BackgroundThe impact of obesity and dyslipidemia on cardiovascular health in adolescents and young adults with diabetes is incompletely understood. This study evaluated the effects of these co-morbidities on markers of inflammation and endothelial dysfunction in young patients with the disease.MethodsThe study investigated sets of inflammatory, endothelial, and adipocyte biomarkers in 79 patients with type 1 diabetes, 55 patients with type 2 diabetes, and 47 controls.ResultsMean (±SD) age was 20±6 y (median = 17, range = 12–31). Patients with diabetes had higher levels of cytoadhesive molecules (sICAM-1 and sVCAM-1, p<0.001), adiponectin (p<0.001), and haptoglobin (p = 0.023). Their heart rate variability assessment revealed lower standard deviation of beat-to-beat intervals and lower total power (p≤0.019), reflecting autonomous nervous dysfunction. Hemoglobin A1c >8.0% (estimated average blood glucose >10 mmol/L) was associated with higher adiponectin (p<0.001) and obesity was associated with lower adiponectin (p<0.001); thus, obesity damped the effect of hyperglycemia on adiponectin. Obesity was associated with higher sICAM-1 (p≤0.015), tumor necrosis factor-α (TNFα), interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP), p<0.001. Similarly, high-density lipoprotein (HDL) <1.02 mmol/L was associated with higher sICAM-1, TNFα, IL-6, and hsCRP (p≤0.009) and lower adiponectin (p<0.001). Adiponectin correlated negatively with the inflammatory biomarkers in patients with diabetes.ConclusionSubclinical inflammation and endothelial dysfunction are common among young patients with diabetes. Poor diabetes control is associated with higher adiponectin. Obesity and dyslipidemia are associated with lower adiponectin and higher inflammatory and endothelial biomarkers. Intuitively, these predictors of cardiovascular disease are amenable to proper glycemic control, nutritional choices, and regular exercise.
Background: The importance of studying cerebral palsy comes from the fact that, this disorder imposes huge burden families psychologically, emotionally, financially and socially. Moreover, it imposes a major burden on the National Health System because it is simply a chronic disorder, which needs a continuous care and multiple financial resources. At the same time, it needs collaborative efforts and team work between many parties and organizations for a good management and rehabilitation. In Iraq, risk factors of cerebral palsy have not been explored before. Our study objective was to measure the association between, maternal factors, foetal and early neonatal factors, and occurrence of cerebral palsy among Iraqi children. Postnatal risk factors of cerebral palsy were excluded in our study. Methods: We did a retrospective case-control study in Baghdad-Iraq. The place of study was The Central hospital of Children of Baghdad. Cases and controls were fully investtigated (retrospectively) for the risk factors of cerebral palsy using a self-administered questionnaire. The sample size was 300. Number of cases in our study was 100 while the number of controls in our study was 200. Results and conclusion: 84% of the mothers of Cerebral Palsy children were employed compared to 49% of the mothers of normal children who were employed (P value 0.00). After using a multiple logistic regression model, the final adjusted odd ratios included 6 variables which were, employment of mother (OR 8.05, 95% CI 0.98 - 6.62), Primigravida(OR 0.24, 95% CI 0.10 - 0.60), gender of the child(OR 0.15, 95% CI 0.04 - 0.51 ), asphyxia (OR 10.58, 95% CI 3.59 - 31.21), hypoglycemia (OR 40.99, 95% CI 6.93 - 242.27) and hypocalcaemia (OR 27.91, 95% CI 2.04 - 380.96). Our study came to a conclusion that neonatal asphyxia, hypoglycemia and hypocalcaemia were still the major risk factors for cerebral palsy In Iraq
Background: Attention-deficit hyperactivity disorder (ADHD) is a chronic disorder that appears first in childhood at preschool age (4 -5) years, and is manifested by a symptomatic pattern of difficulties with attention, motor activity and impulsivity. Maternal factors like stress, sociodemographic and maternal life style factors are potential risk factors for ADHD. Methodology: A retrospective case-control study was conducted in Baghdad-Iraq. Cases have been taken from 5 private paediatric clinics. Controls were chosen from kindergartens within the same residential area of the paediatric private clinics. Mothers of cases and controls were investigated for the risk factors of ADHD using a self-administered questionnaire. The total sample size was 260. Number of cases was 130 and number of controls was 130. Results: Five variables were significantly associated with development of ADHD after using a multivariate logistic regression model, maternal war stress (Adjusted OR 9.08, 95% CI 4.70 -17.52 and P value < 0.001), maternal smoking (Adjusted OR 3.27 95% CI 1.40 -7.63, P < 0.001), father lost job (Adjusted OR 2.81, 95% CI 1.51 -5.24, P value < 0.001), and house damaged (Adjusted OR 2.55, 95% CI 1.04 -6.24, P < 0.05). Family income was also associated with risk of ADHD (OR 1.02 95% CI 1.00 -3.12, P value < 0.05). Conclusion and suggestion: Maternal exposure to war stress has 9 times higher risk of developing ADHD among offspring. This study aimed to offer to the policy makers a good benchmark to plan more programmes related to women and child health with respect to the fourth and fifth Millennium Development Goals (MDGs) in reduction of child mortality and morbidity and improvement of maternal health. There is a real necessity to address the need of vulnerable pregnant mothers at war and disaster's time for programmes which will be able to control the stress that those pregnant mothers would encounter during those hard times.
The prevalence of type 2 diabetes mellitus in the United Arab Emirates (UAE) is one of the highest in the world. This has been attributed to a sedentary lifestyle related to recent affluence leading to obesity and insulin resistance. We evaluated a population‐based sample of Emirati subjects to determine the presence of the metabolic syndrome and the risk for cardiovascular disease in this population. Anthropometrics, fasting venous glucose and lipids, and blood pressure were measured in 309 subjects who were not known to have diabetes mellitus (98 men, 215 women; mean age 38.3 ± 14.6 yrs). Mean (SD) fasting levels (mmol/L) were 5.5 ± 1.0 for glucose, 3.5 ± 1.0 for LDL cholesterol, 1.1 ± 0.3 for HDL cholesterol, and 1.0 ± 0.6 for triglycerides. Mean systolic and diastolic blood pressure values were 119 ± 16 and 71 ± 10 mm of Hg, respectively. Mean waist circumference was 87 ± 14 cm. The prevalence of the metabolic syndrome based on the modified ATP III criteria was 25.2%. Most subjects led a sedentary lifestyle and only a minority (34%) reported that they had performed any form of exercise at least once in the previous 2 weeks. Diet analysis indicated that subjects take a diet high in carbohydrate with rice and dates being major food components. These results indicate that this population is at high risk for cardiovascular disease and other complications associated with diabetes. Results from this baseline evaluation suggest that subjects from this population would benefit from a dietary intervention including carbohydrate restriction.
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