Iranian Journal of Endocrinology & Metabolism
Year:2003 | Volume:5 | Issue:2 (SN 18)|Papers Count:9

Introduction: There are few studies about the relationship between dairy products consumption and BMI. This study was conducted to assess the relationship between milk consumption and body mass index in a group of Tehranian adults, selected from participants of the Tehran Lipid and Glucose Study (TLGS). Material and methods: 404 subjects (202 men and 202 women) aged over 16 years were included in this study. Dietary data was collected by means of a qualitative food frequency questionnaire for one year and two 24-hour dietary recalls. Height and weight were measured according to standard protocols and BMI was calculated. Mean (±SD) of age and BMI for men and women were 36±15 and 31±13 years and 24.6±4.5 and 24.9±5.1 kg/m2, respectively. Frequency of milk consumption was 15.1±13.4 and 14.8±13.7 times per month in men and women, respectively. Subjects with a frequency of ≥30 times per month, had a lower weight (67.1 ±1.5 vs 75±1.1 kg for men and 59±1.6 vs 66.4±1.2 kg for women, p<0.01 for both) and BMI (22.4±0.5 vs 25.6±0.3 kg/m2 for men and 23.6±0.4 vs 26.1±0.5 kg/m2 for women, p<0.01 for both) than persons with the frequency of < 10 times per month, after adjusting the effect of age, energy, carbohydrate and fat intake. The proportion of subjects consuming milk with a frequency of <10 times per month was higher among persons with BMI ≥30 than among persons with BMI<25 (51% vs 11% for men and 52% vs 14% for women, p<0.05). In contrast, the proportion of subjects with milk consumption frequency of ≥30 times per month were higher than persons with BMI≥30 (61% vs 7% for men and 58% vs 11 % for women, p<0.05). The results suggest an inverse relationship between milk consumption and body weight and body mass index. It is recommended that further studies address this issue by adjusting for effect of physical activity.

Introduction: Decreased serum retinol concentrations accompanied with increased hepatic retinyl ester levels have been shown in patients with type 1 diabetes mellitus (T1DM). It seems, therefore, that metabolic availability of vitamin A is impaired in T1DM. Since exogenous insulin acts as a key releasing factor for hepatic stores of vitamin A, it can be assumed that insulin insufficiency will affect both serum retinol and metabolic control indices at the same time. This study was designed to determine serum retinol level, its importance and correlation with routine metabolic control indices in a group of children with T1DM. Material and Methods: Fasting blood samples were drawn from 24 children (6-14 years old) with at least 1.5 years history of T1DM. Patients who were chosen, did not have any other systemic disease, thyroid disorder, or chronic complications of diabetes, like nephropathy, retinopathy, neuropathy, etc. Serum retinol, FBS, HbA1c, total cholesterol (TC), HDL-C and triglyceride levels were measured. LDL-C was calculated. Calculation of Pearson correlation coefficients and regression analysis were done by Excel software. Results: Mean ± SD of serum retinol level was 0.375 ± 0.068 μg/ml (1.313 ± 0.238 μM). Pearson correlation coefficients between fasting serum retinol and FBS, HbA1c, TC, HDL-C, LDL-C and TG levels were - 0.27, -0.08, 0.60, 0.21, 0.29 and 0.02, respectively. None, except TC (P<0.002), was significant. Conclusion: Serum retinol levels in children with T1DM were within lower limits of normal range. There was a linear correlation between serum retinol and TC levels. Therefore, it seems that routine metabolic control indices, except TC, cannot be used to predict serum vitamin A status in patients with T1DM

Introduction: Children with two obese parents have a higher risk of obesity than those with one or neither parent obese. This study was conducted to clarify the hypothesis that parent's dietary intakes are associated with their offspring(s) body mass index. Material and Methods: This is an analytical cross-sectional study among inhabitants of district-13 in the east of Tehran. A total of 117 healthy families comprising 474 subjects with 240 offspring (3-25 years old) were studied. Weight and height were measured by a standard protocol and body mass index (kg/m2) was calculated. Dietary intakes were assessed by means of a two-day dietary recall questionnaire. Results: The prevalence of overweight was 11.8% in offspring of normal weight parents, 19.0% in offspring of overweight fathers and normal weight mothers, 25.4% in offspring of overweight mothers and normal weight fathers and 40.8% in offspring with both parents overweight. The offspring(s) overweight was significantly and independently associated with high energy intake of both parents (odds ratio= 2.7; 95%CI: 1.6-4.5). Adjusted for the sex of parents, the chances of offspring being overweight were higher in overweight (OR= 3.8; 95% CI: 1.5-9.2) and high energy intake mothers (OR= 2.6; 95%CI: 1.2-5.6) and high energy intake fathers (OR= 2.0; 95%CI: 1.1-3.9) as compared to children of normal parents. High fat intake of husbands was an independent risk factor, increasing the chances of their wives being overweight (OR= 2.1; 95%CI: 1.5-3.6) and vice versa (OR= 1.8; 95%CI: 1.2-2.8). Conclusion: The observed familial obesity pattern was shown to be associated with the familial dietary intakes. Hence, familial intervention seems essential to stop the accelerated rise in the prevalence of overweight and obesity in our community.

Introduction: Clinical lore has long suggested that opiates produce hyperglycemia in normal subjects but it has been shown that peripheral administration of morphine can decrease glucose levels in obese diabetic subjects. It has been shown recently that some adipose-derived peptides such as TNF-alpha and leptin are major factors in insulin resistance in obese diabetic subjects. Material and Methods: In this study we decided to determine the effect of peripheral administration of 10 mg/kg morphine on some of adipose derived factors (Ieptin , TNF- a) in 8 diet-induced obese rats (DIO rats). The control group were injected equal volume of saline. Results: Peripheral administration of morphine significantly increased serum insulin levels 30 minuets after injection (p< 0.05). Serum TNF-a levels were significantly suppressed 30 minutes after injection (p< 0.05) but leptin levels decreased 60 minutes after injection (p < 0.05). Serum level of free fatty acids significantly decreased up to 120 minutes after injection (p < 0.05). Serum glucose levels were not affected by morphine in comparison with controls. Conclusion: It has recently been shown that sensitivity of a-2 adrenergic receptors are increased in peripheral tissues of obese patients. Since cAMP is the main regulatory factor of TNF- a, leptin and FFA production in adipocytes, morphine may decrease a - 2 adrenoceptor sensitivity in adipose tissue and increase cAMP levels in adipocytes.

Introduction: Foot problem in diabetic patients is one of the most common and serious chronic complications and is considered to be a consequence of peripheral neuropathy, peripheral vascular disease and immunopathy. The aim of this study was to compare the efficacy of local epidermal growth factors (EGF) and placebo therapy to facilitate wound healing in diabetics with foot ulcer. Material and Methods: This study was a single-blind placebo-controlled trial. Thirty diabetic patients (14 females and 16 males, aged 27-77 years) were treated with EGF and 10 diabetic patients (3 females and 7 males, aged 32-75 years) with placebo. Both groups received debridement, scrubbing with normal saline, systemic antibiotic therapy and bandage with EGF or placebo daily and were followed for 4 weeks. Ulcer closure (%) was calculated by use of an equation [(Final - initial-size)/initial size] × 100. Results: After 4 weeks, mean closure was significantly higher in EGF group compared with placebo (71.2% Vs 48.9%, p<0.03). 100% closure was observed in 7 patients (with 30 ulcers) from EGF group and in one patient (with 12 ulcers) from placebo group. EGF showed a greater efficacy in ulcer healing (RR=3.4, 95%CI: 1.84-13.61). Conclusion: This study showed that EGF was significantly superior to placebo in ulcer healing. As a result, use of EGF appears to be helpful to diabetics with foot ulcers.

Introduction: The role of magnesium in type diabetes is the aim of this investigation. Gestational diabetes is the first presentation of diabetes and it is recognized by impairment of glucose metabolism (OGTT). We can use these individuals as a tool to study the interaction of magnesium and carbohydrate metabolism and extrapolate these results to the diabetes mellitus. Material and Methods: In this study, diagnosis of gestational diabetes was made in 620 pregnant women (by NDDG method). These women were referred to three hospital affiliated to Tehran University of Medical Sciences. 16 individuals (2.58%) had impaired oral glucose tolerance, so they were diagnosed as gestational diabetes. Of these individuals, 13 had risk factors such as age (over 30 years) and obesity (BMI>29). Serum and RBC magnesium, albumin, and total protein of these individuals were measured between 30-32 week of pregnancy and compared with 38 no pregnant women. Results: There was a significant decrease in serum and RBC magnesium of pregnant group compared to non pregnant, and the gestational diabetes compared to the normal pregnant group (p<0.05). Total protein of the groups of non pregnant, pregnant and gestational diabetes were 6.8±0.28, 6.24=0.28, 6.09±0.18 gr/dL, respectively, which shows a significant decrease of total protein of pregnant individual compared to non pregnant individual, but there is no significant difference between pregnant individual and gestational diabetes. Albumin concentrations of non pregnant, pregnant and gestational diabetes groups were 4.2±0.39, 3.82±0.29, 3.37±0.3 gr/dL, respectively, which showed significant decrease in pregnant group compared to the others groups. Conclusion: Severe hypoalbuminemia can be an effective factor for hypomagnesaemia in gestational diabetes.

Introduction: Previous studies have reported different results in the serum levels of T3 and T4 in people fasting. We investigated the effects of Ramadan fasting on serum levels of T3, T4, T3RU, TSH, FT3, and FT4. Material and Methods: This study was a quasi-experimental study performed on 52 male and 46 female healthy volunteers who fasted at least 25 days during Ramadan, 11.5±0.5 hours each day. Blood sampling was done in three sessions: one week before and on days 14th and 28th of Ramadan. Results: Both total T3 and free T4 levels decreased significantly. Mean FT3 level decreased from 153.5±25.7 ng/dL before Ramadan to 129.1±22.7 ng/dL on 28th of Ramadan (p<0.001), and T 4 decreased from 8.5±1.5 μg/dL to 7 .5±1.3 μg/dL in the same period (p<0.001). FT3 levels showed an initial increase by day 14 with subsequent return to the previous levels (p<0.001).FT4 levels decreased significantly only in male subjects (1.3±0.4 μg/dL to 1.2±0.3 μg/dL. P=0.01). There was no significant change in the level of T3RU. Finally, a mild decrease was observed in TSH levels. Conclusion: All changes were within normal limits.

Hypophosphatemic bone disease (HBD) is a phosphopenic rickets accompanied by hypophosphatemia, hyperphosphaturia with no roentgenographic evidence of rickets. This is the report of a girl and his father who have this disorder. A 7.2-yr-old girl visited the hospital because of short stature. Her height SDS (HSDS) was - 3.3 and her weight below 5th percentile. She did not have any bone deformity both clinically and radiologically. Her serum phosphorus was 2.3 mg/dL (normal for age, 4.5 - 6.5) and alkaline phosphatase 455 lU/L (normal up to 440). Fractional excretion of phosphorus (FEP) was 23.7% (normal <15%), Maximum tubular reabsorption of phosphate/glomerular filtration rate (TmP/GFR) was 1.7 mg/dL, PTH 46 pg/mL (normal up to 80 pg/mL). Three years after treatment, her HSDS was -2.3, serum phosphorus 4.3 mg/dL, and AlkP 917 lU/L (180-1200). His father, at the age of 52, had a height of 158.5 cm and weighed 64 kg. He had been suffering from severe bone pain in spine and limbs for more than 10 years. Clinically, he had no remarkable bone deformity but had to take different anti-inflammatory agents for relieving his pains and could not stand and walk without crutches. His serum phosphorus was 1.7 mg/dL, AlkP 624 (normal: 70-306), PTH 47 pg/mL (normal: 40 - 100). Before treatment (during phosphorus depletion) FEP was 10% and TmP/GFR was 3 mg/dL and after 2 months of treatment reached 62.8% and 0.9 mg/dL respectively. After 5 months of treatment for father, bone pains were relieved, all sedatives were discontinued and he could walk and do exercise independently. He has been doing well for 3 years but he suffers from paresthesia of his hands due to cervical spinal cord compression. HBD can cause short stature in children and if its diagnosis is missed will produce disability at adulthood.

Introduction: The recall of neonates with primary abnormal tests has almost always been considered the first step in the detection of congenital hypothyroidism (CH) in the CH screening programs. Considering recall rate as one of the indicators of cost-benefit and operational feasibility assessment of a program, forecasting of recall rate(s) could be beneficial to an optimized allocation of funds and resources. The trend of time-series of neonatal monthly recall rates was assessed in this report. Methods: From March 1998 to March 2002 (48 months), cord blood spot samples from 8 hospitals and a rural birth center in Tehran and Damavand District were collected on filter papers (Whatman BFC 180). TSH values were measured in the Endocrine Research Center laboratory using a two-site IRMA method. Primary TSH levels≥20 mU/L were considered abnormal and recalled for serum confirmatory tests. Monthly recall rate (total number of primary TSH levels ≥ 20 mU/L to total live births per month × 100) was recorded for 48 consecutive months. Monthly recall rates were analyzed using linear models of Box and Jenkins (ARIMA). The autoregressive model was fitted to forecast the next recall rates with a 95% confidence interval. Results: Out of 29908 cord blood spot samples, 314 showed TSH levels≥ 20 mU/L (total recall rate of 1.05%) of whom 32 had CH (1: 935 live births). Total data showed normal distribution and were stationary. Fitting of particular type of AR(3) model showed that monthly recall rate is predictable according to the recall rate obtained three months ago. Therefore, the autoregressive model of Zt = 0.67 + 0.45 Zt-3 + et, with significant parameters (p < 0.003), was obtained to forecast the next recall rates, ultimately. Conclusion: Forecasting of monthly recall rates is possible using the autoregressive model.