IRANIAN JOURNAL OF ENDOCRINOLOGY AND METABOLISM (IJEM)
Year:2011 | Volume:13 | Issue:3 (SN 57)|Papers Count:15

Introduction: This study compared the effects of oat and barley bread on lipid profiles and blood glucose of type 2 diabetic patients.Materials and Methods: In a double blind cross over trial, 36 type 2 diabetic patients were selected based on fasting blood sugar above 126 mg/dl and one lipidemic index that was not within the normal limits, and then randomly assigned into 2 bread groups. Patients were given 250gr oat or barley bread daily for 3 weeks. A 5cc sample of venous blood was taken before, after 10 days and at the end of the trial for assay. After a washout period for 3 weeks, each group was transferred into the opposite group and all underwent the previous phase of that group. A 3 day food recall questionnaire was completed on the 1st, 10th and 21st days in both phases of the trial.Results: Findings indicated that all metabolic and anthropometric indicators were improved in both groups except for WHR. The mean differences of serum fasting glucose in the barley and the oat bread groups were -32±2.7 and 6.2±9.2 mg/dL and for serum HDL in the barley and the oat bread groups were 9.2±1.8 and 1.34±0.2 mg/dL, respectively; however the differences in fasting glucose and HDL were significant between the two groups (P=0.001).Conclusion: This study showed that both oat and barley bread are effective in improving of anthropometric and metabolic indicators, the effects of oat bread being more effective in reducing blood glucose and HDL cholesterol.

Introduction: For renal impairment, in clinical diagnostic practice currently the assessment of urinary enzymes is used. One of these enzymes is N-acetyl-beta-D-glucosaminidase (NAG), a widely distributed lysosomal enzyme with a molecular weight of 140000 Da, located predominantly in the renal proximal tubules. NAG activity in the urine increases in patients with various glomerulonephritides, diabetic nephropathy, tubulointerstitial diseases, renal allograft rejection and toxic renal injury.Materials and Methods: The study population included 30 type 2 diabetes and 30 non-diabetic subjects, and the latter group had normal glucose tolerance test. Urinary NAG, albumin, creatinine, serum glucose and HbA1c% were measured. The urinary NAG and albumin index in non-diabetic subjects were compared with those of the diabetic patients. The differences between the two groups (HbA1c<%7 and HbA1c>%7) were calculated.Results: Significant differences were determined in NAG activity between the diabetic and non-diabetic subjects (p<0.001). Excreted urinary NAG increased in diabetes patients with poor glycemic control (HbA1c>7%) compared to those with good glycemic control (HbA1c<7%), an increase that was significant (p<0.05). There was an increase in urinary NAG excretion in diabetic patients with abnormal albumin excretion compared to those with normal albumin excretion (p= 0.001). NAG excretion had a positive correlation with blood glucose and HbA1c%.Conclusion: Our results showed that determination of urinary NAG activity could be useful marker of early renal damage in diabetic nephropathy and confirmed the use of NAG enzyme as a routine screening test.

Introduction: Considering the importance of quality of life (QoL) affected in chronic diseases including diabetes, this study conducted to evaluate health-related quality of life in patients with type 1-diabetes.Materials and Methods: In this cross-sectional study, 150 patients with type 1 diabetes were enrolled from the Institute of Endocrinology & Metabolism. A quality of Life questionnaire validated previously for assessment of QoL in people with type-1 diabetes in Iran was used. The questionnaire included 20 questions in five areas of social relationships, emotional, daily activity, academic performance and treatment.Results: Mean age of the subjects and duration of disease were 22.14±6.84, 8.97±7.14 years respectively. The mean score for general quality of life was 70.70±13.95 in men and 67.27±11.87 in women. There was no significant difference in general quality of life between men and women. However, regarding treatment, the quality of life in men (65.64±16.65) was higher than in women (P<0.05). General quality of life was significantly correlated with duration of diabetes and type of insulin. In patients treated with insulin-analogues, general quality of life and areas of emotional, social relationships, academic performance and treatment were better. Conclusion: To conclude, comprehensive diabetes care, including mental health counseling and structured patient education programs might improve QoLin Iranian patients with type 1 diabetes.

Introduction: Contrary to the prevalence of type 2 diabetes in different age groups, most previously published educational programs for diabetic patients have been conducted for young or newly diagnosed patients. This study was performed to determine the effect of nutrition education programs on metabolic, anthropometric and blood-pressure indices of elderly individuals, aged above 60 years with type 2 diabetes.Materials and Methods: A hundred elderly diabetic patients participated in this interventional study. Data on the control and intervention groups was collected in two stages, before and 12 weeks after intervention. Intervention of nutrition education was performed based on the BASNEF model and, data collected were analyzed using Chi-square, t-test and the paired t-test.Results: The intervention group showed a significant reduction in body weight (-1.3 kg), body mass index (-.48 kg/m2), triglycerides (−18.25 mg/dl), fasting plasma glucose (−19.5mg/dl), and HbA1c (-36%). A decrease in HDL (-1.02mg/dl, P=.9) and LDL (-4.04, P=.2) was also observed in the interventional group, although the change was not significant. No significant differences were seen in systolic and diastolic blood pressure (p>0.05).Conclusions: Based on the results of the present study, short-term nutrition education can improve biochemical and anthropometric indice of elderly patients with type 2 diabetes.

Introduction: Changes in body fat distribution during menopause lead to increasing risk of cardiac and metabolic diseases. Considering the importance of predicting of cardiovascular diseases using related anthropometric indices, the aim of this study was to determine the correlation of waist circumference (WC), BMI and Conicity with cardiovascular risk factors (serum glucose, insulin [diabetes], blood pressure [BP] and dyslipidaemia).Materials and Methods: In a cross-sectional study, 250 non-smoking postmenopausal women, with BMI<30 were randomly selected. We measured WC, BMI and conicity and a 3 day food dietary recall and a food frequency questionnaire were completed for each participant. Fasting serum glucose, triglycerides, HDL-C, LDL-C and insulin were measured.Results: There were significant correlations between WC and systolic BP (r=0.255, p=0.002), WC and conicity (r=0.67, p=0.0001), BMI and conicity (r=0.31, p=0.0001), conicity and systolic BP (r=0.31, p=0.009) and BMI systolic BP (r=0.21, p=0.009). There were also significant correlations between systolic BP and diastolic BP (p=0.002), serum insulin and systolic BP (r=0.21, p=0.008) and serum total cholesterol with systolic BP (r=0.2, p=0.13).Conclusion: Waist circumference was significantly associated with systolic BP and diabetes, BMI had a significant association with systolic BP and Conicity was significantly associated with systolic BP, serum triglycerides and glucose, but not with diabetes.

Introduction: The aim of this study was to investigate the association betweenfructose intake and cardiovascular disease risk factors in Tehranian adults.Materials and Methods: This study was conducted using data from adults, aged 19-70 years, who participated in the third phase of Tehran Lipid and Glucose study. Dietary data were collected using a validated semi-quantitative food frequency questionnaire with 168 food items. The sum of natural dietary fructose in fruits and vegetables, and fructose in industrialized foods containing added sweeteners, was calculated as total dietary fructose.Results: Forty-five and fifty-five percent of participants were men and women, with mean ages of 40.5±13.6 and 38.6±12.8 years, respectively. Mean dietary intakes of total fructose were 46.5±24.5 g/d in men and 37.3±24.2 g/d in women. Significant positive associations were observed between dietary fructose intake and body mass index (b=0.03 and 0.11, p<0.001, in men and women respectively), systolic blood pressure (b=0.09 and 0.12, p<0.01, in men and women respectively), diastolic blood pressure (b=0.13 and 0.80, p<0.01, in men and women respectively) and fasting blood glucose in men (b=0.01, p<0.05).Conclusion: Dietary fructose intake may have adverse effects on cardiovascular disease risk factors.

Introduction: The iodine deficiency elimination program, which began two decades ago, has resulted in Iran becoming an Iodine Deficiency Disorders (IDD) free country in the Middle-East region. This study was performed to evaluate the adequacy of iodine supplementation after 17 years of universal salt iodization in the province of Qazvin.Materials and Methods: In a crosssectional study, 1200 schoolchildren (600 girls and 600 boys), aged 8 to 10 years, were randomly selected from Qazvin province, and evaluated in 2007. Goiter prevalence, urinary iodine excretion and iodine content of household salts were measured and the data obtained were compared with those obtained in 1996 and 2001.Results: Total prevalence of goiter was 0.8%; and no grade 2 goiter was seen. One-tenth of the children enrolled for goiter assessment, were randomly selected for urinary iodine measurement. The median urinary iodine in these 120 schoolchildren was 151 4g/L, with 4% having urinary iodine excretion less than 504g/L. Sixty-six percent of households were using purified iodized salt, 65% of households had appropriate salt storage, and 30% of the household salts contained less than 15 4g iodide.Conclusion: Goiter prevalence has significantly decreased in Qazvin province, 17 years after universal salt iodization. Similar to reports from 1996 and 2001, the median urinary iodine of schoolchildren was adequate, indicating a well established sustainable IDD program in Iran.

Introduction: Autoimmune thyroid diseases (AITD) are common and it is important to identify the genetic determinants. The aim of this study was to assess the relationship between two polymorphisms of Thyroid Peroxidase gene (TPO) and serum level of Anti-TPO titer in an Iranian population.Materials and methods: We selected 184 individuals from Tehran Lipid and Glucose Study, categorized as the Anti-TPO- (n=72) and Anti-TPO+ (n=112) groups. Inclusion criteria for cases was Anti-TPO and Anti-Tg>100U/L with a history of hypothyroidism. Anti-TPO levels in subjects were measured by the ELISA kit. Genomic DNA was extracted using Saltingout/ Proteinase K method. Polymorphism detection of Exon 8 and 12 was done using the PCR-RFLP method. The PCR products were incubated with restriction enzymes SacII and BsrI, respectively.Results: The C allele frequency of C2145/T polymorphism Exon 12 (rs732608) was observed in 71.2% of patients and in 28.8% of normal individuals. This allele was significantly associated with increased levels of Anti-TPO [(T 140±330 pmol/L; vs. C 436±380 pmol/L; P<0.001), (OR: 9.2)]. The G1193/C was not associated with the level of serum Anti-TPO in this study.Conclusion: We demonstrated that the C allele polymorphism in C2145/T exon 12 is associated with high levels of serum Anti-TPO and that carriers of this allele are predisposed to disease 9.2 times more than those who do not have A allele.

Introduction: Although the effects of exercise on angiogenic factors is a topic that has attracted the attention of many researchers worldwide, the possible impacts of gender and physical activity on the rate of angiogenic factors at rest and response of acute exercise have not been investigated so far and which is why we conducted this research.Materials and Methods: Sixteen women (8 active, 8 sedentary) and 16 men (8 active, 8 sedentary) participated in this study. Three days after determination of V02max, they exercised for 1 h at 70% V02 max. Serum was collected from the vein at rest and at 0 and 2 h, post exercise. Serum vascular endothelial growth factor (VEGF) was measured by ELISA kits.Results: Serum levels of VEGF decreased immediately after exercise in groups, a change that was temporary and transient. At rest, no difference between serum VEGF of groups was seen. On the other hand, changes in VEGF levels in response to exercise between groups were not significant.Conclusion: Acute submaximal exercise decreases the main angiogenic factor involved in development of capillary network. Gender and physical activity do not affect serum levels of the vascular endothelial growth factor at rest or response of exercise.

Introduction: Physical activities can lead to the release of free radicals through oxidation pressure, and can also result in the decrease of free radicals in the body by producing antioxidation enzymes. However the key question is which type of exercise? The aim of this study was to analyze the effects of two kinds of physical activities, Eccentric and Concentric on some oxidation and anti-oxidation factors in the plasma of women involved in physical education.Materials and Methods: Twenty-four female student volunteers were randomly divided into 3 groups, the control group, the eccentric exercise group, and the concentric exercise group. Blood samples were taken from the test group twice (an hour before and again one hour after the training) in order to analyze the non-enzyme oxidation (GSH), oxidation pressure index (MDA) and absolute anti-oxidation capacity (ATC). Data was analysed using SPSS, version 13, through the analysis of variance test with 95% confidence (p<0.05).Result: Results showed that the amount of TAC, MDA, and GSH plasma after eccentric and concentric physical activities showed meaningful increases compared to before the activities. Also the amounts of GSH, MDA plasma after the eccentric and concentric activities had significant increase in comparison to the control group.Conclusion: It seems that severe eccentric and concentric physical activities are important stimulants causing considerable changes in the body’s oxidation system and these activities can improve anti-oxidation capacity.

Introduction: Ghrelin, produced and secreted mainly from the stomach, is a potent stimulator of growth hormone, appetite, and plays a role in energy balance control. There is increased risk of metabolic syndrome with increased LDL-C and TC levels and decreased HDL-C, with lower ghrelin concentrations. The purpose of this study was to compare the effect of different 8-week endurance training regimens on HDL-Ghrelin.Materials and Methods: Thirty Wistar male rats, 6-8 weeks of age, were randomly assigned to 3 groups of 10 rats, including two training groups with either 30 or 90 min of exercise, and a control group. Experimental groups were trained for 8 weeks, 5 days per week at 20m/min for 30 or 90 min. Rats were sacrificed 72 h after the last training session and plasma samples were collected for determining HDL-Ghrelin, HDL-C, HDL-2, HDL3, TG and TC. Analysis was performed using ANOVA and LSD post-hoc test, SPSS 16, at the alpha level of 0.05.Results: Ghrelin concentration paralleled HDL-Ghrelin changes. There was no difference in HDLGhrelin between groups. Despite reduction of TC in the training groups, no significant relationship was observed between HDL-Ghrelin and HDL2, HDL3, TG and TC.Conclusion: This study showed that isolated HDL contained Ghrelin. In addition, the 8 weeks endurance training of different durations had no correlation with HDL-Ghrelin and lipid profiles. Further studies to confirm these findings are warranted.

Introduction: There are many descriptive studies on osteoporosis in Iran, mostly assessing the prevalence of the disease and its associations with various risk factors. In order to gain a better insight into the epidemiology of osteoporosis in Iran and its heterogeneity around the country, we systematically reviewed all the studies available and analyzed their findings using meta-analysis methods.Materials and Methods: All published papers in Iranian and international journals, final reports of research projects, papers presented in relevant congresses, and all dissertations of medical students were reviewed using standard methods and sensitive keywords. After Quality Assessment the main results of studies published during 2000-2008, which met the eligibility criteria, were extracted and Combined with the Random Effect Model, and were entered into metaanalysis.Results: In 21 primary, eligible studies, minimum and maximim prevalence rates in the femur region were 1.5 and 43 respectively and in the Spinal Region these values were 3.2 and 51.3, respectively. The prevalence of osteoporosis in the femur using the Random Effect Model in Iranian Women was 18.9 CI (15- 22.7) and in the Spinal reqion was 18.91 CI (14.6- 23.2) in metaregrresion analysis, with place and sample size as the main heterogenous factors. (p<0.01).Conclusion: Osteoporosis, an important health challenge, increases with age and changes in life style. The prevalence of osteoporosis in Iran, compared to other countries, was lower.