SAJDVD: VOLUME 14, ISSUE 2, DECEMBER 2017
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  1. From the Editor’s Desk
    Authors: Mahomed, FA
    From: South African Journal of Diabetes and Vascular Disease, Vol 14, Issue 2, December 2017
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  2. Obesity in Botswana: time for new cut-off points for abdominal girth?
    Authors: Churchill Lukwiya Onen
    From: South African Journal of Diabetes and Vascular Disease, Vol 14, Issue 2, December 2017
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    Introduction: Country-specific cut-off points for defining central obesity in black Africans are long overdue.
    Methods: Anthropometric data from 215 (51.4%) male and 203 (48.6%) female patients seen in Gaborone between 2005 and 2015 were analysed to establish appropriate cut-off points for waist circumference (WC) corresponding to a body mass index (BMI) of 30 kg/m2. Relative risks for cardiometabolic disorders were calculated for different BMI and WC categories using MedCalc®. The subjects’ mean age was 50.0 ± 10.8 years and 80.6% were Batswana.
    Results: Only 7.2% of patients had a BMI < 25 kg/m2, 27.3% were overweight and 65.5% were obese; mean BMI was 34.9 ± 6.5 kg/m2 in the women versus 31.0 ± 4.9 kg/m2 in the men (p < 0.0001). New cut-off points of 98 cm in men and 85 cm in women emerged. Different weight and WC categories appeared not to confer increased relative risk of hypertension, dysglycaemia or dyslipidaemia.
    Conclusion: The proposed WC cut-off values, if validated, should set the pace for larger studies across sub-Saharan Africa.
     
  3. Prevalence of selected cardiometabolic risk factors among adults in urban and semi-urban hospitals in four sub-Saharan African countries
    Authors: Samuel Kingue , Solofonirina Rakotoarimanana , Nirina Rabearivony , Francois Lepira Bompera
    From: South African Journal of Diabetes and Vascular Disease, Vol 14, Issue 2, December 2017
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    Aim: Cardiovascular diseases (CVDs) are a global challenge but the burden in sub-Saharan African (SSA) countries is less well documented than elsewhere. We aimed to describe the key cardiometabolic risk factors in four SSA countries.
    Methods: A cross-sectional, multi-national, hospital-based study was carried out among adults (> 35 years) across four SSA countries from 12 December 2011 to 7 February 2013. Risk factors were defined using the World Health Organisation and International Diabetes Federation guidelines.
    Results: Of the 844 adults (57.4% female, mean age 52.6 years), 76.6% were urban residents. The predominant CVD risk factors were hypertension (74.1%), obesity (36.2%) and excessive alcohol consumption (25.6%). Diabetes (17.7 vs 10.0%), obesity (42.8 vs 16.8%) and hypercholesterolaemia (25.8 vs 18.0%) were more prevalent among the hypertensive subjects (all p < 0.007) than the normotensives. The metabolic syndrome (39.4%) was more common in women and hyper-tensive subjects.
    Conclusions: Hospital patients in SSA countries present with excessive rates of cardiometabolic risk factors. Focus on their prevention and control is warranted.
     
  4. Telmisartan decreases microalbuminuria in patients with type 2 diabetes mellitus following coronary artery bypass grafting
    Authors: Cevdet Furat, Riza Dogan, Gokhan, Ekrem Bayar, Berkan Ozpak, Hakan Kara, Sahin Bozok
    From: South African Journal of Diabetes and Vascular Disease, Vol 14, Issue 2, December 2017
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    Objective: This prospective study aimed to investigate the effects of the selective angiotensin receptor antagonist, telmisartan, on microalbuminuria after coronary artery bypass surgery in patients with diabetes mellitus.
    Methods: Patients were divided into two groups with block randomisation, using the sealed envelope technique: group T (telmisartan group) consisted of patients who received the angiotensin receptor blocking agent telmisartan 80 mg daily for at least six months in the pre-operative period; group N-T (non-telmisartan group) consisted of patients who received no telmisartan treatment. Clinical and demographic characteristics, operative and postoperative features, microalbuminuria and high-sensitivity C-reactive protein levels were compared.
    Results: Forty patients met the eligibility criteria for the study. The groups did not differ with regard to clinical and demographic characteristics, and operative and postoperative features. Microalbuminuria levels between the groups differed significantly in the pre-operative period, first hour postoperatively and fifth day postoperatively. C-reactive protein levels between the groups differed significantly on the fifth day postoperatively.
    Conclusion: Telmisartan was useful for decreasing systemic inflammation and levels of urinary albumin excretion in patients who had type 2 diabetes mellitus and had undergone coronary artery bypass surgery.

  5. Red cell distribution width is correlated with extensive coronary artery disease in patients with diabetes mellitus
    Authors: Atac Celik, Metin Karayakali, Fatih Altunkas, Kayihan Karaman, Arif Arisoy, Koksal Ceyhan, Hasan Kadi, Fatih Koc
    From: South African Journal of Diabetes and Vascular Disease, Vol 14, Issue 2, December 2017
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    Introduction: Previous studies have predicted an independent relationship between red cell distribution width (RDW) and the risk of death and cardiovascular events in patients with coronary artery disease (CAD). The aim of this study was to investigate the relationship between RDW and extensiveness of CAD in patients with diabetes mellitus (DM).
    Methods: Two hundred and thirty-three diabetic patients who underwent coronary angiographies at our centre in 2010 were included in the study. All of the angiograms were re-evaluated and Gensini scores were calculated. Triple-vessel disease was diagnosed in the presence of stenosis > 50% in all three coronary artery systems.
    Result: RDW was significantly higher in diabetic CAD patients (p < 0.001). Patients with CAD who had a RDW value above the cut-off point also had higher Gensini scores, higher percentages of obstructive CAD and triple-vessel disease (p ≤ 0.001 for all). According to the cut-off values calculated using ROC analysis, RDW > 13.25% had a high diagnostic accuracy for predicting CAD. RDW was also positively correlated with Gensini score, obstructive CAD and triple-vessel disease (r < 0.468 and p < 0.001 for all).
    Conclusion: RDW values were found to be increased in the diabetic CAD population. Higher RDW values were related to more extensive and complex coronary lesions in patients with DM.

  6. Role of melatonin in glucose uptake by cardiomyocytes from insulin-resistant Wistar rats
    Authors: Frederic Nduhirabandi, Barbara Huisamen, Hans Strijdom, Amanda Lochner
    From: South African Journal of Diabetes and Vascular Disease, Vol 14, Issue 2, December 2017
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    Aim: Melatonin supplementation reduces insulin resistance and protects the heart in obese rats. However, its role in myocardial glucose uptake remains unknown. This study investigated the effect of short-term melatonin treatment on glucose uptake by cardiomyocytes isolated from obese and insulin-resistant rats.
    Methods: Cardiomyocytes were isolated from obese rats fed a high-calorie diet for 16 to 23 weeks, their age-matched controls, as well as young control rats aged four to eight weeks. After incubation with melatonin with or without insulin, glucose uptake was initiated by the addition of 2-deoxy-D-[3H] glucose and measured after 30 minutes. Additional control and obese rats received melatonin in the drinking water (4 mg/kg/day) for the last six weeks of feeding (20 weeks) and glucose uptake was determined in isolated cardiomyocytes after incubation with insulin. Intraperitoneal glucose tolerance and biometric parameters were also measured.
    Results: Obese rats (fed for more than 20 weeks) developed glucose intolerance. Cardiomyocytes isolated from these obese rats had a reduced response to insulin-stimulated glucose uptake (ISGU) (p < 0.05). Melatonin administration in vitro had no effect on glucose uptake per se. However, it increased ISGU by cardiomyocytes from the young rats (p < 0.05), while having no effect on ISGU by cardiomyocytes from the older control and obese groups. Melatonin in vivo had no significant effect on glucose tolerance, but it increased basal (p < 0.05) and ISGU by cardiomyocytes from the obese rats (50.1 ± 1.7 vs 32.1 ± 5.1 pmol/mg protein/30 min, p < 0.01).
    Conclusion: These data suggest that short-term melatonin treatment in vivo but not in vitro improved glucose uptake and insulin responsiveness of cardiomyocytes in obesity and insulin-resistance states.

  7. Prevalence of obesity and body size perceptions in urban and rural Senegal: new insight on the epidemiological transition in West Africa
    Authors: Enguerran Macia, Emmanuel Cohen, Lamine Gueye, Gilles Boetsch, Priscilla Duboz
    From: South African Journal of Diabetes and Vascular Disease, Vol 14, Issue 2, December 2017
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    Background: The objectives of this study were to assess the prevalence of obesity in Dakar and in Tessekere, a rural municipality in northern Senegal, and to compare ideal body size between these populations.
    Methods: A cross-sectional survey was carried out in 2015 on a representative sample of 1 000 adults, aged 20 years and older in Dakar, and 500 adults of the same age in Tessekere.
    Results: The prevalence of obesity and overweight was higher in Dakar than in Tessekere. However, overweight and obesity rates of young women living in this rural area were close to those of young women in Dakar. At a body mass index of 27.5 kg/m², less than 40% of the men in Dakar and Tessekere found themselves too fat, compared to 50% of urban women and 30% of rural women.
    Conclusion: This study explains how and why obesity is becoming a rural health problem in Senegal.

  8. Drug Trends in Diabetes
    From: South African Journal of Diabetes and Vascular Disease, Vol 14, Issue  2, December 2017
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  9. Diabetes News
    From: South African Journal of Diabetes and Vascular Disease, Vol 14, Issue  2, December 2017
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