Biomedical subjects

K S Akinlade

Publications and source records attributed to K S Akinlade.

13 recordsLinked to original sources

PubMed2001

Erythrocyte membrane protein alteration in diabetics.

OBJECTIVES: To study the protein components of the erythrocyte membranes of diabetic Nigerians and to compare the results with the erythrocyte membrane protein components of normal healthy Nigerians. DESIGN: Laboratory based cross-sectional study. SETTING: Department of Medicine, University College Hospital (UCH), Ibadan and Biomembrane Research Laboratory, Department of Biochemistry, College of Medicine, University of Ibadan, Ibadan, Nigeria. SUBJECTS AND METHODS: The study was carried out in patients with insulin-dependent diabetes mellitus--IDDM (Type 1 diabetes), non-insulin dependent diabetes mellitus--NIDDM (Type 2 diabetes) and healthy human volunteers (HHm), which served as controls. The subjects were aged 30-65 years. There were 12 subjects in each of the IDDM and NIDDM) and 18 subjects in the HHm group. Blood samples (20 ml per subject) were obtained from each subject and erythrocyte ghost membranes were isolated separately from each sample. Total erythrocyte membrane protein concentration of each sample was determined using bovine serum albumin (BSA) as standard. The protein components of the erythrocyte ghost membranes were determined using sodium dodecyl sulphate polyacrylamide gel electrophoresis. STATISTICAL METHOD: All values given are the mean +/- standard deviation (+/- SD) of the parameters measured. Significance was assessed using Student's t-test and P values of 0.05 or less were taken as statistically significant. RESULTS: The total protein concentration of HHm was 5.5 +/- 0.01 micrograms/ml, total protein concentration of IDDM was 4.5 +/- 0.01 micrograms/ml while NIDDM was 5.1 +/- 0.02 micrograms/ml. The spectrin alpha and beta-chain bands are heavily present in the healthy human erythrocyte membranes and are absent in the insulin dependent diabetic membranes. The ankyrin band, band six and below are more pronounced in IDDM and NIDDM but are relatively absent in the healthy humans. CONCLUSIONS: The results obtained provide evidence of profound quantitative and qualitative alteration of the erythrocyte membrane proteins in diabetic Nigerians. This may likely have serious functional implications of the diabetic patients.

Adult↗

PubMed1996

Biophysical and biochemical analysis of semen in infertile Nigerian males.

Biophysical analysis of semen was performed in fifty-eight Nigerian male partners of infertile marriages. Sperm count concentration was significantly higher (P < 0.001) in oligospermics compared to normospermics as expected. However, there was no significant difference in sperm volume or motility percentage between the normospermics and the oligospermics; of course, no sperms were seen in the azoospermics. Biochemical analyses of serum zinc, copper, magnesium, and manganese by atomic absorption spectrophotometry [8] were further correlated in fifty-two patients. There were no statistically significant differences observed in the serum levels of zinc, magnesium, and copper among the normospermics, oligospermics, and azoospermics. The normospermic infertile patients, however, exhibited higher serum manganese when compared with oligospermics and azoospermics (P < 0.001). This finding suggests a potential role for manganese in the evaluation of infertile males.

Adult↗

PubMed1996

Urinary iodine excretion in mothers and their breast-fed children in relation to other childhood nutritional parameters.

OBJECTIVE: There is currently no coordinated policy on the epidemiology and control of iodine deficiency disorders (IDD) in many parts of Africa even where these disorders are endemic. Assessment of the urinary iodine excretion is believed to give the best index of the prevalence of IDD in the community. This study aimed to establish whether: (i) the breast-fed child of an iodine replete mother was protected from IDD and, (ii) infants at risk of IDD and in need of immediate iodine supplementation could easily be identified through simple screening methods. DESIGN: Randomized, cross-sectional study. SETTING: A tertiary care infant welfare clinic in Ibadan, South-western Nigeria, a geographical area recognised to be outside Nigeria's endemic goitre belt (goitre prevalence < 5.0%). SUBJECTS: 68 healthy mother-child pairs. The children were all aged 9-18 months and breast-fed almost exclusively. INTERVENTIONS: Nil. METHODS: The relationships of anthropometric, iodine status (casual urinary iodine (I) and iodine/creatinine ratio (I/Cr)) and nutritional indices (weights, haematocrits) of the mothers with those of their breast-fed children were assessed, as well as how these parameters differed between the children classified on the basis of their mid-upper arm circumference, MUAC, as: (A) borderline malnourished, MUAC < 13.5 cm and, (B) well nourished, MUAC > 13.5 cm. RESULTS: The maternal values for I and I/Cr were significantly (p < 0.001) greater than those of their breast-fed infants, although the respective mother-child pair values correlated positively (I, r 0.47; I/Cr, 0.21; both p < 0.05). There was thus a gradient in iodine status between the mother and her breast-fed infant that is unfavourable to the growing child; the latter may thus require iodine supplementation in spite of the fact that the mother is iodine replete. Among the children, those considered well nourished (Group B) had similar iodine status parameters as those considered poorly nourished (Group A) suggesting that malnutrition alone should not be the determinant of the prioritization (or otherwise) of iodine supplementation in a population with coexistent iodine deficiency and malnutrition. Mean values for (I) in all the children (9.9 micrograms/dl) fell in the iodine deficiency range ( < 10 micrograms/dL), although all the mothers were iodine replete (mean urinary (I) 14.5 micrograms/dL), despite the fact that all resided in a non iodine deficient area. CONCLUSION: The study suggests that: (i) the breast-fed child of an iodine replete mother resident in a non-iodine deficient area may be iodine deficient and in need of iodine supplementation; (ii) malnutrition, as defined by the simple community screening method of measuring the MUAC, will not accurately identify those infants in immediate need of iodine supplementation. These observations have important implications for planning IDD control programmes in Africa.

Adult↗

PubMed1996

The psychological condition of a cohort of Nigerian diabetic subjects.

The emotional condition and cognitive function of 37 insulin requiring (IDD) and 46 non-insulin requiring (NIDD) diabetics (in stable conditions) were compared, using the Hospital Anxiety and Depressive Scale (HAD) and the Mini-Mental State Examination (MMSE). About 5% of IDD and 4% of NIDD had threshold score for clinical anxiety; while 37.8% of IDD and 15.2% of NIDD had depression. The prevalence rate of depression for the entire cohort was 25.3%, while the rate for anxiety was 4.8%. Only the illiterates among IDD had up to threshold score for depression. The most common reported symptoms were, the feelings of not being able to enjoy things as usual, and not looking forward with enjoyment to things. Cognitive function was predominantly normal, not being significantly associated with HAD scale scores, age, duration of illness and level of education. Compared with previous reports in the same hospital, diabetics experienced significantly less depressive symptoms than cancer patients. The findings are similar to reports from developed countries in showing that IDD subjects are more emotionally disturbed than NIDD subjects; and that depression is a commonly feature of chronic debilitating illness. Clinicians need to be sensitive to the emotional condition of their patients, because depression impairs the ability to comply with treatment and therefore mars prognosis.

Adolescent↗

PubMed1995

The psychosocial problems of sickle cell disease sufferers and their methods of coping.

We interviewed 170 sickle cell disease (SCD) patients (mean age 25 years) with a modified version of the Frankfurter Befindlichkeitskala (FBS, 33-item) and the 12-item General Health Questionnaire (GHQ-12), with a view to highlighting the psychosocial issues which worry them, the way they cope with these problems, and the factors associated with these issues. The mean FBS score of SCD patients was comparable with those of insulin dependent diabetics, but significantly higher than that of non-insulin dependent diabetics. The FBS scores were significantly correlated with GHQ-12 scores. Feelings of inadequacy of social contact were significantly associated with high FBS and GHQ scores. Some common complaints were: the limitations illness placed on social life; depressive feelings; abnormal habitus; suicidal ideation during crises; and the burden of illness on the family. They frequently resorted to prayers as a method of coping, as most had no clear ideas on how to deal with these issues. Worries over psychosocial consequences of SCD, seem to add considerably to the burden of illness, and clinicians will offer better care to patients if they routinely enquire into some of these issues and offer health education and counselling in a group setting.

Activities of Daily Living↗

PubMed1995

The problems of peritoneal dialysis in the management of chronic uraemia in Nigeria.

The problems encountered in the use of peritoneal dialysis (PD) in the initial management of patients with chronic renal failure in Nigeria were highlighted, studying 23 patients (13 males and 10 females) aged between 15 and 68 years (mean age 36.4 years). Peritonitis was the most common complication, occurring in 16 (70%) of patients; effluent drainage obstruction in 11 patients (48%); haemorrhagic effluent in 10 patients (44%); fluid leak from catheter site infection in 7 patients (30%); accidental disconnection of line/catheter joint in 5 patients (22%); and catheter site infection in 2 patients (9%). A positive effluent culture was found in only 4 out of 18 cultured samples, with Klebsiella and Staphylococcus aureus being the organisms isolated. Dialysis was terminated in patients for the following reasons: financial constraints (8 patients), unresolving peritonitis (7 patients), drainage problems (3 patients), and clinical improvement (5 patients). The study concludes that PD in the management of chronic uraemia in developing countries, while producing clinical benefits in the majority of patients, is still not generally acceptable as a long-term treatment modality in view of the number of problems.

Adolescent↗

PubMed1993

Insulin responses following glucose administration in menstruating women.

OBJECTIVE: The aim of the study was to investigate changes in insulin sensitivity during the menstrual cycle, in a group of regularly menstruating black African women. METHOD: Insulin responses to intravenous glucose (300 mg/kg) were assessed, for up to 3 h, in 3 groups of age- and body mass-matched non-obese sedentary Nigerian women: Group A, 7 women in the menstrual follicular phase; Group B, 7 women in the menstrual luteal phase; C, 7 men. RESULT: Women in the menstrual luteal phase had the greatest integrated first-phase insulin response and insulin/glucose ratios, much higher than the similar values for these variables obtained in other groups. This suggests that the menstrual luteal phase is associated with relative insulin resistance. CONCLUSION: Black African women in the menstrual luteal phase demonstrate an exaggerated insulin response to an acute glucose load and are thus relatively insulin-insensitive. This confirms previous observations in Caucasians.

Adult↗

PubMed1993

Glucose and insulin responses to intravenous glucose challenge in relatives of Nigerian patients with non-insulin-dependent diabetes mellitus.

We analysed blood insulin and glucose concentrations before and during frequently sampled intravenous glucose tolerance tests (FSIGT) in 2 groups of Nigerian subjects: (A) Control group (n = 18), without a positive family history of diabetes mellitus, and (B) Experimental group (n = 16), comprising age-, sex- and body mass-matched first-degree relatives of patients with non-insulin-dependent diabetes mellitus (NIDDM). In comparison with Group A subjects, those in Group B had: (i) higher fasting plasma glucose level (mean +/- S.E.M. 4.1 +/- 0.1 vs. 3.8 +/- 0.11 mmol/l, P < 0.05); (ii) similar fasting serum insulin levels (6.7 +/- 5.0 vs. 5.8 +/- 5.6 mU/l, P = NS); (iii) lower mean incremental area under the first-phase (t = 0-10 min) post-glucose challenge insulin curve (376.9 +/- 8.8 vs. 435.6 +/- 5.6 mU/min l-1, P < 0.05); (iv) increased incremental area under the second-phase (t = 10-182 min) post-glucose challenge insulin curve (432.9 +/- 11.5 vs. 161.3 +/- 8.7 mU/min l-1, P < 0.05); (v) reduced KG rate constant of glucose elimination (0.97 +/- 0.12 vs. 1.41 +/- 0.12%/min, P < 0.05). These results suggest that the subjects with a positive family history of NIDDM have a reduced beta-cell insulin secretory reserve (from reduced first-phase insulin response), tendency to rebound hyperinsulinemia during the latter phase of the insulin secretory response, a degree of tissue insulin insensitivity (as evident from high fasting plasma glucose despite similar insulin levels) and a diminished glucose disposal rate, in comparison with subjects without a family history of NIDDM. These features predict subsequent development of diabetes and suggest that as in Caucasians, first-degree relatives of Nigerian patients with NIDDM are at greater risk for future development of the disease.

Adult↗

PubMed1991

Plasma urate in diabetes: relationship to glycaemia, glucose disposal, microvascular complications and the variations following oral glucose.

In order to provide further insights into the conflicting reports of associations between diabetes and uric acid metabolism, we studied 175 adult diabetic patients (56 IDDM, 119 NIDDM) and 114 matched control subjects. Plasma uric acid (PUA) concentrations were not significantly different between diabetic and control subjects, despite increased urinary urate in diabetic patients. There were no significant associations, in diabetic patients, between PUA and (i) type of diabetes, (ii) glycaemic control, (iii) retinopathy and (iv) proteinuria. Plasma urate did not correlate with the KG constant for glucose disposal rate during IVGTT, thus indicating that PUA may not be related to insulin action. In a separate study, PUA rose sharply, peaking at 30 min, and fell subsequently in both newly diagnosed NIDDM patients (n = 20) and subjects with impaired glucose tolerance (n = 15) in response to standard OGTT, in contrast to normal controls (n = 35) in whom PUA rose gradually to a peak at 120 min. Mean rise in PUA from baseline to peak was significant (P less than 0.05) in the diabetic group only. These differences in PUA response during an OGTT between subjects with abnormal glucose metabolism and normal controls may be a feature in the metabolic evolution of diabetes and need further investigation.

Adult↗

PubMedDate not supplied

Circulating immune complexes, immunoglobulin classes (IgG, IgA and IgM) and complement components (C3c, C4 and Factor B) in diabetic Nigerians.

OBJECTIVE: To evaluate serum levels of circulating immune complexes (CICs), immunoglobulin classes (IgG, IgA and IgM) and Complement Components (C3c, C4 and Factor B) in Nigerians with Type 1 or Type 2 diabetes mellitus. DESIGN: Case control study. SETTING: University College Hospital, Ibadan, Oyo State, Nigeria. SUBJECTS: Forty-two subjects with diabetic mellitus (17 Type 1 D. M. and 25 Type 2 D. M.) and 21 apparently healthy control subjects. INTERVENTION: Serum level of CICs was measured by polyethylene glycol precipitation method while single radial immunodiffusion method was used to measure serum levels of immunoglobulins and complement components. RESULTS: Only CICs were significantly higher in Type 1 diabetic subjects compared with the controls whereas CICs C3c, C4 and IgM were significantly increased in Type 2 diabetic subjects compared with the controls. The levels of CICs, C3c and IgM were significantly elevated in Type 2 diabetics compared with Type 1 diabetics. CONCLUSION: CIC concentrations may serve as a useful index of depressed host defences usually associated with diabetics mellitus and that humoral immunity is deranged more in Type 2 diabetics compared with Type 1 diabetics. Probably as a result of hyperinsulinaemia associated with insulin resistance.

Adult↗

PubMedDate not supplied

The effect of glycaemic control on the prevalence and pattern of dyslipidaemia in Nigerian patients with newly diagnosed non insulin dependent diabetes mellitus.

Dyslipidaemia (DL) is a common condition in patients with NIDDM, but its prevalence and the effect of glycaemic control on the disorder have only been scantily reported in Nigerians. The present study is therefore aimed at determining the effect of diabetic control on prevalence and pattern of DL in Nigerian patients with NIDDM. Thirty six diabetics were followed up for 24 weeks. Indices determined included anthropometric measurements, fasting (FBG) and two hour post prandial blood glucose (2 hours PPBG), together with glycated haemoglobin (GHb) levels, and fasting lipids at presentation, 12 and after 24 weeks of treatment. The prevalence rates of raised total cholesterol/high density lipoprotein cholesterol (TC/HDL) ratio reduced HDL-cholesterol and mixed DL decreased significantly between 0-week and 24 weeks of treatment (57.1% vs 14.3% 50% vs 11.4% and 44% vs 22.2% respectively, P < 0.001 for each). The proportion of patient with elevated low-density lipoprotein-cholesterol also decreased significantly from 21.4% at 0-week to 8.8 after 24 weeks (P < 0.025). On the other hand, the prevalence of hypercholesterolaemia and hypertriglycerilaemia were not significantly changed between 0 and 24 weeks (P > 0.05). Patients with DL despite treatment were characterised by higher FBG at 24 weeks of treatment compared with normolipidaemic patients (P < 0.001). It is concluded from this study that improved glycaemic control reduced some dyslipidaemia, and may therefore suffice to correct them in some Nigerian patients with NIDDM.

Blood Glucose↗

PubMedDate not supplied

The effect of oral hypoglycaemic agents on dyslipidaemia in Nigerian patients with newly diagnosed non-insulin dependent diabetes mellitus--a prospective study.

Thirty-five patients with non-insulin dependent diabetes (NIDDM) were treated and followed up for 24 weeks. Six of whom were managed with diet and/or metformin, nine received glibenclamide, twelve had a combination of metformin and glibenclamide, while the remaining eight patients received metformin and/or some other type of sulphonylurea (chlorpropamide or glipizide). By an analysis of variance, the different drug regimes showed equivalent glycaemic controlling effects, but the influence on dyslipidaemia was variable within the treatment groups, while these changes were insignificant between the groups. It is thus concluded that commonly used oral hypoglycaemic agents do not adversely affect plasma lipid levels in Nigerian patients with NIDDM.

Administration, Oral↗

PubMedDate not supplied

Acromegaly in Ibadan--a report of six cases.

Six patients with acromegaly were seen over a six year period at the University College Hospital, Ibadan, Nigeria. There were 5 males and 1 female giving a sex ratio which differed from the equal sex prevalence observed in larger caucasian series. The diagnosis was made strictly on clinical grounds with corroborative evidence from x-ray of the skull and limbs. An unusual and unexpected finding was the observation of a hernia or a history of herniorrhaphy in 4 out of the 5 male acromegalics. It was not certain whether the association was real or what the explanation might be. Transfrontal surgery was the only definitive form of treatment that could be offered to the patients because of lack of facilities for transphenoidal adenomectomy or pituitary irradiation. The operation was refused by 4 of the 5 patients to whom surgery was recommended because of cultural fears regarding operations on the brain. Bromocryptine was prescribed as an alternative therapy but its scarcity and prohibitive cost precluded any serious compliance. There is a need to highlight the problems of the silent sufferer of endocrine disorders in developing countries.

Acromegaly↗