Suhad Bahijri

Background and Objectives :Identification of insulin resistance (IR) in the general population is important for developing strategies to reduce the prevalence of non-insulindependent diabetes mellitus (NIDDM). We used the original and a modified version of the Quantitative Insulin Sensitivity Check Index (QUICKI, M-QUICKI), and the Homeostasis

Background and Objectives :Identification of insulin resistance (IR) in the general population is important for developing strategies to reduce the prevalence of non-insulin-dependent diabetes mellitus (NIDDM). We used the original and a modified version of the Quantitative Insulin Sensitivity Check Index (QUICKI, M-QUICKI), and the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) to divide non-diabetic normotensive adults into high- (HIR) and low-insulin-resistant (LIR) subgroups to investigate similarities and differences in their characteristics. Subjects and Methods : Three hundred fifty-seven healthy adults aged 18-50 years were recruited randomly from health centers in Jeddah in a cross-sectional study design. Anthropometric and demographic information was taken. Insulin, glucose, lipid profile and free fatty acid were determined in fasting blood samples. M-QUICKI, HOMA-IR and QUICKI were calculated. Reported cut-off points were used to identify HIR subjects, who were then matched for age and sex to others in the study population, resulting in 3 HIR and 3 LIR subgroups. Results : Two hundred nine subjects satisfied the selection criteria. M-QUICKI correlated significantly (P=.01) with HOMA-IR and QUICKI values. Increased adiposity was the common characteristic of the three HIR subgroups. HIR subgroups identified using M-QUICKI (97 subjects) and HOMA (25 subjects), but not QUICKI (135 subjects), had statistically different biochemical characteristics compared to corresponding LIR sub-groups. Conclusion : Adiposity, but not sex, is a risk factor for IR in the studied population. Further studies are needed to choose the most appropriate index for detecting IR in community-based surveys.

Objectives: To investigate chromium status of the adult population in the western region of Saudi Arabia and the possibility of using serum chromium status measurement as indicator of this status. Methods: The effect of chromium supplement on glucose tolerance and lipid profile was studied in 44 normal, free living adults. 200mg chromium/day as CrCL3 or a placebo was given in a double blind cross-over study, with 8 weeks experimental periods. Fasting, 1 hour and 2 hour post glucose challenge (75 g of glucose) glucose, serum fructosamine, total cholesterol, high-density lipoprotein-cholesterol, triglycerides, chromium and dietary intakes were estimated at the beginning and the end of each stage. Results: Mean serum chromium increased significantly after supplement (P<.001) indicating proper absorption of the element. Supplement did not effect the total cholesterol, however, the mean high-density lipoprotein-cholesterol level was significantly increased (P<.001), the mean triglycerides levels significantly decreased (P<.001), and the mean fructosamine level significantly decreased (P<.05). In addition, chromium supplement effected 1 hour and 2 hour post glucose challenge glucose levels in subgroups of subjects with 2 hour glucose level > 10% above or below fasting level and significantly differing to it (P<.05 in both cases), by decreasing or increasing them significantly (P<.05 in all cases) so that the 2 hour mean became not significantly different to the fasting mean. Since no significant changes in weight, dietary intake or habits were found, and placebo had no effect, all noted biochemical changes were attributed to chromium. Conclusion: Improved glucose control, and lipid profile following chromium supplement suggests the presence of low chromium status in the studied population. However, serum chromium could not be recommended for use as an indicator of chromium status as subjects with widely varying levels responded favorably to the chromium supplement.

This study was conducted to measure the consumption of fluorine in the population in the Jeddah area to investigate the level of increase in consumption for the limit, and the results of such an increase to public health. Been attracted 145 members of the healthy and aged between 7 50 years, divided into three age groups as follows: from 7 12 years (30 children), and from 13 20 years old (30 individuals), and from 20 50 years ( 85 individuals). Also attracted 30 people suffer from a lack of activity of the thyroid gland. And through a personal interview recorded dietary habits and the quantities of food consumed by individuals as well as their use of health products containing fluorine, and through two questionnaires containing one to the list of foods with a level known from fluorine and identifies the person consumed weekly for each type of them, and the second contains questions about daily consumption cells 24 hours prior to the person of foods, beverages and materials containing the element fluorine, as well as the habits of health care with his teeth. Were also examined clinically and examined their teeth to detect the incidence of caries and Filorucez. 15 people have found adults with Bafilhusiz. At the same time from blood samples were taken in the fasting state. To measure glucose, insulin and thyroid hormones and parathyroid and hormone stimulating the thyroid gland, calcium, phosphate, albumin, urea, creatinine, and then took a blood sample again two hours after the intake of glucose (75 g for an adult and 1 g / kg for children) to measure the level of insulin and glucose is also taken from all individuals, Paul and a sample of drinking water also to measure the fluorine in them. Were measured fluorine in all types of drinking water, tea, coffee and other beverages, and used in addition to the information of other food in the calculation of the amount of fluoride which is addressed in each individual, based on the divided people into groups by age and by daily consumption of fluorine, so that the situation of individuals who consume more than required in the group and others in another group within the age groups, was adopted in the division on the values ​​used in Canada, which takes into account the weight of the individual and thus calculates the consumption Bmaekerogeram / kg / day has been found that the group consuming high a percentage of major total of different ages. 53.33% of the group of children and 20% of a group of adolescents and 64.7% of the Group of adults has appeared on some of these individual signs of lack of thyroid activity, reflected the increased secretion of the hormone stimulating the thyroid gland when many of them, as well as an overactive parathyroid gland represented by the increase in the average the value of thyroid hormone [PTH], and reflected the decrease in the average level of phosphorus in all groups, the age of high consumption, in addition to the back of disorder in glucose tolerance represented by the high level of glucose than normal two hours after intake than in many of these individuals and reflected on the the high level of insulin in the same period, as well as in the case of fasting, along with that suffered many of the individuals in the groups with high consumption of anemia and represented in the low level of hemoglobin and hematocrit, the size and number of red blood cells and hemoglobin concentration by, as suspected dysfunction college when some patients with lack of thyroid activity and those who consume high amounts of fluoride, may reverse the effects of increasing fluorine in the case of reduction of consumption in most cases, except for anemia. One of the reasons for the increased consumption of fluoride in children and adolescents increased medical materials containing fluorine, while the main cause in adults is to increase drinking tea. Based on the above, it was concluded that increased consumption of fluoride is dangerous in our society, but not during the First Age. It remains a continuing risk to the lack of apparent changes in individuals, but the side effects affect the biochemical reactions in the body and the formation of blood cells. Therefore it is necessary to warn against the danger of using materials Alhtoah the fluorine in the daily care of the teeth in the long run, as well as a lot of drinking tea, as it has to be public awareness to the dangers of fluoride consumption.

Background Most of hematology laboratories in Saudi Arabia utilize the reference intervals (RIs) provided by instrument manufacturers. This study aimed to define RIs of hematological parameters for adult population in the western region of Saudi Arabia and to explore their specific features from an international perspective. Method This study was conducted according to the harmonized protocol of IFCC Committee on RIs and Decision Limits. Blood samples collected from 409 healthy Saudi males and females adults were analyzed for complete blood count (CBC) by using Cell-Dyn Sapphire analyzer and for iron profile by using Architect analyzers. The needs for RIs partitioned by sex and age was based on standard deviation ratio (SDR) and/or bias ratio (BR). RIs were derived parametrically with/without application of the latent abnormal values exclusion method (LAVE). Results Based on thresholds of SDR≥0.4 and/or BR≥0.57, RIs were partitioned by sex for red-blood cell count, hemoglobin, hemat...

Abstract: The clustering of risk factors predisposing an individual to cardiovascular morbidity and mortality are usually referred to as the ‘metabolic syndrome’ (MS). Several definitions exist, causing confusion to practicing clinicians. A consensus definition was reached by several major organizations stating that the presence of any three of five risk factors (abdominal obesity, elevated triglyceride, reduced high-density lipoprotein cholesterol, elevated blood pressure, and elevated fasting glucose) constitutes a diagnosis. Cutoff points for each of the risk factors were defined, taking into account ethnicity in case of abdominal obesity. The prevalence of MS has been reported to be on the rise globally, and was mainly attributed to changes in diet and lifestyle, in addition to genetic factors and metabolic susceptibility. The risk of cardiovascular disease (CVD) has almost doubled and the risk of developing type 2 diabetes mellitus (T2DM) has increased fivefold in individuals diagnosed with MS. The prevalence T2DM in Saudi Arabia is increasing, making it an epidemic health hazard. Intervention programs to decrease the risk of progression from MS to full T2DM, and later CVD have been successful in many countries. Therefore, diagnosing MS is important to address risk factors and to prevent progression to the more serious chronic conditions.The prevalence of MS in Saudi adults varies from 16% to 40% depending on the definition used and the study location. Use of the consensus definition might decrease the number of missed cases. However, in the absence of local cutoff points for various risk factors for MS, the use of ratios such as waist/hip ratio and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio, and family history of diabetes and CVD might aid diagnosis. Priority should be given to establishing national normal ranges, screening programs for hyperglycemia and hypertension, and community-directed programs to combat obesity and inactivity.

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory ...

Nonalcoholic fatty liver disease (NAFLD) is common among Saudi patients with type 2 diabetes (T2DM). However, recommended clinical procedures to detect it are unavailable in many locations. Therefore, better and more available diagnostic biomarkers for NAFLD are needed. Various serum parameters were suggested, and algorithms that employ routine measurements in clinical practice have been developed for the prediction of fat stores in the liver in different populations. However, no such studies have been conducted on Saudis. We aimed to compare selected biochemical markers and calculated indices in T2DM patients diagnosed with NAFLD and patients without NAFLD to find the best markers associated with NAFLD. A cross-sectional study was employed to recruit 67 people with T2DM from endocrine outpatient clinics at King Abdul-Aziz University Hospital. NAFLD was detected by ultrasonography in 28 patients. Demographic information, anthropometric, and blood pressure (BP) measurements were take...

The continuous battle between humans and the multitude of pathogenic microorganisms in the environment has sought relief in the form of antimicrobials. But the counter attack by pathogenic organisms in the form of multidrug resistance, acquired by various mechanisms such as transformation, transposition, conjugation and transduction is a major reason for concern. Bacteriophages have contributed in a significant way to dissemination of genes encoding antimicrobial resistance, heavy metal resistance and virulence factors through the phenomenon of transduction. This review aims at compiling information about the different mechanisms by which bacteriophages aid in transferring genes involved in antimicrobial resistance to Escherischia coli in various environments.

The association between lifestyle practices, obesity and increased BP are under-investigated. We aimed to investigate this association to identify the factors associated with hypertension and prehypertension in Saudis. Non-diabetic adults were recruited from public healthcare centers using a cross-sectional design. Recruits were interviewed using a predesigned questionnaire. Weight, height, waist circumference (WC), hip circumference (HC), neck circumference (NC) and BP were measured. The variables were analyzed by comparing the prehypertensive and hypertensive groups with the normotensive group. A total of 1334 adults were included. The study found that 47.2% of men and 24.7% of women were prehypertensive, and 15.1% of men and 14.4% of women were hypertensive. High BMI, WC, NC, and WC: HC ratios were associated with an increased risk of prehypertension and hypertension in men and women. Low physical activity was associated with an increased risk of elevated BP in men, while sleep d...

With increasing prevalence of metabolic syndrome and absence of local waist circumference cut-off point, it is important to determine the local cut-off point of waist circumference to predict metabolic syndrome. The aim of this study is to estimate the prevalence of metabolic syndrome among Saudi adults who attend primary health care centers (PHC) in Jeddah city in 2017, and to determine the appropriate waist circumference cut-off value for identifying a person at risk for the metabolic syndrome. A cross-sectional analytic study was conducted. Results shows; mean age of participants was 30.94±9.70 and waist circumference was 96.87±17.40 in males and 86.51±15.30 in females. The prevalence (CI: 95%) of pre-diabetes was 16.3% (12.9%; 20.1%), while the prevalence of metabolic syndrome was {(95% CI = 10.6%) (7.80%; 13.8%)}. Abdominal obesity was the most frequent component of MetS, detected in 60.6%, and followed by high blood pressure in 25.0%. In males, a waist circumference≥93.5 cm is...

Background: Obesity is a risk factor for many chronic diseases, and its prevalence and trends vary among populations. Saudi Arabia shows a greater rise in prevalence than many other countries. We aimed to study the association between several chronic disorders, demographic, and lifestyle factors with increased body mass index (BMI) in the adult population of Jeddah. Methods: Data were obtained from a door-to-door cross sectional study. A three-stage stratified cluster sampling technique was adopted. Individuals in selected households agreeing to participate were interviewed to complete a predesigned questionnaire covering demographic and lifestyle variables, medical history, and family history of chronic diseases. This was followed by anthropometric and blood pressure measurements. A random capillary plasma glucose (RPG) was measured, followed by further testing using fasting plasma glucose and glycated hemoglobin (HbA1c) to verify whether participants were normal, diabetic, or pred...

Whole blood donation has immunomodulatory effects, and most of these have been observed at short intervals following blood donation. This study aimed to investigate the impact of whole blood donation on lymphocyte subsets over a typical inter-donation interval. Healthy male subjects were recruited to study changes in complete blood count (CBC) (n = 42) and lymphocyte subsets (n = 16) before and at four intervals up to 106 days following blood donation. Repeated measures ANOVA were used to compare quantitative variables between different visits. Following blood donation, changes in CBC and erythropoietin were as expected. The neutrophil count increased by 11.3% at 8 days (p &lt; .001). Novel changes were observed in lymphocyte subsets as the CD4/CD8 ratio increased by 9.2% (p &lt; .05) at 8 days and 13.7% (p &lt; .05) at 22 days. CD16-56 cells decreased by 16.2% (p &lt; .05) at 8 days. All the subsets had returned to baseline by 106 days. Regression analysis showed that the changes i...

Population specific associations between cardiovascular disease with various risk factors including pre-hypertension and hypertension were reported. We aimed to investigate the association of higher than optimal blood pressure with measures of dysglycemia, dyslipidemia, and markers of inflammation in non-diabetic Saudi adults hoping to improve current Saudi guidelines to prevent cardiovascular disease. Volunteers were recruited randomly from public healthcare centers in Jeddah. Demographic information, blood pressure (BP), and anthropometric measurements were taken. Fasting blood samples were drawn, then again following 1-hour oral glucose tolerance test. Glycated hemoglobin, fasting plasma glucose (FPG), lipid profile, highly sensitive C-reactive protein, gamma glutamyl transferase, and 1-hour plasma glucose were measured. Complete data was found for 742 men and 592 women. Pre-hypertension was found in 47.2% of men, and 24.7% of women, while 15.1% of men, and 14.6% of women were hypertensive. Means of measured variables differed significantly between normotensive, pre-hypertensive, and hypertensive groups of men and women in gender specific manner. Association between measured variables and elevated BP, and hypertension were assessed using logistic regression models. After adjustment for age, body mass index and waist circumference, elevated blood pressure was associated with elevated triglycerides in men, while hypertension was significantly associated with elevated fasting plasma glucose, total cholesterol, triglycerides, low density lipoprotein-cholesterol, and low high density lipoprotein-cholesterol in men, and elevated triglycerides, and total cholesterol in women. Therefore, it is strongly recommended to measure lipid profile, specifically TG, for all diagnosed pre-hypertensive and hypertensive patients in addition to FPG for men.

Sobia is a traditional locally made fermented beverage consumed in Saudi
Arabia and made by the fermentation of wheat. We aimed to measure ethanol
concentration in Sobia beverage stored under different conditions. Forty-eight
freshly made Sobia samples were purchased from different vendors. Twentyfour
samples were stored at room temperature (RT: 21–25°C), and another 24
samples at a cold temperature (CT: 2–8°C). Ethanol was measured in RT samples
on 0, 1, 2, 3, 4 and 7 days, and on 0, 4, 7, and 14 days in CT samples. The mean ±
SE ethanol at zero-time for all 48 samples was 27.2 ± 7.2 mg/dL. Ethanol
concentration increased to 121.8 ± 33.5 mg/dL on day 14 at CT, compared to
514.0 ± 91.9 mg/dL after one week at RT. Sobia can be categorized as Halal
beverage, and can be consumed within two weeks when stored at a CT.

Background: The accuracy of 25- hydroxyvitamin D3 (25OHD3) measurement
on specimens collected into serum separator tubes (SSTs) has been questioned
because of possible interference by the gel. Possible interference was investigated
in SSTs from Becton Dickinson (BD).
Design and methods: Blood specimens were collected simultaneously from 50 normal subjects into plain tubes and SSTs. 25OHD3 was assayed on serum using high performance liquid chromatography (Chromsystems), and Architect (Abbott) and Liaison (Diasorin) immunoassays.
Results: There were no significant differences between 25OHD3 results (means ± SE, nmol/l) obtained from specimens collected into plain tubes and SSTs assayed by HPLC (39.0 ± 2.7 vs. 39.3 ± 2.7), Liaison (32.9 ± 2.2 vs. 32.8 ± 2.3), or Architect (43.1 ± 2.8 vs. 43.2 ± 2.8). In specimens collected into plain tubes and SSTs, 25OHD3 measurements by HPLC correlated significantly (P < 0.0001) with those from the Architect (r = 0.895, r = 0.908) and Liaison (r = 0.907, r = 0.913), respectively. Conclusions: The gel in SSTs (BD) does not interfere with the measurement of 25OHD3 by HPLC or common immunoassays. This important finding may enable clinical laboratories to make cost savings by using SSTs without concerns about inaccuracy.

Background of Study: Fluoride excess is toxic resulting in fluorosis affecting dental and skeletal tissues and leading to osteosclerosis. Reported non skeletal effects include hypothyroidism in animals, and hyperparathyroidism in humans. Tea is a major source of fluoride in diet . Fluoridated dental products could also contribute substantially to over all intake . Both sources are widely used in Saudi Arabia. Thus , undetected excessive fluoride intake and endocrine disorder could be a hidden problem. Objectives: To investigate the existence of fluoride excess and its effect on the thyroid and parathyroid glands. Methods: 145 healthy subjects of different ages (7-50 years) were recruited. Dietary intake was recorded using food frequency questionnaire. Subjects were examined dentally for carries and fluorosis, and clinically for any symptoms of disease. They were questioned on their dental hygiene practice. Fasting blood samples were obtained for the estimation of FT3, FT4, TSH,PTH, ...

Several pre‐analytical factors can affect the measurement of intact Parathyroid Hormone (IPTH). In this study, we have investigated the effects of using different types of tubes, time elapsed before separation, and storage conditions over time on the measured values of IPTH.

Population specific associations between cardiovascular disease with various risk factors including pre-hypertension and hypertension were reported. We aimed to investigate the association of higher than optimal blood pressure with measures of dysglycemia, dyslipidemia, and markers of inflammation in non-diabetic Saudi adults hoping to improve current Saudi guidelines to prevent cardiovascular disease. Volunteers were recruited randomly from public healthcare centers in Jeddah. Demographic information, blood pressure (BP), and anthropometric measurements were taken. Fasting blood samples were drawn, then again following 1-hour oral glucose tolerance test. Glycated hemoglobin, fasting plasma glucose (FPG), lipid profile, highly sensitive C- reactive protein, gamma glutamyl transferase, and 1-hour plasma glucose were measured. Complete data was found for 742 men and 592 women. Pre-hypertension was found in 47.2% of men, and 24.7% of women, while 15.1% of men, and 14.6% of women were h...

Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probit-transforme...

Objective: Study the association of dietary habits and other indicators of lifestyle with dysglycemia in Saudi adults. Methods: In a cross-sectional design, data were obtained from 1403 Saudi adults (⩾20 years), not previously diagnosed with diabetes. Demographics, lifestyle variables and dietary habits were obtained using a predesigned questionnaire. Fasting plasma glucose, glycated hemoglobin and 1-hour oral glucose tolerance test were used to identify dysglycemia. Regression analysis was performed to determine the associations of dietary factors and other indicators of lifestyle with dysglycemia. Results: A total 1075 adults (596 men, and 479 women) had normoglycemia, and 328 (195 men, and 133 women) had dysglycemia. Following adjustment for age, BMI and waist circumference, in men the weekly intake of 5 portions or more of red meat and Turkish coffee were associated with decreased odds of having dysglycemia odds ratio (OR) 0.444 (95% CI: 0.223, 0.881; P = .02) and 0.387 (95% CI:...

Diet and other lifestyle habits have been reported to contribute to the development of dyslipidemia in various populations. Therefore, this study investigated the association between dyslipidemia and dietary and other lifestyle practices among Saudi adults. Data were collected from adults (≥20 years) not previously diagnosed with diabetes in a cross-sectional design. Demographic, anthropometric, and clinical characteristics, as well as lifestyle and dietary habits were recorded using a predesigned questionnaire. Fasting blood samples were drawn to estimate the serum lipid profile. Out of 1385 people, 858 (62%) (491 men, 367 women) had dyslipidemia. After regression analysis to adjust for age, body mass index, and waist circumference, an intake of ≥5 cups/week of Turkish coffee, or carbonated drinks was associated with increased risk of dyslipidemia in men (OR (95% CI), 2.74 (1.53, 4.89) p = 0.001, and 1.53 (1.04, 2.26) p = 0.03 respectively), while the same intake of American coffee...