SAJDVD: VOLUME 12, ISSUE 1, July 2015
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  1. From the Editor’s Desk
    Authors: Lombard, L
    From: South African Journal of Diabetes and Vascular Disease, Vol 12, Issue 1, July 2015
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  2. The cardioprotective diet - carbohydrates versus fat : editorial
    Authors: Raal, FJ
    From: South African Journal of Diabetes and Vascular Disease, Vol 12, Issue 1, July 2015
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    Abstract: There is probably no more important topic for discussion than the effect of lifestyle and diet on our health. The impact of lifestyle is hugely underestimated by the general public and is, in my view, by far the biggest contributor to non-communicable disease today. ‘You are what you eat’ is an old statement that still holds true.
     
  3. Lifestyle and diet : review
    Authors: Opie, LH
    From: South African Journal of Diabetes and Vascular Disease, Vol 12, Issue 1, July 2015
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    Abstract: Currently, there is widespread interest in many different diets. The best-known diets include the New Atkins diet in the USA, the Dukan diet in France, and in South Africa the Noakes diet. Two different approaches have emerged, one focusing on a life-long healthy lifestyle and the other emphasising weight loss. These are in fact complementary aims, as will be reviewed and reconciled. Furthermore, besides the dietary approach, there is a valid case for added drug therapy for selected lipid disorders with the use of statins. In addition, new drugs are emerging that in the future might eventually considerably reduce the negative health impact of coronary artery disease.
     
  4. Novel cardiovascular risk markers in women with ischaemic heart disease : review
    Authors: Pop, D; Dădârlat, A; Zdrenghea, D
    From: South African Journal of Diabetes and Vascular Disease, Vol 12, Issue 1, July 2015
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    Abstract: The incidence of coronary heart disease in premenopausal women is lower than in men because of their hormonal protection. Angina pectoris occurs in women about 10 years later than in men. However, mortality from ischaemic heart disease remains higher in women than in men. Current studies are focusing on novel cardiovascular risk biomarkers because it seems that traditional cardiovascular risk factors and their assessment scores underestimate the risk in females. Increased plasma levels of these newly established biomarkers of risk have been found to worsen endothelial dysfunction and inflammation, both of which play a key role in the pathogenesis of microvascular angina, which is very common in women. These novel cardiovascular risk markers can be classified into three categories: inflammatory markers, markers of haemostasis, and other biomarkers.
     
  5. Stem cell therapies for neuropathic pain : review
    Authors: Gillani, SMR; Singh, BM
    From: South African Journal of Diabetes and Vascular Disease, Vol 12, Issue 1, July 2015
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    Abstract: Neuropathic pain is a large-scale epidemiological problem effecting 13–26% of the diabetic population. The complex aetiology and pathophysiology coupled with the lack of a diagnostic test for the underlying cause renders the assessment of neuropathic pain subjective and the treatment difficult, especially as current licensed treatments are limited in their application towards the attainment of palliation.
    Cell therapies offer a novel curative therapeutic dimension for neuropathic pain. This is based on replacing damaged neuronal tissue, protecting against progressive nerve damage, and releasing soluble factors that act in a paracrine or endocrine manner, which facilitate repair and reversal of the pathology that underlies the genesis and propagation of damage within the somatosensory system. Cell therapies with potential utility for the treatment of neuropathic pain include embryonic stem cells, adult stem cells and induced pluripotent stem cells.
     
  6. Diabetes mellitus and male reproductive function: where do we stand? : review
    Authors: Alves, MG; Oliveira, PF
    From: South African Journal of Diabetes and Vascular Disease, Vol 12, Issue 1, July 2015
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    Abstract: Diabetes mellitus (DM) is a metabolic disorder caused by absolute (type 1 diabetes) or relative (type 2 diabetes) deficiency of insulin and is associated with alterations in carbohydrate, lipid and protein metabolism.1 The disease has been closely related with a wide range of long-term systemic complications and co-morbidities, such as renal failure or hypertension.2 Therefore, the study of DM implications in human health is a challenge to experts in any field of research.
     
  7. Prevalence of dyslipidaemia in statin-treated patients in South Africa: results of the DYSlipidaemia International Study (DYSIS) : research article
    Authors: Raal, FJ; Blom, DJ; Naidoo, S; Bramlage, P; Brudi, P
    From: South African Journal of Diabetes and Vascular Disease, Vol 12, Issue 1, July 2015
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    Abstract: Introduction and objectives: Cardiovascular disease (CVD) is the leading cause of mortality worldwide and increased levels of low-density lipoprotein cholesterol (LDL-C) are an important modifiable risk factor. Statins lower LDL-C levels and have been shown to reduce CVD risk. Despite the widespread availability of statins, many patients do not reach the lipid targets recommended by guidelines. We evaluated lipid goal attainment in statin-treated patients in South Africa and analysed variables contributing to poor goal attainment as part of the DYSlipidaemia International Study (DYSIS).
    Methods: This cross-sectional, observational study enrolled 1 029 consecutive South African patients consulting office-based physicians. Patients were at least 45 years old, had to be treated with a stable dose of statins for at least three months and had been fasting for 12 hours. We evaluated lipid goal attainment and examined variables associated with residual dyslipidaemia [abnormal levels of LDL-C, high-density lipoprotein cholesterol (HDL-C) and/or triglycerides (TG)].
    Results: We found that 50.3% of the patients overall did not achieve target LDL-C levels and 73.5% of patients were at very high cardiovascular risk. In addition, 33.7% had low levels of HDL-C, while 45.3% had elevated TG levels despite statin therapy. Asian and mixed-ancestry patients but not black (vs Caucasian ethnicity), as well as obese individuals in South Africa were more likely to still have dyslipidaemia involving all three lipid fractions.
    Conclusions: We observed that many patients in South Africa experienced persistent dyslipidaemia despite statin treatment, supporting the concept that there is a need for more intensive statin therapy or the development of novel treatment strategies. Measures aimed at combating obesity and other lifestyle-related risk factors are also vital for effectively controlling dyslipidaemia and reducing the burden of CVD.
     
  8. Gender and ethnic differences in the control of hyperlipidaemia and other vascular risk factors: insights from the CEntralised Pan-South African survey on tHE Under-treatment of hypercholeSterolaemia (CEPHEUS SA) study : research article
    Authors: Rapeport, N; Schamroth, CL; Blom, DJ
    From: South African Journal of Diabetes and Vascular Disease, Vol 12, Issue 1, July 2015
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    Abstract: Aim: The aim of the CEntralised Pan-South African survey on tHE Under-treatment of hypercholeSterolaemia (CEPHEUS SA) was to evaluate the current use and efficacy of lipid-lowering drugs (LLDs) in urban patients of different ethnicity with hyperlipidaemia, and to identify possible patient characteristics associated with failure to achieve low-density lipoprotein cholesterol (LDL-C) targets. There is little published data on LDL-C attainment from developing countries.
    Methods: The survey was conducted in 69 study centres in South Africa and recruited consecutive patients who had been prescribed LLDs for at least three months with no dose adjustment for six weeks. All patients provided written consent. One visit was scheduled for data collection, including fasting lipid and glucose, and HbA1c levels.
    Results: Of the 3 001 patients recruited, 2 996 were included in the final analyses; 1 385 subjects were of Caucasian origin (818 male), 510 of African ancestry (168 male), 481 of mixed ancestry (222 male) and 620 of Asian origin (364 male). Only 60.5% of patients on LLDs for at least three months achieved the LDL-C targets recommended by the NCEP ATP III/2004 updated NCEP ATP III guidelines and 52.3% the fourth JETF/South African guidelines. African females were on average younger than females of other ethnic origins, and had the lowest smoking rates but the highest prevalence of obesity, hypertension, the metabolic syndrome and diabetes mellitus (DM), with the worst glycaemic control. Although women were less likely than men to reach goal [OR 0.65 (CI 0.54–0.77), p < 0.001 for NCEP ATP III guidelines and OR 0.76 (CI 0.64–0.91), p < 0.003 for fourth JETF guidelines], women of African ancestry were just as likely not to reach goal as their Caucasian counterparts.
    Conclusion: The results of this survey highlight the sub-optimal lipid control achieved in many South African patients, and profile important gender and ethnic differences. Control of cardiovascular disease risk factors across gender and ethnic groups remains poor.
     
  9. Prevalence of the metabolic syndrome and determination of optimal cut-off values of waist circumference in university employees from Angola : research article
    Authors: Magalhães, P; Capingana, DP; Mill, JG
    From: South African Journal of Diabetes and Vascular Disease, Vol 12, Issue 1, July 2015
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    Abstract: Background: Estimates of the prevalence of the metabolic syndrome in Africans may be inconsistent due to lack of African-specific cut-off values of waist circumference (WC). This study determined the prevalence of the metabolic syndrome and defined optimal values of WC in Africans.
    Methods: This cross-sectional study collected demographic, anthropometric and clinical data of 615 Universitary employees, in Luanda, Angola. The metabolic syndrome was defined using the third report of the National Cholesterol Education Program Adult Treatment Panel (ATPIII) and the Joint Interim Statement (JIS) criteria. Receiver operating characteristics curves were constructed to assess cut-off values of WC.
    Results: The crude prevalence of the metabolic syndrome was higher with the JIS definition (27.8%, age-standardised 14.1%) than with the ATP III definition (17.6%, age-standardised 8.7%). Optimal cut-off values of WC were 87.5 and 80.5 cm in men and women, respectively.
    Conclusions: There was a high prevalence of the metabolic syndrome among our African subjects. Our data suggest different WC cut-off values for Africans in relation to other populations.
     
  10. Diabetes News
    From: South African Journal of Diabetes and Vascular Disease, Vol 12, Issue 1, July 2015
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