Sarcopenic Obesity in Patients with Gastroduodenal Ulcer in Lomé, Togo | Chapter 01 | Research Perspective on Biological Science Vol. 9

 

Background: Gastroduodenal ulcer disease (GUD) is a significant health burden in urban West Africa, a region undergoing a rapid nutritional transition. Conventional assessment using Body Mass Index (BMI) may fail to detect complex malnutrition phenotypes like sarcopenic obesity that could impair ulcer healing. While the infectious and pharmacological etiologies of GUD are well-documented, a critical knowledge gap persists regarding the role of nutritional status as a modulator of disease severity and healing capacity. This gap is particularly concerning in the context of the rapid and profound nutritional transition currently underway in urban African centres like Lomé.

Aim: This study aimed to characterise the detailed nutritional and metabolic profiles of GUD patients in Lomé, Togo, to unmask these underlying disorders.

Methods: This cross-sectional analytical study, conducted from July to October 2024, recruited 127 patients with endoscopically confirmed GUD. Data were collected on sociodemographic, clinical, and dietary characteristics, with dietary quality assessed via a Dietary Diversity Score (SDA). A score of ≤ 4 was classified as low dietary diversity, while a score of ≥ 7 was considered high diversity.

Body composition, including visceral fat and skeletal muscle mass, was Evaluated using multi-frequency bioelectrical impedance analysis (BIA). Fasting venous blood was analysed for key biochemical markers, including albumin, folate, and homocysteine.

Results: The cohort (mean age 43.7; 35.4% Helicobacter pylori positive) presented a paradoxical nutritional profile. While BMI classified only 31.5% as overweight or obese, BIA revealed a high prevalence of sarcopenic obesity: 46.5% exhibited a low protein index, and 39.4% had visceral obesity. Poor dietary quality (SDA ≤ 4) was significantly associated with lower concentrations of prealbumin and albumin (p<0.05), reduced serum folate (p<0.01), and consequently higher, detrimental levels of homocysteine (p<0.01). The strong inverse correlation between a low Dietary Diversity Score (SDA) and elevated homocysteine levels, mediated by folate deficiency, unveils a critical metabolic pathway that further hinders recovery. Regular fruit consumption was protective against H. pylori infection (OR = 0.42), while a low education level was an independent risk factor (OR = 2.85).

Conclusion: Patients with GUD in Lomé are affected by a severe "double burden of malnutrition." The high prevalence of sarcopenic obesity, entirely masked by BMI, fosters a systemic metabolic environment of pro-inflammatory visceral adiposity and depleted protein reserves that is fundamentally antagonistic to mucosal healing. These findings highlight the inadequacy of BMI and underscore the urgent need to integrate body composition analysis and key biochemical markers into clinical assessment to guide effective nutritional interventions. This study has some limitations, including its cross-sectional design and its single-centre focus at a tertiary hospital. Future research should explore longitudinal studies to better understand the causal relationships between nutrition, body composition, and GUD progression.

 

Author(s)details:-

 

Kponou Mathieu Bienvenu TOBOSSI
Department of Biochemistry and Cell Biology, Faculty of Sciences and Technologies, University of Abomey – Calavi, 01 BP 526, Cotonou, Benin.

 

Mamatchi MELILA
Department of Biochemistry, Faculty of Sciences, University of Lomé, 01 BP 1515 Lomé 01, Togo.

 

Mlatovi DEGBE
Department of Biochemistry, Faculty of Sciences, University of Lomé, 01 BP 1515 Lomé 01, Togo.

 

Abdel Haziz SINA OROU
Department of Biochemistry and Cell Biology, Faculty of Sciences and Technologies, University of Abomey – Calavi, 01 BP 526, Cotonou, Benin.

 

Please see the book here:- https://doi.org/10.9734/bpi/rpbs/v9/6570

Determining the Homocysteine and D-Dimer Levels and Multilayer Computed Tomography for Diagnosis of Pulmonary Artery Thromboembolism | Chapter 15 | Advancement and New Understanding in Medical Science Vol. 6

The aim of our investigation was to assess the importance of measuring D-dimer and homocysteine levels, along with the use of multilayer computer tomography (CT), in the diagnosis of patients with suspected PATE. According to reports, D-dimer is crucial in the diagnosis of pulmonary embolism. Furthermore, homocysteine has been shown to be a risk factor for thrombosis, vascular disease, and atherosclerosis. The purpose of this chapter is to assess the diagnostic utility of multi-detector computed tomography (CT) in conjunction with D-dimer and homocysteine levels in cases of suspected pulmonary embolism. We examined 54 patients from 18 to 76 years of age, who were suffering from conditions and complaints that are typical of PATE, such as chest pain, haemoptysis, dyspnoea, tachycardia, arterial hypotension and signs of vein thrombosis in the inferior limbs.  In these patients, PATE was found in different localizations with varying rates of severity. D-dimer levels were measured in patients with suspected PATE using enzyme-linked immunosorbent assays. Homocysteine levels were determined by an enzymatic method. Pulmoangiography is the method of choice in pulmonary embolism diagnostics. All patients were examined to evaluate the presence of pulmonary embolism by multi-detector CT angiopulmonography. Changes in homocysteine levels can be considered a separate independent factor for PATE diagnostics. The correlation between multi-detector CT angiopulmonography, elevated D-dimer levels, and concomitant hyperhomocysteinemia can be used not only for diagnostics but also for the assessment of the effectiveness of PATE treatment. Multi-detector CT angiopulmonography, D-dimer levels and related hyperhomocysteinemia can serve as significant laboratory markers in the diagnosis and treatment efficacy of PATE. The changes in homocysteine levels can be considered as a separate independent factor for PATE diagnostics. The interdependence between D-dimer and concomitant hyperhomocysteinemia can be used not only for diagnostics but also for the assessment of the effectiveness of PATE treatment. It can be concluded that multilayer CT pulmoangiography is a non-invasive highly informative method, providing a very low level of complications, and is thus indicated for acute PATE diagnostics, and for control of the disease dynamics after anticoagulation treatment.

Author(s) Details:

Fridon Todua,
Todua Clinic, 0112 Tbilisi, Georgia.

Manana Akhvlediani,
Todua Clinic, 0112 Tbilisi, Georgia.

Elena Vorobiova,
Todua Clinic, 0112 Tbilisi, Georgia.

Giorgi Tsivtsivadze,
Todua Clinic, 0112 Tbilisi, Georgia.

Anna Baramidze,
Todua Clinic, 0112 Tbilisi, Georgia.

Please see the link here: https://stm.bookpi.org/ANUMS-V6/article/view/13395

Study about Homocysteine: A Biomarker in Neurodegenerative Diseases | Chapter 10 | Issues and Development in Health Research Vol. 7

 Homocysteine (Hcy) levels in Indians are greater than in Europeans. Hyperhomocysteinemia (HHcy) is an early risk factor for stroke, MI, and other vascular illnesses that is distinct, powerful, graded, and easily quantifiable. A vitamin deficiency or an inherited trait could be the cause. Vitamin B12, Vitamin B6, and folic acid, all of which are required for methionine metabolism, are in short supply in the majority of vegetarian Indians. A dose-dependent connection between mild to moderate increases in plasma Hcy and the risk of neurodegenerative diseases has been established in epidemiological research. Hcy is a neurotoxic substance that serves as a proxy for vitamin insufficiency. Patients with a high Hcy levels have a higher risk of atherosclerotic events. Hyperhomocysteinemia is a common problem among the elderly. According to the findings of this investigation, Hcy levels are higher in patients with neurologic diseases. Both male and female people have statistically significant Hcy levels. Hcy levels are higher in males with neurological disorders. The availability of vitamin-fortified meals, particularly cereals, can help to avoid or delay the onset of age-related neurological disorders in hyperhomocystemic high-risk patients.

Author(S) Details

N. Jayanthi Bai
Department of Laboratory Medicine, SK Hospital, Edappazhinji, Thiruvananthapuram 695006-India.

S. Jayakrishnan
Department of Laboratory Medicine, SK Hospital, Edappazhinji, Thiruvananthapuram 695006-India.

View Book:- https://stm.bookpi.org/IDHR-V7/article/view/4813