Journal of Metabolic Syndrome

Malaria infection has a complex effect on iron metabolism that may affect the interpretation of haemoglobin, serum ferritin, serum transferrin and serum iron. The main objective of this study was to determine the effect of malaria parasitaemia on the iron store forms of pregnant women in the Buea and Tiko health districts of the S.W Region of Cameroon. This investigation was carried out from the 3rd of August 2011 to the 30th of April 2012. The non-probabilistic sampling method was used to recruit a total of 377 pregnant women into the study. Questionnaires were used for the collection of secondary data. The microscopy method was used to detect the presence of malaria infection. A total of 41.4% (156/377) of the pregnant women were infected with Plasmodium falciparum. Of the infected cases; 32.1% had low levels of serum ferritin (<20 μg/L), 10.9% had high levels of serum transferrin (>360 mg/dl), and 45.5% had low levels of serum iron (<9.0 μmol/l). The quantitative results using regression analysis justified that 88% variation in serum ferritin, transferrin and iron were accounted for by variation in malaria parasitaemia during the second and the third trimesters. Serum iron, ferritin and transferrin measurements should be incorporated as one of the routine laboratory tests during the regular antenatal care visits.

The introduction of highly active antiretroviral therapy (HAART) for the treatment of acquired immunodeficiency syndrome (AIDS) has resulted in greater survival of patients infected with the human immunodeficiency virus (HIV). However, the use of these drugs has been associated with lipodystrophic syndrome (LS), which is characterized by metabolic alterations (dyslipidemia, insulin resistance, diabetes, and lactic acidosis) and abnormal corporal fat distribution. Clinically, LS may manifest as three different forms: lipohypertrophy (accumulation of fat in the central part of the body), lipoatrophy (loss of fat in the extremities, face and buttocks) and mixed (lipohypertrophy + lipoatrophy). Although its physiopathology has not been elucidated, some mechanisms have been described, including leptin and adiponectin deficiency, mitochondrial dysfunction and use of antiretroviral drugs. The type, dose and duration of the antiretroviral treatment, as well as age and puberty are the main risk factors. LS are also associated with increased incidence of cardiovascular illnesses, atherosclerosis and diabetes mellitus. Follow up must be periodic, consisting of measurement of body fat distribution, evaluation of the lipid profile and insulin resistance.

Background: Protease inhibitors (PI) and stavudine are frequently associated with abnormalities of the body composition. The present study aimed to evaluate the body fat composition of HIV-infected Congolese patients receiving antiretroviral other than PI or stavudine.
Patients and Methods: Anthropometric measures and body composition of 125 HIV-infected Congolese patients (average age 41 years, 76% women, 74% on antiretroviral therapy) attending a primary healthcare center was cross-sectionally evaluated. Patients receiving PI and/or stavudine were excluded. Subclinical abnormalities of body composition, evaluated by bioimpedance (BIA), were defined as elevated percentage of fat mass (FM) and perivisceral fat mass (PVF) and low percentage of total FM.
Results: Clinically evaluated abnormalities of fat distribution were rarely seen, with any case of obesity or lipodystrophy. Overweight (16%) and central obesity (6.3%) were present only in a few women. BIA parameters of body fat composition were similar among antiretroviral naive and treated patients. An average higher percentage of FM (28% vs. 12.1%; p<0.001) and PVF (4.0% vs. 2.3%; p=0.002) were observed in women, with as well as a higher proportion of subjects with high levels of FM (12.6%) and PVF (2.2%) in the same group. Thinness was observed only in 6% of patients of whom 83.3% of men and 68.4% of women (p=0.059) had low levels of FM.
Conclusion: Subclinical abnormalities of FM were present in these case series without clinically overt fat
distribution abnormalities, highlighting the need for early detection of these FM abnormalities.