IRANIAN JOURNAL OF ENDOCRINOLOGY AND METABOLISM (IJEM)
Year:2007 | Volume:9 | Issue:1 (SN 33)|Papers Count:17

Introduction: Heart disease is the primary cause of mortality in most countries. Different approaches have been designed for the prevention of heart disease risk factors, of which nutritional interventions is a main one. Materials and Methods: In the Tehran Lipid and Glucose Study, a sub-sample of 1474 subjects, were selected as cases for dietary assessment and implementation of nutritional interventions. After a 3. 8 year follow up, data were collected in both the intervention and case groups. Three hundred and sixteen subjects, aged 20 and over, that were not pregnant and did not use any hypoglycemic agents, lipid-lowering and anti-hypertensive prescription medications were enrolled for the study; they were divided into controls (183 subjects) and cases (133 subjects). Mean energy intakes and macronutrients, were measured and compared within the two groups, using the paired t- test and ANCOVA was used between the two groups after controlling for age, sex, and baseline variables. Chi square and Mantel-Haenszel tests were performed to assess the prevalence of risk factors and metabolic syndrome between and within groups. McNemar test was used to assess the change of risk factors before and after intervention. Results: Mean energy, carbohydrate and fat intake decreased; and cholesterol intake increased significantly in both groups. The prevalence of low HDL and central obesity increased in controls whereas hypercholesterolemia and high LDL cholesterol decreased significantly in the cases. The prevalence of high LDL decreased in cases as compared to the controls, with and without controlling for age, sex, and BMI. Pre- and post intervention evaluations showed improvement in hypercholesterolemia (p<0. 01) and high LDL (p<0. 01) in cases vs controls, whereas lesser improvement were seen in low HDL (p<0. 01) and central obesity (p<0. 01) in controls vs cases. Conclusion: The present study shows the effectiveness of nutritional interventions in curtailing and improving some risk factors of heart disease. 

Introduction: To examine the association between changes in body weight and body fat distribution and development of metabolic syndrome. Materials and Methods: Changes in body weight and body fat distribution and the appearance of metabolic syndrome over a 3 year duration were assessed in 2176 women of the Tehran Lipid and Glucose Study. Metabolic syndrome was defined according to ATPIII criteria. Body fat distribution was determined by waist to hip ratio, waist circumference and hip girth. Stable waist and hip were defined successively as±2cm and -2cm to 0cm, respectively. Results: The mean age of subjects was 36.4±12.7 years and the incidence of metabolic syndrome was 19 percent during this period. After controlling for age, family history, smoking status and physical activity, weight gain was monotonically related to the risk of development of metabolic syndrome (for each Kg of weight gained, risk increased by 1.15%). Changes in waist to hip ratio of over 0.07 cm, were significantly associated with risk (P<0.05), independent of the risk associated with weight change. Compared with women who had a stable waist, ≥ 3cm increase in waist circumference had 3.33 times (95%CI: 2.14-5.22) the risk of metabolic syndrome and ≥ 5cm increase in hip girth had 1.58 times (95%CI: 0.99-2.54) the risk of metabolic syndrome. Conclusion: Findings show that changes in weight and body fat distribution are associated with the risk of metabolic syndrome. 

Introduction: While many studies have reported cross-sectional associations between metabolic syndrome components, few have prospectively examined the development of the metabolic syndrome and comprehensive set of risk factors in a cohort. The objective was to evaluate the role of nutritional and anthropometrical factors in the incidence of metabolic syndrome in adults. Materials and Methods: In this population-based cohort study a representative sample of 410 subjects (male and female), aged 18-74 years who were free of the metabolic syndrome at baseline, were categorized based on quartile cut-points of metabolic syndrome components and food consumption. Baseline blood pressure, waist circumference, serum glucose and lipids, physical activity and dietary intake were measured and tested for predictors of the metabolic syndrome. Results: Metabolic syndrome developed in 71 subjects during the subsequent 3.5 years. The best predictors of incident metabolic syndrome were hypertension [odds ratio (OR) by quartile:1, 1.2, 1.6, 4.2, p for trend<0.05], waist circumference(1, 1.1, 2, 5.3, p for trend<0.05), triacylglycerol (1, 1, 2, 3, p for trend<0.05) and HDL cholesterol(1, 0.4, 0.4, 0.3 p for trend<0.05). In multivariate analysis increased waist circumference was the optimum predictor [OR 8(4-12.2)]. A prominent dose–response relationship across the carbohydrate and fat intake categories and the odds of metabolic syndrome was observed. Conclusion: This report confirms the role of blood pressure, waist circumference and lipid measurements in risk stratification of metabolic syndrome in adulthood. Interventions that address obesity and reduce waist circumference and an appropriate diet may reduce the incidence of the metabolic syndrome in adults. 

Introduction: Until now, few studies have focused on late effect of sulfur mustard on the liver; at present there is no data published on liver enzymes in sulfur mustard exposed veterans. The current study was conducted with the aim of determining alanine aminotransferase (ALT) levels in veterans exposed to sulfur mustard. Materials and Methods: In this cross-sectional study, 263 sulfur mustard exposed veterans were selected from among individuals referring to the respiratory clinic in Bagiyatallah hospital in 2005. ALT was determined in all subjects. Demographic data, exposure related variables, respiratory status and Body Mass Index (BMI) were collected. ALT over 40 unit/liter was considered as abnormal. Results: From a total of 263 sulfur mustard exposed veterans, 43 (16.3%) patients had an elevated ALT level. Range of ALT was 3-94 with a mean (SD) of 26.43 ± 15.22 unit/liter. ALT was correlated with the BMI (r=0.153, p=0.013). ALT was not significantly correlated with age, grading of chemical and overall disability. Mean ALT levels in patients with BMI > 25 (28.81 ± 15.05) were significantly higher than those with BMI less than 25 (21.93 ± 14.58) (p=0.001). Mean ALT level was higher in those with FEV1/FVC, in comparison to others (p<0.05). ALT was not significantly correlated with other study variables (p>0.05). Conclusion: Although any conclusion of the impact of mustard gas on ALT needs a controlled study, we mean while suggest serial measurement of the activity of this enzyme and other measures of liver status.

Introduction: Anemia is an independent risk factor for adverse cardiovascular outcomes in patients with myocardial infarction (MI). On the other hand, elevated Hct and Hgb level are associated with increased risk of MI. We sought to investigate whether increase or decrease of the hemoglobin level (Hgb) and the hematocrit (Hct) was an independent predictor for occurrence of acute coronary syndrome (ACS). Materials and Methods: This retrospective case-control study included 594 MI patients, 596 unstable angina (UA) patients, and 590 controls who were hospitalized between 1994 and 2005. Patients were analyzed according to the baseline Hgb and Hct value. Results: Prevalence of MI, based on Hgb and Hct in anemic patients was 17.9% and 14.0% and in patients with high level of normal range was 8.8% and 20.2%, respectively. Mean of Hgb and Hct concentration in patients with MI were (men: 14.79 ± 1.94 ; women: 13.32 ± 1.96) and (men: 44.90 ± 5.63 ; women: 40.90 ± 5.67), respectively. Mean differences of Hgb and Hct between MI patients, UA patients, and controls were significant only in men. A logistic regression between MI patients and controls showed that the odds ratio (OR) and 95%CI of MI for patients with low vs high Hgb and MCV were 0.215 (0.112-0.412) and 0.368 (0.243-0.558), respectively. The OR of MI for male vs female was 2.325 (1.749-3.090). Conclusions: In MI and UA patients, anemia was an independent predictor of occurrence of ACS based on Hgb; while, based on Hct, both anemia and high Hct were predictors of occurrence of MI. Anemia was a predictor of occurrence of MI with age. 

Introduction: During the month of Ramadan, 400 million adult Muslims all over the world fast during daylight hours. The effect of Ramadan fasting has been studied in various investigations conducted on normal healthy individuals world wide, but the changes of serum osmolarity and hematological parameters during Ramadan fasting are not known well. Materials and Methods: This cohort study was performed during Ramadan on 80 medical students (41 male and 39 female). We evaluated weight, Body Mass Index (BMI), serum osmolarity, sodium and potassium, haemoglobin (Hgb), hematocrit (Hct), platelets, red and white blood cell count (RBC and WBC) and Hgb Index before and after Ramadan. Results: The mean age of subjects was 22.7 years. Weight decreased significantly in both genders, and BMI decreased in female subjects after ramadan. While serum osmalarity and sodium increased and glucose decreased in both genders after ramadan, potassium decreased in males. RBC count increased in both genders, but WBC count and platelet count increased significantly in females. Hgb, Htc decreased after Ramadan Fasting in male subjects. We found no significant changes in levels of urea and creatinin in serum. Conclusion: This study indicated that Ramadan fasting leads to increased serum osmolarity, RBC count and some Hgb indices in both genders, but these changes remain within normal range. However, more investigations are suggested of patients with hematological and nephrological disorders. 

Introduction: Aldostrone is the most physiologically important mineralocorticoid released from the adrenal cortex. The basic function of this hormone is increasing sodium and chloride re-absorption and potassium secretion in the distal tubules of the kidneys and the secretional ducts of sweat glands. The aim of this study was to compare the effects of one session aerobic activity and sauna on serum aldostrone hormone concentration. Materials and Methods: Subjects were 15 football players of Shaheed Beheshti University, who had had at least 3 weekly sessions of physical activity regularly for 6 weeks. Blood samples were taken before and after aerobic activity and sauna. The data were analyzed using mean and standard deviation for statistical description, and dependent t-test for inferential analysis of data. Results: The subject’s vo2max mean was 47±4.41ml/Kg/min which is considered average. The results showed that a single session of physical activity significantly increased serum aldostrone concentration (p<0.05). A single session in the sauna also was significantly increased serum aldostrone concentration (p<0.05). However, there was no meaningful difference between variations of serum aldostrone concentration following aerobic activity and sauna (p>0.05). Conclusion: aldostrone concentration increased, with training and repeated heat exposure. 

Introduction: Locus coeruleus (LC) nucleus modulates certain physiological behaviors such as pain, anxiety, awake, sleep, memory and learning. Some studies have shown that the LC nucleus has both adrenergic neurons and a2-adrenoceptors, and also receives oxytocinergic projections from the paraventricular nucleus of the hypothalamus. The effect and mechanism of this neuropeptide is not fully understood. Considering that the chronic usage of oxytocin decreases anxiety, in the present study the effect of acute administration of oxytocin in the locus coeruleus and its interaction with a2 adrenoceptors on anxiety induced vogel’s test in male adult rats were investigated. Materials and Methods: Male adult wistar rats weighing 285±15 grams were divided into 6 groups: 1) Receiving saline, 2) oxytocin (2ng/2ml), 3) yohimbine (3.3mg/2ml), 4) receiving saline + yohimbine, 5) saline+ oxytocin and 6) yohimbine+oxytocin in locus coeruleus nucleus. Number of received shocks during water drinking was evaluated as an anxiety behavior for 15 minutes in Vogel's test. Results: Oxytocin reduced number of shocks received (Anxiogenic effect). Blocking of a2 adrenoceptors by yohimbine decreased number of shocks received. Anxiogenic effect of oxytocin increased in presence of yohimbine. Conclusion: It seems that the LC a2-adrenoceptors modulate anxiety and the anxiogenic effect of oxytocin and this effect can be eliminated by the blocking of the a2-adrenoceptors.