The relationship between thyroid function and bone health in euthyroid healthy adult Nigerians

There is a dearth of reports on variation in thyroid function within the reference range on bone health in euthyroid healthy adults in Nigeria This study evaluated the variation in thyroid function within reference range on biochemical bone markers and bone mineral density in healthy adults. This prospective study was carried out among 40 healthy participants above 21 years of age but less than 50 years by systematic random sampling. Exclusion criteria included subjects with acute or chronic disease states, previous fractures, any drug use, history of alcohol or smoking. Interviewer ­questionnaire was administered. Anthropometric indices determined. Blood samples for thyroid function tests included triiodothyronine (FT3), thyroxine(FT4), Thyroid Stimulating Hormone(TSH-thyrotropin), osteocalcin (OC), and Alkaline phosphatase (ALP), serum calcium adjusted for albumin, inorganic phosphorus, and urine sample for calcium and creatinine were collected after 10 - 12 hours fast. 24 hour calcium excretion was calculated (CaE). Bone mineral Density determined by Dual X - ray Absorptiometry scan. Statistical analysis done,< 0.05 set as level of significant. The mean age 34.10 years (7.8), with BMI 26.32kg/m2 (4.02),waist circumference 76.60cm (17.07). The mean levels of bone markers were osteocalcin 17.68ng/ml (10.67), alkaline phosphatase70.60 IU/L (16.56) and 24hour calcium excretion 396.10mg/dl (101.89). OC and ALP inversely correlated with age but CaE did not. TSH positively correlates OC( r =0.35,p=0.029), but not CaE, p > 0.05. FT4 correlates bone formation markers OC,ALPand CaE p <0.05. Neither FT3,FT4 or TSH neither correlates with zscore BMD. Normal variation in the levels of ft4 and TSH has an early impact on biochemical bone markers compared to bone mineral density. Biochemical bone markers are thus suggested as screening tools for early detection of metabolic bone diseases in euthyroid healthy adults

Clinical profile, knowledge, and beliefs about diabetes among patients attending a Tertiary Health Centre in Lagos: A cross-sectional survey.

INTRODUCTION: Diabetes affects 347 million people worldwide; more than 80% of the affected live in low- or middle-income countries. Patients' beliefs about their medical conditions are important in helping physician focus on beliefs that needed to be changed or reinforced. The overall aim of this study was to improve the standard of care of patients with diabetes. METHODS: The study designed was a cross-sectional survey; adults with diabetes attending diabetic clinic of LASUTH took part in the survey. Participants were asked to fill a structured questionnaire which was used to assess clinical patterns, beliefs, and practice about diabetes. RESULTS: One hundred and fifty patients with diabetes took part in the study. This study showed that more females presented with diabetes compared with males, type 2 diabetes is commonerthan type 1 and there is a highassociation of the disease with hypertension or being overweight. More than half of the participants do not know the cause of diabetes, 13% believed that disease is curable, and 30% admitted to use alternative medications in addition to the anti-diabetic medications prescribed by the physicians. CONCLUSION: Knowing patients' beliefs and knowledge about diabetes is important to impart overall care for them. Health education about a disease should be planned to address beliefs and knowledge of patients about their medical condition to address misinformation and misconceptions about their disease conditions.

Clustering of hypertension, diabetes mellitus and dyslipidemia in a Nigerian population: a cross sectional study.

OBJECTIVE: The clustering of cardiovascular risk factors and diseases has grievous implications on overall morbidity and mortality. There is however relative paucity of this information among the Nigerian population. This study was aimed at defining the prevalence of the clustering of hypertension (HT), diabetes mellitus (DM) and dyslipidemia (DYSL) in a Nigerian teaching hospital outpatient clinics population. SUBJECTS AND METHODS: A cross sectional study of patients managed at the hypertension and diabetes clinics of the Lagos State University Teaching Hospital, Nigeria between January and December 2008. The baseline demographic characteristics, blood pressures, blood sugars and fasting lipid profiles were obtained retrospectively from hospital records. Using the standard criteria for the diagnosis of HT, DM and DYSL, the prevalence of these conditions and their respective clusters were determined. RESULTS: A total of 506 patients were seen over this period, male; 234 (46.2%), female; 272(53.8%) with mean age of 57.35 (1.28) years. The prevalence of HT, DM and DYSL were 85%, 39.5% and 58.9% respectively. Concurrent HT and DYSL was the most prevalent cluster found in 146 patients (28.9%), followed by the clustering of the three co-morbidities of HT, DM and DYSL in 124 patients (24.5%).Other clusters were DM+HT; 49 (9.7%), DM+DYSL;13 (2.6%). 41.2% of the population had the clustering of at least two co-morbidities and about a quarter had the three conditions coexisting. CONCLUSION: There is a significant burden of the cardiovascular risk factors occurring in clusters in the Nigerian population studied. This calls for purposeful measures to control these risk factors.