1.30-1.60) and 1.14 (95% 1.01-1.28) for TT, SHBG and FT, respectively). Overall, the magnitude of associations was largest in non-overweight men and varied across individual components: stronger associations were observed with hypertriglyceridemia, abdominal obesity and hyperglycaemia and associations were weakest for hypertension. CONCLUSIONS: Associations of testosterone and SHBG with MetS vary according to BMI and individual MetS components. These findings provide further insights into the pathophysiological mechanisms linking low testosterone and SHBG concentrations to cardiometabolic risk.


Asunto(s)
Síndrome Metabólico/epidemiología , Globulina de Unión a Hormona Sexual/análisis , Testosterona/sangre , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Estudios Transversales , Humanos , Masculino , Persona de Mediana Edad , Estudios Observacionales como Asunto , Oportunidad Relativa , Estudios Prospectivos , Adulto Joven
12.
Metabolism ; 62(10): 1416-22, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23769129

RESUMEN

OBJECTIVE: Third generation parathyroid hormone (PTH) assays are new generation assays that do not recognize the PTH7-84 fragment whereas second generation assays detect both PTH1-84 and PTH7-84 fragments. Despite the excellent correlation between both assays in chronic renal failure (CRF) subjects, the mean PTH levels are typically 50% lower with the third compared to the second generation assays. The assessment of third generation PTH assays has not been extensively studied in hemodialysis subjects. The purpose of our study was to compare a third generation PTH assay to a second generation one in a population of hemodialysis subjects. MATERIALS AND METHODS: 92 haemodialysis subjects (36 women and 56 men) with a mean age of 67±12.9 years were included in this study. Anthropometric and clinical parameters (Body Mass Index (BMI) and blood pressure) were measured. Second and third generation PTH assays (Cis biomedical and Diasorin respectively) were performed in each subject. In addition, the following biochemical tests were measured: 25-hydroxyvitamin D (25-(OH)D), 1,25-hydroxyvitamin D (1,25-(OH)2D), crosslaps and alkaline phosphatase. RESULTS: The mean second and third generation PTHs are respectively 211±205 pg/ml and 151±164 pg/ml. The mean third generation PTH values are 28.4% lower compared to the second generation ones. Both methods are strongly correlated (r=0.923, p<0.001). This correlation persisted without any significant difference after controlling for gender, age, BMI and Blood Pressure. However, the difference between both methods increases when baseline PTH increases. Each of the second and third generation method is significantly correlated with hemodialysis duration (p<0.01), crosslaps (p<0.001), alkaline phosphatase (p<0.05), but not with age, BMI, Blood Pressure, 25-(OH)D or 1,25-(OH) 2D levels. CONCLUSION: Our results show that both second and third generation PTH methods are strongly correlated in hemodialysis patients mainly when PTH values are low. However, the difference between both methods increases when PTH values are high. More research is needed to establish which method is the gold standard when PTH values are high.


Asunto(s)
Fallo Renal Crónico/sangre , Hormona Paratiroidea/sangre , Diálisis Renal , Anciano , Fosfatasa Alcalina/sangre , Presión Sanguínea/efectos de los fármacos , Índice de Masa Corporal , Enfermedades Óseas Metabólicas/sangre , Colágeno/sangre , Femenino , Humanos , Fallo Renal Crónico/fisiopatología , Fallo Renal Crónico/terapia , Masculino , Fragmentos de Péptidos/sangre , Estadística como Asunto , Vitamina D/análogos & derivados , Vitamina D/sangre
13.
Eur J Endocrinol ; 168(1): K1-7, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-23045302

RESUMEN

BACKGROUND: Heterozygous mutations in the IGF1 receptor (IGF1R) gene lead to partial resistance to IGF1 and contribute to intrauterine growth retardation (IUGR) with postnatal growth failure. To date, homozygous mutations of this receptor have not been described. SUBJECT: A 13.5-year-old girl born from healthy first-cousin parents presented with severe IUGR and persistent short stature. Mild intellectual impairment, dysmorphic features, acanthosis nigricans, and cardiac malformations were also present. METHODS: Auxological and endocrinological profiles were measured. All coding regions of the IGF1R gene including intron boundaries were amplified and directly sequenced. Functional characterization was performed by immunoblotting using patient's fibroblasts. RESULTS: IGF1 level was elevated at 950NG/ML (+7 S.D.). Fasting glucose level was normal associated with high insulin levels at baseline and during an oral glucose tolerance test. Fasting triglyceride levels were elevated. sequencing of the IGF1R gene led to the identification of a homozygous variation in exon 2: c.119G>T (p.Arg10Leu). As a consequence, IGF1-dependent receptor autophosphorylation and downstream signaling were reduced in patient's fibroblasts. Both parents were heterozygous for the mutation. CONCLUSION: The homozygous mutation of the IGF1R is associated with severe IUGR, dysmorphic features, and insulin resistance, while both parents were asymptomatic heterozygous carriers of the same mutation.


Asunto(s)
Insuficiencia de Crecimiento/genética , Receptor IGF Tipo 1/genética , Anomalías Múltiples/genética , Adolescente , Preescolar , Femenino , Retardo del Crecimiento Fetal/genética , Heterocigoto , Homocigoto , Humanos , Resistencia a la Insulina/genética , Discapacidad Intelectual/genética , Modelos Moleculares
14.
Clin Endocrinol (Oxf) ; 74(6): 720-5, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21521259

RESUMEN

OBJECTIVE: The relationship between androgens and blood pressure, insulin resistance, lipid profile, adiponectin and hs-CRP in a young Middle-Eastern population has not been examined previously. We studied this relationship in a randomly selected population of Lebanese students. METHODS: Three hundred and sixty-eight subjects (201 men and 167 women) aged 18-30 years were included in the study. Anthropometric and biological parameters [waist circumference (WC), systolic and diastolic blood pressure (SBP and DBP), triglycerides, total cholesterol, HDL cholesterol, homeostasis model assessment of insulin resistance (HOMA-IR), total testosterone (TT), dehydroepiandrostenedione sulphate (DHEAS), sex hormone-binding globulin (SHBG), adiponectin (ADP) and hs-CRP] were measured. RESULTS: In men, there were inverse associations of both TT and SHBG with body mass index (BMI), WC, HOMA-IR, triglycerides and hs-CRP. After adjustment for major confounders (BMI, WC, age and smoking), associations disappeared except for those between TT and hs-CRP, and for SHBG HOMA-IR, hs-CRP and triglycerides. In women, only SHBG was inversely associated with BMI, WC, HOMA-IR and hs-CRP and positively correlated with adiponectin. Except for the association between SHBG and adiponectin, these correlations disappeared after adjustment for confounders. Although DHEAS appeared to correlate negatively with blood pressure in men, this relationship disappeared after adjustment for confounders, while a relationship between DHEAS and triglycerides in women persisted after such adjustment. In multivariate regression analysis, SHBG was an independent predictor of hs-CRP, triglycerides and HOMA-IR in men and of adiponectin in women. CONCLUSION: Our results suggest that SHBG is independently associated with HOMA-IR, adiponectin, hs-CRP and triglycerides. A gender difference in these associations is observed. Further studies are needed to elucidate these findings.


Asunto(s)
Andrógenos/sangre , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/fisiopatología , Adolescente , Adulto , Glucemia/metabolismo , Presión Sanguínea/fisiología , Índice de Masa Corporal , Proteína C-Reactiva/metabolismo , Colesterol/sangre , HDL-Colesterol/sangre , Sulfato de Deshidroepiandrosterona/sangre , Femenino , Humanos , Resistencia a la Insulina/fisiología , Masculino , Análisis Multivariante , Análisis de Regresión , Factores de Riesgo , Factores Sexuales , Globulina de Unión a Hormona Sexual/metabolismo , Testosterona/sangre , Triglicéridos/sangre , Circunferencia de la Cintura , Adulto Joven
15.
J Med Liban ; 58(4): 191-4, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-21409940

RESUMEN

Vitamin D inadequacy is highly prevalent in Lebanon in young adults, school children and postmenopausal osteoporotic women. However, this prevalence has not been previously studied in university students. Three hundred and eighty-one students (mean age 23.9 +/- 3.9 years), randomly recruited from Saint-Joseph University, were included in this cross-sectional study (201 males and 180 females). Recruitment was performed across all seasons. The mean 25 hydroxyvitamin D (25(OH)D) was 31 +/- 12A ng/ml. 25(OH)D was inversely correlated with BMI and waist circumference (r = -0.18 and r = -0.19,p < 0.001 for both variables). 25(OH)D was significantly different between the winter season and the other seasons (p = 0.023, p = 0.001 and p < 0.0001 for spring, summer and fall respectively). 25(OH)D was lower in men compared to women (29.01 +/- 11.23 versus 33.2 +/- 13A, p < 0.01). This gender difference disappears after adjustment for both season and BMI. In addition, the inverse relation between 25(OH)D and BMI was non significant in the female population. In a stepwise multilinear regression analysis using 25(OH)D as a dependent variable, season and BMI were the independent predictors of vitamin D levels (p < 0.0001 and p = 0.001 respectively). Our results suggest that, in a population of high educational level, vitamin D status is better compared to other subgroups of the Lebanese population. In addition, we found, after adjustment for BMI and season, no gender difference in 25(OH)D levels while the winter season and a high BMI negatively affect vitamin D status.


Asunto(s)
Hidroxicolecalciferoles/sangre , Adulto , Índice de Masa Corporal , Estudios Transversales , Femenino , Humanos , Líbano , Masculino , Persona de Mediana Edad , Estaciones del Año , Estudiantes , Universidades
16.
Metabolism ; 58(6): 746-52, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19446111

RESUMEN

The metabolic syndrome (MetS) prevalence in a young Middle Eastern population has never been studied. We studied this prevalence in a randomly selected population of Lebanese students using different MetS classifications. Three hundred eighty-one subjects aged 18 to 30 years were included in the study. Anthropometric and biological parameters (waist circumference [WC], systolic and diastolic blood pressures, fasting plasma glucose, triglycerides, total cholesterol, high-density lipoprotein cholesterol, and homeostasis model assessment [HOMA] index to assess insulin resistance) were measured. Receiver operating characteristic (ROC) curves were generated to determine population-specific cutoff values for MetS parameters and HOMA index. The MetS prevalence was calculated using the National Cholesterol Education Program's Adult Treatment Panel III (ATP-III), the actualized ATP-III, and our cutoffs, either with or without HOMA index as an extra risk factor. The MetS prevalence using the ATP-III and the actualized ATP-III was, respectively, 5.25% and 5.28%. It increased to 9.19% when using our cutoff values and to 12.64% when HOMA index was added. This increase was significant only in men. The identified cutoff values are, for WC, 91 cm in women and 99.5 cm in men and, for HOMA index, 2.32. Among the MetS components, WC was the best MetS predictor, whereas fasting plasma glucose was the poorest. Our study shows that the MetS prevalence in Lebanon is comparable with other countries. In addition, we identified in our population new cutoff points for MetS parameters and HOMA index that allow the detection of a higher number of subjects with the MetS, mainly in the male population.


Asunto(s)
Síndrome Metabólico/clasificación , Síndrome Metabólico/epidemiología , Adolescente , Adulto , Glucemia , Presión Sanguínea , Femenino , Homeostasis , Humanos , Resistencia a la Insulina , Líbano/epidemiología , Lípidos/sangre , Masculino , Síndrome Metabólico/diagnóstico , Guías de Práctica Clínica como Asunto , Prevalencia , Curva ROC , Factores Sexuales , Circunferencia de la Cintura , Adulto Joven
17.
Hum Mutat ; 30(7): E682-91, 2009 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-19319977

RESUMEN

Autosomal dominant hypercholesterolemia (ADH), a major risk for coronary heart disease, is associated with mutations in the genes encoding the low-density lipoproteins receptor (LDLR), its ligand apolipoprotein B (APOB) or PCSK9 (Proprotein Convertase Subtilin Kexin 9). Familial hypercholesterolemia (FH) caused by mutation in the LDLR gene is the most frequent form of ADH. The incidence of FH is particularly high in the Lebanese population presumably as a result of a founder effect. In this study we characterize the spectrum of the mutations causing FH in Lebanon: we confirm the very high frequency of the LDLR p.Cys681X mutation that accounts for 81.5 % of the FH Lebanese probands recruited and identify other less frequent mutations in the LDLR. Finally, we show that the p.Leu21dup, an in frame insertion of one leucine to the stretch of 9 leucines in exon 1 of PCSK9, known to be associated with lower LDL-cholesterol levels in general populations, is also associated with a reduction of LDL-cholesterol levels in FH patients sharing the p.C681X mutation in the LDLR. Thus, by studying for the first time the impact of PCSK9 polymorphism on LDL-cholesterol levels of FH patients carrying a same LDLR mutation, we show that PCSK9 might constitute a modifier gene in familial hypercholesterolemia.


Asunto(s)
Mutación , Serina Endopeptidasas/genética , LDL-Colesterol/sangre , Codón sin Sentido , Salud de la Familia , Humanos , Hiperlipoproteinemia Tipo II , Líbano/epidemiología , Mutación Missense , Proproteína Convertasa 9 , Proproteína Convertasas , Receptores de LDL/genética , Serina Endopeptidasas/fisiología
18.
Eur J Endocrinol ; 160(6): 965-71, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19289535

RESUMEN

OBJECTIVES: Several studies suggest a link between circulating 25-hydroxyvitamin D (25(OH)D) and metabolic risk factors. However, this relation has been mainly studied in elderly and/or obese subjects. In addition, the relation between 25(OH)D and adiponectin is unclear. The purpose of this study is to look at these relations in non-obese young individuals. DESIGN: We investigated the relation between serum 25(OH)D and adiposity, blood pressure, glucose metabolism, lipid profile, and adiponectin in 381 randomly selected university students (201 males and 180 females, mean age 23.9+/-3.9). RESULTS: In the overall population, 25(OH)D is significantly inversely correlated with body mass index (BMI), systolic blood pressure (SBP), waist circumference (WC), fasting plasma glucose (FPG), insulin levels, and homeostasis model assessment of insulin resistance (HOMA index) and positively correlated with adiponectin and high density lipoprotein-cholesterol (P<0.01 for all variables). In males, these correlations are still significant for BMI, SBP, WC, and adiponectin (P=0.02, P=0.01, P=0.04 and P=0.01 respectively); also, 25(OH)D is inversely correlated with low density lipoprotein (LDL)-cholesterol (P=0.007). In females, 25(OH)D is only inversely correlated with FPG and HOMA index (P<0.001 and P=0.03 respectively). In multivariate regression analysis models, after adjustment for sex and BMI, 25(OH)D is an independent predictor of FPG and SBP (P=0.032 and P=0.05 respectively) in the overall population, while in males 25(OH)D is a predictor of LDL-cholesterol and SBP independently of BMI (P=0.007 and P=0.035 respectively). CONCLUSION: In non-obese young subjects, we observe new relationships between 25(OH)D and several metabolic risk factors and adiponectin. Further research is needed to elucidate the gender differences and to look at the relation between 25(OH)D and adiponectin.


Asunto(s)
Adiponectina/sangre , Resistencia a la Insulina/fisiología , Vitamina D/análogos & derivados , Adulto , Glucemia , Presión Sanguínea , Índice de Masa Corporal , Grupo de Ascendencia Continental Europea , Femenino , Humanos , Insulina/sangre , Lipoproteínas HDL , Masculino , Medio Oriente , Factores de Riesgo , Vitamina D/sangre , Circunferencia de la Cintura , Adulto Joven
19.
Br J Nutr ; 101(4): 487-91, 2009 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-18631414

RESUMEN

In Middle-Eastern countries, more particularly in Lebanon, the incidence of vitamin D deficiency has been found to be surprisingly high in schoolchildren and young individuals. However, the prevalence and risk factors for vitamin D inadequacy amongst Lebanese osteoporotic women seeking medical health care has never been studied. We analysed vitamin D-inadequacy risk factors among the 251 Lebanese postmenopausal osteoporotic women (from both Muslim and Christian communities) who participated in a vitamin D international epidemiological study. Vitamin D inadequacy prevalence (25-hydroxyvitamin D (25(OH)D) , 30 ng/ml) was 84.9%. 25(OH)D was negatively correlated with BMI (r 20.41; P<0.001) and positively correlated with educational level (r 0.37; P<0.001) and self-reported general health (r 0.17; P<0.01). No significant correlation was found with age and no seasonal variation was observed. There was no significant correlation between 25(OH)D and sun exposure index or vitamin D-rich food consumption. However, 25(OH)D strongly correlated with vitamin D supplement intake (r 0.48; P<0.0001). Muslim community participants had lower 25(OH)D levels compared with their Christian counterparts (P<0.001). They also had higher BMI, lower educational level and vitamin D supplement consumption and followed more frequently a dress code covering the arms (P<0.0001 for all variables). In a multivariate model, in Muslims, inadequate vitamin D supplements and a dress code covering the arms are the independent predictors of 25(OH)D inadequacy (P<0.001 for both variables). However, in Christians, the predictors are inadequate vitamin D supplements, high BMI and low educational level (P<0.001; P=002 and P=0.02 respectively). There is an urgent need to increase vitamin D supplement use in Middle-Eastern osteoporotic women, more particularly in those from the Muslim community.


Asunto(s)
Estilo de Vida , Osteoporosis Posmenopáusica/sangre , Deficiencia de Vitamina D/epidemiología , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Cristianismo , Vestuario , Dieta , Suplementos Dietéticos , Escolaridad , Femenino , Humanos , Islamismo , Líbano/epidemiología , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Luz Solar , Vitamina D/análogos & derivados , Vitamina D/sangre , Vitaminas/sangre
20.
Eur J Endocrinol ; 158(3): 353-9, 2008 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-18299469

RESUMEN

OBJECTIVE: We analyzed the relation of osteoprotegerin (OPG) with insulin sensitivity, lipid profile, serum glutamic pyruvic transaminase (SGPT), adipocytokines, and C-reactive protein (CRP) in obese and non-obese subjects. METHODS: In the study, 170 subjects (106 obese and 64 non-obese, sex ratio female/male=2.03) were included. Thirty-two obese subjects were reevaluated 6 months after the weight loss induced by bariatric surgery. RESULTS: OPG did not differ between obese and non-obese subjects (respective mean values 5.17 and 4.96 pmol/l) or according to gender, but was positively correlated with age (P<0.0001 for both groups). OPG was statistically higher in 18 obese diabetic subjects compared with non-diabetics (P=0.03). After adjustment for age, no significant correlation was found between OPG and body mass index (BMI), waist, systolic and diastolic blood pressure, cholesterol, triglycerides, high density lipoprotein (HDL) cholesterol, leptin, and adiponectin in both the obese and non-obese subjects. However, OPG was positively correlated with homeostasis model assessment (HOMA) index and SGPT levels in obese subjects at baseline (r=0.295, r=0.20, P<0.05) and after adjustment for age (r=0.28, r=0.20, P<0.05). OPG was also significantly correlated with CRP; this correlation persisted after adjustment for age in obese subjects (r=0.30, P<0.01). In a multivariate analysis in the obese group, HOMA index and CRP were independent predictors of OPG while SGPT was not. Six months post-surgery, OPG did not change, despite a significant reduction in glucose, SGPT, cholesterol, triglycerides, CRP, and leptin values (P=0.02, P=0.006, P=0.007, P<0.001, P<0.001, P<0.001 respectively) and a significant increase in adiponectin and HDL values (P<0.001 for both variables). CONCLUSION: Our results show that in obese subjects, OPG is not related to BMI. However, we describe new relationships between OPG and both HOMA index and CRP.


Asunto(s)
Adipoquinas/sangre , Peso Corporal/fisiología , Proteína C-Reactiva/metabolismo , Resistencia a la Insulina , Obesidad/metabolismo , Osteoprotegerina/sangre , Adulto , Alanina Transaminasa/sangre , Cirugía Bariátrica , Enfermedades Cardiovasculares/epidemiología , HDL-Colesterol/sangre , Estudios Transversales , Diabetes Mellitus Tipo 2/epidemiología , Femenino , Homeostasis/fisiología , Humanos , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Obesidad/cirugía , Análisis de Regresión , Factores de Riesgo , Triglicéridos/sangre , Pérdida de Peso/fisiología
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