Open Access Original Research Article

A New Algorithm in the Diagnosis of Thyroid Nodules

Hasan Zafer Acar, Nazmi Özer

Asian Journal of Research and Reports in Endocrinology, Page 1-9

The most important problems in the follow-up of thyroid nodules are missing cancer cases or performing unnecessary thyroidectomy.

The aim of this study is to create a more sensitive, risk free and cost-effective algorithm in the follow-up of thyroid nodules. For this purpose, the current methods used in the diagnosis of thyroid nodules were examined in our study.

As a method to achieve our aim in our study; based on the results of current studies on this subject, noninvasive serum molecular marker diagnosis methods, which have been shown to be superior to invasive biopsy methods in the diagnosis of thyroid cancers in terms of sensitivity, risk and cost, were given priority over invasive biopsy methods in the algorithm and as a result, in this new algorithm; it has been demonstrated that the possibility of missed thyroid cancer cases may be less, and unnecessary surgeries can be prevented at a lower cost.

However, to come to a definitive conclusion about this, our model should be applied in large case series and results should be compared with others.

Open Access Original Research Article

Effect of Emzor Omega 3 Fish Oil on Beta Cell Function of Streptozotocin Induced Diabetic Rats

U. J. O. Orji, H. Brown, E. O. Nwachuku, N. Boisa

Asian Journal of Research and Reports in Endocrinology, Page 10-20

Aim: The aim of this study was to evaluate the effect of Emzor Omega 3 Fish Oil on Beta Cell function of Streptozotocin Induced Diabetic Rats.

Study Design:  An experimental study.

Place and Duration of Study:  Animal House, Department of Applied and Environmental Biology, Rivers State University, Port Harcourt and University of Port Harcourt Rivers State, Nigeria, between February 2020 and August 2020.

Methodology: Thirty Six (36) albino rats were purchased and allowed to acclimatize for two (2) weeks in the laboratory at the animal farm house of the Department of Animal and Environmental Biology, Rivers State University. They were fed the normal rat feed (Chow feed) and water was allowed ad libitum.  The rats were weighed and randomly grouped into six (6) groups with six rats in each group. Group 1 (Negative control) was placed on normal diet while groups 2 to 6 were placed on a high fat diet (HFD) prior to the induction with Streptozotocin to achieve diabetes and the animals were treated according to their groupings for four weeks by means of oral gavage. The dose of Emzor Omega 3 Fish Oil administered to the rats was extrapolated from human doses. The high fat diet was prepared by mixing the animal feed (Chow diet) with margarine in a ratio of 3:1. After each period of treatments, blood samples were collected from the rats at the end of the treatments via cardiac puncture by anaesthetizing the rats with chloroform after a six (6) hour fast. Fasting blood glucose was determined using the Glucose Oxidase method, Insulin Resistance was determined using the homeostatic model assessment for Insulin resistance, plasma insulin and C-peptide levels were measured by ELISA and molecular study was carried out by three stages involving Lysate, Extraction and Real time PCR, and the GC–MS analysis of bioactive compounds from Emzor Omega 3 Fish Oil was done using Agilent Technologies GC systems with GC-7890A/MS-5975C model. Data generated were analysed using SPSS version 22.0 of windows statistical package. Results were considered statistically significant at 95% confidence interval (p < 0.05).

Results: After week 1 - 4 of exposure, the mean INS (Insulin) value of the Negative control group (NC), Positive control (PC) group, diabetic groups exposed for weeks 1, 2, 3 and 4 expressed in mU/ml were 3.78 ± 0.11, 4.94 ± 0.19, 4.58 ± 0.12, 4.31 ± 0.05, 4.03 ± 0.02 and 3.81 ± 0.03  respectively. The mean C-pep (C-peptide) value expressed in ng/ml were 2.91 ± 0.1, 3.98 ± 0.19, 3.95 ± 0.11, 3.89 ± 0.03, 3.75 ± 0.08 and 3.29 ± 0.05 respectively. The mean FBS (Fasting blood sugar) value expressed in mmol/l were 4.36 ± 0.14, 18.65 ± 0.41, 13.43 ± 0.65, 13.30 ± 0.70, 10.85 ± 0.19 and 8.35 ± 0.27 respectively.  The mean HOMA-IR, HOMA-B and HOMA-S (Homeostatic model assessment of insulin resistance and beta cell function) values were respectively 0.71 ± 0.04, 4.10 ± 0.20, 2.70 ± 0.19, 2.56 ± 0.16, 1.95 ± 0.03 and 1.41 ± 0.04 for HOMA-IR, 84.57 ± 12.11, 6.53 ± 0.25, 9.35 ± 0.46, 9.06 ± 0.63, 11.00 ± 0.38 and 16.00 ± 1.10  for HOMA-B and 1.47 ± 0.12, 0.25 ± 0.01, 0.37 ± 0.02, 0.39 ± 0.03, 0.51 ± 0.01 and 0.71 ± 0.02 for HOMA-S. The mean Abl1 gene value were 40.70 ± 1.55, 24.07 ± 0.17, 47.04 ± 0.41, 49.83 ± 0.96, 51.76 ± 1.23 and 55.77 ± 0.56 respectively. The mean GLUT 2 gene value were 66.09 ± 17.52, 23.34 ± 19.53, 51.08 ± 18.06, 57.53 ± 10.56, 59.87 ± 9.41 and 63.16 ± 4.35 respectively.

Conclusion:In this study, supplementation with Emzor Omega 3 Oil had measurable therapeutically potential effect on streptozotocin induced diabetic rats and as such provides evidence that Emzor Omega 3 Oil improve insulin sensitivity in insulin resistant diabetic rats and the expression of GLUT 2 gene which is the major transporter of glucose in pancreatic beta cells is improved in the treated groups as against that seen in the untreated diabetic induced group.

Open Access Original Research Article

Autoantibodies Associated with Diabetes Mellitus in Nigerian Subjects Resident in Port-Harcourt Metropolis

T. Neebee-Sordum, D. G. Tamuno-Emine, D. Onwuli

Asian Journal of Research and Reports in Endocrinology, Page 21-27

Aim: The aim of this study was to determine the autoantibodies associated with diabetes mellitus among diabetics in Port- Harcourt  of Rivers State, Nigeria

Study Design:  This study is a cross-sectional study.

Place and Duration of Study: This study was conducted at Chemical Pathology Department, Rivers State University Teaching Hospital, Port Harcourt, Nigeria, between December, 2019 and February, 2020.

Methodology: A total of 244 subjects, both male and females, 132 subjects 112 controls, aged within 30-70 years. Five (5) ml of blood sample for Islet cell cytoplasm autoantibodies (ICA), Glutamic acid decarboxylase autoantibodies (GADA), Insulinoma-associated-2 autoantibodies (1A-2A) and zinc transporter 8 autoantibodies (ZnT8A), were collected  serum obtained was analyzed  using Enzyme-linked  immunoasorbent assay. Data were analyzed statistically with SPSS version 22.0 and value considered significant at p≤ 0.05.

Results: The mean ± S.D  of serum ICA were 4.48± 2.18u/ml (control)  and 14.91±11.11 u/ml (subject), GADA value were 0.99 ± 0.22u/ml(control) and 1.78 ±0.77u/ml (subjects), IA-2A values were 3.83±1.56 u/ml (control) and 4.20±3.26u/ml and ZnT8A values were 5.61±4.29u/ml (control) and 6.02±3.80u/ml (subjects). The comparison of mean showed significant difference at p=0.0001 for ICA but no significant differences observed GADA, IA-2A and ZnT8A at p=0.152, p=0.595 and p=0.686 respectively.

Conclusion: Diabetes mellitus patient with positive ICA, GADA and IA-2A autoantibodies, higher HbA1c and lower C-peptide suggest an autoimmune or intracellular damage of beta-cells in T2DM and need for insulin dependence or progression to LADA.

Open Access Original Research Article

Effect of Gestational Subclinical Hypothyroidism on the IQ of Offspring

Tamar Peshkova, Irina Nakashidze, Koba Kamashidze, Nino Kedelidze

Asian Journal of Research and Reports in Endocrinology, Page 28-33

Subclinical hypothyroidism (SCH) is the most common endocrine dysfunction during pregnancy. Its impact on the intellectual development of the offspring is not entirely clear. We aimed to evaluate the association between maternal SCH in pregnancy and the Intellectual Quotient (IQ) of offspring and assess benefits from prenatal maternal thyroid hormonal replacement. IQ scores were compared among 8-9-year-old offspring of 146 healthy mothers (control group) whose thyroid-stimulating hormone (TSH) concentrations were < 4.1 mIU/l, of 32 untreated hypothyroid women whose TSH was between 4.1-5.0 mIU/l, and of 29 women (TSH 5-10 mIU/l) who underwent thyroid hormone replacement during pregnancy. In all cases the serum free thyroxine (fT4) was within their respective reference ranges. The IQs of children of healthy and treated for hypothyroid mothers were 105.7 +14.1 and 108.5+14.7, respectively, which was significantly higher (p<0.05) than the mean IQs (98.3+11.4) of offspring from untreated hypothyroid women. Our study demonstrates that the treatment of maternal hypothyroidism during pregnancy appears to be beneficial for the child's intellectual development.

Open Access Original Research Article

Prevalence of Hypertension among Patients with Type-2 Diabetes Mellitus

Md. Ejaj Bari Chowdhury, Farida Yesmin, Tarafder Shahniam Ahmed, Mohammad Mahmudul Huda

Asian Journal of Research and Reports in Endocrinology, Page 34-40

Background: In today’s world diabetes mellitus (DM) and hypertension (HTN) are considered to be the first and second leading causes of all deaths and morbidities. Increasing age, trend of obesity and worsening renal function intensifies the prevalence of hypertension in people with diabetes.

Objective: The aim of this study was to assess the prevalence of hypertension among patients with type-2 diabetes mellitus (T2DM).

Materials and Methods: This was a cross-sectional study was conducted in the Department of Endocrinology of Monowara Sikder Medical College, Shariatpur and Dhaka National Medical College, Dhaka, Bangladesh from January 2020 to December 2020. Total 138 diabetic patients with proper documents were selected as the study population. Besides data regarding T2DM, data about blood pressure as well as hypertension complications were also collected. A predesigned questionnaire was used to obtain patient data. All data were processed and analyzed by MS Office and SPSS version 20.0.

Results: We observed that, out of 138 diabetic patients about 31% were suffering from hypertension. Among them 42.03% patients were pre-hypertensive, 21.01% had stage I HTN and 10.14% had stage II HTN. Besides these, 10.14% participants were with diabetes for 1-5 years, 9.42% for 6-10 years, 6.52% for 11-15 years and 5.07% for more than 15 years.

Conclusion: Prevalence of hypertension among diabetic patients of Bangladesh is pretty alarming. A variety of anthropometrical, physical & personal factors are contributory towards making diabetic patients a potentially vulnerable group for developing hypertension.