Prognostic value of some serum protein fractions as Early Index of Clinical Recovery in Pulmonary Tuberculosis subjects.

BACKGROUND: Malnutrition is an important risk factor for pulmonary tuberculosis and can result to adverse treatment outcomes. AIM: This was a cross-sectional study designed to assess prognostic value of some serum protein fractions in pulmonary tuberculosis (PTB) subjects at Oron, Akwa Ibom State, Nigeria. Thirty (30) TB subjects on Anti-tuberculosis therapy, thirty (30) drug naive TB subjects and thirty (30) apparently healthy control subjects aged 21-52 (35 ± 16) years were conveniently recruited. METHODS: Total protein and albumin were measured colourimetrically, Albumin-globulin ratio was calculated while demographic data was obtained using questionnaire. RESULTS: BMI (kg/m2), Albumin (g/dl) and AGR were significantly lower in TB subjects with or without ATT when compared with control subjects (p < 0.000 respectively), but higher in PTB subjects on ATT when compared with drug naive PTB subjects (p = 0.000 respectively). Serum Total protein (g/dl) level in PTB subjects with or without ATT was significantly higher when compared with controls (p = 0.004) while globulin (g/dl) level was lower in PTB subjects on ATT when compared with drug naive PTB subjects (p = 0.000). CONCLUSION: Decreased BMI in TB subjects signifies reduction in muscle mass and wasting precipitated by PTB infection, while depleted albumin and AGR suggests high degree of malnutrition. Increased albumin and AGR in PTB subjects on ATT suggests improvement with ATT. Assessment of serum albumin and AGR may serve as affordable and early index of clinical recovery in PTB subjects especially in resource limited settings, and may be more reliable than the traditionally used BMI.

Maximum accuracy obesity indices for screening metabolic syndrome in Nigeria: A consolidated analysis of four cross-sectional studies.

BACKGROUND: In sub-Saharan Africa, there is no precise use of metabolic syndrome (MetS) definitions and risk factors screening indices in many clinical and public health services. Methods proposed and used in Western populations are adopted without validation within the local settings. The aim of the study is to assess obesity indices and cut-off values that maximise screening of MetS and risk factors in the Nigerian population. METHOD: A consolidated analysis of 2809 samples from four population-based cross-sectional study of apparently healthy persons≥18 years was carried out. Optimal waist circumference (WC) and waist-to-height ratio (WHtR) cut points for diagnosing MetS and risk factors were determined using Optimal Data Analysis (ODA) model. The stability of the predictions of the models was also assessed. RESULTS: Overall mean values of BMI, WC and WHtR were 24.8±6.0kgm(-2), 84.0±11.3cm and 0.52±0.1 respectively. Optimal WC cut-off for discriminating MetS and diabetes was 83cm in females and 85cm in males, and 82cm in females and 89cm in males, respectively. WC was stable in discriminating diabetes than did WHtR and BMI, while WHtR showed better stability in predicting MetS than WC and BMI. CONCLUSION: The study shows that the optimal WC that maximises classification accuracy of MetS differs from that currently used for sub-Saharan ethnicity. The proposed global WHtR of 0.50 may misclassify MetS, diabetes and hypertension. Finally, the WC is a better predictor of diabetes, while WHtR is a better predictor of MetS in this sample population.