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Abstract Introduction Thyroid disorders and diabetes mellitus coexist and are prevalent endocrinopathies among adult population. Thyroid dysfunction contributes to metabolic imbalances, increase beta‐cell apoptosis and glucose intolerance. There is paucity of data and contradicting findings on how thyroid dysfunction influence glycaemic control. Therefore, we evaluated thyroid dysfunction and glycaemic control among Type 2 diabetes mellitus (T2DM) patients in Ghana. Methods A comparative cross‐sectional study was conducted among 192 T2DM patients from Effia Nkwanta Regional Hospital. Three consecutive monthly fasting plasma glucose (FBG) and glycated haemoglobin (HbA1c) were analysed and the results were classified as, moderate hyperglycaemia (MH) (FBG = 6.1–12.0 mmol/L, HbA1c 7%) and good glycaemic controls (GC) (FBG = 4.1–6.0 mmol/L, HbA1c

Abstract Objective The association between unbalanced iron indices and the conditions of schizophrenia are not well understood. Liver dysfunction which has been linked to iron metabolism might be a contributing factor. This case–control study evaluated serum iron indices and liver function in treatment-naïve schizophrenia patients and those already on treatment at the Psychiatric Department of the Komfo Anokye Teaching Hospital (KATH), Kumasi-Ghana. Results The mean age of the respondents was 39.6 ± 0.8 years. Increased levels of serum iron, TS, AST, ALT and AST:ALT ratio and lower levels of UIBC, TIBC, Transferrin, and log Ferritin:AST ratio levels were observed among the treatment-naïve group compared to the control. The treatment-naïve and treatment groups showed significantly higher serum AST:ALT ratio, and lower log10ferrtin:AST ratio than the healthy controls. There was a significant correlation between log10ferritin and AST, and log10ferritin and GGT in both treatments (r = 0.343; p = 0.003, and r = 0.502; p = 0.001 respectively) and treatment-naïve groups (r = 0.348; p = 0.002, and r = 0.614; p

Abstract Background Glycated hemoglobin (HbA1c), owing to its ability to reflect glycemia over a relatively longer time span, is still been investigated as an adjunct test for fasting plasma glucose (FPG) to identify subjects at risk of metabolic syndrome (MetS) in some Caucasian populations. However, whether or not HbA1c can serve as an adjunct to FPG in the definition of MetS in the Ghanaian population remains unknown. This study determined the prevalence of MetS and evaluated HbA1c ≥ 5.6% and FPG ≥ 5.6 mmol/l as the glycemic component of MetS among non-diabetic population in Ghana. Methods This was a case–control study conducted at St Francis Xavier Hospital, Assin Fosu, Central Region, Ghana. A total of 264 non-diabetic Ghanaian adults consisting of 158 newly diagnosed hypertensives and 106 normotensives, were recruited for the study. Fasting plasma insulin and glucose, HbA1c, and lipid profile was performed for each respondent. Results Using the FPG as glycemic criterion, the overall MetS prevalence was 46.6%, 37.1%, and 12.5% according by the IDF, NCEP ATP III, and WHO criteria, respectively. The prevalence of MetS using the HbA1c criterion was 54.2%, 52.7%, and 42.4% by the IDF, NCEP ATP III and WHO criteria, respectively. The HbA1c criterion identified more participants with MetS compared to the FPG criterion with a good agreement between HbA1c and FPG using the IDF and NCEP ATP III criteria (κ = 0.484 to 0.899) respectively. However, the overlap between HbA1c and FPG based diagnosis of MetS was limited for the WHO criterion. Conclusion The prevalence of metabolic syndrome is high among non-diabetics in Ghana. Introduction of HbA1c in addition to FPG in the screening of MetS improves identification of more people with MetS who would otherwise have been missed when only FPG-based diagnosis of MetS is used; with a substantial agreement with FPG, except when using the WHO criteria.

BackgroundThe association between prolong metformin usage and B12 deficiency has been documented. However, the prevalence estimates of metformin-induced vitamin B12 deficiency showed substantial disparity among studies due to varied study definitions of vitamin B12 deficiency. Metformin blocks the calcium dependent absorption of the vitamin B12-Intrinsic Factor complex at the terminal ileum. Lack of intrinsic factor due to the presence of auto-antibodies to parietal cells (IFA) could lead to vitamin B12 deficiency and subsequently cause peripheral neuropathy. We investigated the prevalence of vitamin B12 deficiency using more sensitive, combined markers of vitamin B12 status (4cB12) and the immuno-biochemical mediators of vitamin B12 deficiency.MethodsIn this observational study, 200 consecutive consenting metformin-treated T2DM patients, aged 35 and above, attending the diabetic clinic at KATH were recruited. Vitamin B12 deficiency was classified based on the Fedosov age-normalized wellness quotient. Anthropometric measurement was taken as well as blood samples for immunological and biochemical mediators. Peripheral neuropathy was assessed using the Michigan Neuropathy Screening Instrument (MNSI). Statistical analysis was performed using the R Language for Statistical Computing.ResultsUsing the combined indicator (4cB12), the prevalence of metformin induced vitamin B12 deficiency was 40.5% whilst the prevalence of MNSI-Q and MNSI-PE diabetic neuropathy was 32.5% and 6.5% respectively. Participants with vitamin B12 deficiency had significantly higher levels of IFA, GPA, TNF-α, TC, LDL and albumin compared to those with normal vitamin B12 levels (p < 0.05). Correlation analysis revealed a statistically significant negative association between 4cB12 and the immunological markers [IFA (rs = -0.301, pConclusionVitamin B12 deficiency and diabetic neuropathy are very high among metformin-treated T2DM patients and it is associated with increased GPA, IFA, TNF-α and cardiometabolic risk factors (higher LDL and TC and lower HDL). Upon verification of these findings in a prospective case-control study, it may be beneficial to include periodic measurement of Vitamin B12 using the more sensitive combined indicators (4cB 12) in the management of patients with T2DM treated with metformin in Ghana.

Background. Vitamin D is a steroid hormone important for the normal functioning of the body. It is produced through skin exposure to sunlight and from the diet. Although Ghana is located in the tropics where sunlight is abundant, factors like culture, diet, skin pigmentation, variation in the ozone layer, and geographical area influence the optimization of vitamin D concentration. It is imperative to evaluate the interplay between sunshine exposure, proinflammatory cytokines, and mediators of vitamin D metabolism and their relationship to vitamin D status in three geographical sections among apparent healthy Ghanaians. Methods and Results. In a cross-sectional study, a total of five hundred (500) healthy blood donors from three geographical areas in Ghana were enrolled. Their age ranged from 17 to 55 years with a mean age of 27.97 ± 8.87 years. The overall prevalence rate of vitamin D deficiency was 43.6% (218/500), with 41.2% (91/221), 45.3% (63/139), and 45.7% (64/140) of vitamin D deficiency being recorded in participants from the Northern Sector (NS), Middle Belt (MB), and Southern Sector (SS), respectively. However, there were no significant differences in the proportions of vitamin D deficiency across various geographical sectors. The median 25-hydroxyvitamin D serum levels were compared among geographical areas (NS, MB, and SS) and there were no significant differences (P=0.275) after adjusting for confounding factors. 25-Hydroxyvitamin D correlated positively with corrected ionized calcium (rs = 0.622, P≤0.001) and phosphorus (rs = 0.299, P≤0.001) and negatively correlated with SBP (rs = −0.092, P=0.039), vitamin D binding protein (VDBP) (rs = −0.421, P≤0.001), intact parathyroid hormone (iPTH) (rs = −0.0568, rs ≤ 0.001), IFN-gamma (rs = −0.684, P≤0.001), and TNF-alpha (rs = −0.600, P≤0.001). After adjusting for possible confounders, not having knowledge about vitamin D foods, taking fewer vitamin D foods, and higher levels of IF-γ and IL-10 were associated with a higher risk of having vitamin D deficiency. Conclusion. The prevalence of 25-hydroxyvitamin D deficiency is high among the general adult population in Ghana despite the abundance of sunlight. Increasing knowledge on vitamin D diet coupled with a daily intake of vitamin D dietary supplements is likely to reduce the risk of developing 25-hydroxyvitamin D deficiency.

Background: Metabolic syndrome (MetS) is a multifactorial disorder and a predisposing factor for diabetes, heart diseases, and stroke. Glycated haemoglobin (HbA1c) has recently received considerable attention as a potential marker to identify subjects at risk of MetS. This study aimed at assessing the performance of fasting plasma glucose (FPG), the American Diabetes Association (ADA) HbA1c cut-off, and a population-derived HbA1c (pHbA1c) cut-off value as the glycaemic criterion for MetS in a non-diabetic population. Methods: In this cross-sectional study, we recruited 728 non-diabetic Ghanaian adults. Venous blood sample was obtained and fasting plasma insulin and glucose, HbA1c, lipid profile, blood pressure and anthropometric measurements were performed for each respondent. Results: The prevalence of MetS using the FPG, ADA HbA1c and pHbA1c criteria were 35.2%, 38.5% and 41.8%, respectively. The pHbA1c cut-off identified 6.6% and 3.3% more subjects with MetS when compared with FPG and the ADA HbA1c cut-offs, respectively while the ADA HbA1c cut-off identified 3.3% more subjects with MetS compared with the FPG criterion. The ADA HbA1c criterion showed a substantial agreement (ĸ = 0.79) with the FPG criterion while pHbA1c showed an almost perfect concordance (ĸ = 0.82) with the FPG criterion and an excellent sensitivity and specificity for identifying subjects with MetS in the study population. Conclusion: Screening of MetS by introduction of the ADA HbA1c criterion in addition to the traditional FPG criterion enhances the detection of more people with MetS. However, the use of population-derived HbA1c cut-off value could potentially identify even greater number of high risk subjects in that specific population.

Objectives. Sub-Saharan Africa (SSA) is observing an accelerating prevalence rate of type 2 diabetes mellitus (T2DM) influenced by gene-environment interaction of modifiable and nonmodifiable factors. We conducted a systematic review and meta-analysis on the heritability and genetic risk of T2DM in SSA. Methods. We reviewed all published articles on T2DM in SSA between January 2000 and December 2019 and available in PubMed, Scopus, and Web of Science. Studies that reported on the genetics and/or heritability of T2DM or indicators of glycaemia were included. Data extracted included the study design, records of family history, pattern and characteristics of inheritance, genetic determinants, and effects estimates. Results. The pattern and characteristics of T2DM heritability in SSA are preference for maternal aggregation, higher among first degree compared to second-degree relatives; early age-onset (

Background: Lower urinary tract symptoms (LUTSs) can significantly reduce men's quality of life and may point to serious pathology of the urogenital tract. This study aimed at finding predictors of symptoms score on the International Prostate Symptom Score (IPSS) for patients with LUTS. Materials and Methods: The study was cross-sectional conducted among 225 Ghanaian men visiting the urology clinic at Komfo Anokye Teaching Hospital. Trained interviewers used the IPSS, which adds a quality of life question to the American Urology Association symptom index to determine the extent to which patients are troubled by their symptoms. Five milliliters of blood was collected for total prostate-specific antigen (PSA) measurement. Transrectal ultrasonography was performed to evaluate the prostate volume (PV). Results: The mean age of the participants was 67.96 ± 14.57. The average score obtained from the study participants using the IPSS scale was 17.52 ± 7.83. There was a significant association between bother score and IPSS symptoms grade (P < 0.0001). Regression plot of the participants' points for IPSS in relation to the age, PSA, and PV showed statistically significant positive associations (P < 0.05). However, the coefficients of determination (R2) were 0.156, 0.022, and 0.048, respectively. This means that each unit increase of age, PSA, and PV only influences 15.6%, 2.3%, and 4.8% of the change in the symptom score. There was statistically significant association between age and moderate-to-severe LUTS with age range of 75 years above recording the highest odds (adjusted odds ratio (AOR) = 18.72, (1.15–99.78), P < 0.0001). The PSA range 20.1–50 ng/ml was significantly associated with moderate-to-severe LUTS (AOR = 17.37 (2.19–223.45), P = 0.006). Moreover, other factors, which were significantly associated with moderate-to-severe LUTS, were smoking (AOR = 0.32 (0.11–0.94) P = 0.038) and being widowed (AOR = 0.05 (0.002–0.52), P =0.010) respectively. Conclusion: The study found a statistically significant correlation between age, PSA, PV, and IPSS scores; however, these influences were mild.

BACKGROUND:Vitamin D plays a major role in physiological processes that modulate mineral metabolism and immune function with probable link to several chronic and infectious conditions. Emerging data suggests a possible influence of vitamin D on glucose homeostasis. This study sought to provide preliminary information on vitamin D status among Ghanaian type 2 diabetics and assessed its association with glucose homeostasis. METHODS:In a case control study, 118 clinically diagnosed Type 2 Diabetes Mellitus (T2DM) patients attending Diabetic Clinic at the Nkawie Government Hospital were enrolled between October and December 2015. Hundred healthy non-diabetics living in Nkawie district were selected as controls. Structured questionnaires were administered to obtain socio-demographic data. Venous blood samples were taken from both cases and controls to estimate their FBG, Lipid profile spectrophotometrically and IPTH, 25OHD by ELISA. Statistical analyses were performed using SPSS v20.0 Statistics. RESULTS:The average age of the study participants was 58.81years for cases and 57.79year for controls. There was vitamin D deficiency of 92.4% among T2DM cases and 60.2% among the non diabetic controls. Vitamin D deficiency did not significantly associate with HOMA-β [T2DM: r2 = 0.0209, p = 0.1338 and Control: r2 = 0.0213, p = 0.2703] and HOMA-IR [T2DM: r2 = 0.0233, p = 0.1132 and Control: r2 = 0.0214, p = 0.2690] in both the controls and the cases. CONCLUSION:Vitamin D deficiency is prevalent in both T2DM and non-diabetics. There is no association between vitamin D deficiency and insulin resistance or beta cell function in our study population. Vitamin D supplementation among type 2 diabetics is recommended.