Background: The epidemiological transition has seen a trend from communicable to non-communicable diseases in developing countries. At the pinnacle of these chronic diseases is hypertension, pre-hypertension, diabetes and obesity. This leads to increased cardiovascular morbidity and mortality worldwide. In addition, environmental and behavioural changes such as lifestyle habits represent modifiable risk factors for the development of cardiovascular diseases. The Caribbean is not immune to this trend. Methods: This was a cross-sectional survey conducted between June and September 2009 and involved individuals 15-74 years of age. Age-gender was weighted to get as close a representative sample of the general population living in the British Virgin Islands (BVI) for more than two years to a total of 301 (n = 301, M: 144, F: 157; CI 95% ± error 5%). The study was carried out using a handout questionnaire that included variables on age, gender, socioeconomic status (SES), income level, cigarette smoking, physical activity, weight, height, body mass index (BMI), blood pressure, fasting blood glucose and cholesterol.

ABSTRACT

Vitamin D has important effects on the immune system as it has been shown to exert antiproliferative and relative immunosuppressant effects. Low levels of this hormone may contribute to the immune activation in systemic lupus erythematosus (SLE) and other autoimmune diseases. Serum levels of 25-OH vitamin D were measured in 75 patients with SLE in Jamaica, using an enzyme-linked immunoassay. Correlations with clinical data and disease activity as determined by the BILAG index were determined. Of a total of 75 patients, 33 (44%) had vitamin D sufficiency with mean vitamin D level of 39.45 ng/ml (range, 30.35-58.16). Forty-two (56%) patients had either vitamin D deficiency or insufficiency, 30 (40%) had vitamin D insufficiency, mean 26.36 ng/ml (range, 20.26-29.88), and 12 (16%) had vitamin D deficiency, mean 16.07 ng/ml (range, 7.78-19.90). There was an overall negative relationship between the total disease activity score using the BILAG index and vitamin D levels, and this was influenced primarily by the relationship seen among the vitamin D-deficient subgroup. This was also impacted on by a patient population that was significantly skewed toward low disease activity. The negative association trended toward statistical significance. Vitamin D deficiency is prevalent among patients with SLE in Jamaica. A relationship between low serum levels of vitamin D and SLE activity may occur.

Background.The kidney is central to many complex pathways in the body and kidney injury can precipitate multiple negative clinical outcomes. The resultant effect on nutrition and elemental body burden is bi-directional, confounding the very complex pathways that maintain homeostasis. These elemental changes themselves increase the risk of nutritional and biochemical disturbances.Objectives.The aim of the present study was to describe how toxic elements interface with complications of chronic kidney disease (CKD).Methods.The present review included studies focusing on the molecular mechanisms induced by exposure to elements with known nephrotoxic effects and associated health complications in CKD patients.Discussion.Many non-essential elements have nephrotoxic activity. Chronic injury can involve direct tubular damage, activation of mediators of oxidative stress, genetic modifications that predispose poor cardiovascular outcomes, as well as competitive uptake and element mobilization with essential elements, found to be deficient in CKD. Cardiovascular disease is the most common cause of mortality among CKD patients. Oxidative stress, a common denominator of both deficient and excess element body constitution, underlies many pathological derivatives of chronic kidney disease. Bone disorders, hematological dysfunction and dysregulation of acid-base balance are also prevalent in kidney patients. The largest contribution of toxic element body burden results from environmental exposure and lifestyle practices. However, standard medical therapies may also potentiate toxic element accumulation and re-injury of vulnerable tissue.Conclusions.For CKD patients, the cumulative effect of toxic elements persists throughout the disease and potentiates complications of CKD. Medical management should be coordinated between a medical team, dietitians and clinical researchers to mitigate those harmful effects.Competing Interests.The authors declare no competing financial interests

Background: The progression of chronic kidney disease (CKD) is concomitant with complications, including thyroid dysfunction, dyslipidemia and cardiovascular diseases. The aim of this study is to determine serum cystatin C levels, and the prevalence of vitamin D deficiency and thyroid dysfunction in CKD patients. Methods: A cross-sectional study was conducted involving 140 CKD patients (stages 1–5) that were referred to a renal clinic. Demographic data was collected and thyroid function tests, serum 25-OH-vitamin D, cystatin C levels, and routine biochemistry tests were determined using cobas 6000 analyzer. Results: 129 (92.1%) of CKD patients had elevated serum cystatin C levels and there was a stepwise increase from stage 1–5. Overt hypothyroidism was present in one patient and nine had subclinical hypothyroidism. There was a stepwise reduction in serum 25-OH-vitamin D levels from stage 2–5, 31 (22.1%) had vitamin D insufficiency and 31 (22.1%) presented with deficiency. Conclusions: 25-OH-vitamin D deficiency and thyroid disorders are exhibited in chronic kidney disease patients and the severity of the former rises with disease progression, as indicated by elevated cystatin C levels. Routine screening and timely intervention is recommended so as to reduce the risk of cardiovascular diseases.