IRANIAN JOURNAL OF ENDOCRINOLOGY AND METABOLISM (IJEM)
Year:2002 | Volume:3 | Issue:4 (SN 12)|Papers Count:9

Thyroid hormones play an important role in the synthesis, metabolism, and catabolism of lipids. Hyperthyroid patients have increased susceptibility to oxidative stresses and thus undergo LDL oxidation. Paraoxonase is an HDL-linked enzyme which, in vitro, prevents LDL oxidation and might have an anti-atherogenic effect. The purpose of this study was to compare paraoxonase activity and lipid status before and after treatment of hyperthyroidism. 24 hyperthyroid patients and 23 control subjects were studied. In all subjects after obtaining history and anthropometric measurements, serum levels of thyroid hormones, lipids, lipoproteins, and apolipoproteins and serum paraoxonase activity were measured in a fasting blood sample. All patients were treated with methimazole and followed up for 7.3±3.9 months. Of 24 patients, 15 attained euthyroidism. There were no significant changes in weight, body mass index, and waist to hip ratio after treatment. There was significant decrease in serum levels of T4 (8.4±2.2 vs. 16.6±4.4 µg/dL, P<0.001), T3 (134±38 vs. 250±90 ng/dL, P<0.05), and increase in serum TSH (1.9±2.2 vs. 0.06±0.06 µU/mL, P<0.001). Serum paraoxonase activity significantly increased after treatment (49.0±22.8 vs. 64.6±37.8 IU/mL, P<0.001). Also, treatment caused significant increase in serum cholesterol, triglycerides, LDL-C, cholesterol to HDL and LDL to HDL ratios. HDL and apolipoproteins A-I and B levels did not change following treatment. The observed changes in serum paraoxonase activity in the present study, suggest that the enhanced oxidation observed in these patients can be, at least to some extent, caused by reduced paraoxonase activity.

The risk of developing vascular diseases in diabetic patients is significantly increased. Its etiology may involve oxidative damage by free radicals, and protection against such damage can be offered by antioxidant systems. To study the antioxidant status and oxidative stress in patients with type II diabetes mellitus. (n=30) and controls (n=28), we measured total antioxidant capacity by ferric reducing ability of plasma (FRAP) assay, malondialdehyde (MDA) as a final product of lipid peroxidation by HPLC method, carbonyl groups, thiol groups, vitamin E and C in plasma samples. In addition, we analyzed biochemical parameters such as blood glucose, HBA1c, cholesterol, triglycerids, HDL-C, LDL-C, bilirubin and uric acid. A significant increase in MDA concentration was found in diabetic patients compared to controls (P<0.005). There was also a significant drop in plasma thiol groups (P<0.05), while no significant difference was observed in total antioxidant capacity, carbonyl groups, vitamin E and C between two groups. Plasma vitamin E/cholestrol ratio was significantly lower in diabetic patients than controls. In conclusion, we have shown that there is enhanced oxidative stress in patients with type II diabetes, an important factor in the pathogenesis of diabetic complications

Glucose intolerance, hypertension, and obesity are important risk factors for cardiovascular diseases. Association of WHR, BMI, and blood pressure with glucose tolerance status was assessed in this study. Of 15000 urban individuals, 3-69 years old, who have been chosen by cluster random sampling in cross-sectional phase of a longitudinal study in east of Tehran, 2886 men and 4013 women were between 30 to 69 years of age. They underwent a 2-h oral glucose tolerance test. Diabetes mellitus (DM) and impaired glucose tolerance (IGT) were defined using WHO criteria. Blood pressure, weight, height, and hip and waist circumferences were measured according to standard protocols, and BMI and WHR were calculated. 911(13.2%) had IGT and 372(5.4%) had diabetes. Obesity (BMI≥30 kg/m2) was more common in DM and IGT than healthy individuals (45.1% and 39.1% vs 22.9%, respectively, P<0.001). There was no significant difference between the prevalences of overweight (25<BMI<30 (WHR obesity Truncal categories. tolerance glucose different in m2) kg><30 kg/m2) in different glucose tolerance between the pervalences of overweight (WHR>0.8 in females and WHR>0.95 in males) was present in 82.7, 75.6 and 53.7% of diabetics, IGT, and normal subjects (P<0.001). In forward stepwise logistic regression adjusted for age and sex, the following variables, in order of entering the model, were significantly associated with DM: age OR=4.4 (P<0.001); Truncal obesity OR=1.8 (P<0.001); obesity OR=3 (P<0.001); and overweight OR=2 (P<0.001). Prevalence of hypertension (systolic BP ≥ 140 or diastolic BP≥90 mm/Hg or antihypertensive drug consumption) in DM, IGT, and healthy subjects were 51.9, 39.5, and 18.8%, respectively (P<0.001) and when adjusted for age, sex, BMI, and WHR, all types of glucose disorders were significantly associated with hypertension: IGT OR=1.8 (P<0.001) and DM OR=2.4 (P<0.001). Hypertension, obesity, and high WHR are more prevalent in diabetes and IGT than in normal population. Furthermore, truncal obesity is associated more often with glucose intolerance than with generalized obesity.

Eleven NIDDM patients (7 women and 4 men, aged 51.2±7.6 year, BMI:29±3.6 kg/m2, duration of diabetes: 9±6.9 years) were selected in a cross-over clinical trial to assess the effects of fortification of bread with wheat bran on blood glucose and lipids. The patients consumed isocaloric diets for 10 weeks and took no drugs. Six patients consumed fortified bread for 4 weeks (period I), followed by a two-week washout period and then crossed over to ordinary bread for another 4 weeks (period II) and the next five patients had the reverse periods. Fasting serum glucose levels at the end of period I were 20.2% and 21.45% less than the baseline value and end of period II, respectively; these differences were significant (P<0.005). At the end of period I, serum glucose 1, 2 and 3 hours after breakfast tolerance test (BTT) were 18.17, 11.54 and 13.57% less than the baseline values, respectively (P<0.005). Serum glucose 1, 2 and 3 hours after BTT at the end of period I were 19.19, 25.52 and 24.3% less than those at the end of period II, respectively, and the differences were significant (P<0.05). Fasting total cholesterol at the end of period I was significantly less than the baseline value (P<0.05). Fasting LDL-C at the end of period I was significantly decreased as compared to that at the end of period II (P<0.005). The differences between serum triglycerides, HDL-C and VLDL-C at the end of period I and at the end of period II were not significant. It can be concluded that bread fortified with wheat bran may cause a reduction in fasting serum glucose, serum cholesterol and LDL-C.

After bone marrow transplantation (BMT) survival of many patients are increased. Due to the increase in survival, medical evaluation of endocrine functions are necessary. Previous studies have showed that growth and development disorders are caused not only by total body irradiation, but also by cytotoxic drugs conditioning regimens. In this study, 12 children (prepuberty: P1G1), 4 female, 8 male, aged 3.5-10 years (mean: 6±2 years) evaluated for growth in prepubertal phase, before and 6, 12, 24 months after bone marrow transplantation by "Little" Busulfan-cyclophosphamide conditioning regimen. Growth velocity in children obviously increased in 12 months after bone marrow transplantation. Growth velocity was 10±3.5 cm/y, growth velocity SD was 4.31±4.21, after one year. Height SDS increased from -1.4±1.2 before BMT to -0.5±1.3 after 12 months (P<0.004) and weight was 20±6 kg before BMT and 26±9.5 kg in 12 months after BMT. This method of BMT not only did not cause growth failure but also relatively caused an increase in the height.

This study was carried out in order to monitor the iodine supplementation programme in school children of Kiga, Keshar, Randan in northwest of Tehran. All inhabitants of these villages had received iodized oil injection (containing 480mg iodine) in 1989 and continued with consumption of iodized salt ever since. In this study, 250 students from these villages aged 6-14 years were studied. Goiter grade was examined by palpation and graded according to WHO classification. Thyroid hormone concentrations were determined by commercial kits and urinary iodine was measured by digestion method. The results were compared with data of our previous study in 1989. Goiter prevalence decreased 40.5% as compared with 1989. Grade 2 goiter in 1989 and 1999 were, 94.5 and 14.3% in Kiga; 66 and 9.4% in Keshar; 82 and 9.7% in Radan, respectively, (P<0.001). Median urinary iodine excretion in 226 students was 18.6±6.1μg/dL that showed a significant increase from 1989 to 1999, (P<0.001). Serum T4, T3, TSH, T3Rup, FT4I in 232 students were in normal ranges. The mean hormone levels in 1989 and 1999 were: T4: 6.5±2 and 8.4±1.6μg/dL; T3: 177±38 and 145±29 ng/dL; TSH: 10.8±15.1 and 1.8±0.8 μU/mL, respectively P<0.001. No correlation was established between thyroid hormones, urinary iodine and goiter grade. These finding demonstrate that iodine supplementaion programme in rural areas with severe iodine deficiency has caused a significant decrease in the prevalence of goiter and a significant increase in urinary iodine excretion, along with correction of hypothyroidism.

40 patients with primary hyperparathyroidism were operated in 20 years period. 90 percent were female and 10 percent male with a ratio of 9/1. Age ranged from 25 to 62 years with a mean of 30±12. Mean total serum calcium was 11.4±09 mg/dL with a mean serum phosphorus of 2±0.3 mg/dL. Eighty percent of the patients presented with musculoskeletal manifestations of the disease and 22.5 percent had renal complications. In comparison with western countries, these patients were younger and female to male ratio was higher. Bone complications were more advanced and tumor size was bigger. Majority of patients had adenoma and the incidence of hyperplasia was much less (0.5%). The differences are, probably, because our patients are diagnosed late. Also, the type of diet, especially low in Vit D, may be responsible

Paragangliomas, tumors arising from neuroendocrine cells, are located in a variety of sites. Paraganglioma of adrenal medulla, pheochromocytoma, is the best-known and most common member of the paraganglioma family. We present a case of paraganglioma of uterine broad ligament with hormonal activity. The tumoral lesion consisted of chromogranin and synaptophysin positive cells.

Osteoporosis is a preventable and treatable disease and its management is effective and safe. Inadequate intake of calcium and vitamin D may contribute to the high prevalence of osteoporosis among older persons. Decreased bone mineral density is a predictor of bone fracture. More epidemiologic studies should be conducted about the frequency of osteoporosis, hypovitaminosis D and intake of calcium in our country. In this article, the role of calcium intake and vitamin D in prevention and treatment of osteoporosis will be discussed.