OBJECTIVE: Obesity, defined as a body mass index (BMI) greater than 30 kg=m 2 , is now recognised as a risk factor for diabetes mellitus, hyperlipidaemia, colon cancer, sudden death and other cardiovascular diseases. In this study, it is hypothesized that obesity is an independent risk factor for lipid peroxidation and decreased activities of cytoprotective enzymes in humans. SUBJECTS: Fifty normal healthy subjects with healthy BMI (19 -25 kg=m 2 ) and 250 subjects with different grades of obesity (30 -50 kg=m 2 ) with no history of smoking or biochemical evidence of diabetes mellitus, hypertension, hyperlipidaemia, renal or liver disease or cancer. MEASUREMENTS: To test this hypothesis, we assessed lipid peroxidation and cytoprotection by measuring the concentrations of plasma malondialdehyde (P-MDA) and the activities of erythrocyte copper zinc-superoxide dismutase (CuZn-SOD) and glutathione peroxidase (GPX). RESULTS: The concentration of P-MDA was significantly lower (P < 0.001) in subjects with healthy BMI (2.53 AE 0.04 mmol=l) than in those with BMI above 40 kg=m 2 (4.75 þ 0.05 mmol=l). Furthermore, there was a significantly positive association (r ¼ 0.342, P ¼ 0.013) between BMI and P-MDA. On the other hand, subjects with healthy BMI had significantly higher (P < 0.001) erythrocyte CUZn-SOD (1464 AE 23 units=g Hb) and GPX (98.4 AE 3.3 units=g Hb) than those with BMI above 40 kg=m 2 (1005 AE 26 units=g Hb) and (84.3 AE 6.7 units=g Hb) respectively. Furthermore, erythrocyte CuZn-SOD and GPX activities were negatively associated with BMI (r ¼ 7 0.566, P ¼ 0.005 and r ¼ 7 0.436, P ¼ 0.018) respectively. CONCLUSION: It is concluded from these results that obesity in the absence of smoking, diabetes mellitus, hyperlipidaemia, renal or liver disease causes lipid peroxidation and decreased activities of cytoprotective enzymes, and should therefore receive the same attention as obesity with complications.

BACKGROUNDThe WHO-ILAR Community Oriented Program for Control of Rheumatic Diseases (COPCORD) primarily aims to estimate the burden of musculoskeletal symptoms/disorders. We estimated the incidence of musculoskeletal pain in the first community-based COPCORD study in Kuwait.SUBJECTS AND METHODSThe validated Arabic version of the WHO-ILAR COPCORD Core Questionnaire was used in a survey of 2500 randomly selected Kuwaiti households to assess the frequency of musculoskeletal pain, disability, and health-seeking behavior in adult Kuwaitis. Those subjects reporting no musculoskeletal pain were identified and followed-up for a period of one year by contacting them every 2 weeks. Once a respondent reported pain, an appointment to report to hospital was offered and the subject was examined by a rheumatologist using American College of Rheumatology (ACR) criteria.RESULTSOf 5159 adults who were non-complainers in an earlier prevalence phase of the study, 3341 responded to phone calls (response rate of 65%). The incidence of musculoskeletal pain was 6.6% (95%CI, 3.4%-9.7%). Age- and sex-adjusted incidence rates were 7.2% (95%CI, 3.4%-10.5%) for females and 6.1% (95%CI, 3.1%-9.2%) for males. The incidence rate increased with increasing age, body mass index, and with being married. The common sites of pain were knee, low back and shoulder.CONCLUSIONThe incidence of musculoskeletal pain among Kuwaiti adults is reported for the first time. Further studies adopting the same instrument in other communities are warranted to compare with our findings.

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Leptin, the obesity gene protein product, is a hormone with multiple physiological functions in the human. However, there are few reports in the literature on its role in trace element metabolism in the normal population. Therefore, we investigated the association among serum leptin, zinc, copper, and zinc/copper ratio in 570 healthy men and women aged 15 yr and older. Serum leptin assay was done with a commercial enzymelinked immunosorbent assay kit; serum zinc and copper levels were measured by an atomic absorption spectrophotometer. Serum leptin was found to be positively associated with age (r=0.254, p<0.001), sex (r=0.406, p<0.001), body mass index (BMI) (r=0.553, p<0.001), and serum copper (r=0.419, p<0.001), but negatively associated with the zinc/copper ratio (r=-0.423, p<0.001). There was no significant association between serum leptin and zinc (r= -0.131, p>0.05). When the confounding effects of age, sex, and BMI were removed, serum leptin was still positively associated with serum copper (r=0.197, p=0.02) and the serum zinc/copper ratio (r=-0.182, p=0.03). These results suggest that copper and not zinc has an effect on serum leptin levels.

Objectives: The purpose of this study was to examine the frequencies of abnormal thyroid function tests and serum thyroid autoantibodies in healthy Kuwaitis and those with autoimmune diseases. Subjects and Methods: Serum concentrations of sensitive thyrotropin, and free thyroxine were measured in 577 apparently healthy controls, 177 patients with rheumatoid arthritis (RA), 60 with systemic lupus erythematosus (SLE) and 25 with primary Sjogren’s syndrome (pSS) using the immunochemiluminescent assay method on IMMULITE 1000. Serum microsomal and thyroglobulin autoantibodies were also measured by passive hemagglutination assay. For analysis of the thyroid function tests, the subjects were classified into five categories: normal, subclinical hypothyroidism, overt hypothyroidism, euthyroid sick syndrome and biochemical hyperthyroidism. Results: Subclinical hypothyroidism was seen in 1.7% of healthy controls, 10.2% of RA, 13.3% of SLE, and 16% of pSS patients. Among RA patients, the frequency of subclinical hypothyroidism in females (11.4%) was significantly higher than among males (5.4%; p < 0.01). In SLE and pSS patients, all those with subclinical hypothyroidism were females. Overt hypothyroidism was seen in 1.4% of controls, 10.2% of RA, 8.3% of SLE, and 4% of pSS patients. Biochemical hyperthyroidism was seen in 0.2% of controls, 4.5% of RA, 5% of SLE and none of pSS patients. The euthyroid sick syndrome was seen in 0.4% of controls, 13.6% of RA, 16.7% of SLE and in none of pSS patients. Thyroid autoantibodies were present in 3.1% of controls, 12.4% of RA, 18.3% of SLE, and 12% of pSS patients. Conclusion: Our data show that abnormal thyroid function tests and thyroid autoantibodies occur frequently in Ku-waitis with autoimmune diseases. Therefore, ordering these tests in these diseases is recommended.