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Background Ghrelin is a gastro-duodenal hormone which plays a major role in the regulation of food intake, energy balance and gastrokinesis. Ghrelin represents a novel biological marker for assessment of the presence as well as the severity of liver cirrhosis. We aimed to measure the level of plasma ghrelin in patients with liver cirrhosis (compensated and decompensated) and to correlate its level with different studied clinical and laboratory parameters. Subjects and methods 40 cirrhotic patients were included in a cross-sectional study and divided equally according to the Child-Pugh classification into Group I: patients with compensated liver cirrhosis (Child A), and Group II: patients with decompensated liver cirrhosis (Child B|C). Also, 20 age and sex matched healthy subjects were included as a control group (Group III). All patients were subjected to: full history taking, full clinical examination, routine biochemical studies together with estimation of plasma ghrelin level, assessment of the severity of liver disease according to Child-Pugh classification, also, abdominal ultrasonography was done. Results Plasma ghrelin level was low among cirrhotic patients (both compensated and decompensated) in comparison to normal control subjects. Conclusion Ghrelin can be used as a serum biomarker for detection and assessment of the severity of liver cirrhosis.

Objectives The objective of this study was to determine whether plasma resistin levels would be useful in the diagnosis of patients with AD and to investigate the relationships between resistin and IL-6, TNF-α, and CRP. Patients and methods Ninety five patients with Alzheimer disease(AD) aged 65 years or more and 35 sex and age matched healthy subjects were included in the study as controls. We excluded participants with DM, hypertension, liver or renal failure, ischemic heart disease, congestive heart failure, stroke, thyroid disorders, active infection or other inflammatory diseases, chronic use of anti-inflammatory drugs. The diagnosis of AD was determined based on the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision criteria and mini mental state examination (MMSE). Serum resistin, IL-6, TNF-α, and CRP were measured for all participants. Results Serum levels of resistin, IL-6, CRP, and TNF-α were significantly higher in patients with AD than healthy controls. The resistin levels were positively correlated with the levels of IL-6, CRP, and TNF-α. MMSE was negatively correlated with IL-6, CRP, and TNF-α, whereas the correlation is only significant with CRP. A high statistically negative correlation was found between MMSE and resistin levels. Conclusion We concluded that serum resistin may be linked to peripheral inflammatory markers which are associated with AD.

Background: Thyroid diseases are considered of the most common and important endocrinological disorders that are associated with multiple deleterious effects. Osteopontin (OPN), a molecule first identified in osteoblasts, is a multifunctional protein involved in inflammation, cell adhesion & remodeling. It has been suggested that OPN plays a role in many diseases. Aim of the work: To assess the alteration of serum OPN in patients with several forms of thyroid dysfunction and the relation of OPN to body mass index (BMI) in those patients. Patients and methods: Study subjects were recruited from the endocrine outpatient clinic in Alexandria Main University Hospital. They were divided into; Group I: 25 hyperthyroid patients, Group II: 25 hypothyroid patients, and Group III: 25 healthy euthyroid subjects as a control group. Results: OPN was significantly higher in hyperthyroid group than in control group (mean 11.07 ± 2.87 µg/l Vs mean 6.50 ± 1.71 µg/l, p

Summary Background Vitamin D level is a common health problem for elderly persons and it is associated with a decrease in physical performance, furthermore, it has been demonstrated that those with low serum vitamin D level has more risk of cognitive impairment, depression and anxiety. Aim The aim of the study was to estimate relation of vitamin D and geriatric syndrome. Methods A prospective study was done on 50 subjects who were normal elderly persons above 65 years. All the participants were subjected to full history taking, complete physical examination, laboratory assessment including serum 25-hydroxyvitamin D (OH)D by enzyme linked immunosorbent assay (ELISA) and geriatric syndrome assessment using 5 methods namely fall risk assessment using timed up &go test, mini-mental state examination (MMSE), geriatric depressive scale, mini nutritional assessment and Tinetti performance – oriented mobility assessment (POMA). Results The number of patients who were vitamin D deficient ( 20 ng/ml) were 11, 24 and 15 respectively. There was significant p association between low vitamin D level and female gender (p = 0.024), advanced age (p = 0.026), no-sun exposure jobs (p = 0.001) and nursing home residency. Mini mental state examination (p = 0.006) and geriatric depressive scale (p = 0.002) had a significant positive correlation with low vitamin D level while mini nutritional assessment (p = 1.000), timed up and go test (p = 0.225) and POMA score (p = 0.133) had no significant correlation with low vitamin D level. Conclusion There is correlation finding between vitamin D deficiency and advanced age, cognitive dysfunction, and depression.

Aim: To study the relationship between obesity, insulin resistance, vitamin D deficiency and sclerostin as a bone biomarker. Materials and methods: Cross-section study of 75 subjects grouped into 3 groups; obese (n = 31), overweight (n = 23) and normal (n = 21) subjects. Sclerostin, fasting insulin, fasting plasma glucose and 25(OH)D were measured and anthropometric measures were taken. Results: 25(OH)D was lower in obese subjects than overweight and control groups (mean ± SD 5.27 ± 5.14 vs. 12.55 ± 6.99 vs.17.65 ± 4.07 ng/L, p

This study was conducted to illustrate the relation between vitamin D deficiency and glycemic parameters.The study was carried out on 80 pregnant females who were attending obstetrics and gynecology out-patient clinic in el-Shatby hospital in Alexandria university, Egypt. They were divided into 2 groups: group 1 (n = 40) pregnant females diagnosed with gestational diabetes de novo at week 24-28 and group 2 (n = 40) pregnant females of the same age group who were not suffering from any glucose intolerance (control group). Each patient was subjected to detailed history taking, complete physical examination, One step 75 gm Oral glucose tolerance test, insulin, glycated hemoglobin(HbA1c),homeostatic model assessment of insulin resistance(HOMA-IR), 25 hydroxy-vitamin D, serum calcium, phosphorous and parathormone were assessed.A statistically significant higher fasting blood glucose (FBG), HbA1c%, fasting insulin and HOMA-IR was observed in patients with Gestational diabetes mellitus (GDM) versus control (p 0.001). However, no significant difference was observed as regards Vitamin D levels in patients with GDM and control group. Among patients with GDM, vitamin D was found to correlate negatively with HbA1c (p 0.001), insulin(p = 0.019) and HOMA-IR(p = 0.034).No definite causal relationship was observed between low vitamin D and subsequent occurrence of GDM.however, a significant correlation was found between the degree of vitamin D deficiency and the insulin resistance in patients with GDM.

Background: A well balanced diet is important for normal function of endothelial cells. Diets high in fat and/or calories can lead to hypertriglyceridemia and postprandial lipidemia and thus are considered a risk factor for the development of atherosclerosis. Big meals may result in chronic elevations in the level of atherogenic lipoproteins as well as evoking chronic inflammatory response. Both may lead to pathological changes on the arterial vessel wall and myocardium. Objective(s): To study the effect of the size of a well-balanced meal on the lipid profile in the post prandial state and its effect on the endothelial function, ventricular filling and diastolic function. Methods: one group pretest-posttest study was carried out on 40 young healthy lean volunteers aged 30 to 39 years who after overnight fast were invited to eat a big breakfast meal. Postprandial blood samples were then drawn after 3-4 hours to determine changes induced by the big meal in the blood. On the following day, the same procedure was adopted but with a breakfast meal which contains only one third of the size of the big meal (small meal). The items of comparison between the two meals included: The changes induced by both types of meals on the lipid profile of the blood by assessing the postprandial levels of TG, TC, LDL-C, HDL-C and FFAs; assessment of the inflammatory response by assessing postprandial levels of CRP; The changes induced on endothelial cell functions by assessing the postprandial levels of ET1 and NO; and the changes induced by the two types of meals on the left ventricular function as determined by echo Doppler as well as tissue Doppler imaging (TDI). Results: The big meal was associated with elevations in TG, TC, LDL-C, CRP, ET1 and NO (P=0.001, 0.021, 0.057, 0.110, 0.002, 0.001respectively). The small meal showed significant increase in levels of HDL-C (P=0.001) and FFAs (P=0.048). The diastolic function of the left ventricle showed significant reduction after the ingestion of the big meal versus the small meal. Conclusions: The study concluded that big meal size negatively impact lipid homeostasis and endothelial function and the recognition of this possible danger of big meals can lead to the possibility of prevention of atherosclerosis through controlling of the meal size. Keywords : Meal size, postprandial, Lipid profile, CRP, endothelin 1, nitric oxide, diastolic function, ventricular filling

Background This study aimed at evaluating serum level of vitamin D in normal elderly persons above or equal to 65 years of age and its relation to geriatric syndrome. Patients and methods A prospective study was done on 50 normal elderly persons above 65 years (23 persons from nursery home and 27 persons from geriatric outpatient clinic in Alexandria Main University Hospital). All the participants were subjecting to full history taking, complete physical examination, laboratory assessment including serum 25-hydroxyvitamin D (OH)D by enzyme-linked immunosorbent assay, and geriatric syndrome assessment using five methods, namely, fall risk assessment using timed up and go test, mini-mental state examination, geriatric depressive scale, mini-nutritional assessment, and Tinetti performance-oriented mobility assessment. Results According to vitamin D level (ng/ml), the number of patients who were deficient ( 20) was 11, 24, and 15, respectively. The mean±SD vitamin D level was 18.44±10.71 for all patients. According to the relation between vitamin D level and demographic data for the studied group, there were significant positive associations between low vitamin D level on one side and female sex (P=0.024), advanced age (P=0.026), no sun-exposure jobs (P=0.001), and nursing home residency on the other side. Mini-mental state examination (P=0.006) and geriatric depressive scale (P=0.002) had a significant positive correlation with low vitamin D level, whereas mini-nutritional assessment (P=1.000), timed up and go test (P=0.225), and performance-oriented mobility assessment score (P=0.133) had no significant correlation with low vitamin D level. Conclusion There is a correlation between vitamin D deficiency and advanced age, cognitive dysfunction, and depression, whereas no correlation was found between vitamin D deficiency and nutritional state and risk of falling.

Introduction Over the past few decades obesity has become a major burden on health worldwide. The prevalence of hypertension has increased with a significant increase in the prevalence of overweight and obesity. Recent studies indicate an important role of adipose tissue hormones called adipokines in obesity-associated complications. Apelin has recently been added to the family of adipokines. One of the physiologic functions of the apelin/APJ system is regulation of the cardiovascular function. The aim of this study was to determine the relation of serum apelin to obesity-associated hypertension as well as to myocardial performance. Patients and methods The study included 30 obese hypertensive patients, 30 obese nonhypertensive patients, and 25 age-matched and sex-matched controls. In all studied participants we determined the lipid profile, serum insulin, fasting blood glucose level, HOMA-IR, serum apelin, and echocardiographic results of left ventricular systolic and diastolic function. Results Higher levels of fasting blood glucose, fasting serum insulin, HOMA-IR, triglycerides, total cholesterol, and low-density lipoprotein were detected in obese hypertensive and nonhypertensive patients. Left ventricular mass index (LVMI) was increased in both obese hypertensive and nonhypertensive patients in comparison with healthy individuals. Left ventricular ejection fraction and E/A ratio were significantly lower in hypertensive obese versus nonhypertensive obese individuals (P = 0.004 and Conclusion Apelin levels are significantly higher in obese hypertensive and nonhypertensive patients. This increase might be a compensatory mechanism against myocardial dysfunction with obesity.