Subclinical Inflammation and Endothelial Dysfunction in Young Patients with Diabetes: A Study from United Arab Emirates.

BACKGROUND: The impact of obesity and dyslipidemia on cardiovascular health in adolescents and young adults with diabetes is incompletely understood. This study evaluated the effects of these co-morbidities on markers of inflammation and endothelial dysfunction in young patients with the disease. METHODS: The study investigated sets of inflammatory, endothelial, and adipocyte biomarkers in 79 patients with type 1 diabetes, 55 patients with type 2 diabetes, and 47 controls. RESULTS: Mean (±SD) age was 20±6 y (median = 17, range = 12-31). Patients with diabetes had higher levels of cytoadhesive molecules (sICAM-1 and sVCAM-1, p<0.001), adiponectin (p<0.001), and haptoglobin (p = 0.023). Their heart rate variability assessment revealed lower standard deviation of beat-to-beat intervals and lower total power (p≤0.019), reflecting autonomous nervous dysfunction. Hemoglobin A1c >8.0% (estimated average blood glucose >10 mmol/L) was associated with higher adiponectin (p<0.001) and obesity was associated with lower adiponectin (p<0.001); thus, obesity damped the effect of hyperglycemia on adiponectin. Obesity was associated with higher sICAM-1 (p≤0.015), tumor necrosis factor-α (TNFα), interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP), p<0.001. Similarly, high-density lipoprotein (HDL) <1.02 mmol/L was associated with higher sICAM-1, TNFα, IL-6, and hsCRP (p≤0.009) and lower adiponectin (p<0.001). Adiponectin correlated negatively with the inflammatory biomarkers in patients with diabetes. CONCLUSION: Subclinical inflammation and endothelial dysfunction are common among young patients with diabetes. Poor diabetes control is associated with higher adiponectin. Obesity and dyslipidemia are associated with lower adiponectin and higher inflammatory and endothelial biomarkers. Intuitively, these predictors of cardiovascular disease are amenable to proper glycemic control, nutritional choices, and regular exercise.

Interrelationships between B-type natriuretic peptides and vitamin D in patients on maintenance peritoneal dialysis.

OBJECTIVE: Experimental evidence suggests that vitamin D deficiency impairs cardiac structure and function. Our objective was to observe relationships between circulating levels of the cardiac natriuretic peptides and vitamin D levels in patients on chronic peritoneal dialysis. METHOD: Measurements were made of circulating levels of 25-hydroxyvitamin D [25(OH)D] and plasma B-type natriuretic peptide (BNP) levels in patients receiving chronic peritoneal dialysis. RESULTS: Both BNP and the 1-76 amino-terminal fragment of pro-BNP correlated inversely with 25(OH)D levels (rs = -0.60, p = 0.007, and rs = -0.64, p = 0.003, respectively) in patients on peritoneal dialysis. CONCLUSIONS: Vitamin D deficiency in chronic renal failure may impair cardiac function, as manifested by elevated levels of B-type cardiac natriuretic peptides.

Assessment of obesity, lifestyle, and reproductive health needs of female citizens of Al Ain, United Arab Emirates.

This study was conducted to determine the reproductive and lifestyle characteristics in a representative sample (n = 535) of women in Al Ain, United Arab Emirates, to guide the development of health programmes for this population with rising affluence. A cross-sectional survey was carried out using the stratified two-stage sampling technique. Although most women were young, were pre-menopausal, did not smoke, reported good health status, and 84% (95% confidence interval [CI] 81-87%) reported being sufficiently active to meet expert recommendations, the prevalence of obesity (defined by body mass index > or = 30) was very high (35%; 95% CI 31-39%) and many (28%; 95% CI 24-32%) reported having a chronic disease. The prevalence of obesity was associated positively with age and negatively with education (p < 0.001 for both). Postmenopausal women had significantly more chronic diseases, reported poor health more often, were less physically active (p < 0.001 for all), and had a higher percentage of body fat (p = 0.002) compared to premenopausal women. Health services should emphasize the prevention and treatment of obesity and improving the general health status of postmenopausal women.