Global estimates of diabetes prevalence for 2013 and projections for 2035.

Nonenzymatically glycated human serum albumin and glycated poly-lysine(Lys) in vitro brought about the reduction of nitroblue tetrazolium and ferricytochrome c at pH 9.06 and pH 7.8, respectively. This reduction was inhibited partially by superoxide dismutase (SOD). Glycated poly-Lys caused the oxidation of NADH in the presence of LDH at pH 7.0 which was completely inhibited by SOD. Glycated material was found to function both as a reductant and an oxidant. The reactivity of glycated material is discussed and a possible mechanism by which superoxide is produced is proposed. Results may give a clue to diabetic complications.

Superoxide production from nonenzymatically glycated protein

*Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine and Department of Gastroenterology, Shanghai First People’s Hospital, Shanghai, Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, Department of Gastroenterology, First Affiliated Hospital, College of Medicine, Zhejiang University, **Department of Hepatology, Hangzhou Sixth People’s Hospital, Hangzhou, Zhejiang Province, Department of Gastroenterology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province. and Department of Internal Medicine, Prince of Wales Hospital, Shatin, The Chinese University of Hong Kong, Hong Kong SAR, China

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1751-2980.2010.00477.x

Guidelines for the diagnosis and management of nonalcoholic fatty liver disease: update 2010: (published in Chinese on Chinese Journal of Hepatology 2010; 18:163-166).

Background: Diabetes mellitus has reached epidemic proportions worldwide. South Asians are known to have an increased predisposition for diabetes which has become an important health concern in the region. We discuss the prevalence of pre-diabetes and diabetes in South Asia and explore the differential risk factors reported. Methods: Prevalence data were obtained by searching the Medline W database with; ‘prediabetes’ and ‘diabetes mellitus’ (MeSH major topic) and ‘Epidemology/EP’ (MeSH subheading). Search limits were articles in English, between 01/01/1980–31/12/2011, on human adults (≥19 years). The conjunction of the above results was narrowed down with country names. Results: The most recent reported prevalence of pre-diabetes:diabetes in regional countries were; Bangladesh–4.7%:8.5% (2004–2005;Rural), India–4.6%:12.5% (2007;Rural); Maldives–3.0%:3.7% (2004;National), Nepal–19.5%:9.5% (2007;Urban), Pakistan–3.0%:7.2% (2002;Rural), Sri Lanka–11.5%:10.3% (2005–2006;National). Urban populations demonstrated a higher prevalence of diabetes. An increasing trend in prevalence of diabetes was observed in urban/rural India and rural Sri Lanka. The diabetes epidemicity index decreased with the increasing prevalence of diabetes in respective countries. A high epidemicity index was seen in Sri Lanka (2005/2006–52.8%), while for other countries, the epidemicity index was comparatively low (rural India 2007–26.9%; urban India 2002/2005–31.3%, and urban Bangladesh–33.1%). Family history, urban residency, age, higher BMI, sedentary lifestyle, hypertension and waist-hip ratio were associated with an increased risks of diabetes. Conclusion: A significant epidemic of diabetes is present in the South Asian region with a rapid increase in prevalence over the last two decades. Hence there is a need for urgent preventive and curative strategies .

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Prevalence and trends of the diabetes epidemic in South Asia: a systematic review and meta-analysis

巻頭言 (Subclinical(特集))

Benign Prostate Hyperplasia (BPH) is the common health problem in ageing male. Free radicals and reactive oxygen species (ROS) are produced more with advancement of age leads to oxidative stress. This study aims to assess Malondialdehyde (MDA), the marker of lipid peroxidation and vitaminic antioxidants e.g. alpha-Tocopherol (Toc) and Ascorbate (Asc) status in plasma of BPH patients. This is a case control study conducted in Department of Biochemistry in collaboration with Dept of Surgery, BPKIHS. Forty eight (n = 48) confirmed patients of BPH and forty six (n = 46) healthy age matched controls were enrolled. Plasma MDA, Asc and alpha-Toc were estimated. Plasma MDA level showed 4.81 +/- 1.87 nmol/ml in BPH patients compared to 3.69 +/- 1.56 nmol/ml in healthy controls (p < 0.001). There were significant decrease in plasma alpha-Toc and Asc level which were 0.85 +/- 0.12 mg/dl and 0.93 +/- 0.13 mg/dl in BPH patients compared to 1.37 +/- 0.31 mg/dl and 1.44 +/- 0.38 mg/dl in healthy controls respectively. Inverse correlation of plasma MDA with a- Toc (r = -0.09) and Asc (r = -0.51) was found in BPH patients. There was mild elevation of PSA in BPH patients compared with control but was not statistically significant. Thus, our study showed the evidence of association of oxidative stress in BPH patients.

Oxidative stress in benign prostate hyperplasia.

AIMS: To ascertain the prevalence of the metabolic syndrome in patients with acute myocardial infarction; to study the impact of the metabolic syndrome on hospital outcomes; and to Þ nd out the association of each component of the metabolic syndrome with acute myocardial infarction (AMI). SETTING: Coronary care unit, Department of Medicine, B P Koirala Institute of Health Sciences, Dharan, Nepal. DESIGN: Hospitalbased cross-sectional study. MATERIALS AND METHODS: A total of 84 unselected consecutive patients hospitalized with AMI (diagnosed on the basis of WHO criteria) were categorized according to NCEP ATP III criteria. STATISTICAL ANALYSIS: Data was analyzed by using the Student’s t test and Chi-square test. RESULTS: Among the 84 AMI patients, 22 (26.19%) fulÞ lled the criteria for metabolic syndrome. Patients with the metabolic syndrome were older (86% were >50 years of age) and females (27%) were more affected than males (25%). Inhospital case fatality was higher in patients having the metabolic syndrome (5/22) than in those without the syndrome (3/62). Among the Þ ve components of the metabolic syndrome, the triglyceride levels had the highest positive predictive value (62%) in AMI; this was followed by fasting blood glucose levels (55%). CONCLUSION: The prevalence of the metabolic syndrome is 26.19%; it is associated with high mortality; among its components, the triglyceride level has the highest positive predictive value in AMI patients.

Prevalence of the metabolic syndrome in acute myocardial infarction and its impact on hospital outcomes

. The present study was undertaken to evaluate differences between urban and rural Nepali populations in terms of hyperglycemia, socioeconomic position (SEP) and hypertension, through a community based survey in Sunsari District, eastern Nepal. Blood glucose levels were measured in participants (N = 2,006) S30 years old from urban and rural communities and were classified according to WHO criteria (1998) into normoglycemia (NGY), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and hyperglycemia (HGY). SEP was assessed by structured health interview along with anthropometric measurements and behavioral variables. Hypertension was classified per Joint National Committee (JNC-VII) criteria. Ten point three percent and 11.9% of subjects in this survey (13.3% urban and 11.0% rural) gave a family history and personal history of diabetes mellitus, respectively. Of urban participants (n = 736) with no history of diabetes 70 (9.5%) had HGY and 143 (19.4%) had glucose intolerance (IFG and IGT). Of rural participants (n = 1,270) 114 (9.0%) had HGY and 176 (13.9%) had glucose intolerance. There was an increasing trend in numbers of cases of hyperglycemia and intolerance with increasing age (chi2 198.2, p < 0.001), body mass index (BMI) (chi2 35.1, p < 0.001), SEP (chi2 48.5, p < 0.001) and hypertension (chi2 130.6, p < 0.001). Rural participants had a lower odds ratio [0.706; 95% confidence interval (CI) 0.455-1.096] of having hyperglycemia than urban participants. Individuals with medium and higher SEP had a lower odds ratio (0.878; CI 0.543-1.868) and higher odds ratio (1.405; CI 0.798-2.474), respectively, compared to individuals with lower SEP of having HGY. Both urban and rural populations are at risk for hyperglycemia and glucose intolerance. Individuals having a medium SEP had lower risk of diabetes mellitus than individuals from lower and higher SEP.

Hyperglycemia, glucose intolerance, hypertension and socioeconomic position in eastern Nepal.

Patients suffering from Alcoholic Liver Diseases (ALD) are often diagnosed by spectrum of physical manifestations and laboratories abnormalities. Among biochemical abnormalities De Ritis Ratio (AST/ALT ratio) is more sensitive during any phase of the disease. This ratio is based on common tests of liver function test and can be investigated in any laboratory and is more relevant in countries like Nepal where alcohol abuse is a major cause of liver disease. Clinically diagnosed 103 ALD cases and 73 healthy controls were enrolled for the study. Selected parameters of liver function tests were analyzed by Vitalab Selectra-2 autoanalyser using Merck diagnostic kits and statistically analyzed by student "t" test. The De Ritis ratio was calculated from serum AST and ALT values and was found 2. 30:1 in patients compared to of 1.10:1 in control group. AST and ALT value showed mild to moderate elevation as it was 124.80 +/- 86.24 IU/L and 54.21 +/- 39.72 IU/L in patients compared to 35.00 +/- 23.49 IU/L and 31.48 +/- 17.79 IU/L in controls. The increase in AST and ALT level in patients was statistically significant (p or = - Glutamyl Transferase showed 425.26 +/- 36.40 IU in alcoholics compared to 70.55 +/- 27.35 IU/L in controls, a significant increase observed (p 2:1, supported by reversal of Albumin/globulin ratio facilitates the diagnosis.

De Ritis ratio as diagnostic marker of alcoholic liver disease.

A glutathione redox cycle is a major antioxidant defense system for the detoxification of reactive oxygen species within erythrocytes. Reactive oxygen species such as superoxide anions, hydrogen peroxide and hydroxyl radicals are generated as a host defense mechanism for killing of engulfed Leishmania donovani, a causative agent of visceral leishmaniasis, are capable of damaging lipids and other biomolecules when produced in excess. Erythrocytes are most vulnerable to Reactive oxygen species. In present study we aimed to evaluate erythrocyte reduced glutathione (GSH) levels as an antioxidant and erythrocyte malondialdehyde (MDA) as a marker of lipid peroxidation. The study included twenty-five Visceral leishmaniasis patients and they were followed up after their complete chemotherapy with antileishmanial drugs (sodium stibogluconate) for 30 days. Forty six age and sex matched healthy individuals were taken as controls. GSH levels in erythrocytes of visceral leishmaniasis patients were increased in spite of significant increased erythrocyte MDA as compared to controls. Whereas erythrocyte GSH and MDA levels of follow up patients were decreased as compared to patients before treatment groups. We concluded that visceral leishmaniasis patients are in oxidative stress which most likely induces the endogenous antioxidant such as GSH or its poor utilization by cells.

S Majhi

Papers

Oxidative stress in benign prostate hyperplasia.

Prevalence of the metabolic syndrome in acute myocardial infarction and its impact on hospital outcomes

Hyperglycemia, glucose intolerance, hypertension and socioeconomic position in eastern Nepal.

De Ritis ratio as diagnostic marker of alcoholic liver disease.

Erythrocyte glutathione status in human visceral leishmaniasis