Keywords : Diabetes
The Medical Journal of Basrah University,
Volume 36, Issue 1, Pages 7-15
Background: Diabetes mellitus has an effect on the peripheral nerves. Such effect may start as asymptomatic peripheral neuropathy.
Objectives: To assess the role of electrodiagnostic study in the diagnosis of patients with different types of diabetic peripheral neuropathy (DPN) and evaluate the usefulness of it in early detecting diabetic peripheral neuropathy in asymptomatic patients and to correlate the findings of nerve conduction study in patients with asymptomatic diabetic peripheral neuropathy with various risk factors.
Subjects and Methods: subjects were allocated into three groups: 50 normal (non-diabetics apparently healthy subjects without peripheral neuropathy), 50 asymptomatic DPN patients and 50 symptomatic DPN patients. Clinical questionnaire, blood sugar, neurological examination and nerve conduction studies were performed for each subject.
Results: This study showed that the prevalence of positive nerve conduction studies was 58% in asymptomatic diabetic patients, 100% for symptomatic diabetic patients and negative for control. The positive nerve conduction study findings in asymptomatic diabetic patients involved sensory more than motor fibers and the lower limbs nerves were affected more than that of the upper limbs. The most commonly involved nerve is the sural nerve sensory fiber which was more prevalent in old age patients (87.5%), patients with longer duration of diabetes (81.8%), over weight (71.4%), patient taking only oral antihyperglycemic drugs (76.9%) and in diabetic patients with poor glycemic control (84.2%) (86.3%) in fasting blood glucose (FBG) and HbA1c respectively. Using the logistic regression, only oral antihyperglycemic drugs (without insulin) and poor control HbA1c were significant predictors of abnormal nerve conduction.
Conclusion: Even in asymptomatic patients, nerve conduction studies show diffuse changes, in a predictable pattern. Electrophysiological finding correlate with age, duration of disease, glycosylated hemoglobin levels, fasting blood glucose, type of the treatment if only oral antidiabetic and body mass index.
HIGH SENSITIVITY C-REACTIVE PROTEIN (HS-CRP) AND METABOLIC SYNDROME: CORRELATION WITH NUMBER AND TYPE OF METABOLIC SYNDROME COMPONENTS IN IRAQI PATIENTS
The Medical Journal of Basrah University,
Volume 30, Issue 1, Pages 49-54
Background: Metabolic syndrome (MetS) is clustered risk factors that arise from insulin resistance and is associated
with risk of coronary heart disease, as well as diabetes. American Heart Association (AHA) defined MetSon the basis
of 5 components: fasting blood glucose, blood pressure, triglycerides, HDL-C, and waist circumference. Highsensitivity
CRP (hs-CRP) is a measure of systemic inflammatory conditions and is considered as a risk factor in
Aim: To investigate the correlation of hs-CRP with the number and type of components of MetS diagnostic criteria in
Iraqi patients and to find out the cutoff point for hs-CRP level that might predict the development of metabolic
Methods: This study involved 78 diabetic patients consulting the outpatient clinic at Al Sadr Teaching Hospital. For
all patients anthropometric measures were obtained and fasting blood samples were taken for determination of blood
glucose, lipid profile and hs-CRP level.
Results: Mets was diagnosed in 48 patients. The level of hs-CRP was found to be significantly increased with
increasing number of components of MetS. The lowest value of (0.07 mg/dl) was found in people with absent
components of metabolic syndrome and the highest level of (4.05 mg/dl) in subjects with 4 components. A significant
positive correlation was observed between hs-CRP and waist circumference, FBG, and triglycerides(r=0.514, 0.531,
0.592 respectively, P<001) and a negative correlation with HDL-cholesterol (r=-0.332, p=0.021). Using the level of
0.65 mg/dl, hs-CRP can predict the development of metabolic syndrome with sensitivity and specificity of 81.3% and
Conclusion: Hs-CRP shows a significant correlation with the number of MetS components and its level correlates
well with waist circumference and other biochemical features of MetS. Hs-CRP can predict the development of MetS
with high sensitivity and specificity.