IRANIAN JOURNAL OF ENDOCRINOLOGY AND METABOLISM (IJEM)
Year:2010 | Volume:12 | Issue:4 (SN 52)|Papers Count:20

Introduction: The risk of obesity among children increases in proportion to parental obesity. This study aimed at investigating the familial clustering of central obesity and cardiovascular disease risk factors. Materials and Methods: In this observational cross-sectional survey, enrolling 787 mother-daughter pairs in three age stratum (3-9 y, 10-15 y, 16-20 y), familial associations for central obesity and cardiovascular disease risk factors were assessed. Results: Mothers with central obesity had higher probability of having daughters with central obesity compared to normal mothers (p=0.0001). Central obesity indices among daughters were positively correlated with those of their mothers (r=0.39, r=0.42 and r=0.46 for waist circumferences in the three age strata, respectively). The correlations were significant and positive between central obesity indices and systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, triglycerides, and LDL-C in mothers (r=0.34, 0.30, 0.28, 0.19, 0.32 and 0.13 respectively) and their daughters (r=0.33, 0.27, 0.17, 0.16, 0.26 and 0.20). Correlation between central obesity indices and HDL-C were negative and significant in mothers (r=-0.18) and daughters (r=-0.21). There was an increase with age in mother-daughter central obesity correlations. After subjects’ cardiovascular risk factor levels were adjusted for mother and daughter waist circumferences, the mother daughter correlations remained significant. Conclusion: The close association of central obesity indices between mothers and daughters may indicate the key role of the mother for the primary prevention of obesity and its complications, particularly in high-risk families.

Introduction: Considering the high prevalence of diabetes mellitus worldwide and in the Middle East countries and high prevalence of cardiovascular disease (CVD) in diabetic patients, this study aimed to compare different abdominal and central obesity measures, as important risk factors of CVD, for prediction of CVD in Iranian men and women with type 2 diabetes. Materials and Methods: We followed 1010 patients with type 2 diabetes for a median follow up period of almost 8 years. The hazard ratios (HRs) for CVD were calculated for a 1 standard deviation (SD) change in each anthropometric measure, using Cox proportional regression analysis. Results: A hundred and eighty-eight cardiovascular events occured in diabetic patients. In the age adjusted model, in diabetic men, waist to hip ratio (WHR), waist to height ratio (WHtR) and waist (WC) were associated significantly with CVD but in the multivariate model, only WHR was a significant and independent predictor of CVD. In diabetic women, in the full adjusted model, WHR was associated significantly with CVD. WC in diabetic women and WHtR in both genders were marginally associated with CVD. Conclusion: Central obesity measures were stronger than the general obesity parameter for prediction of CVD in adults with type 2 diabetes mellitus and WHR was the most important anthropometric measure in these patients in both genders.

Introduction: Breakfast, labeled the most important meal of the day, as part of a healthful diet and lifestyle, can positively impact children’s health and well-being. In this survey we studied breakfast eating and its association to body mass index in boy students in Zahedan. Materials and Methods: In a cross-sectional study, 1278 students were selected, using a cluster sampling. Data was collected via interviews with the students and by measuring their weights and heights to calculate their Body Mass Index (BMI). Data were analyzed using SPSS 13.0 and Chi-square test. Results: Results showed that 5.2% of the students never ate breakfast. Mean BMI was 17.24±3.29 kg/m2. Of students who skipped breakfast, 6% were overweight, and 7.5% were at risk of overweight. In the group of students who always or sometimes ate breakfast, 3% were overweight and 5.5% at risk of it. Using the Chi-square test, breakfast consumption was found to be associated with the level of school (P=0.000). Body mass index was associated with the level of school (P=0.000), and breakfast consumption (P=0.04). Conclusion: Results indicated overweight and obesity in children who skip breakfast. Parents and students should be encouraged to change inappropriate nutritional behaviours and enhance their appropriate nutritional behaviors.

Introduction: The study aimed at determining the prevalence of thyroid disorders among a pregnant population and identifying the related risk factors of thyroid dysfunction in these subjects. Materials and Methods: Between February and July 2008, a nested case-control study was conducted on 608 pregnant women in Bandar Abbas, Iran. We obtained information about thyroid dysfunction in the subject and their family, diabetes mellitus type 1, prior gestational diabetes, hepatitis B and rubella vaccination, any previous miscarriages and fifteen symptoms of hypothyroidism. T4, T3, T3RU, FTI, TPO Abs were measured and thyroid examinations were carried out. Multiple logistic regression tests were used to estimate relative risk of thyroid dysfunction for the variables. The rate of hypothyroidism was compared in groups with significant related risk factors at high or lower risk. Results: Of the 608 pregnant women, 519(85.4%) were euthyroid, 72(11.8%) had sub clinical hypothyroidism, 3(0.5%) overt hypothyroidism and 14(2.3%) were hyperthyroid. There were strong correlations between personal history of thyroid dysfunction (OR:5.23 %95CI:2.11-12.95 P: 0.00), TPO Abs(OR:2.81 CI%95:1.83-4.32 P:0.00), 3 symptoms or more of hypothyroidism(OR:2.50 CI%95:1.48-4.22 P:0.001), goiter (OR:2.24 CI%95: 1.32-3.80 P:0.002), being in the 20-30 year age range (OR:1.87 %95CI:1.004-3.51 P:0.04) and being hypothyroid in pregnancy, respectively, but not with other risk factors, especially family history of thyroid disorder. Conclusion: This study showed thyroid disorders are common among pregnant population and are correlated with personal history of thyroid disorder, TPO Abs, 3 symptoms or more of hypothyroidism, goiter and age range between 20 to 30 years old, all risk factors which should be considered at screening, in clinical practice.

Introduction: The aim of this research was comparison of multilevel and ordinary logistic regression in determining goiter related factors in children, based on hierarchical structure of the data. Materials and Methods: Data of 35747 schoolchildren, aged 8-10 years, was collected in 2007 by the Research Institute of Endocrine Sciences, Shahid Beheshti University of Medical Sciences. Stratified and cluster random sampling methods were employed in 30 provinces across the country. Goiter status, sex, area of residence, altitude from sea level and status of Iodized salt storage in households were documented. Multilevel logistic regression model was applied and the results compared to those obtained using ordinary logistic regression. Results: The study showed that 5.74% of the pupils suffered from goiter. The variance of the 2nd level (districts) was estimated as 0.941 (SE=0.092) in the two-level model (p<0.001), in which no significant relation was seen between goiter and altitude from sea level (OR=1.27; 95%CI: 0.78, 1.62). In the three-level model, the variance in the third level (provinces) was 1.031 (SE=0.287) (p<0.001). In the final three-level model, only sex and area of residence were found to be significant. Conclusion: Results showed that, compared to two and three level logistic regression models, the variances of parameter estimates are underestimated in the ordinary logistic regression.

Introduction: This study investigated the effects of frequent and current use of nutritional supplements in different sub-groups. Materials and Methods: Using a cross sectional descriptive study design, data was collected by nutrition experts, using a questionnaire, and a multistage sampling method. 1004 adults aged 18< years old, referring to 10 medical health centers in 7 areas of west in Tehran, were enrolled to participate in the study. Results: Among 1004 adults (690 female and 314 male) 81.2% were free of any chronic disease, 42% had been using nutritional supplements in last 12 months, including multivitamin, mineral supplement or a combination of these. Nutrition supplement intake was more frequent in women (88.7%), than in men (11.3%) (Significant difference). There were significant differences between age groups, adults £30 years old and women being more frequent users. Of subjects, 38% took multivitamin or combined vitamins and minerals, 30.1% used Ca+D, supplemental Fe 27.1% Fe or a combination, and 4.9% used Omega-3 fatty acids or other fish oil supplements. There were significant differences between the physiological statuses in women supplement users; 67.7% were pregnant or nursing mothers. Adults aged £30 years comprised most supplement users. Nutritional supplements in 75.5% were prescribed by physicians or dietitians. Conclusion: Use of nutritional supplements is more common among women and pregnant or nursing mothers. Most frequent supplements used were multivitamins or vita/minerals.

Introduction: Most population based studies confirm that hypertension increases an individual’s risk of various cardiovascular consequences approximately two or three fold. The purpose of this study was to compare of the effect of aerobic training with diet and diet on cardiovascular risk factors and blood pressure in overweight and obese women with hypertension (stage one).Materials and Methods: Twenty-one female volunteers, with stage one hypertension were selected, and after completion of questionnaires, were randomly divided into two groups; a) aerobic training with diet group (n=11) and b) diet group (n=10). The first group participated in weekly group sessions for instructions on just weight loss (low calorie diet) with exercise. The second group participated in weekly group sessions for instructions on weight loss (low calorie diet). Blood pressure, anthropometric characteristics, metabolic and hormonal profiles and VO2peak were measured in the first, 8th and 16th sessions. Data were analyzed by GLM-Repeated Measures at a significance level of P<0/05. Results: Both groups showed a significant reduction in weight, BMI, body fat percent, mean arterial and systolic blood pressure and an increase in VO2max. Only the first group (aerobic training with diet group) showed a significant decrease in waist circumference, diastolic blood pressure, cholesterol and an increase in renin levels. Conclusion: Results indicate the combined program (aerobic training with diet) is more effective in lowering blood pressure and provides cardiovascular improvements in overweight/obese women who have stage one hypertension.

Introduction: In many countries around the world, diabetic nephropathy is the most common cause of renal transplantation and dialysis. One third of diabetic patients suffer from kidney diseases which, in turn, considerably increase mortality rates and treatment costs. The aim of this study was to compare graft survival rate in diabetic and non-diabetic patients in the Shiraz Namazi Hospital Transplant Center, during the years 1999 to 2009. Materials and Methods: This study was a retrospective cohort study that investigated graft survival rate among diabetic patients who had undergone kidney transplant and compared it with that of non-diabetic patients, in the Transplant Center of Shiraz Namazi Hospital. The Kaplan-Meier method was used to calculate the survival rate and Log-rank test was applied to compare survival curves. Furthermore, to model the factors affecting survival rate, Cox proportional hazard model was implemented. Results: The results of the study revealed that the average follow-up period of patients was 48.15±31.05 (range: 3.07- 118.03) months. The estimated 9-year graft survival rates among diabetic and non-diabetic patients were 84.2% and 85.7%, respectively. Moreover, using Cox proportional hazard model, it was found that the age of a donor <40 years, is an effective factor for higher graft survival rate in diabetic patients. Conclusion: Based on the results of this study, we observed that there was no significant difference between kidney transplant survival rate in diabetic and non diabetic patients. This treatment method can hence be a good option for patients with diabetic nephropathy.

Introduction: Recently osteoporosis (OP) has emerged as a basic public health problem. It is characterized by low bone mass with micro architectural destruction of bone, resulting in increased bone fractures, morbidity and mortality. Materials and Methods: To evaluate the prevalence of OP using the local reference data of rural males of Fars and to compare it with WHO criteria, a total of 263 male adults, aged between 20-94 yrs, participated in this cross-sectional study. Bone Mineral Density (BMD) was measured by DXA. We utilized a fit curve method to determine the best age range over which to calculate Peak Bone Mass (PBM) and we used regression analysis for association of OP with age and Body mass index (BMI). Results: PBM was observed at the age range of 20-24 years, at the various sites. The prevalence of OP increased with age. It was negatively correlated with BMI and varied dramatically based on local versus WHO criteria. Based on local criteria, prevalence of OP in the lumbar spine, femoral neck and total femur were 3.8%, 24.8% and 14.8%, respectively, and, based on WHO criteria, they were 10%, 6.1% and 24%, respectively. Conclusion: Using local or WHO reference values for evaluation of OP may yield different prevalences. Therefore prospective fracture studies in correlation with the two above reference values are recommended.

Introduction: The purpose of this research was to study the effect of eight weeks of aerobic and progressive exercises on blood estrogen and other factors affecting bone density in postmenopausal women. Materials and Methods: Twenty postmenopausal women, with average of age and height and weight of 51/05±0/22yr, 164/5±1/09cm and 67/30±0/85 kg respectively, who had no regular daily physical activity, voluntarily participated in the study. Subjects were randomly divided into two the experimental and the control, groups. Experimental group excercises included eight-weeks of aerobic interval running three sessions per week, with progressive intensity and time. Blood and urine samples were taken before starting the exercise period, to calculate levels of estrogen, calcitonin, paratormon hormones, calcium and phosphorus from the former, and levels of calcium and phosphorus from the lather. Results: Eight weeks of progressive and aerobic exercises caused a significant change in the amount of estrogen(17.6±4.22 to 27.9±8.64), parathormon(20.8±3.58 to 19.2±1.98) hormones, blood calcium (9.44±0.24 to 8.8±0.71), phosphorus (3.87±0.38 to 4.23±0.25) and urine phosphorus(61.22±4.43 to 42.16±10.06), whereas no significant change was seen in the amount of calcitonin hormone (3.94±3.36 to 4.84±1.96) and urine calcium (9.74±0.68 to 9.35±1.30) Conclusion: Based on the results, it seems that long progressive physical exercises, especially weight bearing ones, can be effective in increasing the estrogen level, thereby preventing ostheoprothesis, and also preserving bone salts(calcium and blood phosphorus), by causing hormonal changes effective on these salts(calcitonin and parathormone).

Introduction: This study aims at investigating the effect of vitamin-mineral supplementation on oxidative stress and plasma cytokine response after strenuous training periods in female elite swimmers. Materials and Methods: Twenty-four elite female swimmers volunteered to participate in this study and were randomly divided into two groups, the experimental (Vitamin-mineral supplemented) and the control (Placebo). Both groups were in monthly swimming programs, 3 times a week, for a total of 4 weeks and swimming, almost 3.5 to 4 km/d. Blood sampling was done before and after the training period to assess inflammatory cytokines such as IL-6 and TNF-a, and also MDA. 100 m crawl records were measured at the beginning and the end of the training period. Results: Results showed that inflammatory cytokines decreased significantly in the vitaminmineral supplemented group, and MDA decreased, though not significantly, in this group. There was no significant change between the groups. No significant change was observed in swimming performance in either group. Conclusion: In conclusion, ROS was found to affect exerciseinduced cytokine production, in which vitamin-mineral supplementation was found to play an effective role.

Introduction: The purpose of this study was to determine the response of some immune and inflammatory markers of cardiovascular disease to a single, short intense duration of exrcise, in prepubertal overweight boys exercise. Materials and Methods: To do this, 13 students 11-14 yearsold were selected randomly from among voluntary subjects. In the preliminary session VO2max (26.9±4.9 ml/kg/min), weight (77.07±17.33 kg), height (1.65±0.08), fat percent (31.7±5.6 percent), percent), body composition, BMI (28.9±3.5 kg/m2), skeletal age (12.4±0.9 years) with X-ray, pubertal age with Tanner-stage (T3, T4) was measured and determined familiar illness was done four day before experimental session. In the experimental session, firstly, pre-exercise blood sample collected in fasted state, and then every subject on the ergometer cycle started cycling with 65- 70% VO2max for 40 min, post 5 min warming, with 5 min cool down at the end of the program. Immediately post-exercise and recovery blood samples were drawn for measurement of plasma leukocyte, C-reaction protein and IL-6. Plasma CBC and its subgroups were measured by a cell counter employing Isotone Soluble technique, while for hs-CRP and IL-6, we used the immunometric assay Eliza kit. Data were analyzed using the analysis of variance with repeated measures (R-ANOVA) test. Results: The results showed there was a significant relation between different blood samplings. The post hoc (LSD) test that showed neutrophils count and hs-CRP and IL-6 levels one hour after exercise statistically was more than pre-exercise (p=0.001, 0.01, 0.01, respectively) also lymphocyte, monocytes, neutrophils counts and IL-6 level immediately postexercise (p=0.05, 0.01, 0.004, 0.01, respectively). Exercise may initiate the response of inflammatory and immune factors in prepubertal obese boys, and increase levels of these factors. Conclusion: This study indicates that a single intense bout of exercise with 65-70% Vo2max can increase subgroups of with blood cells, C-reactive protein and IL-6 in immature obese and overweight children, intense exercise can be activate immune and inflammatory system and increase levels of some of the cited factors.

Introduction: Adipose tissue secretes multiple proteins known as adipokines that modulate various biological functions. The present study was designed to determine the effect of resistance exercise intensity on leptin, adiponectin and the insulin resistance index in young healthy men. Materials and Methods: Fifteen healthy male subjects (Mean±SD; age 26.2±4.1 years; weight 75±9.1 kg; height 174±7.0 cm) voluntarily participated in the study. After two familiarization sessions and determining of maximal strength, all subjects completed three resistance exercise trials at an intensity corresponding to 30%, 55%, and 80% of 1-RM randomly. The three resistance exercise protocols included the performance of 1) 3 sets of 20 repetitions at 30% of 1-RM, 2) 3 sets of 11 repetitions at 55% of 1-RM, and 3) 3 sets of 7 repetitions at 80% of 1-RM. All exercise trials were equated for volume and one minute rest was allowed between exercises and sets. Two blood samples were obtained before exercise and immediately after exercise and analyzed for leptin, adiponectin, plasma insulin and glucose. To determine the effect of resistance exercise intensity, data were analyzed using two-way repeated measures of ANOVA. Results: Data analysis revealed that resistance exercise increases adiponectin (F1,12=47.2), insulin (F1,11=19.7), glucose (F1,13=9.6), concentrations and the insulin resistance index, while reducing the leptin concentration (F1,12=31.1) significantly. However, resistance exercise intensity had no significant effect on any of the above variables (P>0.05) except for leptin concentration (F2, 24=5.5, P=0.01). Conclusion: Based on the findings of the present study it could be concluded that resistance exercise induces significant changes in adipokines and insulin resistance index but when the resistance exercise volume is equal, except for changes in leptin, these changes are not related to the intensity of exercise. 

Introduction: Considering the antioxidant properties of Otostegia persica extract and role played by antioxidant agents in the improvement of diabetes mellitus, this study investigated the effect of its methanolic extract on serum levels of glucose and lipids in type I diabetic male rats. Materials and Methods: Type I diabetes was induced in male Wistar rats by injection of 70 mg/kg, i.p of streptozotocin. Before and 5 days after injection, fasting blood samples were collected for measurement of glucose and lipids serum levels. Diabetes was confirmed in rats having FBS above 250 mg/dl. Diabetic rats were divided to 15 groups receiving 100, 200 and 300 mg/kg extract, glibenclamide (600 2g/kg) and distilled water (0.5 ml) daily for 3, 6 and 14 days, individually by gavage. Fasting blood samples were collected at the specified time points and serum levels of glucose, cholesterol and triglycerides were measured, using commercial kits by spectrophotometery. Results: Treatment of diabetic rats with O. persica extracts (100, 200 and 300 mg/kg) for 6 and 14 days and at 300 mg/kg for 3 days significantly decreased glucose serum levels. Also extract at different doses for 3, 6 and 14 days significantly decreased cholesterol and triglycerides serum levels. Extract was more effective than glibenclamide in reducing glucose and triglycerides serum levels in diabetes. Conclusion: Otostegia persica extract has antihyperglycemic and antihyperlipidemic properties in diabetic rats.