Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 23
Filtrar
Más filtros










Base de datos
Intervalo de año de publicación
1.
BMC Public Health ; 19(1): 769, 2019 Jun 17.
Artículo en Inglés | MEDLINE | ID: mdl-31208379

RESUMEN

BACKGROUND: Studies exploring the association between weight and asthma are not conclusive. Both obesity and asthma have been increasing in Lebanon, their association is not yet documented. The aim of this study is to explore the effect of weight on asthma control in adults. METHODS: This is a cross-sectional study, involving all consecutive asthma patients presenting to the outpatient allergy clinic at the Hotel-Dieu de France (HDF) University Hospital between January 1, 2014 and December 30, 2016. Patients included were those who consented to fill the Asthma Control Test (ACT) after 3 months of therapy. BMI was reported at the same time of the questionnaire. RESULTS: A total of 183 records of diagnosed asthma cases in adults were included. Sixty-three (34.4%) were males and 120 (65.6%) females, with a mean age of 38.5 (SD = 14.3). Ninety patients (49.2%) were of normal weight, 65 (35.5%) overweight and 28 (15.3%) obese. Seventy-one percent had an ACT score ≤ 19, which corresponds to poor asthma control. Patients who were overweight or obese were more likely to have poor asthma control compared to patients who had a normal weight at the time of evaluation. CONCLUSION: In conclusion, our study showed a significant association between asthma control as assessed by the ACT and high BMI defining overweight or obesity. This is the first national study exploring the association between asthma and overweight/obesity in Lebanon. A larger study with sampling from different specialists' sites is needed to draw more conclusions about this association.


Asunto(s)
Asma/prevención & control , Obesidad/epidemiología , Sobrepeso/epidemiología , Adolescente , Adulto , Asma/epidemiología , Índice de Masa Corporal , Comorbilidad , Estudios Transversales , Femenino , Humanos , Líbano/epidemiología , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
2.
Metabolism ; 89: 1-7, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30227144

RESUMEN

CONTEXT: Liquid Chromatography Mass Spectroscopy (LC-MS/MS) is the preferred method to measure 25 hydroxyvitamin D (25OHD) levels, but laboratories are increasingly adopting automated platform assays. OBJECTIVE: We assessed the performance of commonly used automated immunoassays, with that of LC-MS/MS, and the National Institute of Standards and Technology (NIST) reference values, to measure 25OHD levels. METHODS/SETTING: We compared serum 25OHD levels obtained from 219 elderly subjects, enrolled in a vitamin D trial, using the Diasorin Liaison platform assay, and the tandem LC-MS/MS method. We also assessed the performance of the Diasorin and Roche automated assays, expressed as mean % bias from the NIST standards, based on the vitamin D External Quality Assessment Scheme (DEQAS) reports, from 2013 to 2017. RESULTS: Serum 25OHD levels were significantly lower in the Diasorin compared to LC-MS/MS assay at baseline, 18.5 ±â€¯7.8 vs 20.5 ±â€¯7.6 ng/ml (p < 0.001), and all other time points. Diasorin (25OHD) = 0.76 × LC-MS/MS (25OHD) + 4.3, R2 = 0.596. The absolute bias was independent of 25OHD values, and the pattern unfit for any cross-calibration. The proportion of subjects considered for vitamin D treatment based on pre-set cut-offs differed significantly between the 2 assays. There also was wide variability in the performance of both automated assays, compared to NIST reference values. CONCLUSION: The performance of most widely used automated assays is sub-optimal. Our findings underscore the pressing need to re-consider current practices with regard to 25OHD measurements, interpretation of results from research studies, meta-analyses, the development of vitamin D guidelines, and their relevance to optimizing health.


Asunto(s)
Toma de Decisiones Clínicas , Deficiencia de Vitamina D/sangre , Vitamina D/análogos & derivados , Anciano , Automatización , Cromatografía Líquida de Alta Presión , Femenino , Guías como Asunto , Humanos , Inmunoensayo , Luminiscencia , Masculino , Espectrometría de Masas , Estado Nutricional , Sobrepeso/sangre , Valores de Referencia , Reproducibilidad de los Resultados , Vitamina D/sangre
3.
J Bone Miner Res ; 32(7): 1486-1495, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28276596

RESUMEN

The optimal dose of vitamin D to optimize bone metabolism in the elderly is unclear. We tested the hypothesis that vitamin D, at a dose higher than recommended by the Institute of Medicine (IOM), has a beneficial effect on bone remodeling and mass. In this double-blind trial we randomized 257 overweight elderly subjects to receive 1000 mg of elemental calcium citrate/day, and the daily equivalent of 3750 IU/day or 600 IU/day of vitamin D3 for 1 year. The subjects' mean age was 71 ± 4 years, body mass index 30 ± 4 kg/m2 , 55% were women, and 222 completed the 12-month follow-up. Mean serum 25 hydroxyvitamin D (25OHD) was 20 ng/mL, and rose to 26 ng/mL in the low-dose arm, and 36 ng/mL in the high-dose arm, at 1 year (p < 0.05). Plasma parathyroid hormone, osteocalcin, and C-terminal telopeptide (Cross Laps) levels decreased significantly by 20% to 22% in both arms, but there were no differences between the two groups for any variable, at 6 or 12 months, with the exception of serum calcitriol, which was higher in the high-dose group at 12 months. Bone mineral density (BMD) increased significantly at the total hip and lumbar spine, but not the femoral neck, in both study arms, whereas subtotal body BMD increased in the high-dose group only, at 1 year. However, there were no significant differences in percent change BMD between the two study arms at any skeletal site. Subjects with serum 25OHD <20 ng/mL and PTH level >76 pg/mL showed a trend for higher BMD increments at all skeletal sites, in the high-dose group, that reached significance at the hip. Adverse events were comparable in the two study arms. This controlled trial shows little additional benefit in vitamin D supplementation at a dose exceeding the IOM recommendation of 600 IU/day on BMD and bone markers, in overweight elderly individuals. © 2017 American Society for Bone and Mineral Research.


Asunto(s)
Calcio , Colecalciferol , Hormona Paratiroidea/sangre , Huesos Pélvicos/metabolismo , Anciano , Anciano de 80 o más Años , Calcio/administración & dosificación , Calcio/farmacocinética , Colecalciferol/administración & dosificación , Colecalciferol/farmacocinética , Femenino , Estudios de Seguimiento , Humanos , Masculino , Factores de Tiempo
4.
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
5.
Am J Clin Nutr ; 104(2): 315-23, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27413130

RESUMEN

BACKGROUND: It is unclear whether and at what dose vitamin D supplementation affects insulin resistance (IR). OBJECTIVE: We sought to investigate whether vitamin D at doses higher than currently recommended decreases indexes of IR in an ambulatory population of overweight elderly subjects. DESIGN: This double-blind, randomized, controlled multicenter trial enrolled 257 elderly overweight individuals aged ≥65 y with baseline 25-hydroxyvitamin D [25(OH)D] concentrations between 10 and 30 ng/mL. All subjects received 1000 mg calcium citrate/d, with vitamin D administered weekly at an equivalent dose of 600 or 3750 IU/d. The homeostasis model assessment (HOMA) of IR index at 1 y was the primary outcome. We also assessed the McAuley index. RESULTS: In total, 222 subjects (55% women) with a mean ± SD age and body mass index (BMI; in kg/m(2)) of 71 ± 4 y and 30 ± 4, respectively, completed the study. Subjects' baseline characteristics, including IR indexes, were similar across groups: 69% had prediabetes, 54% had hypertension (47% were taking antihypertensive medications), and 60% had hyperlipidemia, nearly half of whom were receiving lipid-lowering drugs. At 1 y, mean ± SD serum 25(OH)D increased from 20 ± 7 to 26 ± 7 ng/mL in the low-dose arm (P < 0.0001) and from 21 ± 8 to 36 ± 10 ng/mL in the high-dose arm (P < 0.001). Median HOMA-IR indexes did not change compared with baseline concentrations and were similar in the high- [2.2 (IQR: 1.5, 2.9)] and low-dose [2.3 (IQR: 1.6, 3.3] treatment groups. Adjusted analyses showed that HOMA-IR was predicted by the baseline HOMA index and BMI but not by vitamin D dose, baseline serum 25(OH)D, or change in 25(OH)D. CONCLUSION: Vitamin D3 at 3750 IU/d did not improve HOMA-IR compared with the Institute of Medicine Recommended Dietary Allowance of 600 IU/d in elderly overweight individuals. This trial was registered at clinicaltrials.gov as NCT01315366.


Asunto(s)
Colecalciferol/administración & dosificación , Suplementos Dietéticos , Resistencia a la Insulina , Obesidad , Deficiencia de Vitamina D/tratamiento farmacológico , Vitamina D/análogos & derivados , Vitaminas , Anciano , Índice de Masa Corporal , Colecalciferol/sangre , Colecalciferol/uso terapéutico , Comorbilidad , Método Doble Ciego , Femenino , Humanos , Masculino , Obesidad/sangre , Obesidad/complicaciones , Sobrepeso , Vitamina D/sangre , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones , Vitaminas/administración & dosificación , Vitaminas/sangre , Vitaminas/uso terapéutico
6.
J Med Liban ; 63(2): 59-65, 2015.
Artículo en Francés | MEDLINE | ID: mdl-26164973

RESUMEN

PURPOSE: Diabetes and diabetic retinopathy (DR) are nowadays a major public health threat. The aim of this study is the screening of DR and diabetic maculopathy (DM) in a primary medical care center in Lebanon. We study also the interest of retinography and of SD-OCT in a telemedicine screening program. METHODS: This is a transversal study of patients with type 2 diabetes and with a regular follow-up in a primary medical care center in Beirut. For every patient, a retinography and an SD-OCT of the macula were obtained. Photos were sent by Internet to the Ophthalmology Department of Hôtel-Dieu de France to be evaluated by a retina specialist. Visual acuity and DR risk factors were assessed. RESULTS: 119 patients were included in this study. Mean age was 51.7 ± 10.2 years (54 females and 65 males). Mean diabetes duration was 12.15 years (SD 6:2). Mean of last three measurements of glycated hemoglobin was 8.1 ± 1.34%. Diabetic retinopathy was detected in 36 patients by retinography (30.3%). Diabetic maculopathy was confirmed by SD-OCT in 13 patients. Visual acuity was significantly correlated with central macular thickness. Mean diabetes duration, mean of last three measurements of glycated hemoglobin, peripheral neuropathy, positive macroalbuminuria and treatment with insulin were independently associated to diabetic retinopathy. CONCLUSION: Teleophthalmology is an efficient way for screening diabetic retinopathy in the Lebanese population. National screening program should be undertaken to adapt teleophthalmology on a larger scale.


Asunto(s)
Retinopatía Diabética/patología , Mácula Lútea/patología , Telemedicina , Estudios Transversales , Técnicas de Diagnóstico Oftalmológico , Femenino , Humanos , Líbano , Masculino , Persona de Mediana Edad , Tomografía de Coherencia Óptica
7.
Endocr Pract ; 20(4): e69-74, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24449659

RESUMEN

OBJECTIVE: In contrast to the high incidence of testicular adrenal rest tumors in adult male patients with congenital adrenal hyperplasia (CAH), ovarian adrenal rest tumors (OARTs) in female CAH patients are rare. In this case report, we describe a case of bilateral OART in a female patient with CAH due to 21-hydroxylase deficiency. METHODS: We present a detailed case report with the clinical, imaging, and laboratory findings of the patient. The pertinent literature is also reviewed. RESULTS: A 17-year-old patient was known to have CAH due to 21-hydroxylase deficiency. Since the second month of her gestational age, her mother was treated with cortisone-replacement therapy. The patient was treated with hydrocortisone and fludrocortisone since the neonatal period. Her pertinent history included a bilateral adrenalectomy at the age of 13 years in 2006, and for 3 years she led a normal puberty life with no complaint with hormonal replacement therapy. Nevertheless, in 2009, she developed a virilizing syndrome. Subsequently, she underwent surgery in December 2009 for right adnexectomy. However, the regression of the masculinizing mass was not complete and worsened several months after the surgery. A new pelvic magnetic resonance image showed the activation of a contralateral ovarian mass, necessitating a left adnexectomy in August 2010. CONCLUSION: This case demonstrates some interesting features of OART that pose challenges to its management. If an OART is detected early enough and glucocorticoid therapy is received, it is possible that the OART will decrease in size following suppression of adrenocorticotropic hormone levels.

8.
Metabolism ; 63(1): 50-60, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24140101

RESUMEN

OBJECTIVE: Variants of estrogen receptor α (ERα) have been associated with obesity, dyslipidemia, diabetes and blood pressure. The Middle East registers some of the highest rate of metabolic syndrome worldwide. The aim of this study is to investigate the relationship between metabolic syndrome, a clustered combination of these metabolic factors, and polymorphisms PvuII and XbaI of ERα in Lebanese Caucasian elderly overweight subjects. MATERIAL/METHODS: 250 Caucasian Lebanese unrelated elderly men and women, median age 71 years, were studied. ERα intronic polymorphisms variants, PvuII and XbaI diplotypes and genotypes, were examined. Associations with metabolic syndrome, defined by the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI), and its components, namely high density lipoprotein (HDL), fasting glucose levels, blood pressure, and waist circumference were evaluated in regression models. RESULTS: ER α diplotypes and genotypes distributions were similar between participants with and without metabolic syndrome, in the overall group of subjects, and by gender. No consistent associations between the diplotypes and genotypes tested and metabolic syndrome, or its components, could be detected. CONCLUSIONS: Genetic variants in ERα were not associated with metabolic syndrome or its components, in a group of 250 Lebanese Caucasian elderly participants, a group with a high prevalence of metabolic syndrome.


Asunto(s)
Receptor alfa de Estrógeno/genética , Grupo de Ascendencia Continental Europea/genética , Síndrome Metabólico/genética , Sobrepeso/complicaciones , Polimorfismo de Nucleótido Simple , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Femenino , Genotipo , Humanos , Líbano , Modelos Logísticos , Masculino , Síndrome Metabólico/sangre , Obesidad/complicaciones , Reacción en Cadena de la Polimerasa
9.
J Med Liban ; 60(2): 88-90, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22919863

RESUMEN

GOAL: Idiopathic chronic urticaria may be associated to other auto-immune diseases, in particular thyroiditis. The goal of our study is to show that this association is higher than the incidence of auto-immune thyroiditis in the general population. METHODS: It is a retrospective observational study including 90 patients with chronic urticaria. We calculated the proportion of patients having associated auto-immune thyroiditis based on a level of anti-TPO >220 mUI/ml. RESULTS: The mean age of patients was 36.7 years with a sex ratio F/H of 2.9/1. The anti-TPO antibodies were positive in 16 patients (17.7%). Eight were euthyroid, seven had hypothyroidism and one had hyperthyroidism with positive anti-TSH receptor antibodies. The percentage of anti-TPO antibodies in the chronic urticaria patients was higher than the control group (17.7 vs. 8.7; p < 0.01). CONCLUSION: This significant association between chronic urticaria and autoimmune thyroiditis may change the medical practice in Lebanon by including anti-TPO and anti-thyroglobulin antibodies in the workup of patients with chronic urticaria.


Asunto(s)
Tiroiditis Autoinmune/complicaciones , Urticaria/complicaciones , Adolescente , Adulto , Anciano , Autoanticuerpos/sangre , Enfermedad Crónica , Femenino , Humanos , Yoduro Peroxidasa/inmunología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto Joven
10.
Eur J Endocrinol ; 165(4): 509-15, 2011 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-21753072

RESUMEN

BACKGROUND: Aryl hydrocarbon receptor interacting protein (AIP) mutations (AIPmut) cause aggressive pituitary adenomas in young patients, usually in the setting of familial isolated pituitary adenomas. The prevalence of AIPmut among sporadic pituitary adenoma patients appears to be low; studies have not addressed prevalence in the most clinically relevant population. Hence, we undertook an international, multicenter, prospective genetic, and clinical analysis at 21 tertiary referral endocrine departments. METHODS: We included 163 sporadic pituitary macroadenoma patients irrespective of clinical phenotype diagnosed at <30 years of age. RESULTS: Overall, 19/163 (11.7%) patients had germline AIPmut; a further nine patients had sequence changes of uncertain significance or polymorphisms. AIPmut were identified in 8/39 (20.5%) pediatric patients. Ten AIPmut were identified in 11/83 (13.3%) sporadic somatotropinoma patients, in 7/61 (11.5%) prolactinoma patients, and in 1/16 non-functioning pituitary adenoma patients. Large genetic deletions were not seen using multiplex ligation-dependent probe amplification. Familial screening was possible in the relatives of seven patients with AIPmut and carriers were found in six of the seven families. In total, pituitary adenomas were diagnosed in 2/21 AIPmut-screened carriers; both had asymptomatic microadenomas. CONCLUSION: Germline AIPmut occur in 11.7% of patients <30 years with sporadic pituitary macroadenomas and in 20.5% of pediatric patients. AIPmut mutation testing in this population should be considered in order to optimize clinical genetic investigation and management.


Asunto(s)
Péptidos y Proteínas de Señalización Intracelular/genética , Mutación/fisiología , Neoplasias Hipofisarias/epidemiología , Neoplasias Hipofisarias/genética , Adulto , ADN/genética , Femenino , Pruebas Genéticas , Humanos , Imagen por Resonancia Magnética , Masculino , Neoplasias Hipofisarias/patología , Polimorfismo de Nucleótido Simple , Estudios Prospectivos , Adulto Joven
11.
J Clin Endocrinol Metab ; 95(11): E373-83, 2010 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-20685857

RESUMEN

CONTEXT: AIP mutations (AIPmut) give rise to a pituitary adenoma predisposition that occurs in familial isolated pituitary adenomas and less often in sporadic cases. The clinical and therapeutic features of AIPmut-associated pituitary adenomas have not been studied comprehensively. OBJECTIVE: The objective of the study was to assess clinical/therapeutic characteristics of AIPmut pituitary adenomas. DESIGN: This study was an international, multicenter, retrospective case collection/database analysis. SETTING: The study was conducted at 36 tertiary referral endocrine and clinical genetics departments. PATIENTS: Patients included 96 patients with germline AIPmut and pituitary adenomas and 232 matched AIPmut-negative acromegaly controls. RESULTS: The AIPmut population was predominantly young and male (63.5%); first symptoms occurred as children/adolescents in 50%. At diagnosis, most tumors were macroadenomas (93.3%); extension and invasion was common. Somatotropinomas comprised 78.1% of the cohort; there were also prolactinomas (n = 13), nonsecreting adenomas (n = 7), and a TSH-secreting adenoma. AIPmut somatotropinomas were larger (P = 0.00026), with higher GH levels (P = 0.00068), more frequent extension (P = 0.018) and prolactin cosecretion (P = 0.00023), and occurred 2 decades before controls (P < 0.000001). Gigantism was more common in the AIPmut group (P < 0.000001). AIPmut somatotropinoma patients underwent more surgical interventions (P = 0.00069) and had lower decreases in GH (P = 0.00037) and IGF-I (P = 0.028) and less tumor shrinkage with somatostatin analogs (P < 0.00001) vs. controls. AIPmut prolactinomas occurred generally in young males and frequently required surgery or radiotherapy. CONCLUSIONS: AIPmut pituitary adenomas have clinical features that may negatively impact treatment efficacy. Predisposition for aggressive disease in young patients, often in a familial setting, suggests that earlier diagnosis of AIPmut pituitary adenomas may have clinical utility.


Asunto(s)
Adenoma/genética , Mutación de Línea Germinal , Neoplasias Hipofisarias/genética , Adenoma/patología , Adenoma/terapia , Factores de Edad , Agonistas de Dopamina/uso terapéutico , Femenino , Humanos , Masculino , Neoplasias Hipofisarias/patología , Neoplasias Hipofisarias/terapia , Resultado del Tratamiento
12.
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
13.
Abdom Imaging ; 35(6): 690-3, 2010 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-19885635

RESUMEN

Imaging techniques are in permanent evolution and so are their respective sensitivities. We present a case of a patient who had three abdominal CT scans over 10 years for the detection of pancreatic insulinomas. The first was made on an incremental CT and showed no lesion, the second on a single-slice helical CT which revealed a single centimetric tumor of the head of the pancreas, and the third on 64-slice CT which revealed 5 infracentimetric tumors. We do not know if all were present at the first scan but it is possible that these small tumors could have been missed on thick CT scan slices with overlap. The ideal imaging technique for the detection of endocrine pancreatic tumor is not known yet. The detection rates in the latest publications are 80% for CT scans and 70% for MRI, but there is a slight preference for CT scan because of its larger availability and higher resolution.


Asunto(s)
Insulinoma/diagnóstico por imagen , Neoplasias Pancreáticas/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Adulto , Medios de Contraste , Diagnóstico Diferencial , Femenino , Humanos
14.
J Med Liban ; 57(4): 218-25, 2009.
Artículo en Francés | MEDLINE | ID: mdl-20027797

RESUMEN

In this article, we analyze the clinical and biological data concerning the autoimmune thyroid diseases in patients recruited in an endocrinology clinic at the university hospital center of Hôtel-Dieu de France between March 2005 and November 2005. We studied 121 patients (51 with Basedow disease and 70 with Hashimoto thyroiditis), between 13 and 68 years old, with a BMI of 24.68 kg/m2 and with a female predominance (105 women). Symptoms of hyperthyroidism represented the most frequent cause of consultation. The distribution of patients regarding their thyroid disease showed that 42.1% of patients had hyperthyroidism (only one patient had subclinical hyperthyroidism), 21.5% had a subclinical hypothyroidism, 28.1% had clinical hypothyroidism and 8.3% had euthyroid goiter. Half of the patients had at least a member of their family whith a thyroid disease. The autoimmune thyroid diseases are strongly associated to other autoimmune diseases and to repetitive spontaneous abortion. Thus, 39% of the married women had had at least one spontaneous abortion and 26.4% of the patients had one or more autoimmune disease associated to their thyroid disease; diabetes mellitus type 1 representing the most frequent one. Concerning the treatment, we remarked a remission of 30 patients (66.7%) with Basedow disease after 18 months of antithyroid drug treatment of 45 patients. In Hashimoto thyroiditis, we remarked a frequent evolution of patients with subclinical hypothyroidism to overt hypothyroidism when medical treatment was not initiated.


Asunto(s)
Enfermedad de Graves/epidemiología , Enfermedad de Hashimoto/epidemiología , Adolescente , Adulto , Anciano , Diabetes Mellitus Tipo 1/complicaciones , Femenino , Enfermedad de Graves/diagnóstico , Enfermedad de Graves/tratamiento farmacológico , Enfermedad de Hashimoto/diagnóstico , Enfermedad de Hashimoto/tratamiento farmacológico , Humanos , Líbano/epidemiología , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Servicio Ambulatorio en Hospital/estadística & datos numéricos , Factores de Riesgo , Adulto Joven
15.
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
16.
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
17.
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
18.
Eur J Endocrinol ; 155(1): 167-76, 2006 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-16793964

RESUMEN

OBJECTIVE: The relationships between adipocytokines, sex steroids and the GH/IGF-I axis is poorly studied and subject to controversy in healthy elderly male subjects. We investigated the association between both adiponectin and leptin, and the metabolic syndrome (MetS), lipid parameters, insulin sensitivity, sex steroids and IGF-I in healthy non-diabetic Lebanese men. DESIGN AND METHODS: In this cross-sectional study, a total of 153 healthy non-diabetic men aged 50 and above (mean age 59.3 +/- 7 years) had a detailed clinical and biological evaluation. Subjects were classified according to the National Cholesterol Education Program criteria of the MetS. Insulin sensitivity was determined by the Quantitative Insulin Sensitivity Check Index (QUICKI). RESULTS: Subjects with the MetS had lower adiponectin and higher leptin levels (P < 0.0001 for both variables) compared with individuals without the MetS. Adiponectin was significantly correlated with waist size, triglycerides, high-density lipoprotein (HDL) cholesterol and QUICKI (r = -0.33, -0.26, 0.45 and 0.36 respectively, P < 0.0001 for all variables). The relation between adiponectin and HDL cholesterol, triglycerides and QUICKI remained significant after adjustment for age and body mass index (BMI). Also, leptin was strongly correlated with waist size and QUICKI (r = 0.63 and -0.63 respectively, P < 0.001 for both variables). However, its relation to the lipid profile was weak (for cholesterol r = 0.16, P < 0.05; for triglycerides r = 0.17, P < 0.05) and disappeared after adjustment for BMI. Adiponectin was positively correlated with sex hormone-binding globulin (SHBG) (r = 0.39, P < 0.001) and inversely correlated with free-androgen index (r = -0.24, P < 0.01), estradiol and dehydroepiandrosterone sulfate (r = -0.165, P < 0.05; r = -0.21, P < 0.01 respectively). This difference remained significant for SHBG after adjustment for age and BMI (r = 0.20, P < 0.005). Finally, leptin was inversely correlated with total testosterone and SHBG (r = -0.44, P < 0.001; r = -0.30, P < 0.001 respectively); the relation with testosterone remained significant after adjustment for BMI. No significant relationship of either adiponectin or leptin with GH or IGF-I values was observed. In a stepwise multiple regression analysis, the independent predictors of adiponectin were HDL cholesterol, QUICKI, age and BMI (P < 0.0001, P = 0.005, P = 0.002 and P = 0.047 respectively) while for leptin, it was QUICKI, waist size and testosterone (P < 0.0001, P < 0.0001 and P = 0.004 respectively). The adjusted R2 values were 0.34 and 0.55. CONCLUSION: Our results show that in a healthy elderly male population, both adiponectin and leptin are related to insulin sensitivity, independent of age and BMI. While adiponectin is independently related to triglycerides and HDL cholesterol, the weak relationship of leptin to the lipid profile is completely mediated by BMI. In addition, and more interestingly, both adipocytokines are strongly associated with sex steroids. We speculate that SHBG is regulated by adiponectin and that there is an inhibitory effect of testosterone on the adiponectin gene. Further studies are needed to fully elucidate these relationships.


Asunto(s)
Adiponectina/sangre , Andrógenos/sangre , Hormona de Crecimiento Humana/fisiología , Leptina/sangre , Síndrome Metabólico/sangre , Adipocitos/metabolismo , Anciano , Biomarcadores , HDL-Colesterol/sangre , Citocinas/metabolismo , Humanos , Factor I del Crecimiento Similar a la Insulina/metabolismo , Líbano , Masculino , Valores de Referencia , Análisis de Regresión , Globulina de Unión a Hormona Sexual/metabolismo , Testosterona/sangre
19.
Int J Vitam Nutr Res ; 75(4): 281-9, 2005 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-16229345

RESUMEN

Little is known about calcium and vitamin D intakes in Middle Eastern countries, where the prevalence of hypovitaminosis D is high. This study identifies major sources of calcium and vitamin D in the Lebanese diet, examines lifestyle factors that may influence intake of these nutrients and investigates the relationship between nutritional or lifestyle factors and parathyroid hormone (PTH). Three hundred sixteen young healthy volunteers aged 30 to 50 (men, non-veiled and veiled women) were recruited from different rural and urban Lebanese community centers. Food frequency questionnaire was used to evaluate the consumption of vitamin D and calcium-rich foods. We also measured serum PTH levels. Mean daily calcium and vitamin D intake were respectively 683.8 +/- 281.2 mg and 100.6 +/- 71.0 IU. Daily vitamin D sources were divided as follows: 30.4 +/- 46.4 IU from milk and dairy products, 28.2 +/- 26.3 IU from meat and poultry, 25.8 +/- 25 IU from fish, 8.5 +/- 8.6 IU from eggs, and 7.8 +/- 14.3 IU from sweets (respectively 30.2%, 28%, 25.6%, 8.4% and 7.7% of the total vitamin D intake). Mean daily calcium from animal and vegetable sources were respectively 376.3 +/- 233.6 mg and 307.9 +/- 118.5 mg. Animal/total calcium intake ratio was 52% and was only statistically significantly higher in urban people compared to rural ones. Multivariate analysis showed that male sex and urban residence were independent predictors of both vitamin D and calcium intakes (p < 0.01 and p < 0.01 respectively). In addition, veiling was an independent predictor of low vitamin D intake (p < 0.05) and a high body mass index (BMI) was an independent predictor of low calcium intake (p < 0.05). Finally, PTH was inversely correlated with vitamin D intake and the animal/total calcium intake ratio (r = -0.18 and r = -0.22, p < 0.01), while no significant results were achieved for the vegetable calcium. In a multivariate model, urban living, female gender, low vitamin D and calcium intakes, low animal/total calcium intake ratio, and high BMI, are independent predictors of hyperparathyroidism. The deficient nutritional status of vitamin D and calcium in Lebanon justify the implementation of dietary public health measures. People at most risk for secondary hyperparathyroidism should be advised to increase their dietary calcium (mostly animal calcium) and vitamin D, to take supplements, or to increase their sun exposure.


Asunto(s)
Calcio en la Dieta , Abastecimiento de Alimentos , Estilo de Vida , Hormona Paratiroidea/análogos & derivados , Deficiencia de Vitamina D/sangre , Vitamina D , Adulto , Femenino , Alimentos , Humanos , Hiperparatiroidismo/sangre , Hiperparatiroidismo/epidemiología , Estilo de Vida/etnología , Masculino , Persona de Mediana Edad , Medio Oriente , Hormona Paratiroidea/sangre , Deficiencia de Vitamina D/epidemiología , Deficiencia de Vitamina D/etnología
20.
Metabolism ; 54(7): 947-51, 2005 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-15988706

RESUMEN

BACKGROUND: The effect of statins on insulin resistance is controversial and poorly studied in nondiabetic subjects. In addition, the effect of statins on leptin and adiponectin has never been studied. METHODS: Forty healthy nondiabetic volunteers (22 men and 18 women) aged 28 to 72 were randomized either to placebo or pravastatin 40 mg daily for a 12-week period. Insulin resistance, assessed using the Quantitative Insulin Sensitivity Check Index (QUICKI), as well as serum leptin and adiponectin levels, was measured at baseline and at the end of therapy. RESULTS: Pravastatin treatment decreased total cholesterol, low-density lipoprotein cholesterol, and triglycerides levels by 24%, 32%, and 14%, respectively ( P < .05 for all), but did not affect glucose and insulin levels, the (QUICKI) index, and adiponectin and leptin levels. When stratification was performed according to QUICKI index or sex, no significant differences were observed in the prevalues and postvalues of leptin, adiponectin, or QUICKI index in the pravastatin group. Adiponectin, leptin, and QUICKI index were statistically higher in women than in men ( P < .001 for both variables). Adiponectin was negatively correlated with body mass index (BMI; r = -0.39, P < .05) and positively correlated with the QUICKI index ( r = 0.54, P < .001) and with high-density lipoprotein cholesterol ( r = 0.50, P < .01). The relation between adiponectin and QUICKI index remained significant after adjustment for sex and BMI ( P = .005 and P = .007, respectively). Leptin was only related to BMI ( r = 0.57, P < .001) and to sex ( P < .001) with no significant correlations with lipid parameters or QUICKI index. Both sex and BMI are independent predictors of leptin ( P < .001 and P < .001). CONCLUSION: A 12-week treatment with pravastatin 40 mg/d does not change the QUICKI index and leptin and adiponectin levels in healthy volunteers. In addition, our results emphasize the importance of sex and BMI in the determination of both adiponectin and leptin. Adiponectin was also related to QUICKI index, whereas this relation was not found with leptin.


Asunto(s)
Inhibidores de Hidroximetilglutaril-CoA Reductasas/farmacología , Resistencia a la Insulina , Péptidos y Proteínas de Señalización Intercelular/sangre , Leptina/sangre , Pravastatina/farmacología , Adiponectina , Adulto , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Diabetes Mellitus/prevención & control , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Placebos , Valores de Referencia
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA