Publications by authors named "Mervat Naguib"

16 Publications

  • Page 1 of 1

Does Serum Osteocalcin Level Affect Carotid Atherosclerosis in Post-Menopausal Diabetic Females? A Case-Control Study.

Int J Gen Med 2022 28;15:4513-4523. Epub 2022 Apr 28.

Radiology Department, Faculty of Medicine Kasr Al-Ainy Hospital Cairo University, Cairo, Egypt.

Purpose: To determine the association between serum osteocalcin and carotid intima media thickness (CIMT) in a group of post-menopausal females with type 2 diabetes (T2DM).

Patients And Methods: This cross-sectional study enrolled 75 postmenopausal women with T2DM and 40 age matched postmenopausal healthy females. Age, body mass index, blood pressure were recorded for all subjects. Laboratory tests including fasting blood glucose (FBG), glycated hemoglobin (HbA1c) and lipid profile were measured. Serum osteocalcin was measured using ELISA. Bone mineral density (BMD) was measured by DEXA scan. CIMT was assessed with B-mode ultrasonography.

Results: Patients with T2DM had significantly lower serum osteocalcin compared to control (63.73±27.20 vs 136.16±21.96 pg/mL, <0.001). Patients with osteoporosis had significantly lower osteocalcin level compared to those with normal BMD. Patients with T2DM had a significant negative correlation between serum osteocalcin and CIMT (r= -0.332; =0.003), FBG (r= -0.732; < 0.001), HbA1c (r=-0.672; < 0.001), and HOMA-IR (r= -0.672; < 0.001). However, multiple linear regression analysis revealed that CIMT in patients with diabetes was only significantly associated with age (= 0.001), duration of diabetes (< 0.001), SBP (< 0.001), HOMA-IR (=0.033), LDL (=0.005), and HDL (< 0.001). Furthermore, serum insulin (β= -0.183, P=0.033), FBG (β= -0.604, < 0.001) and LDL (β= -0.195, = 0.02) were independently negatively correlated with serum osteocalcin.

Conclusion: In this study, Postmenopausal women with diabetes had significantly lower osteocalcin compared to non-diabetic women. Although serum osteocalcin was negatively correlated with CIMT, multivariate regression analysis revealed that osteocalcin level was only independently related to worse glycemic parameters in postmenopausal women with T2DM.
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http://dx.doi.org/10.2147/IJGM.S353492DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9059994PMC
April 2022

Elevated Serum Cyclophilin D Level is Associated with Nonalcoholic Fatty Liver Disease and Higher Fibrosis Scores in Patients with Diabetes Mellitus.

Int J Gen Med 2021 18;14:4665-4675. Epub 2021 Aug 18.

Hepatology Unite, Internal Medicine Department, Faculty of Medicine, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.

Background: Cyclophilin D (CypD) is a mitochondrial matrix protein involved in liver steatosis and fibrosis in vitro. However, the role of CypD in the development of fatty liver and liver fibrosis in humans has not been determined.

Purpose: To measure the serum level of CypD in patients with type 2 diabetes (T2DM) and nonalcoholic fatty liver disease (NAFLD) and to assess its relation to the presence of hepatic steatosis and fibrosis in this group of patients.

Patients And Methods: In this cross-sectional study, 30 patients with diabetes and NAFLD were compared to 30 patients with diabetes without NAFLD and 30 age- and sex-matched healthy subjects. Abdominal ultrasound was used to diagnose NAFLD. Serum CypD was measured using ELISA. Fibrosis-4 (FIB-4) index, AST to platelet ratio index (APRI), and NAFLD fibrosis score (NFS) were used as markers of liver fibrosis in patients with NAFLD. Patients with NAFLD were divided into two subgroups based on FIB-4 index: patients with liver fibrosis (FIB-4 >1.45) and patients without liver fibrosis (FIB-4 <1.45). CypD and other clinical and biochemical parameters were validated as predictors of NAFLD and liver fibrosis in diabetic patients in multivariate logistic regression analysis.

Results: Diabetic patients with NAFLD had higher serum CypD levels than those without NAFLD (11.65±2.96 vs 6.58±1.90 ng/mL, respectively, <0.001). Correlation analysis revealed a significant positive correlation between CypD and FIB-4 index (=0.001), APRI (=0.013) and NFS (<0.001). GGT and CypD were the only predictors of NAFLD. For the prediction of significant fibrosis, AUROC of CypD was 0.835 with a cutoff >14.05 ng/mL provides specificity of 81.8% and sensitivity of 75%.

Conclusion: Serum CypD is related to hepatic steatosis and fibrosis in diabetic patients. Serum CypD may thus provide a novel marker and therapeutic target of NAFLD and liver fibrosis.
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http://dx.doi.org/10.2147/IJGM.S322986DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8380628PMC
August 2021

Beclin1 circulating level as predictor of carotid intima-media thickness in patients with type 2 diabetes mellitus.

Medicine (Baltimore) 2021 Jul;100(28):e26630

Diabetes and Endocrinology Unite, Faculty of Medicine Kasr Al-Ainy Hospital, Cairo University, Egypt.

Abstract: Type 2 diabetes (T2DM) represents a major risk factor for atherosclerosis that is the underlying cause of most cardiovascular diseases. Identifying reliable predictive biomarkers are needed to improve the long-term outcome in diabetic patients. Autophagy plays a pivotal role in the pathogenesis of atherosclerosis. Beclin1 is a key regulatory protein of autophagy and has been localized in human atherosclerotic lesions. However, the relation of serum level of Beclin1 and atherosclerosis in patients with diabetes has not been clarified yet.To assess the relationship between serum level of Beclin1 and carotid intima-media thickness (CIMT) in patients with T2DM.In this case-control study participants were recruited from tertiary care hospitals in Egypt. The study enrolled 50 patients with T2DM and 25 healthy subjects between January, 2019 and January, 2020. Age, gender, and body mass index were recorded for all subjects. Laboratory works up including glycated hemoglobin, lipid panel, and serum Beclin1 (by enzyme-linked immunosorbent assay) were measured. CIMT was assessed by color Doppler. Comparisons between patients and the control group were done using analysis of variance and Chi-square test. Correlations between CIMT and Beclin1 level and different variables were done using the Pearson correlation coefficient. Receiver operator characteristic curve was constructed with the area under curve analysis performed to detect the best cutoff value of Beclin1 for detection of CIMT > 0.05 cm.The level of Beclin1 in the patient group was significantly lower compared with that in the control group (1.28 ± 0.51 vs 5.24 ± 1.22 ng/dL, P < .001). The level of Beclin1 apparently decreased in the higher CIMT group in T2DM patients. Serum Beclin1 levels were negatively correlated with CIMT (r = -0.762; P < .001), low-density lipoprotein-cholesterol (r = -0.283; P = .04), and triglycerides (r = -0.350; P = .01) but positively correlated with high-density lipoprotein-cholesterol (r = 0.491; P < .001) in patients with T2DM. Beclin1 level >2.2 ng/dL was an accurate predictor of CIMT >0.05 cm with an area under the curve value of 0.997, 93.9% sensitivity, and 100% specificity.Beclin1 levels were negatively correlated with atherosclerotic load in patients with T2DM and it may be considered as a promising diagnostic and therapeutic target.
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http://dx.doi.org/10.1097/MD.0000000000026630DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284749PMC
July 2021

Impact of Combined Photo-Biomodulation and Aerobic Exercise on Cognitive Function and Quality-of-Life in Elderly Alzheimer Patients with Anemia: A Randomized Clinical Trial.

Int J Gen Med 2021 14;14:141-152. Epub 2021 Jan 14.

Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt.

Purpose: Few data are available on the positive impact of photo-biomodulation (PBM) using low-level laser therapy as a complementary treatment for improving the cognitive function and optimizing the hemoglobin (Hb) level and oxygen carrying capacity in anemic elderly patients and consequently improving the quality-of-life. The present study aimed to evaluate a new, safe, and easy therapeutic approach to improve Alzheimer's disease-related symptoms that interfere with the whole life activities and social interaction of elderly patients.

Patients And Methods: In this placebo-controlled clinical trial, 60 elderly patients suffering from anemia and mild cognitive dysfunction were randomly assigned into two equal groups to receive active or placebo low-level laser in addition to a moderate-intensity aerobic exercise over a 12-week period. Hb level as well as cognitive and functional tests were reassessed for any change after 12 weeks of intervention.

Results: By the end of this study, both groups showed significant improvements in Hb level, Montreal Cognitive Assessment Scale (MoCa - B basic), Quality-of-Life for Alzheimer's Disease scale, and Berg Balance scale scores along with significant reduction in body mass index (BMI) and waist-hip ratio (WHR) (<0.0001). The experimental group which received active low-level laser in addition to moderate-intensity aerobic exercise showed more significant results compared to the control group which received placebo low-level laser in addition to moderate-intensity aerobic exercise in all the measured outcomes (<0.001).

Conclusion: Combined low-level laser therapy and moderate-intensity aerobic exercises are more effective in improving the cognitive function and quality-of-life of Alzheimer's disease patients.

Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT04496778.
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http://dx.doi.org/10.2147/IJGM.S280559DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7813463PMC
January 2021

Hepatotoxic effects of silver nanoparticles on ; Biochemical, histopathological, and histochemical studies.

Toxicol Rep 2020 7;7:133-141. Epub 2020 Jan 7.

Department of Zoology, Faculty of Science, Assiut University, Assiut, 71516, Egypt.

The current study investigates the hepatotoxic effects of two acute doses of silver nanoparticles (AgNPs) and silver nitrate (AgNO) on African catfish ( using biochemical, histopathological, and histochemical changes and the determination of silver in liver tissue as biomarkers. AgNPs-induced impacts were recorded in some of these characteristics based on their size (20 and 40 nm) and their concentration (10 and 100 μg/L). Concentrations of liver enzymes (Aspartic aminotransferase; AST, Alanine aminotransferase; ALT), alkaline phosphatase (ALP), total lipids (Tl), Glucose (Glu) and Ag-concentration in liver tissue exhibited a significant increase under stress in all exposed groups compared to the control group. The total proteins (Tp), albumin (Al), and globulin (Gl) concentrations exhibited significantly decrease in all treated groups compared to the control group. At tissue and cell levels, histopathological changes were observed. These changes include proliferation of hepatocytes, infiltrations of inflammatory cells, pyknotic nuclei, cytoplasmic vaculation, melanomacrophages aggregation, dilation in the blood vessel, hepatic necrosis, rupture of the wall of the central vein, and apoptotic cells in the liver of AgNPs-exposed fish. As well as the depletion of glycogen content in the liver (feeble magenta coloration) was observed. The size and number of melanomacrophage centers (MMCs) in liver tissue showed highly significant difference in all exposed groups compared to the control group. Recovery period for 15 days led to improved most alterations in the biochemical, histopathological, and histochemical parameters induced by AgNPs and AgNO. In conclusion, one can assume liver sensitivity of for AgNPs and the recovery period is a must.
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http://dx.doi.org/10.1016/j.toxrep.2020.01.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6962648PMC
January 2020

A significant upsurge of body mass index in patients with chronic hepatitis C successfully treated with direct-acting antiviral regimens.

Turk J Gastroenterol 2019 08;30(8):708-713

Endemic Medicine and Hepato-Gastroenterology Department, Cairo University School of Medicine, Cairo, Egypt.

Background/aims: There is less data regarding the changes in body mass index (BMI) after treating hepatitis C virus (HCV) patients with new direct-acting antiviral agents (DAAs). This study aimed to assess the changes in BMI in chronic HCV patients treated with DAAs in Egypt and to explore other factors influencing this change.

Materials And Methods: The data of chronic HCV patients who received antiviral therapy with new DAAs in one of Egypt's specialized viral hepatitis treatment centers were retrospectively analyzed. In addition to the routine clinical and laboratory workup, changes in body weight during and after treatment were monitored and BMI was calculated. Viral load was measured at 12 weeks post-treatment to assess a sustained virological response. Patients with documented thyroid abnormalities, bariatric surgery, or ensuing special diets were excluded. BMI of >30 was taken as the cutoff for pa¬tients with obesity.

Results: The study included 162 patients with a mean age of 48.56±11.49 years, of whom 61.1% were males, 16% were treatment-experienced, 12% were diabetic, and 29% were obese. Treatment duration was 12 weeks in 84% of patients and 24 weeks in 16% of patients. There was a significant increase in BMI post-treatment as compared to pretreatment measures (28.68±5.35 vs 28.18±4.55) (p=0.03). BMI changes were constant regardless of cirrhosis or previous treatment experience.

Conclusion: Treatment of chronic HCV with DAAs was associated with increased body mass index. Further studies are needed to explore if this effect is secondary to treatment with DAAs or is an improvement in the liver function and lifestyle of treated patients.
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http://dx.doi.org/10.5152/tjg.2019.18514DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6699564PMC
August 2019

Silver nanoparticle-induced nephrotoxicity in Clarias gariepinus: physio-histological biomarkers.

Fish Physiol Biochem 2019 Dec 10;45(6):1895-1905. Epub 2019 Aug 10.

Department of Zoology, Faculty of Science, Assiut University, Assiut, 71516, Egypt.

The present study investigates the nephrotoxic effects of two acute doses of silver nanoparticles (AgNPs) and silver nitrate (AgNO) on the African catfish, Clarias gariepinus, using biochemical, histochemical, and histopathological changes as biomarkers. AgNP-induced impacts were recorded in some of these characteristics on the bases of their size (20 and 40 nm) and concentration (10 and 100 μg/L) but no significant interaction between size and concentration. AgNO had low significant adverse effects on some parameters in comparison with those impacts of AgNPs. The concentrations of creatinine and uric acid exhibited different significant variations under stress in all exposed groups compared with those in the control group. On the tissue and cell levels, histopathological changes were observed. These changes include hypertrophies of glomeruli, proliferation in the haemopoietic tissue, dissociation in renal tubules, shrinkage of glomerulus, hydropic degeneration, dilatation of renal tubules, aggregation of melanomacrophages, rupture of Bowman's capsule, and the glomerular tuft and dilatation of Bowman's space. In more severe cases, the degenerative process leads to tissue necrosis in the kidney of AgNP-exposed fish as well as carbohydrate depletion; a faint coloration was also observed in the brush borders and basement membrane with a large amount of connective tissue fibers around the blood vessels and the renal tubules. Recovery period for 15 days led to improvement of most of the alterations in biochemical, histopathological, and histochemical parameters induced by AgNPs and AgNO. In conclusion, one can postulate on the sensitivity of the kidney of C. gariepinus to AgNPs and recovery strategy is a must.
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http://dx.doi.org/10.1007/s10695-019-00686-7DOI Listing
December 2019

Abdominal subcutaneous fat thickness and homeostasis model assessment of insulin resistance as simple predictors of nonalcoholic steatohepatitis.

Diabetes Metab Syndr Obes 2019 11;12:1105-1111. Epub 2019 Jul 11.

Department of Internal Medicine, School of Medicine, Cairo University, Cairo, Egypt.

Obesity, insulin resistance, and diabetes are major risk factors for nonalcoholic fatty liver disease (NAFLD). This study aims to evaluate the association between different grades of NAFLD and abdominal subcutaneous fat thickness with the homeostasis model assessment of insulin resistance (HOMA-IR). In this pilot study, 59 obese nondiabetic participants with NAFLD were enrolled. Total cholesterol, Hb, and HOMA-IR were measured. Abdominal subcutaneous fat thickness in the midline just below the xiphoid process in front of the left lobe of the liver (LSFT) and in the umbilical region (USFT), and the degree of hepatic steatosis, were evaluated by ultrasound scans, and their correlation with the degree of steatosis and the NAFLD Activity Score in liver biopsy was assessed. Of the 59 studied participants, 15 had mild, 17 had moderate, and 27 had severe hepatic steatosis by abdominal ultrasound. The mean ± SD HOMA-IR level in NAFLD patients was 5.41±2.70. The severity of hepatic steatosis positively correlated with body mass index (<0.001), HOMA-IR (0.001), serum triglycerides (=0.001), LSFT (<0.001), and USFT (<0.001). Receiver operating characteristics analysis showed that LSFT at a cut-off of 3.45 cm is the most accurate predictor of severe hepatic steatosis, with 74.1% sensitivity and 84.4% specificity. The best cut-off of USFT for identifying severe hepatic steatosis is 4.55 cm, with 63% sensitivity and 81.3% specificity. Abdominal subcutaneous fat thicknesses in front of the left lobe of the liver and in the umbilical region, together with HOMA-IR, are reliable indicators of the severity of NAFLD in obese nondiabetic individuals.
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http://dx.doi.org/10.2147/DMSO.S202343DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628957PMC
July 2019

Ovarian reserve in an Egyptian cohort with end-stage kidney disease on hemodialysis and after successful kidney transplantation: a prospective study.

Int Urol Nephrol 2019 Apr 8;51(4):737-743. Epub 2019 Feb 8.

Urology Department, Cairo University School of Medicine, Cairo University, Cairo, Egypt.

Background: Women with chronic kidney disease commonly have menstrual irregularities and fertility abnormalities. Antimüllerian hormone (AMH) and antral follicle count (AFC) are well-recognized indicators of ovarian reserve.

Aims: To assess AMH level and total AFC in women who are on hemodialysis and after successful kidney transplantation (KTx).

Methods: Sixty women with end-stage kidney disease (ESKD) on regular hemodialysis were included in this study with 20 patients of them were going to have renal transplant. Fifty age-matched healthy females were enrolled as control. Serum AMH level was measured in all participants once and in transplant patients four times (before surgery, and at 1, 6, and 12 months after surgery). AFC was evaluated once in all subjects and in transplant patients twice (before and 1 year after surgery).

Results: ESKD patients had significantly lower AMH concentration and AFC than healthy controls (1.8 ± 1.2 vs. 3.5 ± 1.7 ng/ml, p < 0.001) and (12 ± 4.6 vs. 17.4 ± 4.3, p < 0.001), respectively. In the subgroup transplant patients, AMH level decreased significantly from (1.7 ± 1.3 ng/ml) before Ktx to (1.5 ± 1.2 ng/ml, p = 0.001) at 1 month, (1.1 ± 0.9 ng/ml, p < 0.001) at 6 months, (0.9 ± 0.8 ng/ml, p < 0.001) at 1 year after Ktx. Also, total AFC declined in transplant females from (11.1 ± 4.5) before KTx to (6.6 ± 3.4) after KTx (p < 0.001).

Conclusions: Women with ESKD who are on hemodialysis have lower ovarian reserve than healthy females. Moreover, renal transplantation was associated with reduction in AMH level and AFC.
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http://dx.doi.org/10.1007/s11255-019-02089-2DOI Listing
April 2019

Diabetes Association with Liver Diseases: An Overview for Clinicians.

Endocr Metab Immune Disord Drug Targets 2019 ;19(3):274-280

Faculty of Medicine, Cairo University, Cairo, Egypt.

Background: There is a strong association between liver diseases and diabetes (DM) which is higher than expected by a correlation between two very common diseases. Liver diseases may occur as a result of diabetes, and the reverse is true as well.

Aim: To review the etiology of this association between liver diseases and diabetes and how to diagnose it.

Methods: Studies that identified this association between liver diseases and diabetes and how to diagnose it was reviewed.

Results: This association can be divided into the following categories: liver disease related to diabetes (Diabetic hepatopathy), hepatogenous diabetes (HD), and liver diseases that occur in conjunction with Diabetes mellitus. Two hours after glucose loading is the best screening test for HD. HbA1c may neither be suitable for diagnosis nor monitoring of diabetes that links liver disease.

Conclusion: NAFLD, hepatogenous diabetes, glycogenic hepatopathy and diabetic hepatosclerosis are the most important association between liver diseases and diabetes. The criteria for the diagnosis of diabetes associating liver disease are the same for primary diabetes. Two hours post glucose load is the best screening test for HD due to the fact that fasting glucose can be normal early in the disease. The tool used for diabetes monitoring depends on stage and severity of liver condition.
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http://dx.doi.org/10.2174/1871530318666181116111945DOI Listing
August 2019

Managing diabetes and liver disease association.

Arab J Gastroenterol 2018 Dec 9;19(4):166-179. Epub 2018 Nov 9.

Kasr Al Aini, Egypt.

There is strong association between liver diseases and diabetes (DM) which is higher than expected by a chance association of two very common disorders. It can be classified into three categories: Liver disease related to diabetes, hepatogenous diabetes (HD), and liver disease occurring coincidentally with DM. The criteria for the diagnosis of diabetes associating liver disease are the same for primary diabetes. Two hours post glucose load is a better screening test for HD. HbA1c may not be suitable for diagnosis or monitoring of diabetes associating advanced liver disease. Apart from the increased cardiovascular risk in patients with type 2 DM (T2 DM) and NAFLD, the cardiovascular and retinopathy risk is low in HD. Patients with metabolic derangement should be screened for NAFLD which in turn may predict T2 DM development. Similarly, patients with established T2 DM should also be screened for NAFLD which further contributes to diabetes worsening. Diabetes is a significant risk factor for progression of the chronic liver disease. It is associated with poor patient survival. Treatment of diabetes associating liver disease appears beneficial. Metformin, if tolerated and not contraindicated, is recommended as a first-line therapy for patients with diabetes and chronic liver disease (CLD). If the hepatic disease is severe, insulin secretagogues should be avoided because of the increased risk of hypoglycaemia. Pioglitazone may be useful in patients with fatty liver disease. DPP-4 inhibitors showed effectiveness and safety for the treatment of T2 DM in CLD patients up to those with child B stage. GLP-1 receptor agonists and SGLT-2 inhibitors exhibit positive effects on weight and are associated with minimal risk of hypoglycaemia. Insulin must be used with caution, as hypoglycaemia may be a problem. Insulin analogues are preferred in the context of hypoglycaemia Statins can be used to treat dyslipidaemia in NAFLD, also the use of angiotensin II receptor antagonist for hypertension is safe and beneficial Given the clear association between diabetes mellitus and hepatocellular carcinoma, the strict control of glycaemia with insulin sensitizers can be essential in its prevention. The addition of DM to the currently used scores (Child-Pugh and MELD scores) may enhance the sensitivity and the specificity for prediction of morbidity and mortality rates in cirrhotic patients. In the new era of directly acting antiviral agents (DAAs) for HCV treatment, it is recommended to follow up lipid profile and blood sugar levels following SVR in order to adjust doses of medications used in diabetic (SVR is associated with reduction in insulin requirements) and dyslipidaemic patients (rebound increase in the lipid profile after clearing the virus may increase risk of cardiovascular disease (CVD)). The issues of post liver transplant diabetes and relation between DM and chronic HBV are highlighted. This narrative review and Consensus-based practice guidance (under revision and criticism) are based on a formal review and analysis of the recently published world literature on the topic (Medline search up to September 2017); and the experience of the authors and independent reviewers.
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http://dx.doi.org/10.1016/j.ajg.2018.08.003DOI Listing
December 2018

Towards hepatitis C virus elimination: Egyptian experience, achievements and limitations.

World J Gastroenterol 2018 Oct;24(38):4330-4340

Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo 11599, Egypt.

Worldwide, more than one million people die each year from hepatitis C virus (HCV) related diseases, and over 300 million people are chronically infected with hepatitis B or C. Egypt used to be on the top of the countries with heavy HCV burden. Some countries are making advances in elimination of HCV, yet multiple factors preventing progress; remain for the majority. These factors include lack of global funding sources for treatment, late diagnosis, poor data, and inadequate screening. Treatment of HCV in Egypt has become one of the top national priorities since 2007. Egypt started a national treatment program intending to provide cure for Egyptian HCV-infected patients. Mass HCV treatment program had started using Pegylated interferon and ribavirin between 2007 and 2014. Yet, with the development of highly-effective direct acting antivirals (DAAs) for HCV, elimination of viral hepatitis has become a real possibility. The Egyptian National Committee for the Control of Viral Hepatitis did its best to provide Egyptian HCV patients with DAAs. Egypt adopted a strategy that represents a model of care that could help other countries with high HCV prevalence rate in their battle against HCV. This review covers the effects of HCV management in Egyptian real life settings and the outcome of different treatment protocols. Also, it deals with the current and future strategies for HCV prevention and screening as well as the challenges facing HCV elimination and the prospect of future eradication of HCV.
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http://dx.doi.org/10.3748/wjg.v24.i38.4330DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189850PMC
October 2018

Serum level of the autophagy biomarker Beclin-1 in patients with diabetic kidney disease.

Diabetes Res Clin Pract 2018 Sep 28;143:56-61. Epub 2018 Jun 28.

Department of Medical Biochemistry, School of Medicine, Cairo University, Egypt.

Autophagy is a major cellular clearance mechanism that maintains cellular survival and homeostasis. Autophagy has a crucial role in the progression of diabetes and kidney diseases.

Aims: To investigate serum concentrations of Beclin-1, a key regulator of autophagy, in patients with diabetic kidney disease (DKD).

Methods: The study included 70 patients with type 2 diabetes and DKD (group 1; 35 patients with estimated glomerular filtration rate (eGFR) ≥ 30 ml/min/1.73 m and group 2; 35 patients with eGFR < 30 ml/min/1.73 m) and 20 age- and sex-matched healthy subjects (group 3). Laboratory work up included; glycated hemoglobin (HbA1c), serum creatinine, eGFR using modification of diet in renal disease (MDRD) formula, urine albumin to creatinine ratio (ACR), and serum Beclin-1 measurement.

Results: Patients with DKD had significantly lower Beclin-1 levels (2.38 ± 1.46 ng/mL) compared to control group (6.03 ± 1.94 ng/mL; P < 0.001). Moreover, serum Beclin-1 significantly decreased in group 2 (1.43 ± 0.83 ng/mL) compared to group 1 (3.36 ± 1.30 ng/mL; P < 0.001). In univariate analysis, the concentration of Beclin-1 correlated well with eGFR (r = 0.64, P < 0.001), ACR (r = -0.63, P < 0.001), and duration of diabetes (r = -0.43, P < 0.001) but didn't correlate with HbA1c (r = -0.17, P = 0.15). However, ACR was the only significant predictor of Beclin-1 level on performing multiple regression analysis (β = -0.40, P = 0.01).

Conclusion: Serum level of Beclin-1 is reduced in patients with DKD. Furthermore, its level is related to the stage of DKD and correlates with the degree of albuminuria.
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http://dx.doi.org/10.1016/j.diabres.2018.06.022DOI Listing
September 2018

Fibroblast growth factor-23 is a strong predictor of insulin resistance among chronic kidney disease patients.

Ren Fail 2018 Nov;40(1):226-230

a Nephrology Unit, Internal Medicine Department, School of Medicine , Cairo University , Cairo , Egypt.

Insulin resistance (IR) is very common among chronic kidney disease (CKD) patients. Disturbance in mineral and bone metabolism (MBD) seems to play a role in the pathogenesis of insulin resistance. Fibroblast growth factor-23 (FGF23) is evolving as the most important link between MBD and many pathologic sequences of CKD. The aim was to evaluate IR in pre-dialysis CKD patients looking for a possible association to mineral metabolism among CKD patients. A total of 100 stage 3-5 CKD patients were selected beside 20 normal control subjects. Homeostatic model assessment of insulin resistance (HOMA-IR) was used to assess IR in selected cases. Both groups were compared for fasting blood glucose (FBG), fasting blood insulin (FBI), HOMA-IR, estimated glomerular filtration rate (eGFR), serum calcium (Ca), phosphorus (P), 25 hydroxy vitamin D (25 OH vit D), parathormone (PTH), and uric acid (UA). Correlation study between HOMA_IR and different studied parameters was performed. HOMA-IR is significantly higher in CKD (8.87 ± 3.48 vs. 3.97 ± 0.34 in CKD vs. control, respectively, p < .001). In addition CKD patients have significantly higher FGF23 (235 ± 22.96 vs. 139 ± 12.3 pg/mL, p < .001), PTH (76.9 ± 15.27 vs. 47.9 ± 2.52 pg/mL, p < .001), P (4.3 ± 0.67 vs. 3.6 ± 0.23 mg/dL, p < .001), and UA (5 ± 1.22 vs. 4.85 ± 0.48 mg/dL, p < .001) and significantly lower Ca (8.2 ± 0.3 vs. 8.9 ± 0.33 mg/dL, p < .001), and 25 (OH) vit D (17 ± 5.63 vs. 37 ± 3.43 ng/mL, p < .001). Stepwise linear regression analysis revealed that BMI, GFR, Ca, P, and FGF23 were the only significant predictors of HOMA IR. Increased IR in CKD is a consequence of the uremic status and is intimately associated with disturbed phosphate metabolism and FGF23. Further studies are needed to look for an underlying mechanism.
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http://dx.doi.org/10.1080/0886022X.2018.1455594DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6014287PMC
November 2018

Effects of cadmium on some haematological and biochemical characteristics of Oreochromis niloticus (Linnaeus, 1758) dietary supplemented with tomato paste and vitamin E.

Fish Physiol Biochem 2011 Mar 13;37(1):71-84. Epub 2010 Jul 13.

Department of Zoology, Faculty of Science, Assiut University, Assiut, Egypt.

The present study investigates the potential protective effects of tomato paste (9 mg/kg-lycopene) in comparison with vitamin E (50 mg/kg) against the impacts of cadmium (Cd) toxicity (4.64 mg/l: ¼ of 96 h LC50) on fishes Cd exposed for 15 and 30 days. Cd impacts were evaluated in terms of biological, haematological and biochemical characteristics. Cd significantly induced free radicals in serum and liver. The activities of aspartate aminotransferase and alanine aminotransferase in serum were significantly increased due to Cd. Treatment with Cd caused a significant increase in Lipid peroxidation and DNA fragmentation in liver tissue and serum glucose and total lipid. On the other hand, Cd significantly led to decline in serum total protein, blood haemoglobin, red blood cell count, haematocrit value, mean corpuscular volume, mean corpuscular haemoglobin and mean corpuscular haemoglobin concentration. Dietary supplementation with vitamin E and/or tomato paste to Cd-exposed fish declined significantly the increased lipid peroxidation and DNA fragmentation in liver tissue and the increased aspartate aminotransferase, alanine aminotransferase, glucose and total lipid in serum to the normal condition. This supplementation also significantly increased the declined serum total protein, blood haemoglobin, red blood cell count, haematocrit value, mean corpuscular volume, mean corpuscular haemoglobin and mean corpuscular haemoglobin concentration to the normal state. Cd impacts and tomato paste/or vitamin E supplementations did not reflected on the condition factor of the fish. These findings demonstrated the beneficial diet supplementation of tomato paste phytonutrients and vitamin E in counteracting the harmful effects of Cd on the characters investigated.
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http://dx.doi.org/10.1007/s10695-010-9418-3DOI Listing
March 2011
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