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Association of Serum Levels of 25 Hydroxyvitamin D and Type 2 Diabetes Mellitus: Age and Gender Dependent Study

Abid A Thaker; Basil O Saleh; Thana I Mustafa

Iraqi Postgraduate Medical Journal, 2017, Volume 16, Issue 2, Pages 138-143

ABSTRACT:
BACKGROUND:
Vitamin D deficiency has been found to have an inverse relationship with the occurrence of diabetes mellitus (DM). The aims of this study were to investigate the serum levels of vitamin D in type 2 DM and to correlates the obtained values with their age and gender.
SUBJECTS AND METHODS:
This case-control study was carried out at Al-Ramadi General Teaching Hospital, and the National Diabetes Center for Treatment and Research at Al- Mustansiriya University, Iraq, during the period from December 2014 to November 2015. It involved, 80 patients with type 2 DM, and 60 healthy subjects. Investigations included serum measurement of 25 Hydroxyvitamin D (25OHD), fasting glucose, Insulin, glycated hemoglobin (HbA1c) in all patients and controls using ELISA technique.
RESULT:
The median concentration of serum 25 OHD of patients with type 2 DM (15.70 ng/ ml) were significantly lower than that of healthy controls (20.27 ng/ ml, P= 0.001). The rate of vitamin D deficiency (VDD) was significantly higher in type 2(82.5%) diabetic patients than in healthy controls (48.3%, P=0.001). Type 2 diabetic patients with age of 60 years and above and female had the highest VDD compared to others, type 2 diabetic patients with age of ≥ 60 years increased the risk of having VDD by 9.8 times compared to those with age group <18 years, but still insignificant (P =0.07).
CONCLUSION:
The results revealed significant deficiency of serum vitamin D in diabetic patients type 2. Supplementation of vitamin D may improve the control of this syndrome or even delay its incidence and complication.
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Autoantibodies and Cytokines Levels in Type 1 Diabetic Patients

Meroj Ahmed Jasem

Iraqi Postgraduate Medical Journal, 2013, Volume 12, Issue 3, Pages 351-358

ABSTRACT:
BACKGROUND:
Type 1 diabetes is characterized by a complete or near-complete insulin deficiency caused by an
immune-mediated selective destruction of the insulin-producing β-cells in the Islets of
Langerhans. Inflammatory mechanisms play a key role in the pathogenesis of type 1 diabetes.
Many findings suggest that the Islet autoantibody status in type 1 diabetes is linked to disease
activity.
OBJECTIVE:
To investigate the hypothesis that the systemic immunoregulatory balance, as defined by levels of
circulating cytokines, is associated with Islet autoantibody status.
METHODS:
Cytokines (IL-2, IL-4, IL-5,IL-10, TNF-β and INF-γ) and Islet autoantibodies (ICA, GADA, IA-2)
were measured in 56 patients with insulin dependent diabetes mellitus (IDDM) and 20 healthy
control patients.
RESULTS:
The three proinflammatory cytokines measured [interleukin-2 (IL-2) , interferon gamma (IFN-γ)
and tumor necrosis factor-β (TNF-β)], both TNF-β (50.0 ±5.9) (63.4± 5.4) and INF-γ (13.8 ± 10.9)
(13.7 ± 5.5) showed a significant increase (P <0.05) with Islet autoantibody positivity, while the
other three cytokines,(IL-4,IL-5 and IL-10), only IL-4 showed a positive increase (54.4 ± 1.4) with
Islet autoantibody positivity although it is non- significant association.
CONCLUSION:
The study reveals the possibility of the of Islet autoantibodies in the domination of
proinflammatory cytokines over the immunoregulatory cytokine

The Relationship between Diabetic Retinopathy and Metabolic Syndrome in Type 2 Diabetes Mellitu

Ikhlas Khalid Hammed

Iraqi Postgraduate Medical Journal, 2013, Volume 12, Issue 1, Pages 62-68

ABSTRACT:
BACKGROUND:
Diabetic retinopathy (DR) is the leading cause of blindness in both the developing and developed countries.The “metabolic syndrome” (MetS) is the clustering of abdominal obesity, insulin resistance, dyslipidemia, and elevated blood pressure and is associated with other comorbiditiesincluding the prothrombotic, and proinflammatory state, MetSis clearly associated with macrovascular complications, but its association with microvascular disease as retinopathy is unclear.
OBJECTIVE:
To find out the possible association between DR and MetS.
SUBJECTS AND METHOD:
Four hundred thirty one diabetic patients fulfilling the inclusion criteria were selected for this study The metabolic syndrome was definedfollowing the national cholesterol education program-Adult. treatment panel III guidelines.the ophthalmologic examinations wereperformedbyophthalmologiststoconfirmorexcluderetinopathy.Height,weight,waist circumference and blood pressure were obtained from all participants. Fasting venous blood samples were collected from all the subjects, HbA1c was estimated by high performance liquid chromatography,the serum wasused for analyzing Fasting Blood Glucose (FBG), Total cholesterol (TC), HDL-cholesterol (HDL-C) andTriglycerides (TG).
Statisticalanalysis of data was performed using statistically package for social science (SPSS) version 17.0
RESULTS:
The DR prevalence differedsignificantlybetween diabetics with and without metabolic syndrome (20.8% vs. 6.08%)the prevalence of metabolic syndrome in the whole studied sample was 72.6 %. Diabetics with DR hadsignificantlylonger duration of diabetes, had wider WC,higherFBG,higher HbA1c,higher systolic BP,are more likelyto be female,older, have a higher prevalence of MetS, and nonsignificant lower HDL-C and TG.Patients with concomitant MetSand DR hadsignificantly higher FBG, HbA1C, SBP, TG, WC and lower HDL than diabetics with MetS but without DR.theprevalence of DR increased as the numbers of metabolic syndrome components increased.
CONCLUSION:
Diabetic subjects with metabolic syndrome are at higher risk to develop retinopathy. The prevalence of DR increased as the numbers of metabolic syndrome components increased

LDL Particles Size Index and Lipid Peroxidation in Type 2 Diabetic Male Patients

Kismat M.Turki; Hind Sh.Ahmed; Perry H.Saifullah

Iraqi Postgraduate Medical Journal, 2013, Volume 12, Issue 1, Pages 57-61

ABSTRACT:
BACKGROUND:
Diabetes mellitus is a heterogeneous condition reflecting different metabolic disorders accompanied by a variety of complications. In DM, there is a change in oxidative stress (elevation in free radical generation with increase lipid peroxidation and derived oxidized products, and serum lipid profile abnormalities.
OBJECTIVE:
Several free radical species are normally produced in the body to perform specific functions. Increased free radicals in diabetes may cause the pathogenesis of atherosclerosis, and the degenerative disorders. In the present study, the oxidative stress in type 2 diabetic male patients was evaluated by estimating the lipid peroxidation. Malondialdehyde (MDA) is one of the major aldehyde derived from lipid peroxidation.
PATIENTS AND METHODS:
Serum MDA, Oxidized HDL (ox.HDL), and lipid profile were measured after 12 hr fasting in 30 diabetic patients, their age range was (40-55) years and compared with 30 healthy controls. RESULTS:
Serum MDA and ox.HDL were significantly increased in the diabetic group (P<0.05). All patients had significant elevation in serum levels of glycated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and LDL particles size index (TG/HDL-C ratio).
CONCLUSION:
This may be due to different glycemic control in these patients. There was a significant positive correlation between serum MDA and LDLs size index, while serum MDA was negatively correlated with serum HDL-C in diabetic patients. Our results indicate that oxidative stress status increases during type 2 diabetes mellitus in parallel to glucose and lipid changes