RESUMEN

BACKGROUND AND STUDY AIMS: Hepatitis C virus (HCV) infection is a major cause of chronic liver disease worldwide. In Egypt, 92.5% of HCV infection cases reportedly involve infection with HCV genotype 4. HCV infection may induce liver steatosis directly and indirectly. Host genetic polymorphisms may also contribute to the pathogenesis of steatosis. Folate deficiency indirectly cuase liver damage. Folate status is mostly affected by MTHFR C677T polymorphism. The pathophysiology of thrombocytopenia (TCP) in HCV infection remains unclear. Thus, the present study investigated the roles and consequences of MTHFR C677T SNP and folate status in patients with early HCV genotype 4 infection and their relation with steatosis and thrombocytopenia. PATIENTS AND METHODS: Fifty patients with the HCV genotype 4 and 50 healthy controls were enrolled in the study. All the participants underwent laboratory, demographic, and anthropomorphic examinations. Serum folate level was determined, and genomic analysis of MTHFR C677T SNP was performed. RESULTS: No significant difference in allelic frequency of MTHFR C677T was observed between patients and controls. However, significantly lower serum folate level, hemoglobin level, and platelet count were found in patients than controls (p = 0.014, p = 0.005, and p = 0.001, respectively). The cholesterol, triglyceride, and high-density lipoprotein levels were also significantly lower in patients than controls (p < 0.001, p = 0.001, and p < 0.001, respectively), whereas the low-density lipoprotein level was significantly higher in patients (p < 0.001). Patients harboring the MTHFR CT genotype had a significantly lower serum folate level (p = 0.033) than the controls. Among the patients with HCV infection, those with the TT genotype had the highest body mass index (p = 0.003) and levels of cholesterol, triglyceride, and high-density lipoprotein (p = 0.007, p = 0.025, and p = 0.040, respectively). CONCLUSION: MTHFR C677T SNP may contribute to the development of complications associated with early HCV genotype 4 infection, such as dyslipidemia and decreased folate levels.

Asunto(s)

Hepacivirus , Metilenotetrahidrofolato Reductasa (NADPH2) , Egipto , Ácido Fólico , Genotipo , Humanos , Metilenotetrahidrofolato Reductasa (NADPH2)/genética , Polimorfismo Genético

RESUMEN

BACKGROUND: Obesity has emerged as a public health crisis in many populations including Egypt. Adipose tissue produces a number of adipokines, one of them is adiponectin which has attracted much attention because of its antidiabetic and antiatherogenic effects. OBJECTIVE: To determine the effect of a weight loss program on serum adiponectin level and insulin resistance among overweight and obese adult premenopausal females. STUDY DESIGN: A pre-postintervention study was carried out among 95 premenopausal overweight and obese females (body mass index ≥ 25 kg/m2) aged 20 to 40 years at the integrated health clinic affiliated to the High Institute of Public Health, Alexandria, Egypt, from February 2016 to February 2017. All participants underwent a weight loss program based on a reduced calorie balanced diet and advised to increase their physical activity. Dietary instructions and follow-up were done weekly throughout 16 weeks. Blood samples were collected to investigate serum adiponectin level and insulin resistance at the beginning and the end of the intervention. RESULTS: After 16 weeks, a significant decrease in body weight by 9.7% was associated with a significant increase in serum adiponectin from 13.3 ± 4.9 µg/ml to 18.5 ± 5.6 µg/ml. Both fasting insulin and insulin resistance had decreased significantly by 13.6% and 13.7%, respectively. CONCLUSION: A weight reduction program depending on a reduced calorie diet for 16 weeks was associated with a significant increase in total adiponectin level and reduction in insulin resistance. An emphasis on the importance of keeping normal weight through nutritional education and the promotion of healthy diets is recommended to reduce the risk of occurrence of insulin resistance, type 2 diabetes, and cardiovascular diseases.