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Radioactive element separation is of particular interest in nuclear technology. For this purpose, batch experiments were carried out in order to find the best separation conditions of uranium [U(VI)] and thorium [Th(IV)] from aqueous solution using rice straw activated carbon. The influence of pH and contact time on selective adsorption of U(VI) and Th(IV) was investigated. The results indicate that the velocity of these species from liquid phase to the surface of carbon is rapid enough. The reaction rate was fast, requiring only a short contact time of 40 min for U(V1) and 100 min for Th(IV). Sorption reaches maximum at pH 4 for Th(IV) and at pH 5.5 for U(VI). U(VI) and Th(IV) can be separated by the judicious controlling of pH and contact time. They can be separated from each other at pH 4 with different contact time [Th(IV) at lower time and U(V1) at 200 min]. Studies were conducted to examine the change in the adsorption behavior of U(VI) and Th(IV) on adsorbent as a function of employing different complexing agents of mineral and organic acids that are important in industrial and environmental processes, including hydrochloric, nitric, acetic, sulfuric, and phosphoric acids at 0.1M concentration. Acetic acid enhances U(VI) and Th(IV) uptake compared to mineral acids. These procedures may be useful in the separation of U(VI) and Th(IV) from natural or industrial samples containing these elements. [ABSTRACT FROM AUTHOR]

The impact of common cations and anions on the adsorption of uranium on rice straw activated carbon has been examined. The presence of these ions in solution was found to inhibit the uptake of cadmium by chitin to different degrees. Presence of Fe ions depressed the uranium removal to 77 and 20% at 20 and 100 mg/l, respectively. Coexistence of some anions induced small positive effect on uranium adsorption percent like Cl–; 91.0%, CO32- ; 89.3%, HCO-3 ; 88.8%, S2O2-3; 93.8%, and OH–; 91.6% compared to 84.2% uranium removal. Simultaneous presence of both uranium and thorium reduced uranium sorption from 100 to 35.9 mg/g. Data were good fitted by the Langmuir isotherm with correlation coefficient higher than 0.998. This means, the adsorption is monolayer chemical in nature on homogenous surface. [ABSTRACT FROM AUTHOR]

In this work, the adsorption of polycyclic aromatic hydrocarbons (PAHs) from aqueous solution by rice husk activated carbon (RHAC) was compared with adsorption using conventional, powdered activated carbon as the adsorbent. The adsorbent capacity of RHAC was found to be higher than all other agricultural and industrial adsorbents evaluated. The kinetics of PAHs was similar even after 24 hours. The removal of PAH occurred in the following order: naphthalene < phenanthrene < pyrene. Our study results show that molecular weight and solubility play vital roles in the adsorption of PAH on RHAC. The study results pointed to the occurrence of an intra-particle mechanism in all cases. The isotherm models that best represented the data obtained were Freundlich for naphthalene, Redlich-Peterson for phenanthrene, and Langmuir for pyrene. The results of this study were compared with previous studies. [ABSTRACT FROM AUTHOR]

Nanocrystalline sensors having the general formula ZnO + x wt% CeO2, where x = 0, 2, 4 and 6 were prepared by chemical precipitation method and sintered at 400, 600 and 800 °C for 2h in static air atmosphere. The crystal structure and the morphology of the prepared samples were investigated and characterized by using XRD, IR, SEM and TEM techniques. The investigation revealed that the average crystallites size increases with increasing the sintering temperature. The electrical conductivity is found to increase with CeO2 additions and sintering temperature. Gas sensing properties of the prepared samples were also investigated. The effect of CeO2 content and sintering temperature on the structure, electrical conductivity and ethanol gas sensing properties of the prepared samples are discussed. [ABSTRACT FROM AUTHOR]

Date pits (DP) and sawdust (SD) were used as precursors for activated carbons which were prepared by steam pyrolysis of DP and chemical activation of SD, respectively. Surface characterization of both activated carbons was undertaken using the BET method. Adsorption of the radionuclides onto the activated carbon was studied as a function of shaking time, adsorbent mass and pH employing the batch technique. Such adsorption was strongly dependent on the pH of the aqueous medium in contact with the adsorbent, with the removal efficiency attaining a maximum at pH 6. The process was very fast initially, with maximum adsorption being attained within 180 min of initial contact. The adsorption rate could be best fitted by the pseudo-second-order kinetic model. The equilibrium data were analyzed using the Freundlich, Langmuir, Langmuir-Freundlich, Dubinin-Radushkevich, Temkin and Frumkin isotherms. The Langmuir-Freundlich and Frumkin equations were found to best represent the equilibrium data for both radionuclides. The isotherm model constants were determined and used to characterize the distribution of 60Co and 134Cs ions onto the adsorbent surfaces and to provide an insight into the affinity of the adsorbents towards these ions. [ABSTRACT FROM AUTHOR]

Trihalomethanes (THMs) are carcinogenic by-products of disinfection that are present in drinking water. In the present research, adsorption and photodegradation, either individually or in tandem, were employed for the removal of the principal THMs found in water supply systems. The effects of pH, contact time, adsorbents and adsorbate concentration on the adsorption system were investigated. The Langmuir and Freundlich adsorption isotherm models were used to analyze the resulting adsorption data. Photodegradation of THMs was carried out in the presence and absence of activated carbon. The integration of adsorption and photodegradation systems as a hybrid treatment process resulted in a synergetic enhancement of the THM removal efficiency. The kinetics of THM removal were found to follow the pseudo-second-order model rather than the Langmuir-Hinshelwood pseudo-first-order model. [ABSTRACT FROM AUTHOR]

The differences in the adsorption/desorption behavior of benzene, toluene, ethyl-benzene, and p-xylene (BTEX) using rice husk activated carbon (RHAC) were studied. It was proved that RHAC were quite effective in removing BTEX compounds from aqueous solutions. About 48 h was sufficient to attain maximum BTEX adsorption and desorption. Adsorption kinetics data proved a closer fit to the Weber-Morris model, while the isotherm experimental data were better fit to the Freundlich model, producing values of 1/n less than one, indicating favorable adsorption. Adsorption isotherms were determined in polluted surface water and it was found that the removal efficiency depends on the initial concentration of BTEX pollutants. Desorption equilibrium is less rapid than the adsorption equilibrium. BTEX adsorption/desorption was affected by chemical structure, solubility, and molecular weight. About 22% benzene, 33% toluene, 58% ethylbenzene, and 18.8% of p-xylene were released from RHAC after contact between the loaded matrix and reagent water. Sorption/desorption of p-xylene in RHAC was found to yield co-incident equilibrium isotherms and no significant hysteresis was observed. [ABSTRACT FROM AUTHOR]

Adsorption of three polycyclic aromatic hydrocarbons (PAH) in one mixture, namely naphthalene (NA), phenanthrene (PH), and pyrene (PY), was tested using various adsorbent materials: Bone charcoal (B-1 and B-2), Peat Moss (PM), Pyrolysis Residue (PR), Activated Rice Husk (RH), and powdered activated carbon (PAC). It was found that adsorption capacity RH carbon for PAH is comparable with the conventional adsorbent (PAC). Kinetics, equilibrium, and thermodynamic studies were carried out for the adsorption of selected PAH on RH carbon in single-component systems. Two days are sufficient contact time between each solute and the RH carbon. Intraparticle mechanism was proved for all compounds. Langmuir, BET, Freundlich, Redlick-Peterson, Toth, Generalized and Fritz-Schlünder isotherm equations were studied. It was found that the Freundlich isotherm for NA, Generalized isotherm for PH and BET isotherm for PY gave an excellent overall fit. The fitting was improved independent on the number of isotherm parameters. The calculated values of dimensionless separation factor RL of NA, PH, and PY were between 0 and 1 supporting the adsorption of PAH compounds onto RH carbon is very favorable. The results indicated the exothermic nature of PH adsorption onto RH carbon. Thermodynamic parameter was determined. Comparison with other studies was investigated. [ABSTRACT FROM AUTHOR]

Background: Dietary intake is widely known to play a crucial role in achieving peak bone mass among children and adolescents. Unfortunately, this information is lacking among Arab adolescents, an understudied demographic that has recently been observed to have a high prevalence of abnormal mineralization markers [low serum 25(OH)D, high serum alkaline phosphatase (ALP), low calcium (Ca) and/or inorganic phosphate (Pi)] suggestive of biochemical osteomalacia (OM, defined as any 2 of the 4 parameters). In order to fill this gap, we aimed to evaluate the associations of serum markers of biochemical OM with dietary intake of macronutrients, vitamins and trace minerals., Methods: Saudi adolescents ( N  = 2,938, 57.8% girls), aged 12-17 years from 60 different schools in Riyadh, Saudi Arabia were included. Dietary intake of nutrients was calculated following a semi-quantitative 24 h dietary recall over 3 weekdays and 1 weekend-day using a validated food frequency questionnaire. Compliance to reference daily intake (RDI) of macronutrients, vitamins and trace minerals were calculated. Fasting blood samples were collected and circulating levels of 25(OH)D, ALP, Ca, and Pi were analyzed., Results: A total of 1819 (1,083 girls and 736 boys) adolescents provided the dietary recall data. Biochemical OM was identified in 175 (9.6%) participants (13.5% in girls, 3.9% in boys, p  < 0.01) while the rest served as controls ( N  = 1,644). All participants had serum 25(OH)D levels <50 nmoL/L. Most participants had very low dietary intakes of Ca (median ~ 290 mg) and vitamin D (median ~ 4 μg) which are far below the RDI of 1,300 mg/day and 20 μg/day, respectively. In contrast, excess dietary intakes of Pi, Na, K, and Fe were observed in all participants. In the biochemical OM group, thiamine and protein intake were significant predictors of serum 25(OH)D, explaining 4.3% of the variance perceived ( r  = 0.23, adjusted r 2  = 4.3%, p  = 0.01). Among controls, dietary vitamin C and vitamin D explained 0.6% of the total variation in serum 25(OH)D ( r  = 0.09, adjusted r 2  = 0.6%, p  = 0.004)., Conclusion: Arab adolescents do not meet the RDI for dietary Ca and vitamin D, and none have sufficient vitamin D status (25(OH)D levels >50 nmol/L) but they exceed the RDI for dietary Pi. Interpreting these data in the light of the increased prevalence of rickets in Arab countries, food fortification to optimise vitamin D and Ca intake in Saudi adolescents should be considered., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Al-Daghri, Sabico, Wani, Hussain, Yakout, Aljohani, Uday and Högler.)

Nutrition-acquired osteomalacia is a bone mineralization disorder associated with dietary calcium and/or solar vitamin D deficiency, risk factors considered common in the Middle Eastern region. Establishing less invasive, cheap, and widely available diagnostic markers for this underdiagnosed entity is essential, in particular for screening in high-risk groups. This study assessed the prevalence of biochemical osteomalacia in Arab adolescents. In this cross-sectional study performed between September 2019 and March 2021, adolescents aged 12−17 years from 60 different secondary and preparatory year schools in Riyadh, Saudi Arabia were included. Anthropometrics and fasting blood samples were collected. Biochemical osteomalacia was defined as any two of the following four serum markers of hypomineralization, namely low 25 hydroxyvitamin D (25OHD < 30 nmol/L), high alkaline phosphatase (ALP), low calcium (Ca), and/or inorganic phosphorous (Pi). A total of 2938 Arab adolescents [1697 girls; mean age (years) 14.8 ± 1.8; 1241 boys; mean age 15.1 ± 1.6] were recruited. Vitamin D deficiency was noted in 56.2% (n = 953) of girls and 27.1% (n = 336) of boys (p < 0.001). The overall prevalence of biochemical osteomalacia was 10.0% (n = 295/2938) and was higher in girls than boys (14.7% vs. 3.6%, p < 0.001). The prevalence of low serum Ca and/or Pi was also higher in girls than in boys (24.2% vs. 12.5%, respectively, p < 0.001), as well as elevated ALP (5.1% vs. 1.5%, p < 0.001). Overall, girls were 4.6 times (95% CI 3.3−6.4) more likely to have biochemical osteomalacia than boys. Screening of apparently healthy Arab adolescents revealed a high prevalence of deranged mineralization markers suggestive of biochemical osteomalacia, which was significantly more common in girls than boys and was likely associated with Arab traditional clothing and diet. The proposed combination of typically altered mineralization markers for the diagnosis of osteomalacia is, at best, suggestive until further comparisons with established diagnostic tools (histological analysis of bone biopsies) are conducted.

Objectives: Type 2 diabetes mellitus (T2DM) outcomes were observed to be influenced by circulating trace elements' status. The differences and correlations between serum levels of chromium (Cr), manganese (Mn), nickel (Ni), and selenium (Se) in Saudi patients with and without T2DM as well as those with prediabetes (pre-DM) were examined in this retrospective cross-sectional study., Methods: Anthropometrics and fasting blood samples were collected from 119 patients with T2DM (aged 41-64 years), 95 non-T2DM (aged 27-55 years), and 80 with pre-DM (aged 35-57 years). An inductively coupled plasma-mass spectrometer was used to measure trace minerals in the blood., Results: T2DM patients had significantly lower Mn serum concentrations than controls. There was no difference in Cr and Ni levels between groups. Serum Mn and Ni levels were lower in pre-DM subjects than controls. Serum Se concentrations were higher in pre-DM and T2DM patients than controls. In T2DM patients, serum Cr and Mn levels were inversely correlated with glucose, while Ni and Se levels were positively correlated with glucose in the T2DM group., Conclusions: Because of their roles in glucose metabolism, impaired trace element status may also play a role in T2DM pathogenesis. Appropriate dietary control and mineral supplementation are recommended., Competing Interests: None., (AJTR Copyright © 2022.)

The present study aims to investigate the association of the serum levels of Fetuin-A and Fetuin-B with type 2 diabetes mellitus (T2DM) in obese Saudi patients and explore the mechanism that links obesity and T2DM in Saudi patients. In this study, a total of 240 adult Saudis (116 men and 124 women) in the age group of 42.7±11.6 years were divided into three groups based on fasting blood glucose (FBG) levels: controls, T2DM and prediabetic. The levels of FBG, lipid profile and serum insulin were measured. Enzyme-linked immunosorbent assay (ELISA) was done to measure Fetuin-A, Fetuin-B and C-reactive protein (CRP). The results show that participants of the prediabetic and T2DM groups had significantly higher body mass index (BMI) values and elevated blood pressure (BP), FBG, total cholesterol (TC), triglyceride (TG), insulin, homeostatic model assessment-IR (HOMA-IR) and homeostatic model assessment-β (HOMA-β) as compared to the control group (P<0.001). The T2DM group participants exhibited significantly higher BMI, BP, FBG, TG, insulin, HOMA-IR and HOMA-β as compared to the prediabetic group participants (P<0.001). The serum levels of high-density lipoprotein-cholesterol (HDL-C) and low-density lipoprotein-cholesterol (LDL-C) were not significantly different among the three tested groups. The serum concentrations of CRP, Fetuin-A and Fetuin-B were slightly higher in T2DM patients as compared to the control group, but the difference failed to reach statistical significance (P>0.05). When results were segregated according to gender, FBG and HDL-C were significantly elevated (P=0.043 and P=0.002, respectively) in T2DM women (12.6±3.6 mmol/l and 1.0±0.3 mmol/l, respectively) compared to T2DM men (11.0±3.3 mmol/l and 0.86±0.2 mmol/l, respectively). However, the diastolic BP and waist-hip ratio (WHR) were significantly increased (P=0.010 and P=0.006, respectively) in T2DM men. The BMI and TC and all other measured parameters were similar between the two genders. Fetuin-A was significantly and positively associated with insulin levels (R=0.19, P=0.05), HOMA-IR (R=0.25, P=0.01) and TG (R=0.20, P=0.01) among overall participants of this study. The T2DM participants exhibited a significantly positive correlation with body weight. Fetuin-A was significantly and positively correlated with Fetuin-B in prediabetic participants, but this relation was not observed in the T2DM participants. Fetuin-B correlated inversely (P<005) with systolic BP (R=-0.20, P=0.01) and diastolic BP (R=-0.18, P=0.05). Interestingly, a strong inverse correlation was observed between Fetuin-B and TG in overall participants (R=-0.21, P=0.01) and specifically in T2DM women (R=-0.41, P=0.01). In conclusion, our study did not find a significant association of Fetuin-A or Fetuin-B levels in serum with T2DM. However, our results suggest that Fetuin-A may influence insulin resistance and serum Fetuin-B concentrations were inversely associated with TG in the general adult Saudi population., Competing Interests: None., (AJTR Copyright © 2022.)

Iron and vitamin D deficiencies are some of the most common health problems in the world. Iron is essential in oxygen transport and participates in many enzymatic systems in the body, with important roles in vitamin D metabolism. Osteoporosis is one of the most prevalent chronic disease of the elderly in the world as well as in the Saudi population. The relationship between iron, vitamin D deficiency and bone health comes from clinical observations in iron overload patients who suffered bone loss. The opposite scenario, whether iron and vitamin D deficiencies affect bone metabolism, has not been fully addressed. This is of great interest, as this nutrient deficiency is a worldwide public health problem and at the same time osteoporosis and bone alterations are highly prevalent. The relationship between 25(OH)D and iron deficiencies with osteoporosis is unknown up to date. This review presents the current knowledge on nutritional iron and vitamin D deficiencies in bone remodeling, and discuss the link between iron and bone metabolism among postmenopausal women. Finally, it is hypothesized that chronic iron and vitamin D deficiencies induces bone resorption and risk of osteoporosis, thus complete recovery from anemia and its prevention should be promoted in order to improve quality of life including bone health. Several mechanisms are implicated; hence, further investigation on the possible impact of iron and vitamin D deficiencies on the development of osteoporosis is needed., Competing Interests: None., (AJTR Copyright © 2022.)

The homeostasis of trace elements were observed to contribute to certain diabetic outcomes. This cross-sectional study determined the differences and associations between serum levels of copper (Cu), iron (Fe) and zinc (Zn) in Saudi patients with and without type 2 diabetes mellitus (T2DM) as well as those with prediabetes. Anthropometrics were measured, and fasting blood samples were collected from 119 patients with T2DM (aged 41-64 years), 95 non-T2DM (aged 27-55 years) and 80 with prediabetes (aged 35-57 years). Circulating trace minerals were determined using an inductively coupled plasma-mass spectrometer. Serum levels of Cu and Fe were significantly lower in T2DM than non-T2DM (adjusted p -values < 0.001). There was no difference in the Zn levels of the T2DM and non-T2DM groups. The serum Cu levels were significantly lower in the prediabetes group than the non-T2DM group ( p < 0.05). The serum levels of Cu, Fe and Zn were inversely associated with circulating glucose in the T2DM and prediabetes subjects ( p -values < 0.001). In conclusion, the differences in circulating trace elements were observed in Saudi subjects with varying glycemic statuses, suggesting an inverse association between T2DM progression and the decreasing serum Cu, Fe and Zn levels. Intervention trials are warranted to determine whether early correction of trace mineral deficiencies is beneficial in populations at higher risk for T2DM.

The study examined the associations between physical activity and appendicular lean mass (ALM), fat mass, and bone mineral density (BMD) and examined the role of physical activity on these variables. The participants included 497 men (age: 32.2 ± 10.4 years and body mass index: 28.2 ± 5.4 kg/m 2 ). The study was cross-sectional, and measurements included body composition measured on dual-energy X-ray absorptiometry and self-reported physical activity assessed using the International Physical Activity Questionnaire. Physical activity, including light physical activity, was associated with increased ALM ( P ≤ 0.05). Fat indicators, including waist circumference, were positively associated with ALM ( P ≤ 0.05), but not with BMD. Physical activity, including moderate-to-vigorous physical activity, was not associated with BMD, whereas ALM and handgrip strength were significantly associated with BMD ( P ≤ 0.05). Physical activity independent of exercise intensity was directly associated with ALM and indirectly associated with BMD through increased muscle mass and strength., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright © 2019 Shaea Alkahtani et al.)

Objective: Subjects with low vitamin D levels are at risk of cardiometabolic disease. The aim of this study was to identify novel serological markers linking vitamin D status with cardiometabolic profile in non-diabetic adults with obesity., Methods: For the discovery phase, we used quantitative serum proteomics in sex-matched, age-matched and BMI-matched subjects with obesity [BMI: 25-35 kg/m 2 ] and low [25(OH)D < 50 nmol/L] vs. high vitamin D status [25(OH)D > 50 nmol/L] (n = 16). For the validation phase, we performed ELISA in a larger cohort with similar characteristics (n = 179)., Results: We identified 423 and 549 differentially expressed proteins in the high vs. low vitamin D groups of the male and female cohorts, respectively. The small molecule biochemistry protein networks and the glycolysis|gluconeogenesis pathway were significantly enriched in the DEPs of both sexes. As surrogate markers to these processes, the insulin-like growth factor binding protein -2  (IGFBP-2) was upregulated in males, whereas   IGFBP-3 was upregulated in females from the high Vitamin D status. This sex-specific trend  was confirmed using Luminex ELISA to an independent but clinically analogous cohort of males (n = 84, p = 0.002) and females (n = 95, p = 0.03)., Conclusions: The high Vitamin D status correlated with the serological upregulation of IGFBP-2 in males and IGFBP-3 in females with obesity and may constitute surrogate markers of risk reduction of cardiometabolic disease.

Background: The present randomized clinical trial characterized the beneficial effects of a multi-strain probiotics supplementation on improving circulating endotoxin levels (primary endpoint) and other cardiometabolic biomarkers (secondary endpoint) in patients with T2DM., Methods: A total of 78 adult Saudi T2DM patients (naïve and without co-morbidities) participated in this clinical trial and were randomized to receive twice daily placebo or probiotics [(2.5 × 10 9  cfu/g) containing the following bacterial strains: Bifidobacterium bifidum W23, Bifidobacterium lactis W52, Lactobacillus acidophilus W37, Lactobacillus brevis W63, Lactobacillus casei W56, Lactobacillus salivarius W24, Lactococcus lactis W19 and Lactococcus lactis W58 (Ecologic ® Barrier)] in a double-blind manner for 12 weeks. Anthropometrics and cardiometabolic profiles were obtained at baseline and after 12/13 weeks of treatment., Results: After 12/13 weeks of intervention and using intention-to-treat analysis, no difference was noted in endotoxin levels between groups [Placebo - 9.5% vs. Probiotics - 52.2%; (CI - 0.05 to 0.36; p = 0.15)]. Compared with the placebo group however, participants in the probiotics groups had a significant but modest improvement in WHR [Placebo 0.0% vs. Probiotics 1.11%; (CI - 0.12 to - 0.01; p = 0.02)] as well as a clinically significant improvement in HOMA-IR [Placebo - 12.2% vs. Probiotics - 60.4%; (CI - 0.34 to - 0.01; p = 0.04)]., Conclusion: Using a multi-strain probiotic supplement daily for 12/13 weeks significantly improved HOMA-IR and modestly reduced abdominal adiposity among medication naïve T2DM patients., Trial Registration: ClinicalTrials.gov Identifier: NCT01765517 , Registered January 10, 2013.

Vitamin D binding protein (DBP) and albumin are the important determinants of circulatory 25(OH)D in adults. Physiological function of vitamin D is particularly regulated by DBPs. Serum parathyroid hormone (PTH) is considered as the biological activity reader of circulating 25(OH)D. We therefore examined the relationships between serum total, free, and bioavailable 25(OH)D versus PTH in apparently healthy Saudi female adults.A total of 350 apparently healthy Saudi female adults ([Mean ± standard deviation] age [years] 52.9 ± 9.2; body mass index [kg/m] 32.9 ± 5.4) were included in this observational study. Anthropometrics was measured as well as fasting glucose, lipid profile, calcium and phosphorous using routine methods. Serum 25(OH)D was measured using an electrochemiluminescence immunoassay. Serum DBP was determined by ELISA. Free and bioavailable 25(OH)D were calculated by comparing concentrations of total 25(OH)D, DBP, and albumin.Data revealed that circulating total 25(OH)D had weak but significant inverse association with DBP (R = -0.24; P < .01), and strong inverse associations with free 25(OH)D (R = -0.87; P < .001), albumin-bound 25(OH)D (R = -0.88; P < .001), and bioavailable 25(OH)D (R = -0.89; p < 0.001). None of the vitamin D metabolites, including 25(OH)D, correlated with serum PTH.Various metabolites of 25(OH)D are not correlated with serum PTH in Saudi adult females. Bioavailable, albumin-bound and free 25(OH)D cannot be surrogate measures for vitamin D status, at least in this population.

Postmenopausal osteoporosis is an important metabolic bone disease characterized by rapid bone loss occurring in the postmenopausal period. Recently, the most prevalent form of clinically significant osteopenia and osteoporosis involves various inflammatory conditions. The aim of the study is to evaluate the association between proinflammatory markers (interleukin [IL]-1β, IL-6, TNF-α) with bone turnover markers (BTMs) in postmenopausal Saudi women with and without osteoporosis. A total of 200 postmenopausal Saudi women ≥50 years old, 100 with osteoporosis and 100 without osteoporosis (control) were recruited under the supervision of qualified physicians in King Salman Hospital and King Fahd Medical City, Riyadh, Saudi Arabia. Serum tumor necrosis factor alpha (TNF-α), IL-1, IL-4, IL-6, and parathyroid hormone (PTH) were determined using Luminex xMAP technology. N-telopeptides of collagen type I (NTx) was assessed using ELISA, 25(OH) vitamin D and osteocalcin were determined using electrochemiluminescence, serum calcium and inorganic phosphate (Pi) were measured by a chemical analyzer. Serum IL-1β, IL-6, NTx, and PTH levels in women with osteoporosis were significantly higher than controls. Although IL-4 and osteocalcin were significantly lower than controls. IL-1β and TNF-α were positively associated with NTx in osteoporosis women. TNF-α, IL-6, and TNF-α were positively correlated with IL-lβ in both groups. A significant negative correlation between osteocalcin and IL-1β in healthy women and women with osteoporosis were observed. Findings of the present study implicate a role for cytokine pattern-mediated inflammation in patients with osteoporosis., Competing Interests: The authors have no conflicts of interest to disclose.

Background: Overweight adults are at increased risk for cardiovascular disease and vitamin D deficiency, whereas an important feature to vitamin D physiology is its sex dependence. The aim of this study was to examine whether vitamin D status improvement exerts a sexually dimorphic effect on serum proteins associated with cardiovascular risk among overweight adults., Materials and Methods: Unprocessed serum from age- and BMI-matched men (n = 26) and premenopausal women (n = 24) with vitamin D deficiency and after they achieved sufficiency through a 12-month nutritional intervention was analysed using our previously published depletion-free quantitative proteomics method. Key findings were verified with ELISA. Differentially expressed proteins were subjected to in silico bioinformatics assessment using principal component analysis, hierarchical clustering and Metacore ™ pathway analysis. All mass spectrometry proteomic data are available via ProteomeXchange (identifier: PXD003663)., Results: A total of 282 proteins were differentially expressed after the intervention between men and women (P-value ≤ 0·05), in which the blood coagulation pathway was significantly enriched. In agreement with the proteomics findings, ELISA measurements showed vitamin K-dependent protein C, von Willebrand factor, fibrinogen gamma chain and multimerin-1 proteins, of relevance to blood coagulation, to be differentially affected (P-value ≤ 0·05) between sexes after vitamin D status correction., Conclusions: This study identified novel protein-level molecular indicators on the sexually dimorphic effect of vitamin D status correction associated with blood coagulation among overweight adults. These sex-mediated vitamin D effects should be factored in the design and interpretation of vitamin D observational and interventional studies testing cardiometabolic outcomes., (© 2016 Stichting European Society for Clinical Investigation Journal Foundation.)

Background: This study aimed to examine the relationship between changes in systemic vitamin B12 concentrations with pro-inflammatory cytokines, anthropometric factors and biochemical markers of cardiometabolic risk in a Saudi population., Methods: A total of 364 subjects (224 children, age: 12.99 ± 2.73 (mean ± SD) years; BMI: 20.07 ± 4.92 kg/m² and 140 adults, age: 41.87 ± 8.82 years; BMI: 31.65 ± 5.77 kg/m²) were studied. Fasting blood, anthropometric and biochemical data were collected. Serum cytokines were quantified using multiplex assay kits and B12 concentrations were measured using immunoassay analyzer., Results: Vitamin B12 was negatively associated with TNF-α (r = -0.14, p < 0.05), insulin (r = -0.230, p < 0.01) and HOMA-IR (r = -0.252, p < 0.01) in all subjects. In children, vitamin B12 was negatively associated with serum resistin (r = -0.160, p < 0.01), insulin (r = -0.248, p < 0.01), HOMA-IR (r = -0.261, p < 0.01). In adults, vitamin B12 was negatively associated with TNF-α (r = -0.242, p < 0.01) while positively associated with resistin (r = 0.248, p < 0.01). Serum resistin was the most significant predictor for circulating vitamin B12 in all subjects (r² = -0.17, p < 0.05) and in children (r² = -0.167, p < 0.01) while HDL-cholesterol was the predictor of B12 in adults (r² = -0.78, p < 0.05)., Conclusions: Serum vitamin B12 concentrations were associated with pro-inflammatory cytokines and biochemical markers of cardiometabolic risks in adults. Maintaining adequate vitamin B12 concentrations may lower inflammation-induced cardiometabolic risk in the Saudi adult population., Competing Interests: The authors declare no conflict of interest.

Vitamin D deficiency is a global health threat that has been associated with several chronic diseases. Selenium is an essential trace element because of role in major metabolic processes, immune function, thyroid hormone metabolism, male infertility, neoplasms and cardiovascular disease. We aimed to investigate for the first time in the Saudi population the association between vitamin D and selenium status with various dietary products consumption. A total of 259 children and 95 adults were included in this cross-sectional study. We estimated the consumption frequencies of various dietary food products using a qualitative food frequency questionnaire (FFQ) and also measured serum levels of 25-hydroxyvitamin D and selenium. Associations between variables of interest were assessed. Vitamin D deficiency and insufficiency were observed in 80% of the boys, 90% of the girls, 64% of men and 50% of women. Modest associations were found between mean serum 25 (OH) D concentration and consumption frequencies of fresh milk in children (r=0.11; P<0.05), more specifically in girls (r=0.12; P<0.05), and to the overall consumption of dairy products in women (r=0.12; P<0.05). Vitamin D status was also inversely associated with selenium in adults (r=-0.43; P<0.05). There was a significant correlation between delta changes of serum selenium, triglycerides and HDL levels (P-values <0.05). Vitamin D and selenium levels are modestly associated with dietary products consumption. Changes in selenium levels were associated with increased serum triglyceride levels, indicating a potential biomarker for cardiovascular risk and dyslipidemia. The widespread vitamin D deficiency observed in the present study highlight the need for adequate fortification of dairy products.

Postmenopausal osteoporosis is characterized by rapid bone loss occurring in the post-menopausal period. The bone loss predominantly involves the trabecular bone and is brought about by an imbalance between the bone remodeling process which can be influenced by factors that could cause or contribute to osteoporosis. Pro-inflammatory cytokines (Il-1β, Il-6, IL-8 and TNF-α) have been implicated in the regulation of bone cells and play a critical role in bone remodeling. They act both directly and indirectly to increase bone resorption, and/or inhibit bone formation. The aim of the study is to determine whether pro-inflammatory cytokines correlate with bone turnover markers (BTM) in a cohort of Saudi post-menopausal women with or without osteoporosis and which BTMs will correlate with PTH and Vitamin D for use in osteoporosis diagnosis. The study is composed of 100 post-menopausal patients and 100 controls aged around 50 years. Serum concentrations of pro-inflammatory and BTMs as well as PTH and vitamin D were determined by ELISA, Luminex and electrochemiluminescence. Serum calcium, phosphorus, glucose, and lipid profile were measured by using a chemical analyzer. There was a significant increase in the levels of pro-inflammatory cytokines, PTH, CTx, and glucose. A significantly lower vitamin D and osteocalcin levels were observed in subjects with osteoporosis than those without. No significant differences were recorded in the circulating lipid profile between groups. The present study proved that the pro-inflammatory cytokines accelerate the bone loss in postmenopausal women.

Pesticide exposure has been implicated as an environmental risk factor for the development of type 2 diabetes mellitus (T2DM). The aim of this study was to investigate the association of the body burden of the pesticide hexachlorocyclohexane (HCH) with the risk of T2DM in a sample of adults from Saudi Arabia. Serum samples were obtained from 280 adult subjects. Hexachlorocyclohexane isomer residues were measured by high-resolution gas chromatography-mass spectrometry. Data on lifestyle, dietary habits, and health status were gathered. Associations between exposure and T2DM were analyzed by logistic regression. Around 49% of adults enrolled in this study were diagnosed with T2DM. Among various HCH isomers, serum concentrations of the pesticides β and γ-HCH were most strongly and consistently linked to T2DM in our studied subjects. Associations of HCH varied across five components of the metabolic syndrome. It positively and significantly associated with four out of the five components, especially elevated triglycerides, high fasting glucose, high blood pressure and HOMA-IR but negatively and significantly with HDL-cholesterol. This study in line with earlier ones about diabetes associated with HCH pesticide exposure and proposes possible hormonal pathways worthy of further investigation.

Background: Sub-clinical hypothyroid dysfunction, a relatively understudied disorder in the Kingdom of Saudi Arabia (KSA), has significant clinical implications if not properly monitored. Also from KSA, more than 50% of the population suffer from hypovitaminosis D (<50 nmol/l). In this cross-sectional case-control study, we described the differences and associations in the metabolic patterns of adult Saudis with and without hypothyroid dysfunction in relation to their vitamin D status, PTH, calcium and lipid profile., Methods: A total of 94 consenting adult Saudis [52 controls (without subclinical hypothyroidism), 42 cases (previously diagnosed subjects)] were included in this cross-sectional study. Anthropometrics were obtained and fasting blood samples were taken for ascertaining lipid and thyroid profile, as well as measuring PTH, 25(OH) vitamin D and calcium., Results: Cases had a significantly higher body mass index than the controls (p < 0.001). Circulating triglycerides was also significantly higher in cases than the controls (p = 0.001). A significant positive association between HDL-cholesterol and PTH (R = 0.56; p = 0.001), as well as a negative and modestly significant negative association between LDL-cholesterol and PTH (R = - 20.0; p = 0.04) were observed. FT3 was inversely associated with circulating 25 (OH) vitamin D (R = -0.25; p = 0.01)., Conclusions: Patients with hypothyroid dysfunction possess several cardiometabolic risk factors that include obesity and dyslipidemia. The association between PTH and cholesterol levels as well as the inverse association between vitamin D status and FT3 needs to be reassessed prospectively on a larger scale to confirm these findings.

Background: The hallmark of vascular inflammation is the recruitment of circulating leucocytes, primarily monocytes, macrophages and T lymphocytes, into the vascular wall; however, the link between monocyte/macrophage activation and hypertension has not been established as yet. In this study, we determined how sCD163, a monocyte/macrophage soluble scavenger receptor and immunomodulator, relates to arterial blood pressure (BP) in hypertensive Saudi individuals., Materials and Methods: A total of 90 (30 non-hypertensive obese, 30 hypertensive obese and 30 lean normotensive controls) adult Saudi subjects, aged 40-60 years, participated in this cross-sectional study. Serum fasting blood glucose, triglycerides, total cholesterol, HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), leptin, adiponectin, resistin, insulin, tumour necrosis factor-alpha (TNF-α), PAI-1, angiotensin II, high-sensitivity C-reactive protein (hsCRP) and sCD163 were measured in all subjects studied., Results: sCD163 concentrations were significantly increased in obese hypertensive patients compared to controls (P=0.016). Positive correlations between sCD163 and body mass index (BMI) (r=0.27, P=0.01), systolic BP (r=0.25, P=0.01), diastolic BP (r=0.33, P=0.001), LDL-C (r=0.21, P=0.04), TNF-α (r=0.23, P=0.02) and hsCRP (r=0.33, P=0.008) were observed. Positive correlations between sCD163 and diastolic BP (r=0.23, P=0.04) and LDL-C (r=0.22, P=0.03) remained significant after controlling for BMI., Conclusions: Taken together, these data demonstrate that the monocyte/macrophage activation-related sCD163 is positively associated with BMI and increased arterial BP with the elevation in diastolic BP being independent of the BMI., (© 2012 The Authors. European Journal of Clinical Investigation © 2012 Stichting European Society for Clinical Investigation Journal Foundation.)

Background: Diabetes Mellitus (DM) is a major health problem worldwide and its prevalence in Saudi Arabia has reached 31.6%. Patients with diabetes mellitus are at an increased risk of thyroid disease. The purpose of this study was to examine the urinary excretion of iodine in type 2 DM (T2DM) patients, and to assess the clinical implication of iodine status on T2DM., Methods: A total of 266 adult Saudis aged 18-55 years (109 T2DM patients and 157 healthy controls) were randomly selected from the Riyadh Cohort Study. Subjects were assessed for anthropometry, morning blood chemistries including fasting glucose, and lipid profile; serum concentrations of leptin, adiponectin, resistin, insulin, aPAI, hsCRP, Ang II, TNF-α, TSH, T3, T4, urine creatinine, urine iodine were measured using specific assays., Results: The concentration of urine iodine was significantly lower in T2DM than in healthy control subjects (84.6±2.3 vs. 119.4±3.4, p<0.001), which remained significant after creatinine correction and controlling for age (p=0.01). Furthermore, urinary iodine is negatively correlated with waist, hips, SAD, glucose, insulin, HOMA-IR triglyceride, resistin, angiotensin II (Ang II), and CRP, while it was positively associated with TSH., Conclusions: The decreased levels of iodine concentration in T2DM patients and its likely deleterious effects on metabolic functions calls for a systematic approach to thyroid disease screening in diabetic patients. Routine annual urinary iodine determination is recommended and should target T2DM patients at risk of thyroid dysfunction., (© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.)

Background: Coffee and tea consumption was hypothesized to interact with variants of vitamin D-receptor polymorphisms, but limited evidence exists. Here we determine for the first time whether increased coffee and tea consumption affects circulating levels of 25-hydroxyvitamin D in a cohort of Saudi adolescents., Methods: A total of 330 randomly selected Saudi adolescents were included. Anthropometrics were recorded and fasting blood samples were analyzed for routine analysis of fasting glucose, lipid levels, calcium, albumin and phosphorous. Frequency of coffee and tea intake was noted. 25-hydroxyvitamin D levels were measured using enzyme-linked immunosorbent assays., Results: Improved lipid profiles were observed in both boys and girls, as demonstrated by increased levels of HDL-cholesterol, even after controlling for age and BMI, among those consuming 9-12 cups of coffee/week. Vitamin D levels were significantly highest among those consuming 9-12 cups of tea/week in all subjects (p-value 0.009) independent of age, gender, BMI, physical activity and sun exposure., Conclusion: This study suggests a link between tea consumption and vitamin D levels in a cohort of Saudi adolescents, independent of age, BMI, gender, physical activity and sun exposure. These findings should be confirmed prospectively.

Background: Sagittal abdominal diameter (SAD) is a novel anthropometric measure hypothesized to be a surrogate measure of visceral abdominal obesity in adults. This study aims to determine whether SAD is superior to other anthropometric measures such as body mass index (BMI) and waist to hip ratio (WHR) in terms of association to cardiometabolic risk and circulating adipocytokine concentrations in a cohort of Saudi children and adolescents., Methods: A total of 948 (495 boys and 453 girls) apparently healthy children with varying BMI, aged 10-17 years, were included in this cross sectional study. Fasting glucose, lipid profile, leptin, adiponectin, resistin, insulin, TNF-α and aPAI-1 were measured in serum and HOMA-IR was calculated. MetS components were defined according to the International Diabetes Federation (IDF) criteria., Results: BMI was superior to SAD as well as WHR, and had the highest number of significant associations to MetS components and adipocytokines even after adjustment for age and gender, including blood pressure, lipids, glucose and leptin., Conclusion: In conclusion, while SAD is significantly associated with components of MetS among children and adolescents, it is not superior to BMI. The use of SAD therefore may not be practical for use in the pediatric clinical setting. Follow-up studies are needed to determine whether SAD has clinical significance in terms of harder outcomes such as predicting diabetes mellitus or cardiovascular diseases.

Unlabelled: Vitamin D deficiency has been linked to several chronic diseases in adults. Studies focusing on children and adolescents, however, are limited. In this randomized cross-sectional study, we aimed to determine the prevalence of vitamin D deficiency and its relationship with childhood obesity and dietary calcium intake among a population of healthy urban Saudi children and adolescents. To achieve this, 331 randomly selected Saudi children (53.8% females and 46.2% males) aged 6-17 years were included. Demographic, medical, and dietary information were collected; anthropometrics were measured. Levels of serum fasting glucose, lipid profile, 25(OH) D, and for albumin corrected calcium were analyzed. Vitamin D deficiency was noted in all subjects, with girls having significantly lower vitamin D levels than boys. Mean calcium intake was found to be 60% of the required dietary allowance (RDA), while the mean vitamin D intake was 23% of RDA. Vitamin D status and calcium intake were comparable in both normal and overweight/obese children and adolescents. Vitamin D status was highest among children who had calcium intake >800 mg/day. In adolescents there was insignificant but decreasing trend in BMI, which was observed to be highest among those whose calcium intake was <250 mg/day and lowest among those taking >800 mg/day., Conclusion: results from this study suggest the importance of vitamin D fortification and increased dietary calcium in the Saudi diet to meet RDA requirements and avoid onset of vitamin D deficiency-related diseases in Saudi children and adolescents.

In this study we examined the association of adiponectin gene variants with circulating adiponectin, and known metabolic diseases in 298 healthy controls and 297 Saudi subjects with type 2 diabetes mellitus (T2DM). Anthropometric and biochemical parameters were measured by standard procedures. Genotyping of T45G and G276T single nucleotide polymorphisms of adiponectin gene was carried out by PCR-RFLP analysis. No significant differences in the genotype distribution of T45G and G276T polymorphism were found between control and diabetic subjects. Neither SNP conferred an association with T2DM, obesity, hypertension or dyslipidemia. Despite a marked decrease in patients as opposed to controls, adiponectin levels were not different according to genotypes of T45G and G276T polymorphisms in control and patients. Thus, neither adiponectin SNPs independently conferred increased T2DM risk nor in other metabolic conditions considered such as obesity, hypertension or dyslipidemia. These findings support the existence of population based differences in the association of adiponectin gene variants with metabolic phenotypes and emphasize the importance of studying multiple polymorphisms, sufficient enough to identify the adiponectin gene as a genetic marker for several non-chronic communicable diseases., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Central adiposity is a significant determinant of obesity-related hypertension risk, which may arise due to the pathogenic inflammatory nature of the abdominal fat depot. However, the influence of pro-inflammatory adipokines on blood pressure in the obese hypertensive phenotype has not been well established in Saudi subjects. As such, our study investigated whether inflammatory factors may represent useful biomarkers to delineate hypertension risk in a Saudi cohort with and without hypertension and/or diabetes mellitus type 2 (DMT2). Subjects were subdivided into four groups: healthy lean controls (age: 47.9±5.1 yr; BMI: 22.9±2.1 Kg/m(2)), non-hypertensive obese (age: 46.1±5.0 yr; BMI: 33.7±4.2 Kg/m(2)), hypertensive obese (age: 48.6±6.1 yr; BMI: 36.5±7.7 Kg/m(2)) and hypertensive obese with DMT2 (age: 50.8±6.0 yr; BMI: 35.3±6.7 Kg/m(2)). Anthropometric data were collected from all subjects and fasting blood samples were utilized for biochemical analysis. Serum angiotensin II (ANG II) levels were elevated in hypertensive obese (p<0.05) and hypertensive obese with DMT2 (p<0.001) compared with normotensive controls. Systolic blood pressure was positively associated with BMI (p<0.001), glucose (p<0.001), insulin (p<0.05), HOMA-IR (p<0.001), leptin (p<0.01), TNF-α (p<0.001) and ANG II (p<0.05). Associations between ANG II and TNF-α with systolic blood pressure remained significant after controlling for BMI. Additionally CRP (p<0.05), leptin (p<0.001) and leptin/adiponectin ratio (p<0.001) were also significantly associated with the hypertension phenotype. In conclusion our data suggests that circulating pro-inflammatory adipokines, particularly ANG II and, TNF-α, represent important factors associated with a hypertension phenotype and may directly contribute to predicting and exacerbating hypertension risk.

Fluoride in drinking water above permissible levels is responsible for human and skeletal fluorosis. In this study, activated carbons (AC) prepared by one-step steam pyrolysis of rice straw at 550, 650, 750 degrees C, respectively, were modified by liquid-phase oxidation using HNO3, H2O2 and KMnO4. Characterization of these 12 carbons was made by their surface area, porosity, acidity, basicity, pH(pzc), pH and ability to remove fluoride anion. Based on the data of the latter factor, the RS2/KMnO4 carbon was selected. Along with batch adsorption studies, which involve effect of pH, adsorbate concentration, adsorbent dosage, contact time, temperature, and Co-ions (SO4(2-), Cl-, Br-). The effects of natural organic matter (NOM) were also made to remove the fluoride from natural water. On the basis of kinetic studies, specific rate constants involved in the adsorption process using RS2/KMnO4 carbon was calculated and second-order adsorption kinetics was observed. Equation isotherms such as Langmuir (L), Freundlich (F), Langmuir-Freundlich (LF) and Dubinin-Radushkevich (DR) were successfully used to model the experimental data. From the DR isotherm parameters, it was considered that the uptake of F- by RS2/KMnO4 carbon proceeds by an ion-exchange mechanism (E=10.46 kJ mol(-1)). The thermodynamic parameters of fluoride sorption were calculated and the sorption process was chemical in nature. The ability of RS2/KMnO4 to remove F- from Egyptian crude phosphoric acid (P(2)O(5)=48.42%) was tested and the adsorption capacity of F- in H(3)PO(4) was greater than that in distilled water. This is may be due to fluoride adsorption enhanced at lower pH of crude acid.