International Journal of Endocrinology and Metabolism
Year:2021 | Volume:19 | Issue:1|Papers Count:8

Background: Glycated hemoglobin (HbA1c) levels are dependent not only on the average blood glucose levels over the preceding 2-3 months but also on the turnover of erythrocytes. Hyperthyroidism is known to be associated with an increase in erythrocyte turnover that may falsely lower the HbA1c in relation to the level of glycemia. Objectives: To assess the impact of medical correction of hyperthyroidism on HbA1c, independent of changes in the fasting plasma glucose and 2-hour post-oral glucose tolerance test plasma glucose. Methods: Adult patients with overt hyperthyroidism (n = 36) were tested for their hemoglobin, reticulocyte percentage, HbA1c and fasting and post-oral glucose tolerance test (OGTT) 2-hour plasma glucose, both at baseline and following at least three months of near normalization of serum thyroxin on Carbimazole treatment. Results: Correction of hyperthyroidism in 36 patients was associated with an increase in the hemoglobin (P = 0. 004) and a rise in HbA1c (P = 0. 025), even though no signifi cant change was observed in both the fasting (P = 0. 28) and post OGTT two-hour plasma glucose (P = 0. 54). Also, the proportion of patients with HbA1c  5. 7% rose from 3/36 to 10/36; P = 0. 016, while the proportion of patients with either abnormal fasting or abnormal post OGTT 2-hour plasma glucose or both did not show any signifi cant change (P = 0. 5). The sensitivity of HbA1c to diagnose prediabetes increased from 20% to 50% post-treatment. Conclusions: Glycated hemoglobin is falsely low in relation to glycemia in patients with untreated hyperthyroidism.

Background: Congenital hypothyroidism (CH), as one of the most common endocrine disorders, is a preventable cause of mental retardation. Objective: This study aimed to identify familial-related risk factors for CH in Iranian newborns. Methods: A population-based case-control study was performed on the National Registry System of patients with CH in Iran. In this study, 906 controls and 454 cases were studied for one year. Familial related factors were investigated using logistic regression models. Population attributable fraction (PAF) was also calculated for each signifi cant risk factor. Results: Using multivariate analysis, an increased risk for CH was observed in patients with congenital anomalies (odds ratio (OR): 5. 77, 95% confi dence interval (CI): 2. 37-14. 01), history of mental retardation in family (OR: 2. 10, 95% CI: 1. 15-3. 83), mother’ s hypothyroidism during pregnancy (OR: 2. 01, 95% CI: 1. 33-3. 03), intra-family marriage (OR: 1. 49, 95% CI: 1. 18-1. 89), gestational diabetes (OR: 1. 69, 95% CI: 1. 09-2. 63), having a hypothyroid child in the family (OR: 2. 48, 95% CI: 1. 39-4. 42), and twins or more (OR: 2. 61, 95% CI: 1. 31-5. 21). The highest PAF among familial-related risk factors for CH is related to the intra-family marriage (14. 9%). Conclusions: This study revealed that familial-related risk factors and consanguine marriages play an essential role in the high incidence of CH in Iran. About 15% of CH in Iran could be attributed to intra-family marriage alone.

Introduction: Primary hyperparathyroidism (PHPT) is a rare condition in the pediatric population. Parathyroid carcinoma (PC) is a very uncommon cause of PHPT, accounting for < 1% of pediatric PHPT cases. It is challenging to distinguish between parathyroid adenoma (PA), the most common cause of PHPT, and PC. In this report, we described a young female who presented with a history of progressive limping and was finally diagnosed with PC. Case Presentation: A 15-year-old girl presented with progressive limping and bone pain for 8 years. She was referred by an orthopedic surgeon because of elevated intact parathyroid hormone (iPTH) for further evaluation. Physical examination revealed a large, firm, and non-tender neck mass, left hip tenderness, and limited range of motion. The initial biochemistry tests showed a borderline high calcium level of 10. 8 mg/dl, an elevated iPTH level of 2876 pg/mL, and a decreased phosphorus level of 2. 4 mg/dL. The 99m Technetium (Tc) sestamibi scan displayed early intense activity in the right thyroid lobe persisting in the three-hour repeat scan, compatible with a parathyroid lesion. The patient underwent right-sided neck exploration and parathyroidectomy. Intraoperative and pathology findings confirmed the diagnosis of PC. Immunohistochemistry (IHC) staining revealed creatine kinase (CK) and CD31 in endothelial cells of the tumor. Ki67 staining was also positive in 2%-3% of tumor cells. The whole exome sequencing (WES) study was negative for cell division cycle 73 (CDC73) and multiple endocrine neoplasia 1 (MEN1) genes. Conclusions: PC should be considered as a differential diagnosis of PHPT in the pediatric population, even in the presence of mild hypercalcemia.

Background: The burden of chronic kidney disease (CKD) is on the rise worldwide; diabetes and hypertension are mentioned as the main contributors. Objectives: The current study aimed to investigate the multiplicative and additive interaction of diabetes and hypertension in the incidence of CKD. Methods: In this population-based cohort study, 7342 subjects aged 20 years or above (46. 8% male) were divided into four groups: no diabetes and hypertension; diabetes and no hypertension; hypertension and no diabetes; and both diabetes and hypertension. The multivariable Cox regression was used to determine the effect of diabetes, hypertension, and their multiplicative interaction on CKD. The following indices were used to determine the additive interaction of diabetes and hypertension: the relative excess risk of interaction, the attributable proportion due to interaction, and the synergism index. Results: Diabetes and hypertension had no significant multiplicative interaction in men (hazard ratio of 0. 93, P value: 0. 764) and women (hazard ratio of 0. 79, P value: 0. 198); furthermore, no additive interaction was found in men (relative excess risk due to interaction of 0. 79, P value: 0. 199; attributable proportion due to interaction of 0. 22, P value: 0. 130; synergy index of 1. 44, P value: 0. 183) and women (relative excess risk due to interaction of-0. 26, P value: 0. 233, attributable proportion due to interaction of-0. 21, P value: 0. 266; synergy index of 0. 48, P value: 0. 254). Conclusions: This study demonstrated no synergic effect between diabetes and hypertension on the incidence of CKD.

Dear Editor, This letter describes a proposed method to prevent children from gaining weight during not attending school due to COVID-19. The pandemic of Coronavirus Disease 2019 (COVID-19) is making considerable mortality and morbidity, putting pressure on health care systems, winding down the economy, and increasing school absenteeism. While lowering its immediate impact is a priority, I want to focus on a long-term impact on the health of children. By not attending school and staying at home, COVID-19 may lead to a stepped-up children’ s obesity epidemic and increases obesity disorders. The COVID-19 pandemic has prevented students from attending school, forcing them to stay at home in many parts of Iran. . .

Context: Gestational diabetes mellitus (GDM) is an important endocrine disorder in perinatology, associated with several maternal and neonatal complications. Development of national guidelines can inform clinicians, health policymakers, and researchers about the most recent evidence and practical issues of diagnosis and management of GDM. Objectives: We aimed to develop clinical practice guidelines for the diagnosis and management of GDM in Iranian pregnant women. Evidence Acquisition: The Iranian Endocrine Society constituted a task force, consisting of obstetrician-gynecologists, endocrinologists, a clinical nutritionist, a clinical epidemiologist, and a librarian, to review the published literature and propose national guidelines for the diagnosis and management of GDM. The consensus was reached on all recommendations in several group meetings with a majority decision. The evidence and recommendations were graded according to the American College of Physicians’ Guideline Grading System. Results: The proposed guidelines included recommendations for screening, diagnosis, and management of GDM in Iran. Conclusions: By using an evidence-based approach, these national GDM guidelines can address important clinical issues in the diagnosis and management of Iranian women with GDM.

Background: Oxidative stress is commonly accrued in thyroid tissue during hormone synthesis. Objectives: We aimed to examine oxidative stress in patients with thyroid cancer, benign thyroid nodules, and healthy individuals. Methods: In this study, 138 individuals were involved. Among the selected participants, 108 had thyroid nodules, including 30 papillary thyroid cancer (PTC), 30 follicular thyroid cancer (FTC), six anaplastic thyroid cancer (ATC), 12 medullary thyroid cancer (MTC), and 30 benign nodules. In addition, 30 individuals were selected as a healthy control group. The levels of total antioxidant capacity (TAC) and total oxidant status (TOS) of thyroid tissue were measured using the ELISA method, and the oxidative stress index (OSI) was calculated. Results: The TAC level was signifi cantly lower in MTC and FTC subtypes than in controls. The TOS level was considerably higher in the MTC group than in the control and benign nodule groups. The TOS level was not changed in other groups. The OSI was considerably higher in MTC and FTC subtypes. The TAC and OSI in benign nodules were signifi cantly lower and higher than those of controls, respectively. The OSI was higher in female patients than in males. Conclusions: The OSI can not be considered a diagnostic biomarker for benign nodules and MTC. The diverse oxidative stress status between genders may be related to the elevated cancer incidence in females.

Publishing in peer-reviewed high-quality journals is a gold standard method for disseminating scientific work. Choosing the right journal is one of the most important and diffcult aspects of publishing research results. Submitting to an inappropriate journal is one of the most common reasons for fast rejection of manuscripts, resulting in time wasted by the authors and journals' editors. Here, we discuss important factors that should be considered for choosing the right journal to get your work published successfully and effectively. The most important factors for journal targeting are: (1) The journal's characteristics, including its scientific prestige, performance, publishing model, acceptance possibility, and specialty; (2) the manuscript's characteristics, including its relevance to the journal's aim and scope, its intrinsic value, meaning the novelty of the research, soundness of the methodology, potential impact in the field, and its implication; and (3) authors' priorities and limitations.