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BACKGROUND: The study was designed to examine the value of post-operative and post-ablative serum thyroglobulin levels and diagnostic whole body scan in predicting remission in patients with differentiated thyroid carcinoma. METHODOLOGY: Serum TG levels and diagnostic iodine-123 whole body scans performed prior to and 6-12 months after 131I ablation for DTC were evaluated in 100 consecutive patients at King Faisal Specialist Hospital Riyadh. Patients were followed up for a period of 7.6 years (range 7-10 years). All patients underwent total thyroidectomypriorto 131I ablation. RESULTS: Patients with serum TG levels < 8 ng/ml post thyroidectomy (50 patients) also maintained low TG < 8 ng/ml after 131I ablation and had better outcome (60%) remission. On the other hand DTC subjects with higher TG > 8 ng/ml post thyroidectomy (50 patients) 40% remained in remission X2 = 4.00, p = 0.046. For the group with initial high post-operative TG, it became < 8 ng/ml in 34/50 (68%) patients after ablation with 131I and in this subgroup, remission was seen in 16/34 (47%) of patients in contrast to 4/16 (25%) remission rate in those who continue to have TG > 8 ng/ml after ablation. At the end of follow up, 123I-WBS was positive in 4% and 10% of patients with initial TG < 8 ng/ml and TG > 8 ng/ml respectively; X2 = 1.38, p= 0.24. CONCLUSION: Post-operative and post-ablative serum TG levels -but not follow up diagnostic WBS- have predictive values and permit selection of patients with higher risk for persistent/recurrent disease.
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Radioisótopos de Yodo/uso terapéutico , Periodo Posoperatorio , Tiroglobulina/sangre , Neoplasias de la Tiroides/cirugía , Tiroidectomía , Adulto , Femenino , Humanos , Masculino , Pronóstico , Estudios Prospectivos , Curva ROC , Inducción de Remisión , Factores de TiempoRESUMEN
In an attempt to find genes that may be of importance in malignant progression of papillary thyroid carcinoma (PTC) in the Middle East, which therefore can be targeted in cancer therapy, we screened and validated the global gene expression in PTC using cDNA expression arrays and immunohistochemistry (IHC) on tumour tissue microarrays. Twenty-nine PTC tissue specimens were compared with seven non-cancerous thyroid specimens by use of cDNA microarray. Results for selected genes were confirmed by quantitative real-time PCR. Protein expression of selected genes was further studied using a tissue microarray consisting of 536 PTCs and compared with histologically non-cancerous tissue samples. One hundred and ninety-six genes were overexpressed in PTC tissues relative to non-cancerous thyroid tissues. The genes that were up-regulated in PTC were involved in cell cycle regulation, cell signaling, and oncogenesis. Among these genes, c-MET was identified by immunohistochemical methods as a protein that is overexpressed in 37% of PTCs and was significantly associated with more aggressive behaviour, eg higher stage, nodal involvement, and tall cell variant (p value = 0.01, 0.01 and 0.04, respectively). In this study, 55% of the PTC cases expressed activated AKT (P-AKT), which suggests that activated AKT may play an important role in PTC tumourigenesis. The fact that most of the PTC cases that had activated AKT showed overexpression of c-MET (p = 0.027) leads us to hypothesize that c-MET may be an alternative mechanism of AKT activation in Middle Eastern PTCs. Finally, our data suggest that c-MET dysregulation is associated with aggressive behaviour and may serve as a molecular biomarker and potential therapeutic target in this disease.
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Biomarcadores de Tumor/metabolismo , Carcinoma Papilar/metabolismo , Proteínas Proto-Oncogénicas c-met/metabolismo , Neoplasias de la Tiroides/metabolismo , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/genética , Carcinoma Papilar/genética , Carcinoma Papilar/patología , Carcinoma Papilar/secundario , Niño , ADN Complementario/genética , ADN de Neoplasias/genética , Femenino , Perfilación de la Expresión Génica/métodos , Regulación Neoplásica de la Expresión Génica , Humanos , Masculino , Persona de Mediana Edad , Análisis de Secuencia por Matrices de Oligonucleótidos/métodos , Reacción en Cadena de la Polimerasa/métodos , Proteínas Proto-Oncogénicas c-met/genética , Glándula Tiroides/metabolismo , Neoplasias de la Tiroides/genética , Neoplasias de la Tiroides/patología , Regulación hacia ArribaRESUMEN
OBJECTIVE: Presentation of indications for growth hormone use in children, from the view of physicians practising in Saudi Arabia. METHODS: A questionnaire containing a list of common possible indications of growth hormone use was collected from 52 physicians practising in Saudi Arabia who were attending a didactic endocrinology course. RESULTS: All (100%) physicians considered growth hormone deficiency to be an indication. Sixty four and 29% considered Turner's syndrome and chronic renal failure to be indications. Other indications included Russell-Silver syndrome in 23%, X-linked hypophosphatemic rickets in 10%, Achondroplasts in 10%, Sickle cell anemia in 10% and Bartter's syndrome in 2%. Genetic and constitutional short stature were considered in 17 and 19%. Only 65% did not advocate the use of growth hormone for short non-growth hormone-deficient children. CONCLUSION: Indications of growth therapy are not clearly defined in Saudi Arabia. It is indicated to define this by a clear, national decided criteria which should take into consideration the internationally approved indications, availability and cost of this hormone.
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Actitud del Personal de Salud , Trastornos del Crecimiento/tratamiento farmacológico , Trastornos del Crecimiento/etiología , Hormona del Crecimiento/uso terapéutico , Selección de Paciente , Médicos/psicología , Guías de Práctica Clínica como Asunto , Acondroplasia , Anemia de Células Falciformes/complicaciones , Síndrome de Bartter/complicaciones , Niño , Endocrinología/educación , Endocrinología/métodos , Femenino , Trastornos del Crecimiento/diagnóstico , Hormona del Crecimiento/deficiencia , Hormona del Crecimiento/economía , Hormona del Crecimiento/provisión & distribución , Conocimientos, Actitudes y Práctica en Salud , Humanos , Hipofosfatemia Familiar/complicaciones , Medicina Interna/métodos , Fallo Renal Crónico/complicaciones , Masculino , Pediatría/métodos , Arabia Saudita , Encuestas y Cuestionarios , Síndrome de Turner/complicacionesRESUMEN
OBJECTIVES: To study the prevalence and determinants of cigarette smoking among Saudi nationals in three regions of Saudi Arabia. PARTICIPANTS: A sample of 8310 individuals aged 15 years and above from both sexes, randomly selected from the three regions, using a stratified cluster sampling technique. DESIGN: A cross-sectional, household, community-based survey. Using a predesigned and tested questionnaire, the participants were interviewed by primary care physicians. The interview covered personal, social, and educational characteristics of the respondents, and also included questions about their smoking status, duration of smoking, and daily cigarette consumption. MAIN OUTCOME MEASURES: Association between current smoking and sociodemographic variables, in univariate and multivariate analysis. Degree of interaction between the different determinants of cigarette smoking. RESULTS: The overall prevalence of current smoking was 21.1% for males and 0.9% for females. Most smokers (78%) were young to middle-aged (21-50 years old). Smoking prevalence was higher among married people, among uneducated people, and among those in certain occupations: manual workers, businessmen, army officers, and office workers. CONCLUSIONS: Cigarette smoking is an important public health problem in Saudi Arabia. A more intense and comprehensive tobacco control effort is needed.
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Fumar/epidemiología , Adolescente , Adulto , Análisis por Conglomerados , Estudios Transversales , Escolaridad , Femenino , Humanos , Modelos Logísticos , Masculino , Estado Civil , Persona de Mediana Edad , Ocupaciones , Prevalencia , Salud Pública , Distribución Aleatoria , Arabia Saudita/epidemiologíaRESUMEN
OBJECTIVE: To show the pattern of etiology of childhood obesity referred to our endocrinology clinic between December 1989 and December 1994. SUBJECT AND METHODS: All the children referred to our clinic at the above stipulated dates were studied. This is a retrospective medical records review of these patients. The patients' height and weight were measured by trained staff of the clinic. The Quetelet index also known as Body Mass Index (BMI) was calculated as weight (kg)/height (m)2 for each patient. Laboratory data as well as results of clinical investigations were also obtained from the records of the patients. RESULTS: 52 patients with ages ranging between 2 years and 16 years (median 8 years) were studied. Male:female ratio was 1:1.35 (67.3%) of the patients were Saudis while 17 (32.7%) were non-Saudis. The etiology of obesity among the series were nutritional 46 (88.5%), Prader-Willi Syndrome 3 (5.8%), Laurence-Moon-Biedl Syndrome 1 (1.9%), pseudohypoparathyroidism 1 (1.9%) and hypothyroidism 1 (1.9%). The study showed that the majority of the patients had simple nutritional obesity.
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This study aimed at determining the outcome of pregnancy in unbooked mothers with regard to maternal complications and foetal outcome. This retrospective study was based on investigations of medical records of 467 unbooked mothers who presented for delivery at the Obstetrics Unit at King Khalid University Hospital, Riyadh, during the period 1991 and 1992, and 415 booked mothers with regular clinic attendance selected as controls. Data collected from the records included patients' socio-demographic characteristics, past obstetric history, prevalence of pregnancy-related diseases, and data relating to labour, delivery, and foetal outcome. Chi-square test and Fisher's exact test were used for assessing the statistical significance of the association between the various factors which were investigated. The tendency for mothers to be booked was found to be significantly associated with their age, occupation, parity, and gestational age at delivery. Booked and unbooked mothers did not differ significantly in relation to the mode of delivery and foetal outcome, although the prevalence of previous complications of pregnancy was generally lower among unbooked mothers. There was no statistically significant association between the absence of antenatal care and outcome of pregnancies, unbooked mothers had a higher proportion of MICU admissions and dead babies compared with the controls. Educating the community about the benefits of receiving regular antenatal care, even if at primary care level, may be of great importance in improving the pregnancy outcome.
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Resultado del Embarazo , Atención Prenatal/normas , Negativa del Paciente al Tratamiento/estadística & datos numéricos , Adolescente , Adulto , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Femenino , Hospitales Universitarios , Humanos , Edad Materna , Paridad , Embarazo , Prevalencia , Estudios Retrospectivos , Arabia Saudita , Factores SocioeconómicosRESUMEN
The study aims to determine the cytological pattern of thyroid lesions, in addition to the utility and accuracy of fine needle aspiration (FNA) cytology as an initial diagnostic method in the investigation of these lesions among Saudi patients. Four hundred and seventy-nine (479) FNAs were performed on patients presenting with diffuse or nodular thyroid enlargement to the endocrinology clinic at King Khalid University Hospital in Riyadh during the period September 1993 to September 1996. The results of the FNA and the 125 histological diagnoses obtained from the subsequent partial and subtotal thyroidectomies were retrospectively and independently reviewed and compared by two cytopathologists. The results of the FNA cytological diagnosis showed that 372 patients (77.7%) had benign lesions, 24 (5%)) had lesions which were suspected of malignancy, 25 (5.2%) had malignant neoplasms, and 58 (12.1%) had FNAs which were inadequate for cytological assessment. Colloid and adenomatous nodules were the most common benign lesions reported (47.8%). Papillary carcinoma was the most common malignant neoplasm (4.2%). Despite the relatively limited number of patients who underwent surgery, cytohistopathology combined with statistical analysis of the results showed that our FNA accuracy rate is in the region of 94.4% with a sensitivity of 78% and a specificity of 100%. In addition, the negative predictive value (NPV) and the positive predictive value (PPV) of FNA thyroid cytology were 93% and 100% respectively. Our findings indicate that FNA cytology can be used effectively in the evaluation of both nodular and diffuse thyroid lesions whilst cytopathologist should be aware of the potential diagnostic pitfalls and the limitations of the procedure in the diagnosis of follicular, cystic, and small neoplasms, the positive identification of thyroiditis and most cases of neoplasia by itself provides justification for FNA.
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Enfermedades de la Tiroides/patología , Glándula Tiroides/patología , Adulto , Anciano , Anciano de 80 o más Años , Biopsia con Aguja , Femenino , Hospitales de Enseñanza , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Arabia Saudita , Enfermedades de la Tiroides/terapiaRESUMEN
BACKGROUND: The pattern and factors which can be associated with the glycemic control of Saudi adult diabetic patients were examined in this study. PATIENTS AND METHODS: Confirmed diabetic patients from all regions of Saudi Arabia constituted the study population. Random blood glucose <10 mmol/L and >10 mmol/L was used to categorize patients into good and poor glycemic control patients, respectively. RESULTS: There were 613 confirmed non-insulin dependent diabetic patients (NIDDM), 50% with good glycemic control. Patients with poor glycemic control were significantly older than patients with good glycemic control (51.5 vs. 47 years, P=0.0001). The insulin-treated diabetic population amounted to 13%, compared with 43% and 44% for oral agent and diet, respectively. The rate of insulin users among poor glycemic control diabetic population was 18%, compared with 50% for oral agents. There was a significant relationship between glycemic control and age, and treatment modalities of DM. Subjects who had good glycemic control of DM were younger and following a diet regimen, while those who had poor glycemic control were older and on insulin treatment. Multivariate analysis comprising 415 individuals was conducted to find out the factors that can potentially influence, or may be associated with, the control of DM. CONCLUSION: The association of insulin therapy with poor glycemic control is not a cause-effect relationship. Insulin therapy in our study population is underutilized, given the high rate of poor glycemic control and high rate of relative occurrence of complication among the Saudi diabetic population. There is a need to address the importance of maintaining good glycemic control, and the reason for the low rate of insulin users. Close periodic monitoring of glycemic control, utilizing laboratories and home glucose monitoring devices, is required. Effective implementation of these measures, in addition to diabetes education, will have an impact on the future outcome of the Saudi diabetic population.
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OBJECTIVES: To study the characteristics of risk factors for hypercholesterolemia among the Saudi population. DESIGN: Population-based cross-sectional national epidemiological randomized household survey. SUBJECT: 4548 Saudi subjects, aged 15 years and above. Sample was representative and in accordance with the national population distribution with respect to age, gender, regional and residency, urban vs. rural, population distribution. MEASUREMENT: Height and weight with calculation of body mass index, blood samples were drawn and assayed for glucose and total cholesterol concentration. Hypercholesterolemia (HC) was defined: borderline high HC (5.2-6.2 mmol l-1) and high HC (> 6.2 mmol l-1). Univariate, multivariate, simple logistic, multiple logistic, odd ratio and chi-square were employed in the statistical analysis. RESULTS: The risk of developing HC increased with age by 2% and 1% for each year increase in age for borderline high HC and high HC. The risk of developing HC was significantly higher among female subjects. There was no significant relation between the spectrum of BMI group, underweight to obesity, with risk of developing borderline high or high HC. There was a significant increase in the risk of developing HC among residents of urban communities. There was no significant regional variation for risk of borderline high HC, however, there was a significant increase in the risk of developing high HC among residents of Central and Eastern regions, compared with other regions. CONCLUSION: The characteristics of risk factors for HC among the Saudi population differ in many respects from other populations. Overweight and obesity are not significant risk factors for HC. Rural communities are more at risk of HC than urban communities. The population of the Eastern and Central regions were at significantly higher risk of developing HC. The relatively recent urbanization may account for the low prevalence of HC. It may partially explain the dissociation between obesity and HC. Food habits, both in quantity and quality in rural communities in genetically predisposed homogenous populations may account for the increase in the prevalence of HC in rural communities. There is a need to propagate information about the potential health hazard of obesity and HC among Saudi communities, at large, and specifically in the Eastern and Central regions. There is a need to study the food patterns of rural communities which may explain partially the relative increase in the prevalence of HC in rural communities.
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Hipercolesterolemia/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , Estudios de Cohortes , Países en Desarrollo , Femenino , Encuestas Epidemiológicas , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Análisis Multivariante , Prevalencia , Distribución Aleatoria , Factores de Riesgo , Arabia Saudita/epidemiología , Distribución por SexoRESUMEN
The prevalence and associated factors for glucose intolerance among Saudi populations in urban and rural communities were investigated among 13177 subjects, 15 years and over, from different regions of Saudi Arabia. The data were standardized using the known age structure of the Saudi population. The sample was randomly selected from subjects who participated in the National Epidemiological Household Study for Chronic Metabolic Diseases. Medical and social history was ascertained from all the study population during house visits. All subjects were then requested to attend a local primary care centre for physical examination and phlebotomy for measurement of random plasma glucose (RPG). A 75 g oral glucose tolerance test was employed for subjects with borderline values. WHO criteria for diagnosis of diabetes mellitus (DM) and impaired glucose tolerance (IGT) were applied. Mean RPG from the urban population was significantly higher than in the rural population. Age adjusted prevalence of DM was significantly higher in the urban population (males 12%, 95% CI 11-13 and females 14%, 95% CI 13-15) than in the rural population (males 7%, 95% CI 7-8 and females 7.7%, 95% CI 7-9) and is among the highest in the world. The prevalence of DM increased with age. The lowest and highest prevalences of DM in the urban population were 2% for subjects aged 15-20 years and 49% for female subjects aged 51-60 years. The lowest and highest prevalences of DM among rural population were 1% for subjects aged 15-20 years and 29% for female subjects over the age of 60 years. Fifty-six per cent of diabetic patients were newly diagnosed at the time of the study. Age adjusted prevalence of IGT was not significantly higher in the urban population. The highest prevalence of obesity, BMI>30, was among urban female subjects. Age, obesity, and family history of DM were associated with DM. Considering the young nature of Saudi population, the prevalence is expected to increase in the near future. There is a need to develop a multi-disciplinary approach for the general population with special attention to female subjects for prevention through controlling modifiable risk factors such as obesity and sedentary life style, improving glycemic control of the diabetic population, and early identification and treatment of diabetic complications.
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Intolerancia a la Glucosa/epidemiología , Salud Rural/estadística & datos numéricos , Salud Urbana/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Anciano , Glucemia/análisis , Índice de Masa Corporal , Estudios Transversales , Demografía , Complicaciones de la Diabetes , Diabetes Mellitus/epidemiología , Femenino , Intolerancia a la Glucosa/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Participación del Paciente/estadística & datos numéricos , Prevalencia , Arabia Saudita/epidemiologíaRESUMEN
The objectives of this Community-based National Epidemiological Household Survey, conducted between 1990-1993, were to estimate the prevalence of overweight and obesity in Saudi Arabia and to examine its association with the socio-demographic characteristics of the adult population. A sample of Saudis 20 years and over was selected using a multistage stratified cluster sampling technique with probability proportionate to size. The selected subjects were requested to visit primary health care centers in their localities. Physicians in these clinics took measurements of heights and weights and collected other relevant data. Obesity was measured by the Body Mass Index, using the Quetelet Index. The results showed the sample of 10,651 subjects of which 50.8% were males, had a mean age of 35.8 years (SD = 14.27 years). The prevalence of overweight was 31.2% (95% confidence interval: 30.3%, 32.1%); 33.1% for males and 29.4% for females. For obesity, the overall prevalence was 22.1%; males 17.8% and females 26.6%. The study design suggested that these estimates could be closer to the true values. The multiple logistic regression analysis showed that age, residential area, region, income, gender, and education are statistically significant predictors of obesity. The prevalence of obesity was higher in females than males, lower in subjects living in rural areas with traditional lifestyles than those in more urbanized environments, and increased with increasing age. The observed prevalence and pattern of overweight and obesity with age and gender is similar to those observed in the Arab community and some Western nations. There is a need for increased physical activity and better nutrition education programs to reduce the extent of obesity and to prevent the serious health consequences, especially, in the middle age group.
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Obesidad/epidemiología , Adulto , Factores de Edad , Índice de Masa Corporal , Distribución de Chi-Cuadrado , Estudios Transversales , Escolaridad , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Prevalencia , Análisis de Regresión , Arabia Saudita/epidemiología , Factores Sexuales , Factores SocioeconómicosRESUMEN
The aim of this study was to study the effect of overweight and obesity on glucose intolerance and dyslipidemia in Saudi Arabia. A cross-sectional national epidemiological randomized household survey of 2059 Saudi subjects, aged 30-64 years was carried out. The sample was representative and was in accordance with the national population distribution with respect to age, gender, regional and residency, urban versus rural population distribution. The subjects height and weight for the calculation of body mass index (BMI) was measured. Blood samples were drawn and assayed for glucose, total cholesterol, triglyceride and high density lipoprotein (HDL). Low density lipoprotein (LDL) was calculated. The oral glucose tolerance test was carried out for subjects with borderline random glucose concentration and the overall prevalence of diabetes mellitus was calculated. A high prevalence of obesity among the Saudi population was observed and mean serum glucose concentration was significantly higher among overweight and obese groups. The prevalence of diabetes mellitus was significantly higher among obese groups. The mean serum triglyceride concentration was only significantly higher among male obese groups. There was no significant difference in the mean of serum total cholesterol concentration between control and obese groups. Mean serum HDL concentration was lower among the obese group, however, the difference was not significant. There was no significant difference in the prevalence of hypercholesterolemia between control and obese groups. Prevalence of hypertriglyceridemia was higher among obese groups and was significantly higher among male subjects across all BMI groups. Prevalence of hypo HDL cholesterolemia exceeded 50% of the study population. Obesity, glucose intolerance, hypertriglyceridemia, hypo HDL cholesterolemia and features of insulin resistance syndrome (IRS) are widely prevalent among the Saudi population over the age of 40 years. IRS is probable a significant contributor to the pathologic process of cardiovascular (CVD) disease among the Saudi population, especially in view of the low prevalence of hypercholesterolemia.
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Peso Corporal/fisiología , Intolerancia a la Glucosa/fisiopatología , Hiperlipidemias/fisiopatología , Obesidad/epidemiología , Obesidad/fisiopatología , Adulto , Factores de Edad , Glucemia/análisis , Índice de Masa Corporal , Colesterol/sangre , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Estudios Transversales , Interpretación Estadística de Datos , Diabetes Mellitus/epidemiología , Femenino , Intolerancia a la Glucosa/epidemiología , Intolerancia a la Glucosa/patología , Humanos , Hiperlipidemias/epidemiología , Hiperlipidemias/patología , Lípidos/sangre , Lipoproteínas HDL/sangre , Lipoproteínas LDL/sangre , Masculino , Persona de Mediana Edad , Prevalencia , Arabia Saudita/epidemiología , Triglicéridos/sangreRESUMEN
Data on the status of iodine deficiency in the Arabian peninsula is scarce. We have conducted a cross-sectional national epidemiological survey in Saudi Arabia to study the iodine status of Saudi schoolchildren, between eight and ten years, who were randomly selected, after taking into consideration the gender, provincial population and area distribution. Casual urine samples were collected and sent to the central laboratory for analysis. Clinical assessment for the presence of goiter was conducted in four areas with different geographical natures. The survey included 4638 subjects, and their median and mean (SD) of urinary iodine concentration was 18 and 17 m g/dL, respectively. We found provincial differences with respect to urinary iodine concentration and the percentage of subjects with urinary iodine concentration <10 m g/dL. The Southern province had the lowest median (11 m g/dL) and the highest percentage (45%) of subjects with urinary iodine concentration <10 m g/dL. On the other hand, subjects of the Western province had the highest median (24 m g/dL) and the lowest percentage (8%) of subjects with urinary iodine concentration <10 m g/dL. The clinical assessment revealed that the highest prevalence and more advanced grade of goiter (22%, 95% CI 19-25, grade 1; 8%, 95% CI 6-10, grade 2) was found in the Asir region, a high-altitude area in the Southern province. The lowest prevalence of goiter (4%, 95% CI 0.8-7.2, grade 1) was found in Gizan, an urban coastal community. There was a significant relationship between the prevalence of goiter and the urinary iodine concentration. The survey for iodine deficiency disorder (IDD) in Saudi Arabia has shown a mild degree of iodine deficiency in the Southern province. Odds ratio (OR) was used to study the statistical relationship between the prevalence of goiter and the urinary iodine concentration. There is a need to launch a control program to ensure the exclusive availability of iodized salt in Saudi Arabia, especially in the Southern province.
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This is a study of the regional variation in Saudi Arabia with respect to the pattern of distribution of total serum cholesterol concentration, low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol to HDL ratio (CH/HDL) and prevalence of hypercholesterolemia (HC) among Saudi population. It is a cross-sectional national epidemiological randomized household survey. The subjects consisted of 4548 Saudis over the age of 15 years. The sample was representative and in accordance with the national population distribution with respect to age, gender, regional and residency population distribution. Blood samples were drawn and assayed for total cholesterol concentration (TCC), triglyceride and high-density lipoprotein concentration. Low- density lipoprotein and total cholesterol/high-density lipoprotein ratio were calculated. The mean serum TCC of female subjects was higher than for male subjects across all regions; however, the difference reached a significance only in the Southern and Western regions. The 90th percentile of serum TCC for male subjects was either equal to or higher than that for female subjects at early age groups across all regions; however, the 90th percentile of serum TCC for female subjects was higher than for male subjects at older age groups across all regions. Mean serum HDL concentration for female subjects was either equal to or higher than for male subjects across all regions, except the Central region. The difference, however, reached a significance in the Western region only. The prevalence of borderline high HC (5.2 to 6.2 mmol/L) was higher among male subjects in the Central region and equal between male and female subjects of Western and Eastern regions and higher among female subjects in the Northern and Southern regions. The prevalence of high HC (>6.2 mmol/L) was higher among female subjects compared with male subjects across all regions. The highest and lowest prevalence of high HC among male subjects in the Eastern and Northern regions, respectively, while the highest and lowest prevalence of high HC among female subjects were in the Eastern and Northern regions. The prevalence of HC (>5.2 mmol/L) among subjects over the age of 40 years was highest and lowest for male subjects of Eastern and Southern regions, respectively, and for female subjects of Eastern and Western regions, respectively. There was a variable pattern of serum total and fractionated cholesterol concentration distribution among Saudi subjects. It appears, however, that at large, the subjects of the Eastern and Northern regions had the highest and lowest prevalences of cholesterol-related risk factors for CVD, respectively. There is a need to study the underlying factors for the regional variation with respect to cholesterol-related risk factors with emphasis on nutritional habits, including the quantity and quality of food, the prevalence of obesity, glucose intolerance and smoking. Identification of such factors is essential for monitoring the effectiveness of any future plan for combating cholesterol-related risk factors for CVD.
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This is a study of the pattern of distribution of body mass index and prevalence of overweight and obesity among the population of different regions of Saudi Arabia. It is a cross-sectional population-based national epidemiological randomized household survey. There were 13,177 Saudi subjects, over the age of 15 years. The sample was representative and in accordance with the national population distribution with respect to age, gender, regional and residency population distribution. Height and weight were measured for all study population. Body mass index (BMI) was calculated. WHO criteria was used for definition of overweight and obesity. The obesity/overweight (ob/ow) ratio was used to study the relation between prevalence of overweight and obesity. Mean BMI values for female subjects were significantly higher than for male subjects across all regions. Mean BMI values were highest at the fifth decade for male and female subjects in all regions. Mean and 90th percentile of BMI values of male and female subjects of the Eastern region across all age groups were higher than for other regions. There was a progressive increase in prevalence of overweight with age among male subjects; the highest prevalence was achieved in the age group 51-60 years across all the regions. The overall prevalence of overweight was higher among male subjects across all the regions. There was a progressive increase in the prevalence of obesity with age among male and female subjects. The highest was achieved in the age group of 41-50 years across all the regions. There was a regional variation with respect to the prevalence of overweight and obesity among Saudi subjects. The prevalence of overweight was higher among male subjects across all the regions, while the prevalence of obesity was higher among female subjects across all the regions. A high prevalence of obesity was observed in most of the regions. Underlying factors such as lifestyle, nutritional habits, social and cultural beliefs and habits in different regions need to be studied. There is a need to establish a national control program for combating obesity and related complications.
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Hypercholesterolemia is recognized as an independent risk factor for cardiovascular diseases. Data on serum total cholesterol concentration distribution from Saudi Arabia are scarce. We have conducted a cross sectional, national, epidemiological randomized household survey to study the distribution of serum total cholesterol (TCC), low density lipoprotein (LDL) and high density lipoprotein (HDL) concentrations, total cholesterol/high density lipoprotein (CH/HDL) ratio and prevalence of hypercholesterolemia (HC) among subjects aged 25-64 years in urban and rural communities of Saudi Arabia. The sample was 2924 Saudi subjects which was adjusted in accordance with the national population distribution with respect to age, gender, regional and residency, urban vs. rural population distribution. Height and weight were measured with calculation of body mass index (BMI). Blood samples were drawn and assayed for total cholesterol, triglyceride, high density lipoprotein concentration and calculation of low density lipoprotein concentration. The mean of BMI was significantly higher among female subjects and significantly higher among urban subjects. The prevalence of obesity was higher among female subjects and higher, however, not significant, among urban subjects. Mean serum TCC was higher among rural subjects. Mean serum LDL concentration was higher among female subjects and higher among urban subjects. Mean serum HDL concentration was lower among female subjects and lower among urban subjects. Mean CH/HDL ratio was higher among female subjects and higher for urban subjects. Female and male subjects living in rural communities had the highest and lowest percentages of subjects with high concentrations of LDL, respectively. Female and male subjects, living in rural communities had the highest and lowest percentages of subjects with low concentration of HDL, respectively. Male and female subjects living in rural communities had the highest and lowest percentages of studied subjects with a high CH/HDL ratio. The age-adjusted prevalence of HC (5.2-6.2 mmol/l) was equal among all the four groups. The prevalence of HC (> 6.2 mmol/l) was significantly higher among rural male subjects, compared with their counterparts in urban areas, while it was equal among female subjects. There was an increase in age-specific prevalence of HC (> 6.2 mmol/l) with maximum prevalence achieved at an age of 56-64 years for urban subjects, while it was achieved a decade earlier for rural subjects. The prevalence of HC, in general, was higher among rural male and urban female subjects. In conclusion, among Saudi subjects, means of total, fractionated cholesterol concentration, CH/HDL ratio > 6.5 and prevalence of obesity were higher among urban female subjects. The prevalence of HC, whether > 5.2 or > 6.2 mmol/l was higher among rural subjects. The difference, however, reached significance among female subjects. There is a need to study the possible underlying factors for the increase in prevalence of HC among rural subjects with special emphasis on the food components and nutritional habits of rural communities in Saudi Arabia. There is also a need to establish a control program throughout the country with the aim of halting the upward trend in incidence of CVD through control of modifiable risk factor such as obesity and hypercholesterolemia.
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Hipercolesterolemia/epidemiología , Adulto , Distribución por Edad , Índice de Masa Corporal , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Hipercolesterolemia/sangre , Masculino , Persona de Mediana Edad , Prevalencia , Salud Rural/estadística & datos numéricos , Muestreo , Arabia Saudita/epidemiología , Distribución por Sexo , Salud Urbana/estadística & datos numéricosRESUMEN
During the period between December 1988 and February 1995, a total of 279,482 newborn infants were screened in the regional neonatal screening program for congenital hypothyroidism (CH) in Riyadh province, Saudi Arabia. Eighty-one infants were confirmed to have CH giving an incidence of 1 in 3,450. Variable congenital anomalies, other than those of the thyroid gland, were present in 16 (19.8%). The anomalies most frequently encountered were congenital heart defects (7), unclassified multiple congenital anomalies (5) and Down's syndrome (2). The results of our study confirm this association, and emphasize the need to search for such anomalies in infants born with CH. Nationwide studies, however, on birth defects in the general population and those associated with CH are still needed to help us understanding the role of local genetic and environmental factors.
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Anomalías Múltiples/genética , Hipotiroidismo Congénito , Tamizaje Neonatal , Femenino , Humanos , Hipotiroidismo/diagnóstico , Recién Nacido , Masculino , Arabia Saudita , Tirotropina/sangreRESUMEN
OBJECTIVE: Study the prevalence of metabolic risk factors for cardiovascular diseases, obesity, diabetes mellitus, hypercholesterolemia and other cholesterol related risk factors among Saudi population, aged 30-64 years. DESIGN: Cross sectional national epidemiological randomized household survey. SUBJECT: 2059 Saudi subjects, aged 30-64 years. Sample was representative and in accordance with the national population distribution with respect to age, gender, regional and residency, urban vs. rural, population distribution. MEASUREMENT: Height and weight with calculation of body mass index, blood samples were drawn and assayed for glucose, total cholesterol, triglyceride and high density lipoprotein. Low density lipoprotein and cholesterol/high density lipoprotein ratio were calculated. Oral glucose tolerance test was done for subjects with borderline random glucose concentration. The overall prevalence of diabetes mellitus was calculated. RESULTS: Mean body mass index (BMI) was significantly higher among female subjects 28.3(6) vs. 26.6(4.6), P=0.0001. The 90th percentile of BMI was higher among female subjects across all age groups. The 90th percentile of BMI for Saudi subjects were higher across all age group than sex and age matched European subjects. Mean serum total cholesterol (TC) concentration was higher, however, not significant among female, compared with male subjects. The 90th percentile of serum TC concentration was higher among female, compared with male subjects for all age groups after the age of 40 years. The 90th percentile of serum TC concentration for Saudi subjects was lower across all age groups than sex and age matched European subjects. The prevalence of overweight was significantly higher among male subjects whereas the prevalence of obesity was significantly higher among female subjects. The prevalence of diabetes mellitus was significantly higher among female subjects whereas the prevalence of impaired glucose tolerance was significantly higher among male subjects. The prevalence of hypercholesterolemia, whether using cut-off levels of >5.2 mmol/l or >6.2 mmol/l. were similar between male and female subjects. They were lower than the prevalence of hypercholesterolemia among sex and age matched subjects whether from developed or from some developing countries. The prevalence of hypo HDL cholesterolemia, <0.9 mmol/l, was significantly higher among male subjects. The prevalence of total cholesterol/high density lipoprotein ratio, >6.5, for Saudi subjects was higher than some other developing countries. CONCLUSION: This study has shown high prevalence of metabolic risk factors for CVD. As atherosclerosis is ongoing process and considering the young nature of this country with 60% of population are <30 years old, one would expect the magnitude of CVD to multiply in the future especially with the continuous exposure to metabolic and non-metabolic risk factors. Several of the metabolic risk factors are modifiable either through change of lifestyle or medical treatment. There is a need to address such risk factors at national and regional level with aim of early identification and prevention. There is a need to monitor the trend of CVD and the risk factors which can be used to assess the efficacy of control programs.
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Enfermedades Cardiovasculares/epidemiología , Adulto , Glucemia , Índice de Masa Corporal , Enfermedades Cardiovasculares/sangre , Colesterol/sangre , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Estudios Transversales , Diabetes Mellitus/epidemiología , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Hipercolesterolemia/epidemiología , Lipoproteínas/sangre , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Prevalencia , Factores de Riesgo , Arabia Saudita/epidemiología , Caracteres Sexuales , Fumar/epidemiología , Triglicéridos/sangreRESUMEN
Neonatal screening for congenital hypothyroidism using cord serum thyroid-stimulating hormone (TSH) was initiated in Najran health region in September 1990. A total of 30810 newborn infants were screened by April 1995. Of the 24 infants with abnormal thyroid function tests on recall, 22 had permanent primary congenital hypothyroidism (incidence; 1:1400) and in two male siblings transient congenital hypothyroidism (incidence; 1:15400) was proved on follow-up. There was a significantly higher incidence of dyshormonogenesis. Eight (57 per cent) of the 14 infants who were adequately studied thyroid scan revealed ectopic glands with increased 99mTc uptake, while thyroid ectopy and aplasia were present only in three (22 per cent) infants each. Furthermore, goiter was evident clinically in two other patients.
Asunto(s)
Hipotiroidismo Congénito , Hipotiroidismo/epidemiología , Tamizaje Neonatal , Femenino , Humanos , Hipotiroidismo/diagnóstico , Incidencia , Recién Nacido , Masculino , Arabia Saudita/epidemiología , Tirotropina/sangre , Tiroxina/sangreRESUMEN
OBJECTIVE: To determine the prevalence of overweight and obesity among male school children in Saudi Arabia and provide a growth chart for males 6-18 y old. DESIGN: Three stage stratified cluster sampling procedure. SUBJECTS: The study population was 9061 male school children, attending public schools in Saudi Arabia. Their ages ranged from 6-18 y and covered all the 12 grade levels of school. Children with evidence of chronic or acute diseases were excluded from the study. MEASUREMENT: Structured questionnaire, including: location of school, socio-demographic characteristics and age of the student. Anthropometric measurements of weight and height was done for all the study sample. Growth charts were designed through fitting the polynomial regression model of degree three. The percentage of body mass index (BMI) of expected BMI at the 50th percentile for each age group was computed. The 50th percentile of The National Center for Health Statistics/Center for Disease Control reference population was used as the expected standard population values for defining childhood overweight and obesity. RESULTS: The overall prevalence of overweight was 11.7% and obesity 15.8%. There was a statistically significant variation in the regional distribution of overweight and obesity (P < 0.01). The highest prevalence (18.0%) was recorded in Riyadh, capital of Saudi Arabia, and the lowest was in Sabea (11.1%) located in the Southern region. CONCLUSION: These findings of a high prevalence of childhood obesity when compared with the NCHS/CDC calls for an early health education program on the appropriate choice of diets for growth, health and longevity. However, because of the possible ethnic differences between the Saudi and American populations, the growth charts presented could serve as a better reference for future comparisons.