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Coronary artery disease is an inflammatory disease. Systemic markers of inflammation such as Interleukin-6, Tumor Necrosis Factor alpha and C-reactive protein have previously been shown to be associated with increased risk of cardiovascular events. The aim of the present study is to assess the role of variants in the IL-6 (− 174 G/C), TNFα (− 308 A/G) and CRP (+ 1059G/C) genes as susceptibility markers for CAD in a Tunisian population. The investigation was conducted as a case–control study involving 204 patients and 400 age-gender matched controls. Genotyping was performed using polymerase chain reaction and restriction fragment length polymorphism analysis. There are significant differences between CAD patients and the control group with regard to BMI (p

BACKGROUND: Type-2 diabetes (T2D) is a multifactorial disease characterised by the severity of its complications. In addition to traditional risk factors, many emerging factors are now described as certain genetic polymorphisms. PURPOSE: The objective of this study was to evaluate the place of G894T polymorphism of the eNOS gene as a new risk factor for T2D. MATERIAL AND METHODS: The study was carried out at the Department of Biochemistry in collaboration with the Department of Endocrinology. We conducted a case-control study including a group of patients with T2D and a group of non-diabetic controls. The patient group included 100 T2D participants, who were hospitalised in the Endocrinology Department and whose age ≥18 years old. The control group included 100 non-diabetic participants in good health, receiving no treatment and whose age ≥18 years old. This latter group were recruited from medical staff and volunteers. Questioning was conducted for each patient and control to fill-in a clinical information sheet. For each patient and control we sought G894T polymorphism of the eNOS gene by PCR-RFLP technique. The statistical analysis of the collected data was analysed using an SPSS statistical software version 19.0 RESULTS: We studied 69 patients with T2D and 71 healthy controls. The mean age of the T2D group was 51.41±6.484. Patients with an age 60 years-old represent 32% (n=22). The frequency of GT mutant heterozygous genotype in the diabetic group (55.07%); (n=38) was significantly higher compared to the control group (19.72%); (n=14); (p

Ochratoxin A is a natural mycotoxin with nephrotoxic properties that can contaminate food products. It has been detected in high amount in human serum collected from nephropathy patients, especially those categorized as having a chronic interstitial nephropathy of unknown etiology. In the present study, ochratoxin A levels were measured in commonly consumed food items and in serum samples from nephropathy and healthy subjects in Tunisia. To assess ochratoxin A, a high performance liquid chromatography method was optimized. The ochratoxin A assay showed very different scales of ochratoxin A serum and food contamination from 0.12 to 1.5 ng/mL and 0.11 to 6.1 ng/g respectively, and in healthy subjects and 0.11 to 33.8 ng/g for food and 0.12 to 3.8 ng/mL for serum in nephropathy patients suffering from chronic interstitial nephropathy of unknown etiology. The disease seems related to ochratoxin A serum levels and food contaminations, since the healthy group was significantly different from the nephropathy group (P0.001) for both food and serum ochratoxin A contamination. Those results combined with data published already, emphasize the likely endemic aspect of ochratoxin A-related nephropathy occurring in Tunisia.

Hyperhomocysteinaemia is considered as an important independent risk factor for atherosclerosis and thrombotic disease. This study determined the distribution of homocysteine (Hcy) levels in healthy Tunisian subjects and evaluated the relationship between Hcy levels and some cardiovascular risk factors. Randomly selected subjects (592 men and 114 women) were recruited from different regions of Tunisia. The overall mean Hcy level was 12.6 (SD 5.4) micromol/L. Hcy levels in subjects with hyperhomocysteinaemia varied according to geographical region. Subjects with hyperhomocysteinaemia had significantly elevated total cholesterol, LDL cholesterol, apolipoprotein A and apolipoprotein B and lower vitamin B12 levels compared with subjects with normohomocysteinaemia. Hcy levels correlated with total cholesterol (r = 0.09), apolipoprotein A (r = 0.012), and B (r= 0.013) levels and total/HDL cholesterol ratio (r = -0.085). Further epidemiological studies are needed to determine the precise role of Hcy in cardiovascular disease.

Resume Introduction Le diabete de type 2 est une pathologie chronique dont la survenue est associee a la presence de plusieurs facteurs. Parmi les nouveaux facteurs etudies, on cite la proteine C-reactive et la micro-albumine. Objectif Etudier la correlation entre le taux d’excretion urinaire d’albumine, les concentrations plasmatiques de la CRP et la presence de complications cardiovasculaires chez un groupe de patients diabetiques non insulinodependants. Patients et methodes L’etude a porte sur 48 diabetiques de type 2 subdivises en trois groupes selon le type de complication vasculaire (GI : diabetiques sans complications, GII : avec complications microvasculaires et GIII : avec complications macrovasculaires). Le dosage de la CRP et de la micro-albumine a ete realise pour tous les individus. Resultats Les diabetiques avec complications vasculaires presentent des taux significativement plus eleves de la CRP et de la micro-albumine lorsque compares aux diabetiques sans complications, avec des valeurs plus elevees chez les diabetiques avec complications macrovasculaires. Une correlation significativement positive a ete trouvee entre les taux de la CRP et ceux de la μalb ( r = 0,32 ; p Conclusion Le dosage des nouveaux marqueurs : CRP et la micro-albumine presente un interet dans le depistage des complications vasculaires chez les diabetiques de type 2.

L’homocysteine, ainsi que de nouveaux biomarqueurs inflammatoires sont lies a la survenue des maladies cardiovasculaires. Ces marqueurs ne sont pas bien etudies dans le syndrome coronaire aigu. Nous avons etudie la distribution des concentrations plasmatiques de l’homocysteine et des marqueurs inflammatoires chez des patients avec syndrome coronaire aigu, et avons evalue l’association entre ces parametres et le degre de severite de la maladie. Les patients avec syndrome coronaire aigu, au nombre de 122, ont ete recrutes de l’unite de soins intensifs de cardiologie. Les facteurs de risque classiques, les parametres lipidiques, l’homocysteine, la CRPus, l’IL-6 et le TNF-α ont ete determines pour tous les patients. La distribution de ces parametres est determinee en fonction du nombre des arteres affectees. Les patients avec trois arteres affectees montrent des concentrations significativement elevees d’homocysteine, CRPus, IL-6, cholesterol total, LDL-choloesterol et Lp (a) compares a ceux avec une ou deux arteres affectees. L’homocysteine (OR = 1,14 ; 95 %IC : 1,04-1,25 ; p = 0,006), le TNF-α (OR = 1,27 ; 95 %IC : 1,13-1,44 ; p = 10 -3), la CRPus (OR = 1,09 ; 95 %IC : 1,03-1,16 ; p = 0,005) et l’IL-6 (OR = 1,15 ; 95 %IC :1,06-1,25 ; p = 0,001) sont des predicteurs significatifs de la severite de la maladie. En conclusion, l’homocysteine et les biomarqueurs inflammatoires peuvent augmenter le degre de la severite des maladies coronariennes.

Aims: A prospective study was performed to characterize the main human enteric viruses able to persist in sewage samples and in shellfish tissues, and to establish the correlation between environmental strains and viral infantile diarrhoea observed in the same area during the same period. Methods and Results: A total of 250 sewage (raw and treated) and 60 shellfish samples were collected between January 2003 and April 2007 in Monastir region, Tunisia. Group A rotavirus (RVA) was detected in 80 (32%) sewage samples, norovirus (NoV) in 11 (4·4%) and enteric adenovirus (AdV) in 1 (0·4%). Among 60 shellfish samples collected near sewage effluents, one was contaminated by NoV (1·6%). Conclusion: Our data represent the first documentation in Tunisia, combining gastroenteritis viruses circulating in the environment and in clinical isolates. We observed a correlation between environmental strains and those found in children suffering from gastroenteritis during the same period study. This suggests the existence of a relationship between water contamination and paediatric diarrhoea. Significance and Impact of the Study: Our results address the potential health risks associated with transmission of human enteric viruses through water-related environmental routes. The research findings will aid in elucidating the molecular epidemiology and circulation of enteric viruses in Tunisia and in Africa, where data are rare.

Summary Introduction Nowadays the role of liver in the development of type 2 diabetes presents an interest in the recent studies research. Objectives In the present study we intend to determine the relationship between hepatic enzymes and insulinresistance in type 2 diabetic patients. Material and method The study group consists of 68 diabetics subdivided into two sub-groups: insulinsensitive diabetics (n = 26) and insulinresistant diabetics (n = 42) and a group of 24 control subjects. Results Diabetics have significant elevated levels of Alat (p = 0.03), Asat (p = 0.02) and GGT (p = 0.03) when compared to control subjects. Insulinresistant diabetics present the highest levels of hepatic enzymes Asat, Alat and GGT when compared to insulinsensitive diabetics. Conclusion Insuline may play a role in the hepatic function.

Summary Aims The aims of this study were to evaluate the chronic subclinical inflammation by determining high-sensitivity C-reactive protein level and to study the relation between inflammation and insulin resistance syndrome in a non-insulin-dependent diabetes mellitus group. Methods The study population consisted of 100 subjects divided into two groups. A control group consisted of 30 healthy subjects and a patients group of 70 non-insulin-dependent diabetes mellitus subjects. This group was subdivided into two subgroups according to the insulin resistance. The insulin resistance was estimated by the insulin resistance index of homeostasis model assessment (HOMA index). High-sensitivity C-reactive protein was measured by an immunonephelometric method. Results High-sensitivity C-reactive protein levels were significantly higher in diabetic patients than in controls (3.52 ± 1.49 mg/l versus 1.25 ± 0.78 mg/l, p Conclusion Our study confirmed the association between the inflammation, obesity and insulin resistance in non-insulin-dependent diabetes mellitus.

Summary Hyperhomocysteinemia is considered a risk factor for cardiovascular diseases. Many factors can cause hyperhomocysteinemia and the more evocated is the C677T mutation on the methylenetetrahydrofolate reductase gene (MTHFR). In the present study we intend to determine the relation between homocysteine (Hcy) concentrations and the C677T mutation in a type 2 diabetics group. The population study consists of 51 type 2 diabetic patients (29 men/22 women) with mean age 53,52 ± 13,56 years. The mutation was determined by PCR, and homocysteine, VitB12 and folates were assayed for each subject. The mutation was detected in 30 patients. CT and TT genotypes were found respectively in 16 and 14 patients. Hcy in diabetics with TT genotype was more elevated than in diabetics with CT genotype (p

Summary Thyroiditis in diabetic patients is always diagnosed at the latest stage. In the present study, we report results from 92 diabetic patients without any autoimmune thyroid disease (35 of type 1 diabetes mellitus and 57 of type 2 diabetes mellitus patients). We assayed two anti-thyroid antibodies: anti-thyroid peroxydase antibody (ATPOAb) and anti-thyroglobuline antibody (ATGAb), using an immunometric method with a luminescent marquer. The prevalence of ATPOAb and ATGAb were, respectively, 37 and 11.42% in type 1 diabetes mellitus patients and 22.8 and 3.5% in type 2. The anti-thyroid antbodies must be systymatically assayed in diabetes mellitus patients in order to detect infraclinical autoimmune thyroid disease.

Mabrouka El Oudi1, Zied Aouni1, Haroun Ouertani2, Chakib Mazigh2, Salem Machghoul11Département de biochimie, 2Service d’endocrinologie, Hôpital militaire de Tunis, 1008 Montfleury, TunisieAim: Evaluate the effect of lipopenic and hypotensive treatment on homocysteine levels.Methods: We recruited 145 type 2 diabetics and 130 control subjects. Thirty-seven diabetics had no complications, 54 had microvascular complications and 54 had macrovascular complications. We determined the parameters homocysteine of lipid, vitamin B12, triglycerides, and folates for all subjects. Associated treatments used one or more of the following drugs, statin, fibrate, angiotensin-converting enzyme inhibitor and beta-blockers.Results: Hyperhomocysteinemia was present in 35.6% of patients. Diabetics had elevated serum levels of triglycerides (P < 0.001), homocysteine (P < 0.01), folates (P < 0.01) and vitamin B12 (P < 0.001). A strong association was found between type 2 diabetes and hyperhomocysteinemia (P < 0.001). Diabetics with associated treatment had elevated homocysteine, vitamin B12 and folate levels when compared to diabetes-free controls. For diabetics with macrovascular complications, we found significant differences in homocysteine (P = 0.010) and folate (P = 0.014) between those taking associated drugs and those who did not. For diabetics with microvascular complications, a significant difference was found in folate only (P = 0.012). Conclusion: Drugs used for hypertension and hyperlipidemia may have an effect on homocysteine levels, for this reason the interaction between drug action and homocysteine levels should be taken into consideration.Keywords: type 2 diabetes, complications, homocysteine, hypolipemiant drug, hypotensive drug