The Pattern of Haemoglobin Phenotypes and the Clinical Identity of Clients Tested at a Private Diagnostic Center in South-West Nigeria

BACKGROUND

Haemoglobinopathies are diseases of global importance and the countries with high disease burdens have inaccurate national data on the incidence of the various haemoglobin (Hb) phenotypes.

OBJECTIVE

To review the Hb phenotype distribution, the referral identity of patients, and the clinical reasons for phenotyping.

METHODS

A retrospective descriptive study conducted at a private diagnostic laboratory in Lagos, South-West, Nigeria. The anonymous results of Hb phenotypes of the patients determined using gel electrophoresis were retrieved from the laboratory information system (LIS).

RESULTS

There were 942 patients: 519(55.1%) males and 423(44.9%) females with median ages 30yrs (11months-89yrs) vs 27yrs (9months-89yrs), p=0.0018. The phenotypes were HbAA, 592(63.2%); HbAS(26.4%); HbSS(7.1%); HbAC(2.1%), HbSC(0.7%) and HbCC(0.4%). Of the total, 757(80.4%) were referred by health care providers and 185(19.6%) were selfreferred, and there was no association between gender and referral identity of patients. However, there were more males [353(46.6%)] with clinical reasons for referrals than females [94(12.4%)], p<0.0001, and annual check was the commonest reason for Hb phenotyping.

CONCLUSION

Most patients were referred for Hb phenotyping and an annual health check is the commonest reason for phenotype requests. This emphasizes the need for policies to support national Hb phenotype/genotype screening programmes to aid the early detection of sickle cell disease.

The prevalence of metabolic syndrome in persons with type 2 diabetes at the Lagos University Tteaching Hospital, Lagos, Nigeria

BACKGROUND

Over the past decade, Lagos state has witnessed greater industrialization and increased economic prosperity. Lifestyle has become increasingly westernized, characterised by intake of excesscalories and physical inactivity. It is possible that these changes would lead to increases in the prevalence of metabolic syndrome and type 2 diabetes which are known cardiovascular risk factors. It became important therefore to study the prevalence of metabolic syndrome in type 2 diabetes in Lagos, Nigeria as at the present time and compare it with previous prevalence rates as well as rates from other centres as a way of assessing current cardiovascular risk burden in this population.

OBJECTIVES

This study is to determine the prevalence of metabolic syndrome in type 2 diabetes and to correlate the presence of microalbuminuria with glycaemic control.

METHODS

One hundred subjects with type 2 diabetes were selected by simple random sampling from patients attending The Diabetic Clinic at the Lagos University Teaching Hospital, Lagos, Nigeria.Age and sex matched controls were recruited from members of staff of the hospital.Clinical data was obtained by interviewing the participants. Anthropometric measurements were made and blood and urine specimens were collected for analysis. The World Health Organisation (WHO) criteria which is specified for the diagnosis of metabolic syndrome in the setting of type 2 diabetes was used to determine the prevalence of metabolic syndrome in this population.

RESULTS

Central obesity had the highest prevalence (79%) among persons with diabetes,followed by hypertension (69%), low HDL (50%), general obesity (40%), microalbuminuria (24%) and hypertriglyceridemia (10%). The prevalence of metabolic syndrome was 86%in this group. The commonest occurring metabolic syndrome component among patients with type 2 diabetes and metabolic syndrome was obesity (91.9%). There was a moderate positive correlation(r=0.52; p=0.01) between HbA1c values and microalbuminuria in persons with diabetes and the metabolic syndrome.

CONCLUSION

The prevalence of metabolic syndrome is very high among patients with type 2 diabetes in The Lagos University Teaching Hospital, Lagos, Nigeria.