BackgroundNeutrophil elastase level/activity is elevated in a variety of diseases such as atherosclerosis, systolic hypertension and obstructive pulmonary disease. It is unknown whether obese individuals with prehypertension also have elevated neutrophil elastase, and if so, whether it has a deleterious effect on pulmonary function. Objectives: To determine neutrophil elastase levels in obese prehypertensive women and investigate correlations with pulmonary function tests.MethodsThirty obese prehypertensive women were compared with 30 obese normotensive subjects and 30 healthy controls. The study groups were matched for age. Measurements: The following were determined: body mass index, waist circumference, blood pressure, lipid profile, high sensitivity C-reactive protein, serum neutrophil elastase, and pulmonary function tests including forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio.ResultsSerum neutrophil elastase concentration was significantly higher in both prehypertensive (405.8 ± 111.6 ng/ml) and normotensive (336.5 ± 81.5 ng/ml) obese women than in control non-obese women (243.9 ± 23.9 ng/ml); the level was significantly higher in the prehypertensive than the normotensive obese women. FEV1, FVC and FEV1/FVC ratio in both prehypertensive and normotensive obese women were significantly lower than in normal controls, but there was no statistically significant difference between the prehypertensive and normotensive obese women. In prehypertensive obese women, there were significant positive correlations between neutrophil elastase and body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, high sensitivity C-reactive protein and negative correlations with high density lipoprotein cholesterol, FEV1, FVC and FEV1/FVC.ConclusionNeutrophil elastase concentration is elevated in obese prehypertensive women along with an increase in high sensitivity C-reactive protein which may account for dyslipidemia and airflow dysfunction in the present study population.

Preptin is an endocrine peptide secreted from pancreatic β cells; it acts as a physiological amplifier of glucose-mediated insulin secretion. Osteocalcin, secreted by osteoblasts, is also involved in the regulation of body energy in that it modulates fat and glucose metabolism. The aim of this study was to investigate circulating preptin and osteocalcin levels and the possible association between them in obese and overweight adults. A total of 100 obese-overweight adults and 50 healthy controls matched for age and sex were enrolled in this study. Anthropometric measurements were taken and fasting glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), lipid profile, preptin, and osteocalcin were assessed. Preptin was significantly higher in obese and overweight subjects than in controls, whereas osteocalcin was significantly lower. In multiple regression analysis, preptin was independently influenced by waist circumference (WC) (β = 3.75, P = 0.03), fasting insulin (β = 4.77, P = 0.01), HOMA-IR (β = 8.21, P = 0.003), and osteocalcin (β = -28.41, P = 0.04). Osteocalcin was independently influenced by body mass index (β = -1.46, P = 0.05), WC (β = -2.04, P = 0.03), fasting insulin (β = -2.69, P = 0.02), HOMA-IR (β = -0.19, P = 0.006), and triglyceride (β = -4.54, P = 0.001). In conclusion, elevated serum preptin and decreased osteocalcin concentrations, together with insulin resistance, are associated with obesity and overweight. Serum preptin is also independently associated with osteocalcin, which may explain, at least in part, the crosstalk between bone and the β cells of the pancreas.

BackgroundConstitutional delay of growth and puberty (CDGP) is a variation of the onset and timing of pubertal development without a defined endocrine abnormality. Recently published studies indicate that leptin and ghrelin play a role in puberty initiation and progress. They have been implicated in regulation of GnRH secretion, with ghrelin having inhibitory and leptin, facilitatory effects. We hypothesized that elevated ghrelin and reduced leptin concentrations could be implicated in altering the tempo of puberty in adolescents with CDGP. So in the current study we evaluate variations in leptin and ghrelin levels in adolescent boys with CDGP, the relationships between both hormones and reproductive hormones including LH, FSH and testosterone were also evaluated.MethodsThe study enrolled 23 adolescent boys with CDGP and 20 healthy controls matched for age and sex. Weight, height, BMI, testicular volume, bone age, bone age delay, serum FSH, LH, testosterone, leptin and ghrelin were assessed.ResultsAdolescent boys with CDGP had significantly lower leptin and higher ghrelin than normal controls. Leptin was positively correlated with BMI, bone age, testicular volume, FSH, LH and testosterone and negatively correlated with delayed bone age and ghrelin. Ghrelin was negatively correlated with BMI, bone age, testicular volume, FSH, LH and testosterone. With multiple regression analysis BMI, FSH, LH, testosterone and ghrelin remained independently correlated with leptin while BMI, LH and testosterone remained independently correlated with ghrelin.ConclusionElevated serum ghrelin and decreased leptin concentrations and their associations with reproductive hormones may explain the sexual immaturity in adolescent boys with CDGP.

Pathogenesis of osteoarthritis may have a systemic metabolic component. This study was undertaken to assess the prevalence of primary knee osteoarthritis (OA) in a sample of Egyptian patients with metabolic syndrome (MetS) and to examine the relationship of metabolic syndrome and its components with clinical, functional, and radiographic findings of knee OA. A total of 60 patients (55 females, 5 males) diagnosed as having MetS according to the National Cholesterol Education Program Adult Treatment Panel III (ATP III) criteria and 30 obese subjects without MetS (24 females, 6 males), serving as a control group, were included in this study. All participants had completed preliminary questionnaires, clinical and laboratory examinations, and an evaluation for radiographic knee OA. Scores from the Western Ontario and Mc-Master University (WOMAC) were used for the pain, stiffness, and disability assessments of OA patients. X-rays were classified according to the Kellgren-Lawrence (KL) radiographic rating scale. We tested the relationship of metabolic syndrome and its components with the WOMAC score and radiographic findings of knee OA after adjusting for BMI. The prevalence of OA was 83.3% in MetS group compared with 63.3% in control group (P = 0.034). MetS patients with OA had higher WOMAC score and radiographic grading than controls with OA (P = 0.034, 0.019). MetS patients with OA had more waist circumference (WC) (P = 0.022), and higher frequency of hypertension (HTN) and diabetes mellitus (DM) (P = 0.009, 0.002 respectively) than MetS patients without OA. There were significant associations of MetS, WC, HTN, DM, high TG, and low HDL with OA (P = 0.041, 0.007, < 0.001, < 0.001, 0.016, 0.012 respectively) by linear regression analysis. There were also significant associations of MetS with WOMAC score and X-ray grading (P = 0.003, 0.019 respectively) by linear regression analysis. Knee OA is prevalent in patients with MetS and associated with worse pain and functional impairment score and advanced radiographic changes. Abdominal obesity, hypertension, and diabetes are the most common components of MetS in patients with knee OA.

BackgroundRecent evidence has suggested an association between subclinical hypothyroidism (SCH) and microalbuminuria in patients with type 2 diabetes. However, whether SCH is related to microalbuminuria among subjects with prediabetes has not been studied. Thus, we evaluated the association between SCH and microalbuminuria in a cohort of prediabetic Egyptian adults.MethodsA total of 147 prediabetic subjects and 150 healthy controls matched for age and sex were enrolled in this study. Anthropometric measurements, plasma glucose, lipid profile, homeostasis model assessment of insulin resistance (HOMA-IR), thyroid stimulating hormone (TSH), free thyroxine, triiodothyronine levels, and urinary albumin-creatinine ratio (UACR) were assessed.ResultsThe prevalence of SCH and microalbuminuria in the prediabetic subjects was higher than that in the healthy controls (16.3% vs. 4%, P<0.001; and 12.9% vs. 5.3%, P=0.02, respectively). Prediabetic subjects with SCH were characterized by significantly higher HOMA-IR, TSH levels, UACR, and prevalence of microalbuminuria than those with euthyroidism. TSH level was associated with total cholesterol (P=0.05), fasting insulin (P=0.01), HOMA-IR (P=0.01), and UACR (P=0.005). UACR was associated with waist circumference (P=0.01), fasting insulin (P=0.05), and HOMA-IR (P=0.02). With multiple logistic regression analysis, SCH was associated with microalbuminuria independent of confounding variables (β=2.59; P=0.01).ConclusionOur findings suggest that prediabetic subjects with SCH demonstrate higher prevalence of microalbuminuria than their non-SCH counterparts. SCH is also independently associated with microalbuminuria in prediabetic subjects. Screening and treatment for SCH may be warranted in those patients.