?Division of Chemical Pathology

Research

 

The division is actively involved in research. Several different research groups, consisting of scientists, consultants, registrars and students with collaborating institutions, have been established within the department.

  • Bellville South Africa Study
  • Gene Environment Research Unit 
  • HIV and electrophoresis patterns and free light chains 
  • HIV Immune Activation and Inflammation Group (HAIG)
  • Point of Care Testing 
  • Reference Range Study
  • Acanthosis Nigricans 
  • Insulin resistance and obesity 
  • Operational research

 

Bellville South Africa Study

Prof RT Erasmus, Dr A Zemlin

South Africans have one of the highest prevalence rates of diabetes and obesity in continental Africa. From both a public and clinical perspective there is an increasing need to detect people at risk for future development of obesity related diseases such as diabetes as it is a strong risk factor for cardiovascular disease. The Belliville South Africa Study Group was established in 2006/2007 by Professor Erasmus following the completion of a study that examined the prevalence of obesity, diabetes and hypertension amongst learners residing in the Western Cape.Initially it was a collaborative project between Chemical Pathology, Stellenbosch 肆客足球 (Prof Erasmus) and Biomedical Sciences, Cape Peninsula 肆客足球 of Technology (Prof Matsha & Mr Hassan) but has since expanded to include the 肆客足球 of Western Cape (Sports Sciences) (Dr Basset), Department of Physiology (Stellenbosch 肆客足球, main campus) (Prof Essop), North Western 肆客足球, Potchefstroom (Prof Kruger) and the Medical Research Council (Dr Kengne).To assess the magnitude of obesity, insulin resistance and diabetes (metabolic syndrome) in children and adults in the Western Cape, South Africa.

  • Investigate mutations and/or polymorphisms in various obesity, and insulin resistance related genes.
  • Assess the role of identified mutations and/or polymorphisms in obesity and their relationship with environmental factors
  • To examine whether smoking independently or in association with other risk factors increase oxidative stress in IGT, consequently leading to CVD.
  • To explore and assess  various environmental and genetic factors that predispose to cardiovascular disease states
  • To develop tests and  tools that can identify subjects with impaired glucose tolerance and diabetes at an earlier stage which are also more sensitive and specific than the current ones
  • Determine the factors that are associated with chronic kidney disease and hyperlipidaemia  in this population group
  • Explore the relationship between diabetes and dementia
  1. Somers A, Hassan S, Rusford E, Erasmus RT (2006).  Screening for diabetes in learners residing in the Western Cape.  SA FamPract, 88 (5) : 16-20.
  2. Somers A, Rusford E, Shafiek H, Erasmus R (2006).  Obesity and Overweight in      children residing in the Western Cape.  Medical Technology, 20 (1): 11-20.
  3. Somers A, Hassan S, Rusford E, Erasmus RT (2007).  Childhood Obesity:  Blood  pressure levels in learners from the urban communities of Cape Town,  South   Africa.  Medical Technology, 21 (2) : 14-18.
  4. Matsha T, Hassan S, Bhata A, Yako Y, Fanampe B, Somers A, Hoffmann M, Mohammed Z,
  5. Erasmus RT. Metabolic Syndrome in 10 -16 year old learners from the Western Cape, South Africa: Comparison of the NCEP ATP III and IDF criteria. Atherosclerosis, 2009; 205: 363-366.
  6. Matsha T, Fanampe B, Yako Y, Hassan S, Hoffman M, van der Merwe L, Erasmus RT. Association of the ENPP1 rs997509 polymorphism with obesity in the South African population. East African Medical Journal, 2010; 87(8): 323 - 329.
  7. Yako Y, Hassan MS, Erasmus RT, Hoffman M, Fanampe B, Matsha T. Sequence variants in the melanocortin receptor (MC4R and MC3R) genes in obese and overweight youth from Western Cape South Africa.  S Afric Med J 2011; 101: 417 – 420.
  8. Yako YY, Fanampe BL, Hassan MS, Erasmus RT, van der Merwe L, van Rensburg SJ, Matsha TE. Leptin-melanocortin genes and obesity traits in South African learners. J NutrigenetNutrigenomics 2011;4:210-221 (DOI: 10.1159/000329614)
  9. Zemlin AE, Matsha TE, Hassan MS, Erasmus RT (2011) HbA1c of 6.5% to Diagnose Diabetes Mellitus—Does It Work for Us?—The Bellville South Africa Study. PLoS ONE, 2011; 6(8): e22558. doi:10.1371/journal.pone.0022558.
  10. Matsha T, Hassan MS, Kidd M, Erasmus RT.  The 30-year Cardiovascular Risk Profile of South Africans with Diagnosed Diabetes, Undiagnosed Diabetes, Pre-Diabetes or Normoglycaemia.The Bellville-South Africa Study.Cardiovasc J Afr 2012; 23: 5–11 DOI: 10.5830/CVJA-2010-087
  11. Yandiswa Yolanda Yako, MogamatShafick Hassan, Rajiv Timothy Erasmus, Lize van der Merwe, Susan Janse van Rensburg,Tandi Edith Matsha. Associations of MC3R polymorphisms with Physical activity in South African Adolescents. J Physic Activity Health 2012 (in press).
  12. Macharia M, Hassan MS, Blackhurst DM, Erasmus RT, Matsha TE. The growing importance of PON 1 in cardiovascular health. J Cardiovsc Med 2012 (in press).
  13. Matsha T, Tjaronda T,  Hon G, Esterhuyse J,  Hassan M,  Erasmus R. Antibodies against oxidized LDL and cardiovascular risk factors in individuals with hyperglycaemia. S Afric J Diab and Cardiovasc Dis 2012 (in press).
  14. Rensburg M, Matsha T,  Hoffmann M, Hassan M,  ErasmusRT.  Distribution of hsCRP and its association with Cardiovascular risk factor variables of the Metabolic Syndrome in Adolescent learners from the Western Cape. Afric J Lab Med 2012 (in press).
  15. Erasmus RT, Soita D, Blanco, E, Kengne A, Matsha T.High Prevalence of Diabetes Mellitus and Metabolic Syndrome in a South African Mixed Ancestry Population: The Bellville-South Africa Study - Baseline Data SAMJ , 2012 (In press)
  16. Springhorn C, Matsha T,  Erasmus R,Essop F. Exploring Leukocyte O-GlcNAcylation as a Novel Diagnostic Tool for the Earlier Detection of Type 2 Diabetes Mellitus. J ClinEndocrin&Metab, 2012 (In press)
  17. MatshaT,Soita D, Yako Y, Hon D, Hassan SKengne A, Erasmus R. Three-year's changes in glucose tolerance status in the Bellville South cohort: Rates and phenotypes associated with progression. Journal of   Diabetes Research and Clinical Practice, 2012 (In press)


Gene Environment Research Unit

Prof SJ van  Rensburg

ALZEIMER’S DISEASE – METALS, METAL CARRIER PROTEINS, FREE RADICAL THEORY OF AGING, MEMBRANE FLUIDITY

  1. Van Rensburg SJ, Carstens ME, Potocnik FCV, Aucamp AK, Taljaard JJF and Koch KR. 1992. Membrane fluidity of platelets and erythrocytes in patients with Alzheimer's disease and the effect of small amounts of aluminium on platelet and erythrocyte membranes. Neurochemical Research 17:825-829.
  2. Van Rensburg SJ, Carstens ME, Potocnik FCV, Aucamp AK and Taljaard JJF. 1993. Increased frequency of the transferrin C2 subtype in Alzheimer's disease. NeuroReport 4:1269-1271.
  3. Van Rensburg SJ. 1994. Combating Alzheimer's disease. Specialist Medicine 14:66-70.
  4. Van Rensburg SJ, Daniels WMU, Van Zyl J, Potocnik FCV, Van der Walt BJ and Taljaard JJF. 1994. Lipid peroxidation and platelet membrane fluidity - implications for Alzheimer's disease? NeuroReport 5:2221-2224.
  5. Van Rensburg SJ, Carstens ME, Potocnik FCV, Van der Spuy GD, Van der Walt BJ and Taljaard JJF. 1995. Transferrin C2 and Alzheimer's disease: Another piece of the puzzle found? Medical Hypotheses 44:229-306.
  6. Van Rensburg SJ, Carstens ME, Potocnik FCV, Van der Spuy GD, Van der Walt BJ and Taljaard JJF. 1995. Transferrin C2 and Alzheimer's disease: Another piece of the puzzle found? Invited to publish an extended abstract in: PARKINSON/ALZHEIMER DIGEST.
  7. Van Rensburg SJ, Potocnik FCV, Carstens ME and Taljaard JJF. 1995. Zinc and platelet membrane microviscosity in Alzheimer's disease. The in vitro effect of zinc and aluminium on platelet membranes. Alzheimer's Research 1:41-44.
  8. Daniels WMU, Van Rensburg SJ, Van Zyl J, Van der Walt BJ  and Taljaard JJF. 1996. Melatonin and serotonin as free radical scavengers - possible mechanism. NeuroReport 7:1593-1596.
  9. Van Rensburg SJ, Daniels WMU, Potocnik FCV, Van Zyl JM, Taljaard JJF and Emsley RA. 1997. A new model for the pathophysiology of Alzheimer's disease: Aluminium toxicity is exacerbated by hydrogen peroxide and attenuated by an amyloid protein fragment and melatonin. S Afr Med J 87:1111-1115.
  10. Potocnik FCV, Van Rensburg SJ, Taljaard JJF and Emsley RA. 1997. Zinc and platelet membrane microviscosity in Alzheimer's disease. The in vivo effect of zinc on platelet membranes and cognition. S Afr Med J  87:1116-1119.
  11. Daniels WMU, Van Rensburg SJ, Van Zyl JM and Taljaard JJF. 1998. Melatonin reduces ?-amyloid-induced lipid peroxidation. Journal of Pineal Research 24:74-82.
  12. Van Rensburg SJ and Potocnik FCV. 1998.  The Free Radical Theory of Ageing. Southern African Journal of Gerontology 7:35-36.
  13. Van Rensburg SJ, Potocnik FCV, de Villiers JNP, Kotze MJ and Taljaard JJF. 2000. Earlier age of onset of Alzheimer’s disease in patients with both the Transferrin C2 and Apolipoprotein E-?4 alleles. Ann NY AcadSci 903:200-203.
  14. Van Rensburg SJ, Carstens ME, Potocnik FCV and Taljaard JJF. 2000. The effect of iron and aluminium on transferrin and other serum proteins as revealed by isoelectric focusing gel electrophoresis. Ann NY AcadSci 903:150-155.
  15. Van Rensburg SJ, Berman PA, Potocnik FCV and Taljaard JJF. 2000. Glycosylation of transferrin in Alzheimer's disease and alcohol-induced dementia. Metabolic Brain Disease 15:243-247.
  16. Van Rensburg SJ, Daniels WMU, van Zyl JM and Taljaard JJF. 2000. A comparative study of the effects of cholesterol, beta-sitosterol, beta-sitosterol glycoside, dehydroepiandrosterone sulphate and melatonin on in vitro lipid peroxidation. Metabolic Brain Disease 15:257-265
  17. Van Rensburg SJ, Potocnik FCV, de Villiers JNP, Kotze MJ and Taljaard JJF. 2002. Earlier age of onset of Alzheimer’s disease in patients with both the Transferrin C2 and Apolipoprotein E-?4 alleles. Dementia Review Journal 2/2002: 16 – 17.
  18. Zatta P, Lucchini R, Van Rensburg SJ, Taylor A. 2003. The role of metals in neurodegenerative processes: aluminium, manganese and zinc. Brain Research Bulletin 62:15-28.
  19. Van Rensburg SJ, Berman P, Potocnik FCV, MacGregor P, Hon D and de Villiers JNP. 2004. 5- and 6-Glycosylation of Transferrin in Patients with Alzheimer’s Disease. Metabolic Brain Disease 19:89-96.
  20. Daniels WMU, Hendricks J, Salie R, van RensburgSJ. 2004. A mechanism for Zinc Toxicity in Neuroblastoma cells. Metabolic Brain Disease 19: 79 – 88.
  21. Potocnik FCV, van Rensburg SJ, Bouwens C. Management of Alzheimer’s disease. The Specialist Forum, May 2004: 34 – 44.
  22. Zatta P, Messori L, Mauri P, van Rensburg SJ, van Zyl J, Gabrielli S, Gabbiani C. 2005. The C2 variant of human serum transferrin retains the iron binding properties of the native protein. BiochimBiophysActa. 2005 1741:264-270.
  23. Sensi S and Van Rensburg S. 2005. Editorial: It’s all in the metals. J Alzheimers Dis. 8:207-208.
  24. Potocnik FCV, Bouwens C, van Rensburg SJ. 2005. Neurobiological Ageing Factors: Neurobiology of Ageing and Prevention of Dementia. Continuing Medical Education 23:307-309.
  25. Van Rensburg SJ, van Zyl JM, Potocnik FCV, Daniels W, Uys J, Marais L, Hon D, Van der Walt BJ and Erasmus RT. 2006. The effect of stress on the antioxidative potential of serum: implications for Alzheimer’s disease. Metabolic Brain Disease 21:171-179.
  26. Potocnik FCV, van Rensburg SJ, Hon D, Emsley RA, Moodie IM, and Erasmus RT. 2006. Oral zinc augmentation with vitamins A and D increases plasma zinc concentration: implications for burden of disease. Metabolic Brain Disease 21:139-147.
  27. Momeni P, Rogaeva E, Van Deerlin V, Yuan W, Grafman J, Tierney M, Huey E, Bell J, Morris CM, Kalaria RN, van Rensburg SJ, Niehaus D, Potocnik F, Kawarai, Salehi-Rad S, Sato C, St George-Hyslop P, Hardy J. 2006. Genetic variability in CHMP2B and frontotemporal dementia. Neurodegener Dis. 3:129-133
  28. Kalaria RN, Maestre GE, Arizaga R, Friedland RP, Galasko D, Hall K, Luchsinger JA, Ogunniyi A, Perry EK, Potocnik F, Prince M, Stewart R, Wimo A, Zhang ZX, Antuono P; World Federation of Neurology Dementia Research Group. Collaborators: Akinyemi R, Arasho BD, Bellaj T, Bertelote J, Daya S, van der Flier WM, Dotchin C, Fasanaro A, Feigin V, Francis P, Gatere S, Houlden H, Hogervorst E, Homma A, Ince P, Jones J, Jusabani AM, Kabir Z, Kamadore T, Kashama JM, Kayembe T, Kivipelto M, Kotwal GJ, Krishnamoorthy ES, Lahiri D, Lehmann D, Makrelouf M, Mukaetova-Ladinska E, Nagata K, Nakasujja NK, Ndetei D, Oakley A, Padjen A, Perry R, Pickering-Brown S, Pokorski M, Purohit D, Skoog I, Tripathi M, Van Rensburg S, Varghese M, Williams J. 2008. Alzheimer's disease and vascular dementia in developing countries: prevalence, management, and risk factors. Lancet Neurol. 7:812-826
  29. Kotze MJ, Van Rensburg SJ. 2012. Pathology supported genetic testing and treatment of cardiovascular disease in middle age for prevention of Alzheimer's disease. Metab Brain Dis. 2012 Sep;27(3):255-66.


CHRONIC FATIGUE SYNDROME:

  1. Van Rensburg SJ, Potocnik FCV, Kiss T, Hugo F, van Zijl P, Mansvelt E, Carstens ME, Theodorou P, Hurly PR, Emsley RA and Taljaard JJF. 2001. Serum concentrations of some metals and steroids in patients with Chronic Fatigue Syndrome with reference to neurological and cognitive abnormalities. Brain Research Bulletin 55:319-325.


SCHIZOPHRENIA:

  1. Emsley R, Myburgh C, Oosthuizen P, van Rensburg SJ. 2002. Randomized, placebo-controlled study of ethyl-eicosapentaenoic acid as supplemental treatment in schizophrenia. Am J Psychiatry 159:1596-1598.
  2. Emsley R, Myburgh C, Oosthuizen P, van Rensburg SJ. 2003. Clinical Potential of Omega-3-Fatty Acids in the treatment of schizophrenia. CNS Drugs. 17:1081-1091.
  3. Emsley R, Niehaus DJ, Koen L, Oosthuizen PP, Turner HJ, Carey P, van Rensburg SJ, Maritz JS, Murck H. 2006. The effects of eicosapentaenoic acid in tardive dyskinesia: A randomized, placebo-controlled trial. Schizophr Res. 84:112-120.
  4. Van Rensburg SJ, Hon GM, Smuts CM, Kidd M, Van der Merwe S, Myburgh C, Oosthuizen P, Emsley RA. Changes in erythrocyte membrane fatty acids during a clinical trial of eicosapentaenoic acid (EPA) supplementation in schizophrenia. 2009. Metab Brain Dis 24:659-672


OESOPHAGEAL CANCER:

  1. Matsha T, Stepien A, Blanco-Blanco E, Brink LT, Lombard CJ, Van Rensburg S, Erasmus RT. 2006. Self-induced vomiting – risk factor for oesophageal cancer? SAMJ 96:209-212.
  2. Matsha T, Brink L, Van Rensburg S, Hon D, Lombard C, Erasmus R. 2006. Traditional home-brewed beer consumption and iron status in patients with esophageal cancer and healthy control subjects from Transkei, South Africa. Nutrition and Cancer 56: 67-73.
  3. Matsha T , Brink L, Van Rensburg SJ, Erasmus RT. 2006. Soluble transferrin receptors and soluble transferrin receptor – ferritin index in a healthy African population of South Africa. Medical Technology SA 20:5-6.


MULTIPLE SCLEROSIS:

  1. Van Rensburg SJ, Kotze MJ,Hon D, Haug P, Kuyler J, Hendricks M, Botha J, Potocnik FCV, Matsha T and Erasmus R. 2006. Iron and the Folate-Vitamin B12-Methylation Pathway in Multiple Sclerosis. Metabolic Brain Disease 21:121-137.
  2. Kotze MJ, Van Velden DP, Van Rensburg SJ, Erasmus R. 2009. Pathogenic mechanisms underlying iron deficiency and iron overload: New insights for clinical application. eJIFCC-02-01 Online Journal.
  3. Hon GM, Hassan MS, Janse van Rensburg S, Abel S, Erasmus RT and Matsha T. 2009. Membrane saturated fatty acids and disease progression in Multiple Sclerosis patients. MetabBrain Dis 24:561-568.
  4. Hon GM, Hassan MS, Janse van Rensburg S, Abel S, Van Jaarsveld P, Erasmus RT and Matsha T. 2009. Red blood cell membrane fluidity in the aetiology of multiple sclerosis. 
    J MembrBiol 232:25-34
  5. Van Toorn R, Schoeman J, Solomons R, Rensburg M, Van Rensburg SJ. 2010. Iron status in children with recurrent episodes of tumefactive cerebral demyelination. J Child Neurol25(11):1401-1407.
  6. Van Rensburg SJ, Van Toorn R. 2010. The controversy of CCSVI and iron in multiple sclerosis: is ferritin the key? Neurology 75(18):1581-1582
  7. MJ Kotze, DP van Velden, SJ van Rensburg, R Erasmus. 2011. Pathogenic Mechanisms Underlying Iron Deficiency and Iron Overload: New Insights for Clinical Application. The Journal of the International Federation of Clinical Chemistry and Laboratory Medicine. Published online.
  8. Hon GM, Hassan MS, van Rensburg SJ, Abel S, Erasmus RT, Matsha T. 2011. Monounsaturated fatty acids in blood cell membranes from patients with multiple sclerosis. Inflammation. 34(6):681-7.
  9. Hon GM, Hassan MS, Van Rensburg SJ, Abel S, Erasmus RT &Matsha T (2011) Peripheral blood mononuclear cell membrane fluidity and disease outcome in patients with Multiple Sclerosis. 2012.  Indian Journal of Hematology and Blood Transfusion 28(1):1-6.
  10. Hon GM, Hassan MS, Van Rensburg SJ, Abel  S, Erasmus RT &Matsha  T (2011) Plasma non-esterified fatty acids in patients with Multiple Sclerosis. Neurology Asia 16(3):217–222
  11. Hon GM, Hassan MS, van Rensburg SJ, Erasmus RT, Matsha TE. 2012. Assessment of Epstein-Barr virus in blood from patients with multiple sclerosis. Metab Brain Dis. 27(3):311-8
  12. Van Rensburg SJ, Kotze MJ, Van Toorn R. 2012. The Conundrum of Iron in Multiple Sclerosis – Time for an Individualised Approach.Metab Brain Dis. 2012 Sep;27(3):239-53.


HIV and electrophoresis patterns and free light chains

Dr A Zemlin

AIM: HIV is known to be associated with B-cell dysfunction. This project studies the levels of free light chains in HIV subjects both on and off treatment. We hypothesize that as immunoglobulins are synthesized by B-cells, which are abnormal in HIV, these subjects will have abnormal free light chain levels. Levels of free light chains may be used to decide which subjects need earlier access to ART. We also examine the serum protein electrophoresis patterns in these groups.

  • Jansen van Vuuren M, Zemlin AE, Germishuys JJ. Monoclonal gammopathy and other serum protein electrophoresis patterns in patients with HIV infection in South Africa. Ann Clin Biochem 2010;47:366-374


HIV Immune Activation and Inflammation Group (HAIG)

Dr A Zemlin, Dr C Hudson

AIM: This project aims to delineate affordable and easily measurable markers of the activation and inflammation in asymptomatic HIV-infection, in order to identify patients who may be at increased risk of progressive disease or adverse events such as cardiac disease or cancer. This would lead to the design of a panel of tests for application in resource-limited settings that have direct impact on the management of patients in the chronic stage of HIV-infection. The implementation of this approach would facilitate earlier access to treatment and thereby ultimately, assist in delaying the onset of AIDS. A secondary objective is the identification of points of potential therapeutic interventions in the inflammatory signalling cascade and antioxidant metabolic pathways.
This project is a collaboration between the departments of Chemical Pathology, Haematology and Virology. From the Chemical Pathology side, Dr AE Zemlin (Consultant), Dr C Hudson (Senior Registrar) and an honours student is involved.

 

Point of Care Testing

Dr M Rensburg

POCT involves the collecting and testing of specimens near the patient and has several advantages such as:

  • Decreased turn-around time
  • Increased clinical effectiveness
  • Improved patient outcome, etc.

These advantages are only relevant though if the result that is delivered is accurate and reliable. Accuracy and reliability of POCT results can only be guaranteed if there are clearly defined and well-structured guidelines in place to ensure that the test is performed in a safe and effective manner that conforms to acceptable analytical and clinical standards.

In our division we evaluate the accuracy and precision of POCT instruments. These include instruments like glucose meters, blood gas analyzers and HBA1C analyzers, as well as urine dipsticks and pregnancy test kits.

 

Reference Range Project

Prof RT Erasmus, Dr M Hoffmann

The establishment of reference (“normal”) values that are representative of our local populations are not only part of good laboratory practice, but are also a recommendation made by most pathology bodies and manufacturers concerned with the different chemistry analyzers.

In many African countries such values are non existent and when they are available these values have frequently being derived using either small samples or using populations that have not been carefully selected. Frequently many laboratories and heath care institutions in Africa are using values that have been derived from non local populations (frequently from subjects from USA and UK) whose characteristics are very different from the local populations where these values are often used. In some studies the exclusion criteria have not been strictly enforced according to IFCC (International Federation of Clinical Chemistry) and CLSI (Clinical and Laboratory Standard Institutes) guidelines.

The lack of reference values that have been derived using well defined local populations often impacts on patient management given the fact that 70% of diagnoses made are dependant on laboratory tests. Thus the lack of such evidenced based values can lead to misdiagnosis and mismanagement and often, may also be associated with unnecessary investigation and wastage of scarce resources. It is evident that the clinical laboratory plays a vital role in the clinical decision making process of patients.

The aim of this study is to establish

  1. Common reference values for certain analytes from three countries in Africa (South Africa, Nigeria and Kenya) on serum samples collected from a carefully selected reference population that is representative of the local population (African, white, mixed ancestry) with the whole process being standardized according to international guidelines.
  2. Examine the effect of age, sex and region on common biochemical analytes
  3. Examine if regional differences occur between such values

This project is a collaboration between the Department of Chemical Pathology (NHLS and the 肆客足球 of Stellenbosch), PathCare Private Laboratories and the Cape Peninsula 肆客足球 of Technology. The project will also include extend to other African countries such as Nigeria and Kenya. In addition, the project forms part of an international study led by Prof K Ichihara from the Yamaguchi 肆客足球 in Japan.

A total number of 2000 healthy South Africans will be recruited for this study. Sampling started October 2012. Prof RT Erasmus and Dr M Hoffmann closely involved in the project.


Acanthosis Nigricans

Dr M Hoffmann

Acanthosis nigricans (AN) is a dermatological condition thought to be associated with insulin resistance, obesity and T2DM. Our clinical impression is that AN is relatively common in our patients of mixed ancestry (both diabetic and non-diabetic patients). The proposed study aims to determine the prevalence of AN and its clinical relevance in this population group.

This project is a collaboration between the Division of Chemical Pathology, Endocrinology and Dermatology.

  1. Hoffmann M, Kruger W, Visser W. Hough FS. The prevalence and clinical significance of acanthosis nigricans in women of mixed ancestry. JEMDSA Vol 16, Nr 1, 2011. p31 (Published Abstract)

 

Insulin resistance and Obesity

Obesity has sharply increased in recent years in both developed and developing countries. Obesity is usually associated with many health risks, and these include type 2 diabetes, hypertension, and heart diseases. On the other hand, insulin resistance which defined as a state that requires more insulin to obtain the biological effects achieved by a lower amount of insulin in the normal state is considered as a key feature of these diseases.

Current ongoing projects:

1. Adiponectin gene expression during adipogenesis and lipolysis
2. Mechanism of weight loss in patients with TB
3. Fat migration in patients with HIV
4. Hormonal regulation of Vaspin

 

The division is also actively involved in operational research in the form of audits and method evaluation, e.g.


Laboratory Audits

  1. Nutt L, Zemlin AE, Erasmus RT. Incomplete laboratory request forms: the extent and impact on critical results at a tertiary hospital in South Africa. Ann Clin Biochem 2008;45:463-466
  2. Hoffman M, Zemlin AE, Meyer WP, Erasmus RT. Hypophosphataemia at a large academic hospital in South Africa. J Clin Pathol 2008;61:11-4-1107
  3. Rensburg MA, Nutt L, Zemlin AE, Erasmus RT. An audit on the reporting of critical results in a tertiary institute. Ann Clin Biochem 2009;46:162-164
  4. Erasmus RT, Zemlin AE. Clinical audit in the laboratory. J Clin Pathol 2009;62:593-597 (Editors choice)
  5. Zemlin AE, Burgess LJ, Engelbrecht A. Two cases of severe hypoalbuminaemia (< 10 g/l). Nutrition 2009;25:1006-1010 (Editorial by MA Crook in same edition: Hypoalbuminemia: the importance of correct interpretation. Nutrition 2009;25:1004-1005)
  6. Zemlin AE, Nutt L, Burgess LJ, Eiman F, Erasmus RT. Potential for medical error: incorrectly completed request forms for thyroid function tests limit pathologist’s advice to clinicians. S Afr Med J 2009;99:668-671
  7. Vanker N, van Wyk J, Zemlin AE, Erasmus RT. A six sigma approach to the rate and clinical effect of registration errors in a laboratory. J Clin Pathol 2010;63:434-437
  8. Jacobsz LA, Zemlin AE, Roos MJ, Erasmus RT. Chemistry and haematology sample rejection and clinical impact in a tertiary laboratory in Cape Town. Clin Chem Lab Med 2011;49(12)


Method validations

  1. Zemlin AE, Essack Y, Rensburg M, Jephtha E, Abrahams N, Brinkmann T. Red blood cell folate stability study: stability of whole blood prior to haemolysate preparation and stability of the haemolysate at various temperatures. Med Tech SA 2009;23:14-16
  2. Zemlin AE, Essack Y, Rensburg M, Keller T, Brinkmann T. Stability of red blood cell folate in whole blood and haemolysate. Clin Lab 2010;56:391-396


ADA and tuberculous fluids

  1. Zemlin A, Burgess LJ, Carstens ME. The diagnostic utility of adenosine deaminase isoenzymes in tuberculous effusions. Int J Tuberc Lung Dis 2009: 13(2): 214-220