Meta-analysis of MTHFR C677T polymorphism and type 2 diabetes mellitus in MENA region.

BACKGROUND AND AIMS: The association of the C677T polymorphism of the Methylenetetrahydrofolate Reductase (MTHFR) gene with susceptibility to type 2 diabetes mellitus (T2DM) has been widely debated. Therefore, our aim is to conclusively resolve this controversy in the Middle East and North Africa region population through a meta-analysis. MATERIEL AND METHODS: We identified relevant articles by searching literature databases, such as PubMed, Web of Science, and Science Direct, to retrieve studies that examined the association between the MTHFR C677T polymorphism and the risk of developing T2DM. Using meta-analysis, we calculated the odds ratio (OR) and confidence interval (CI) values of these studies to assess the susceptibility to T2DM related to the C677T polymorphism of MTHFR gene. RESULTS: In this meta-analysis, we included a total of 13 publications comprising 2072 T2DM patients and 2164 control subjects. The results of the meta-analysis suggested that there is a significant association between the C677T polymorphism and T2DM risk in overall comparisons for allele contrasts (T vs C): OR = 1.25, 95% CI = 1.04-1.50, p = 0.015 and homozygous (TT vs CC): OR = 1.44, 95% CI = 1.01-2.05, p = 0.038). Subgroup analysis revealed that the C677T polymorphism is associated with a risk of T2DM in Asian populations, while there is no significant association between this polymorphism and T2DM in Caucasian and African populations. Furthermore, there was no evidence of publication bias. CONCLUSION: Our study's results suggest that the allele contrast of the C677T polymorphism of the MTHFR gene is associated with an increased risk of T2DM in the overall population, particularly among Asians.

Prevalence and risk factors of chronic complications among patients with type 2 diabetes mellitus in Morocco: a cross-sectional study.

Introduction: microvascular and macrovascular complications of type 2 diabetes mellitus (T2DM) are one of the major causes of morbidity and mortality worldwide among patients with T2DM. This study aims to estimate the prevalence of these chronic complications and identify the associated risk factors among Moroccan patients with T2DM. Methods: this cross-sectional study was conducted on 505 T2DM patients followed by the healthcare Centers of the Casablanca-Settat region from January 2017 to July 2018. The socio-demographic, anthropometric, biochemical, and clinical data were recorded using a structured survey. For statistical analysis, SPSS version 20 is used. Univariate and multivariate logistic regression analyses are used to determine the risk factors associated with chronic complications of T2DM. Results: among the 505 Moroccan patients with T2DM, 84.98% were women. The average age of the patients was 57.27±10.74 years. Diabetic eye disease was the most frequent complication (29.5%) followed by cardiovascular diseases (CVDs) (22.4%), kidney disease in diabetes (9.8%), diabetes foot (2.8%), and neuropathy (1.8%). Logistic regression analysis showed that the CVDs was associated with hypertension (OR: 2.41; 95% CI: 1.11-5.22; p=0.026), hypolipidemia treatment (OR: 2.20; 95% CI: 1.06-4.59; p=0.034), insulin use (OR= 0.39; 95%CI: 0.15-0.96, p=0.043) and LDL-C (OR: 1.01; 95% CI: 1-1.02; p=0.035) in T2DM patients. However, the major risk factors for the development of kidney disease in T2DM patients were a lack of regular physical activity (OR: 3.77; 95% CI: 1.22-11.67; p=0.021), hypolipidemia treatment (OR: 8.31; 95% CI: 1.86-36.97; p=0.005), and high serum creatinine (OR: 1.33; 95% CI: 1.16-1.53; p≤0.001). In addition, LDL-C levels were found to be a significant risk factor for diabetes eye disease (OR: 1.01; 95% CI: 1.00-1.03; p=0.008). Conclusion: this study shows that the increased duration of diabetes, insulin use, lack of regular physical exercise, hypertension, hypolipidemia treatment, high serum creatinine, and LDL-C were significant risk factors for chronic complications of T2DM in Moroccan patients.

Prevalence of dyslipidemia and the relationship between HbA1C and lipid profile in Moroccan patients with T2DM: a cross-sectional study.

Introduction: the increased prevalence of dyslipidemia in patients with type 2 diabetes mellitus (T2DM) results from uncontrolled hyperglycemia and consistently contributes to an elevated risk of cardiovascular complications. This study sought to estimate the prevalence of dyslipidemia and to investigate the relationship between glycated hemoglobin (HbA1C) and serum lipid levels in Moroccan patients with T2DM. Methods: a total of 505 patients with T2DM were included in this cross-sectional study, 77.4% with chronic complications and 22.6% without. The collected data were examined using statistical package for the social sciences (SPSS) version 20.0 software and appropriate statistical methods. Results: the data analysis showed that the mean and SD of age were 57.27±10.74 years. Among 505 patients with T2DM, the prevalence of hypercholesterolemia, hypertriglyceridemia, increased low-density lipoprotein cholesterol (LDL-C), and decreased HDL-C was 41.4%, 35.9%, 27.1%, and 17%, respectively. In addition, the data analysis showed that levels of total cholesterol (TC) (p≤0.001), triglycerides (p≤0.001), Low-density lipoprotein cholesterol (LDL-C) (p≤0.001), TC/HDL-C ratio (p=0.006), and LDL-C/HDL-C ratio (p=0.006) were significantly higher in T2DM patients with complications as compared to those without complications. The patients with HbA1C > 7.0% had significantly higher values of fasting blood glucose (FBG) (p≤0.001), total cholesterol (p≤0.001), triglycerides (p≤0.001), and TC/HDL-C ratio (p=0.025) as compared to the patients with HbA1C ≤ 7.0%. The HbA1C demonstrated a significant negative correlation with age (r=-0.139), and positive correlation with FBG (r=0.673), total cholesterol (r=0.189) and triglycerides (r=0.243). Conclusion: our results showed that HbA1C is the most important biomarker of long-term glycemic control and can also be a good indicator of the lipid profile.

Phytochemical Screening and Toxicological Study of Aristolochia baetica Linn Roots: Histopathological and Biochemical Evidence.

Aristolochia baetica (A. baetica) is a wild species of Aristolochiaceae family; its roots are used by Moroccan people against cancer for many years ago. The objective of the study was to investigate the phytochemical screening, acute and subacute toxicity of A. baetica roots growing in the north of Morocco. Qualitative and quantitative analyses of A. baetica roots were performed using standard methods; the acute toxicity of the root extract of the studied plant was assessed in mice by gavage of single doses of 1, 2, and 4 g/kg body weight for 14 days; by the time the subacute toxicity was done using repeated doses 1, 1.5, and 2 g/kg/day for 28 days. Histological changes and biochemical parameters as markers of kidney and liver function were evaluated. The results of phytochemical screening showed the presence of polyphenols, tannins, alkaloids, flavonoids, saponins, and the absence of anthraquinones, sterols, and terpenes. The results of acute toxicity showed the absence of mortality and signs of toxicity in groups treated with 1 and 2 g/kg; however, the clinical signs of toxicity were important and the rate of mortality was estimated at 16 % in the group treated with 4 g/kg. The results of subacute toxicity showed several changes of serum parameters registered in groups treated with 1.5 and 2 g/kg/day, respectively. The results showed also the absence of histological injuries in groups treated with 1 and 1.5 g/kg/day; meanwhile, the histological alterations were remarkable in treated group with the highest dose administered of 2 g/kg/day. The outcome of this work showed that the roots' extract of the studied plant was toxic in mice with repeated doses, but no toxic effect was observed with a single dose under 4g/kg.

Ethnopharmacological Survey of Herbal Remedies Used for the Treatment of Cancer in the Greater Casablanca-Morocco.

Medicinal plants played an important role in traditional medicine for the treatment of diseases since antiquities. The aim of the study is to carry out an ethnobotanical survey on medicinal plants used traditionally in cancer treatment in the region of Greater Casablanca-Morocco, and to enhance the traditional herbal medicine knowledge. 110 traditional healers in the study area were interviewed face to face to response a survey questionnaire including the names of plants used in cancer treatment, used parts, methods of preparation, and route of administration. Indices of Fidelity Level (FL), Use Value (UV), and Relative Frequency of Citation (RFC) were calculated to identify the most effective plants used for cancer treatment. Eight species were specified including Aristolochia baetica, Aristolochia paucinervis, Bryonia dioica, Aquilaria malaccensis, Marrubium vulgare, Lavandula maroccana, Ephedra alata, and Euphorbia resinifera belonging to 7 families. Aristolochiaceae, Aquilariaceae, and Cucurbitaceae were the most useful families in cancer treatment with high significant indices of UV, FL, and RFC with values of 1, 100%, and 1, respectively. Roots and leaves were the most commonly used plant parts. Decoction and powder mixed with honey were the frequently used method for remedies preparation. The present study showed that the people living in Morocco's economic capital are still highly dependent on traditional herbal medicine for the treatment of cancer. Therefore, it seems that herbal medicine still plays a crucial role in the primary healthcare system for the local population. During this survey, it was reported that even some plant families are highly toxic for humans like Aristolochiaceae that are frequently used in cancer treatment in the study area. As many people still rely on natural traditional medicine considering (it is safe with no side effects), so combined effort between all social categories including scientists and traditional healers should be established for involving the scientific validity of the used plants in the treatment of diseases.