Awatef Jmal

University of Tunis El Manar, Tunis-Ville, Tūnis, Tunisia

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Publications (10)9.01 Total impact


  • No preview · Article · Oct 2014

  • No preview · Article · Oct 2014
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    ABSTRACT: C-reactive protein (CRP) is an independent risk factor of diabetes and cardiovascular disease and it is proposed as a component of metabolic syndrome (MS). This study was undertaken to investigate the relationship between CRP and various characteristics of the MS in a sample of the Tunisian population One hundred and forty nine patients with MS and 152 controls, aged 35-70 years were recruited. Waist circumference (WC), blood pressure, HDL-cholesterol (HDL-C), triglycerides (TG), glucose, insulin and CRP were measured. Insulin resistance was assessed by homeostasis model assessment of insulin resistance (HOMA-IR). MS was defined by NCEP-ATPIII report CRP levels were significantly higher in MS group (4.41±3.73 mg/L vs. 2.68±2.59 mg/L, p<0.001) compared to without MS group. For both sexes, CRP increased as the number of MS components increased (p=0.015 for men and p<0.001) after adjustment for age, smoking, alcohol intake and, for women, menopause. There were statistically significant positive correlations for log CRP with WC, log TG, and log HOMA-IR in both sexes adjusted for confounding factors listed above. A significant negative correlation was found between HDL-C and log CRP only in women. In both sexes, WC was identified, by multiple linear regression models, as significant independent predictor of CRP level variability. HDL-C showed also a significant contribution only in women The present study provides evidence that CRP levels are elevated in MS subjects. In addition, WC and HDL-C are significant predictors of the CRP elevation.
    Full-text · Article · Jan 2012 · European Journal of Internal Medicine
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    ABSTRACT: Buts Déterminer la prévalence du syndrome métabolique (SM) et de ses paramètres, dans une population d’enfants tunisiens obèses et en surpoids et étudier la relation entre SM, leptine et insuline. Méthodes Le travail a porté sur une population de 607 enfants âgés de 6 à 12 ans : 75 obèses, 184 en surpoids et 348 témoins de poids normal appariés aux malades selon l’âge et le sexe. Les enfants ont été recrutés dans le cadre d’une enquête épidémiologique portant sur l’étude de l’obésité infantile dans le grand Tunis. L’obésité était définie selon les critères de l’IOTF. Les enfants ont bénéficié d’une mesure des paramètres anthropométriques (poids, taille, tour de taille) et du calcul de l’indice de masse corporelle (IMC, poids/taille2). Un prélèvement sanguin a été pratiqué après 12 heures de jeûne pour le dosage des paramètres biochimiques. L’insulinorésistance était appréciée par le « Homeostasis Model Assesment of Insulin Resistance (HOMA-IR). Le SM était défini par les critères du National Cholesterol Education Program Adult Treatment panel III modifiés par Cook. Résultats La prévalence du SM était de 25,3% chez les enfants obèses. Elle était significativement plus élevée que celle trouvée chez les enfants en surpoids (7,6%) et les enfants de poids normal (0,3%) (p < 0,001). La prévalence était plus élevée chez les garçons (37,1%) que chez les filles (15%) (p = 0,035). L’obésité abdominale était présente dans 83,8% des cas. La prévalence de l’hypertension artérielle était de 73%. L’augmentation des triglycérides et la diminution du HDL cholestérol étaient observées dans respectivement 25% et 24% des cas. Aucun des enfants n’a présenté d’élévation de la glycémie à jeun. La leptine était positivement corrélée avec l’IMC (r = 0,545, p < 0,001), le tour de taille (r = 0,542, p < 0,001), la PAS (r = 0,28, p < 0,001), la PAD (r = 0,161, p = 0,011), la glycémie (r = 0,136, p = 0,031), les triglycérides (r = 0,280, p < 0,001), le HOMA (r = 0,389, p < 0,001), l’insuline (r = 0,397, p < 0,001) et le nombre de paramètres du SM (r = 0,284, p < 0,001). Après ajustement par l’IMC, la leptine restait corrélée avec le tour de taille (r = 0,196, p = 0,002), les triglycérides (r = 0,19, p = 0,003), le HOMA (r = 0,283, p < 0,001) et l’insuline (r = 0,284, p < 0,001). Conclusion La prévalence du SM chez l’enfant obèse tunisien est de 25,3%. L’obésité abdominale et l’HTA sont les paramètres les plus fréquents. Après ajustement par l’IMC, le tour de taille, les triglycérides, l’insuline et le HOMA présentent une corrélation avec la leptine.
    No preview · Article · Dec 2011 · Obésité
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    ABSTRACT: This study was undertaken to investigate the relationship between the Apolipoprotein B/Apolipoprotein A 1 (ApoB/ApoA 1) ratio and various characteristics of the metabolic syndrome (MetS) in a sample of the Tunisian population. The study included 330 adults aged 35-74 (172 patients with MetS and 158 controls). Waist circumference (WC), blood pressure (BP), HDL-cholesterol (HDL-C), triglycerides (TG), glucose, insulin, and apolipoprotein concentrations were measured. Homeostasis model assessment (HOMA) was used to assess insulin resistance (IR). MetS was defined by NCEP-ATPIII report. The ApoB/ApoA 1 ratio was significantly higher in patients with MetS versus normal control subjects (p<0.001). Mean values of ApoB/ApoA 1 ratio increased significantly as the numbers of MetS components increased in men (p<0.001) and women (p<0.001). ApoB/ApoA 1 ratio showed statistically significant associations with WC, HDL-C, TG, systolic and diastolic BP, and HOMA-IR. After adjusting for age and gender, the high ApoB/ApoA 1 ratio was significantly associated with the presence of MetS (odds ratio [OR]=6.10), IR (OR=1.88), and with each of the MetS components, including: high WC (OR=2.43), High TG (OR=6.14), and low HDL-C (OR=6.92). Our findings suggest that the ApoB/ApoA 1 ratio is strongly associated with MetS and its components, as well as with IR.
    Full-text · Article · Jul 2011 · Experimental and Molecular Pathology
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    ABSTRACT: The aim of this study was to investigate the association of CRP levels with type 2 diabetes (T2D) and its related variables in a sample of the Tunisian population. Our sample included 129 patients with T2D and 187 control subjects. Body mass index (BMI), plasma lipids, glucose, insulin, and CRP concentrations were measured for each participant. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. T2D was defined as a fasting plasma glucose (FPG) level ≥ 7.0 mmol/L, the use of anti-diabetic drugs, or both. Statistical analyses were performed using SPSS 11.5. A significant difference in mean values of BMI, plasma lipids, FPG, insulin, and HOMA-IR was observed between subjects with and without T2D. CRP level was significantly higher in subjects with T2D than those without (p = 0.023), and this result persisted even after adjustment for age, gender, BMI, smoking, and alcohol consumption. In both diabetes statuses, log CRP was significantly associated with FPG, insulin, and HOMA-IR. Subjects with elevated CRP levels (>5 mg/L) had an increased risk of T2D (OR = 2.02, 95% CI 1.18-3.46, p = 0.010) than those whose CRP levels were less or equal to 5 mg/L. Even after adjustment for potentially confounding factors, the risk of T2D was still increased in subjects with elevated CRP levels (OR = 1.91, 95% CI 1.08-3.36, p = 0.025). These results suggest that elevated CRP levels are independently associated with T2D.
    Full-text · Article · Jul 2011 · Inflammation
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    ABSTRACT: Aim : To report the serum calcium, phosphorus and protein abnormalities in cancer subjects during abdominal surgery. Methods : 41 patients are collected (32 F / 9 M) with a mean of age 57.78 ± 12.7 years, who had undergone abdominal surgery. Serum samples were obtained on the day before surgery and on days 3 and 8 post surgery for measurement of serum total calcium, protein, and phosphorus. Results : The different parameters studied fall significantly at day 3 and increase at day 8 postsurgery in all patients. The means levels of total calcium, phosphorus and protein before surgery are 2,04 ± 0,2 mmol/l, 1,12 ± 0,21 mmol/l and 55 ± 7 g/l vs 1,9 ± 0,26 mmol/l, 0,98 ± 0,18 mmol/l and 50 ± 8 g/l at day 3 post surgery. Conclusion : Post operative hypocalcemia was attributed to the fall in protein and the decrease in phosphorus may be resulted from renal losses of phosphorus due to extracellular volume expansion.
    No preview · Article · Mar 2008 · La Tunisie médicale
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    ABSTRACT: Anemia is frequent in cancer patients, is the result of decreased erythropoietin production. In fact in cancer, alteration of immune system alters iron metabolism and inhibits erythropoietin production. In this study we proposed to determine the profile of erythropoietin secretion in anaemic cancer patients in the pre and postoperative period. Our prospective study from January to March 2005 included 41 anemic cancer patients from 30 to 79 years old and 31 healthy individuals with iron deficiency anemia. A measure of erythropoietin, CRP, ferritin, iron levels and hemoglobin were released in healthy individuals and in cancer patients in preoperative period (J0) and postoperative period (J3, J8, J21). In preoperative period, the increase of serum erythropoietin was significantly lower in patients than in healthy individuals. In postoperative period, the levels of erythropoietin at J3 and hemoglobin's at J8 and J21 were significantly higher than in preoperative period (J0) (p < 0.05). In conclusion, despite the presence of inflammatory syndrome caused by surgery, cancer patients with anaemia increase their erythropoietin production in immediate postoperative period.
    No preview · Article · Apr 2007 · Bulletin du cancer
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    ABSTRACT: The aim of this study is to evaluate the endogenous erythropoietin production in cancer patients with anemia. Our prospective study interested 99 cancer patients with anemia from 17 to 80 years old, during the period going from March 2002 to December 2004, and 31 healthy individuals with anemia caused by iron deficiency. A blood sample was collected from each patient, as well as healthy individuals to measure serum erythropoietin, C reactive protein and ferritin. The increase of serum erythropoietin was significantly lower in patients than in healthy individuals (P < 0.05). 25.2% of our cancer patients have inflammatory anemia and 74.7% presented microcytic anemia associated with increase of serum ferririn and CRP. These values were significantly higher than in healthy individuals (p < 0.05). Anemia in cancer patients results from activation of inflammatory system, which inhibit erythropoietin production. Apart from etiologic treatments, anemia can be treated with recombinant human erythropoietin.
    No preview · Article · Feb 2007 · La Tunisie médicale
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    ABSTRACT: Interindividual differences observed in the metabolism of xenobiotics have been attributed to the genetic polymorphism of genes, which code for enzymes involved in detoxification. This genetic variability seems to be associated with the individual's susceptibility to certain cancers, including nasopharyngeal carcinoma. In this study, we have investigated the genotypic frequencies of DNA polymorphisms of two detoxification's genes: the gluthatione-S-transferase (GST) and the N-acetyl transferase 2 (NAT2). The study has included 45 patients with nasopharyngeal carcinoma compared to 100 healthy Tunisian controls. The presence of the GSTM1 null and GSTT1 null polymorphism was screened by using a multiplex PCR procedure. A PCR-RFLP method was used to detect polymorphism for the most common alleles of the NAT2 gene. Allelic frequencies between the two groups were compared using a chi2 test and odds ratio with 95% confidence intervals were calculated. The results indicate that the genotypic frequency of GSTM10/0 between controls and patients was significantly different. This genotype confers an increased risk of nasopharyngeal carcinoma (Odds Ratio = 2.12, [0.64-4.7]). However, genotypic frequencies of NAT2*6/NAT2*6 were significantly higher in the group of nasopharyngeal carcinoma patients. The calculated Odds Ratio showed an association between this genotype and nasopharyngeal carcinoma. In conclusion, the increase of nasopharyngeal carcinoma risk in Tunisia seems to be associated with GSTM10/0 and NAT2*6/6 genotype.
    No preview · Article · Apr 2006 · Bulletin du cancer