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- Volume 12, Issue 1, 2007
Journal of Endocrinology, Metabolism and Diabetes in South Africa - Volume 12, Issue 1, 2007
Volume 12, Issue 1, 2007
Author Willie MollentzeSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 12 (2007)More Less
The metabolic syndrome using the National Cholesterol Education Program and International Diabetes Federation definitions among urbanised black South Africans with established coronary artery diseaseSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 12, pp 6 –12 (2007)More Less
Background. The International Diabetes Federation (IDF) introduced a new definition of the metabolic syndrome (MS) that emphasises ethnic-specific cut-offs for waist circumference (WC).
Objective. To compare MS prevalence rates using the National Cholesterol Education Program Adult Treatment Panel III (NCEP: ATP III) and IDF definitions.
Methods. Anthropometric data, fasting biochemical variables and MS prevalence rates were measured in 40 black patients with established coronary artery disease (CAD). Glucose metabolism was assessed using the oral glucose tolerance test (OGTT), and insulin-mediated glucose disposal (M-value) was evaluated using the hyperinsulinaemic euglycaemic clamp technique.
Results. Based on the NCEP: ATP III definition, MS prevalence was 60% and using the IDF definition, it was 57.5%. The two definitions similarly classified ~83% of patients as being MS positive or MS negative. Lower WC cut-offs in the IDF definition classified greater numbers of men and women as having WC as a risk factor - IDF v. NCEP: ATP III men 57.6% v. 36.4%; women 100% v. 71.4%. Impaired glucose tolerance (IGT) was found in 12 of the 40 patients (30%) and diabetes mellitus (DM) in 8 (20%). Mean M-value was reduced in IGT and DM groups compared with the normal group, significantly so in the DM group (p = 0.01).
Conclusions. NCEP: ATP III and IDF definitions both generated similar MS prevalence estimates. The two definitions similarly identified the presence or absence of the MS in the majority of patients. The IDF definition classified greater numbers of men and women as having WC as a risk factor. There was a high prevalence of previously undiagnosed IGT and DM in our South African black patients with established CAD.
Source: Journal of Endocrinology, Metabolism and Diabetes in South Africa 12, pp 14 –16 (2007)More Less
3 years' duration, presented with acute-onset bilateral cataracts. Normal vision was restored to both eyes after Two patients, an adult female with newly diagnosed diabetes and an adolescent female with type 1 diabetes of the cataracts had been extracted successfully.
Source: Journal of Endocrinology, Metabolism and Diabetes in South Africa 12, pp 18 –23 (2007)More Less
Positron emission tomography (PET) has many clinical applications in oncology, neurology and cardiology. PET is widely available in developed countries, and has also become available in a number of middle-income countries, including South Africa. Commonly used PET radionuclides include fluorine-18, carbon-11, nitrogen- 13 and oxygen-15, which are commonly found in organic chemistry and biochemistry. Undoubtedly the most important radiopharmaceutical used in PET scanning at present is [F-18]-FDG, which accumulates in many tumour cells. FDG PET imaging has some specific uses in the evaluation of patients with endocrine tumours. These include the detection of recurrent differentiated thyroid carcinoma in patients with a rising thyroglobulin level and negative iodine scan, and cases of recurrent medullary thyroid carcinoma with rising calcitonin levels. In parathyroid adenoma, FDG PET appears useful in cases where conventional nuclear medicine imaging is negative. For adrenal masses, FDG PET appears to be a highly accurate tool to distinguish benign from malignant lesions. The role of FDG PET in phaeochromocytomas, carcinoids and endocrine pancreatic tumours is probably limited to those that are less well differentiated and metabolically active. However, a future role for PET imaging in the detection of endocrine tumours, using more specific substrates, appears very promising.
Author Martin J. AbrahamsonSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 12, pp 26 –48 (2007)More Less