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Article
Resistin , Insulin resistance and BMI in type 2 diabetes mellitus and healthysubjects.

Authors: Hashim M. Hashim --- Hedef D. Al-Yassin --- Zainab A. Al-Shamma
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 / 24108057 Year: 2008 Volume: 50 Issue: 3 Pages: 377-382
Publisher: Baghdad University جامعة بغداد

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Abstract

Background : Obesity and insulin resistance have been quite well recognized as fundamental
and leading causes of major health issues such as diabetes, hyperlipidemia, hypertension, and
cardiovascular diseases. Abdominal obesity, particularly visceral adiposity is considered to
play a major role in causing insulin resistance and type 2 diabetes mellitus , T2DM
The resistin is considered one of the causes of insulin resistance which lead to
hyperinsulinemia and a decrease in the quantitative insulin sensitivity check index (Quicki)
which has been recently reported to be a useful marker of insulin resistance in patients with
T2DM.
Objective : The aim of the present study is to find the relationship between resistin and
obesity as modulated by T2DM.
Subjects and methods : The study involved 50 patients with T2DM with age range of 30 -70
years , and 30 healthy subjects ( control group ) of matching age and sex.
Ten mLs of blood were collected from each patient and normal control subject after an
overnight fast . One mL. was kept in an EDTA tube for mesureement of glycated Hb ( HbA1c)
and the rest was allowed to clot , centrifuged and serum was divided into aliquots . Some
was kept at (- 20
o
C ) for measurement of resistin and insulin ( by enzyme linked
immunosorbant assay , ELISA) and the rest for measurement of glucose , urea and creatinine (
by the available routine laboratory tests ) at the same day of collection.
Results showed a significant rise in serum resistin in the obese diabetic patients as compared
to the non obese patients. There are significant correlations between resistin and each of insulin
resistance ( Quicki ) and degree of obesity (BMI) .
Conclusion : Resistin & insulin resistance are significantly affected by BMI in diabetic
patients only and not in the control group which implies that the obese control subjects didn’t
have insulin resistances enough to show any change in resistin level. This confirms the
synergistic effect of the obesity and diabetes on resistin level, while no effect of the disease per se could be detected from the present study.


Article
Periodontal Health Status and Assessment of Osteocalcin levels in Saliva of Diabetic Patients and Systemically Healthy Persons (Comparative study)

Authors: Zina Ali Daily --- Ayser Najah Mohammed
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2017 Volume: 29 Issue: 1 Pages: 89-95
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Diabetes and periodontitis are complicated prolonged disorders through a recognized two-way association. There is elongated-conventional mark that hyperglycaemia in diabetes is affected on immune-inflammatory response and disturb the action of osteoclast and in balance bone turnover, which might rise the person vulnerability to the progress of prolonged periodontitis. Osteocalcin is one of the greatest plentiful matrix proteins originate in bones and produced absolutely there. Small osteocalcin crumbles are noticed in regions of bone remodeling and are in fact degradation products of the bone matrix, that is released outside cells into the Gingival Crevicular Fluid (GCF) and saliva after destruction of periodontal tissue during periodontitisMaterials and Methods: Eighty patients with Type2Diabetes Maleates (T2DM), males and females, were recruited for the study, with an age range of (30-50) years were divided into four groups, (20 subjects each): poorly controlled Type 2Diabetes Mellitus with chronic periodontitis group (CP+pT2DM ) and well controlled Type 2Diabetes Mellitus with chronic periodontitis group(CP+wT2M) , group of patients with only chronic periodontitis (CP )and control group with healthy periodontium and systemically healthy. From all subjects five ml of unstimulated whole salivary samples were collected, then, the samples were centrifuged and the supernatants were collected and kept frozen until the biochemical analysis to measure OC concentrations then clinical periodontal parameters (plaque index, gingival index, bleeding on probing, probing pocket depth and clinical attachment loss) were recorded for all subjects at four sites per tooth except for the third molars.Results: The results of this study revealed highly significant differences among all study and control groups for all the clinical periodontal parameters (plaque index, probing pocket depth, clinical attachment loss) ,and OC concentrations. Additionally patients had chronic periodontitis with poorly controlled Type 2Diabetes Mellitus(CP+pT2DM )demonstrated the highest median values of all clinical periodontal parameters and highest increase in levels of salivary OC followed by CP+wT2M group then CP and Control groups. The current study demonstrates the correlation between OC concentrations with each one of the clinical parameters.It revealed highly significant strong positive correlations with PLI, GI and BOP score 1, while highly significant strong negative correlations with PPD. Also, non-significant weak positive correlation existed with CAL in CP+pT2DM group. Also, high significant strong positive correlation with PLI, GI, BOP and CAL; while, non-significant weak positive correlation with PPD in CP+wT2M group . High-significant strong positive correlation with BOP and CAL, as well as, high significant moderate positive correlation with PPD and significant weak positive correlation with PLI, while non-significant weak positive correlation with GI existed in CP group .Finally, high significant moderate positive correlation with PLI and GI existed in the Control group.Conclusion: Patients with poor glycemic control had more severe periodontal tissue break down with increase in levels of OC than well controlled type 2 diabetic patients and non-diabetic patients all of them with chronic periodontitis. So, this biochemical marker may be useful of periodontal tissue destruction and allowed practitioners for early diagnosis, prognosis and efficient management of periodontal diseases and type 2 diabetes mellitus


Article
Does the tertiary health care for Type 2 diabetic patients can

Author: Tawfeeq F. R. AL-Auqbi M.B, Ch.B FICMS *Ahmed A. A. AL-Sabbagh M.B, Ch.B FICMS
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2012 Volume: 8 Issue: 2 Pages: 48-52
Publisher: Baghdad University جامعة بغداد

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Abstract

Objectives: To study the effect of providing tertiary (specialized) health care for type 2 diabetic patients to meet the WHO and ADA standards and glycemic targets.Method: Six months, Jan. – Jun. 2010, cohort study was conducted on 600 adult diabetics who registered in the National Diabetes Center (NDC) / Al-Mustansiriya University, Baghdad – Iraq. They were followed for 3- 6 months; each time patients were examined physically and their blood pressure, height, weight and BMI were measured. Fasting blood samples were taken from all patients to test the FPG, HbA1c, T.Chol, TG, HDL and LDL.Results: Patients’ age was 52.85±15.56 year and the male/female ratio was 1.01, the median duration of disease was 7 years and their BMI was 28.80 ± 13.02 kg/m2. Patients’ achievement during study period, of glycemic and cardiovascular risk factors, meet the targets of ADA, NHANES and NCEP/ATP III Guidelines of FPG, PPG, HbA1c, T.Chol, TG, LDL, HDL, systolic and diastolic blood pressure by 26.74%, 29.09%, 32.78%, 61.0%, 60.86%, 76.19%, 74.35%, 52.54% and 62.50% respectively.Conclusions: We concluded that tertiary health service can help to meet the international guidelines and recommended targets for type 2 diabetes. Improving quality and coverage of tertiary health services may help in achieve and sustain targets; and afterward close adhering to the WHO and ADA standards and glycemic targets.Abbreviations: BMI=Body Mass Index, FPG= Fasting Plasma Glucose, PPG = post prandial plasma glucose, HbA1c =glycated hemoglobin, T.Chol. = total cholesterol, TG = Triglyceride, LDL = low-density lipoprotein, HDL = high-density lipoprotein, ADA= American Diabetes Association, NHANES = National Health and Nutrition Examination Survey, NCEP/ATP III = National Cholesterol Education Program/Adult Treatment Panel III.Key words: Tertiary health care, Type 2diabetes mellitus, glycemic standards and targets


Article
Salivary α-Amylase and Albumin Levels in Patients with Chronic Periodontitis and Poorly or Well Controlled Type II Diabetes Mellitus

Author: Maha Abdul Aziz Ahmed مها عبد العزيز احمد
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2016 Volume: 28 Issue: 1 Pages: 114-120
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Recent studies suggest that chronic periodontitis (CP) and type2 diabetes mellitus (T2DM) arebidirectionally associated. Analysis of saliva as a mirror of oral and systemic health could allow identification of αamylase (α-Am) and albumin (A1) antioxidant system markers to assist in the diagnosis and monitoring of bothdiseases. The present study aims at comparing the clinical periodontal parameters in chronic periodontitis patientswith poorly or well controlled Type 2Diabetes Mellitus, salivary α-Am, A1, flow rate (FR) and pH then correlatebetween biochemical, physical and clinical periodontal parameters of each study and control groups.Materials and Methods: 80 males, with an age range of (35-50) years were divided into four groups, (20 subjectseach): two groups had well or poorly controlled Type 2Diabetes Mellitus both of them with chronic periodontitis,group of patients with only chronic periodontitis and control group with healthy periodontium and systemicallyhealthy. From all subjects unstimulated whole salivary samples were collected to measure FR, pH, Al and α – Am,then clinical periodontal parameters (plaque index, gingival index, bleeding on probing, probing pocket depth andclinical attachment level)were recorded.Results: Patients had chronic periodontitis with poorly controlled Type 2Diabetes Mellitus demonstrated the highestmedian values of all clinical periodontal parameters and highest increase in levels of salivary α-Am and Al withlowest median values of FR and pH, in addition to the highly significant differences among the study and controlgroups regarding biochemical and physical parameters. Positive correlations were revealed between α-Am with Aland both of them with all clinical periodontal parameters but, they were negative with FR and pH.Conclusion: Patients with poor glycemic control had more severe periodontal tissue break down with decrease in FRand pH also obvious increase in levels of A1 and α- Am so, these biochemical markers will provide an objectivephenotype to allow practitioners for early diagnosis, which is essential for improved prognosis and effective delay ofclinical complications associated with chronic periodontitis and DM and an important strategy to lower theincidence of both diseases world wide


Article
Homestasis Model Assessment–Adiponectin ratio and Adiponectin –Resistin index as markers of insulin resistance in type 2diabetes mellitus
قياس مقاومة الانسولين باستخدام الادبونكتين والادبونكتين-ريزستين لدى مرضى السكري من النوع الثاني

Author: Ikhlas Khalid Hameed اخلاص خالد حميد
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 / 24108057 Year: 2013 Volume: 55 Issue: 2 Pages: 175-178
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Insulin resistance (IR) is an important clinical and biochemical determinant of diabetes and many other clinical states. The gold standard method for IR estimation is the hyperinsulinemic euglycaemic glucose clamp. Adiponectin and resistin are adipocytes derived hormones that play important role in the regulation of glucose, fat metabolism and insulin resistance.Objective: this study aimed to assess the validity of Homestasis Model Assessment–Adiponectin ratio and Adiponectin –Resistin index as markers of insulin resistance in type 2 diabetic mellitus (T2DM) patients.Design: Ninety (T2DM) overweight male subjects were enrolled in this cross sectional study, detailed history, physical examination and anthropometric measures including BMI, waist, and hip circumference were done to all the participants. Fasting serum samples were obtained and used for the measurement of serum glucose, serum triglyceride, high density lipoprotein(HDL),very low density lipoprotein(VLDL),HbA1c ,also serum insulin, adiponectin ,resistin were measured and HOMA-IR, HOMA-AD and AR-index were calculated.SPSS-17 was used to analyze the data. Results: AR-index correlates significantly with FSG, Fasting Insulin and HOMA-IR (r =0.534.p=0.005), (r=0.545, p=0.005), (r=0.506, p=0.008) respectively HOMA-AD correlates with FSG (R=0.551, P=0.001), insulin (P=0.956,p=0.000),HOMA-IR(r =0.952, p=0.000). AUC for AR-index (0.800) and for HOMA-AD (0.905).Conclusions: HOMA-AD and AR-index are reliable and valid measures for the assessment of insulin resistance in type 2 diabetic patients.Keywords: HOMA- Adiponectin, Adiponectin –Resistin index , insulin resistance ,type 2diabetes mellitus

الخلاصه:مقاومة الانسولين لها اهميه سريريه وبايوكيميائيه في مرض السكري وامراض اخرى مثل ارتفاع ضغط الدم وامراض القلب والسمنه لذلك من الضروري قياس مقاومة الانسولين .الادبوسايتوكين مثل الادبونكتين والريزستين الذي له دور مهم في ايض الكلوكوز والدهون في الجسم ومقاومة الانسولين.الهدف: لتقييم صلاحية الادبونكتين-ريزستين والHOMA - ادبونكتين كطرق لقياس مقاومة الانسولين في داء السكري من النوع الثانيالاشخاص وطرق العمل:اشترك في هذه الدراسه 90 مصاب بداء السكري من النوع الثاني .تم قياس معامل كتلة الجسم ومحيط الخصر والحوض وقياس مستوى الكلوكوزوالكوليسترول الكلي والنافع والضار والشحوم الثلاثيه في وضع الصيام وخضاب الدم السكري ايضا تم قياس مستوى الانسولين ،الادبونكتين والريزستين وحساب مقاومة الانسولين بطرق مختلفه. النظام الاحصائي SPSS-17 تم استعماله لمعالجة البيانات احصائياالنتائج: اظهرت الدراسه ان مقاومة الانسولين بواسطة (الادبونكتين-ريزستين) مرتبطه احصائيا مع مستوى الكلوكوز،الانسولين المصلي،والHOMA-IR وكذلك لوحظ وجود ارتباط احصائي مهم بين HOMA-AD و مستوى الكلوكوز،الانسولين المصلي،والHOMA-IR المساحه تحت المنحني للاول كانت(0.800) ولل HOMA-AD(0.905).الاستنتاج : الادبونكتين-ريزستين والHOMA - ادبونكتين هي طرق فعاله لقياس مقاومة الانسولين في داء السكري من النوع الثانيالمفاتيح الداله: مقاومة الانسولين ،الادبونكتين ،ريزستين ،داء السكري من النوع الثاني

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