45 results on '"Muhammad Mujammami"'
Search Results
2. Plasma Proteomic Signature of Endometrial Cancer in Patients with Diabetes
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Muhammad Mujammami, Mohamed Rafiullah, Khalid Akkour, Assim A. Alfadda, Afshan Masood, Salini Scaria Joy, Hani Alhalal, Maria Arafah, Eman Alshehri, Ibrahim O. Alanazi, and Hicham Benabdelkamel
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Chemistry ,QD1-999 - Published
- 2024
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3. Cost consequence analysis of adding semaglutide to treatment regimen for patients with Type II diabetes in Saudi Arabia
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Yazed AlRuthia, Khaled Hani Aburisheh, Sondus Ata, Raghad Bin Salleeh, Shahad B. Alqudhibi, Raghad B. Alqudhibi, Ziad Alkraidis, Hala Humood Alkhalaf, Abdulrahman Abdullah Almogirah, Muhammad Mujammami, and Reem Al Khalifah
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Semaglutide ,Diabetes ,Weight reduction ,Saudi Arabia ,Cost-effectiveness ,Medical cost ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Introduction: Semaglutide, a Glucagon-like Peptide-1 Receptor Agonist (GLP-1 RA), is often prescribed for managing type 2 diabetes, particularly in cases unresponsive to other hypoglycemic agents. Despite its popularity, the real-world efficacy and cost-effectiveness of Semaglutide relative to other treatments remain understudied. Objective: This study aimed to examine the direct medical cost and consequences of adding Semaglutide to the treatment regimen for patients with type 2 diabetes in Saudi Arabia. Methods: We conducted a single-center, retrospective review of Electronic Medical Records (EMRs) for adults with type 2 diabetes. Patients who had been on Semaglutide for at least three months were matched with those receiving alternative hypoglycemic therapies. Exclusions were made for patients with cancer, incomplete EMRs, or lacking prescription data. Investigated outcomes included changes in HbA1C levels and weight, and the direct costs comprised medications, clinic visits, and emergency care. Baseline adjustments were made through inverse probability treatment weighting, and uncertainty was assessed via bootstrapping with 10,000 replications. Results: Out of 350 patients meeting the criteria, 116 were on Semaglutide. Predominantly females (62%), the cohort had an average age of 60 and a disease duration of 22 years. The difference in HbA1C (%) reductions between Semaglutide and non-Semaglutide users over 3,6, and 12 months were 0.154 (95% CI: –0.452-0.483), –0.031(95% CI: –0.754-0.239), –0.16(95% CI: –1.425-0.840), respectively. Semaglutide users did experience modest weight reductions ranging from 0.42 kg to 1.16 kg. The annual additional direct medical cost for Semaglutide was USD 4,086.82 (95% CI: $3,710.85 - $4,294.99). Conclusion: Although Semaglutide induced modest weight reductions, it did not offer significant advantages in lowering HbA1C levels compared to other hypoglycemic treatments. These findings suggest the need for further research involving larger and more diverse cohorts to corroborate these findings.
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- 2024
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4. Label-free quantitative proteomics analysis for type 2 diabetes mellitus early diagnostic marker discovery using data-independent acquisition mass spectrometry (DIA-MS)
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Refat M. Nimer, Mahmoud A. Alfaqih, Eman R. Shehabat, Muhammad Mujammami, and Anas M. Abdel Rahman
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Medicine ,Science - Abstract
Abstract Type-2 diabetes mellitus (T2DM) therapy requires early diagnosis and complication avoidance. Unfortunately, current diagnostic markers do not meet these needs. Data-independent acquisition mass spectrometry (DIA-MS) offers a solution for clinical diagnosis, providing reliable and precise sample quantification. This study utilized DIA-MS to investigate proteomic differential expression in the serum of recently diagnosed T2DM patients. The study conducted a comparative protein expression analysis between healthy and recently diagnosed T2DM groups (discovery cohort). A candidate protein was then validated using enzyme-linked immune assay (ELISA) on serum samples collected from T2DM patients (n = 87) and healthy control (n = 60) (validation cohort). A total of 1074 proteins were identified, and 90 were significantly dysregulated between the two groups, including 32 newly associated with T2DM. Among these proteins, the expression of S100 calcium-binding protein A6 (S100A6) was validated by ELISA. It showed a significant increase in T2DM samples compared to the control group. It was evaluated as a biomarker using the receiver operating characteristic (ROC) curve, consistent with the DIA-MS results. Novel proteins are reported to be involved in the development and progression of T2DM. Further studies are required to investigate the differential expression of candidate marker proteins in a larger population of T2DM patients.
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- 2023
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5. Prevalence of QT prolongation and its risk factors in patients with type 2 diabetes
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Khaled Aburisheh, Mohammad F. AlKheraiji, Saleh I. Alwalan, Arthur C. Isnani, Mohamed Rafiullah, Muhammad Mujammami, and Assim A. Alfadda
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QTc prolongation ,diabetes ,ECG ,QTc interval ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Abstract Background QT prolongation increases cardiovascular mortality in diabetes. The risk factors for QT prolongation vary across different studies. There is no data on the QT prolongation in patients with diabetes from the Arab region, where diabetes is highly prevalent. Here we aimed to assess the prevalence of QT prolongation and its associated risk factors in patients with type 2 diabetes from Saudi Arabia. Method This was a retrospective, cross-sectional, hospital-based file review study. Data were collected from the medical records of patients with type 2 diabetes aged above 14 years and underwent ECG examination, and laboratory investigations were done within one month of ECG. Results The study included 782 patients with a prevalence of QTc prolongation of 13%. Patients with prolonged QTc interval were characterized by older age, higher BMI, longer diabetes duration, lower total cholesterol and LDL-C, and more diabetic nephropathy, hypertension, and CVD cases. They were also more in insulin treatment, antihypertensive medications, loop diuretics, and potassium-sparring diuretics. Logistic regression analysis revealed the odds of prolonged QTc interval increased significantly with CVD (OR = 1.761, 95% CI:1.021–3.036, p = 0.042), and usage of loop diuretics (OR = 2.245, 95% CI:1.023–4.923, p = 0.044) after adjusting for age, gender, and duration of diabetes. Conclusion The risk factors associated with QTc prolongation in patients with type 2 diabetes are CVD, and loop diuretics. Age, BMI, and diabetes duration were more in people with QTc prolongation, whereas total cholesterol and LDL-C levels were lower. More patients had diabetic nephropathy, hypertension, and CVD with prolonged QTc.
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- 2023
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6. Lipidomics Profiling of Metformin-Induced Changes in Obesity and Type 2 Diabetes Mellitus: Insights and Biomarker Potential
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Muhammad Mujammami, Shereen M. Aleidi, Adriana Zardini Buzatto, Awad Alshahrani, Reem H. AlMalki, Hicham Benabdelkamel, Mohammed Al Dubayee, Liang Li, Ahmad Aljada, and Anas M. Abdel Rahman
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lipidomics ,high resolution mass spectrometry ,metformin ,type 2 diabetes mellitus (T2DM) ,obesity ,biomarker ,Medicine ,Pharmacy and materia medica ,RS1-441 - Abstract
Metformin is the first-line oral medication for treating type 2 diabetes mellitus (T2DM). In the current study, an untargeted lipidomic analytical approach was used to investigate the alterations in the serum lipidome of a cohort of 89 participants, including healthy lean controls and obese diabetic patients, and to examine the alterations associated with metformin administration. A total of 115 lipid molecules were significantly dysregulated (64 up-regulated and 51 down-regulated) in the obese compared to lean controls. However, the levels of 224 lipid molecules were significantly dysregulated (125 up-regulated and 99 down-regulated) in obese diabetic patients compared to the obese group. Metformin administration in obese diabetic patients was associated with significant dysregulation of 54 lipid molecule levels (20 up-regulated and 34 down-regulated). Levels of six molecules belonging to five lipid subclasses were simultaneously dysregulated by the effects of obesity, T2DM, and metformin. These include two putatively annotated triacylglycerols (TGs), one plasmenyl phosphatidylcholine (PC), one phosphatidylglycerol (PGs), one sterol lipid (ST), and one Mannosyl-phosphoinositol ceramide (MIPC). This study provides new insights into our understanding of the lipidomics alterations associated with obesity, T2DM, and metformin and offers a new platform for potential biomarkers for the progression of diabetes and treatment response in obese patients.
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- 2023
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7. The association of cell adhesion molecules and selectins (VCAM-1, ICAM-1, E-selectin, L-selectin, and P-selectin) with microvascular complications in patients with type 2 diabetes: A follow-up study
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Khalid Siddiqui, Teena P. George, Muhammad Mujammami, Arthur Isnani, and Assim A. Alfadda
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adhesion molecule ,diabetic neuropathy ,diabetic retinopathy ,diabetic nephropathy ,complications ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
ObjectiveChronic hyperglycemia induces pathogenic changes in the vascular endothelium and leads to the development of microvascular complications in patients with type 2 diabetes mellitus. Early identification of markers of diabetes complications may help to minimize the risk of the development and progression of microvascular complications.MethodsThis follow-up study was conducted in type 2 diabetic cohort aged between 30-70 years. Out of 160 eligible participants, 70 of them completed follow-up. Levels of cell adhesion molecules and selectins (VCAM-1, ICAM-1, E-selectin, L-selectin and P-selectin) at baseline and follow-up were measured using Randox Evidence biochip analyzer (UK). Development of microvascular complications (diabetic neuropathy, retinopathy and nephropathy) was evaluated.ResultsDuring the follow-up (2 years, median), 31 (44.3%) developed diabetic neuropathy, 10 (14.3%) developed diabetic retinopathy and, 27 (38.6%) developed diabetic nephropathy. A significant difference in levels of cell adhesion molecules and selectins were found in type 2 diabetic patients with and without microvascular complications. Multiple logistic regression analysis reveals that baseline level of VCAM-1 is significantly associated with microvascular complications; diabetic neuropathy(p=0.028), retinopathy (p=0.007) and nephropathy(p=
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- 2023
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8. Proteomic Profiling Identifies Distinct Regulation of Proteins in Obese Diabetic Patients Treated with Metformin
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Awad Alshahrani, Ahmad Aljada, Afshan Masood, Muhammad Mujammami, Assim A. Alfadda, Mohthash Musambil, Ibrahim O. Alanazi, Mohammed Al Dubayee, Anas M. Abdel Rahman, and Hicham Benabdelkamel
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metformin ,proteomics ,obesity ,type 2 diabetes mellitus ,mass spectrometry ,Medicine ,Pharmacy and materia medica ,RS1-441 - Abstract
Background: Obesity and type 2 diabetes mellitus (T2DM) are characterized by underlying low-grade chronic inflammation. Metformin has been used as the first line of therapy in T2DM as it decreases hepatic glucose production and glucose intestinal absorption, enhances insulin sensitivity and weight loss, and is known to ameliorate inflammation. The mechanisms through which metformin exerts its effect remain unclear. Proteomics has emerged as a unique approach to explore the biological changes associated with diseases, including T2DM. It provides insight into the circulating biomarkers/mediators which could be utilized for disease screening, diagnosis, and prognosis. Methods: This study evaluated the proteomic changes in obese (Ob), obese diabetics (OD), and obese diabetic patients on metformin (ODM) using a 2D DIGE MALDI-TOF mass spectrometric approach. Results: Significant changes in sixteen plasma proteins (15 up and 1 down, ANOVA, p ≤ 0.05; fold change ≥ 1.5) were observed in the ODM group when compared to the Ob and OD groups. Bioinformatic network pathway analysis revealed that the majority of these altered plasma proteins are involved in distinct pathways involving acute-phase response, inflammation, and oxidative response and were centered around HNF4A, ERK, JNK, and insulin signaling pathways. Conclusions: Our study provides important information about the possible biomarkers altered by metformin treatment in obese patients with and without T2DM. These altered plasma proteins are involved in distinct pathways involving acute-phase response, inflammation, and oxidative response and were centered around HNF4A, ERK, JNK, and insulin signaling pathways. The presented proteomic profiling approach may help in identifying potential biomarkers/mediators affected by metformin treatment in T2DM and inform the understanding of metformin’s mechanisms of action.
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- 2023
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9. Targeted Metabolomics Analysis of Individuals Carrying the ANGPTL8 R59W Variant
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Mohamed Abu-Farha, Shibu Joseph, Anwar Mohammad, Arshad Channanath, Ibrahim Taher, Fahd Al-Mulla, Muhammad Mujammami, Thangavel Alphonse Thanaraj, Jehad Abubaker, and Anas M. Abdel Rahman
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ANGPTL8 ,R59W variant ,rs2278426 SNP ,metabolites ,metabolome ,inflammation ,Microbiology ,QR1-502 - Abstract
ANGPTL8 is recognized as a regulator of lipid metabolism through its role in inhibiting lipoprotein lipase activity. ANGPTL8 gene variants, particularly rs2278426 leading to the R59W variant in the protein, have been associated with lipid traits in various ethnicities. We aimed to use metabolomics to understand the impact of the ANGPTL8 R59W variant on metabolites in humans. We used the Biocrates-p400 kit to quantify 408 plasma metabolites in 60 adult male Arab individuals from Kuwait and identify differences in metabolite levels between individuals carrying reference genotypes and those with carrier genotypes at ANGPTL8 rs2278426. Individuals with carrier genotypes (CT+TT) compared to those carrying the reference genotype (CC) showed statistically significant differences in the following metabolites: acylcarnitine (perturbs metabolic pathways), phosphatidylcholine (supports liver function and cholesterol levels), cholesteryl ester (brings chronic inflammatory response to lipoprotein depositions in arteries), α-aminoadipic acid (modulates glucose homeostasis), histamine (regulates glucose/lipid metabolism), sarcosine (links amino acid and lipid metabolism), diacylglycerol 42:1 (regulates homeostasis of cellular lipid stores), and lysophosphatidylcholine (regulates oxidative stress and inflammatory response). Functional aspects attributed to these metabolites indicate that the ANGPTL8 R59W variant influences the concentrations of lipid- and inflammation-related metabolites. This observation further highlights the role of ANGPTL8 in lipid metabolism.
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- 2023
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10. Islet Autoantibodies to Pancreatic Insulin-Producing Beta Cells in Adolescent and Adults with Type 1 Diabetes Mellitus: A Cross-Sectional Study
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Khalid Siddiqui, Shaik Sarfaraz Nawaz, Assim A. Alfadda, and Muhammad Mujammami
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age ,autoantibody ,type 1 diabetes ,zinc transporter 8 ,tyrosine-phosphatase-like insulinoma type 2 ,Medicine (General) ,R5-920 - Abstract
(1) Background: Type 1 diabetes mellitus (T1D) is a chronic autoimmune disease caused by the destruction of pancreatic insulin-producing beta cells. T1D is one of the most common endocrine and metabolic disorders occurring in children. Autoantibodies against pancreatic insulin-producing beta cells are important immunological and serological markers of T1D. Zinc transporter 8 autoantibody (ZnT8) is a recently identified autoantibody in T1D; however, no data on ZnT8 autoantibody in the Saudi Arabian population have been reported. Thus, we aimed to investigate the prevalence of islet autoantibodies (IA-2 and ZnT8) in adolescents and adults with T1D according to age and disease duration. (2) Methods: In total, 270 patients were enrolled in this cross-sectional study. After meeting the study’s inclusion and exclusion criteria, 108 patients with T1D (50 men and 58 women) were assessed for T1D autoantibody levels. Serum ZnT8 and IA-2 autoantibodies were measured using commercial enzyme-linked immunosorbent assay kits. (3) Results: IA-2 and ZnT8 autoantibodies were present in 67.6% and 54.6% of patients with T1D, respectively. Autoantibody positivity was found in 79.6% of the patients with T1D. Both the IA-2 and ZnT8 autoantibodies were frequently observed in adolescents. The prevalence of IA-2 and ZnT8 autoantibodies in patients with a disease duration < 1 year was 100% and 62.5%, respectively, which declined with an increase in disease duration (p < 0.020). Logistic regression analysis revealed a significant relationship between age and autoantibodies (p < 0.004). (4) Conclusions: The prevalence of IA-2 and ZnT8 autoantibodies in the Saudi Arabian T1D population appears to be higher in adolescents. The current study also showed that the prevalence of autoantibodies decreased with disease duration and age. IA-2 and ZnT8 autoantibodies are important immunological and serological markers for T1D diagnosis in the Saudi Arabian population.
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- 2023
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11. Clinical presentation, evaluation and case management of primary empty sella syndrome: a retrospective analysis of 10-year single-center patient data
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Aishah A. Ekhzaimy, Muhammad Mujammami, Shabana Tharkar, Manahel A. Alansary, and Daad Al Otaibi
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Case management ,Empty Sella syndrome ,Hormone assessment ,Saudi Arabia ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Abstract Background Primary Empty Sella (PES) syndrome is an increasingly common disorder, mostly diagnosed as an incidental finding during brain imaging scans. We intended to review the clinical management and hormonal profile of patients with PES. Methods The study included ten-year retrospective analysis of registry containing PES cases in the period 2007 to 2017, from a single tertiary care center. The keyword ‘primary empty sella’ was used to retrieve patient details from the radiology unit. The clinical and biochemical profile of PES patients was analyzed. Case management of PES patients and their rate of referral to endocrinologists was explored. Results The registry had 765 cases with a male: female ratio of 1:3.8 suggesting female predominance by almost four times. Although not significant, the onset of disease was earlier for males [Mean ± standard deviation (SD) (46.7 years ±17.3 vs 48.8 years±14.1), p = 0.110]. Almost 79% of the cases were found as an incidental finding during Magnetic Resonance Imaging. Of the total PES cases, only 20% were referred to the endocrinologists and the rest were handled by general physicians. Only 1–2.5% of the cases were evaluated for gonadal, growth and adrenal hormones by the general physicians. The hormonal evaluation by the endocrinologists was also found to be sub-optimal. Headache and visual disturbances were the most common presenting complaints followed by menstrual abnormalities. Endocrine abnormalities like thyroid dysfunction, hyperprolactinemia, hypogonadism and hypocortisolism were highly prevalent among those assessed. Conclusion There is a gross under-evaluation of hormonal assessment and minimal case-referral to Endocrinologists. PES is associated with varying degrees of hormonal dysfunction, and hence early assessment and management is needed. Establishing a standard protocol for diagnosis and case management is essential with the involvement of a multidisciplinary team consisting of endocrinologists, neurologists, primary care phys icians and ophthalmologists.
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- 2020
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12. Association of urinary non-albumin protein with the different urinary marker for glomerular and tubular damage in patients with type 2 diabetes
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Khalid Siddiqui, Salini Scaria Joy, Shaik Sarfaraz Nawaz, Dhekra Alnaqeb, Muhammad Mujammami, and Khalid Al-Rubeaan
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Non-albumin protein ,Total protein ,Transferrin ,Retinol-binding protein ,Neutrophil gelatinase-associated lipocalin ,Urinary markers ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background/aim In recent years, the diagnostic utility of urinary protein levels has been demonstrated for the early detection and progression of kidney disease. This study aimed to evaluate the associations of the non-albumin protein (NAP) with different urinary marker for tubular and glomerular damage in patients with type 2 diabetes (T2D). Methods In this observational cross-sectional study, 424 patients with T2D duration > 10 years were classified into two groups according to estimated glomerular filtration rate (eGFR). The ratios of different urinary markers (albumin, NAP, total protein, transferrin, retinol-binding protein (RBP), and neutrophil gelatinase-associated lipocalin (NGAL) to creatinine were analyzed. Results The levels of urinary biomarkers increased significantly with decrease in eGFR levels. In the group with moderately decreased eGFR, the albumin to-creatinine ratio (ACR), non-albumin protein-to-creatinine ratio (NAPCR), and total protein-to-creatinine ratio (PCR) were independently associated with all urinary markers after being adjusted for risk factors. The area under the receiver operating characteristics (ROC) curve for ACR and PCR had a better diagnostic value than other urinary biomarkers. Comparing ROC curve of NAPCR with other urinary biomarkers, it was significantly better than NGAL/Cr (p = 0.033). Conclusions The findings of the present study confirm that ACR and PCR are diagnostic biomarkers in T2D patients with decreased eGFR. NAPCR in these patients diagnostically only outperformed NGAL/Cr.
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- 2020
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13. Rare occurrence of central diabetes insipidus with dermatomyositis in a young male
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Aishah Ekhzaimy, Afshan Masood, Seham Alzahrani, Waleed Al-Ghamdi, Daad Alotaibi, and Muhammad Mujammami
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Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Central diabetes insipidus (CDI) and several endocrine disorders previously classified as idiopathic are now considered to be of an autoimmune etiology. Dermatomyositis (DM), a rare autoimmune condition characterized by inflammatory myopathy and skin rashes, is also known to affect the gastrointestinal, pulmonary, and rarely the cardiac systems and the joints. The association of CDI and DM is extremely rare. After an extensive literature search and to the best of our knowledge this is the first reported case in literature, we report the case of a 36-year-old male with a history of CDI, who presented to the hospital’s endocrine outpatient clinic for evaluation of a 3-week history of progressive facial rash accompanied by weakness and aching of the muscles.
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- 2020
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14. A Metabolic Pattern in Healthy Subjects Given a Single Dose of Metformin: A Metabolomics Approach
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Lina A. Dahabiyeh, Muhammad Mujammami, Tawfiq Arafat, Hicham Benabdelkamel, Assim A. Alfadda, and Anas M. Abdel Rahman
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metabolomics ,metformin ,branched-chain amino acids ,mass spectrometry ,glycerophospholipid ,eicosanoids ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Metformin is a widely prescribed medication for the treatment of type 2 diabetes mellitus (T2DM). It possesses effective roles in various disorders, including cancer, dyslipidemia, and obesity. However, the underlying mechanisms of metformin's multiple benefits are not fully understood. Herein, a mass spectrometry-based untargeted metabolomics approach was used to investigate the metabolic changes associated with the administration of a single dose of metformin in the plasma of 26 healthy subjects at five-time points; pre-dose, before the maximum concentration of metformin (Cmax), Cmax, after Cmax, and 36 h post-dose. A total of 111 metabolites involved in various biochemical processes were perturbed, with branched-chain amino acid (BCAA) being the most significantly altered pathway. Additionally, the Pearson similarity test revealed that 63 metabolites showed a change in their levels dependent on metformin level. Out of these 63, the level of 36 metabolites was significantly altered by metformin. Significantly altered metformin-dependent metabolites, including hydroxymethyl uracil, propionic acid, glycerophospholipids, and eicosanoids, pointed to fundamental biochemical processes such as lipid network signaling, energy homeostasis, DNA lesion repair mechanisms, and gut microbiota functions that could be linked to the multiple beneficial roles of metformin. Thus, the distinctive metabolic pattern linked to metformin administration can be used as a metabolic signature to predict the potential effect and mechanism of actions of new chemical entities during drug development.
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- 2021
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15. Lipids Alterations Associated with Metformin in Healthy Subjects: An Investigation Using Mass Spectrometry Shotgun Approach
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Lina A. Dahabiyeh, Muhammad Mujammami, Reem H. AlMalki, Tawfiq Arafat, Hicham Benabdelkamel, Assim A. Alfadda, and Anas M. Abdel Rahman
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metformin ,arachidonic acid ,sphingosine-1-phosphate ,hydroxyeicosatetraenoic acids (HETE) ,glycerophospholipid ,cancer ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
Metformin is an orally effective insulin-sensitizing drug widely prescribed for treating type 2 diabetes mellitus (T2DM). Metformin has been reported to alter lipid metabolism. However, the molecular mechanisms behind its impact on lipid metabolism remain partially explored and understood. In the current study, mass spectrometry-based lipid profiling was used to investigate the lipidomic changes in the serum of 26 healthy individuals after a single-dose intake of metformin. Samples were analyzed at five-time points: preadministration, before the maximum concentration of metformin (Cmax), Cmax, after Cmax, and 36 h post-administration. A total of 762 molecules were significantly altered between the five-time points. Based on a comparison between baseline level and Cmax, metformin significantly increased and decreased the level of 33 and 192 lipids, respectively (FDR ≤ 0.05 and fold change cutoff of 1.5). The altered lipids are mainly involved in arachidonic acid metabolism, steroid hormone biosynthesis, and glycerophospholipid metabolism. Furthermore, several lipids acted in an opposed or similar manner to metformin levels and included fatty acyls, sterol lipids, glycerolipids, and glycerophospholipids. The significantly altered lipid species pointed to fundamental lipid signaling pathways that could be linked to the pleiotropic effects of metformin in T2DM, insulin resistance, polycystic ovary syndrome, cancer, and cardiovascular diseases.
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- 2022
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16. Obesity Connected Metabolic Changes in Type 2 Diabetic Patients Treated With Metformin
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Shereen M. Aleidi, Lina A. Dahabiyeh, Xinyun Gu, Mohammed Al Dubayee, Awad Alshahrani, Hicham Benabdelkamel, Muhammad Mujammami, Liang Li, Ahmad Aljada, and Anas M. Abdel Rahman
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metabolomics ,metformin ,obesity ,body mass index-BMI ,type 2 diabete mellitus ,mass spectrometry-LC-MS/MS ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Metformin is widely used in the treatment of Type 2 Diabetes Mellitus (T2DM). However, it is known to have beneficial effects in many other conditions, including obesity and cancer. In this study, we aimed to investigate the metabolic effect of metformin in T2DM and its impact on obesity. A mass spectrometry (MS)-based metabolomics approach was used to analyze samples from two cohorts, including healthy lean and obese control, and lean as well as obese T2DM patients on metformin regimen in the last 6 months. The results show a clear group separation and sample clustering between the study groups due to both T2DM and metformin administration. Seventy-one metabolites were dysregulated in diabetic obese patients (30 up-regulated and 41 down-regulated), and their levels were unchanged with metformin administration. However, 30 metabolites were dysregulated (21 were up-regulated and 9 were down-regulated) and then restored to obese control levels by metformin administration in obese diabetic patients. Furthermore, in obese diabetic patients, the level of 10 metabolites was dysregulated only after metformin administration. Most of these dysregulated metabolites were dipeptides, aliphatic amino acids, nucleic acid derivatives, and urea cycle components. The metabolic pattern of 62 metabolites was persistent, and their levels were affected by neither T2DM nor metformin in obesity. Interestingly, 9 metabolites were significantly dysregulated between lean and obese cohorts due to T2DM and metformin regardless of the obesity status. These include arginine, citrulline, guanidoacetic acid, proline, alanine, taurine, 5-hydroxyindoleacetic acid, and 5-hydroxymethyluracil. Understanding the metabolic alterations taking place upon metformin treatment would shed light on possible molecular targets of metformin, especially in conditions like T2DM and obesity.
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- 2021
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17. Proteomic Analysis of Endometrial Cancer Tissues from Patients with Type 2 Diabetes Mellitus
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Muhammad Mujammami, Mohamed Rafiullah, Assim A. Alfadda, Khalid Akkour, Ibrahim O. Alanazi, Afshan Masood, Mohthash Musambil, Hani Alhalal, Maria Arafah, Anas M. Abdel Rahman, and Hicham Benabdelkamel
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uterus ,endometrial cancer ,diabetes ,tissue ,proteomics ,2D-DIGE ,Science - Abstract
Endometrial cancer (EC) is the most common form of gynecological cancer. Type 2 diabetes mellitus is associated with an increased risk of EC. Currently, no proteomic studies have investigated the role of diabetes in endometrial cancers from clinical samples. The present study aims to elucidate the molecular link between diabetes and EC using a proteomic approach. Endometrial tissue samples were obtained from age-matched patients (EC Diabetic and EC Non-Diabetic) during surgery. Untargeted proteomic analysis of the endometrial tissues was carried out using a two-dimensional difference in gel electrophoresis (2D-DIGE) coupled with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI TOF). A total of 53 proteins were identified, with a significant difference in abundance (analysis of variance (ANOVA) test, p ≤ 0.05; fold-change ≥ 1.5) between the two groups, among which 30 were upregulated and 23 downregulated in the EC Diabetic group compared to EC Non-Diabetic. The significantly upregulated proteins included peroxiredoxin-1, vinculin, endoplasmin, annexin A5, calreticulin, and serotransferrin. The significantly downregulated proteins were myosin regulatory light polypeptide 9, Retinol dehydrogenase 12, protein WWC3, intraflagellar transport protein 88 homolog, superoxide dismutase [Cu-Zn], and retinal dehydrogenase 1. The network pathway was related to connective tissue disorder, developmental disorder, and hereditary disorder, with the identified proteins centered around dysregulation of ERK1/2 and F Actin signaling pathways. Cancer-associated protein alterations such as upregulation of peroxiredoxin-1, annexin 5, and iNOS, and downregulation of RDH12, retinaldehyde dehydrogenase 1, SOD1, and MYL 9, were found in the EC tissues of the diabetic group. Differential expression of proteins linked to cancer metastasis, such as the upregulation of vinculin and endoplasmin and downregulation of WWC3 and IFT88, was seen in the patients with diabetes. Calreticulin and alpha-enolase, which might have a role in the interplay between diabetes and EC, need further investigation.
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- 2022
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18. Type 1 Diabetes Mellitus in Saudi Arabia: A Soaring Epidemic
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Asirvatham Alwin Robert, Abdulrahman Al-Dawish, Muhammad Mujammami, and Mohamed Abdulaziz Al Dawish
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Pediatrics ,RJ1-570 - Abstract
Type 1 diabetes mellitus (T1DM) is quite prevalent in the world, with a proportion of 1 in every 300 persons and steadily rising frequency of incidence of about 3% every year. More alarmingly, the incidence of T1DM among infants is also increasing, with children as young as 6 months succumbing to it, instead of that at a rather established vulnerable age of around seven and near puberty, when the hormones antagonize the action of insulin. These reports pose a unique challenge of developing efficient T1DM management system for the young children. The Kingdom of Saudi Arabia (KSA) is the largest country in the Middle East that occupies approximately four-fifths of the Arabian Peninsula supporting a population of more than 33.3 million people, of whom 26% are under the age of 14 years. As per the Diabetes Atlas (8th edition), 35,000 children and adolescents in Saudi Arabia suffer from T1DM, which makes Saudi Arabia rank the 8th in terms of numbers of TIDM patients and 4th country in the world in terms of the incidence rate (33.5 per 100,000 individuals) of TIDM. However, in comparison with that in the developed countries, the number of research interventions on the prevalence, incidence, and the sociodemographic aspects of T1DM is woefully inadequate. In this review we discuss different aspects of T1DM in Saudi Arabia drawing on the published literature currently available.
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- 2018
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19. Low Circulating Free Triiodothyronine Levels are Associated with the Progression of Diabetic Nephropathy in Patients with Type 2 Diabetes
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Khalid Siddiqui, Shaik Sarfaraz Nawaz, Assim A Alfadda, and Muhammad Mujammami
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International Journal of General Medicine ,General Medicine - Abstract
Khalid Siddiqui,1 Shaik Sarfaraz Nawaz,1 Assim A Alfadda,1â 3 Muhammad Mujammami1,2,4 1Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Department of Medicine, College of Medicine, and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia; 3Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 4University Diabetes Center, King Saud University Medical City, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Khalid Siddiqui, Strategic Center for Diabetes Research, College of Medicine, King Saud University, P.O. Box 245, Riyadh, 11411, Saudi Arabia, Tel +966 114724179 Ext.3106, Fax +966 114725682, Email ksiddiqui@ksu.edu.saBackground: Diabetic Nephropathy (DN) is one of the most typical causes of end-stage renal disease and thyroid hormone exerts effects on the kidney. There are few reports on the role of thyroid hormone in the progression of DN. We aimed to assess the relationship between thyroid hormone and DN.Methods: In this cross-sectional study, 400 patients with type 2 diabetes (T2D) (aged between 35 and 70 years) were divided into two groups T2D control and DN group according to albumin creatinine ratio (ACR). Clinical biochemistry parameters were measured using the Rx Daytona chemistry analyzer and thyroid hormone levels (TT4, TT3, TSH, FT4, and FT3) using the Evidence Biochip analyzer. To assess the relationship between thyroid hormone and DN, multiple logistic regression models were developed.Results: Serum FT4 and FT3 levels were significantly lower in DN compared to T2D controls (p< 0.05). Thyroid hormone levels tend to decrease with the progression of DN. In unadjusted and adjusted logistic regression models, FT3 levels were negatively associated with odds of having DN (OR=0.28, CI=0.128â 0.616, p=0.002).Conclusion: The free triiodothyronine level was negatively associated with the progression of DN. Further longitudinal studies are required to assess the cause of thyroid hormone differences.Keywords: diabetic nephropathy, type 2 diabetes, thyroid hormone
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- 2022
20. Clinical significance of Saussurea Costus in thyroid treatment
- Author
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Muhammad Mujammami
- Subjects
Saussurea ,endocrine system ,endocrine system diseases ,Bioactive molecules ,Anti-Inflammatory Agents ,Saudi Arabia ,Review Article ,030204 cardiovascular system & hematology ,Plant Roots ,clinical ,thyroid ,03 medical and health sciences ,0302 clinical medicine ,Hypothyroidism ,medicine ,Humans ,Clinical significance ,030212 general & internal medicine ,Flavonoids ,treatment ,biology ,Traditional medicine ,Plant Extracts ,business.industry ,Thyroid disease ,Thyroid ,General Medicine ,Anti-Ulcer Agents ,biology.organism_classification ,medicine.disease ,Antineoplastic Agents, Phytogenic ,Saussurea costus ,medicine.anatomical_structure ,Thyroid hormones ,Medicine, Traditional ,business ,Costus ,Phytotherapy - Abstract
Saussurea costus (S. costus) belongs to family of Asteraceae and is one of the therapeutic plants extensively used as a traditional medicine in Saudi Arabia. Constituents of this plant have the potential to be developed as bioactive molecules. Among Arabs, the prevalence of thyroid disorders ranges from 6.18 % to 47.34% and hypothyroidism has been reported to be the most prevalent. Although there is no natural treatment that can directly replace thyroid hormones, their role as an alternate treatment or as an add-on to available thyroid treatment has been explored. Flavanoids and antioxidant properties of S. costus may be an important mechanism involved in supporting its medicinal use. Current data on the possible role of S. costus in thyroid disorders is lacking and the available evidence is inconclusive. This review deal with the current understanding of use and myth regarding the use of this medicinal plant in thyroid disease.
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- 2020
21. Evaluation of Risk Factors for Diabetic Peripheral Neuropathy Among Saudi Type 2 Diabetic Patients with Longer Duration of Diabetes
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Nawaf A Alshammari, Abdulaziz A Alodhayani, Salini S Joy, Arthur Isnani, Muhammad Mujammami, Assim A Alfadda, and Khalid Siddiqui
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Pharmacology ,Internal Medicine ,Targets and Therapy [Diabetes, Metabolic Syndrome and Obesity] - Abstract
Nawaf A Alshammari,1,2,* Abdulaziz A Alodhayani,3,* Salini S Joy,4 Arthur Isnani,5 Muhammad Mujammami,1,4,6 Assim A Alfadda,4â 6 Khalid Siddiqui4 1University Diabetes Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia; 2King Salman Specialist Hospital, Diabetes and Endocrine Center, Hail Health Cluster, Hail, Hail Region, Saudi Arabia; 3Department of Family and Community Medicine College of Medicine, King Saud University, Riyadh, Saudi Arabia; 4Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 5Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 6Department of Medicine, College of Medicine, and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia*These authors contributed equally to this workCorrespondence: Khalid Siddiqui, Strategic Center for Diabetes Research, College of Medicine, King Saud University, P.O. Box 245, Riyadh, 11411, Saudi Arabia, Email ksiddiqui@ksu.edu.saBackground: Neuropathy is the most common microvascular complications among diabetic patients. Diabetic peripheral neuropathy (DPN) is the predominant variety which may associate with increased in mortality and morbidity among type 2 diabetes mellitus (T2DM).Objective: To assess the prevalence of diabetic peripheral neuropathy and its correlation with risk factors among T2DM.Methods: This was a cross-sectional retrospective study, data was collected from a previous cohort study conducted at the University Diabetes Center, King Saud University Medical City (KSUMC), King Saud University, Riyadh, Saudi Arabia. The data of T2DM patients were collected from case report form, included demographic data, history of chronic diabetes neuropathy, and laboratory reports. Statistical analysis includes Student`s t test, chi square test, and Pearson correlation and logistic regression were performed.Results: A total of 430 patients with T2DM data was collected and analyzed, and of them 54% were females, with the mean age of 55.88 years. The prevalence of diabetic neuropathy among study participants were 40.2%, and 73.3% of them having the subtype polyneuropathy. The mean BMI; p = 0.006, FBS; p < 0.001, HbA1c; p < 0.001, cholesterol p = 0.001, LDL; p < 0.001, and triglyceride; p < 0.001 levels were a significantly higher among participants with diabetic neuropathy than without neuropathy. The male gender (Risk Ratio: 1.294, 95% CI:1.090, 1.536) p = 0.003, fasting blood glucose (Risk Ratio: 1.157, 95% CI:1.051, 1.273) p = 0.003 Cholesterol (Risk Ratio: 1.588, 95% CI:1.174, 2.147) p = 0.003, triglyceride (Risk Ratio: 1.290, 95% CI:1.086, 1.538), p = 0.004, and LDL (Risk Ratio: 1.299, 95% CI:1.073, 1.574), p = 0.007) were found to be significant risk factors for DPN.Conclusion: DPN is highly prevalent among T2DM patients in Saudi Arabia. Poor glycemic control and hyperlipidemia were associated with significantly higher risk for DPN patients among T2DM.Keywords: diabetic peripheral neuropathy, hyperlipidemia, glycemic control, type 2 diabetes
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- 2022
22. Variation in the Level of Thyroid Markers in Association with Inflammation in Patients with Type 2 Diabetes
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Khalid Siddiqui, Salini Scaria Joy, Teena P George, and Muhammad Mujammami
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Adult ,Blood Glucose ,Male ,Thyroid Hormones ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Saudi Arabia ,Thyroid Gland ,Thyrotropin ,Blood Pressure ,Inflammation ,Type 2 diabetes ,Thyroid Function Tests ,Carbohydrate metabolism ,Body Mass Index ,Insulin resistance ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Immunology and Allergy ,Aged ,business.industry ,Thyroid ,Middle Aged ,medicine.disease ,Cross-Sectional Studies ,Endocrinology ,medicine.anatomical_structure ,Diabetes Mellitus, Type 2 ,Thyroid hormones ,Female ,Insulin Resistance ,medicine.symptom ,Thyroid function ,business ,Biomarkers - Abstract
Background: A possible relationship between thyroid hormones and glucose metabolism in diabetes has already been established. Objectives: We aimed to evaluate the thyroid function markers and their relationship with inflammation, which is considered as a pathogenic condition of diabetes. Methods: This cross-sectional study included 276 patients with type 2 diabetes. Serum levels of thyroid (TSH, FT4, and FT3) and inflammatory markers (CRP, IL-6, and TNF-α) were measured. Results: The mean age of the subjects was 55.2 years and mean diabetes duration of 16.8 years. The inflammatory markers showed significant differences with the tertiles of TSH and thyroid hormones. TSH was significantly correlated with inflammatory markers, IL-6 (r = 0.13, P = 0.020) and TNF-α (r = 0.17, P = 0.003), while FT4 had a correlation only with TNF-α (r = 0.25, P = Conclusion: Abnormalities in the thyroid hormone metabolism are related to the increased inflammatory activity as well as insulin resistance, and are associated with the disorders of glucose metabolism.
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- 2020
23. Association of urinary non-albumin protein with the different urinary marker for glomerular and tubular damage in patients with type 2 diabetes
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Dhekra AlNaqeb, Khalid Siddiqui, Khalid Al-Rubeaan, Salini Scaria Joy, Muhammad Mujammami, and Shaik Sarfaraz Nawaz
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Nephrology ,Male ,medicine.medical_specialty ,Urinary system ,Kidney Glomerulus ,030232 urology & nephrology ,Urology ,Renal function ,030209 endocrinology & metabolism ,Type 2 diabetes ,Lipocalin ,lcsh:RC870-923 ,Total protein ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Lipocalin-2 ,Internal medicine ,Albumins ,medicine ,Albuminuria ,Humans ,Diabetic Nephropathies ,Tubular markers and glomerular marker ,Creatinine ,Neutrophil gelatinase-associated lipocalin ,business.industry ,Albumin ,Transferrin ,Middle Aged ,medicine.disease ,lcsh:Diseases of the genitourinary system. Urology ,Retinol-Binding Proteins ,Proteinuria ,Kidney Tubules ,chemistry ,Diabetes Mellitus, Type 2 ,Retinol-binding protein ,Non-albumin protein ,Urinary markers ,Female ,business ,Kidney disease ,Glomerular Filtration Rate ,Research Article - Abstract
Background/aim In recent years, the diagnostic utility of urinary protein levels has been demonstrated for the early detection and progression of kidney disease. This study aimed to evaluate the associations of the non-albumin protein (NAP) with different urinary marker for tubular and glomerular damage in patients with type 2 diabetes (T2D). Methods In this observational cross-sectional study, 424 patients with T2D duration > 10 years were classified into two groups according to estimated glomerular filtration rate (eGFR). The ratios of different urinary markers (albumin, NAP, total protein, transferrin, retinol-binding protein (RBP), and neutrophil gelatinase-associated lipocalin (NGAL) to creatinine were analyzed. Results The levels of urinary biomarkers increased significantly with decrease in eGFR levels. In the group with moderately decreased eGFR, the albumin to-creatinine ratio (ACR), non-albumin protein-to-creatinine ratio (NAPCR), and total protein-to-creatinine ratio (PCR) were independently associated with all urinary markers after being adjusted for risk factors. The area under the receiver operating characteristics (ROC) curve for ACR and PCR had a better diagnostic value than other urinary biomarkers. Comparing ROC curve of NAPCR with other urinary biomarkers, it was significantly better than NGAL/Cr (p = 0.033). Conclusions The findings of the present study confirm that ACR and PCR are diagnostic biomarkers in T2D patients with decreased eGFR. NAPCR in these patients diagnostically only outperformed NGAL/Cr.
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- 2020
24. Risk Predictors of High Uric Acid Levels Among Patients with Type-2 Diabetes
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Zobeida Eljaaly, Muhammad Mujammami, Shaik Sarfaraz Nawaz, Mohamed Rafiullah, and Khalid Siddiqui
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Pharmacology ,uric acid ,diabetes ,education ,gender ,Saudi Arabia ,Internal Medicine ,risk factors ,hyperuricemia ,Targets and Therapy [Diabetes, Metabolic Syndrome and Obesity] ,Original Research - Abstract
Zobeida Eljaaly,1,2,* Muhammad Mujammami,1â 3,* Shaik Sarfaraz Nawaz,3 Mohamed Rafiullah,3 Khalid Siddiqui3 1University Diabetes Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia; 2Division of Endocrinology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 3Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia*These authors contributed equally to this workCorrespondence: Khalid SiddiquiStrategic Center for Diabetes Research, College of Medicine, King Saud University, P.O. Box 245, Riyadh, 11411, Saudi ArabiaEmail ksiddiqui@ksu.edu.saObjective: Patients with diabetes are at higher risk of the negative consequences of hyperuricemia. The objective of this study was to investigate gender and age-specific differences in the uric acid levels and to evaluate the associated risk factors among patients with diabetes.Methods: A retrospective cross-sectional study was conducted at Strategic Center for Diabetes Research from September 2019 to January 2020, among adult type-2 diabetic patients. Serum uric acid (SUA) and several other metabolic and clinical parameters were examined. Multiple regression analysis was done to identify risk factors independently associated with hyperuricemia.Results: A total of 433 patients were included in the analysis. SUA level was higher in males than females (5.82± 1.65 mg/dL versus 5.29± 1.54 mg/dL, p < 0.001). The prevalence of hyperuricemia was higher in females than males (28.8% versus 20.5%, p = 0.049). There was no significant difference in uric acid levels or the prevalence of hyperuricemia by age groups in the total sample or gender-stratified samples. In multivariate analysis, hyperuricemia was associated with bigger hip circumference (odds ratios [OR] were 1.03, 95% CI = 1.01â 1.05), higher triglycerides (OR = 1.005, 95% CI = 1.002â 1.008), and higher serum creatinine (OR = 1.34, 95% CI = 1.21â 1.49). Hip circumference, total cholesterol, high-density lipoprotein, and serum creatinine were independent risk factors in males, while triglycerides and higher serum creatinine were independent risk factors among females.Conclusion: The present study demonstrates gender-specific differences in the uric acid levels and hyperuricemia prevalence. In males and females, hyperuricemia was associated with hip circumference, total cholesterol, high-density lipoprotein, triglycerides, and serum creatinine. Future large studies are needed to confirm our findings, especially in elderly females.Keywords: uric acid, hyperuricemia, gender, diabetes, risk factors, Saudi Arabia
- Published
- 2021
25. Determinant of Osteopontin Levels in Microvascular Complications in Patients with Diabetes
- Author
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Shaik Sarfaraz Nawaz, Khalid Siddiqui, Muhammad Mujammami, Obeed Alotaibi, Saud Sulaiman Alanazi, and Mohamed Rafiullah
- Subjects
stomatognathic system ,education ,International Journal of General Medicine ,General Medicine - Abstract
Shaik Sarfaraz Nawaz,1,* Khalid Siddiqui,1,* Muhammad Mujammami,1â 3 Obeed Alotaibi,2 Saud Sulaiman Alanazi,1 Mohamed Rafiullah1 1Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2University Diabetes Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia; 3Division of Endocrinology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia*These authors contributed equally to this workCorrespondence: Khalid Siddiqui, Strategic Center for Diabetes Research, College of Medicine, King Saud University, P.o Box: 245, Riyadh, 11411, Saudi Arabia, Tel +966 114724179 Ext.3106, Fax +966 114725682, Email ksiddiqui@ksu.edu.saBackground: Osteopontin (OPN) is a 44-kDa multifunctional protein and has a diverse role in biomineralization, tissue remodeling, and chronic inflammation. However, its role in type 2 diabetes (T2D) patients with microvascular complications is not clear. Therefore, the present study aimed to investigate the role of OPN in T2D patients with microvascular complications.Methods: A total of 324 type 2 diabetes patients in the age group of 38â 66 years were included in this study; 249 T2D patients were diagnosed with microvascular complications. OPN was measured using an enzyme-linked immunosorbent assay kit. Clinical data, such as age, gender, diabetes duration, systolic blood pressure, diastolic blood pressure, were measured. Correlation between OPN levels with different clinical parameters was evaluated.Results: In patients with microvascular complications, OPN levels were significantly higher than those without microvascular complications (p < 0.05). Moreover, OPN levels were positively associated with systolic blood pressure (SBP), C-reactive protein, and albumin creatinine ratio (ACR). Multiple linear regression analysis showed that OPN levels were independently associated with C-reactive protein (p < 0.045).Conclusion: The findings in the present study showed that OPN level was more positively associated with C-reactive protein than that with glucose metabolism in patients with microvascular complications. Thus, OPN might serve as a marker in predicting vascular disease.Keywords: osteopontin, diabetes, microvascular complication, inflammation, C-reactive protein
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- 2021
26. Fructosamine as an Index of Short-Term Glycemic Control in Pregnant Women with Diabetes: Before, During and After Ramadan
- Author
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Aishah Ekhzaimy, Shadin Alkatari, Mohamed AlMaatouq, Daad Alotaibi, Sarah Aljasser, Amal Aseeri, Anwar Jammah, Muhammad Mujammami, Mona Fouda, Assim A Alfadda, and Riad Sulaimani
- Subjects
Oncology ,education ,Maternity and Midwifery ,International Journal of Women's Health ,Obstetrics and Gynecology - Abstract
Aishah Ekhzaimy,1 Shadin Alkatari,1 Mohamed AlMaatouq,1 Daad Alotaibi,1 Sarah Aljasser,1 Amal Aseeri,1 Anwar Jammah,1 Muhammad Mujammami,1â 3 Mona Fouda,1 Assim A Alfadda,1,2,4 Riad Sulaimani1 1Division of Endocrinology, Department of Medicine, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia; 2Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia; 3University Diabetes Center, King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia; 4Obesity Research Center, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi ArabiaCorrespondence: Aishah Ekhzaimy, Division of Endocrinology, Department of Medicine, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia, Email aishahekhzaimy@hotmail.comPurpose: Impact of ramadan fasting on healthy and women with diabetes is already known. However, there is a scarcity of data on impact of fasting on pregnant women with diabetes. Moreover, religious and medical recommendations advise pregnant women against fasting as it is unsafe. Despite being exempted, many pregnant Muslim women with diabetes still choose to fast during ramadan. This study investigated different glycemic marker as an indicator for diabetes control in fasting pregnant women.Patients and Methods: This is a prospective observational study. A total of 89 pregnant diabetes women were recruited. Blood glucose was self-monitored in all the pregnant women using glucose monitoring device at home. We measure the fructosamine, HbA1c levels before, during and after ramadan.Results: Pregnant women with type 1 diabetes were 14 (25%), type 2 diabetes were 21 (37.5%), and gestational diabetes were 21 (37.5%). The mean fructosamine level decreased during and after ramadan in gestation diabetes pregnant women compared to type 2 diabetes and type 1 diabetes pregnant women subjects (p = 0.009).Conclusion: The present study indicates that pregnant women with diabetes were able to fast during ramadan and there fructosamine level reduced during fasting. Utilization of fructosamine for short-term monitoring of glycemic control in addition to home glucose monitoring in pregnant women with diabetes will provide a good index of glycemic control.Recommendation: Religious and medical recommendations advise pregnant women against fasting as it is unsafe, and they are under high risk. However, if they insist to do fast, they must do under strict medical supervision and fructosamine can be used as a glycemic control marker.Keywords: ramadan fasting, gestational diabetes, type 2 diabetes, type 1 diabetes, pregnant women, fructosamine
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- 2021
27. Clinical presentation, evaluation and case management of primary empty sella syndrome: a retrospective analysis of 10-year single-center patient data
- Author
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Muhammad Mujammami, Aishah Ekhzaimy, Shabana Tharkar, Manahel A. Alansary, and Daad Al Otaibi
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Time Factors ,Referral ,Hormone Replacement Therapy ,Endocrinology, Diabetes and Metabolism ,Saudi Arabia ,030209 endocrinology & metabolism ,Disease ,Single Center ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,Empty sella syndrome ,Case management ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Humans ,Medicine ,Endocrine system ,Retrospective Studies ,Empty Sella syndrome ,lcsh:RC648-665 ,medicine.diagnostic_test ,business.industry ,Hormone assessment ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Pituitary Hormones ,Female ,Presentation (obstetrics) ,business ,human activities ,030217 neurology & neurosurgery ,Follow-Up Studies ,Research Article - Abstract
Background Primary Empty Sella (PES) syndrome is an increasingly common disorder, mostly diagnosed as an incidental finding during brain imaging scans. We intended to review the clinical management and hormonal profile of patients with PES. Methods The study included ten-year retrospective analysis of registry containing PES cases in the period 2007 to 2017, from a single tertiary care center. The keyword ‘primary empty sella’ was used to retrieve patient details from the radiology unit. The clinical and biochemical profile of PES patients was analyzed. Case management of PES patients and their rate of referral to endocrinologists was explored. Results The registry had 765 cases with a male: female ratio of 1:3.8 suggesting female predominance by almost four times. Although not significant, the onset of disease was earlier for males [Mean ± standard deviation (SD) (46.7 years ±17.3 vs 48.8 years±14.1), p = 0.110]. Almost 79% of the cases were found as an incidental finding during Magnetic Resonance Imaging. Of the total PES cases, only 20% were referred to the endocrinologists and the rest were handled by general physicians. Only 1–2.5% of the cases were evaluated for gonadal, growth and adrenal hormones by the general physicians. The hormonal evaluation by the endocrinologists was also found to be sub-optimal. Headache and visual disturbances were the most common presenting complaints followed by menstrual abnormalities. Endocrine abnormalities like thyroid dysfunction, hyperprolactinemia, hypogonadism and hypocortisolism were highly prevalent among those assessed. Conclusion There is a gross under-evaluation of hormonal assessment and minimal case-referral to Endocrinologists. PES is associated with varying degrees of hormonal dysfunction, and hence early assessment and management is needed. Establishing a standard protocol for diagnosis and case management is essential with the involvement of a multidisciplinary team consisting of endocrinologists, neurologists, primary care phys icians and ophthalmologists.
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- 2020
28. Self-awareness of HbA1c and its association with glycemic control among patients with type 2 diabetes: A multicenter study
- Author
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Abdullah M Alshahrani, Muhammad Mujammami, Mohammed A. Batais, Turki A. AlMogbel, Abdullah M. Al Zahrani, Turky H. Almigbal, Hiba Y Alraheem, and Joud Shabeeb Almutairi
- Subjects
medicine.medical_specialty ,Multicenter study ,business.industry ,Internal medicine ,Self-awareness ,medicine ,Type 2 diabetes ,medicine.disease ,business ,Association (psychology) ,Glycemic - Abstract
Background Diabetes-related complications can be prevented by maintaining good glycemic control. Despite huge efforts to obtain acceptable glycemic control among diabetics, this has not yet been achieved. Thus, there is a need to discover all factors that might affect glycemic control. Here, our main aim was to assess the association between self-awareness of Hemoglobin A1c (HbA1c) among Saudi patients with type 2 diabetes and glycemic control, thereby identifying those factors that might affect the glycemic control. Methods The data for this study was collected using questionnaires through interviews among 600 patients with type 2 diabetes. The study was conducted in outpatient diabetes clinics in tertiary hospitals in Riyadh, Qassim and Jeddah, Saudi Arabia. The data collection was done during the period from March and April 2018. The subject’s self-awareness about the HbA1c test was assessed based on the combined score of four questions. The latest HbA1c result before the time of data collection was obtained from medical records. Frequencies and percentages were calculated for all categorical variables used in the analysis. Means and standard deviations were calculated for continuous variables. A p-value of less than 0.05 was considered statistically significant for all analyses. Results The mean age of the respondents was 54.7 years, and the mean duration of diabetes was 11.9 years. The prevalence of HbA1c self-awareness was approximately 40%. Overall, 63.9% accurately reported their Hemoglobin A1C Self-Knowledge (HbA1csk). The prevalence of good glycemic control (defined as HbA1c less than 7.0%) was 21.0%. Five of the participants’ characteristics were associated with better glycemic control: good HbA1c self-awareness (OR = 3.25, 95%CI: 1.15–9.24), duration of diabetes (negatively associated with glycemic control) (OR = 0.91, 95%CI: 0.87–0.95), discussed HbA1c target with the health care provider (OR = 2.42, 95%CI: 1.22–4.79), monthly income between 10,001 and 15,000 SR (OR = 2.28, 95%CI: 1.13–4.60), and number of follow up visit (OR = 0.77, 95%CI: 0.63–0.94). Conclusions We conclude that there is a positive association between HbA1c self-awareness and glycemic control. Glycemic control was good among those who were educated about the meaning of the test, their levels, and their target goal. Awareness among health care providers regarding the role of the patient’s education about their condition might help in providing the patient with optimal care. Further studies with different experimental designs are needed to study this association, which will contribute to the development of a structured educational program.
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- 2020
29. Risk Stratification of Thyroid Nodules with Bethesda III Category: The Experience of a Territorial Healthcare Hospital
- Author
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Shuaa Asiri, Eyad Alkharashi, Salwa Hawsawi, Mohannad Alrasheed, Muneerah Alzouman, Asirvatham Alwin Robert, Muhammad Mujammami, Mohamed Abdulaziz Al Dawish, Khalid Al Shehri, and Ibrahim Ali Al Basha
- Subjects
Thyroid nodules ,medicine.medical_specialty ,aus/flus ,tsh ,Bethesda system ,Malignancy ,Thyroid carcinoma ,medicine ,Atypia ,risk of malignancy ,Thyroid cancer ,medicine.diagnostic_test ,business.industry ,thyroid nodules ,Thyroid ,General Engineering ,Endocrinology/Diabetes/Metabolism ,Nodule (medicine) ,medicine.disease ,ti-rads ,medicine.anatomical_structure ,Oncology ,Radiology ,medicine.symptom ,business ,bethesda - Abstract
Background The Bethesda System for Reporting Thyroid Cytolopathology (TBSRTC) is the standardized category-based reporting system for thyroid nodule (TN) aspirations; however, atypia of undetermined significance/follicular lesion of undetermined significance (Bethesda category III, AUS/FLUS) is the most controversial category. The aim of this study was to identify the degree of malignancy risk and the related risk factors in the surgical pathology of the Bethesda Category III thyroid nodules. Methods A total of 4074 patients (15-90 years, 81.5% of females) were subjected to retrospective analysis, and a total of 463 nodules were classified as Bethesda Class III and included in the analysis. Once all the thyroid cytopathological slides and ultrasound (US) reports were reviewed, they were classified according to the Bethesda System for Reporting Thyroid Cytology, the American College of Radiology (ACR) and the Thyroid Imaging Reporting and Data System (TI-RADS). Results Among the 463 Bethesda class III nodules, 167 nodules were surgically excised, showing an overall malignancy of 27.6% (n = 46/167). Patients having thyroid-stimulating hormone (TSH) levels of >4.5 mIU/L (35%), TN
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- 2020
30. Knowledge, awareness and perceptions of diabetes mellitus among the Saudi population
- Author
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Aishah Ekhzaimy, Abdulaziz A Alodhayani, Sultan Sayyaf Alanazi, Mohammad Ibrahim AlJabri, Ahmad Alhumaidi Alanazi, Abduelah Ghaith Alanazi, and Muhammad Mujammami
- Subjects
Adult ,Male ,medicine.medical_specialty ,Health Knowledge, Attitudes, Practice ,media_common.quotation_subject ,Health Personnel ,Population ,Saudi Arabia ,030209 endocrinology & metabolism ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Perception ,Health care ,medicine ,Diabetes Mellitus ,Prevalence ,Humans ,Obesity ,Risk factor ,education ,Curriculum ,media_common ,education.field_of_study ,Knowledge awareness ,business.industry ,Health Policy ,medicine.disease ,Health Surveys ,Cross-Sectional Studies ,Family medicine ,Female ,business - Abstract
Background: High prevalence of undiagnosed cases of diabetes mellitus (DM) has increased over the last two decades, most patients with DM only become aware of their condition once they develop a complication. Limited data are available regarding the knowledge and awareness about DM and the associated risk factors, complications and management in Saudi society. Aim: This study aimed to assess knowledge of DM in general Saudi society and among Saudi healthcare workers. Results: Only 37.3% of the participants were aware of the current DM prevalence. Obesity was the most frequently identified risk factor for DM. Most comparisons indicated better awareness among health workers. Conclusion: A significant lack of knowledge about DM in Saudi society was identified. Social media and educational curriculum can improve knowledge and awareness of DM.
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- 2020
31. Rare occurrence of central diabetes insipidus with dermatomyositis in a young male
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Daad Alotaibi, Waleed Al-Ghamdi, Seham Alzahrani, Afshan Masood, Aishah Ekhzaimy, and Muhammad Mujammami
- Subjects
Male ,genetic structures ,Endocrinology, Diabetes and Metabolism ,Levothyroxine ,Kidney ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,0302 clinical medicine ,White Blood Cell Count ,Outpatient clinic ,Testosterone ,Myasthaenia ,Antinuclear Antibody ,Creatine Kinase ,Thyroid ,TSH ,Diabetes ,Autoimmune disorders ,Rash ,C-Reactive Protein ,Nephrology ,030220 oncology & carcinogenesis ,Urine Osmolality ,Nocturia ,medicine.symptom ,Asian - other ,General practice ,Mri ,Weakness ,medicine.medical_specialty ,Thyroxine (T4) ,Saudi Arabia ,Hypothalamus ,030209 endocrinology & metabolism ,Dermatology ,Methylprednisolone ,Radiology/Rheumatology ,Inflammatory myopathy ,Adolescent/young adult ,03 medical and health sciences ,Hypothyroidism ,Desmopressin ,Internal Medicine ,medicine ,Polydipsia ,February ,lcsh:RC648-665 ,business.industry ,Polyuria ,Electromyography ,Hypogonadism ,Sodium ,Myalgia ,Dermatomyositis ,medicine.disease ,Antidiuretic Hormone ,Unique/Unexpected Symptoms or Presentations of a Disease ,Prolactin ,Oedema ,Pituitary ,Erythema ,Diabetes insipidus - neurogenic/central ,Diabetes insipidus ,Etiology ,Ft4 ,Differential diagnosis ,Erythrocyte Sedimentation Rate ,business ,Diabetes Insipidus - Abstract
Summary Central diabetes insipidus (CDI) and several endocrine disorders previously classified as idiopathic are now considered to be of an autoimmune etiology. Dermatomyositis (DM), a rare autoimmune condition characterized by inflammatory myopathy and skin rashes, is also known to affect the gastrointestinal, pulmonary, and rarely the cardiac systems and the joints. The association of CDI and DM is extremely rare. After an extensive literature search and to the best of our knowledge this is the first reported case in literature, we report the case of a 36-year-old male with a history of CDI, who presented to the hospital’s endocrine outpatient clinic for evaluation of a 3-week history of progressive facial rash accompanied by weakness and aching of the muscles. Learning points: Accurate biochemical diagnosis should always be followed by etiological investigation. This clinical entity usually constitutes a therapeutic challenge, often requiring a multidisciplinary approach for optimal outcome. Dermatomyositis is an important differential diagnosis in patients presenting with proximal muscle weakness. Associated autoimmune conditions should be considered while evaluating patients with dermatomyositis. Dermatomyositis can relapse at any stage, even following a very long period of remission. Maintenance immunosuppressive therapy should be carefully considered in these patients.
- Published
- 2020
32. The Validity of using a Single-Question Self-Report of Erectile Dysfunction as a Screening Tool among Men with Type 2 Diabetes Mellitus
- Author
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Mohammed A. Batais, Turki A. Binmoammar, Khaled K. ldossari, Muhammad Mujammami, Turky H. Almigbal, Mashael M. Al-Enzi, and Talal Alghamdi
- Subjects
Response rate (survey) ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Receiver operating characteristic ,business.industry ,Type 2 Diabetes Mellitus ,030209 endocrinology & metabolism ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Erectile dysfunction ,Sexual dysfunction ,Internal medicine ,Diabetes mellitus ,medicine ,Screening tool ,medicine.symptom ,business ,Body mass index - Abstract
Background and objectiveThis study aimed to determine the validity of using a single-question self-report of erectile dysfunction (ED) as a screening tool among Saudi men with type 2 diabetes mellitus (T2DM). Materials and methodsA cross-sectional study was conducted using a single-question self-report questionnaire to determine the association between the risk of ED and poor glycemic control among men with T2DM. The study was conducted in a hospital-based diabetes clinic in Riyadh, Saudi Arabia. Married adults (aged >18 years) suffering from T2DM for at least 1 year were included in the study. All statistical analy-ses were performed using SAS version 9.2 and R software (Foundation for Statistical Computing, Vienna, Austria). ResultsWith 86% response rate, 293 participants were included in this study. Over half (53.9%) of the partic-ipants were below 60 years of age. More than half (55.3%) were suffering from uncontrolled diabetes (i.e., HbA1c > 7%). There was significant correlation between the International Index of Erectile Function (IIEF) and self-reported question in terms of duration of T2DM (p < 0.001), type of treatment (p = 0.004), income of the participants (p = 0.005), age (p < 0.001), education level (p = 0.032), and occupation (p < 0.001). However, there was no significant correlation between IIEF and self-reported question in terms of body mass index (p = 743) and smoking. Regarding overall diagnostic accuracy of IIEF score to predict self-reported ED, receiver operating characteristic curve showed area under curve as 89.4%, which is sta-tistically significant. ConclusionSingle-question self-report of ED is a valid and reliable tool to screen diabetic patients suffering from sexual problems. Such tool may help to identify ED in diabetic patients and warrant early management.
- Published
- 2020
33. Celiac autoantibody positivity in relation to clinical characteristics in children with type 1 diabetes
- Author
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Khalid, Siddiqui, Shaik Sarfaraz, Nawaz, Nada Hareb Al, Sumri, Dhekra, Alnaqeb, Asim, AlQurashi, and Muhammad, Mujammami
- Subjects
type 1 diabetes ,Original Article ,anti-endomysial ,anti-tissue transglutaminase ,celiac disease - Abstract
Background: Type 1 diabetes is an autoimmune disorder with a high risk of celiac disease (CD). Aim: This study aimed to determine the celiac autoantibody status and the clinical characteristics among children with type 1 diabetes and autoantibody positivity for CD compared to those without serological evidence of CD. Materials and Methods: In this cross-sectional study, 240 children with type 1 diabetes underwent serological screening CD. Blood glucose, glycated hemoglobin (HbA1c), hemoglobin, calcium, phosphorous, Vitamin D, alanine aminotransferase (ALT), alkaline phosphatase (ALP), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) were evaluated. The participants were screened for human anti-endomysial antibody and human anti-tissue transglutaminase antibody. Results: Of the 240 children with type 1 diabetes, 66 children were antibody positive for either anti-endomysial or anti-tissue transglutaminase or both autoantibodies for CD. There were 36 (54.5%) female and 30 (45.5%) male children with the mean age of 15.5±2.1 years. The mean duration of diabetes was 6.8±3.8 years. Only 35 (14.6%) children were found to have serological evidence of CD. Conclusion: CD is associated with type 1 diabetes. Serological screening for CD autoantibody should be performed routinely in children with type 1 diabetes. There is discrepancy in screening CD with antibodies, so a prospective follow-up of this cohort is needed for endoscopic evaluation and histopathological examination of intestinal biopsy to confirm CD in this population. Relevance for Patients: Anti-endomysial and anti-tissue transglutaminase autoantibodies should be included for screening CD among children with type 1 diabetes. Patients should undergo an endoscopy to confirm a diagnosis of CD.
- Published
- 2019
34. A Mendelian Randomization Study of the Effect of Type-2 Diabetes and Glycemic Traits on Bone Mineral Density
- Author
-
J. Brent Richards, Muhammad Mujammami, Julie A. Miller, John A. Morris, Aaron Leong, Vincenzo Forgetta, and Omar S. Ahmad
- Subjects
musculoskeletal diseases ,0301 basic medicine ,medicine.medical_specialty ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,Osteoporosis ,030209 endocrinology & metabolism ,Type 2 diabetes ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Diabetes mellitus ,Mendelian randomization ,medicine ,Orthopedics and Sports Medicine ,Femoral neck ,Glycemic ,Bone mineral ,business.industry ,nutritional and metabolic diseases ,medicine.disease ,030104 developmental biology ,medicine.anatomical_structure ,Endocrinology ,business ,Body mass index - Abstract
Type-2 diabetes (T2D) is associated in observational studies with both higher bone mineral density (BMD) and higher fracture risk for given BMD. These relationships may however be confounded by factors such as body mass index (BMI). Here we used Mendelian randomization (MR) to obtain non-confounded estimates of the effect of T2D and glycemic traits on BMD. We identified genetic variants strongly associated with T2D risk (34,840 T2D cases and 114,981 controls) and fasting glucose (133,010 nondiabetic individuals), but not associated with BMI, and determined the effects of these variants on BMD (up to 83,894 individuals). Using these variants as instrumental variables, we found that a genetically-increased risk of T2D increased femoral neck BMD (+0.034 SD in BMD per unit increase in log-odds of T2D [95% CI, 0.001 to 0.067; p = 0.044]). Genetically-increased fasting glucose also increased femoral neck BMD (+0.13 SD in BMD per mmol/L increase in fasting glucose [95% CI, 0.01 to 0.25; p = 0.034]). Similar nonsignificant trends were observed for the effects of T2D and fasting glucose on lumbar spine BMD. Our results indicate that both genetically-increased T2D risk and genetically-increased fasting glucose have weak positive effects on BMD. © 2016 American Society for Bone and Mineral Research.
- Published
- 2017
35. Vitamin D cutoff point in relation to parathyroid hormone: a population based study in Riyadh city, Saudi Arabia
- Author
-
Rana Hasanato, Abdulaziz A Alodhayani, Nasser M. Al-Daghri, Ambreen Kazi, Muhammad Mujammami, Shafi Ahamed Shaik, and AlJohara M AlQuaiz
- Subjects
Adult ,Male ,0301 basic medicine ,Vitamin ,medicine.medical_specialty ,Population ,Saudi Arabia ,Nutritional Status ,Parathyroid hormone ,030209 endocrinology & metabolism ,Sensitivity and Specificity ,Gastroenterology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Reference Values ,Internal medicine ,medicine ,Vitamin D and neurology ,Humans ,Cutoff ,Orthopedics and Sports Medicine ,Vitamin D ,education ,education.field_of_study ,Receiver operating characteristic ,business.industry ,Area under the curve ,Gold standard (test) ,Middle Aged ,Vitamin D Deficiency ,Cross-Sectional Studies ,chemistry ,Parathyroid Hormone ,Female ,030101 anatomy & morphology ,business - Abstract
The current recommended cutoff value for low vitamin D may result in overestimation of hypovitaminosis D. Vitamin D levels at 30.0 nmol/L can diagnose the hyperparathyroid cases leading to bone loss, with moderate accuracy, in the Saudi population. The new cutoff may help in identifying true cases that need clinical treatment and can reduce the burden on healthcare system. Different regions of the world have reported varying cutoff points as optimal values for vitamin D status to maintain bone health. A cross-sectional study comprising of interviews, anthropometrics, and blood samples was conducted in primary healthcare centers in Riyadh, Saudi Arabia. Standardized serum 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH) were measured using electrochemiluminescence immunoassays. Independent sample and paired sample t test were conducted to compare the true means. Pearson correlation co-efficient was calculated to measure the association between original and standardized 25(OH)D. Software program, MedCalc, was utilized to measure the receiver operating curve (ROC) for determining the optimal threshold value for vitamin D. The mean standardized 25(OH)D levels for 846 males and 1285 females were (32.0 ± 14.4 nmol/L vs 31.6 ± 16.7 nmol/L) respectively. Using the gold standard PTH cutoff > 6.9 pmol/L, the ROC had an optimal criterion value for males and females at 30.0 and 24.0 nmol/L, respectively. In the males, the sensitivity and specificity were 72% and 51%, whereas in females, it was 58.2% and 66.7%, respectively. The area under the curve (AUC) was at 0.62 and 0.65 (p
- Published
- 2019
36. The coronavirus disease of 2019 pandemic-associated stress among medical students in middle east respiratory syndrome-CoV endemic area
- Author
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Mohamad-Hani Temsah, Turky H. Almigbal, Hesham AlGhofili, Amr Jamal, Ayman Al-Eyadhy, Ali M. Somily, Fahad Alsohime, Abdulkarim Alrabiaah, Mohammed A. Batais, Nawaf AlRuwayshid, Muhammad Mujammami, and Rabih Halwani
- Subjects
medicine.medical_specialty ,Generalized anxiety disorder ,Cross-sectional study ,business.industry ,education ,General Medicine ,medicine.disease ,Mental health ,03 medical and health sciences ,0302 clinical medicine ,Universal precautions ,030220 oncology & carcinogenesis ,Family medicine ,Pandemic ,Epidemiology ,medicine ,Anxiety ,Observational study ,030212 general & internal medicine ,medicine.symptom ,business - Abstract
The coronavirus disease of 2019 (COVID-19) pandemic significantly affected different life aspects, including healthcare communities and academic institutes. We aimed to assess the level of stress and risk factors among medical students and interns during the COVID-19 pandemic in the setting of the middle east respiratory syndrome -CoV endemic area.A questionnaire-based cross-sectional study was conducted on a randomly selected sample of medical students and interns. The questionnaire was anonymously self-administered to indicate perceive hygienic practice change, importance of viral prevention domestic hygiene, perceive adequacy of received information, perceived agreement to facilitators to alleviate covid stress, self-reported stress level, and generalized anxiety disorder score.A total of 322 returned the questionnaire (69.7% response rate). Participants had good knowledge regarding severe acute respiratory syndrome -CoV2 in multiple aspects, with an average score of 13.8 out of 14. Two-thirds (62.4%) of the students experienced mild anxiety, (23.9%) had moderate anxiety, (6.8%) had clinically high anxiety level, and another (6.8%) had a clinically very high anxiety level. The stress level, as reported by the respondents (on a 1-10 scale), showed a correlation with the Generalized Anxiety Disorder scale. We observed an increased level of social avoidance and hygienic practice facilitated by availability of hand sanitizers. Majority of the students receive information regarding COVID-19 from reliable and official resourcesMost students reported mild to moderate levels of anxiety, and was associated with enhancement of their universal precaution measures. The availability of alcohol-based hand sanitizers and the off-campus study were great relievers. The importance of reliable pandemic resources in educating students during pandemics is emphasized. Furthermore, this study indicate the importance of students' support services to address mental health and students' wellbeing in the era of pandemics.
- Published
- 2021
37. Long-Term Outcomes of Patients with Papillary Thyroid Cancer Undergoing Remnant Ablation with 30 milliCuries Radioiodine
- Author
-
Michael Tamilia, Muhammad Mujammami, Richard J. Payne, Louise Rochon, and Michael P. Hier
- Subjects
medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Thyroid ,Thyroidectomy ,030209 endocrinology & metabolism ,medicine.disease ,Surgery ,Papillary thyroid cancer ,Thyroid carcinoma ,Radiation therapy ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Clinical endpoint ,Carcinoma ,Medicine ,business ,Thyroid cancer - Abstract
Background: The study considered the long-term outcome of patients with papillary thyroid carcinoma treated with 30 mCi radioiodine. Objective: The aims of this study were to define and compare the remission rates of papillary thyroid carcinoma ablated with 30 mCi 131I prepared by either thyroid hormone withdrawal (THW) or recombinant human thyrotropin (rhTSH; Thyrogen®), and to identify variables predictive of a favorable prognosis. Method: An observational study was conducted at an academic medical center and a comparative summary of six studies is presented. Three hundred and seventy patients (THW group, n = 203; rhTSH group, n = 167) were recruited from a prospectively managed registry. The mean follow-up was 9.3 years (range 5.1–15.8 years) in the THW group and 7.1 years (range 5.0–9.7 years) in the rhTSH group. The primary endpoint was the long-term remission rates (no evidence of disease) in the THW group compared with the rhTH group. Results: The response at 12–18 months after 30 mCi remnant ablat...
- Published
- 2016
38. SAT-163 ASSOCIATION OF OSTEOPONTIN WITH THE RISK FACTORS OF NEPHROPATHY IN PATIENTS WITH TYPE 2 DIABETES
- Author
-
Khalid Siddiqui, Shaik Sarfaraz Nawaz, and Muhammad Mujammami
- Subjects
medicine.medical_specialty ,biology ,Nephrology ,business.industry ,Internal medicine ,medicine ,biology.protein ,In patient ,Type 2 diabetes ,Osteopontin ,medicine.disease ,business ,Nephropathy - Published
- 2020
39. Type 1 Diabetes Mellitus in Saudi Arabia: A Soaring Epidemic
- Author
-
Abdulrahman Al-Dawish, Asirvatham Alwin Robert, Mohamed Abdulaziz Al Dawish, and Muhammad Mujammami
- Subjects
endocrine system diseases ,Population ,education ,Psychological intervention ,030209 endocrinology & metabolism ,Review Article ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,parasitic diseases ,Medicine ,Type 1 diabetes ,education.field_of_study ,Middle East ,business.industry ,Incidence (epidemiology) ,lcsh:RJ1-570 ,lcsh:Pediatrics ,medicine.disease ,Pediatrics, Perinatology and Child Health ,business ,Developed country ,geographic locations ,Demography - Abstract
Type 1 diabetes mellitus (T1DM) is quite prevalent in the world, with a proportion of 1 in every 300 persons and steadily rising frequency of incidence of about 3% every year. More alarmingly, the incidence of T1DM among infants is also increasing, with children as young as 6 months succumbing to it, instead of that at a rather established vulnerable age of around seven and near puberty, when the hormones antagonize the action of insulin. These reports pose a unique challenge of developing efficient T1DM management system for the young children. The Kingdom of Saudi Arabia (KSA) is the largest country in the Middle East that occupies approximately four-fifths of the Arabian Peninsula supporting a population of more than 33.3 million people, of whom 26% are under the age of 14 years. As per the Diabetes Atlas (8th edition), 35,000 children and adolescents in Saudi Arabia suffer from T1DM, which makes Saudi Arabia rank the 8th in terms of numbers of TIDM patients and 4th country in the world in terms of the incidence rate (33.5 per 100,000 individuals) of TIDM. However, in comparison with that in the developed countries, the number of research interventions on the prevalence, incidence, and the sociodemographic aspects of T1DM is woefully inadequate. In this review we discuss different aspects of T1DM in Saudi Arabia drawing on the published literature currently available.
- Published
- 2018
40. Abstract #1071 Giant Posterior Mediastinal Goiter: A Case Report and Literature Review
- Author
-
Muhammad Mujammami, Aishah Ekhzaimy, and Mohammed Al-Jaberi
- Subjects
Mediastinal goiter ,medicine.medical_specialty ,Endocrinology ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine ,General Medicine ,Radiology ,business - Published
- 2018
41. A Mendelian Randomization Study of the Effect of Type-2 Diabetes and Glycemic Traits on Bone Mineral Density
- Author
-
Omar S, Ahmad, Aaron, Leong, Julie Ann, Miller, John A, Morris, Vincenzo, Forgetta, Muhammad, Mujammami, and J Brent, Richards
- Subjects
Blood Glucose ,Male ,Diabetes Mellitus, Type 2 ,Bone Density ,Femur Neck ,Glycemic Index ,Humans ,Female ,United Kingdom ,Genome-Wide Association Study - Abstract
Type-2 diabetes (T2D) is associated in observational studies with both higher bone mineral density (BMD) and higher fracture risk for given BMD. These relationships may however be confounded by factors such as body mass index (BMI). Here we used Mendelian randomization (MR) to obtain non-confounded estimates of the effect of T2D and glycemic traits on BMD. We identified genetic variants strongly associated with T2D risk (34,840 T2D cases and 114,981 controls) and fasting glucose (133,010 nondiabetic individuals), but not associated with BMI, and determined the effects of these variants on BMD (up to 83,894 individuals). Using these variants as instrumental variables, we found that a genetically-increased risk of T2D increased femoral neck BMD (+0.034 SD in BMD per unit increase in log-odds of T2D [95% CI, 0.001 to 0.067; p = 0.044]). Genetically-increased fasting glucose also increased femoral neck BMD (+0.13 SD in BMD per mmol/L increase in fasting glucose [95% CI, 0.01 to 0.25; p = 0.034]). Similar nonsignificant trends were observed for the effects of T2D and fasting glucose on lumbar spine BMD. Our results indicate that both genetically-increased T2D risk and genetically-increased fasting glucose have weak positive effects on BMD. © 2016 American Society for Bone and Mineral Research.
- Published
- 2016
42. A Mendelian randomization study of the effect of type-2 diabetes on coronary heart disease
- Author
-
J. Brent Richards, Celia M. T. Greenwood, George Thanassoulis, Aaron Leong, Robert Sladek, Maxime Turgeon, Omar S. Ahmad, Vincenzo Forgetta, Rui Li, James B. Meigs, John A. Morris, and Muhammad Mujammami
- Subjects
Adult ,Blood Glucose ,medicine.medical_specialty ,endocrine system diseases ,General Physics and Astronomy ,Coronary Disease ,Type 2 diabetes ,030204 cardiovascular system & hematology ,Polymorphism, Single Nucleotide ,Article ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Diabetes mellitus ,Internal medicine ,Mendelian randomization ,Odds Ratio ,medicine ,Humans ,cardiovascular diseases ,Aged ,030304 developmental biology ,Glycated Hemoglobin ,0303 health sciences ,Multidisciplinary ,business.industry ,Confounding ,Case-control study ,nutritional and metabolic diseases ,Mendelian Randomization Analysis ,General Chemistry ,Odds ratio ,Middle Aged ,medicine.disease ,3. Good health ,Causality ,Endocrinology ,Diabetes Mellitus, Type 2 ,Case-Control Studies ,Cardiology ,Observational study ,business - Abstract
In observational studies, type-2 diabetes (T2D) is associated with an increased risk of coronary heart disease (CHD), yet interventional trials have shown no clear effect of glucose-lowering on CHD. Confounding may have therefore influenced these observational estimates. Here we use Mendelian randomization to obtain unconfounded estimates of the influence of T2D and fasting glucose (FG) on CHD risk. Using multiple genetic variants associated with T2D and FG, we find that risk of T2D increases CHD risk (odds ratio (OR)=1.11 (1.05–1.17), per unit increase in odds of T2D, P=8.8 × 10−5; using data from 34,840/114,981 T2D cases/controls and 63,746/130,681 CHD cases/controls). FG in non-diabetic individuals tends to increase CHD risk (OR=1.15 (1.00–1.32), per mmol·per l, P=0.05; 133,010 non-diabetic individuals and 63,746/130,681 CHD cases/controls). These findings provide evidence supporting a causal relationship between T2D and CHD and suggest that long-term trials may be required to discern the effects of T2D therapies on CHD risk., In order to effectively design interventions, it is useful to understand the complex interplay between multiple syndromes. Here, Ahmad et al. use genome-wide association study data and Mendelian randomisation to examine the influence of Type 2 diabetes and fasting glucose levels on coronary heart disease.
- Published
- 2015
43. Response to Tulchinsky and Avram re: 'Long-Term Outcomes of Patients with Papillary Thyroid Cancer Undergoing Remnant Ablation with 30 Millicurie Radioiodine'
- Author
-
Michael Tamilia and Muhammad Mujammami
- Subjects
medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Treatment outcome ,Remnant ablation ,030209 endocrinology & metabolism ,medicine.disease ,Iodine Radioisotopes ,Papillary thyroid cancer ,03 medical and health sciences ,Treatment Outcome ,0302 clinical medicine ,Endocrinology ,Millicurie ,030220 oncology & carcinogenesis ,medicine ,Long term outcomes ,Humans ,Thyroid Neoplasms ,Radiology ,business - Published
- 2017
44. Metachronous Collision Tumors of the Thyroid Gland Unveiled in Real Time by a Change in the Thyroid Nodule Phenotype
- Author
-
Muhammad Mujammami
- Subjects
Pathology ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Colorectal cancer ,medicine.medical_treatment ,Thyroid ,Thyroidectomy ,Combination chemotherapy ,medicine.disease ,medicine.disease_cause ,Metastasis ,medicine.anatomical_structure ,Fine-needle aspiration ,medicine ,Adenocarcinoma ,KRAS ,business - Abstract
Introduction: The term collision tumor refers to the coexistence of two histologically distinct neoplastic tumors within the same mass. Collision tumor of the thyroid (also referred to as tumor-to-tumor metastasis) with metastatic colorectal carcinoma to a preexisting thyroid adenomatoid nodule is rare. Preoperative diagnosis of this disorder is exceedingly difficult. This report highlights the rare occurrence of a tumor-to-tumor metastasis of colorectal cancer to a preexisting thyroid adenomatoid nodule unveiled in real time by serial positron emission tomography CT scans (PET/CT). Since cytological diagnosis of these lesions is often insufficient, we present a stepwise diagnostic approach with a combination of investigations in the preoperative setting. The patient management is reviewed together with a rationalized use of targeted therapy based on the genetic status of the tumor. Methods: Ultrasound (US)-guided fine needle aspiration (FNA) biopsies of the collision tumor of thyroid were performed and analyzed for cytologic, immunologic, and molecular tumor phenotyping. KRAS gene analysis of the metastatic lesion was also performed. Results: The samples revealed adenocarcinoma of the colon (Tg-negative, TTF-1-negative, HBME-1-negative, galectin-3 negative, CEA-positive, CK-20 positive) intense glucose transporter-1(GLUT-1) expression and KRAS positivity. The patient was then brought to surgery for a left hemithyroidectomy and ipsilateral central compartment node dissection. Final histology revealed metastatic colonic carcinoma, invading the benign adenomatoid nodule. His recovery was uneventful and the post-op chemotherapeutic regimen was guided by the KRAS analysis of the tumor. Conclusion: Once a collision tumor of the thyroid gland is suspected on PET/CT, the lesion should be corroborated by sonography of the thyroid gland. FNA with combined cytological, immunocytochemical and when necessary KRAS gene analysis can lead to a timely diagnosis and a treatment plan. In the context of limited systemic malignant disease and good performance status, palliative thyroidectomy with or without combined chemotherapy may control local disease and prevent tracheal invasion.
- Published
- 2014
45. Double diabetes in Saudi Arabia: A new entity or an underestimated condition
- Author
-
Mohamed Abdulaziz Al Dawish, Samia Hasan Sobki, Rania Ahmad Ahmad, Monther Zitouni, Rim Braham, Aus A. Alzaid, Muhammad Mujammami, and Asirvatham Alwin Robert
- Subjects
medicine.medical_specialty ,Diabetic ketoacidosis ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Saudi Arabia ,030209 endocrinology & metabolism ,030204 cardiovascular system & hematology ,Overweight ,03 medical and health sciences ,chemistry.chemical_compound ,Autoantibody response ,0302 clinical medicine ,Retrospective Study ,Therapeutic approaches ,Diabetes mellitus ,Internal medicine ,Hybrid diabetes ,Internal Medicine ,medicine ,Family history ,Acanthosis nigricans ,Traditional medicine ,C-peptide ,business.industry ,Insulin ,medicine.disease ,Double diabetes ,chemistry ,Population study ,medicine.symptom ,business - Abstract
AIM To determine the clinical and biological characteristics of double diabetes (DD) among young people in Saudi Arabia. METHODS This was a retrospective descriptive chart review study including 312 young newly diagnosed diabetic patients (aged 12-20 years), whom were admitted over a five year period (January 2009 to December 2013). Family history of diabetes mellitus (DM) (first degree), physical body mass index (BMI), acanthosis nigricans, history of auto-immune disease and laboratory information for glycosylated hemoglobin, basal C peptide level and diabetes autoantibody response (anti-GAD, anti-IA2 and anti-ICA) were collected from medical report. A mean follow-up of 3 years for these patients was performed. RESULTS Patients were categorized into 4 groups, based on the autoantibody response (Ab+ or Ab-) and C-peptide secretion (β+ for fasting level 0.4-2.1 ng/mL and β- if < 0.4 ng/mL). Group1 (type 1a): Ab+ β- (21%), group 2 (type 1b): Ab- β- (9%), group 3 (DD): Ab+ β+ (31%) and group 4 (classic type 2 DM): Ab- β+ (39%). The mean age of the DD patients in our study was 15.1 ± 6.4 years. A total of 41% of the study population presented with diabetic ketoacidosis and 61% of the study population presented with positive family history of DM. The mean BMI was 26.8 kg/m2 with 64% of overweight or obese patients. Ninety two percent of the patients were started on insulin at the time of diagnosis. During a mean follow-up of 3 years, only 32% of the patients with DD required insulin and 78% were on metformin alone or with insulin. CONCLUSION Our findings enable us to arrive at the conclusion that almost one-third of the young Saudi diabetic patients reveal atypical forms of DM (double diabetes) expressing features resulting from both T1D and T2D.
- Published
- 2016
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