ABSTRACT
Leprosy is a chronic granulomatous infection that primarily affects developing and underdeveloped countries. Co-infection with the hepatitis B virus can complicate its natural course by altering the host immune system response and thereby the disease outcomes. Early detection and treatment of the disease is thus imperative for preventing debilitating deformities. Several studies have shown positive viral markers for human immunodeficiency virus (HIV) and hepatitis B in patients with leprosy. However, in the Indian subcontinent, we have limited evidence highlighting this correlation. We present a case of a 42-year-old male with chronic hepatitis B infection presenting with new-onset lepromatous leprosy. The patient was successfully managed with a multibacillary multidrug regimen. In patients with hepatitis B co-infection, clinicians must be vigilant about the higher risk of complications and poorer patient outcomes. Extensive longitudinal studies assessing the correlation between leprosy and hepatitis B in India can help tailor future guidelines for management.
ABSTRACT
BACKGROUND: The association of serum prolactin (PRL) with diabetes is still uncertain, with a paucity of data in the south Indian population. This study aims to compare the serum PRL levels between type 2 diabetes mellitus (T2DM) patients and normoglycaemic volunteers and correlate the serum PRL level with fasting plasma glucose (FPG), postprandial plasma glucose (PPG), glycated haemoglobin (HbA1c) levels, and the lipid profile in the study population. METHODS: This was a comparative cross-sectional study among 112 T2DM participants and 112 healthy volunteers in a tertiary care centre in India. All participants were tested for FPG, PPG, HbA1c, fasting serum lipid profile, and serum PRL, which were compared between T2DM patients and healthy volunteers. RESULTS: The serum PRL in T2DM patients was significantly lower compared to healthy volunteers (8.67 ± 4.37 vs. 13.76 ± 6.55 ng/ml, P < 0.001). FPG, PPG, and HbA1c correlated inversely with serum PRL in our study population. On multivariable logistic regression adjusted for age and sex, a higher serum PRL level within the physiological range was protective for T2DM (adjusted odds ratio: 0.83, 95% CI: 0.77-0.90, P < 0.001). Serum PRL levels were inversely correlated with serum total cholesterol, low-density lipoprotein cholesterol, and triglycerides, but not with high-density lipoprotein cholesterol. CONCLUSIONS: A high serum PRL within the physiological range was inversely associated with the prevalence of T2DM in the south Indian population. Serum PRL also correlated inversely with glycaemic and blood lipid parameters. Larger longitudinal studies are required to further validate the association of serum PRL with various components of metabolic syndrome in the south Indian population.
ABSTRACT
AIM: We aimed to identify the predictors of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (type 2 DM). METHODS: About fifty Asian Indian patients with type 2 DM patients aged >40 years and fifty sex- and age-matched nondiabetic controls were enrolled for this study. Following complete medical history and baseline clinical data, laboratory investigations were performed to assess fasting and postprandial plasma glucose levels, lipid profile, blood urea, serum creatinine, and serum uric acid levels. RESULTS: Body mass index (BMI), waist-to-hip ratio, serum uric acid, serum total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, very LDL cholesterol were significantly higher among diabetic patients compared to controls. On univariate analysis, serum LDL cholesterol (odds ratio [OR]: 29.67, P < 0.001), serum uric acid (OR: 25.65, P < 0.001), low high-density lipoprotein (HDL) cholesterol (OR: 21.12, P < 0.001), hypertension (OR: 17.06, P < 0.001), family history of cardiovascular disease (CVD) (OR: 9.43, P = 0.002), and duration of diabetes (OR: 4.65, P = 0.03) were identified as predictors of CVD among diabetic patients. On multivariate regression, only LDL cholesterol (OR: 1.51, P = 0.002) and serum uric acid (OR: 1.21, P = 0.01) were the independent predictors of CAD among diabetic patients. Significant positive correlation of serum uric acid with duration of diabetes (r = 0.38, P = 0.006), BMI (r = 0.35, P = 0.01), triglycerides (r = 0.356, P = 0.01), LDL cholesterol (r = 0.38, P = 0.007), HDL cholesterol (r = -0.514, P < 0.001), and hypertension (r = 0.524, P < 0.001) was observed. CONCLUSION: Serum LDL cholesterol and hyperuricemia may serve as independent predictors of CAD among Asian Indian subjects with type 2 DM.