IRANIAN JOURNAL OF ENDOCRINOLOGY AND METABOLISM (IJEM)
Year:2008 | Volume:10 | Issue:3 (SN 39)|Papers Count:15

Introduction: Two years after legislation of salt iodization of 40 parts per million (ppm) in 1994, goiter was still endemic and urinary iodine concentration (UIC) remained elevated in many provinces of Iran. Goiter prevalence and UIC were compared two and seven years after sustained consumption of uniformly iodized salt by Iranian households. Material and Methods: From December 2000 to June 2001, schoolchildren (7-10 yr) of all provinces were randomly selected by cluster sampling; their goiter rate, UIC, and household salt iodine levels were compared to similar data collected in 1996. Factory salt iodine produced in 2001 was also compared to that of 1996. Ultrasonographically determined thyroid volumes of 7-10 yr old children were compared in 2001 to those of 1999. Results: Total, grade 1, and grade 2 goiters were 13.9 vs. 53.8%, 11.0% vs. 44.8%, and 2.9% vs. 9.0%, in 2001 (n=33600) vs. 1996 (n=36178), respectively (p<0.0001). Median (range) UIC in 2001 (n=3329) was 165 (18-410) mg/L and in 1996 (n=2917) was 205 (10-2300) mg/L (P<0.0001). Means for iodine salt content were 32.7±10.1 and 33.0±10.2 (P=0.79) in households and 33.2±13.4 and 33.8±13.2 (P=0.67) in factories, in 2001 and 1996, respectively. Only 7-yr-old children in 2001 (the only group with probably no history of iodine deficiency) showed significantly smaller thyroid volumes compared to those in 1999. Conclusion: After seven years of optimized iodized-salt supplementation in Iran, adequate UIC values and marked reduction in goiter rate have been achieved.

Introduction: Despite substitution of iodized salt for common salt since 1996 in Iran, goiter prevalence has not decreased, as expected, in poor districts. Maintaining iodine salt and its addition to the meal at the time of cooking are considered as the main reasons for goiter prevalence. The purpose of this study is to investigate the effects of knowledge, attitude and practice of married women being educated in medical community-oriented era of Kermanshah city on the consuming of iodized salt in 2004. Material and methods: According to census data collected and documented in 1999, 400 families were chosen randomly to be visited and observed on their consumption and maintenance of iodized salt. The woman or the person in charge of cooking was also asked to complete the questionnaire of knowledge, attitude and practice.Results: Of the women, questioned aged 32.91±7.5 years, 28% were under 29 years old, 34.8% 30-34, and 37.3% were over 35 years old; 50.5% were illiterate, 18.3% high school educated and 31.3% university educated. The reports showed knowledge rate at 48.3% (weak), attitude 55.9% (mediocre) and function 83.8% (mediocre). Although Chi Square Test was not significant enough to review the relation between women’s function, awareness, attitude and education as well as the relation between function, attitude and age, the relation of attitude and age was meaningful.Conclusion: Considering the lack women’s awareness regarding regular maintaining and consumption of iodized salt in Kermanshah city and the role of media, it is vital to educate people via media.

Introduction: Considering the influence of geographical, genetic and ethnic factors on the prevalence of thyroid pathological lesions, this study was performed to assess the prevalence of pathological lesions in thyroid autopsic samples obtained from adult cadavers of Isfahan Forensic Medical Center. Material and Methods: In this study, 202 thyroid glands from cadavers with no evidence of thyroid diseases, removed during autopsies at Isfahan Forensic Medicine Center, were analyzed. After gross studies, thyroid glands were fixed in 5% formalin for 72 hrs, and then 3-6 sections were obtained from each gland. Tissue sections were microscopically studied by two pathologists for histopathological lesions. Results: Among 202 thyroid glands (removed from 159 males and 43 females), 131(64.85%) were histopathologically normal, and goiter (nodular, and diffuse), Hashimoto's thyroiditis, lymphocytic thyroiditis, follicular adenoma and papillary carcinoma were observed in 41 (20.3%), 10 (4.95%), 12 (5.94%), 2 (1.49%) and 12 (5.94%) of the thyroid glands, respectively. Twenty-six glands (12.23%) had nodules sized£1cm, which included 7 cases of occult papillary carcinoma (papillary micro carcinoma) and the prevalence was significantly different by sex (P<0.05). Conclusion: Clinically-normal thyroid glands may contain major pathological lesions when they are microscopically studied. Considering the high prevalence of thyroid malignancy and occult carcinoma in Isfahan County compared to other parts of the world, more attention should be paid even to the minor findings during clinical examination of thyroid gland.

Introduction: Adequate nutrition is crucial for growth and maintenance of the body skeleton health. Nutrients consumed affect leptin and adiponectin levels and bone mass. This study was done to determe the relationship between serum leptin, adiponectin and bone mass with energy intake and nutrients in postmenopausal women, 40-60 years old. Material and Methods: The present cross-sectional study was done on 85 postmenopausal women, aged 40-60 years. Samples of fasting blood were taken to determine concentrations of leptin and adiponectin of serum and bone mineral density was measured by the DXA method in the two areas of L2-4 and the femoral neck. Food intake was documented using questionnaires including frequency of food and was analyzed by FP2 Software. Results: Leptin had a negative relationship with energy intake, protein and magnesium and a positive relationship with carbohydrate; there was a positive relationship between adiponectin and energy and carbohydrate. BMD of femur had a negative relationship with energy and carbohydrate, while it had positive relationship with calcium, and there was direct and significant relationship between BMD of the spine and zinc. Conclusion: Increase in consumption of carbohydrate and decrease in consumption of protein lead to increase in leptin. Consumption of calcium and zinc can have a protective effect on bones.

Introduction: Obesity is associated with a number of endocrine and metabolic abnormalities. Leptin is a peptide that is strongly correlated with adiposity and is a potential determinant of obesity and its complications. The aim of this study was to evaluate the relationship between serum leptin levels with anthropometric and hormonal factors in healthy women with different grades of obesity. Material and methods: This cross- sectional study enrolled 38 women with BMI ranging between 18.9-24.9, as the normal weight group, 35 women with BMI 24.9-29.9, as overweight, 37 women with 29.9-34.9, as obese grade I and 34 women with BMI 34.9-39.9, as obese grade II. Body Mass Index was defined as the weight in kilograms divided by the square of the height in meters. Serum levels of dehydroepiandrosterone sulfate, insulin, cortisol and Leptin were measured by commercially available enzyme immunoassay kits. Results: There was a dramatic, continuous increase in serum leptin concentration when the degree of obesity was increased and concordance was seen with serum insulin concentrations. There was a direct and significant correlation between serum leptin concentration and BMI in obese subjects(r=0.736, P<0.001). We found significant correlation between dehydroepiandrosterone sulfate concentrations and cortisol (r=0.237, P<0.05). There was a significant negative correlation between leptin and insulin in grade 2 obese subjects(r=-0.566, p<0.05). and a significant positive correlation between cortisol and dehydroepiandrosterone sulfate in grade 2 obese subjects (r=0.610, P<0.001). Conclusion: Serum leptin levels continuously rose with increasing degrees of obesity and serum leptin concentrations were strongly correlated with BMI. Concentrations of insulin and cortisol increase with increasing serum leptin levels.

Introduction: Obesity and overweight are major underlying factors for many chronic diseases. Considering the increasing obesity among people with low levels of physical activity especially administrative personnel, assessing obesity prevalence and its relationship to lifestyle patterns in sedentary jobs plays a key role in finding appropriate solutions for this problem. Material and Methods: All male personnel working in administrative posts at Jondi-Shapour University of Medical Sciences filled out questionnaires on some aspects of their lifestyles; their anthropometric data were also obtained. Study variables were body mass index (BMI), body fat percent (BFP), physical activity patterns, smoking and drug usage. Body fat percentage was measured by the BIA method using on Omron BF-300 analyzer. Statistical data were analyzed by ANOVA, t-and Pearson coefficient tests using SPSS version 11.5. Results: Prevalences of overweight and obesity among male personnel were 26 and 52 percent, respectively. Seventy-one percent reported no exercise in their daily activity. A significant reverse relationship was found between physical activity and BMI, BFP and waist circumference (r=-0.31, -0.32, -0.34, respectively, P<0.001). Ninety-five percent used to go to work driving their own vehicles or using public transportation. There was a significant relationship between the ways they attend their work, BMI, and BFP. BMI and BFP were significantly higher among older subjects. No significant relationship was found between subjects’ BMI and their ethnicity, education levels, smoking habits, drinking tea and coffee, working period, having breakfast and drug usage. Conclusion: Considering the association between low physical activities and high BMI and BFP, it is suggested that university personnel should be made aware of their daily calorie intakes and need to arrange a regular plan for their physical activity.

Introduction: The purpose of this study was to determine changes in salivary immunoglobulin A concentrations (S-IgA) & cortisol levels and any relationship between them, in adults after eight weeks of moderately intense exercise in the morning. Material and Methods: Thirty, healthy, adult men (aged 30-50 years) having a sedentary lifestyles, were randomly selected and assigned to either the control or the exercise group; their exercise program consisted of three sessions a week, for eight weeks. Each subject performed exercise at 06:00 a.m at 75% of maximum heart rate during the study, while controls continued their normal life style. Changes in fasting S-IgA concentrations and cortisol serum levels were monitored at the beginning and end of exercise at (0900) a.m following every session. Analysis of data was performed, using t-student test for comparing means of pre and post test. Pearsons correlation was used to determine any relationship between S-IgA concentration with cortisol concentration. The level of significance was chosen at P£0/05. Results: Results indicated significant changes in S-IgA concentrations in the pre and post exercise evaluations for the experimental group, while these remained unchanged in the control group. No significant differences were observed in serum cortisol levels, between experimental and control groups, without any relationship with salivary cortisol. Conclusion: Regular moderate exercise in the morning seems to enhance some factors of mucosal immune function in adults, which, in turn may contribute a decrease risk of infection.

Introduction: While missing breakfast has been known to result in declines in cognitive function, not all studies show positive effects of breakfast consumption on cognitive function. Differences in breakfast composition may account for some of the contradictory results across studies. However, since we could not find any published study from Iran investigating the effect of breakfast composition on cognitive performance, this study designed to assess the effect of 2 common Iranian breakfast foods (high carbohydrate, high protein) on the cognitive performance of elementary school children. Material and Methods: Fifty-one well-nourished children (27 girls) aged 9-11 years took part in the present study. Children consumed one of 2 breakfasts (subjects) or took no breakfast (controls) in a randomized cross-over design with one week in between for a wash-out period. The two breakfasts were high carbohydrate (60%) and high protein (25%), similar in energy and fat, but differing in carbohydrate and protein composition. Cognitive performance was assessed prior to and 30 and 120 minutes after breakfasts, using a selection of tests from the CDR standard computerized assessment system. Statistical analysis was conducted by using SPSS (version 15) and P<0.05 was considered as the level of significance. Results: Results indicated that all 3 treatments (high carbohydrate, high protein, fasted state) were followed by decline in cognitive performance in both sexes, with no significant differences between the 2 groups, in most of the tasks. Conclusion: Our results did not show the effect of breakfast composition on the memories of well-nourished children and further research should address the extent to which different types of breakfast influence different domains of cognitive function. Also quality and quantity of breakfast should be assessed besides cognition, because of their effect on mood.

Introduction: Evidence indicates that hipppocampus and activation of glucocorticoid receptors in this area are necessary for emotional learning and memory processes; also some studies suggest that glucocorticoid’s effects probably involve with processes of protein synthysis in the hippocmapus. The aim of this study was to determine the role of intrahippocampal microinjections of anisomycin [(ANS) as a protein synthysis inhibitor)] on dexamethasone-induced modulation of memory consolidation in the passive avoidance learning (PAL) task in rats. Material and Methods: In this study, 90 male Wistar rats (250–300 gr) were surgically implanted bilaterally with cannulae aimed at the dorsal hippocampus (DH) were trained in PAL task. In experiment 1. Dexamethasone (0.1, 0.5, 1 and 3 mg/kg IP) was injected immediately after training and vehicle injected into DH. In experiment 2. Anisomycin (0.5, 1: g/:l/side) or vehicle were injected bilaterally into the DH followed immediately by IP injection of Dexamethasone (1 mg/kg) or vehicle. Two days after training, retention tests were done and step-through latency (STL) and total time spent in light chamber (TLC) of apparatus were recorded during 10 min and compared with controls. Results: Data indicated that injection of Dexamethasone immediatly after training enhanced memory consolidation (P<0.01) and this effect was blocked by injection of ANS in to the DH (P<0.01). Conclusion: The findings above showed that glucocorticoids play on important role in consolidation of emotional learning and probably in processes of protein synthesis in the hippocampus may play an important role in mediating these effects.

Introduction: Impaired carbohydrate metabolism is a common finding in patients with chronic renal failure. Although intermittent hemodialysis results in a significant improvement of impaired glucose metabolism of uremia, complete normalization did not occur. Vitamin D3 deficiency, it seems is linked with disturbance of glucose metabolism. A role of vit D in endocrine pancreatic function has been suggested. The aim of this study was to determine the effects of 1.25 (OH)2D3 treatment on glucose tolerance, insulin resistance and beta cell function in hemodialysis patients.Material and Methods: Of sixty-five patients with uremia on hemodialysis, twenty –seven who had never been treated with vitamin D or related drugs and without history of diabetes were selected for this study. These patients were randomly divided to two groups. group l were treated with oral calcitriol (0.5 mcg/day ) for 8 weeks and group ll received placebo for the 8 weeks. In all cases, before and 8 weeks after treatment fasting glucose, insulin, total cholesterol, triglycerides, HDL, LDL, calcium, phosphorous, PTH, HbA1C and blood sugar after 75 gr load of glucose were measured. Insulin resistance (homostatic model assessment-insulin resistance = HOMA–IR) and beta cell function (homostatic model assessment- insulin secretion =HOMA-SECR) were calculated and results of these measurements, before and after 8 weeks, in both groups were compared.Results: In group I, after calcitriol treatment, blood sugar after 75 gr load of glucose (p= 0.045), HOMA –IR (p= 0.035), HbA1C (p=0.00), total cholesterol (p=0.037), and triglycerides (p=0.036) decreased, whereas calcium levels increased, significantly (0.014); changes in other parameters were not significant. In group II(without treatment) after 8 weeks of observation, fasting blood sugar (p=0.002), HbA1C (p=0.004), HOMA –IR (p=0.036) significantly increased and beta cell function decreased significantly (p= 0.032); again alterations in other parameters were not significant. Conclusion: These results seem to confirm that the active form of vitamin D influences glucose and lipid metabolism, by the improvement of insulin resistance.

Introduction: Hyperprolactinemia is an exclusion criterion for the diagnosis of polycystic ovarian syndrome (PSOS) in women presenting with a combination of clinical or paraclinical hyperandrogenism, menstrual dysfunction and polycystic ovaries following ultrasonography; however hyperprolactinemia is common in hyperandrogenemic women. Macroprolactinemia may account for a significant number of hyperprolactinemic sera including hyperandrogenemic women and this may lead to unnecessary diagnostic and therapeutic procedures and false exclusion of PCOS. The aim of this study was evaluation of macroprolactinemia in women presenting with hyperandrogenemic symptoms and hyperprolactinemia. Material and Methods: In a series of 200 hyperandrogenemic women, aged 14-40 years, presenting to the endocrine clinic of Ghaem Hospital between 2004-2006, serum prolactin was measured. If there was significant hyperprolactinemia (>35mg/L), they were investigated for the presence of macroprolactinemia using the polyethylene glycol precipitation test. Results: Thirty-eight (19%) patients had raised serum prolactin, of which in 9, the rise was significant. Macroprolactinemia was detected in 5, and they were diagnosed with PCOS. In the remaining 4 patients, there was true hyperprolactinemia.Conclusion: it is necessary to rule out macroprolactinemia in women presenting with hyperandrogenemic symptoms and hyperprolactinemia to prevent false exclusion of PCOS, expensive and unnecessary diagnostic procedures and inappropriate use of dopaminergic agonists.

Introduction: Diabetes Mellitus (DM) is the most common chronic and non-communicable disease, with many complications including renal failure, blindness and non traumatic amputation. Prevention of DM is possible through monitoring and control of blood glucose levels. Considering how easy home blood glucose monitoring is, we decided to evaluate the performance of two available glucometers for detection of blood glucose compared with standard laboratory methods.Material and Methods: In this study, we compared of capillary blood glucose levels of 402 patients as determined by test strips (Glucometer) with venous blood glucose levels measurements by the enzymatic method (the standard laboratory kit). Results: Of the 402 patients studied, there were 230 (57.2%) males and 172 (42.8%) females; 65 (16.2%) had past history of DM. Their mean age was 40.2 ± 14.9 years (range 3-70), mean BMI was 24.4±3.2 Kg/m2 and mean HCT was 45.4±4.1 percent. The mean blood glucose measurements reported using the Glucomen glucometer, the Prestic glucometer and the standard laboratory method were 128.0±45.2mg/dl, 127.4±45.9 mg/dL and 125.3±43.2 mg/dL, respectively with increase of HCT (polycytemia); sensivity of devices for detection of hyperglycemia (BS³126 mg/dl) was increased but specificity was decreased (64.7%).Results obtained using the 2 devices had no differences with the standard method levels.Conclusion: Good correlation was observed between the glucometer and the standard enzymatic method of blood glucose measurements, advocating usage of glucometers at home environments.