Thesis (M.P.H.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 61-66).

published_or_final_version / Community Medicine / Master / Master of Public Health

Thesis (Ph. D.)--University of Missouri-Columbia, 2004. / Typescript. Vita. Includes bibliographical references (leaves 63-70). Also available on the Internet.

Thesis (Ph. D.)--University of Missouri-Columbia, 2004. / Typescript. Vita. Includes bibliographical references (leaves 63-70). Also available on the Internet.

Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 46-05, page: 2672. Adviser: Wendell C. Taylor. Includes bibliographical references.

Thesis (doctoral)--Institute of Dentistry, University of Helsinki, 2003. / Includes bibliographical references.

published_or_final_version / Public Health / Master / Master of Public Health

B. Tech. (Department of Biotechnology, Faculty of Applied and Computer Sciences), Vaal University of Technology. / Cardiovascular diseases (CVDs) are the leading cause of death worldwide, and the prevalence thereof is on the rise in developing countries due to the demographic transition and urbanization. The inflammatory process, atherosclerosis, is at the root of the majority of CVDs and is caused by unresolved inflammation. Various cardiovascular risk factors such as hyperglycaemia, dyslipidaemia, hypertension, smoking and aging stimulate the development of atherosclerosis through triggering inflammation. Being in a state of chronic low-grade inflammation therefor places an individual at higher risk of developing CVD, with inflammation playing a cause and effect role. The aim of this study was to investigate the inflammatory status of an elderly black South African population by analysis of inflammatory markers HS-CRP, TNF-α and IL-6, as well as the genetic polymorphism C174G associated with increased serum levels of IL-6 in some populations. The research was conducted in the field of Biomedical Sciences as a quantitative, cross-sectional, analytical observational design. The study was ethically approved and involved collection of 84 blood samples from volunteers in a purposively selected population as part of a larger collaborative study. Serum was used to analyse HS-CRP, TNF-α and IL-6 and DNA was extracted from whole blood for analysis of the C174G polymorphism. The median serum HS-CRP of 6.44mg/L (IQR = 2.82 - 9.86mg/L) fell within the highest risk (>5mg/L) of CVD and 75% of participants were at high (3.01-5mg/L) or very high (>5mg/L) risk. The median TNF-α of 0.00pg/mL was within the normal range and only 2.6% of participants had high serum TNF-α levels. The median serum IL-6 level was 1.92pg/mL and was also within the normal range with only 2.6% of participants who had high serum IL-6 levels. For the C174G polymorphism analysis, 98.6% had the GG, 1.4% the GC genotype and no participants had the CC genotype. The median serum IL-6 level of the homozygous GG group was 6.51mg/L, higher than the 4.13mg/L serum IL-6 of the heterozygous GC group. The difference in IL-6 should be considered with caution as only one participant had the C allele. A highly significant (p=0.001) correlation was found between HS-CRP and IL-6, as well as between IL-6 and TNF-α (p = 0.048). The elderly black Sharpeville community is in an increased inflammatory state which puts them at risk of CVD. The prevalence of the C allele in the C174G polymorphism is low in this population. Further research could be conducted as intervention studies to decrease the inflammatory state of the population and influence health policy changes to improve prevention of CVD.

M. Tech. (Department of Biotechnology, Faculty of Applied and Computer Sciences), Vaal University of Technology. / Background: Increased serum homocysteine is well known as an independent cardiovascular risk factor. Hyperhomocysteinemia may be due to several factors such as nutritional deficiencies and genetics. The MTHFR C677T polymorphism is associated with increased serum homocysteine. Folate and vitamin B12 play essential roles in lowering homocysteine levels. Limitations have been identified using serum vitamin B12 as a marker for vitamin B12 status due to lack an efficient of test. Holotranscobalamin has been reported as a more accurate marker for vitamin B12 status. Cardiovascular risk due to hyperhomocysteinemia has been confirmed among the elderly in Sharpeville. Knowledge of the prevalence of MTHFR C677T polymorphism among Black elderlies in South Africa is limited. Objectives: The main aim of the study was to evaluate the prevalence of MTHFR C677T polymorphism as a cardiovascular risk in an elderly black population in Sharpeville. Correlations between the presence of MTHFR C677T polymorphism and homocysteine metabolic markers were evaluated. Holotranscobalamin as a diagnostic test for vitamin B12 status was also assessed in this study. Materials and methods: This study was ethically approved by the Vaal University of Technology ethics committee (20140827-1ms). It was an observational, experimental study conducted in 102 elderly (≥60 years) attending the day-care centre in Sharpeville. Real-Time PCR was used to determine MTHFR genotypes. Folate and vitamin B12 were measured with AIA-PACK. Homocysteine levels were determined with an automated Konelab™ 20i and holotranscobalamin by ELISA. STATA 12 software was used for analysis of descriptive and inferential statistics. Results: The prevalence of MTHFR C677T polymorphism in this sample population was 19%. Heterozygous CT single nucleotide polymorphism was 17% and mutant homozygous TT was 2%. The majority (81%) of the subjects had wild type homozygous CC genotypes. No associations were found between MTHFR C677T genotypes and homocysteine and folate levels. Hyperhomocysteinemia was high (54%) and low (5%) folate deficiency found. No vitamin B12 deficiency was found however 7% were on the category of likely to be deficient. Sensitivity and specificity of holotranscobalamin were 100% and 95% respectively. Conclusion: The conclusions drawn from the study is that the prevalence of MTHFR C677T polymorphism is low within elderly in Sharpeville. There is a high risk of cardiovascular disease as a result of high prevalence of hyperhomocysteinemia. An intervention to lower homocysteine concentration of elderlies residing in Sharpeville is needed. Other genetic predisposing factors of increased homocysteine levels should be investigated.