IRANIAN JOURNAL OF ENDOCRINOLOGY AND METABOLISM (IJEM)
Year:2010 | Volume:11 | Issue:5 (SN 47)|Papers Count:8

Introduction: The metabolism of Zine (Zn), an essential nutrient, changes in diabetes. It has been shown that there is a relationship between Zn and both, type 1 or insulin-dependent diabetes mellitus (IDDM) and type 2 or non-insulin-dependent diabetes mellitus (NIDDM). Increased lipid peroxidation in diabetic patients leads to MDA production. This study aimed to investigate relationships between serum Zn concentration and insulin, insulin resistance and oxidative stress in postmenopausal diabetic women. Materials and Methods: We studied 45 diabetic women and 45 healthy ones (controls) with BMI 25-30 kg/m2 and age 45-60 y. Fasting blood sugar (FBS), serum zinc, insulin, insulin resistance and MDA were determined in both groups. Results: There were non significant correlations between Zn, insulin (r=-0.06) and insulin resistance (r=-0.027) and MDA (r=-0.09) as well in diabetic group. Conclusion: There were no significant relationships between serum zinc and insulin, insulin resistance and MDA in postmenopausal diabetic women.

Introduction: The purpose of this study was to determine the effect of an educational program, based on Health Belief Model (HBM), on control sugar in women with type 2 diabetes. Materials and Method: This perspective, quasi-experimental intervention study was carried out on 88 women with type 2 diabetes. Data was collected using a questionnaire based on the health belief model, a checklist related to patient practices and recording patient HbA1c and FBS levels. All group completed the questionnaire and checklist. Results were documented before and three months after intervention. The patients of the experimental group participated in 4 educational classes during the one month of intervention and again two months after, with 2 sessions as the follow up of the intervention. Data were collected and analyzed. Results: Our findings indicated that mean scores of HBM Model variables, i.e susceptibility, severity, benefit and barriers perceived, were significantly increased in the experimental group compared to controls after intervention. Also, behavioral walking, rates of HbA1c (before intervention - 9.59%, after three months - 8.63%) and FBS levels (before intervention 184.63, after three months 151.29) improved significantly among the experimental group, compared to controls (p<0/001). Conclusion: Applying the HBM Model proved is very effective in developing an educational program for diabetics, to control their blood sugar and enhance walking. Besides such programs, follow up education for controlling and monitoring are highly recommended.

Introduction: Precise control of diabetes mellitus, one of the most prevalent endocrine diseases, is important for prevention of serious vascular complications. Helicobacter pylori (H. pylori) is one of the most common chronic bacterial infections in the world and data reveals that diabetic patients with concomitant H. pylori infection require higher doses of insulin, despite which they have higher levels of HbA1c than their uninfected counterparts. Our study was hence designed to assess the effect of H. pylori eradocatopmon hyperglycemia control in diabetic patients. Materials and Methods: Between January and June 2005, patients with type 2 diabetes mellitus and positive urea breath tests, were randomly allocated into two groups, the first treated for H. pylori infection (cases) and the second served as controls. HbA1c and FBS were measured in all patients at initiation of study and three months later. Results: The study included 19 cases and 22 controls. Mean decrease of HbA1c and FBS in the two groups showed no significant differences. Conclusion: Study results indicate that treating H. pylori in patients with type 2 diabetes mellitus has no role in short-term control of the disease. In most studies numbers and types of evaluated cases have limitations, and results differ. More extensive studies, using long term randomized clinical trials-term are recommendated.

Introduction: Vitamin D deficiency is prevalent worldwide. Low 25 hydroxyvitamin D3 concentration is inversely associated with type 2 diabetes, metabolic syndrome, insulin resistance, and probably cardiovascular disease. The objective of this study was to evaluate of association between vitamin D deficiency and cardiovascular risk factors among diabetic patients. Materials and Methods: This cross-sectional study, which investigated 119 type 2 diabetes patients, was conducted in Mashhad between December 2007 and March 2008. Coronary, cerebrovascular and peripheral vascular diseases in the subjects were confirmed, and blood biochemical parameters, including laboratory risk markers of cardiovascular disease were determined. Serum 25 (OH) D was measured during winter to determine the correlation between vitamin D deficiency and cardiovascular prevalent and the laboratory variables. Results: Mean patient age was 55.3±11.2 years. Mean 25 (OH) D concentration was 32.4±21.6 ng/ml. Prevalence of vitamin D level / deficiency D was 26.1% among diabetic patients, difference with control group not being significant (P=0.12). Overall, 36 (30.3%) patients were positive for coronary vascular disease (CVD). The correlation between hypovitaminosis D and CVD was not significant (p=0.11). Patients with vitamin D deficiency had significant differences in body mass index (P=0.003), metabolic syndrome (P=0.05), high sensitive CRP (P=0.009), microalbuminuria (P=0.04), and glumerolar filtration rate (P=0.02) compared with patients with sufficient vitamin D; FBS, HbA1c, lipid profiles, homocysteine, uric acid and insulin resistance were not related to vitamin D deficiency. Conclusion: Results showed an association between hypovitaminous D and coronary risk markers indicating the importance of this vitamin in cardiovascular health.

Introduction: Dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S) are the most abundant steroids in human plasma. The aim of this study was to evaluate the relationship between DHEA and DHEA-S and anthropometric indices in women with different grades of obesity. Materials and Methods: This cross- sectional study investigated 170 women; 35 normal weight (BMI=18.9-24.9), 33 overweight, (BMI=25-29.9) as 36 women (BMI=30-34.9) as obese grade I, 33 (BMI=35-39.9) as obese grade II and 33 (BMI³40) as obese grade III. Body mass index was defined as weight in kilograms divided by the square of the height in meters. Serum levels of dehydroepiandrosterone, dehydroepiandrosterone sulfate and glucose were measured by commercially available enzyme immunoassay kits and the glucose oxidase method, respectively. Results: There was a negative and significant correlation between DHEA and age in the normal (r=-0.457, P=0.006) overweight (r=-0.414, P=0.017) obese I (r=-0.402, P=0.015) obese II (r=-0.391, P=0.024) and obese III (r=-0.354, P=0.043) groups, respectively. Also a negative and significant correlation was found between DHEA-S and age in overweight (r=-0.394, P=0.019), obese grade I (r=-0.455, P=0.005) and obese grade II (r=-0.390, P=0.023) groups respectively. We found a positive and significant correlation between DHEA and frame size in individuals of the Obese I, Obese II and Obese III groups, and also a positive and significant correlation between DHEA-S and frame sizes in individuals of these three groups. Conclusion: Results showed that serum levels of DHEA decrease with increasing grades of obesity, whereas serum levels of DHEA-S increase with increasing obesity.

Introduction: Existing data show a rising prevalence of overweight and obesity among Iranian adolescents. Considering the lack of related studies from Iran, the current study investigates personal barriers to life style Modification among overweight/obese adolescents. Materials and Methods: This is a qualitative study, conducted according to the grounded theory approach. Participants were 35 school children (19 girls and 16 boys), aged 15-17 years, who were either overweight or obese. To collect data, 5 semi-structured focus group discussions and 10 in-depth interviews were conducted. To obtain views across a range of socioeconomic backgrounds, two demographically diverse areas in Tehran were selected, and in each area, participants were recruited from schools. All interviews and focus group discussions were audio recorded and transcribed verbatim. Data collection and analysis were done simultaneously according to the Strauss and Corbin analysis method. Results: Based on data analysis, positive perception of conditions, priority of studying, lack of willingness, negative experiences, low self-esteem, and perceived lack of control were the major personal barriers to adolescents’ healthy lifestyles. Conclusion: Study results demonstrated the main personal barriers for a healthy life style as perceived by adolescents, barriers that any effective interventions require to address for tackling overweight and obesity in adolescents.

Introduction: This study amis at determining which components of the metabolic syndrome are the best predictors of its development. Material and Methods: In this cohort study, from the participants of the cross sectional phase of the Tehran Lipid and Glucose Study(TLGS), 2279 subjects (aged 20-87) who did not have the metabolic syndrome, based on modified ATP III criteria, and 2310 subjects (aged 20-87) without the metabolic syndrome according to IDF criteria were followed. Results: After a mean interval of 6.5 years, 462 and 602 new cases of the metabolic syndrome were diagnosed on basis of the modified ATP III and IDF criteria, respectively. The adjusted odds ratio for development of the metabolic syndrome by ATP III criteria was highest for central obesity in men, 2.8 (2.2-3.7) and for triglycerides in women, 2.8 (2.0-4.1). The adjusted odds ratio for development of the metabolic syndrome by IDF criteria was highest for triglycerides in both men and women, OR being: 2.8 (2.2-3.7) and 2.9 (1.9-4.3) respectively. The area under the ROC curves for waist circumference, triglycerides and HDL were the highest. A model that included waist circumference and triglycerides or waist circumference and HDL predicted the metabolic syndrome as well as a model that included all five metabolic syndrome components. Conclusion: High risk subjects should undergo periodic screening, including measurement of waist circumference, triglycerides and plasma HDL, for timely prediction of development of metabolic syndrome.