In ART-naive patients, CKD is common, and low eGFR was associated with lower CD4 counts.

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Background Type 2 diabetes mellitus has reached epidemic proportions worldwide and improved detection techniques and biomarkers are urgently needed across the spectrum of diabetes initiation and progression. Inflammatory biomarkers play a role in the development of the condition and blood is the gold standard body fluid for the diagnosis of diabetes mellitus. Serum glycated haemoglobin is a widely used marker of chronic hyperglycemia, and it is currently used to diagnose type 2 diabetes mellitus and it is the standard biomarker for the adequacy of management. However, saliva offers an alternative to serum as a biological fluid for diagnostic purposes. Non-invasive measures of inflammatory biomarkers (such as saliva diagnostics) are increasingly being investigated due to significant similarities between salivary and serum proteome. The role of saliva diagnostics in diabetes mellitus has not been explored in our study population. Objectives This study investigated the association of selected salivary inflammatory biomarkers (Interleukin 6 [IL-6], C-reactive protein [CRP], and Tumour necrosis factor α [TNF-α]) to glycated haemoglobin (HbA1C) in type 2 diabetics. Materials and methods Seventy-five participants, 39 type 2 diabetics (52%) and 36 (48%) healthy controls were recruited. Saliva and blood samples were collected for each participant. The levels of selected salivary inflammatory biomarkers (IL-6, CRP and TNF-α) were estimated by Enzyme Linked Immunosorbent Assay (ELISA) method and glycated haemogloin (HbA1C) was estimated using the liquid chromatography method. Periodontal status of the participants were determined using the Basic Periodontal Examination (BPE). Results The mean salivary levels of CRP was significantly higher in diabetics, 0.05 ± 0.04 µg/ml than in controls, 0.02 ± 0.02 µg/ml (p < 0.001). Mean TNF-α was also significantly higher in diabetics, 5.39 ± 12.10 pg/ml than in controls, 1.51 ± 3.66 pg/ml (p = 0.036). Mean salivary IL-6 was also higher in diabetics compared with controls (47.20 ± 18.49 versus 41.94 ± 16.88 pg/ml), but the difference was not statistically significant, p = 0.204. In the multivariate analysis adjusting for age and periodontal status, only the mean salivary CRP was significantly higher in diabetics, 0.034 higher than controls (95% CI 0.009, 0.059 and p = 0.01). There was a positive correlation between salivary CRP and HbA1C levels, which was moderate with r-value 0.4929 and p-value < 0.0001. Conclusions Salivary inflammatory biomarkers especially CRP are higher in diabetics compared with controls and CRP is positively correlated with serum HbA1C levels. The biomarkers show potentials as non-invasive alternative method to evaluate glycaemic control in diabetes.

Leg ulceration is a debilitating chronic complication of sickle cell disease (SCD) the pathogenesis of which is yet to be fully elucidated. We hypothesized that SCD patients with histories of previous leg ulcers would have intima hyperplasia of the common femoral artery (CFA). We enrolled 44 SCD patients and 33 age-matched and sex-matched controls with hemoglobin AA. Anthropometric measurements, biochemical parameters, and sonographic intima-media thickness (IMT) of the CFA were determined. The median CFA IMT in SCD limbs with history of leg ulcers (SWLU) was 1.0 mm, whereas it was 0.7 mm in SCD limbs with no history of leg ulcer (SNLU) and 0.60 mm in controls (P &lt; .001). Among the SNLU, 70.3% had CFA IMT &lt;0.9 mm, whereas only 29.7% had CFA IMT ≥0.9 mm. Conversely, only 20.8% of SWLU had CFA IMT &lt;0.9 mm, whereas the remaining 79.2% had CFA IMT ≥0.9 mm. All the controls had CFA IMT &lt;0.9 mm. Binary logistic regression to determine the odds of having leg ulcer among SCD limbs with CFA IMT of ≥0.9 mm yielded an odds ratio of 9, indicating that SCD limbs with CFA IMT ≥0.9 mm had a 9 times greater risk of having leg ulcer compared with those with CFA IMT &lt;0.9 mm. There is a significant increase in the CFA IMT of SCD limbs with ulcer compared with controls and SCD limbs without ulcer, suggesting that arterial vasculopathy plays a major role in the formation of these ulcers.

ObjectivesTo evaluate the risk of obstructive sleep apnea (OSA) in a primary care population of elderly Nigerians and to determine its correlates.MethodsClinical and demographic data of 414 elderly individuals in a primary care clinic were obtained. Their risk of OSA was estimated using Berlin questionnaire while Epworth sleepiness scale and the Center for Epidemiologic Studies Depression Scale (CESD-10) were also administered.ResultsOf the 414 subjects, 96 (23.2%) met the criteria for a high risk for OSA with a male to female ratio of 1:1. Subjects at high OSA risk (high OSA risk group) were younger than those at low OSA risk (low OSA risk group) (71.4±6.8 vs 73.6±7.7, p=0.011). Mean body mass index (BMI, kg/m2) (27.3±5.8 vs 24.7±5.1, p<0.001) and waist circumference (WC, cm) (90.7±13.1 vs 86.5±13.9, p=0.011) were higher in the high OSA risk group compared with the low OSA risk group. A total of 215 (51.9%) and 62 (15.0%) subjects had clinically significant depressive symptoms (CESD-10 score≥10) and excessive daytime sleepiness (EDS), respectively. On regression, the odds of EDS, depressive symptoms, increased BMI and younger age were significantly higher in the high OSA risk group compared with the low OSA risk group.ConclusionsHigh risk for OSA and depressive symptoms are common in our sample of elderly Nigerians. Depressive symptoms, EDS, BMI and age independently predict high OSA risk in the elderly.

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Background: Vitamin D is partly responsible for maintaining calcium and phosphate homeostasis but has been shown to have immune modulatory functions. Objective: To measure serum levels of vitamin D, and plasma levels of calcium and phosphate in children with pneumonia and compare with those of apparently healthy controls. Methods: A cross-sectional study involving seventy-six children with pneumonia, matched with 76 apparently healthy controls. Results: There was no statistically significant difference in the mean serum vitamin D levels between the cases and the controls (t = 1.190, p = 0.236). The mean serum vitamin D level was significantly higher in children with non-severe pneumonia than in those with severe pneumonia (t = 3.299, p = .002). The mean serum vitamin D level was higher among the controls than those with severe pneumonia (t = 2.674, p = 0.009). The mean plasma calcium and phosphate levels in the controls were significantly higher than in the cases (t = 2.528, p = .013 and t = 4.594, p < .001 respectively). Plasma calcium and phosphate levels did not vary with the severity of pneumonia. Pneumonia was independently associated with the occurrence of hypocalcaemia and hypophosphataemia (OR = 4.366, 95% CI = 1.851-10.295, p = 0.001; OR = 7.355, 95% CI = 1.545-35.027, p = 0.01 respectively). Conclusion: Children with severe pneumonia had lower levels of vitamin D than those with the non-severe disease. Derangements in plasma levels of calcium and phosphate are common in children with pneumonia, and these abnormalities occur independently of low vitamin D levels.