Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
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Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Original article / research
Year : 2007 | Month : October | Volume : 1 | Issue : 5 | Page : 347 - 351

Relationship of IQ with Glucose and Lipid Level

MITRA A, THAKUR G

School of Medical Science and Technology. Indian Institute of Technology, Kharagpur- 721302, India

Correspondence Address :
Dr. Analava Mitra, School of Medical Science and Technology. Indian Institute of Technology, Kharagpur- 721302, India. Tele: 913222282656/57 -Fax: 913222282221Email: amitra@adm.iitkgp.ernet.in; analavamitra@rediffmail.com

Abstract

IQ is the score derived from a set of standardized tests of intelligence. 190 male fresh students, in the B Tech and the integrated MSc and other courses, who get admitted in Indian Institute of Technology at Kharagpur and other institutes are considered for the study to see the relationship of IQ with glucose assimilation, utilization and metabolism in respect to a glucose load and also the corresponding changes in serum insulin levels. The study also deals with relationship of IQ with some common bio-chemical parameters like lipid profile and serum bilirubin. It is being observed that with an increase in IQ level, the blood glucose absorption remains high with a rise in serum insulin level. Logically this will lead to more cerebral blood glucose availability. Correlation of IQ with different blood biochemical parameters shows a positive relationship with total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, very low density lipoprotein cholesterol and triglycerides and with serum bilirubin the correlation is found to be negative.

Keywords

Intelligence, IQ level, Glucose assimilation, Serum bilirubin

Introduction
The score derived from a set of standardized tests of intelligence is the intelligence quotient or IQ of an individual. Intelligence tests are of many forms. Most of the tests yield an overall score as well as different individual subtest scores. Regardless of design, all IQ tests have the fallacy of measuring the general intelligence or g only. General intelligence has a large number of biological correlates. Strong correlates are mass of the prefrontal lobe, glucose metabolization rate within the brain and overall brain mass. Brain size has long been known to be correlated with g (1). An MRI study on twins (2) showed that frontal gray matter volume was highly significantly correlated with g. General intelligence correlates significantly with overall body size. There is conflicting evidence regarding the correlation between g and peripheral nerve conduction velocity, with some reports of significant positive correlations, and others of no or even negative correlations. The Flynn effect describes a rise in IQ scores over time.

The Flynn effect is the year-on-year rise of IQ test scores, an effect seen in most parts of the world, although at greatly varying rate. The average rate of rise seems to be around three IQ points per decade. Attempted explanations have included improved nutrition, a trend towards smaller families, better education, greater environmental complexity, heterosis (3) and an increased familiarity of the general populace with IQ tests. There is no strong consensus as to whether rising IQ scores imply an increase in g. Statistical analyses of IQ subtest scores suggest a g-independent input to the Flynn effect (4). IQ also correlates with sex, educational achievement, job performance, socioeconomic advancement, and social pathologies.

Material and Methods

Selection of Samples
Kharagpur has an entry of large number of male students through the examination for its B Tech and integrated MSc programmes and other programmes. Depending on their similarities in socio-economic and socio-cultural conditions and food habits (Questionnaire and interview) 500 residential fresh male students who are being otherwise normal and all aged around 19 years are initially screened for the study. As per ICMR protocol they are being explained of the study. Of them, 390 students are chosen in total whose initial blood glucose values are in the range of 70-100 mg/dl (values above and below are not chosen due to medical reasons). Of them 190 students give written consents for the study. Institute ethical committee is being approached for clearance as per ICMR protocol.

Equipment used
Alexandra Battery and WAIS, Accu-chek active (Roche, Ireland, Serial No G No 1795843, Art No 03533565001), Photometer 4010 of Boehringer, Germany (6), estimation of serum insulin (radio-immunoassay).

Methodology
The students IQ are being measured by similar and identical tests and it ranges from 110 to 140. Four groups are made: 110-115 the first group, 115-120 the second group, 120-125 the third group and 125-140 the fourth group respectively. The students live in different residential hostels. The wardens of the hostels are being requested to give identical food to all the students in these two hostels to maintain similarities and for masking effects. Clinical and anthropometrical evaluations of the volunteers are being done. On the day just before the day of experimentation food being served to the halls on usual hour of 7-30 pm and the volunteers are observed that they are asked to take meal and not to consume anything outside. On the day of experimentation they are being kept in fasting conditions till 7 AM and then 75 g of glucose is given to each of them. No food is given to them till capillary blood glucose (CBG) is measured at 9 AM (Accu-chek active, Roche, Ireland, Serial No G No 1795843, Art No 03533565001). CBG is being measured at 30 minutes interval and values are observed and are being analyzed statistically. Blood samples (10 cc of blood) are being drawn from anti-cubital vein with all protections for testing of lipid profile values by using Photometer 4010 of Boehringer, Germany (5) and Serum insulin values (radio-immunoassay). As students have an increased incidence of jaundice, serum bilirubin tests (5) are being done for all the volunteers. Regarding other indices of liver function tests like enzymes, total protein etc are not being done due to financial inadequacies of the research team. The volunteers are being observed for one hour after blood testing as a precautionary step and though institute hospital caters to all health related problems of students, the volunteers (all students) are being requested to report to the principal investigator of the study in case of any difficulties.

Statistical Analysis
Let us write the four IQ groups viz. 110-115, 116- 120, 121-125 and 126-140 as groups 1, 2, 3 and 4 respectively, and the four time points, after 30 minutes, 1 hour, 1 hour and 30 minutes and 2 hours of intake of 75 gram of glucose as t1, t2, t3 and t4 respectively. On the basis of the data obtained, it is statistically observed that both of µi (t), the mean glucose level, and µi (t), the mean serum insulin level are increasing in i for all t=t1, t2, t3, t4. Firstly, we consider Analysis of Variance (ANOVA), and get the null hypothesis of equality of mean values of the four groups rejected. (This is done by standard F-test for ANOVA). Once the equality of mean values is rejected, then the next question arises- is all the mean values different from each other or a particular pair of means is different? This could be done by pair-wise comparisons. These tests of pair-wise comparison

Results

The students underwent clinical and anthropometrical evaluation before the study. The characteristics of the students are:
Average age: 19.2 +/-0.29 years, (Mean +/-SD)
Average weight: 53.36 +/- 4.08 kg
Body Mass Index (BMI) = 19.32 +/- 1.23.

Blood samples analyzed for plasma glucose utilisation in respect of IQ are shown in (Table/Fig 1). It is being observed that in the group where IQ is 110-115 (n=37) FBS is 84+/-9 mg/dl. With 75 gm of glucose the blood sugar values are 95+/-13 mg/dl, 110+/-12 mg/dl, 105+/-9 mg/dl and 95+/-7 mg/dl respectively for the four different time intervals mentioned above, e.g., at 30 minutes, 1 hour, 1 hour 30 minutes and 2 hours after the glucose intake. In the second group where IQ values range from 116-120 (n=63), FBS value is 85+/-11 mg/dl while it rises to 98+/-11 mg/dl after 30 minutes of glucose intake. Blood sugar values are 115+/-9 mg/dl, 110+/-11 mg/dl and 97+/-10 mg/dl after 1 hour of intake, 1 hour and 30 minutes of intake and after 2 hours of intake respectively. In the third group (n=53) IQ values are in the range from 121 to 125. FBS value is 86+/-12 mg/dl. With 75 gm of glucose the blood sugar values are 104+/-9 mg/dl, 123+/-11 mg/dl, 115+/-12 mg/dl and 98+/-9 mg/dl respectively after those four intervals. In the fourth group IQ values range from 126-140 (n=37) and FBS value is 87+/-11 mg/dl while the corresponding blood sugar values after those time intervals are 108+/-12 mg/dl, 129+/-9 mg/dl, 120+/-10 mg/dl, and 98+/-9 mg/dl respectively.

On the basis of the data obtained, it is statistically observed that µ2 (t), the mean glucose level is increasing in for all . These tests are conducted separately for each of µ2 (t) using standard (student’s) t test.

Let Pij be the p-value for the test H0:µi(j) =µi+1(j) against the alternative H1:µi(j)less than or equal to µi+1(j).
The p-values thus obtained are listed in (Table/Fig 2).

Analyzing (Table/Fig 3) relationship of IQ and Serum insulin values at different times after glucose load, it is being observed that serum insulin values are 27 +/-3 iu, 26 +/- 4 iu, 24+/-4 iu, 23+/-5 iu respectively in different groups at the fasting stages. Serum insulin values are 333+/-12 iu, 360+/-8 iu, 400+/-12 iu and 410+/-9 iu respectively half an hour after glucose intake. One hour after oral glucose intake, serum insulin values are 250+/-8 iu, 182+/-10 iu, 242+/-6 iu and 186+/-12 iu respectively. One and half hour after glucose intake, values are 152+/-8 iu, 148+/-8 iu, 144+/-6 iu and 140+/-6 iu respectively. Two hour after glucose intake, values are 106+/-8 iu, 103+/-7 iu, 100+/-6 iu and 94+/-8 iu respectively.

Let P*ij be the p-value for the test H0i(j) =ηi+1(j) against the alternative H1i(j) less than or equal to ηi+1(j).
The p-values thus obtained are listed in (Table/Fig 4).

Values showing the relationship of IQ with serum lipid profile values (measured in fasting blood only) are being shown in (Table/Fig 5). Regarding TLC, in the group where IQ is in the range 110-115, TLC values are 97+/-9 mg/dl, in the second group TLC values are 99+/-7 mg/dl, while in the third and fourth groups TLC values are 103+/-8 mg/dl and 107+/-8 mg/dl respectively (p=0.232). Regarding LDLC the values are 57 +/-9 mg/dl, 61+/-8 mg/dl, 63 +/-6 mg/dl and 66 +/-6 mg/dl respectively in four different groups (p=0.242). In VLDLC the values in different groups are 15+/-4 mg/dl, 14+/-5 mg/dl, 16+/-

Discussion

The score derived from a set of standardized tests of intelligence is the intelligence quotient or IQ of an individual. A standardized test is a test administered and scored in a standard manner. The tests are so designed that the questions, conditions for administering, scoring procedures, and interpretations are consistent and are administered and scored in a predetermined, standard manner (6). Brand et al. (7) found the correlation between reasoning IQ and neonatal blood glucose levels was weak and not statistically significant. Haier et al. (8) found that IQ was related to cerebral blood flow. Thompson et al. (3) elaborated genetic influences on brain structure and Posthuma et al. (9) reported association between brain volume and intelligence is of genetic origin. Meisenberg (10) reported strong linkage of heredity factors and g but the linkage pathways are currently unknown. The heritability of most test performance is thus attributed to G. Bouchard and McGue(11)have reviewed such correlations reported in 111 original studies. The mean correlation of IQ scores between monozygotic twins was 0.86, between siblings, 0.47, between half-siblings, 0.31, and between cousins, 0.15. From such data the heritability of IQ can be estimated, varying between 0.40 and 0.80. While most of IQ determinates are heritable this study shows that in students with higher IQ glucose assimilation from a standard glucose load is more and the higher sugar value persists for a longer time in the body with rapid decline towards the fasting level. Whether this is heritable or not is yet to be found and needs further researches. Several aspects of our present knowledge on (A) the relations of blood sugar to brain waves and on (B) the occurrence of epileptic attacks at different blood sugar levels summarized reveal a significant positive correlation between the electroencephalographic 21/2 per second wave and spike on one hand and the blood sugar level on the other (12).

Conclusion

IQ is very important as it reflects intelligence and as such thought to be related to the academic performance. Many of the factors related to a higher IQ is hereditary and cannot be changed. To increase IQ or academic performances many workers are concentrating their works on changeable and achievable objectives. Studies are done showing IQ is related to cerebral blood glucose level and overall brain size. The study as done here shows that IQ is strongly correlated with glucose assimilation after a glucose load, overall utilization and metabolism. Further, IQ is also showing relationship with lipid profile values and serum bilirubin level. Further studies are needed to establish this.

Acknowledgement

The authors are indebted to Prof. A.K. Nanda of Mathematics and Statistics Department for statistical workouts. The authors are also indebted to Prof. M.B. Sharan of Humanities and Social Science Department. The authors thank Prof. S. Dey, Head of Bio-Technology Department, all in IIT, Kharagpur for the help and use of the laboratory facilities. The authors were also indebted to Prof. A. K. Basak. Head, Chemistry Department for expert suggestions, help and active participation. The authors are grateful to Dr. D. Gupta, Dr. S. Chowdhury, Mr. L. K. Pradhan, Mr.S. Mondal, Mr. A .K .Roy, Mr. R.R. Mishra, Mr. L. Chingri, Mr. K. Pattanayek, of B. C. Roy Technology Hospital and Prof. A. K. Roy, Head of School of Medical Science and Technology and Doctors of that School for assistance in the monitoring process and for continuous help in the work. The authors thank Mr. Biswanath Dutta of Information Cell of IIT, Kharagpur for information’s and data processing. The authors acknowledge gratefulness to Dr. Arunava Mitra of Crompton Greaves Limited for financial assistance and active participation in the project.

References

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Thompson MP, Cannon DT, Narr LK, Erp T, Poutanen V, Huttunen M, Lönnqvist J, Standertskjöld-Nordenstam C, Kaprio J, Khaledy M, Dail R, Zoumalan IC, and Toga WA. Genetic influences on brain structure. Nature neuroscience December 2001;4 12: 1253-1258.
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Tables and Figures
[Table / Fig - 1] [Table / Fig - 2] [Table / Fig - 3] [Table / Fig - 4] [Table / Fig - 5] [Table / Fig - 6]

JCDR is now Monthly and more widely Indexed .