United Arab Emirates Nationals Research Articles

Combined intake of glucose-and lipid-lowering medications further elevates plasma levels of PCSK9 in type 2 diabetes patients

Background and aimThis study examined the status of plasma levels of protein convertase subtilisin/kexin 9 (PCSK9) in association with glucose-and lipid-lowering medications in subjects with type 2 diabetes (T2D). MethodsThis study comprised 177 diabetics and 115 non-diabetic subjects recruited from the United Arab Emirates National Diabetes Study (UAEDIAB). Clinical and biomedical data were collected by standard techniques. Plasma levels of PCSK9 were determined using ELISA. ResultsPCSK9 levels were higher in diabetics than non-diabetics (P < 0.001). Diabetics with disease duration >5 years, HbA1c > 7.0%, or male subjects, had significantly higher levels of PCSK9 than their counterparts (P < 0.05). Regression analysis revealed that HbA1c and age are predictors for PCSK9 in T2D subjects. Diabetic subjects with abnormal lipids profile on lipid-lowering medications had a higher level of PCSK9 compared to those with normal lipids profile (85.6 ± 40.5 vs. 63.7 ± 39.5 ng/ml, respectively; P < 0.01). Diabetics on combined intake of insulin and oral glucose-lowering drugs had higher levels of PCSK9 than those not taking any (86.1 ± 41.6 vs 69.7 ± 36.1 ng/ml, respectively; P < 0.05). The highest levels of PCSK9 however, were in diabetics on combined lipid- and glucose-lowering therapy when compared to those, not on any (96.2 ± 34.0 vs 66.0 ± 35.1 ng/ml, respectively; P < 0.01). ConclusionsAge and HbA1c are the most predictors for the elevated levels of PCSK9 in Emirati T2D subjects. Combined therapy of glucose-and lipid-lowering medications further elevates plasma levels of PCSK9 in diabetic subjects.

Pre-diagnostic biomarkers of type 2 diabetes identified in the UAE\u2019s obese national population using targeted metabolomics

Currently, type 2 diabetes mellitus (T2DM) and obesity are major global public health issues, and their prevalence in the United Arab Emirates (UAE) are among the highest in the world. In 2019, The UAE diabetes national prevalence was 15.4%. In recent years there has been a considerable investigation of predictive biomarkers associated with these conditions. This study analysed fasting (8 h) blood samples from an obese, normoglycemic cohort and an obese, T2DM cohort of UAE nationals, employing clinical chemistry analysis, 1D 1H NMR and mass spectroscopy (FIA-MS/MS and LC-MS/MS) techniques. The novel findings reported for the first time in a UAE population revealed significant differences in a number of metabolites in the T2DM cohort. Metabolic fingerprints identified by NMR included BCAAs, trimethylamine N-oxide, β-hydroxybutyrate, trimethyl uric acid, and alanine. A targeted MS approach showed significant differences in lysophosphatidylcholines, phosphatidylcholines, acylcarnitine, amino acids and sphingomyelins; Lyso.PC.a.C18.0, PC.ae.C34.2, C3.DC..C4.OH, glutamine and SM.C16.1, being the most significant metabolites. Pearson’s correlation studies showed associations between these metabolites and the clinical chemistry parameters across both cohorts. This report identified differences in metabolites in response to T2DM in agreement with many published population studies. This contributes to the global search for a bank of metabolite biomarkers that can predict the advent of T2DM and give insight to its pathogenic mechanisms.

External validation and clinical usefulness of three commonly used cardiovascular risk prediction scores in an Emirati population: a retrospective longitudinal cohort study

ObjectivesCardiovascular disease (CVD) risk prediction models are useful tools for identifying those at high risk of cardiovascular events in a population. No studies have evaluated the performance of such risk...

Prevalence and associations of moderately increased albuminuria in patients with type 2 diabetes in United Arab Emirates

Background and aimsOur study sought to investigate the prevalence of moderately increased albuminuria in United Arab Emirates (UAE) nationals with type 2 diabetes, and to identify the associated factors. MethodsThis prospective cross-sectional study was conducted in two hundred and seven UAE nationals with type 2 diabetes mellitus attending the internal medicine department of a secondary care hospital. Moderately increased albuminuria was estimated in random spot urine samples and was defined as urinary albumin-to-creatinine ratio (UACR) of 3–30 mg/mmoL. Prevalence and associations of moderately increased albuminuria were evaluated. ResultsThe study population had a mean UACR of 7.2 ± 10.2 mg/mmoL with mean eGFR of 94.5 ± 11.7 mL/min/1.73 m2. Prevalence of moderately increased albuminuria in our study population was found to be 44.0%. Multivariate logistic regression analysis showed that duration of diabetes (OR:1.72, 95% CI:1.34–2.19; p<0.001), presence of hypertension (OR:3.42, 95% CI:0.96–12.20; p=0.050) and neuropathy (OR:2.85, 95% CI:1.03–7.84; p=0.042), BMI (OR:1.08, 95% CI:1.01–1.16; p=0.019), HbA1c (OR:1.39, 95% CI:1.00–1.93; p=0.045), CRP (OR:1.10, 95% CI:1.00–1.22; p=0.035), serum creatinine (OR:1.04, 95% CI:1.02–1.06; p<0.001) and HDL-C (OR:0.10, 95% CI:0.01–0.28; p<0.001) were independently correlated with moderately increased albuminuria. Stepwise multiple linear regression analysis demonstrated that duration of diabetes, HbA1c, CRP and serum creatinine were independent predictors of UACR. ConclusionWe report a high prevalence of moderately increased albuminuria in UAE nationals with type 2 diabetes in a secondary care setting. Routine screening and timely management of moderately increased albuminuria in type 2 diabetes mellitus can lead to better patient outcomes.

LIVER TRANSPLANTATION IN THE UNITED ARAB EMIRATES: INITIAL TWO-YEAR EXPERIENCE

Background: Passage of the landmark brain death law in the United Arab Emirates (UAE) in May 2017 enabled the establishment of solid organ transplantation, including liver transplant (LT). The shortage of deceased donor (DD) organs mandated the development of living donor LT (LDLT) as well. We report our initial experience following the formal establishment of LT in the UAE. Materials and Methods: The first DDLT and LDLT in the UAE were performed on Feb 1 and July 29, 2018 respectively.Since inception, a total of 11 DDLTs and 12 LDLTs have been performed – 8 left-lobe and 4 right-lobe LDLTs. Five (22%) recipients were expatriates (four of whom underwent DDLT), while the remainder were UAE nationals. Primary indication for LT was NAFLD (48%). All four (17%) recipients with HCC had cirrhosis from NAFLD. Two recipients (9%) each underwent LT for PSC, Wilson’s disease, HBV and AIH. Two emergent LTs were performed - one for fulminant Wilson’s disease (left lobe LDLT), and the other for early graft dysfunction following LDLT. Mean graft to recipient weight ratio (GRWR) for LDLTs was 0.92 (range: 0.64 – 1.30). GRWR for left and right lobe grafts were 0.83 and 1.1 respectively. All but one of the left lobe recipients underwent splenectomy. All recipients underwent duct to duct biliary reconstruction. Results: All living donors recovered uneventfully with a median duration of hospitalization of 6.5 days (6 and 8 days respectively for left and right lobe donors). Two recipients underwent unplanned re-operation within 30 days of LT. Four (17%) recipients developed acute cellular rejection. All episodes were mild-moderate and responded to either escalation of immunotherapy or pulse steroids, with the exception of one severe episode due to non-compliance. CMV viremia was noted in 11, with invasive disease (retinitis) occurring only in one recipient. Four DDLT and 6 LDLT recipients developed biliary strictures, all of which were anastomotic in nature and responded promptly to endoscopic therapy, with the exception of four post-LDLT strictures that required more than 3 ERCPs. 14 recipients have completed at least a year of follow up, with one-year actual graft and patient survival of 100% and 100% respectively. The overall patient and graft survival for the 22 patients and 23 grafts were 100% and 96% respectively. The solitary graft loss occurred due to portal vein steal syndrome via coronary vein shunt following left lobe LDLT causing graft dysfunction, necessitating emergent DDLT. Conclusions: We report the successful establishment of LT from living and deceased donors in the UAE and our results after the first two years. Ongoing efforts to overcome shortage of deceased donor organs include creation of a national digital donor registry, regional organ sharing agreements for critically ill patients and establishment of donation after circulatory death. These initiatives will enable us to build on our early success and meet the anticipated increase in demand for LT related to the growing burden of NAFLD in the region.

Performance of the Framingham coronary heart disease risk score for predicting 10-year cardiac risk in adult United Arab Emirates nationals without diabetes: a retrospective cohort study

BackgroundPrimary prevention guidelines recommend the use of the Framingham risk score (FRS) to estimate the 10-year coronary heart disease (CHD) risk in patients without diabetes for statin eligibility. However, the FRS model has never been validated in an Arab population. Therefore, this study aimed to examine the clinical performance of the FRS model for predicting 10-year CHD risk in adult United Arab Emirates (UAE) nationals without diabetes.MethodsThis 10-year retrospective cohort study included patients from the primary care clinics and outpatient specialty departments of a large tertiary care hospital in Al-Ain, UAE. They were aged 30–79 without a baseline history of cardiovascular disease and diabetes. The FRS for each subject was calculated. Follow-up data on hard CHD (hCHD) events (myocardial infarction or coronary death) for each participant were collected from the baseline visit in 2008 until December 31, 2019. The area under the time-dependent receiver operating characteristic (ROC) curve (AUROC) was used to assess the FRS model discrimination. Calibration was measured by using the Hosmer-Lemeshow χ2 test and the calibration curve. The optimal cutoff-point for hCHD risk prediction was determined by ROC curve analysis.ResultsA total of 554 participants were included. The mean age was 48.0 ± 12.8 years and 45% were men. The mean predicted FRS of the study cohort was 5.2% and approximately 7% were classified as high-risk (≥ 20% threshold) by the FRS model. During a median follow-up of 10.2 years (interquartile range, 7.8–11.0 years), 26 hCHD events occurred. The FRS model displayed reasonably good discrimination (time-dependent AUROC value: 0.83) and calibration in predicting hCHD (Hosmer-Lemeshow χ2 statistic 11.2, P = 0.191). Applying the 20% high-risk threshold, the FRS model had a sensitivity of only 37% in identifying patients at high-risk for an hCHD event over 10 years. While a 7.5% optimal cutoff-point improved the sensitivity to 74%.ConclusionsThe FRS can be used in the prediction of coronary risk among UAE nationals without diabetes, however, the recommended hCHD risk threshold for statin eligibility may be too high. Lowering the cutoff-point to 7.5% could improve the identification of patients for preventive treatment.

Trauma system developments reduce mortality in hospitalized trauma patients in Al-Ain City, United Arab Emirates, despite increased severity of injury

BackgroundTrauma is a leading cause of death in the United Arab Emirates (UAE). There have been major developments in the trauma system in Al-Ain City during the last two decades. We aimed to study the effects of these developments on the trauma pattern, severity, and clinical outcome of hospitalized trauma patients in Al-Ain City, United Arab Emirates.MethodsThis is a retrospective analysis of two separate sets of prospectively collected trauma registry data of Al-Ain Hospital. Data were collected over two periods: from March 2003 to March 2006 and from January 2014 to December 2017. Demography, injury mechanism, injury location, and clinical outcomes of 2573 trauma patients in the first period were compared with 3519 patients in the second period.ResultsTrauma incidence decreased by 38.2% in Al-Ain City over the last 10 years. Trauma to females, UAE nationals, and the geriatric population significantly increased over time (p < 0.0001, Fisher’s exact test for each). Falls on the same level significantly increased over time, while road traffic collisions and falls from height significantly decreased over time (p < 0.0001, Fisher’s exact test for each). Mortality significantly decreased over time (2.3% compared with 1%, p < 0.0001, Fisher’s exact test).ConclusionsDevelopments in the trauma system of our city have reduced mortality in hospitalized trauma patients by 56% despite an increased severity of injury. Furthermore, the injury incidence in our city decreased by 38.2% over the last decade. This was mainly in road traffic collisions and work-related injuries. Nevertheless, falls on the same level in the geriatric population continue to be a significant problem that needs to be addressed.

Radiography Advanced Practice in the United Arab Emirates: The Perceptions and Readiness of Mammographers.

IntroductionThis study is a part of an effort to determine the challenges faced by the United Arab Emirates (UAE) radiographers towards role extension and advanced practice. It reflects the current practice and challenges facing role extension compared to international advancement. The study aimed to assess the radiographers who worked at mammography screening perception and readiness to accept role extension and advanced practice in mammography.MethodsA cross-sectional descriptive study using an online survey was conducted among radiographers who practice mammography. The survey captured demographics, qualifications, professional education, future development plans, interest in role extension, and incentive to pursue the mammography profession.ResultsForty-five radiographers were invited to participate in the study the response rate was 71% (n=32), 34.4 (11%) were UAE nationals with the remainder being expats. The majority were young between 25 and 45 years old (84.4%), 81.3% hold a BSc qualification. 56.3% completed a post-qualification training specialized mammography certificate. 81% of the participants showed interest in role extension after appropriate education, training, and supervision by radiologists.ConclusionThis study reports on the perceptions and readiness of radiographers on advanced practice within breast-screening centers. The results show acceptance and support after proper training, clear career pathway, and licensing body recognition. The role of the radiographer in the UAE is still growing.

Arabic Version of the Personality Inventory for the DSM-5 (PID-5) in a Community Sample of United Arab Emirates Nationals.

Background:Section III of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) proposes a model for conceptualizing personality disorders in which they are characterized by impairments in personality functioning and maladaptive personality traits. The Personality Inventory for DSM-5 (PID-5) is a self-report measure that assesses the presence and severity of these maladaptive personality traits.Objective:The current study examined the reliability and validity of the Arabic version of the Personality Inventory for DSM-5 (PID-5) to measure maladaptive personality traits in the Emirati population of the United Arab Emirates.Methods:The Arabic version of the PID-5 was administered to a community sample of 1,090 United Arab Emirates nationals (89.5% female and 10.5% male, mean age = 22.44 years old). The descriptive measures, internal consistency, test-retest reliability, convergent validity with NEO – Five Factor Inventory, as well as PID-5’s factor structure, were all addressed.Results:The PID-5facets and domains mean scores were higher in the Emirati sample compared to the original US sample. Internal consistency of the PID-5 scales was acceptable to high and test-retest coefficients ranged from 0.84 (facets) to 0.87 (domains). As expected, the five domains of the Arabic version of the PID-5 correlated significantly with all Five-Factor Model domains of personality. Additionally, the Arabic version of the PID-5 confirmed a five-factor structure that resembles the PID-5 domains.Conclusion:The findings of this study provided initial support for the use of the Arabic version of the PID-5 to assess maladaptive personality traits in the Emirati population of the United Arab Emirates.

Whole Genome Sequencing of Four Representatives From the Admixed Population of the United Arab Emirates.

Whole genome sequences (WGS) of four nationals of the United Arab Emirates (UAE) at an average coverage of 33X have been completed and described. The selection of suitable subpopulation representatives was informed by a preceding comprehensive population structure analysis. Representatives were chosen based on their central location within the subpopulation on a principal component analysis (PCA) and the degree to which they were admixed. Novel genomic variations among the different subgroups of the UAE population are reported here. Specifically, the WGS analysis identified 4,161,067–4,798,806 variants in the four individual samples, where approximately 80% were single nucleotide polymorphisms (SNPs) and 20% were insertions or deletions (indels). An average of 2.75% was found to be novel variants according to dbSNP (build 151). This is the first report of structural variants (SV) from WGS data from UAE nationals. There were 15,677–20,339 called SVs, of which around 13.5% were novel. The four samples shared 1,399,178 variants, each with distinct variants as follows: 1,085,524 (for the individual denoted as UAE S011), 1,228,559 (UAE S012), 791,072 (UAE S013), and 906,818 (UAE S014). These results show a previously unappreciated population diversity in the region. The synergy of WGS and genotype array data was demonstrated through variant annotation of the former using 2.3 million allele frequencies for the local population derived from the latter technology platform. This novel approach of combining breadth and depth of array and WGS technologies has guided the choice of population genetic representatives and provides complementary, regionalized allele frequency annotation to new genomes comprising millions of loci.

Exploring the Relations of Gender, Science Dispositions and Science Achievement on STEM Career Aspirations for Adolescents in Public Schools in the UAE

The United Arab Emirates (UAE) has undergone immense transformation since the discovery of oil in the late 1950s, and the educational sector has seen vivid reform. The UAE government is increasingly seeking diversification of its economy and, as a result, the country’s goals heavily emphasise education in the development of its Knowledge Economy. There is a strong emphasis on science skills and knowledge among the national population in the UAE National Vision for 2021, to drive technological innovations that will necessitate large numbers of highly qualified nationals working in the STEM sector. Therefore, the study of young peoples’ STEM career aspirations is critical in the UAE. Using data from the PISA (Program for International Student Assessment) 2015 database, this study investigates the relationship between STEM career aspirations among 15-year-old girls and boys (N = 5158) with science achievement, and the links between students’ enjoyment of science, science self-efficacy, interest in science and instrumental motivation to learn science with STEM career aspirations. Students’ science achievement was found to be positively associated with STEM career aspirations and a significantly stronger association was observed for male students. Students’ enjoyment of science, science self-efficacy, interest in science and instrumental motivation to learn science were found to be significantly positively associated with STEM career aspirations for both genders. However, a considerably stronger relationship with STEM career aspirations was observed for female students with higher levels of instrumental motivation to learn science. Possible implications of these findings for the UAE are discussed.

Incidence and risk factors of type 2 diabetes mellitus in an overweight and obese population: a long-term retrospective cohort study from a Gulf state

ObjectivesA high body mass index (BMI) is associated with risk of type 2 diabetes mellitus (DM). The United Arab Emirates (UAE) is experiencing a marked increase in obesity. Nonetheless, no...

Identifying coastal and marine priority areas for conservation in the United Arab Emirates

The waters of the United Arab Emirates (UAE) host a diversity of marine and coastal habitats that are under increasing pressure from multiple anthropogenic activities related to rapid economic growth. In response, Marine Protected Areas (MPAs) currently cover 12% of the UAE’s coastal and marine zones. The UAE National Biodiversity Strategy and Action Plan aims to increase the extent of protection to 14% by 2021, a target that exceeds current global commitments. We applied systematic conservation planning to (1) assess whether conservation features (i.e. species and habitats of conservation concern) are adequately represented in the current system of MPAs, and (2) identify complementary coastal and marine priority areas for conservation and management. Eight planning scenarios were produced based on different conservation targets, the inclusion (or not) of existing MPAs in the generated solutions, and the consideration (or not) of dredging (an activity linked with coastal development in the UAE). A gap analysis demonstrated that to achieve the targets set by experts for all conservation features, additional areas would need to be integrated in conservation plans and policies. Key coastal and marine priority areas were consistently selected for conservation across all planning scenarios. The findings of this work provide a basis for the identification of conservation priorities that can be embedded in the current network of MPAs by extending their boundaries, in post-2020 conservation strategies including plans for creating new MPAs, and in broader spatial planning initiatives.

Changing the model of radiography practice in the UAE: A snapshot of a profession in transition

IntroductionThis study forms part of a needs assessment in relation to the challenges United Arab Emirates (UAE) radiographers face as they move beyond the role of a technician, and their learning needs to facilitate role advancement. It presents a snapshot of the workforce in terms of qualifications, clinical experience, and responsibilities, as it transitions towards an Emirati, led profession. The results will aid the radiography workforce to embrace a broader role within medical imaging and radiographic practice in the UAE. MethodsAn electronically distributed cross-sectional study was conducted among radiographers in the UAE. The questionnaire captured radiographer demographics, qualifications, professional experience, postgraduate training, professional development plans, and their interest in future role developments. Results272 radiographers were invited to participate with a response rate of 68% (n = 185). Thirty-four (18%) radiographers were UAE nationals with the remainder educated overseas. BSc qualifications were held by 153 (82.7%) and had 6–20 years of experience. There were 12 masters’ qualified and two with doctoral qualifications. Modality vendors were significant providers of professional development. Improved job satisfaction and the development of an Emirati led radiography profession were identified as the main gains for role advancement by 171 (92.4%) respondents. ConclusionCurrently, UAE radiographers work within traditional professional boundaries focussing on image acquisition under direct radiologist supervision. At the same time, many respondents revealed they had embraced advanced practice roles after appropriate education and training. Implications for practiceThe findings suggest an Emirati led profession requires the creation of a distinct professional body to represent the interests of radiographers, more investment in postgraduate education, and the creation of a career structure that encompasses positive role development.

An Investigation of the Factors Influencing UAE Nationals to undertake Technical and Vocational Education

Technical and vocational skills are essential for the United Arab Emirates (UAE) to secure growth and wealth as per the UAE Vison 2021, Abu Dhabi Vision 2030 and Emiratization strategies. Gaining insights about the factors that influence Emirati students that study technical and vocational education can support the UAE to attract more Emiratis into that area. What are those major influential factors, and are there any differences related to the gender, age level, and location of living in the UAE? The factor analysis revealed five underlying factors; the career factor, the economic factor, the guidance factor, the media factor, and the social environment factor. The career factor (M = 3.48) is perceived as the most influential one, followed by the social environment factor (M = 3.32). The independent sample t-test presented a statistically significant difference between male (M = 2.8, SD = 1.066, N = 178) and female (M = 2.6, SD = 1.066, N = 250) perceptions in the economic factor (t [426] = 2.042 = 0.042, p &lt; 0.05). The result shows that males place more emphasis on the economic aspect when considering their educational paths. The one-way ANOVA revealed a statistically significant variance in the economic factor for the location of living (F [7,420] = 4.278, p &lt; 0.05). The research discloses that the career aspects and future job perspectives in addition to parents of national students are the most considerable influencer, which is forming the basis for this study. Differences in perceptions could be discovered for economic aspects only. The findings reveal it is essential to consider the career, economic aspect, and parents’ involvement when marketing technical and vocational education to Emirati students. Social media marketing is recommended as an advertising tool for best results.

A review of gestational diabetes mellitus management, risk factors, maternal and neonatal outcomes in two major maternity hospitals in the United Arab Emirates: A report from Dubai.

This study was conducted in order to explore and analyze the status of gestational diabetes (GDM) amongst pregnant women in Dubai, United Arab Emirates (UAE); a country with high prevalence of diabetes. We aimed to describe GDM-associated risk factors and clinical outcomes of pregnant women and their neonates. Our objective was to contribute to the broader literature on reproductive health disparities and to inform efforts to improve GDM care at our region. Chart review of case records were used to collect data on both maternal and neonatal parameters and outcomes during the specified study period from two main maternity hospitals in Dubai. UAE national women with GDM were more prone to be obese or overweight compared to non-UAE women (p < 0.0001, and p < 0.0001 respectively). In addition, UAE national women with GDM had higher history of GDM in previous pregnancies (p < 0.0001) and more family history of diabetes (p < 0.0001).The neonate admission into NICU was significantly associated with cesarean section (p < 0.0001), twins (p < 0.0001), preeclampsia (p = 0.02), receiving MgSO4 (p = 0.02), birth weight less than 2500 g (p < 0.0001), low Apgar scores (p < 0.0001), baby with congenital anomaly (p < 0.0001), and neonatal hypoglycemia (p < 0.0001). Our results demonstrate that pregnant women with GDM who are UAE nationals and have higher parity need to be under special attention during their pregnancy in order to improve both maternal and neonatal outcomes.

Genetic Diversity and Low Stratification of the Population of the United Arab Emirates.

With high consanguinity rates on the Arabian Peninsula, it would not have been unexpected if the population of the United Arab Emirates (UAE) was shown to be relatively homogenous. However, this study of 1000 UAE nationals provided a contrasting perspective, one of a relatively heterogeneous population. Located at the apex of Europe, Asia, and Africa, the observed diversity could be explained by a plethora of migration patterns since the first Out-of-Africa movement. A strategy to explore the extent of genetic variation of the population of the UAE is presented. The first step involved a comprehensive population stratification study that was instructive for subsequent whole genome sequencing (WGS) of suitable representatives (which is described elsewhere). When these UAE data were compared to previous smaller studies from the region, the findings were consistent with a population that is a diverse and admixed group of people. However, rather than sharp and distinctive clusters, cluster analysis reveals low levels of stratification throughout the population. UAE emirates exhibit high within-Emirate-distance/among-Emirate distance ratios. Supervised admixture analysis showed a continuous gradient of ancestral populations, suggesting that admixture on the south eastern tip of the Arabian Peninsula occurred gradually. When visualized using a unique technique that combined admixture ratios and principal component analysis (PCA), unappreciated diversity was revealed while mitigating projection bias of conventional PCA. We observe low population stratification in the UAE in terms of homozygosity versus separation cluster coefficients. This holds for the UAE in a global context as well as for isolated cluster analysis of the Emirati birthplaces. However, the subtle clustering observed in the Emirates reflects geographic proximity and historic migration events. The analytical strategy used here highlights the complementary nature of data from genotype array and WGS for anthropological studies. Specifically, genotype array data were instructive to select representative subjects for WGS. Furthermore, from the 2.3 million allele frequencies obtained from genotype arrays, we identified 46,481 loci with allele frequencies that were significantly different with respect to other world populations. This comparison of allele frequencies facilitates variant prioritization in common diseases. In addition, these loci bear great potential as biomarkers in anthropological and forensic studies.

T31. TIME TO TALK MENTAL HEALTH IN DUBAI: DESCRIBING A SAMPLE OF ADOLESCENT HELP-SEEKERS ACCESSING MENTAL HEALTH SERVICES

BackgroundMost mental health disorders begin to develop in adolescence and early adulthood. These disorders account for a significant portion of hospitalization and other societal costs. The United Arab Emirates (UAE) has a rapidly growing population, one-third of which is below 25 years of age. The UAE government has pointed at mental health as one of the areas requiring attention and has approved a strategic plan supporting mental health research, education and promotion with a specific focus on youth (Dubai Mental Health Strategy 2021). The current study represents the first investigation aimed at characterizing youth who access mental health services in the UAE (specifically Dubai).MethodsData was collected retrospectively from child psychiatry case records of inpatients who accessed the Mental Health Clinic at Rashid Hospital between 2011–2016. Patients who received a diagnosis of schizophrenia spectrum disorders, bipolar and related disorders, depressive disorders or anxiety disorders were included. From patients’ records, information collected included demographics, life stressors (related to family, friends, health, academic performance, or religion), duration of untreated illness (DUI), family history of mental illness, parents’ age and education, main diagnosis, presence/absence of psychotic features. Demographic information and family history had been acquired from patients and family members at the time of intake.ResultsThe final sample (N=99; Age 12–19) included 47.5% local (UAE national) and 52.5% non-local patients. The frequency of life stressors did not differ across ethnic groups except for relationships with friends, which were less likely to be reported as a source of stress among UAE nationals (χ2=4.35; p=0.04) compared to other nationalities. Suicidal thoughts were less common in patients with psychotic features compared to patients without psychotic features (χ2=4.64; p=0.03). A diagnosis of Depression was more common in females than males (χ2=3.93; p<.05) and was associated with more frequent suicidal thoughts (χ2=23.81; p<0.001) and self-harm behavior (χ2=16.20; p<0.001). Separate ANOVAs were conducted to explore the effect of different variables on DUI: results showed that presence of Psychotic features was associated with shorter DUI (F (1,55) =4.37; p<0.05) while Self-harm was associated with longer DUI (F (1,70) =5.82; p<0.05).DiscussionTo our knowledge, this is the first study attempting to describe youth who access mental health services in the urban multi-cultural context of Dubai. A number of interesting findings were highlighted. Relationships with friends were more likely to represent a source of stress for non-local than local patients, suggesting a possible role of adjustment and social stress in migrant/expatriate youth. Suicidal thoughts were more common in patients diagnosed with depressive disorders (somewhat expected) but less common in patients presenting psychotic features. Patients experiencing psychotic symptoms were accessing mental health services sooner (shorter DUI) compared to patients who did not experience psychotic symptoms, in line with previous literature. Interestingly, patients reporting self-harm behaviors had longer DUI. Several interpretations can be proposed, for example, it is possible that self-harm represented a copying strategy to temporarily “handle” mental illness and delay help seeking in our sample. Studies in support of this and alternative explanations will be discussed. Taken together, our study can be a useful start point to open prevention-focused mental health discussions in the UAE and lead to improved national policies to promote youth wellbeing in the region.

Low Vitamin D Serum Level Is Associated with HDL-C Dyslipidemia and Increased Serum Thrombomodulin Levels of Insulin-Resistant Individuals.

BackgroundInsulin-resistant individuals are known to have dyslipidemia and are predicted to be at high risk of cardiovascular events. Vitamin D deficiency was shown to be associated with dyslipidemia; however, the type of dyslipidemia associated with vitamin D deficiency in insulin-resistant individuals is not determined. Furthermore, there is evidence linking insulin resistance with low-grade inflammation suggesting levels of pro-inflammatory cytokines to be increased in insulin-resistant states.ObjectiveThis study was performed to evaluate the impact of vitamin D deficiency, defined as serum level of 25(OH)D below 20 ng/mL, on lipid profile and inflammatory markers such as interleukin (IL-6) and IL-8, as well as soluble thrombomodulin (TM) in the serum of insulin-resistant individuals.MethodsA total of 4114 individuals had simultaneous serum 25(OH)D, insulin, and lipid panel testing during 2013 as part of the United Arab Emirates National Diabetes and Lifestyle (UAEDIAB) study. Multivariate logistic regression analysis was used to assess the association between serum level of 25(OH)D and lipid profile in insulin-sensitive versus -resistant individuals. The lipid panel was stratified into high total cholesterol (TC: >6.2 mmol/L), high low-density lipoprotein-cholesterol (LDL-C: >2.59 mmol/L), high triglycerides (TG: >2.3 mmol/L), and low high-density lipoprotein-cholesterol (HDL-C: <1.55 mmol/L) dyslipidemia. Furthermore, the immunomodulatory and vasculoprotective effects of 25(OH)D were assessed by measuring the levels of IL-6, IL-8, and soluble TM in serum using ELISA.ResultsMore than half of the 4114 individuals were insulin resistant (n=2760, 67%) and around one-fifth of them were vitamin D-deficient (n=796, 19%). After adjusting for age, gender, body mass index, smoking, ethnicity, and educational level, the only dyslipidemia associated with vitamin D-deficient-insulin-resistant individuals (OR 2.09 [95]; P=0.009) was lower HDL-C. Furthermore, deficient 25(OH)D individuals with low HDL-C levels had higher circulatory IL-6 and IL-8 levels, and higher serum soluble TM compared to individuals with sufficient 25(OH)D and normal lipid profiles (median, IL-6 pg/mL 0.82 vs 1.71, P=0.001; median, IL-8 pg/mL 51.31 vs 145.6, P=0.003; and median, soluble TM ng/mL 5.19 vs 7.38, P<0.0001; in sufficient vs deficient groups, respectively).ConclusionThe results of our study showed that in insulin-resistant individuals, vitamin D deficiency status is associated with HDL-C dyslipidemia and higher serum inflammatory and endothelial damage markers.

An Integrative Phenotype-Genotype Approach Using Phenotypic Characteristics from the UAE National Diabetes Study Identifies HSD17B12 as a Candidate Gene for Obesity and Type 2 Diabetes.

The United Arab Emirates National Diabetes and Lifestyle Study (UAEDIAB) has identified obesity, hypertension, obstructive sleep apnea, and dyslipidemia as common phenotypic characteristics correlated with diabetes mellitus status. As these phenotypes are usually linked with genetic variants, we hypothesized that these phenotypes share single nucleotide polymorphism (SNP)-clusters that can be used to identify causal genes for diabetes. We explored the National Human Genome Research Institute-European Bioinformatics Institute Catalog of Published Genome-Wide Association Studies (NHGRI-EBI GWAS) to list SNPs with documented association with the UAEDIAB-phenotypes as well as diabetes. The shared chromosomal regions affected by SNPs were identified, intersected, and searched for Enriched Ontology Clustering. The potential SNP-clusters were validated using targeted DNA next-generation sequencing (NGS) in two Emirati diabetic patients. RNA sequencing from human pancreatic islets was used to study the expression of identified genes in diabetic and non-diabetic donors. Eight chromosomal regions containing 46 SNPs were identified in at least four out of the five UAEDIAB-phenotypes. A list of 34 genes was shown to be affected by those SNPs. Targeted NGS from two Emirati patients confirmed that the identified genes have similar SNP-clusters. ASAH1, LRP4, FES, and HSD17B12 genes showed the highest SNPs rate among the identified genes. RNA-seq analysis revealed high expression levels of HSD17B12 in human islets and to be upregulated in type 2 diabetes (T2D) donors. Our integrative phenotype-genotype approach is a novel, simple, and powerful tool to identify clinically relevant potential biomarkers in diabetes. HSD17B12 is a novel candidate gene for pancreatic β-cell function.