Correlation between Serum CD36 Level and Lipid Profile in Patients with Type 2 Diabetes Mellitus, Khartoum State, Sudan

Background: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia. DM-related dyslipidemia are associated with complications resulting from progressive damage of various organs. CD36 is 88-kD, class B scavenger receptor, expressed on different types of cells. In diabetic patients, LDL particles are glycated with strong level;this increases CD36 expression, initiates foam cell formation and accelerates atherosclerosis. Objective: This study aimed to determine the correlation between serum CD36 level and lipid profile among patients with type 2 diabetes mellitus in Zeenam Specialized center, Khartoum State, Sudan, in a period between 2019 and 2022. Methodology: Hundred participants at different ages were included in this study;70 were type 2 diabetic patients (cases) and 30 apparently healthy individual (control). 3 ml of venous blood were collected from the participants by using a sterile needle and syringe into a labeled plain container. Each sample was stood until complete clot occurs. Clotted blood sample was then centrifuged to obtain the serum. Then they were used for measurement of total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride and soluble CD36 levels. Total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides were measured using Biosystem chemistry analyzer BTS-302. Serum CD36 was measured using Microplate Reader (URIT-660). Results: The results revealed that serum total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride levels were significantly higher in patients with type 2 diabetes mellitus compared with control (P = 0.03, P = 0.031, P = 0.000, P = 0.000) respectively, while there is no statistically significant differences in serum CD36 level between cases and control (P = 0.129). Also this study showed that there is no statistically significant correlation between serum CD36 level and total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, age and body mass index. Conclusion: This study concluded that there is no statistically significant difference in serum CD36 level between cases and control. And sCD36 level was not correlated with total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, body mass index, and age.

The Possibilities of Chronic Renal Failure Patients Contracting Occult Hepatitis B Virus Infection, Sudan

Introduction: Chronic kidney disease (CKD) is a major cause of death in sub-Saharan Africa. The effects of the CKD on the host and the continuous therapeutic measures increase the hypothesis of blood-borne diseases transmission. Objective: This study aimed to find the frequency of occult hepatitis B virus (OBI) in patients of chronic renal failure (CRF) and to study the possibilities of infection acquisition. Methods: During 2017 and 2019, two hundred CRF patients under regular haemodialysis and attending Gezira Hospital for Renal Diseases and Surgery were recruited. Plasma specimens were collected and used for detection of hepatitis B surface antigens (HbsAg), total hepatitis B core antibodies (anti-HBc) and hepatitis B virus DNA isolation. Nested PCR reaction was followed to identify HBV. Socio-clinical data for each participant was obtained. Results: Male patients represented 64% (128/200), most frequent age group was from 41 to 60 years with percentage of 56.5% (113/200), 86% (172/200) of CRF patients were received blood while 42% (84/200) get HBV vaccination. Hepatitis B core antibodies were found in 54% (108/200) of studied cases, and 22% (42/188) of tested DNA were positively amplified for target gene. Detection of Hepatitis B core antibodies was significantly associated with marital status while absence of vaccination significantly associated with the detection of both hepatitis B core antibodies and HBV DNA. Conclusion: This study found high frequency of OBI in CRF patients, to reduce the transmission of the disease, possible hypotheses should be studied, including blood transfusion, haemodialysis process and HBV vaccination status.

Occult Hepatitis B Virus Infection: A Killer Hidden in Transfused Blood, Sudan

Introduction: Transmission of hepatitis B virus (HBV) through the blood is a significant risk, especially in poor countries with high endemicity. Occult transmission of HBV (OBI) is an important acquisition scenario. Objective: A cross-sectional laboratory-based study followed to detect OBI in blood of accepted donors admitted to Mad Medani Blood Bank, Sudan. Methods: During the study, 200 accepted blood units were examined for HBsAg by ELISA technique and negative samples were tested for total anti-HBc antibodies using electroluminescence immunoassay (ECLIAS). HBV DNA amplification was performed for units that showed total anti-Hbc positivity. Results: Of the 200 blood units, 3 appeared positive by ELISA. Total anti-HBc antibodies were present in 34% (67/197) of blood units. HBV DNA was successfully amplified in 52.2% (35/67) of total anti-HBc positive samples. A significant association was observed between reactive total anti-HBc and age group (p Conclusion: OBI was recorded at a high rate in the blood of donors, which necessitates the implementation of detection methods to protect the recipients.

Association of Hyperhomocysteinaemia with Hyperglycaemia, Dyslipidaemia, Hypertension and Obesity

There is conflicting scientific data about the link between, high homocysteine (Hcy) levels in the general population, and obesity. This is a case-control study aimed to assess the role of hyperhomocysteinemia in obesity and its associated illnesses, including hypertension, dyslipidemia, and hyperglycemia in Gezira state, Sudan. Two hundred and eleven participants were included in the study, 140 were obese (117 females and 23 males) and 71 were normal weight control, the obese median age was 49.49 ± 12.2 years. The control group consisted of 71 individuals with an average age of 45.78 ± 17.67 years. Among those who were already known to be obese, 67 (47.9%) reported having type II diabetes mellitus, 71 (50.7%) reported having hypertension, and 35 (25%) were obese without having either diabetes or hypertension. Three mls of venous blood from each participant were collected in the morning after a 12 h overnight fasting in Lithium heparin containers then the plasma was separated and stored at -80&deg;C for analysis. Serum Hcy and lipid profile were measured using the enzymatic method by Cobas C 411 analyzer. In comparison to obese non-hypertensive, the results showed that obese hypertensive with Hcy levels > 15 mol/L had a considerably increased risk (OR 1.12). When Hcy levels > 15 mol/L were compared to obese diabetics and obese non-diabetics, insignificant difference was shown (P: 0.345). Males had a higher likelihood of having hyperhomocysteinemia than females did (OR 1.2). Homocysteine, cholesterol triglyceride, LDL, and HDL mean values were compared between case and control groups using the independent sample t-test, and the results revealed statistically significant (P: <0.05). Relationships between hyperhomocysteinaemia and cholesterol, triglycerides, LDL, and HDL in the group of obese individuals were not statistically significant (P: 0.574, 0.265, 0.748, and 0.14), respectively. Obesity and Hcyconcentrations were shown to be substantially correlated. However, there was no statistically significant association between baseline plasma Hcy levels and hyperglycemia, hypertension, or dyslipidemia.

Prediction of Acute Renal Failure in Dengue Fever Patients

Background: Dengue virus (DENV) infection is caused by an arboviral strain and is transmitted by the mosquito Aedes aegypti which is found in Sudan especially Red Sea and Kassala states in the east. The disease is known to cause renal disturbances and a thorough understanding of that will potentially help in the prediction, diagnosis and treatment of the disease. Methods: This study is a prospective observational cross sectional study conducted in the Eastern Sudan College of Medical Science and Technology and Port Sudan Teaching Hospital. 200 confirmed Dengue virus infected patients along with 200 healthy appearing adults (control) were enrolled for the study. Statistical analysis was carried out after the collection of patients’ demographic, clinical, and investigational data including serum urea and creatinine values. Ethical approval was obtained from the ministry of health, Red Sea state and informed written consent was obtained from each participant. Results: The highest incidence of DENV infection was observed in individuals of the middle age group (29%). Elevated blood urea levels were detected in 10 (5%) patients while elevated creatinine levels were seen in 17 (8.5%) patients. Although fallen within reference ranges found in the literature, mean blood urea and creatinine values differed significantly between patients and controls and between different categories of the disease. Mean blood urea concentration showed a statistically significant difference between the control (22.3 mg/dl) and the test (28.4 mg/dl) (P value Conclusion: We strongly conclude that renal involvement is not uncommon in Dengue fever and that blood urea and creatinine evaluation should be considered in the counseling of DENV infection patients. Patients need to be subjected to necessary laboratory investigations associated with acute kidney injury to decrease the rate of morbidity and mortality associated with the disease.

Significance of Serum Electrolyte Pattern in an Eastern Sudanese Dengue Fever Patients Population

Background: Dengue virus (DENV) infection is caused by an arboviral strain and is transmitted by the mosquito Aedes Egyties which is found in Sudan especially Red Sea and Kassala states in the east. In the year 2020 there was a significant outbreak in the both states. The disease is known to cause renal and electrolyte disturbances and a thorough understanding of that which will potentially help in the prediction, diagnosis and treatment of the disease. Methods: This study is a prospective observational cross sectional study conducted in the Eastern Sudan College of Medical Science and Technology and Port Sudan Teaching Hospital. 200 confirmed Dengue virus infection patients along with 200 healthy appearing adults (as a control) were enrolled for the study. Statistical analysis was carried out after the collection of patients’ demographic, clinical, and investigational data including electrolyte values. Results: The highest incidence of DENV infection was observed in individuals of the middle age group (29%). Although fallen within reference ranges found in the literature, mean serum electrolyte values differed significantly between patients and controls and between different categories of the disease. For our patients, hyponatraemia was seen in 43.5%, hypokalaemia in 37%, hypocalcaemia in 30%, hypophosphataemia in 12% and low magnesium concentrations in 13%. Mean serum sodium concentration differed in the control (138.2 mmol/l) from in the test (132.5 mmol/l) (P. value 0.02). Similarly, mean serum potassium in the control (3.97 mmol/l) differed significantly (P. value 0.01) from test (3.30 mmol/l). Mean calcium and phosphorus (8.80 and 3.50 mg/dl) in the control were also differed from test (8.51 and 3.30), (P. values 0.02 and 0.004, respectively). In contrast, serum magnesium (mg/dl) in the control group (1.96) showed no significant difference from that of test group (1.90) (P. value 0.08). The biochemical parameters studied were neither affected by age nor by gender of the patient group. Clinically, fever was present in 97.5% of patient, headache in 95.5%, joints pain in 71%, lethargy 67%, vomiting in 49%, skin rash in 40%, abdominal pain 24% and bleeding in 17.5%. Conclusion: We strongly conclude that electrolyte evaluation should be considered in the counseling of DENV infected patients. Patients need to be subjected to necessary laboratory investigations including serum electrolyte levels to decrease the rate of morbidity and mortality associated with the disease.

The Frequency of rs1799889 in Plasminogen Activator Inhibitor Type-1 Gene in Sudanese Type 2 Diabetic Patients, Gezira State, Sudan, 2020-2021

Background and Objectives: The cornerstone of the regulation fibrinolytic system is plasminogen activator inhibitor type-1. The 4G/5G polymorphism in the PAI-1 gene is a key genetic predictor of increased plasma levels which is the most polymorphism associated with cardiovascular complications. The 4G carriers have six times higher PAI-1 levels than 5G carriers leading to an increase in the level of plasma inhibitor by about 25% more than 5G allele (wide type). Type 2 diabetes presents symptoms of hypercoagulability and hypofibrinolytic system that lead to contribute in the atherothrombosis and then the myocardial infarction (MI). These findings supported the hypothesis that there is a link between diabetes patients and this SNP. There is no data about the prevalence of this allele in Sudanese diabetic patients with type 2 and the allele differs in prevalence according to ethnicity, for these reasons, the aim of this study was to determine the allele and genotype frequency of the rs1799889 among Sudanese T2DM patients. Methods: A case-control study was conducted using 70 diagnosed diabetes type 2 patients and 50 healthy individuals as the control group. AS-PCR technique was used to genotype the rs1799889, and the allelic frequency was calculated according to Hardy-Weinberg equilibrium. Allelic frequencies were assessed using gene counting (SNP-STAT software V. Release 3.13), and genotypes were scored. Results: The result showed that 4G allele frequency was 28% among Sudanese diabetic patients without statistical difference when compared with control group (P-value = 0.998) but, high when compared with other studies in African population 13% and very low when compared with white and Indian populations studies. Conclusion: By this study, the allele frequency was higher in Sudanese diabetic patients with type 2, and also we need another study to evaluate the effect of this polymorphism in thrombophilic complications in Sudanese diabetic patients with type 2.