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Background: Diabetes mellitus (DM) is a well-recognised cause of end-stage renal disease (ESRD) through diabetic nephropathy (DN). Elevated intact parathyroid hormone (intact PTH) in DN represents a serious metabolic threat. Objective: We aimed to detect determinants of intact PTH changes during micro-albuminuria stage of DN. Patients and Methods: An observational study included 294 patients with type 2 diabetes mellitus (T2D) divided into 2 groups. Case group; 220 patients of DN with micro-albuminuria versus control group; 74 patients without albuminuria. Participants were subjected to history taking, clinical examination and laboratory assessment of glycosylated haemoglobin (HBA1c), serum creatinine, blood urea nitrogen (BUN), urine albumin creatinine ratio (urine ACR), estimated glomerular filtration rate (eGFR), 25(OH) vitamin D, intact PTH, serum ionized calcium, phosphorus and magnesium. Results: Among 220 patients of mean age 48.7 years and 57.7% male, albuminuria was significantly higher (P<0.001). We found non-significant difference between the study groups in estimated glomerular filtration rate (eGFR) and serum creatinine (P=0.375 and 0.294) respectively. Meanwhile, intact PTH was significantly elevated (P<0.001) in case group. Intact PTH was positively correlated with urine ACR, HBA1c, BUN, and serum creatinine and inversely correlated with eGFR. However, urine ACR was the only independent determinant of intact PTH in diabetic patients with micro-albuminuria (OR: 1.177; 95% CI: 1.074-1.290, P= 0.001). Conclusion: Interestingly, urine albumin creatinine ratio was the only independent determinant of intact PTH in diabetic patients with micro-albuminuria. [ABSTRACT FROM AUTHOR]

Background and objective: Can overweight and obesity exert a detrimental or a protective effect on bone density in premenopausal women? We studied the correlation between obesity and bone mineral density (BMD) in premenopausal women in Egypt. Patients and methods: a Case-control study included 50 overweight and obese premenopausal women compared to 50 normal weight women of matched age. Clinical history, examination, laboratory tests and DEXA scan were done. Results: T–score and Z-score at the forearm, hip, and lumbar vertebrae were significantly lower in the case group than the control group. In all participants, we found a significant negative correlation between body mass index (BMI) with Z-score ( forearm), BMI and bodyweight with Z-score (hip) and BMI, waist circumference (WC) and bodyweight with Z-score (lumbar vertebrae). We found a significant negative correlation between waist/hip ratio (WHR) and T-score (hip) and between BMI, waist/hip ratio and bodyweight with T-score (lumbar vertebrae). In the overweight and obese participants, BMI was inversely correlated with Z-score (forearm, hip, and lumbar vertebrae) as well as waist circumference with Z-score (lumbar vertebrae). With post-hoc analysis, T-score at the lumbar vertebrae was significantly lower in the obese group. With adjustment of the age, (age and WC) and (age and WHR), we found a significant negative association in the obese group versus the lean group with Z-score (forearm, hip and lumbar vertebrae). Conclusion: Overweight and obese Egyptian premenopausal women were more vulnerable to lower bone density. [ABSTRACT FROM AUTHOR]