Spectrum of Thyroid Dysfunction in Patients with Chronic Kidney Disease in Benin City, Nigeria.

There is an indication of abrupt rise in chronic kidney disease (CKD) in Nigeria and thyroid function involvement has not been sufficiently evaluated. This study determined thyroid gland function among subjects with CKD in Benin City, Nigeria. A total of 184 randomized CKD patients attending specialist clinic and 80 healthy control subjects were recruited for this study. A well-structured questionnaire was used to obtain data on socio-demography. Blood specimens were collected and used for the determination of thyroid function parameters; thyroid stimulating hormone (TSH), triiodothyronine (T3), free triiodothyronine (fT3), thyroxine (T4), free thyroxine (fT4), thyroid peroxidase antibody (TPO-Abs), thyroid globulin antibody (Tg-Abs) and Deiodinase enzyme Type 1 (D1). SPINA GD and SPINA GT were calculated using Michaelis-Menten model. The CKD was classified into stages using Modification of Drug in Renal Disease (MDRD) formula. Thyroid dysfunctions observed were clinical hyperthyroidism 1 (0.54%), non-thyroidal illness 78 (42.4%), clinical hypothyroidism 11 (6.0%), sub-clinical hyperthyroidism 3 (1.60%), and sub-clinical hypothyroidism 11 (6.0%), while euthyroid were 80 (43.5%). SPINA GD of CKD patients (33.85 ± 10.94) was not significantly different when compared with controls (24.85 ± 1.57), whereas, SPINA GT was significantly higher (p < 0.01) among CKD patients (3.74 ± 0.31) than controls (2.68 ± 0.11). Autoimmune thyroid disease demonstrated by positive Tg-Abs and TPO-Abs were observed among approximately 7.9% of CKD patients. Serum TPO-Abs concentration increased with CKD progression. Thyroid dysfunction is involved in the pathogenesis of CKD patients. The etiologies are multifactorial and immunological mechanisms of autoimmune thyroid disease may be a contributing factor.

Toxic Metal Concentrations in Drinking Water and Possible Effect on Sex Hormones among Men in Sabongida-Ora, Edo State, Nigeria.

Drinking water can be a potential source of toxic metals, which are a known leading cause of infertility in men. This study determines the concentrations of lead (Pb), cadmium (Cd), zinc (Zn), copper (Cu) in drinking water (borehole, hand-dug well and treated water) and sex hormone levels (serum follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PROL), estradiol (E2), progesterone (PROG), and testosterone (T) in males who drink water mainly from these sources. The concentrations of Cd, and Pb in hand-dug wells were higher than the permissible limit recommended by the World Health Organization (WHO) while Zn and Cu were within the permissible levels in drinking water. Blood Cd and Pb levels were significantly higher (p < 0.001) among subjects who consumed hand-dug and borehole water than treated water, while serum Zn was significantly lower (p < 0.001) in hand-dug well and borehole water consumers than in control subjects. Also, serum FSH (p < 0.001), LH (p < 0.001), E2 (p < 0.002), PROG (p < 0.04) and T (p < 0.001) were significantly lower among hand-dug well and borehole water consumers than controls, while PROL (p < 0.001) was significantly higher in hand-dug well and borehole water consumers than controls. Blood Cd and Pb levels were significantly higher (p < 0.001) in hand-dug well water consumers than borehole water consumers. The consumption of water from hand-dug wells may have adverse reproductive sequelae among consumers.

Serum levels of copper, zinc and disease severity scores in sickle cell disease patients in Benin City, Nigeria.

BACKGROUND: Micronutrient deficiency is recognized in sickle cell anaemia (SCA) but it is not known for certain whether changes in zinc, copper and copper-to-zinc ratio are associated with Sickle cell disease severity scores. OBJECTIVE: To compare serum levels of copper, zinc and copper-to-zinc ratio in SCA subjects with control group and correlate the variables with objective disease severity scores. METHODS: Serum copper and zinc were determined in 100 SCA patients and 50 controls using kits supplied by Centronic, Germany. Unpaired Students't-test was used to compare the variables between SCA patients in steady clinical state, vaso-occlusive crisis and controls, while Spearman correlation coefficient was used to associate the parameters with disease severity scores. RESULTS: Serum copper level was higher (P=0.008) in SCA patients than controls, while serum zinc level was lower (P<0.001) in SCA patients than controls. The copper/zinc ratio was higher (P<0.001) in SCA patients than controls. Significantly higher (P<0.001) copper and lower (P<0.001) zinc levels were observed in patients in vaso-occlusive crisis than in steady clinical state. Zinc correlated inversely (r=-0.2743; P=0.006) while copper-to-zinc ratio correlated positively with disease severity scores. CONCLUSION: Copper-to-zinc ratio may be an indicator of disease severity in SCA patients.