Irisin is an exercise-regulated myokine inducing browning of white adipose tissue and has gained interest as a potential new strategy to combat obesity and its associated disorders, such as type 2 diabetes mellitus (T2DM). The aim of this study is to evaluate the circulating serum irisin levels in obesity and T2DM and also to elucidate possible relationships between serum irisin levels with anthropometric and metabolic parameters of obesity and T2DM. One hundred fifty newly diagnosed T2DM patients as well as 150 nondiabetic control subjects were enrolled in this study. Nondiabetic controls were then stratified according to their body mass index (BMI) into three subgroups; lean, overweight, and obese. Serum irisin levels were evaluated by enzyme-linked immunosorbent assay. Serum irisin levels were significantly decreased in T2DM patients compared with nondiabetic controls. Obese nondiabetic controls had significantly higher serum irisin levels compared with lean nondiabetic controls. In both nondiabetic controls and T2DM patients, serum irisin was significantly positively correlated with BMI (r 5 0.985, P < 0.001 and r 5 0.218, P 5 0.007, respectively), fat mass (r 5 0.959, P < 0.001 and r 5 0.202, P 5 0.013, respectively), fat-free mass (r 5 0.606, P < 0.001 and r 5 0.194, P 5 0.017, respectively), fat-free mass index (r 5 0.820, P < 0.001 and r 5 0.179, P 5 0.028, respectively), waist-to-hip ratio (r 5 0.880, P < 0.001 and r 5 0.194, P 5 0.017, respectively), fasting insulin (r 5 0.989, P < 0.001 and r 5 0.207, P 5 0.011, respectively), and HOMA-IR (r 5 0.989, P < 0.001 and r 5 0.185, P 5 0.023, respectively), whereas; significantly negatively correlated with insulin sensitivity (r 5 20.992, P < 0.001 and r 5 20.187, P 5 0.022, respectively). In this study, we demonstrated that circulating serum irisin levels were increased in obese nondiabetic subjects, while decreased in T2DM patients. Moreover, serum irisin levels were correlated with anthropometric and metabolic markers of obesity and T2DM. V C 2016 IUBMB Life, 68(7): [544][545][546][547][548][549][550][551][552][553][554][555][556] 2016
Background: Gastroesophageal reflux disease (GERD) may need repeated endoscopy for diagnosis and follow up, this may concern psychological and financial burden on patient. Aim of the work:The aim of our work was to evaluate the benefit of the FSSG as a useful and a practical tool for diagnosing of GERD patients compared to the endoscopic results. This was mainly to avoid repeated uses of endoscopy for diagnosis and may reduce the medical costs and save the patients time Patients & Methods: This study was carried out at Zagazig University, Faculty of Medicine, Internal Medicine Department, Gastroenterology and endoscopy unit during the period from June 2015 to December 2015.The subjects were 131 Egyptian patients aged ≥18 year (mean 46.3± 16.8 year; male/female ratio 1.8/1) who presented with symptoms of heartburn, regurgitation and epigastric pain or discomfort. They were scheduled for esophagogastroduodenoscopy. It was done after approval of Local Ethics Committee and patient's consent was obtained. Pre-endoscopy Procedure: Our study depends on a simplified questionnaire for evaluation of the symptoms of GERD called FSSG (Frequency Scale for Symptoms of GERD) which consists of 12 questions; all must be answered by all subjects Endoscopy Procedure: All subjects underwent esophagogastroduodenoscopy. The results of endoscopy were classified and graded according to Los Angeles classification into GERD A, B and C according to the severity of the endoscopic findings. After that the final endoscopic diagnosis was compared to the predicted diagnosis resulting from the Regression model and Equation. Results: Based on the endoscopic findings, the number of patients with GERD Los Angeles Class A, B and C was 18.3, 15.3 and 6.9 % respectively. Clinical obesity patients were 3 distributed as duodenal ulcer (DU) = 2 and GERD B = 1 patient. Overweight patients were 58 distributed as gastric ulcer (GU) = 13, DU = 7, functional dyspepsia (NUD) = 14, GERD A = 8, GERD B = 8 and GERD C = 8 patients. Normal weight patients were 63 distributed as GU = 14, DU = 11, NUD = 11, GERD A = 16, GERD B = 10 and GERD C = 1 patients. Underweight patients were 7 distributed as DU = 1, GU = 2, NUD = 3, GERD A = 0, GERD B = 1 and GERD C = 0 patients. Usage of the FSSG questionnaire with Regression Model help us to predict strongly GERD A by 95.8%, also GERD B by 95% and weakly predict DU by 81.8%, GERD C by 77.7%, GU by 60.7% and NUD by 50%.Conclusion: Noninvasive assessment tool FSSG questionnaire was useful for objective evaluation of symptoms in GERD patients and avoid repeated endoscopic examination which is undesirable in terms of medical costs and the burden on the patient and save our developing country efforts and resources.
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