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Background: HELLP is a potentially life-threatening conditions which has some similarity with preeclampsia therefore, it poses a challenging diagnostic and management issues for clinician. It is composed of H=hemolysis, EL=elevated liver enzymes and LP=low platelets. The aims of this study are to assess the prevalence of HELLP syndrome among Saudi Arabian, besides, assessing the risk factors related to it. Methodology: This is an analytical cross-sectional study conducted in kingdom of Saudi Arabia (female who previously get pregnant) from 07/08/2020 till 29/11/2020. The study was depending on using of online questionnaire assessing demographic factors including age and nationality besides disease-related information: Heart disease, Smoker patient, related risk factors of disease and DM patient. Results: We included 457 women who agreed to participate in the study and completed the questionnaire. 36.1% of participants were aged between 25-35 years. 13.3% of the sample had reported that they are smokers and 6.1% as X-smokers while 16.8% of the sample had diabetes mellitus. The prevalence of HELLP was 38.3%. It was found that age is not a significant factor in occurrence of HELLP symptoms except in having distribution of liver function (P=0.005). Cardiac diseases are another significant risk factor in developing symptoms of HELLP especially high blood pressure where 46% of patients with cardiac disease reported having high blood pressure during pregnancy with a risk of eight times over those with no cardiac disease (OR=8.03, 95% CI=4.2100 to 15.3, P=0.000) however, it has no significant effect on developing disturbance in liver function. Conclusion: we had found the 38.3% of females in Saudi Arabia had HELLP in their pregnancy, with increase the prevalence of some other conditions including smoking, diabetes mellitus, hypertension and autoimmune diseases which all found to increase the risk for developing HELLP in females. More investigation is needed to explore the same prevalence using hospital based study design.

BACKGROUND As the seventh leading cause of death by 2030, type 2 diabetes mellitus (T2DM) is considered the most common chronic metabolic disease worldwide. Vitamin D metabolic axis players were identified as good candidates for T2DM. We aimed to analyze the circulating levels of total 25-hydroxy vitamin D (25-OHD), vitamin D receptor (VDR) transcript and VD-binding protein (VDBP) in a sample of Saudi T2DM and to correlate these profiles with diabetic nephropathy and insulin resistance. METHODS Ninety T2DM patients, classified into normo-, micro- and macro-albuminuria groups (n = 30/each) and 50 healthy controls were studied. Serum (25-OHD) and VDBP levels were assayed by ELISA. The peripheral blood mononuclear cell (PBMN) VDR expression level was quantified by real-time RT-PCR. Insulin resistance was evaluated by the homeostasis model assessment index (HOMAI). RESULTS The normo-albuminuria group showed the highest levels of PBMN VDR expression, whereas the macroalbuminuria group had the lowest levels among T2DM patients. However, serum VDBP levels were significantly elevated in all patient groups. There was a significant positive correlation between PBMN VDR expression levels and serum (25-OHD) in the total patient group (r = 0.579, p < 0.001). Spearman's correlation showed significant correlations of the circulatory markers with many clinico-laboratory variables. Stepwise regression analysis indicated that serum VDBP levels, HBA1c, and BMI were independent predictors for albuminuria. CONCLUSIONS The study findings suggest a potential role of vitamin D metabolic players in DN, with a special concern regarding serum VDPB as a putative predictor of DN severity in type 2 DM Saudi patients. Large-scale validation studies are warranted.