1.Metabolic changes of overweight and obese adults
Yumchinsuren Ts ; Dolgion D ; Ganchimeg D ; Enkhmend Kh ; Otgongerel N ; Gantogtokh D ; Amin-Erdene G ; Bolor U ; Tegshjargal S ; Batbold B ; Shiirevnyamba A ; Tulgaa L
Diagnosis 2024;111(4):97-104
Introduction:
The worldwide prevalence of obesity and its metabolic complications have increased substantially in recent decades. According to the World Health Organization (WHO) indicate that in 2016, over 1.9 billion
adults were overweight and, of these, over 650 million were obese. Obesity is a major risk factor for heart disease, type 2 diabetes, steatotic liver, chronic liver disease, stroke, and some cancers. The global prevalence of obesity and its associated comorbidities continue to increase on a pandemic scale.
Aim:
To determine metabolic changes in overweight and obese adults and their related diseases based on some parameters of anthropometric and laboratory tests.
Materials and Methods:
This study was conducted with a case-control design in 2023–2024. There were 150 participants in
the study, 50 in the control group with normal weight, 50 in the overweight (BMI<29.9kg/m2)
case group, and 50 in the obesity (BMI>30kg/m2) case group. Subjects of three groups were matched by age (±1) and sex. We estimated anthropometric parameters and biochemical
laboratory analysis including glucose, lipid, ferrum, and liver parameters. CBC All statistical analysis was performed using SPSS 23 software. Categorical variables were described by numbers and percentages, and the numerical variables were characterized by the median (min and max) for the normal distribution, and mean± standard deviation for the non-normal distribution. The statistical
tests utilized were the Chi-square, Fisher’s exact, student t-test, and Mann–Whitney tests. Ethical approval for the survey was obtained from the Medical Ethics Committee under the Ministry of Health Of Mongolia in January 2023.
Results:
The participants' average age was 46.73±11.45, with 60% being women (90) and 40% being men (60). The prevalence of central obesity and fat % were 52.3% and 37.2%, respectively. Between study
groups, there were significant differences in fat% (p=0.004), central obesity (p<0.001), FBG (p=0.024), cholesterin (p=0.017), LDL (p=0.018), HDL (p=0.003), ferrum (p=0.010), АЛАТ (p=0.020), and GGT (p<0.001).
Conclusion
In overweight and obesity groups, the body fat, fasting blood glucose, cholesterol, LDL, and ALT levels are
increased. These changes often lead to conditions like type 2 diabetes, arterial hypertension, steatotic liver disease, and liver fibrosis. Therefore, it is important to develop plans for prevention, early detection,
public awareness, and intervention programs targeting obesity in the general population.
2.Association between serum cryoglobulinemia and clinical manifestation in chronic hepatitis C patients
Amin-Erdene G ; Gantogtokh D ; Yumchinsuren Ts ; Dolgion D ; Bolor U ; Otgongerel N ; Enkhmend Kh ; Ganchimeg D ; Tulgaa L ; Sarnai Ts ; Batbold B
Mongolian Journal of Health Sciences 2025;88(4):92-99
Background:
The most common clinical manifestation of HCV infection, which includes both hepatic and extrahepatic
manifestations, is mixed cryoglobulinemia, which is characterized by the precipitation of certain proteins in the blood at
temperatures below 37°C (in vitro), aggregation, and deposition in the walls of small and medium-sized vessels, causing
vasculitis, which is clinically manifested by a triad of joint pain, fatigue, and rash on the soles of the feet. Cryoglobulinemia is commonly diagnosed in people with HCV infection, with a prevalence ranging from 10% to 70%. Vasculitis that
occurs when cryoglobulinemia is detected mainly affects the small vessels of the skin, kidneys, and peripheral nerves,
causing complications in other organ systems.
Aim :
To determine the prevalence of cryoglobulinemia in people with HCV infection, study it in relation to the stage of
liver fibrosis, and determine its clinical relevance.
Materials and Methods :
200 chronic HCV infected individuals were included in the study according to the inclusion
and exclusion criteria. After obtaining informed consent from each participant, a questionnaire was used to collect information, perform physical measurements, and collect peripheral blood samples. Complete blood count and biochemical
tests (liver and kidney function) were performed. The degree of liver fibrosis was assessed non-invasively (APRI, FIB4). The glomerular filtration rate was calculated electronically using the MDRD GFR Equation. Skin examination was
performed to assess the presence of rash, ulcers, and scarring on the shins and ankles of cryoglobulinemia. To determine
cryoglobulinemia, 8 ml of blood was collected in a tube without anticoagulant, and the sample was kept motionless for
1 hour at room temperature until clotting was complete. After centrifugation, the samples were separated and stored in a
refrigerator at +4°C for 7 days, and then at room temperature for 30 minutes, the precipitate was detected.
Results :
A total of 200 people participated in the study, of which 71 were men (35.5%), the average age was 53.39±13.0.
Cryoglobulinemia protein precipitates were determined in a total of 148 people, of which 50 were men (33.8%), the
average age was 52.95±13.0. Cryoglobulinemia protein precipitates were detected in 89 people, or 60.1% of the study
participants. Of the total study participants, 176 (88.0%) had chronic hepatitis C (CHC). Of these, 57 people had CHC
with cryoglobulinemia. Comparing laboratory parameters, the mean GGT level in the cryoglobulinemia group was statistically significantly higher than in the non-cryoglobulinemia group (p=0.039). However, when laboratory parameters
were grouped by increasing or decreasing, AST and ALT levels were significantly higher in the cryoglobulinemia group,
indicating more hepatocellular damage (p<0.000). Increased creatinine levels may be associated with the risk of renal
dysfunction. The FIB-4 index and APRI index showed a more severe degree of fibrosis in the cryoglobulinemia group
(p<0.005; p<0.000). Univariate logistic regression analysis showed that age was associated with the occurrence of cryoglobulinemia (OR=2.48; 95% CI:1.31–4.70; p=0.005). Platelet count had a statistically significant positive effect in multivariate analysis (OR=14.38; 95% CI:1.26–163.89; p=0.032).
Conclusion
The prevalence of cryoglobulinemia among HCV-infected patients was 60.1%, and older age and decreased
platelet count among infected individuals were associated with the occurrence of cryoglobulinemia.
3.Correlation between FTO gene rs9939609, rs17817449 polymorphisms and, obesity
Yumchinsuren Ts ; Dolgion D ; Yesukhei E ; Baljinnyam T ; Enkhmend Kh ; Ganchimeg D ; Gantogtokh D ; Otgongerel N ; Batbold B ; Shiirevnyamba A ; Tulgaa L
Mongolian Journal of Health Sciences 2025;85(1):136-141
Background:
In 2022, the World Health Organization (WHO) reported that globally, 2.5 billion (43%) of adults aged
18 and older were overweight, with 890 million (16%) of these individuals classified as living with obesity. Some genes
such as the FTO gene are strongly associated with obesity and overweigh. The FTO protein is crucial in regulating food
consumption, appetite, energy equilibrium, and expenditure.
Aim:
The identify single nucleotide polymorphisms rs9939609 and rs17817449 of the FTO gene, which are associated
with obesity, and to study their correlation with antropometric measurements and some laboratory test parameters.
Materials and Methods:
According to the inclusion and exclusion criteria, 50 obese (BMI >30 kg/m²) were included in
the case group, and 50 relatively healthy and normal weight (BMI 18.5-24.9 kg/m²) were enrolled in the control group,
for a total of 100 people matched for age and gender (1:1). We took physical measurements and collected peripheral blood
samples after obtaining informed consent from each participant. Laboratory analyses assessed some parameters of lipid
and glucose metabolism. We used the PCR-RFLP technique on two genotype SNPs. A p-value below 0.05 was considered
a statistically significant result.
Results:
In this study, including 100 people aged 23 to 75, the mean age was 46.81±11.54 years, with 60% being female.
In terms of antropometric measurements, body mass index, waist circumference, and arterial pressure were markedly
elevated in the case group compared to the control group (p<0.001). In laboratory measures, fasting blood glucose,
cholesterol, and mean LDL mean levels were statistically significantly higher in the case group compared to the control
group. On the other hand, HDL cholesterol levels were lower in the case group compared to the control group. The FTO
gene rs9939609 single nucleotide polymorphism was identified in 62% of the total study individuals as TT, 35% as AT,
and 3% as AA genotypes. Also, FTO gene rs17817449 single nucleotide polymorphism was identified in 62% of the total
study individuals as TT, 33% as AT, and 5% as AA genotypes.
Conclusion
The rs9939609 AT/AA genotype of the FTO gene elevates the risk of obesity and is associated with increased body weight, waist circumference, and BMI.
4.Studying the relationship between Cryoglobulinemia and liver fibrosis in patients with chronic Hepatitis C virus infection
Amin-Erdene G ; Gantogtokh D ; Turmanduul Ch ; Yumchinsuren Ts ; Dolgion D ; Enkhmend Kh ; Bolor U ; Otgongerel N ; Ganchimeg D ; Tegshjargal B ; Tulgaa L ; Batbold B
Diagnosis 2024;111(4):10-19
Introduction:
Hepatitis C virus (HCV) infection has both hepatic and extrahepatic manifestations, and it is one of the leading cause of liver transplantation. There’s limited research on extrahepatic symptoms of chronic HCV in Mongolia, thus we aimed to investigate the relationship between cryoglobulinemia and it’s related factors.
Methods:
The study included 200 participants with active HCV, collecting blood samples for various tests (biochemical analysis, kidney function, and cryoglobulinemia detection). The degree of liver fibrosis was assessed using APRI and FIB4 scores, and the study evaluated other health conditions through a questionnaire. Statistical analysis was performed using SPSS-26.
Results:
Out of 200 participants, 148 checked for cryoglobulin precipitation and 89 (60.1%) were positive. There
was a statistically significant age difference between those with and without cryoglobulinemia (54.62 vs. 50.44 years). A higher percentage of participants with cryoglobulinemia had significant liver fibrosis (10.8% vs. 4.7% without). Liver fibrosis scores tended to increase with age, especially in men.
Conclusion
Liver fibrosis scores above 3.25 are associated with older age, lower platelet counts, elevated AST and ALT levels, and the presence of cryoglobulinemia. FIB4 scores were higher in men with active HCV and cryoglobulinemia.