Iranian Journal of Endocrinology & Metabolism
Year:2001 | Volume:3 | Issue:2 (SN 10)|Papers Count:11

Iodine deficiency disorders are usually found in the countries with malnutrition problems. One of the most important problems of malnutrition is iron deficiency, which can affect thyroid metabolism and it may decrease the effect of iodine supplementation. This is a cross-sectional study to determine serum ferritin concentration and its association with the prevalence of goiter, urinary iodine and thyroid function. Schoolboys and girls aged 8-10 years were equally and randomly selected from 26 provinces of the country. In total, 36178 schoolchildren were assessed for goiter. Blood and urinary samples were taken randomly from 10% of the subjects for the measurement of T4, T3, TSH, T3RU, ferritin and urinary iodine. The prevalence of goiter was more than 50% in 6, 40-50% in 7 and less than 40% in 13 provinces. Changes in ferritin concentration in these 3 groups of provinces were not statistically significant. The median urinary iodine excretion was more than 50 in 4, 30-40 in 2, 20-29 in 11 and 13-20 µg/dl in 9 provinces. The mean serum ferritin value was higher in the provinces where the median urinary iodine value of schoolchildren was desirable (13-20 µg/dl) than the provinces where the median urinary iodine value of schoolchildren was more than 20 µg/dl (P<0.001). There was a significant difference in the prevalence of goiter in schoolchildren with serum ferritin above 10 µg/dl and those with serum ferritin below 10 µg/dl (20% vs. 80%, P<0.0001). Serum ferritin was significantly correlated with T3RU, T3 and FT3I (P<0.05). The data shows that goiter is more prevalent in schoolchildren with low serum ferritin, but there is an unimportant change in thyroid function. Low serum ferritin may impair the efficacy of iodized salt supplementation in reducing goiter size. Therefore, we suggest that iodized salts with Dextran-coat should be considered in the national IDD program.  

The present study was designed to explore the influence of route of delivery on fetal pituitary-thyroid axis. The endocrine profiles (umbilical venous plasma) of three groups of term infants were compared immediately after delivery. Samples were taken after 30 vaginal deliveries, 30 emergency cesarean during labor and 30 elective cesarean sections before labor. The study was performed in Kowsar hospital. The samples were matched based on parity, age, gestational age, and none of them had previous history of medical complications. Measurement of hormones was done using RIA. The mean cord serum TSH level of fetuses in vaginal or emergency cesarean group was significantly lower than that of fetuses in elective cesarean one (P<0.0001) (3.3±1.8mlu/mL, 9.0±3.2 mlu/mL, 12.1±6.4 mlu/mL respectively). The mean cord plasma concentration of T4 and T3 were significantly higher after elective cesarean section compared with the two labor groups (P<0.05). (T4: 7.4±1.3 µg/mL, 7.4±2.4 µg/mL, 8.5±1.3 µg/mL) (T3: 0.51±0.16 ng/mL, 0.62±0.12 ng/mL, 0.76±0.2 ng/mL). These results suggest that labor reduces plasma thyroid hormone concentration at birth. These adaptations seems to be as a stimulus for the subsequent surge in T3 previously reported to occur over the first few hours after birth in vaginally delivered infants.

This study aimed at assessing changes in thyroid hormones in women with preeclampsia. Thirty-nine patients, 17 with mild preeclampsia and 22 with severe preeclampsia were compared with 42 healthy pregnant women with a gestational age over 20 weeks, regarding free T4, free T3, T3 resin uptake, T4, T3, TSH, free T3 index (FT3I), free T4 index (FT4I), and thyroid binding globulin. Mild preeclampsia was associated with higher serum TSH and lower T4, FT3I and FT4I (P<0.002). In patients with severe preeclampsia FT4 and TSH were higher than healthy pregnant women (P<0.04). It seems that thyroid dysfunction, in mild preeclampsia, is in the form of decreased thyroid hormones and increased TSH, and as toxemia progresses, free thyroid hormones increase significantly. To interpret these findings, the role of systemic illnesses, increased hCG, acute hepatic failure, previous thyroid dysfunction, and other factors must be considered. To establish a causal relationship between these changes in preeclampsia, more extensive research is necessary.

Sexual hormones have important role, in skeletal development and maintaining bone balance. There is little information on effects of testosterone on bone repair. In the present study the effects of testosterone on bone and its repair were studied. Sixty male wistar rats, 12-14 weeks old, weighing between 250-300gr were randomly divided into four groups. The first group were not gonadectomized and did not receive testosterone. The second group were not gonadectomized but were treated with testosterone. The third groups were gonadectomized and treated with testosterone. The fourth group gondectomized but did not receive testosterone. A hole was made on the medial surface of right tibia in all rats. The dose of testosterone was 1mg/kg I.P daily for 3 weeks, at the end of which all rats were killed by ether inhalation. A bone sample was extracted from each rat and was fixed, decalcified, processed, sectioned and was stained by H & E and Trichrome Mason methods. Sections were examined descriptively and quantitatively by light microscopy. Data were analysed by student’s t test and analysis of variance methods. Results showed that in rats treated with testosterone, the rate of bone repair were accelerated, bone density in the defect region was increased, number of osteoblasts were increased (31.3±2.25), and number of osteoclasts were decreased significantly (1.90±0.9). Also, the thickness of periosteum in the region of defect was increased markedly, and dimension and weight of bone were increased significantly (P<0.001). It is concluded that testosterone has positive effect on accelerating bone repair in male rats.

Hypo and hyperthyroidism can both cause mental disorders, but the effects of psychiatric disorders on thyroid function has not been determined. In acute psychosis, thyroid function tests are temporarily impaired. So that total and free T4 are increased in 35% and 20%, respectively, and TSH and T3 are changeable. All patients with different acute psychiatric disorders were studied. These included 144 patients (80 female, 64 male, aged 27.88±10.67 and 27.69±9.19, respectively). Patients were evaluated according to disease type, drugs, and the presence of goiter, and thyroid function tests were done during the acute attack. The tests were repeated 3 weeks later in those with abnormal results. 21 patients (14.5%) had abnormal TSH during disease attack. TSH was suppressed in 14 (TSH<0.3 mU/L, mean: 0.121±0.043), and increased in 7 (TSH>5.5 mU/L, mean: 13.8±10.8). T4 level was abnormal in 13 patients (9%), 12 of whom had high T4 (T4>12.8 ?g/dl, mean: 16±3.85) and 1 had low T4 (T4<4.8 ?g/dl). In eleven patients (8%) T3 was increased (T3>3nmol/L, mean: 5.8±3.08). Ten patients (7%) had abnormal FTI; FTI was increased in 8 (FTI>4.4, mean: 7.55±1.66) and decreased in 2 (FTI<1.2, mean: 0.18±0.08). 7 patients had thyroid dysfunction (4 hyperthyroid, 3 hypothyroid) at the time of diagnosis of psychiatric disorder. When these were excluded, 14 patients (9.7%) with acute psychosis had abnormal TSH (suppressed in 10 and above normal in 4) and T4, FTI and T3 were abnormal in 8 (5.5%), 4 (2.7%), and 7 (5%) patients, respectively. Three weeks later, all thyroid function tests returned to normal. The prevalence of hyperthyroxinemia in acute psychotic patients was 2.7% in this study, which is much less than other studies. In management of acute psychosis, thyrotoxicosis must be considered as a possible cause of psychosis.

Zinc deficiency could be a cause of growth retardation in children with insulin dependent diabetes. In this study 20 diabetic children (11-15 years old) who were under 5th percentile of weight and height for their age were enrolled. None of this group of patients had the signs of sexual maturity. Not any underlying disease such as urinary tract infection or hypothyroidism was detected. The patients were randomly divided into two groups of 10 patients. 10 patients were treated with daily zinc sulfate equal to 25mg. Height, weight, blood sugar and HbA1C were measured at the onset of study, three and six months after treatment with zinc. The other 10 patients were followed as the control group. Mean blood sugar and HaA1C at the onset of study, followed by three and six months later are as follows: (150±30mg/dL, 6.7±3.4%), (140±28 mg/dL, 7±2.3%) and (158±25mg/dL and 6.4±3.8%). According to SDS formula the velocity of increase of weight and height was significantly more in the treated group compared with the control group (P<0.001). Oral zinc therapy is recommended in growth retarded diabetic children to accelerate the growth velocity.

Due to high prevalence of diabetes and the importance of controlling biochemical parameters in diabetic patients and effect of Ramadan fasting on them, we conducted this study in diabetics of Islamshahr. Forty-nine volunteer diabetics (30 women and 19 men) aged 32-67 years (mean±SD: 47±9 years) were selected randomly. Each patient filled an individual questionnaire. Blood samples were taken 2 months before, during the last week of, and 2 months after Ramadan. RAXT auto-analyzer was used to test blood sugar, triglycerides, cholesterol, uric acid, urea and creatinin. Height and weight were measured and BMI was calculated. Blood pressure was obtained in sitting position. Paired t-test was used for analysis. Sixty-three percent of studied subjects had a positive family history. Mean BMI value was 29.6±4.8, 29.2±4.4 (P<0.005) and 29.1±14.3 (P<0.001, compare with before Ramadan) before, during and after Ramadan, respectively. Mean systolic blood pressure value was 139±23, 137±20 and 130±20 (Ns, compare with before Ramadan) before, during and after Ramadan, respectively. The prevalence of diastolic blood pressure more than 89 mmHg was lower during Ramadan in comparison with before and after it. Mean fasting blood sugar increased during Ramadan (202±76 mg/dL) in comparison with before (163 ± 53 mg/dL, P<0.0001) and after (186 ± 60 mg/dL, p<0.05) it. Mean serum triglycerides, cholesterol and uric acid decreased during Ramadan (243 ± 130 vs. 340 ± 228 mg/dL, p<0.005), (222 ± 43 vs. 258 ± 56 mg/dL, P<0.0001) and (4.5±1.4 vs. 4.9±1.2 mg/dL, P<0.003) in comparison with before it, respectively. During Ramadan, the prevalence of abnormal serum cholesterol concentration decreased to lower than half of its prevalence before it. Also, abnormal serum triglycerides was observed less during Ramadan. Any statistical difference was not detected in urea and creatinin before, during and after Ramadan. We concluded that Ramadan fasting is not harmful, but instead it is beneficial by reducing weight, blood pressure, serum cholesterol, triglycerides and uric acid for improvement of patients with diabetes type 2.

In our study, in addition to determination of frequency of appearance of aggravation of diabetes in our patients, we considered suggesting some risk factors which can predict the appearance of aggravation of diabetes in order to control the diabetes in its early stages. Recorders of 127 patients who had been transplanted in Sina hospital during years 1376-78, were studied. Patients were divided into 2 general groups before transplantation: diabetic and non-diabetic. The frequency of appearance or aggravation of diabetes in each group was determined and in each case, its distribution according to age, sex, blood levels of cyclosporine, Cholesterol, TG, Cr, duration of dialysis, acute rejection and source of transplanted kidney was determined. Graft survival after one year was also determined. Before transplantation, 7 patients had diabetes. In non-diabetic group, 14 patient (11.7%) had got diabetes. By increasing age, duration of dialysis, blood levels of cyclosporine, cholesterol, creatinin and also female sex, the percentage of appearance of diabetes was higher. In diabetic group, all the patients (100%) had aggravation of diabetes. All these diabetic patients and also those who had post transplantation diabetes, had functioning graft after one year and no acute rejection was seen. The source was living donor in former patients. Relative frequency of post transplantation diabetes appearance and aggravation was 11.7% and 100% respectively. It is probable that variables such as blood levels of cyclosporine, cholesterol, creatinin, duration of dialysis, sex and age can be used as predictors of appearance or aggravation of diabetes in transplanted patients. If it becomes true, early diagnosis and treatment of diabetes will be held in order to give and end to the effects of diabetes in transplanted patients.