Elevation of small, dense low density lipoprotein cholesterol-a possible antecedent of atherogenic lipoprotein phenotype in type 2 diabetes patients in Jos, North-Central Nigeria.

BACKGROUND: The global prevalence of type 2 diabetes is increasing. Dyslipidaemia is a known complication of diabetes mellitus manifesting frequently as cardiovascular diseases and stoke. Elevation of small, dense low density lipoprotein has been recognised as a component of the atherogenic lipoprotein phenotype associated with cardiovascular complications. We speculate that the elevation of this lipoprotein particle may be the antecedent of the atherogenic lipoprotein phenotype. This study therefore aims to determine the pattern of dyslipidaemia among diabetes mellitus patients in Jos, North-Central Nigeria. METHODS: One hundred and seventy-six patients with type 2 diabetes and 154 age-matched controls were studied. The patients with diabetes were regular clinic attenders and had stable glycaemic control. None were on lipid-lowering therapy. Anthropometric indices, blood pressure, and lipids (including total cholesterol, high density lipoprotein cholesterol, and triglyceride) were measured by chemical methods using the Hitachi 902 analyzer. Low density lipoprotein cholesterol was calculated using the Friedewald's equation. Small, dense low density lipoprotein cholesterol, -sdLDL-C was measured using the precipitation method by Hirano et al. Means of the different groups were compared using EPI Info and a P-value of <0.05 was accepted as significant difference. RESULTS: Total cholesterol, low density lipoprotein cholesterol, triglyceride and small, dense lipoprotein cholesterol were all significantly higher in diabetes patients than controls except high density lipoprotein cholesterol. The percentage of LDL-C as sdLDL-C among the diabetes versus control group was 45% ± 17.79 v 32.0% ± 15.93. Serum sdLDL-C concentration was determined to be 1.45 ± 0.64 among diabetes patients and 0.8 ± 0.54 among control subjects. 75% of diabetes patients had hypertension and were taking blood pressure lowering medications. CONCLUSION: The classical atherogenic lipoprotein phenotype was not demonstrated among subjects with type 2 diabetes mellitus in this study, but the elevation of serum small dense low density lipoprotein cholesterol in patients with sustained hypertension suggests the establishment of atherogenic complications among our diabetes patients.

Plasma Malondialdehyde (MDA): An Indication of Liver Damage in Women with Pre-Eclamsia.

BACKGROUND: One of the features associated with pre-eclampsia is elevated liver transaminases. The reason this happens has not been fully described. However, the hepatocytes are not known to be spared by free radical injury. This study was conducted to examine the relationship between product of free radical injury (malondialdehyde) and transaminases in pre-eclamptic women. PATIENTS AND METHODS: A total of 98 and 115 pre-eclamptic and apparently normal pregnant women were selected from the booking clinic of Ladoke Akintola University of Technology Teaching Hospital, Osogbo. Non-pregnant women were selected from volunteered members of staff. Malondialdehyde (MDA), aspartate transaminase (AST) and alanine transaminase (ALT) analyses were determined on collected venous blood sample. Statistical analyses of variables were done using SPSS 17 taking level of significance to be p<0.05. RESULTS: Subjects with plasma AST between 10 and 20U/L had mean plasma MDA of 0.92µmol/l whereas those with plasma levels greater than 41U/L had mean plasma MDA of 4.72µmol/l. Similarly, Subjects with plasma ALT between 10 and 20U/L had mean plasma MDA of 0.86µmol/l, and subjects with plasma ALT greater than 51 U/L had mean plasma MDA of 4.71µmol/l. Positive correlation was observed between AST and ALT(r=0.79; p=0.047), between AST and MDA(r=0.690; p=0.061) as well as between ALT and MDA(r=0.571; p=0.049). CONCLUSION: The elevated liver enzymes seen in women with pre-eclampsia may be due to free radical injury to the liver. Pre-eclamptic women without free radical injury did not have elevated transaminases.

Free radical attack on membrane lipid and antioxidant vitamins in the course of pre-eclamptic pregnancy.

BACKGROUND: Despite the volume of knowledge and daily reports on pre-eclampsia, its pathogenesis is still yet to be ascertained. Oxidative stress (oxidant (free radical) in excess of antioxidant) injury is one of the recently suggested pathogenetic mechanisms. This study, however, was designed to determine second and third trimesters of plasma malondialdehyde (product of free radical attack on membrane lipid) and vitamins C and E in pre-eclamptic Nigerian women. SUBJECTS AND METHODS: A Total of 100 subjects, each for pre-eclamptic, apparently normal and non-pregnant women qualified for the study. Venous blood samples were taken in the second and third trimesters of pregnancy and at the point of contact for non-pregnant women. Variables were analyzed using SPSS version 16, taking level of significance to be 0.05. RESULTS: Plasma malondialdehyde in the third trimester of normal pregnancy (2.03±0.71µmol/l) was found to be significantly higher than the one in the second trimester (1.65±0.62µmol/l) (p<0.0001). For pre-eclamptic subjects, the malondialdehyde in the third trimester (3.13±0.61µmol/l) was also higher than the malondialdehyde in the second trimester (3.00±1.21µmol/l). The mean vitamin C values for subjects with normal pregnancy were similar in the second and third trimesters (38.25±19.66 vs. 38.66±19.40; p=0.882). For subjects with pre-eclampsia, the mean Vit C values were also similar in the 2(nd) and 3(rd) trimesters (35.05±18.37 vs. 37.20±24.44µmol/l; p=0.175). Mean vitamin E values in the second and third trimesters were also similar for subjects with normal pregnancy (28.62±13.85 vs. 28.50±13.35µmol/l; p=0.950). A similar finding was observed in pre-eclamptic subjects (25.09±12.79 vs. 28.00±14.83µmol/l; p=0.067). CONCLUSION: There was an increased product of membrane lipid attack (malondialdehyde) with no change in plasma levels of vitamins C and E as pregnancy advances into the third trimester of both normal and pre-eclamptic pregnancies. Antioxidant vitamins may not be useful in stopping the progression of free radical attack on membrane lipid to control pre-eclampsia.

The impact of blood and seminal plasma zinc and copper concentrations on spermogram and hormonal changes in infertile Nigerian men.

Zinc (Zn) and copper (Cu) concentrations in sera and seminal plasma of 60 infertile males (40 oligozoospermic and 20 azoospermic) and 40 males with evidence of fertility (normozoospermic; controls) were estimated using atomic absorption spectrophotometry. The results were correlated with the subject's spermogram and hormonal levels in order to determine their relationship and significance in male infertility. The mean serum concentration of zinc was significantly (p<0.01) higher in oligozoospermic males when compared to azoospermic subjects and controls. The ratios of serum Zn to seminal plasma Zn were 1:1, 1:3 or 1:4 in oligozoospermic, normozoospermic or azoospermic subjects, respectively. While the mean Cu concentration was significantly higher in serum than seminal plasma in all groups, the Zn concentration was significantly (p<0.05) higher in seminal plasma than serum. The Cu/Zn ratio in seminal plasma was significantly (p<0.01) higher in controls compared with other groups. A significant (p<0.01) inverse correlation was observed between serum Zn and sperm counts. Similarly, seminal plasma Zn negatively correlated with spermatozoa viability. In conclusion, the measurement of serum Zn level, apart from being a good index of the assessment of prostatic secretion and function, may be considered a useful tool in addition to other parameters in assessing male infertility. Also, a lower Cu/Zn ratio in seminal plasma may serve as a supportive tools in assessing male infertility.