The Effect of Clothing on Vitamin D Status, Bone Turnover Markers, and Bone Mineral Density in Young Kuwaiti Females.

Many Arab women in the Gulf region cover their bodies for cultural and religious reasons, limiting the skin's exposure to sunlight and therefore its ability to synthesize vitamin D. The aim of this study is to determine whether the clothing style of Kuwaiti premenopausal women affects their vitamin D status, bone marker expression, and bone density. Three groups of healthy unmarried single Kuwaiti females (20-35 years old; n=30 per group) were recruited randomly from the general community: a control group who wear Western-style clothing (unveiled group), a group who wear a hejab that covers the whole body except for the face and hands (hejab group), and a group who wear a black veil with the entire body covered (veiled group).

Is there a relationship between vitamin D with insulin resistance and diabetes mellitus?

Available data suggest a possible link between abnormal vitamin D level and abnormal glucose homeostasis, two of the most common chronic medical conditions. Both conditions are associated with inflammation, and the exact mechanism for role of either on the other is not well clear. Literature investigating the link between vitamin D and either pre-diabetic states or diabetes is reviewed.

Altered activities of kininase II, an angiotensin converting enzyme, prekallikrein, and nitric oxide in Kuwaiti patients with type 2 diabetes.

The current investigation was conducted to examine kininase II or angiotensin converting enzyme (ACE), plasma prekallikrein (PK), and nitric oxide (NO) concentrations in healthy Kuwaiti subjects and newly diagnosed Kuwaiti type 2 diabetic patients before and after treatment for 6 weeks with metformin hydrochloride 500 mg twice daily after meal. With the consent of volunteers, blood and urine samples were collected after an overnight fasting. Samples were collected from the diabetic patients before and after treatment for 6 weeks.

Bradykinin-forming components in Kuwaiti patients with type 2 diabetes.

Diabetes is the most common risk factor in inducing hypertension, nephropathy and retinopathy. The bradykinin (BK)-forming system has been proposed to protect cardiovascular and renal functions. We therefore evaluated urinary active and proactive kallikrein, total kininogen, plasma tissue kallikrein, plasma creatinine, plasma glucose and plasma HbA1c in newly diagnosed untreated type 2 diabetic patients and healthy subjects.

Does insulin resistance in type 2 diabetes alter vitamin D status?

Aims: Data on changes of vitamin D due to insulin resistance are conflicting. We assessed vitamin D concentrations and parameters of glycemia and mineral homeostasis in patients with insulin resistant type 2 diabetes and in matched normal controls.

Methods: Sixty-nine patients with type 2 diabetes and 60 matched normal control subjects were studied.

Prevalence of low bone mass in postmenopausal Kuwaiti women residents in the largest province of Kuwait.

Unlabelled: We measured bone mineral density (BMD) in Kuwaiti women residents in the largest province of Kuwait state to highlight the BMD changes with each age, in particular when they reach the postmenopausal stage. Healthy Kuwaiti females between the ages of 10 and 89 years, who were residents in the largest province of Kuwait, were included in the study. After measurements of their height and weight, their bone mineral density of L2-L4 lumbar spine and femur (neck and total) was measured using dual-energy X-ray absorptiometry.

Serum chromogranin A concentration in hyperthyroidism before and after medical treatment.

Objective: The aim was to evaluate changes in chromogranin A (CgA) concentration in hyperthyroidism and to assess its metabolic correlations.

Methods: We studied CgA levels in hyperthyroidism. First, 38 hyperthyroid patients matched with 86 normal controls were studied after an overnight fast.

Serum leptin and its relationship with metabolic variables in Arabs with type 2 diabetes mellitus.

Background And Objectives: Most studies on serum leptin in type 2 diabetes mellitus have focused on white populations. We studied serum leptin concentrations and parameters related to glycemic control and the association between leptin levels and anthropometric and metabolic factors in Arab patients with type 2 diabetes and in Arab control subjects.

Subjects And Methods: Ninety-two patients (65 females and 27 males) with type 2 diabetes and 69 matched normal control subjects (48 females and 21 males) were included.

Normal measurement of orbital structures: implications for the assessment of Graves' ophthalmopathy.

Compute tomography anatomy of the orbits is well described, but only a few reports are available on normal measurements of the extraocular muscles (EOM) and globe position (GP). We obtained CT images from patients who were referred to our department for CT of the paranasal sinuses using a standard protocol for evaluation of normal orbital measurements. Our study suggests that optimum results are attained with the use of a coronal scan at a window level and width setting that results in an optimum image at the maximum muscle width for assessment of EOM and an axial scan at the mid-GP for GP and interzygomatic line.

Leptin levels in Arabs with primary hyperthyroidism.

Background: The aim of this report was to study leptin status in hyperthyroid men and women (prior to and after medical treatment) and in matched controls in Arabs.

Subjects And Methods: Twenty-nine hyperthyroid patients (19 women and 10 men) and 32 controls (20 women and 12 men) matched for age, ethnic status and body mass index (BMI) were studied. The patients were studied at the time of diagnosis and six months after antithyroid treatment with carbimazole-titrating dose, which rendered them euthyroid.

Steroidogenic alterations and adrenal androgen excess in PCOS.

Background: This cross-sectional study was undertaken to improve our understanding of the steroidogenic alterations leading to adrenal hyperandrogenism in polycystic ovarian syndrome (PCOS).

Methods: Two-hundred and thirty-four women with clinical and biochemical features suggestive of PCOS underwent metabolic and hormonal evaluation. We used the androstenedione/DHEAS ratio as a surrogate for the level of ovarian 3betaHSD activity.

Effects of treatment of hyperthyroidism on glucose homeostasis, insulin secretion, and markers of bone turnover.

Objective: To study glucose and bone metabolism in hyperthyroidism, assess their changes after treatment, and investigate their interrelationships.

Methods: Thirty patients with hyperthyroidism matched with 32 normal control subjects were studied. After a 10- to 12-hour overnight fast, blood samples were collected for measurement of glucose, insulin, C-peptide, and intact proinsulin levels as well as for measurement of bone markers: serum alkaline phosphatase (ALP), osteocalcin, and procollagen type I C-terminal peptide (PICP) as markers of bone formation and serum C-terminal cross-linked telopeptide of type I collagen (ICTP) as a marker of bone resorption.

Optimal use and interpretation of the aldosterone renin ratio to detect aldosterone excess in hypertension.

With the introduction of the aldosterone/renin ratio as a screening test, the detection rate of primary aldosteronism has increased considerably. Nevertheless, no consensus has so far been reached regarding the cutoff points, operating characteristics or indeed even the reference values for reporting the aldosterone/renin ratio using plasma active renin (ng/l or mU/l) measured by immunoradiometric assay. We review the characteristics of this ratio in normal individuals, essential hypertension and primary hyperaldosteronism in an attempt to reach an agreement regarding its optimum use and interpretation - both using the renin activity or concentration.

Relationship between cortisol increment and basal cortisol: implications for the low-dose short adrenocorticotropic hormone stimulation test.

Background: We analyzed the low-dose (1 microg) rapid adrenocorticotropic hormone test (LDST) in 17 patients with a normal hypothalamic-pituitary-adrenal axis to determine reference intervals for the LDST on the basis of poststimulation cortisol increments.

Methods: We analyzed test results for 17 patients (14 females and 3 males; age range, 18-46 years) who had received a 2-mL aliquot of low-dose (1 microg) adrenocorticotropic hormone prepared from one 250-microg vial of Synacthen diluted in 500 mL of sterile normal saline solution. Sampling took place at 0, 20, 30, and 60 min post stimulation.

Ovarian steroids modulate neuroendocrine dysfunction in polycystic ovary syndrome.

Objective: Neuroendocrine dysfunction in polycystic ovary syndrome (PCOS) was addressed by studying the steroid hormone changes in women with PCOS with either high or normal LH levels leading to inferences regarding the primacy of elevated LH in the pathophysiology of PCOS.

Methods: A cross-sectional study was designed in an academic clinical facility involving 234 women with PCOS. Patients were divided into two groups based on an LH/FSH ratio < or >1 and hormonal and metabolic studies were performed in both groups.

Irregular cycles and steroid hormones in polycystic ovary syndrome.

Background: This cross-sectional study was undertaken to evaluate the factors that relate to menstrual status (oligo-amenorrhoea versus eumenorrhoea) in polycystic ovary syndrome (PCOS).

Methods: A total of 234 women with clinical and biochemical features suggestive of PCOS underwent metabolic and hormonal evaluation. A forward stepwise logistic regression model was created based on the results to determine variables related to ovulatory status.

Glucocorticoid replacement in panhypopituitarism complicated by myelinolysis.

Objective: To report a case of glucocorticoid substitution in panhypopituitarism that can lead to uncontrolled rise in serum sodium and myelinolysis.

Clinical Presentation And Intervention: A 42-year-old man presented with disturbed conscious level and hyponatremia. Initial data suggested glucocorticoid deficiency.

PCOS: an ovarian disorder that leads to dysregulation in the hypothalamic-pituitary-adrenal axis?

This review focuses on the role of the ovaries in the pathogenesis of the polycystic ovarian syndrome. In particular, the failure of follicular development, hypothalamo-pituitary dysregulation, alterations in adrenal steroid output and derangement of intermediary metabolism are discussed in the context of the ovaries. It is concluded that the central and adrenal alterations associated with PCOS are unlikely to be primary but rather are secondary to the events within the ovary.

Technical observations on the assessment of thyroid volume by palpation and ultrasonography.

Objective: The diagnosis of increased thyroid volume, in field studies of goiter prevalence, has been based on inspection and palpation of the thyroid. Because clinical examination, compared with ultrasonography, has a low positive predictive value for the presence of a goiter, it overestimates goiter prevalence. It also has the problem of marked interobserver variability.

The use of corticosteroids versus other treatments for Graves' ophthalmopathy: a quantitative evaluation.

Background: The purpose of the present study was to evaluate the efficacy of corticosteroids in the treatment of Graves' ophthalmopathy in comparison to other treatment modalities.

Material/methods: 15 studies were identified but only 14 were included in the final analysis, 5 cohort and 9 randomized. A total of 813 patients were included in this quantitative review.

Spironolactone for the treatment of hypercalciuric hypocalcemia.

A patient with hypocalcemia and hypomagnesemia, and renal wasting of both cations, is presented. This patient had a dramatic calcium response to treatment with spironolactone. The possible diagnoses and mechanisms of response are discussed.

Diagnostic criteria for diabetes revisited: making use of combined criteria.

BACKGROUND: Existing cut-offs for fasting plasma glucose (FPG) and post-load glucose (2hPG) criteria are not equivalent in the diagnosis of diabetes and glucose intolerance. Adjusting cut-offs of single measurements have not helped so we undertook this project to see if they could be complementary. METHODS: We performed oral glucose tolerance tests and mean levels of hemoglobin A1c (HbA1c) measurements on 43 patients referred to a diabetes clinic for possible diabetes.