The impact of vitamin D, vitamin C, and zinc supplements on immune status among Jordanian adults during COVID-19: cross-sectional study findings.

BACKGROUND AND AIMS: Nutritional status is essential for the maintenance of the immune system, with malnutrition suppressing immunity. The aims of the current study were to assess the immune status of a group of Jordanian adults and to evaluate the association between vitamin C, vitamin D, and zinc consumption and the Immune Status during the COVID-19 pandemic. METHODS: A total of 615 adults Jordanian participants were enrolled in this study, an online- based cross sectional survey was used as a tool for this study. Data was collected by distributing the questionnaire form link through social media platforms. The association between ISQ score and the supplement intake pattern (daily, weekly, monthly and rarely) was assessed using multinomial logistic regression analysis, described as Odds ratio and 95% CI. RESULTS: Data have indicated that the majority of the participants did not take Vitamin D supplements during the pandemic (46.3%). Also, there was a significant association between the frequency of Vitamin D supplement intake and ISQ (r = 12.777; P < 0.05). Data showed that the majority of participants used vitamin C supplementation (49.4%). Also, there was a significant association between the frequency of Vitamin C supplement intake and ISQ (r = 12.797; P < 0.05). Data also have indicated that the majority of the participants did not increase their consumption of Zinc during the COVID-19 pandemic (55.6%). CONCLUSIONS: The findings of this study suggest a significant association between the frequency of Vitamin D, and vitamin C supplement intake and ISQ. Nutritional status is essential for the maintenance of the immune system, with malnutrition suppressing immunity.

Brain insulin resistance as a mechanistic mediator links peripheral metabolic disorders with declining cognition.

BACKGROUND AND AIMS: Studies continue to investigate the underlying mechanism of the association between the increased risk of different types of cognitive decline and metabolic dysregulation. Brain insulin resistance (BIR) has been suggested to explain this association. The vital role of insulin in the body has been examined intensively and extensively; however, its role in the brain requires further investigation. Herein, we confined our focus to summarize the role of brain insulin signaling and the negative effect of dysmetabolism on insulin functioning in the brain. METHODS: Published scientific manuscripts between 1998 and 2020 that discussed the effect of selected metabolic disorder conditions such as obesity, type 2 diabetes mellitus (T2DM), and high-fat diet (HFD) on brain functions were reviewed. The main keywords used were insulin resistance, brain insulin resistance, obesity, T2DM, and cognition. RESULTS: Various metabolic disorders were linked to the increased risk of BIR, and was suggested to increase the probability of cognition impairment occurrence. Several proposed mechanisms explain this association among which insulin resistance and hyperinsulinemia were primary factors attributed to an increased risk of BIR among various metabolic disorders. CONCLUSIONS: Understanding the trajectory of the association between metabolic disorders and alternation in cognition status could expand our vision of those overlapping conditions and pave the road to both treatment and preventative strategies for cognitive disorders.

Does obesity put your brain at risk?

BACKGROUND AND AIMS: The negative impact of obesity on the brain is an issue of increasing clinical interest. Hence, this review summarized evidence linking obesity with brain morphology (gray and white matter volume), brain function (functional activation and connectivity), and cognitive function. METHODS: A criticals review of the relevant published English articles between 2008 and 2022, using PubMed, Google Scholar and Science Direct. Studies were included if (1) an experimental/intervention study was conducted (2) the experiment/intervention included both high fat diet or body weight, whether it could counteract the negative effect brain morphological or functional change. Critical analysis for a supporting study was also carried out. RESULTS: Brain dysfunction can be recognized as result from neuroinflammation, oxidative stress, change in gut-brain hormonal functionality decrease regional blood flow or diminished hippocampal size and change in gut-brain hormonal functionality; which collectively translate into a cycle of deranged metabolic control and cognitive deficits, often obesity referred as changes in brain biochemistry and brain function. Recently, a few changes in brain structure and functions could be traced back even to obese children or adult. Evidence here suggested that obesity elicits early neuroinflammation effects, which likely disrupt the normal metabolism in hypothalamus, and hippocampus result from brain insulin resistance. The mechanisms of these robust effects are discussed herein. CONCLUSION: Brain disease is inseparable from obesity itself and requires a better recognition to allow future therapeutic targeting for treatment of obesity. Additional research is needed to identify the best treatment targets and to identify if these changes reversible.

Healthy nutritional behavior during COVID-19 lockdown: A cross-sectional study.

BACKGROUND: Ongoing outbreak of the novel coronavirus infectious disease 2019 (COVID- 19) constitutes a major global pandemic health care system challenge. Shortly following the disease outbreak, like SARS-CoV virus, all affected countries are implementing various preventive and control measures to mitigate the spread of the disease. Optimizing public health system during COVID-19 pandemic requires not only advanced medical and biological sciences knowledge, but also all human sciences related to social, as well as nutritional behavior, and lifestyle practices. AIM: To investigate the effect of COVID-19- quarantine on healthy nutritional behavior and lifestyle practices among Jordanian population. METHODS: A cross-sectional study among Jordanian population was conducted using an online questionnaire between March and April 2020. Participants were kindly requested to answer a standardized and validated structured questionnaire. Demographic information (age, gender, place of residence, and occupation), anthropometric data (reported weight and height); nutritional behavior information (number of meals per day, snakes, water intake), and physical activity behavior were requested. RESULTS: A total of 4473 respondents were included in the study; obese (n = 1135), normal body weight (n = 1561), and underweight (n = 116). During COVID-19 quarantine, a significant increase in body weight (12.9% underweight, 28.5% normal body weight, 36.4% overweight' and 41.1% of obese (p < 0.001) was reported. Moreover, the number of snacks between meals (p < 0.001), number of main meals (p < 0.001), and the smoking rate was also increased significantly; however, there was no significant difference regarding physical activity among various weight status groups (p < 0.05). CONCLUSIONS: In this study, we have provided evidence, for the first time, that there were significant negative changes in healthy nutritional behavior among Jordanians during COVID-19 quarantine who encountered significantly increased body weight, appetite, and smoking. Hence, future larger cross-sectional studies are warranted.

Androgens and hirsutism score of overweight women with polycystic ovary syndrome improved after vitamin D treatment: A randomized placebo controlled clinical trial.

BACKGROUND & AIM: The objective of this study was to investigate the effect of vitamin D treatment on androgen levels and hirsutism scores in overweight women with PCOS. METHODS: A prospective, randomized, double-blind, placebo-controlled clinical study was conducted at King Abdullah University Hospital in Irbid, Jordan. Overweight Jordanian females aged 18-49 years with vitamin D deficiency and PCOS (n = 60) were assigned to two groups: the treatment group (n = 30) who received 50,000 IU per week of vitamin D3 and the control group (n = 30) who received a placebo. RESULTS: After receiving the treatment for 12 consecutive weeks, the levels of total testosterone, parathyroid hormone, free androgen index, and hirsutism score were significantly decreased (P < 0.001), and the levels of 25-hydroxyvitamin D (25(OH)D), sex hormone binding globulin, and phosphorus were significantly increased (P < 0.05). Furthermore, significant changes were observed in ovarian volume and follicle numbers and size ultrasonography, and in the regularity of the menstrual cycle (P < 0.001). In the placebo group, no significant changes were observed in either androgen levels, hirsutism score, or menstrual regularity. CONCLUSION: Vitamin D3 at a treatment dose of 50,000 IU per week improved 25(OH)D levels and decreased the hirsutism scores and androgen levels of overweight women with PCOS. These results could mean increased fertility and better reproductive health for overweight women with PCOS; the use of vitamin D3 as a treatment for these patients should be further investigated. CLINICALTRIALS. GOV REGESTRATION NUMBER: NCT02328404.

The association between fat mass and subclinical atherosclerosis in healthy schoolchildren.

BACKGROUND AND AIMS: Childhood obesity is associated with increased risk of cardiovascular disease (CVD) later in life. The aims of this study were to investigate the change of atherosclerosis risk factors in three fat mass percentiles and to examine the association between fat mass and atherosclerosis risk factors among a group of schoolchildren. METHODS: A total of 125 schoolchildren (64 boys) aged 10-15 years were distributed into three groups: (i) the lower fat mass (LFM) group, for participants who reported fat mass ≤50th percentile; (ii) the middle fat mass (MFM) group, for participants who reported fat mass >50th percentile and <75th percentile; and (iii) the higher fat mass (HFM) group for participants who reported ≥ 75th percentiles. Measurements of carotid intima-media thickness (cIMT) using high-resolution B-mode ultrasound, lipemic profile, blood pressure, serum proinflammatory cytokines and soluble adhesion molecules were performed. RESULTS: Significant differences (p ≤ 0.05) were shown between the three groups in total cholesterol (TC), triglycerides (TG), LDL, interlukien-6 (IL-6), and interlukien-1 beta (IL-1ß). Using multiple linear regression analysis of fat mass as the dependent variable with the studied subclinical atherosclerosis risk, fat mass was significantly (p ≤ 0.05) associated with the variation expressed in systolic blood pressure (ß = 0.490), diastolic blood pressure (ß = 0.470), TC (ß = 0.399), TG (ß = 0.306), HDL (ß = -0.281), LDL (ß = 0.446), E-selectin (ß = 0.314), and cIMT (ß = 0.257). CONCLUSION: Higher fat mass is associated with increased risk of atherosclerosis in schoolchildren. Atherosclerosis risk factors including biomarkers of inflammation, endothelial dysfunction, a state of dyslipidemia, increased cIMT, and high blood pressure were associated with fat mass. Studies evaluating the appropriate fat mass cut-off points in children and adolescents are needed.

Physical activity, sedentary behaviors and dietary patterns as risk factors of obesity among Jordanian schoolchildren.

OBJECTIVE: To identify certain risk factors associated with childhood obesity related to lifestyle; dietary patterns, physical activity, and sedentary behavior. METHODS: A cross-sectional study was conducted among 977 schoolchildren (473 boys and 449 girls) aged 7-18 years. Children were selected randomly from three main cities in Jordan: Amman, Irbid, and Mafraq by using multistage cluster sampling method. Sedentary behaviors, physical activity and child eating behaviors were measured by using validated questionnaires. Overweight and obesity were defined by International Obesity Task Force (IOTF) criteria. RESULTS: Sedentary activities increase the risk of overweight among schoolchildren by 2-fold [RR(Relative risk) = 2.0, 95% CI(Confidence interval) (1.1-3.6), p = 0.02]. Whereas, sedentary activities for less than 3 h increased the risk of overweight by 0.8-fold [RR = 0.8, 95%CI (0.6-1.3), P = 0.388], Schoolchildren who spent<30 min/day in exercising decreased the risk of overweight by 0.5-fold [RR = 0.5, 95% CI (0.2-1.0), P = 0.06)]. Both Students who ate one meal daily and daily ate snacks from schools cafeterias had a higher tendency to be obese [(RR = 1.8, 95%CI (0.5-5.9), P = 0.368], and [RR = 1.5, 95%CI (0.9-2.5), P = 0.169] respectively. CONCLUSIONS: Physical activity, eating meals regularly and homemade food, all together play a significant role in decreasing obesity among Jordanian schoolchildren, thus a national policy that promoting active living and healthy eating among schoolchildren is warranted.

Increased waist circumference is associated with subclinical atherosclerosis in schoolchildren.

BACKGROUND: Waist circumference (WC) is an indicator of adiposity; particularly visceral fat, cardiometabolic risk factors and related morbidity. The aim of this study was to determine the attribution of WC to increased carotid intima-media thickness (cIMT) and circulating levels of inflammation and endothelial dysfunction in schoolchildren. METHODS: A total of 122 children (61 boys and 61 girls) aged 10-15 years were distributed into three groups: (i) the lower smoothed sex- and age-specific WC (LWC) group (ii) the middle smoothed sex- and age-specific WC (MWC) group, and (iii) the higher smoothed sex- and age-specific WC (HWC) group. Measurements of cIMT using high-resolution B-mode ultrasound, lipemic profile, blood pressure, serum proinflammatory cytokines and soluble adhesion molecules were performed. RESULTS: Mean measured values in the HWC and/or MWC groups showed significantly higher values (p ≤ 0.05) of cIMT (mm), total cholesterol, triglycerides, low-density lipoprotein (LDL), blood pressure, interlukien-6 (IL-6), and interlukien-1 beta (IL-1ß), vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1(ICAM-1) and E-selectin, and significantly lower values of high-density lipoprotein (HDL) as compared to the LWC group. Using multiple linear regression analysis of WC-SDS adjusted for BMI-SDS with the studied subclinical atherosclerosis risk, WC-SDS was significantly (p ≤ 0.05) associated with the variation in HDL (R2 = -0.12), LDL (R2 = 0.36), IL-6 (R2 = 0.26), and VCAM-1 (R2 = 0.26). CONCLUSIONS: Higher WC is positively associated with atherosclerosis risk factors including increased cIMT, a state of dyslipidemia, higher blood pressure and circulating levels of inflammation and adhesion molecules among schoolchildren. Waist circumference seems to be useful for the prediction of subclinical atherosclerosis in schoolchildren.

Validation of resting metabolic rate equations in obese and non-obese young healthy adults.

BACKGROUND AND AIMS: Although validating resting metabolic rate (RMR) prediction equations in different populations is warranted to estimate total energy requirements, there are no data about the accuracy and applicability of RMR predictive equations in young healthy Jordanians. This study aimed to test the validity of predicted RMR using four prediction equations and its agreement with RMR measured using indirect calorimetry in healthy young obese and non-obese Jordanian adults. METHODS: Predicted RMR was tested for agreement with indirect calorimetry. Harris-Benedict, Food and Agriculture Organization/World Health Organization/United Nations University, Mifflin and Owen equations were used to predict RMR. A total of 406 (200 females, 206 males) normal bodyweight, overweight, and obese healthy young adults aged 18-25 years were included. RESULTS: Of all tested equations, Harris-Benedict equation showed no significant differences compared to measured RMR using indirect calorimetry (p > 0.05) in normal bodyweight (1374.1 ± 72.5 vs. 1347.6 ± 333.4), overweight (1513.1 ± 66.8 vs. 1492.9 ± 374.8) and obese (1673.5 ± 178.4 vs. 1736.4 ± 386.9) females. While significant differences (p<0.05) were found in all male participants. The other studied equations showed significant differences (p ≤ 0.05) compared to measured RMR in gender based groups with different bodyweight status. CONCLUSION: Only Harris-Benedict equation was the most accurate in predicting RMR among females regardless of bodyweight status. Apart from that, these equations did not perform well at the group level. The tested prediction equations further underestimated RMR. Future studies aiming at validating RMR prediction equations in different populations are warranted in order to understand the factors that could affect the accuracy of RMR prediction.

Thinking about brain insulin resistance.

INTRODUCTION: Dementia and type 2 diabetes mellitus (T2DM) are two of the epidemics of our time; in which insulin resistance (IR) is playing the central role. Epidemiological studies found that different types of dementia development may be promoted by the presence of T2DM. OBJECTIVES: We aimed in this review to highlight the role of insulin and the IR in the brain as a pathophysiological factor of dementia development and also to expand our understanding of T2DM as a mediator of IR in the brain and to review the possible mechanisms of action that may explain the association. METHODOLOGY: A critical review of the relevant published English articles up to 2018, using PubMed, Google Scholar, Science Direct, ADI, and WHO database was carried out. Keywords were included insulin resistance, T3DM, T2DM, dementia, brain insulin resistance were used. CONCLUSION: The rapidly increased prevalence of dementia concurrently with T2DM and obesity need urgent action to illustrate guidelines for prevention, modifying, and treatment based on mechanistic studies.

The associations of body composition and anthropometric measures with carotid intima-media thickness in obese and non-obese schoolchildren: A possible predictor for cardiovascular diseases.

Background Increased carotid intima-media thickness is one of the predictors of future cardiovascular diseases. However, it is still unknown which body composition parameter or anthropometric measure is the best predictor for carotid intima-media thickness change among children and young adolescents. Objective To investigate the associations of body composition and anthropometric measures with carotid intima-media thickness among a group of obese and normal bodyweight schoolchildren. Methods A total of 125 schoolchildren (10-15 years) were recruited from four public schools in Amman, Jordan. Of them, 60 (29 boys and 31 girls) were normal bodyweight students and 65 (35 boys and 30 girls) were obese students. Anthropometric measures, fat mass and fat-free mass were determined. Carotid intima-media thickness of the common artery was measured using high-resolution B-mode ultrasound. Results Compared to normal bodyweight students, obese participants exhibited greater carotid intima-media thickness (mm) (0.45 ± 0.10 vs. 0.38 ± 0.08, p = 0.002) and fat-free mass (kg) (48.01 ± 11.39 vs. 32.65 ±7.65, p < 0.001). Pearson's correlation coefficient and linear regression analysis revealed significant associations ( p≤0.05) between mean carotid intima-media thickness and body mass index, waist circumference, hip circumference, waist-to-hip ratio, fat mass and fat-free mass. Stepwise linear regression analysis revealed that waist circumference was the only measure that was statistically significant ( p ≤ 0.05) with mean carotid intima-media thickness (r2 = 0.129, p = 0.002). Conclusions Obesity is related to greater carotid intima-media thickness and other cardiovascular risk factors among schoolchildren. Waist circumference is more sensitive in predicting increased carotid intima-media thickness than other body composition or anthropometric measures. Waist circumference measurement in the analysis of future studies assessing the cardiovascular risk among obese children is warranted.

Association between complement component C3 and body composition: a possible obesity inflammatory biomarker for insulin resistance.

BACKGROUND AND OBJECTIVES: The C3 complement component (C3) is increasingly recognized as a cardiometabolic risk factor. We aimed to examine the role of C3 in insulin resistance (IR) and its association with adiposity. METHODS AND STUDY DESIGN: Sixty-seven obese (18-35 years) participants were matched with normal weight participants from the University of Jordan. BMI, waist-hip ratio (WHpR), and waist-height ratio (WHtR) were calculated. Body percent fat mass (%FM) was determined using the bioelectrical impedance analysis. C3, insulin, and glucose serum concentrations were measured. IR was assessed by the homeostasis model assessment of IR (HOMA-IR). RESULTS: Serum concentrations of C3 and IR were significantly higher in the obese group than that in the normal body weight, regardless of gender (women: 1.2±0.08 and men: 1.2±0.08 vs women: 0.88±0.07 and men: 0.94±0.05, p<0.01; women: 3.6±0.34 and men: 3.9±0.43 vs women: 1.7±0.12 and men: 2.0±0.24, respectively; p<0.001). After adjustment for the potential confounders, BMI, waist circumference, WHtR and %FM were correlated positively with C3 (r=0.44; 0.42; 0.47; 0.43, respectively; p<0.001), and with IR (r=0.67; 0.61; 0.59; 0.59, respectively; p<0.001). C3 was correlated with IR (r=0.35, p<0.001). In linear regression analysis, C3 was not associated with IR independent of BMI (p>0.05). CONCLUSIONS: C3 may be a marker of chronic inflammatory process independently underlying IR obese individuals regardless of gender, which may have a role in the progression of IR during obesity.

Vitamin D Insufficiency Predicts Elevated Levels of Complement 3 Independent of Insulin Resistance and BMI.

This study was to determine serum 25-hydroxyvitamin D (25(OH)D), the complement 3 (C3), and C-reactive protein (CRP) levels, and their association with the risk of insulin resistance (IR). A case-control study was carried out among 134 participants with body mass index (BMI) ≥30 kg/m2 and BMI=18.5-24.99 kg/m2. Anthropometric and body composition indicators were measured. Serum levels of C3, CRP, 25(OH)D, insulin, and glucose were also measured. IR was assessed by the homeostasis model assessment (HOMA-IR). C3, CRP, insulin, and HOMA-IR levels were higher in participants with obesity than that of controls (p<0.001). After adjustment for the potential confounders, anthropometric and body composition indicators were correlated positively with C3 (p<0.001), and negatively with 25(OH)D (p<0.05). C3, and 25(OH)D were correlated with HOMA-IR (r=0.350; r=-0.212; p<0.05). In logistic regression analyses, C3 and CRP were significantly related to increased odds of IR among participants with obesity as compared to controls after progressively adjusting for the potential confounders (p<0.001), whereas 25(OH)D was negatively, but insignificantly, related to decreased odds of IR among participants with obesity (p>0.05). C3 was associated positively with 25(OH)D insufficiency/deficiency independent of HOMA-IR and/or BMI (ß=0.183, p<0.05). Obesity is associated with elevated levels of proinflammatory biomarkers and IR. 25(OH)D insufficiency/deficiency was associated with C3 regardless of HOMA-IR or BMI, which could in turn, have a role in the augmentation of IR during obesity.

Markers of subclinical atherosclerosis in schoolchildren with obesity and metabolic syndrome.

BACKGROUND: Although increased carotid intima-media thickness (cIMT), soluble adhesion molecules and proinflammatory biomarkers are strongly implicated in the development of atherosclerotic lesions, the role of obesity and metabolic syndrome (MetS) in atherogenicity and inflammation among schoolchildren is not well investigated. AIM: To determine the levels of cIMT, endothelial dysfunction and inflammatory biomarkers in a group of schoolchildren with obesity and MetS. METHODS: Eighty-seven schoolchildren (age 10-15 years) were categorised into three groups: normal bodyweight group, obese group and severely obese with MetS group (17 boys and 12 girls in each group). Levels of cIMT were measured with high-resolution B-mode ultrasound. Serum proinflammatory cytokines interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1ß), and soluble adhesion molecules E-selectin, vascular cell adhesion molecule-1 (VCAM-1), and intercellular adhesion molecule-1(ICAM-1) were measured. RESULTS: Mean cIMT levels were significantly higher (p 0.05) among severely obese schoolchildren with MetS (0.49 ± 0.02 mm) compared with both the obese (0.43 ± 0.03 mm) and the normal bodyweight counterparts (0.36 ± 0.03 mm). Serum levels of IL-6, TNF-α, IL-1ß, E-selectin, VCAM-1 and ICAM-1 were significantly higher (p 0.05) in severely obese with MetS and obese children compared with the normal bodyweight group. However, no significant differences (p >0.05) were found between the severely obese schoolchildren with MetS and the obese without MetS. CONCLUSIONS: Severely obese schoolchildren having MetS exhibited higher cIMT levels than obese and normal bodyweight counterparts. Biomarkers of inflammation and endothelial dysfunction were higher in obese schoolchildren, but biomarkers were not increased any further by the degree of obesity nor the MetS cluster.

Could omega-3 fatty acids a therapeutic treatment of the immune-metabolic consequence of intermittent hypoxia in obstructive sleep apnea?

Obesity and Obstructive sleep Apnea (OSA) seems to bi-directional; obesity itself increases the risk of OSA, but on the other hand, OSA may also predispose the individuals to weight gain, both obesity and OSA share a common immune-metabolic link state which have a synergistic effect on the activation of inflammation, insulin resistance and dyslipidemia, and cardiovascular disease. The Immune-metabolic role of omega-3 fatty acids Docosahexaenoic acid (DHA) and Eicosapentaenoic acid (EPA), which capable of modulating both metabolic and immune process, which may decrease pro-inflammatory cytokines, insulin resistance, and dyslipidemia. To date, no study in humans suffering from OSA and omega-3 fatty acids has been performed. Hence, the objective of this review aimed to discussing the link between immune-metabolic consequences related to intermittent hypoxia and does Omega-3 fatty acids a therapeutic treatment for co-morbidity associated with obstructive sleep apnea.

Complement 3 serum levels as a pro-inflammatory biomarker for insulin resistance in obesity.

INTRODUCTION: Obesity is frequently characterized by chronic inflammation and insulin resistance (IR). Obesity-associated inflammation is responsible for the complement system activation of which the third component (C3) plays the central role. OBJECTIVE: to discuss several aspects of the central component of the complement system in relation to obesity and obesity-associated IR. METHODS: A critical review of the relevant published English articles from 2003- 2014 was carried out using several search engines including PubMed, Google Scholar, and ScienceDirect. Keywords were used, including complement system, C3, obesity-induced inflammation, IR, ASP, and adipose tissue. CONCLUSION: The defect in the adipose tissue secretory function during obesity may result in different metabolic disorders including IR. The C3 role during obesity-associated inflammation in IR is emerging. More longitudinal studies are warranted to evaluate the role of C3 among other pro-inflammatory biomarkers for IR.

Markers of subclinical atherosclerosis in schoolchildren with obesity and metabolic syndrome.

BACKGROUND: Although increased carotid intima-media thickness (cIMT), soluble adhesion molecules and proinflammatory biomarkers are strongly implicated in the development of atherosclerotic lesions, the role of obesity and metabolic syndrome (MetS) in atherogenicity and inflammation among schoolchildren is not well investigated. AIM: To determine the levels of cIMT, endothelial dysfunction and inflammatory biomarkers in a group of schoolchildren with obesity and MetS. METHODS: Eighty-seven schoolchildren (age 10-15 years) were categorised into three groups: normal bodyweight group, obese group and severely obese with MetS group (17 boys and 12 girls in each group). Levels of cIMT were measured with high-resolution B-mode ultrasound. Serum proinflammatory cytokines interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1ß), and soluble adhesion molecules E-selectin, vascular cell adhesion molecule-1 (VCAM-1), and intercellular adhesion molecule-1(ICAM-1) were measured. RESULTS: Mean cIMT levels were significantly higher (p 0.05) among severely obese schoolchildren with MetS (0.49 ± 0.02 mm) compared with both the obese (0.43 ± 0.03 mm) and the normal bodyweight counterparts (0.36 ± 0.03 mm). Serum levels of IL-6, TNF-α, IL-1ß, E-selectin, VCAM-1 and ICAM-1 were significantly higher (p 0.05) in severely obese with MetS and obese children compared with the normal bodyweight group. However, no significant differences (p >0.05) were found between the severely obese schoolchildren with MetS and the obese without MetS. CONCLUSIONS: Severely obese schoolchildren having MetS exhibited higher cIMT levels than obese and normal bodyweight counterparts. Biomarkers of inflammation and endothelial dysfunction were higher in obese schoolchildren, but biomarkers were not increased any further by the degree of obesity nor the MetS cluster.

In vitro evaluation of potential complexation between bovine insulin and bovine serum albumin.

The objective of this study was to examine the possible binding of bovine insulin (BI) with bovine serum albumin (BSA) to form a new potential diabetogenic irreversible complex protein. Several preparations of BSA and BI were prepared. Both capillary electrophoresis and spectrophotometric analysis were undertaken to test the possibility of complexation between BI and BSA. HPLC was used to test whether the potential complex of BI and BSA is reversible or irreversible. The optimum deviation between the real and calculated absorbances was observed at a BI/BSA ratio of 2. Moreover, the migration time of BI decreased substantially with increasing ratio of BI to BSA until it became almost constant at equal molar ratio of BI/BSA. While the majority of the 2:1 BI-BSA sample detached during the HPLC analysis, which confirms the reversible character of BI-BSA binding, the HPLC chromatogram also emphasizes the formation of an irreversible complexation between the two proteins. This study provides evidence of the formation of reversible and irreversible new BI-BSA complexes under physiological conditions. This highlights the importance of examining the possible diabetogenicity of BI-BSA complex in genetically susceptible people.

Depression among adults with diabetes in Jordan: risk factors and relationship to blood sugar control.

OBJECTIVES: The aims of this study were to estimate the prevalence of undiagnosed depression among adults with diabetes mellitus in Jordan and to determine the factors that may indicate the presence of depression and to examine the relationship between depression and blood sugar control among Jordanian subjects with diabetes. METHODS: A systemic random sample of 649 type 1 and type 2 diabetic patients aged 18-75 years was selected during the period from July 2009 to January 2010. A prestructured questionnaire was used for collecting the information about sociodemographic data and clinical characteristics. Depression was evaluated using the Patients' Health Questionnaire-8 (PHQ-8). A PHQ-8 score ≥10 has been recommended as a cutoff point for depression. Self-care management behaviors and barrier to adherence were collected. Weights and heights were measured. Glycated hemoglobin was abstracted from each patient directly after the interview. RESULT: Of the 649, 128 (19.7) have depression according to the PHQ-8 scores. According to the multivariate analysis, females are more likely to develop depression than males with [odds ratio (OR), 1.91; P=001] and low-educated people versus educated people (OR, 3.09; P≤.002). Being on insulin treatment also has a significant association with depression (OR, 3.31; P=.001). Not following eating plans as recommended by dietitians, lacking self-monitoring blood glucose and increased barriers to adherence scale scores were also associated with depression among the subjects with diabetes. CONCLUSION: The prevalence of depression among Jordanian subjects with type 1 and type 2 diabetes is high compared with some developed countries. This was associated with gender, educational level, insulin treatment, low self-management behaviors and increased barriers to adherence. This result shows the urgent need to include the routine screening of depression during outpatient visit, which might help prevention, early detection and management of depression.

Eating disturbances among adolescent schoolgirls in Jordan.

OBJECTIVES: Several studies indicated that the prevalence of eating disorders has increased among adolescent girls. The aim of the present study, therefore, is to investigate the occurrence and correlates of eating disorders among adolescent girls in Amman, Jordan. METHOD: A sample of 432 adolescent girls aged 10-16 years were recruited from public and private schools in Amman. Information was collected from adolescent schoolgirls through a socio-demographic data sheet, eating attitude test, body shape and eating habits questionnaires. RESULTS: One third of participants had eating disorders, including bulimia nervosa (0.6%), binge eating disorder (1.8%) and eating disorder not otherwise specified (31%), however no anorexic cases were found. Findings also suggested that pubertal, familial and social variables were associated with eating disorders occurrence. CONCLUSION: Eating disturbances were prevalent among the present population sample. Participants have been more preoccupied with their body weight due to socio-cultural norms that are reinforced by media messages. Further research is needed to develop intervention programs to control eating disorders occurrence in Jordan.