International Journal of Endocrinology and Metabolism
Volume:7 Issue: 3, Sep 2009

This study aimed at determining serum leptin levels in ART naïve HIV-1 infected adults in relation to body mass index (BMI), CD4 cell count and presence or absence of symptomatic HIV disease or features of AIDS. This cross sectional study was undertaken in 2008 among patients, attending Ahmadu Bello University Teaching Hospital. Serum leptin levels by ELISA were determined in 40 consecutive sex matched, HIV infected adults (20 normal weight and 20 underweight) and 26 sex matched HIV negative, healthy, normal weight controls. Symptomatic and asymptomatic HIV infected patients as well as AIDS and non-AIDS patients with similar BMI were compared. CD4 cell counts were correlated with leptin levels. The median leptin levels of healthy controls and asymptomatic normal weight patients were not significantly different. Female patients tended to have lower leptin values than male ones. Median leptin was lower in underweight patients when compared to normal weight patients (13.8 vs 39ng/mL, p=0.009) and also lower in symptomatic patients when compared to asymptomatic patients (27.9 vs 43.9ng/mL, p=0.038) but not significantly different between AIDS and non-AIDS cases. Among healthy controls, leptin levels positively correlated with CD4 T counts (r=0.47, p=0.04) but in HIV/AIDS patients the correlation (r=0.28, p=0.07) was not significant. In wasted HIV infected patients, low leptin levels were reflective of loss of adipose mass and were worse in females. It is suggested that independent of the effect of BMI, leptin secretion is down regulated in untreated symptomatic HIV/AIDS patients with secondary infections. The results also suggest that the nor-mal leptin induced rise with CD4 T cell counts may be blunted by untreated HIV infection.

a available suggests that Adiponectin, an adipocyte–derived peptide, is associated with adiposity and could effect the regulation of glucose and lipid metabolism in humans. The aim of this study was to evaluate the association between serum adiponectin concentrations and anthropometric indices and lipid profiles among Iranian women with different grades of obesity. In this analytical de-scriptive study of 157 non-diabetic women (33 normal weight, BMI< 25 kg/m2 and 124 over-weight and obese, BMI≥ 25kg/m2), serum adipo-nectin and leptin levels were measured using an enzyme-linked immunoassay. Fasting glucose and lipid profile levels determined by the glu-cose oxidize and enzymatic methods, respective-ly. Mean serum adiponectin concentra-tion significantly decreased with obesity (p<0.05). Although adiponectin showed a significant neg-ative correlation with BMI (r=-0.321), it was cor-related with serum leptin (r=-0.139), glucose (r=0.259), LDL-C (r=-0.125), TGs (r=-0.210) levels, TSF (r=-0.145), WHR (r=-0.159), and positively with serum HDL-C concentration (r=0.218) in all subjects (p<0.05). Results of multiple regression analyses showed that adiponectin as a dependent variable had a significant correlation with BMI (ß=-0.605, P=0.017), waist circumference (ß=0.624, p=0.029), WHR (ß=-0.251, p=0.048), frame (ß=0.260, p=0.018), TC/HDL-C ratio (ß=-0.1.309, p=0.040) and LDL/HDL ratio (ß=-1.343, p=0.007) and changes in waist size had a significant effect on serum adiponectin levels. Our results suggested that adiponectin had an inverse correlation with adiposity indices and un-favorable lipid profiles, and that variation of waist circumference mostly affected Iranian women.

Postprandial hyperlipemia is associated with the development of cardiovascular disease. Orlistat is a pancreatic lipase inhibitor that reduces fat absorption from the diet by inhibition of hy-drolysis of triglycerides. Since the effect of orlis-tat on postprandial lipemia has not been fully elucidated, we studied the effect of orlistat on postprandial lipemia after a 50% oral fat chal-lenge test (OFCT). Twenty-seven healthy volunteers, aged 18-45 years old, with normal body mass index (BMI) and normal fasting lipid levels, were studied. The control group (n=15) was given the 50% OFCT while the study/orlistat group (n=12), was given 120 mg orlistat followed by intake of the 50% OFCT. Total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were determined at baseline and serially over a 6-hour period. Re-sults: In the control group, TC, TG and HDL peaked in the 4th hour. This lipid peaking was not observed in the orlistat group. Percentage change between baseline to the 4th hour values in the control vs. the study group were, respec-tively, as follows: TC = 65.80% vs. -1.60%; TG = 262.64% vs. 24.74%; and HDL = 205.26% vs. -1.43%. The mean postprandial levels for TC, TG and LDL were well within the normal fasting cut-offs of &amp;lt;6.20 mmol/L, &amp;lt;2.26 mmol/L, and &amp;lt; 4.14 mmol/L respectively throughout the entire 6-hour study period. Orlistat ab-olished the peaking of TC, TG, and HDL after a 50% OFCT. Nonetheless, lipid values were main-tained within normal fasting levels in the orlistat group.

Inflammatory bowel disease (IBD) is a chronic gastrointestinal inflammatory disease of unknown etiology. Nutrition has been proposed as an important factor in etiology of IBD. The aim of this study was to compare dietary intake of antioxidants and serum levels of α -tocopherol and vitamin C in IBD patients with that of healthy subjects. Twenty-six IBD and twenty-eight sex and age matched healthy subjects were selected as the case and control groups from gastroenterology and other wards respectively, during the fall and winter of 2005. Subjects’ serum vitamin C and alpha-tocopherol levels were analyzed using the HPLC method. Semi-quantitative food frequency questionnaires were completed by all subjects during interviews. There was no significant difference in serum levels of vitamin C and α-tocopherol between the two study groups. Intakes of whole grain bread and fresh vegetables in healthy subjects were 2.5 and 1.5 times higher than those of patients, respectively (p<0.05). Although patients consumed fewer cups of tea daily (p<0.05), no significant difference was seen in the intakes of other dietary antioxidant sources between the two groups. Results of this study indicated that although there was no significant difference between vitamin C and α-tocopherol serum levels in the both groups, dietary intake of the main antioxidant sources in IBD patients was lower than healthy matched subjects. More advanced studies with higher number of subjects are needed to explore the antioxidant status in such patients.

Osteoporosis is a common disease in which the bones become prone to fracture as a result of loss of bone mineral density (BMD). The estrogen receptor (ER) gene is a candidate gene for os-teoporosis. This study assesses the relation be-tween estrogen receptor-α gene polymorphism and osteoporosis in a population of Iranian women. In the present study, we investigated 200 pre- and/or post-menopausal Iranian women, aged 35-80 years, stratified for BMD into normal and patient groups. The genomic DNA of both groups was amplified by PCR using specific primers and products were digested by restriction enzymes PvuII or XbaI to identify the related genotypes. The genotypes of intron 1 PvuII or XbaI poly-morphisms of the ER-α gene were detected and introduced so that the upper case and lower case letters of Pp (PvuII) and Xx (XbaI) signified the absence or presence of restriction sites in RFLP experiments. Based on our results, no significant relationship was observed between BMD and intron 1 RFLPs of the estrogen recep-tor alpha gene. Three genotypes, Pp XX, pp XX and PP xx, were detected, all at a very low fre-quency in this population of Iranian women. To conclude no significant relation-ship was found between BMD and intron 1 RFLPs of the estrogen receptor alpha gene. Larg-er numbers of patients need to be investigated to ascertain and confirm whether ER-α genotypes are associated to the disease etiology and if any other factors are involved.

Iodine deficiency (ID) is the leading cause of preventable mental retardation worldwide. The most effective method of eliminating ID disorders (IDD) is promoting the widespread consumption of adequately iodized salt. To measure the impact of legislation banning the import and sale of noniodized salt, the Republic of Georgia government and UNICEF conducted a national survey of IDD prevalence in November 2005. A cross-sectional cluster survey of 970 school-aged children measured: 1) urinary iodine excretion (UIE), 2) prevalence of goiter by palpation, and 3) the iodine content of household salt. The median UIE was 320.7 μg/L, and only 40 (4.4%) of 900 urinary samples were below 100 μg/L. Palpation of 4420 children revealed a total goiter rate of 32.4% (95% confidence interval [CI]=27.2-37.5). Of 957 salt samples analyzed with rapid salt testing kits, 867 (90.6%, 95% CI=86.9-94.3%) were adequately iodized (≥15 ppm), and only 39 (4.1%) had no iodine. Iodization of salt was validated in 136 random samples using iodometric titration; 94.1% (95% CI=89.1-97.2%) were adequately iodized. Due in part to effective legislation and implementation, Georgia now meets the primary World Health Organization criteria for IDD elimination (i.e., >90% of households using adequately iodized salt and <50% of population with UIE <100 μg/L). Findings of potential excessive iodine intake should be further examined. To maintain elimination of IDD, it is important to continue to enforce legislation and sustain Georgia’s salt io-dization program.

Primary hyperparathyroidism is not uncommon. It has varied presentations ranging from asymp-tomatic disease to the classic “stones, groans, moans”. This is a case report of a 49 year-old woman, who presented with sensory obtunda-tion, abdominal pain, associated with vomiting and denovo detected diabetes mellitus. She had a past history of bilateral nephrolithiasis, and was found to have hypercalcemia (serum corrected calcium 12.8 mg/dL) with elevated serum intact parathormone (183 pg/mL, normal range 13-54 pg/mL). The 99m-Tc MIBI scintigraphy localized the source of parathormone to the right inferior parathyroid gland. Being dehydrated, she was treated with saline diuresis, salmon calcitonin and intravenous pamidronate. Her blood sugar was reported to be 421 mg/dL, and the glycemia was controlled with insulin therapy. A 2 X 2 cm sized right inferior parathyroid adenoma was later removed. The glycemic status improved dramatically after parathyroidectomy and the patient was euglycemic on low doses of glimepiride. This case study suggests that pri-mary hyperparathyroidism might also contribute to hyperglycemia in subjects with diabetes mel-litus.