Browsing by Author "Okpechi, Ikechi Gareth"

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    Blood pressure gradients and cardiovascular risk factors in urban and rural populations in Abia State South Eastern Nigeria using the WHO STEPwise approach
    (Public Library of Science, 2013) Okpechi, Ikechi Gareth; Chukwuonye, Innocent Ijezie; Tiffin, Nicki; Madukwe, Okechukwu Ojoemelam; Onyeonoro, Ugochukwu Uchenna; Umeizudike, Theophilus Ifeanyichukwu; Ogah, Okechukwu Samuel
    BACKGROUND: Developing countries of sub-Saharan Africa (SSA) face a double burden of non-communicable diseases (NCDs) and communicable diseases. As high blood pressure (BP) is a common global cardiovascular (CV) disorder associated with high morbidity and mortality, the relationship between gradients of BP and other CV risk factors was assessed in Abia State, Nigeria. METHODS: Using the WHO STEPwise approach to surveillance of chronic disease risk factors, we conducted a population-based cross-sectional survey in Abia state, Nigeria from August 2011 to March 2012. Data collected at various steps included: demographic and behavioral risk factors (Step 1); BP and anthropometric measurements (Step 2), and fasting blood cholesterol and glucose (Step 3). RESULTS: Of the 2983 subjects with complete data for analysis, 52.1% were females and 53.2% were rural dwellers. Overall, the distribution of selected CV disease risk factors was diabetes (3.6%), hypertension (31.4%), cigarette smoking (13.3%), use of smokeless tobacco (4.8%), physical inactivity (64.2%) and being overweight or obese (33.7%). Presence of hypertension, excessive intake of alcohol, smoking (cigarette and smokeless tobacco) and physical inactivity occurred more frequently in males than in females (p<0.05); while low income, lack of any formal education and use of smokeless tobacco were seen more frequently in rural dwellers than in those living in urban areas (p<0.05). The frequency of selected CV risk factors increased as BP was graded from optimal, normal to hypertension; and high BP correlated with age, gender, smokeless tobacco, overweight or obesity, annual income and level of education. CONCLUSION: Given the high prevalence of hypertension in this part of Nigeria, there is an urgent need to focus on the reduction of preventable CV risk factors we have observed to be associated with hypertension, in order to effectively reduce the burden of NCDs in Africa.
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    Metabolic syndrome, the leptin gene and kidney disease in non-diabetic black South Africans
    (2008) Okpechi, Ikechi Gareth; Meissner, P; Rayner, B L; Ramesar, R; Pascoe, M D
    Obesity is a worldwide problem and is a factor in the pathogenesis of the metabolic syndrome and kidney disease through the development of obesity-related hypertension and neurohormonal mechanisms that include the action of leptin. As there appear to be no focussed studies that have looked at the association of the LEP gene with kidney disease phenotypes or cardiovascular disease markers like hypertension, the metabolic syndrome and obesity, and especially so in native black Africans, this study sought to establish an association between the obesity gene (LEP) and kidney disease phenotypes (independent of diabetes and hypertension) in a homogenous black African population.
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    Using urinary MCP-1 and TWEAK to assess disease activity in a cohort of South African patients with lupus nephritis
    (2020) Rusch, Jody Alan; Okpechi, Ikechi Gareth; Omar, Fierdoz
    Background: Renal involvement is common in systemic lupus erythematosus (SLE) and can lead to chronic kidney disease (CKD). Diagnosis of lupus nephritis (LN) is dependent on renal biopsy. Due to its invasiveness, repeat renal biopsy for monitoring disease activity is not recommended, thus creating a need for noninvasive and accurate biomarkers. Monocyte chemoattractant protein-1 (MCP-1) and tumour necrosis factor-like weak inducer of apoptosis (TWEAK) have been implicated in the pathogenesis of LN and are thus potential biomarkers for disease activity monitoring. Methods: In this study urinary MCP-1 (uMCP-1) and TWEAK (uTWEAK), together with standard markers of disease activity, were analysed in a cohort of 50 biopsy-proven LN patients at baseline, after sixmonths of induction therapy, and at one-year. Results: Throughout the study there was correlation between uMCP-1 and uTWEAK (r=0.52, p< 0.001). Both biomarkers also correlated with standard of care tests and clinical scores. The median [interquartile range] of uMCP-1 and uTWEAK were significantly increased in the active group when compared to the quiescent group (1440 [683–2729] vs 256 [175–477] pg/mL, p< 0.0001, and 209 [117–312] vs 74 [11– 173] pg/mL, p=0.0008, respectively). After completion of induction therapy in the active group, there was no significant difference in biomarker results between the groups. The sensitivity and specificity for indicating disease activity was 95% and 73% for uMCP-1 (area under curve [AUC]=0.875), and 60% and 90% for uTWEAK (AUC=0.783), respectively. Conclusion: uMCP-1 and uTWEAK reflect LN disease activity, and correlate with standard of care biomarkers in a South African cohort. Further studies are needed to assess additional clinical benefit.