Lipid profile in children with insulin dependent diabetes mellitus

OBJECTIVE

To evaluate serum lipids in children with type 1 diabetes mellitus and its relation to glycemic control, in comparison with matched controls.

SETTING

Basrah Maternity and Children Hospital, Basrah, Iraq.

METHOD

Lipid profile was studied in 32 children (17 males and 15 females) with type 1 diabetes mellitus from October 1999 to September 2000. Seventy seven non-diabetic children (35 males and 42 females) admitted with acute illness in the same hospital were selected as controls.

RESULTS

The age and BMI was similar in both groups. The mean total cholesterol, triglycerides, HDL-C, LDL-C, VLDL-C and LDL-C/HDL-C ratio were significantly higher in diabetic children compared to control group. There was no significant difference in the levels of Apo O and Apo B in both groups.

CONCLUSION

Children with type 1 diabetes should be screened for serum lipids as significant lipid abnormalities are related to glycemic control. Both can be improved with dietary management and insulin therapy.

Correlation between normal glucose-6-phosphate dehydrogenase level and haematological parameters

The study involved 143 individuals and aimed to correlate normal glucose-6-phosphate dehydrogenase (G6PD) level with haematological parameters. A statistically significant negative correlation was found between G6PD level and haemoglobin, packed cell volume, red blood cell count, mean corpuscular haemoglobin and mean corpuscular volume. A statistically significant positive correlation was found between G6PD level and white blood cell count and reticulocyte count, but no significant correlation was found between G6PD level and mean corpuscular haemoglobin concentration. The negative correlation between G6PD level and haemoglobin suggests that anaemic people have higher G6PD levels than normal individuals. The positive correlation between G6PD level and white blood cell count indicates that white blood cells may play an important role in contributing to G6PD level.

Levels of uric acid, urea and creatinine in Iraqi children with sickle cell disease

OBJECTIVE

To determine the levels of serum uric acid, urea and creatinine in subjects with sickle cell disease and compare them to those reported in literature.

SETTING

Department of Paediatrics, College of Medicine, University of Basrah.

METHODS

Plasma uric acid, urea and creatinine was estimated by Varley's method, group of 65 sickle cell patients (35 Hb AS, 30 Hb SS) aged between 2-11 years. The results were compared with those obtained in a group of 45 age and sex-matched controls with normal haemoglobin (Hb AA).

RESULTS

The uric acid level was elevated in sickle cell patients as compared with the normal control group. The 95% confidence intervals for differences in the mean of the two groups: HbAA vs HbAS was 4.22 (0.3), while for HbAA for HbSS was 3.4 (0.06), both being statistically highly significant [p < 0.0001]. Urea and creatinine levels were considerably lower in the sickle cell disease patients. The difference in the patient's mean for urea compared to the mean in the normal group (Hb AA) was 9.64 (1.95) and 8.55 (1.76) for HbSS and HbAS, respectively. Like wise, the difference in the mean for creatinine in HbSS group was 0.71 (0.12) and in HbAS was 0.76 (0.12), which was statistically significant [p < 0.0001].

CONCLUSION

Raised serum uric acid levels were found in Iraqi children with sickle cell disease, creatinine clearance studies will be valuable to assess renal function.

Haemolytic potential of three chemotherapeutic agents and aspirin in glucose-6-phosphate dehydrogenase deficiency

The potential haemolytic effect of three chemotherapeutic drugs and aspirin was tested in vitro by gluthathione stability tests. Blood was collected from the local population of Basra, Iraq where previous studies had found a high frequency of glucose-6-phosphate dehydrogenase (G6PD) deficiency. Primaquine, chloramphenicol and sulfanilamide caused significant concentration-dependent reductions of glutathione levels in G6PD-deficient red cells when compared to normal red cells. Acetylsalicylic acid had no effect on glutathione level. The G6PD-deficient erythrocytes behaved as previously reported, probably due to similar patterns in the distribution of its variants. Studies on each local variant are warranted and new drugs should be tested for haemolytic potential prior to their introduction in areas where the deficiency is common.

Glucose-6-phosphate dehydrogenase, hexokinase and pyruvate kinase activities in erythrocytes of neonates and adults in Basrah

The mean activities (95% confidence interval; number of patients) for erythrocyte glucose-6-phosphate dehydrogenase (G6PD), hexokinase (HK), and pyruvate kinase (PK) in haemolysate of clinically normal neonates from Basrah, Iraq were found to be 3.29 (0.10; n = 456), 0.61 (0.02; n = 219), and 5.10 (0.07; n = 500), respectively, all expressed as U/10(10) RBC at 37 degrees C. Comparative values for apparently healthy adults were: 2.14 (0.06; n = 186), 0.41 (0.02; n = 46), and 3.61 (0.07; n = 243). Differences between sexes in the mean activities of each of the three enzymes were not significant (p > 0.5), being several times less than the corresponding 95% confidence intervals. However, differences were highly significant between neonates and adults (p < 0.001), presumably reflecting the greater proportion of 'young' cells and/or their programming for higher activity in cord blood. The neonate-adult difference (95% confidence interval) for each enzyme was: G6PD, 1.15 (0.43); HK, 0.20 (0.14); and PK, 1.49 (0.64). Some degree of G6PD-deficiency was observed in 7.9% of male and 9.7% of female neonates, whereas the frequency in adults was 9.2% and 11.8% for males and females, respectively. The higher frequency in females accords with expectations based on gene frequency estimations.