Background The prevalence of monoclonal gammopathy of undetermined significance (MGUS), a premalignant plasma-cell disorder has not been determined in our geographic area Nigeria. Methods A cross sectional survey was carried on apparently healthy Nigerians selected by multistage sampling technique from the cosmopolitan city of Lagos, Nigeria. Subjects enrolled into the study had 2-step screening for the presence, type and concentration of monoclonal band. Agarose-gel electrophoresis was performed on all serum samples, and any serum sample with a discrete band of monoclonal protein or thought to have a localized band was subjected to Immunofixation. Subjects were also evaluated for Bence jones proteinuria, haematological and biochemical parameters. Results Four hundred and ten subjects with a mean age of 45.68 ± 10.3 years, a median of 45.00 years and a range of 20 to 80 years were enrolled into the study. MGUS was identified in only one (0.24 percent) of the 410 study subject. This subject was demonstrated to have a double monoclonal gammopathy; IgGλ at 16.9 g/L and IgAκ at 8.5 g/L. None of them including the sole subject with MGUS had a monoclonal urinary light chain. Conclusion Among residents of Lagos, Nigeria, MGUS was found in only 0.24% percent of apparently normal persons with a median age of 45 years. This suggests that MGUS which represents the earliest stage of monoclonal plasma/lymphoid cell proliferation is not a common finding in the relatively young population of Nigeria. Future epidemiologic studies dealing with plasma cell disorders in older people are required to carefully examine the relationship between environmental factors and prevalence of MGUS and its ultimate progression to MM.
Context: Iron overload has been established to play a role in the etiopathogenesis of Type 2 diabetes mellitus (DM) as evidenced by its high prevalence among patients with hemochromatosis and transfusion-dependent diseases. This is as a result of iron redox reaction which generates free radicals that cause peroxidation of lipid-rich pancreas, leading to reduced insulin sensitivity. Aims: This study therefore evaluated the impact of regular blood donation, an effective method of reducing iron load, on β-islet cell functions and level of glycemic control among regular whole blood donors. Settings and Design: This is a cross-sectional, analytical study. Subjects and Methods: Forty-two consenting regular blood donors who had donated whole blood at least twice and not more than thrice in the last 1 year were selected as cases, while 42 age-matched individuals who have never donated blood previously were selected as controls. Samples were obtained and analyzed for fasting plasma glucose, fasting plasma insulin, serum ferritin, transferrin receptor, total iron-binding capacity (TIBC), and serum iron, while Homeostatic Model Assessment (HOMA) of insulin resistance (IR) and beta sensitivity, HOMA-IR, and HOMA-β-cell function (HOMA-β%) were calculated for both groups. Statistical Analysis Used: Statistical analysis was done using Microsoft Excel package and the Statistical Package for the Social Sciences (SPSS) version 20.0 (SPSS Inc., Chicago, IL, USA). Results: Iron studies among regular blood donors and nondonors revealed lower serum iron (37.2 ± 7.3 vs. 41.1 ± 7.9 μmol/L, P = 0.180) and lower serum ferritin levels (30.2 ± 26.1 vs. 42.9 ± 38.5 ng/mL, P = 0.117), which were not statistically significant, while there were higher serum transferrin receptor (155.5 ± 22.6 vs. 112.8 ± 43.4 ng/mL, P < 0.001) and higher serum TIBC (42.3 ± 6.4 vs. 37.8 ± 7.4 μmol/L, P < 0.05), among cases than controls. The mean HOMA-IR and HOMA-β% were also significantly better among donors than nondonors. Conclusions: Regular blood donation may protect the body from the toxic effects of excessive iron store, which includes improved insulin sensitivity and glycemic control.
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