Background and Objectives: Imbalance of calcium/magnesium ratio could lead to clinical complications in sickle cell disease (SCD). Low levels of magnesium have been associated with sickling, increased polymerization and vaso-occlusion (VOC) in sickle cell due to cell dehydration. The K-Cl cotransport plays a very important role in sickle cell dehydration and is inhibited by significantly increasing levels of magnesium. The study evaluated total serum magnesium levels and computed calcium/magnesium ratio in SCD patients and “healthy” controls. Materials and Methods: The study was a case-control cross-sectional one, involving 120 SCD patients (79 Haemoglobin SS (HbSS)and 41 Haemoglobin SC (HbSC)) at the steady state and 48 “healthy” controls. Sera were prepared from whole blood samples (n = 168) and total magnesium and calcium measured using a Flame Atomic Absorption Spectrometer (Variant 240FS manufactured by VARIAN Australia Pty Ltd., Melbourne, VIC, Australia). Calcium/magnesium ratios were calculated in patients and the controls. Results: The prevalence of hypomagnesemia and hypocalcaemia among the SCD patients was observed to be 39.17% and 52.50% respectively, higher than the controls (4.17% and 22.92%, for hypomagnesemia and hypocalcaemia, respectively). Level of magnesium was significantly lower in the SCD patients compared to their healthy counterparts (p = 0.002). The magnesium level was further reduced in the HbSS patients but not significantly different from the HbSC patients (p = 0.584). calcium/magnesium ratio was significantly higher in the SCD patients (p = 0.031). Although calcium/magnesium ratio was higher in the HbSC patients compared to those with the HbSS genotype, the difference was not significant (p = 0.101). Conclusion: The study shows that magnesium homeostasis are altered in SCD patients, and their levels are lower in HbSS patients. Although calcium/magnesium ratio is significantly higher in SCD patients compared with controls, there is no significant difference between patients with HbSS and HbSC genotypes. Magnesium supplementation may be required in sickle cell patients.

The activity of Na ⁺ -K ⁺ ATPase is altered in sickle cell disease (SCD), which affects serum electrolyte levels. This alteration is associated with several complications in sickle cell patients. This study evaluated the serum levels of sodium, potassium, and chloride in patients with SCD. The study was a case-control cross-sectional study involving 120 SCD patients in the steady state and 48 ‘healthy’ controls. The SCD patients were made up of 69 HbSS patients and 41 HbSC patients. Serum electrolyte levels (Na ⁺ , K ⁺ , and Cl ⁻ ) were measured using a Flame Atomic Absorption Spectrometer (Variant 240FS; Varian Australia Pty Ltd). Serum sodium levels were significantly lower in the sickle cell patients, compared with their ‘healthy’ counterparts ( P = .0001). Although the study found significantly higher serum levels of potassium in the SCD patients ( P = .0001), there was no significant difference in serum chloride levels between patients with SCD and the controls ( P = .098). Serum sodium and chloride levels were not significantly different in both HbSS and HbSC patients ( P = .197 and P = .553, respectively). The level of serum potassium in the HbSS patients was, however, significantly higher compared with those with the HbSC genotype ( P = .0001). There is higher efflux of K ⁺ from the intracellular into the extracellular space in HbSS patients, which may lead to red cell membrane dysfunction and associated complications.

Background and aim: Obesity has reached epidemic proportions worldwide, with large differences across regions. European data on obesity trends among ethnic groups is scarce, particularly regarding the influence of age and socioeconomic status on these trends, which is crucial for guiding targeted interventions. In this study, we assessed the prevalence of obesity and changes in body mass index (BMI) and waist circumference (WC) over time and the effects of key sociodemographic factors on these changes using longitudinal data from a large multi-ethnic cohort. Methods: Using baseline and follow-up data from 10 484 participants in the HEalthy Life in an Urban Setting (HELIUS) study, representing Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Moroccan and Turkish populations; age-adjusted obesity prevalence; BMI and WC changes over an average follow-up of 6.3 (SD 1.2) years were calculated. Linear mixed models were used to assess changes in BMI and WC over time, adjusting for age, sex and socio-economic position. Key analyses were stratified by age (younger <50 years, older ≥50 years). Results: Median age of the baseline population was 48.0 years (IQR 38.0, 56.0), with 56.7% being women. Age-adjusted prevalence of obesity increased from 23.6% at baseline to 28.7% at follow-up, with steeper increases in ethnic minority groups compared with the Dutch origin group. The steepest increase in BMI and WC was observed in younger migrants, especially in those of Ghanaian and African-Surinamese descent. In older participants, only individuals of Ghanaian and Turkish descent showed a further increase in BMI over time. Conclusion: Obesity is increasingly prevalent in ethnic minority groups under 50 years, potentially raising obesity-related health risks and underscoring the need for targeted interventions to prevent further complications.

Background: The rapidly rising cardiometabolic disease (CMD) burden in urbanizing sub-Saharan African populations and among sub-Saharan African migrants in Europe likely affects serum adiponectin and leptin levels, but this has not yet been quantified. Objectives: To compare the serum levels of adiponectin and leptin among migrant, and non-migrant (urban and rural) populations of Ghanaian descent. Methods: Cross-sectional analysis of serum leptin and adiponectin in the multi-centre Research on Obesity and Diabetes among African Migrants (RODAM) study. Logistic-regression models were used to examine the association between these adipocyte-derived hormones after stratification (sex, geographic area) and adjustments for potential confounders. Results: A total of 2518 Ghanaians were included. Rural participants had the highest serum adiponectin and lowest leptin levels compared to Amsterdam and urban Ghanaians ( P < .001). In fully adjusted models, participants living in urban Ghana had significantly higher odds of hyperleptinemia compared to rural participants (women-odds ratio 2.88; 95% CI, 1.12-7.38, P = .028 and men 43.52, 95% CI, 4.84-391.25, P < .001). Urban Ghanaian men also had higher odds of elevated leptin: adiponectin ratio (6.29, 95% CI, 1.43-27.62, P = .015). The odds of hyperleptinemia were only higher in Amsterdam Ghanaian men (10.56; 95% CI, 1.11-100.85, P = .041), but not in women (0.85; 95% CI, 0.30-2.41, P = .759). There was no significant association between hypoadiponectinemia and geographical location in both sexes. Conclusion: Urbanization is associated with serum adiponectin and leptin levels after adjusting for confounding covariates in sub-Saharan Africans. These findings serve as a backdrop for further research on the role adipokines play in CMD epidemiology among Africans.

Background. Associated with preventable mortality, 50% of abdominopelvic patients require an intensive care unit (ICU). Limited ICU beds in South Africa are significantly impacted by prolonged stays, with 20% of prolonged stays being a result of abdominopelvic injuries. Objective. To describe the clinical profile and the determinants of length of stay and mortality in patients with abdominopelvic injury admitted to a tertiary hospital ICU. Methods. A retrospective analysis of abdominopelvic injury patients admitted to the surgical ICU at Tygerberg Hospital from January 2021 to December 2023. Using REDCap, demographic and clinical profile data were captured from the Electronic Content Management system. Negative binomial and logistic regression models were used to examine the determinants of length of stay and ICU mortality. respectively. Results. Of the 82 eligible participants, 79.3% were male, mean age of 36.5 years (95% confidence interval (CI) 33.8 - 39.1), with isolated abdominal injury accounting for 14.6% of cases. The median length of ICU and hospital stay was 5 days (interquartile range (IQR) 3 - 13), and 19 days (IQR 9 - 40.5), respectively, with age, acute physiology and chronic health evaluation (APACHE II) score, shock index and relook surgery being the key determinants of length of ICU stay. Further to these factors, ICU mortality was associated independently with serum lactate levels (odds ratio 1.37 (95% CI 1.04 - 1.80) with the crude mortality rate (CMR) being 29.3%. Conclusion. The majority of abdominopelvic injuries admitted to the ICU are non-isolated, with age, APACHE II score, shock index and relook surgery key determinants of ICU length of stay. Further, ICU mortality is associated with serum lactate levels. Adequate resuscitation and optimising initial surgery may help reduce patients’ stay in the ICU, and mortality.

Introduction: Sub-Saharan African migrant populations are exposed to new environmental factors, both of which have been linked to increased rates of obesity and insulin resistance. Given the complex relationship between adipokines and cardiometabolic traits, we hypothesized that these associations may vary depending on geographical context. Our aim was to examine the influence of geographic location on the association between serum leptin and adiponectin and cardiometabolic traits. Methods: This is a cross-sectional analysis among 2,640 participants from the RODAM study living in Amsterdam, the Netherlands, and urban and rural Ghana. Correlation and linear regression models were used to examine the relationship between adipokines and cardiometabolic traits, including body mass, insulin resistance, inflammation, and lipid metabolism per location. Results: Body mass was the key determinant of serum leptin, less so for serum adiponectin. There was a significant (p < 0.001) interaction in the association between BMI and serum leptin according to geographic location in women and in the association between waist circumference and serum leptin in men, suggesting increased leptin resistance during rural to urban transition, but with similar slopes for urban Ghanaians living in tropical and temperate climates. There was no significant interaction with location in the association between body mass and adiponectin. Inflammation and lipid metabolism explained the least amount of variance in serum adipokines across the locations. Conclusion: There was significant variability in the relationship between serum leptin and the cardiometabolic traits examined across locations. These findings suggest that rural to urban transition significantly affects this relationship. Future studies may help to further delineate the effects of environmental factors on adipokine production, obesity, and cardiometabolic disease.