IRANIAN JOURNAL OF ENDOCRINOLOGY AND METABOLISM (IJEM)
Year:2009 | Volume:11 | Issue:3 (SN 45)|Papers Count:17

Introduction: As documented in epidemiological studies, the prevalence of non-communicable diseases (NCDs) is fast increasing. Changes in lifestyle factors like improper dietary habits could positively affect risk factors of NCDs. We conducted this study to evaluate the nutritional knowledge, attitudes and practices among Tehranian schoolchildren of district 13, Tehran.Materials and Methods: This cross-sectional study was conducted in 3 phases between 2003 and 2007, on 19944 schoolchildren, aged 11-17 years within the frame work of Tehran Lipid and Glucose Study (TLGS) in district 13 of Tehran. The schools were randomly divided into the intervention (n=12) and control (n=10) groups. Besides sending posters and pamphlets for the intervention area, we educated volunteers (teachers and parents) on interventions. Children were assessed using a knowledge-attitude and practice questionnaire every 2 year, which they completed themselves. Results: Of the subjects studied, 50.6 and 49.4% were male and female, respectively. Initially, mean±SD of knowledge, attitude and practice scores were 27±5, 19±6 and 33±6, for both the intervention and control groups. Intervention vs. control area: 1.6 vs. 2.1 percent of adolescents had a poor nutritional knowledge during 2003, which changed to 1.7 vs. 2.1% and 18 vs; 17% had good nutritional practices in the first phase which was 29 vs. 28% in 2007. The scores increased for intervention group during first phase of intervention (2005) but showed no difference with the scores of 2007, except for practice and were equal for two areas; knowledge: 28±5, attitude: 20±5 and practice: 35±7. Conclusions: There was an increasing trend in scores, but levels of poor attitude and practice were high among children, indicating the necessity of nutritional modeling education for adolescents and implementation of changes in school strategies to promote the quality of their dietary patterns.

Introduction: Majority of diabetic patients eventually develop hypertension. Becase of its antioxidative properties, alpha-lipoic acid plays an effective role in decreasing oxidative stress and preventing endothelium dysfunction. The purpose of the present study was to determine the effect of alpha-lipoic acid on blood pressure in type 2 diabetic patients. Materials & Methods: Fifty-seven type 2 diabetic patients (14 male and 43 female), mean age 53.5 years, were enrolled in this study. Upon arrival subjects were randomly divided into either the experimental (n=29) or control (n=28) groups. The experimental group received 300 mg alpha-lipoic acid daily for eight weeks, while the control group received a placebo for eight weeks. Blood pressure and 24 hours diet recall were measured at the beginning of the study and every two weeks after that. Results: The results of the study showed a significant decrease in both systolic and diastolic blood pressures at the end of study in the alpha lipoic acid group compared to their initial values (p<0/0001), and to the control group (p=0/001). Conclusion: This study suggests that alpha-lipoic acid supplements can be recommended for type 2 diabetic patients to prevent high blood pressure.

Introduction: Diabetic mellitus disease can negatively influence the physical functioning, emotional state, and individual, family and social relationships of patients with diabetes and, in general, their health and feeling of wellness. Caloric restriction and oral hypoglycemic agents also have undesirable effects on the mental health of these patients. The purpose of this study was to examine the effect of aerobic exercise training on mental and physical health, anxiety, insomnia, social functioning and depression in patients of type 2 diabetes mellitus. Materials and Methods: In this clinical trial, fifty-three patients with type 2 diabetes, age range 45.15±6.11 years, with average of 5±3 years of disease were chosen purposively and were randomly assigned into 2 groups, the 8 week aerobic exercise training (n=27) and the non-training (n=26) group. The aerobic exercise training group participated in an aerobic training program, intensity 60-70% heart rate reserve, frequency 3 days/week, duration 45-60 min/session. Mental health was evaluated using a general health questionnaire (GHQ) in the two groups before and after the study. The independent t-test was used for data analysis. Results: The 8 week aerobic exercise training had a significant effect on mental health, subscales of physical symptoms, anxiety & insomnia (p<0/05). However no significant effect on subscales of social functioning and depression was observed (p>0/05). Conclusion: Aerobic exercise training, as part of a health promotion program, can be effective on the mental health of patients with type 2 diabetes.

Introduction: Diabetes is chronic disease affecting all aspects of daily life and hence is a priority health care strategy. Its treatment needs a bio-psychosocial approach. One of the major problems in its management is patient noncompliance to therapeutic regimens. This qualitative phenomenological study aimed at assessing to patient experiences of factors facilitating self management.Materials and Methods: Patients were recruited from the “Glands and Metabolism Research Center” and “Alzahra hospital” in Isfahan in 2006. A purposive sample of 11 diabetic patients volunteered to participate in the study. Unstructured one-on-one interviews were conducted and interview data were transcribed and analyzed for themes using the Collizi method. Results: Themes, identified as facilitators to patient adherence to the therapeutic regimen are fear, satisfaction, support, objective alarm, feedback. Conclusion: The research highlights that factors such as patient satisfaction of treatment, insight into nature of disease, patient anxiety, family involvement as a major source of support, feedback on test results and the self-management process should be considered in designing heath care strategies to facilitate changes in behavior and enhance motivation.

Introduction: Although Iran is known as an iodine sufficient area, congenital hypothyroidism (CH) is prevalent. Because iodine excess can contribute to hypothyroidism, we evaluated the role of iodine excess and ID in the etiology of CH. Methods and Materials: In a cross sectional study UICs (Urine Iodine Concentration) in newborns with CH as well as UIC and MIC (Milk Iodine Concentration) of their mothers were compared with a control group. After acid digestion of urine samples milk samples, iodine concentrations were determined by the Sandell-Kolthoff method. Chi-square and Wilcoxon, and Pearson correlation tests were used for statistical analysis. A P value less than 0.05 was considered statistically significant. Results: The median of MIC of CH (n=68) and healthy subjects (n=179) was different (210 vs. 170;g/L respectively, P<0.05). However the median of UIC in neonates and those of mother's of CH and healthy subjects were not different statistically (305 vs. 300;g/L and 150 vs.130;g/L respectively, P>0.05); 71.2% and 46.7% of mothers of hypothyroid and healthy subjects had MICs above 180 ;g/l (iodine excess) respectively (p=0.002). Conclusion: Based on the higher levels of MIC in mothers of CH neonates, iodine excess could be a possible risk factor for CH. Since however comparison of UIC between the control and neonate groups showed no differences, further investigations are needed to facilitate deeper insight into and clarification of the etiology of CH.

Introduction: The risk of acute cardiovascular and thrombotic events increases after menopause. Changes in hormones, body composition and especially abnormalities in endogenous coagulation and the fibrinolysis system may play important roles in the risk of an acute cardiovascular event. Physical activity and physical fitness have consistently been linked to lower CVD rates in women. In this study we evaluated the effect of short-term aerobic training on the fibrinolytic and coagulative factors, anthropometric parameters and fat profiles in postmenopausal women. Materials and Methods: Twenty healthy postmenopausal women, aged between 48-55 years, were randomly divided into two groups, the training (n=10), and control groups (n=10). Training consisted of 10 sessions of sub-maximal aerobic cycling, 35 minutes for a 3 weeks period, 3 times a week (5 min warm up, 25 min aerobic training, and 5 min active and 15 min passive recovery). Changes in specific coagulation, fibrinolytic factors and fat profiles were assessed, both before the first, and again and before and after the 10th session of the aerobic program. Results: At the end of the training we found no statistically differences in weight and BMI (Body Mass Index) between the two groups; lean body mass however increased (p=0.01) and percentage of fat decreased in the training group (p=0.05). Rest heart rate (p=0.000), systolic (p=0.004) and diastolic blood pressure (p=0.006) also decreased after training. Although after training PAI-1-Ac decreased before (p=0.05) and after (p=0.004) the 10th session, tPA-Ac showed a significant increase only after the 10th session (p=0.002). Also fibrinogen (p=0.04) and vWF-Ag, (Von Willebrand Factor), showed significant reduction before and after the 10th session (p=0.004). After training, total cholesterol (p=0.006), triglycerides (p=0.05) and LDL (p=0.03) decreased, whereas HDL (p=0.007) increased. Conclusion: In postmenopausal women aerobic training increased activity levels of fibrinolytic factors and decreased acute and permanent effects of coagulative factors. These changes in the coagulative factors and fat profiles suggest that regular sub-maximal aerobic training in postmenopausal women may prevent cardiovascular diseases.

Introduction: The aim of this research was to compare the effects of endurance vs. resistance training upon local BMD changes. Materials and Methods: Thirty-six young volunteer girls (age 22.66±1.56 y, BMI: 22.85±2.17), with sedentary lifestyles, were selected and randomly divided to three groups (n=12). The endurance group ran 36 sessions on a treadmill, 3/wk at 70 to 80% of MHR, 40 min per session, while resistance training included 36 circuit training sessions, 70 to 80% of 1RM, 6 to 8 repetitions in 3 sets by 2 min rest in between. Results: Both the endurance and resistance training protocols induced significant increases in the BMD lumbar spine, femur neck and distal radius BMD (P<0.05). Although only resistance training induced significant variations in BMD at femur neck in the control group, it was in the aerobic group that better effects were observed in the back position (P<0.05). Conclusion: There are considerable differences in the skeleton’s local BMD responses to different modes of exercise.

Introduction: The aim of this study was to assess the effect of concurrent training on salivary IgA, cortisol, DHEA concentration and DHEA:cortisol ratio in untrained female. Materials and Methods: Thirty-nine untrained volunteer female students (aged; 24±2.5 yr, height; 161 ± 8.2 cm, weight; 56.8±14.61 kg) were selected objectively and were randomly divided into four groups: Control (C; n=9), Endurance (E; n=10), Resistance (S; n=10) and the Concurrent (SE; n=10) groups. E training consisted of running 65% MHR for 16 minutes during the first week, reaching 80% MHR for 30 minutes during the 8th week. S training consisted of four leg-press, bench-press, pull down curls, and legs curls. During the first week, the intensity of training was at 50% 1RM in two sets with 10 repetitions, and was the increased to 80% 1RM in 3 sets and 6 repetitions, during the 8th week. The SE training included a combination of two S and E trainings in the same manner for each respective group. Before and after 4 and 8 weeks of trainings, at 8 o’clock in the morning unstimulated saliva samples were collected and measured by ELISA. Results: ANOVA for repeated measures showed, that the S group, compared to other groups, had significant difference in IgA,DHEA and DHEA: cortisol ratio (p £0.05). There were no alterations in the cortisol concentrations of groups and no significant correlation was found between IgA and cortisol (p£0.05). Conclusion: Findings indicated that resistance training caused increase in salivary IgA as one of the immune indexes and increase in DHEA and the DHEA: cortisol ratio as one of the body anabolic status indexes. Endurance training however, performed after resistance training suppressed some of the positive adaptation of resistance training per se.

Introduction: Age, gender, body composition and genetic background affect cardio respiratory fitness. In children, the variability of physiological responses to exercise yield different interpretations of the effective parameters. The aim of the present study was to investigate the effect of age, gender, body composition on cardio respiratory fitness of students of Semnan city aged 8-11 years, using the FFMI-FMI regression model. Materials and Methods: This cross sectional study was performed on 685 students (347 boys and 338 girls). Subjects were selected via a multi-level cluster sampling. After adjustment for differences in age, gender and body mass using the FFMI – FMI regression model, i.e. Fat free mass index (FFMI), (dividing fat free mass to squared stature) was predicted by fat mass index (FMI) (dividing fat mass to squared stature) subjects were categorized into 3 groups: The Normal, the Solid (higher than normal FFM group) and the Slender (lower than normal FFM group). The 20 m Shuttle run test used to estimate maximal oxygen uptake (VO2max) as an index of cardio respiratory fitness, expressed in absolute values. Results: There was a positive significant association between age and VO2max (P< 0.05). The solid group had higher values, while the slender group had lower values in VO2max. Boys had better cardio respiratory fitness than girls in. Conclusion: There are significant direct positive associations between age and body composition and VO2max.

Introduction: Calcitonin Gene-Related Peptide (CGRP), a 37-amino acid peptide generated by alternative processing of primary transcripts from calcitonin gene, is broadly distributed in the peripheral and central nervous systems of vertebrate and invertebrate species. CGRP plays a main role in the neuromuscular junction. This paper investigates the effects of endurance and resistance training on the content of CGRP in the slow and fast twitch muscles. Materials and Methods: Twenty-two male Wistar rats, (age 10 mo, weight 220± 20 gr, Pasteur Institute) were randomly divided to three groups. (Control (n=7), Endurance training (n=7), and Resistance training (n=8)) and underwent 12 weeks training according to protocols. Animals of the resistance training group were housed in a metal cage with a wire-mesh tower; endurance training included treadmill running), 5 days a week, 60 min/day, 30 m/min speed, for animals in this group. Forty-eight hours after last session of protocols, animals were anaesthetized. The right soleus and anterior tibialis were removed, and, tissues were immediately frozen in liquid nitrogen and kept at -70°C for use later. CGRP content was measured by the ELISA method. Results: For data analyses, one-way ANOVA was used. There was no significant difference between control and endurance training groups in the CGRP of slow and fast twitch muscles. However, the content of CGRP in both fast and slow twitch muscles was significantly different in the resistance training group as compared to the control group.Conclusion: That training can be a main factor for CGRP release in muscles. In addition, the type and intensity of activity probably contribute to increase in CGRP content.

Introduction: The high-molecular weight (HMW) form of adiponectin is reported to be the most active form of this hormone and current data reveals decreased plasma HMW adiponectin levels to be associated with insulin resistance. This study was intended to investigate the effect of exercise intensity on plasma HMW adiponectin concentrations. Materials and Methods: Thirty-two eight week-old male Wistar rats (185±50 g) were randomly assigned to one of four groups as follows: High intensity (HI: 34m/min ~%80-%85 VO2max), moderate intensity (MI: 28m/min ~ %70-%75 VO2max), low intensity (LI: 20m/min ~%50-%55 VO2max), and the sedentary control (SED) groups. All experimental groups performed a 12 week exercise program, including treadmill running on a 0° slope for 1 hr/day, 5 days/week. Fasting levels of circulating HMW adiponectin, testosterone, and insulin resistance index (HOMA-IR) were measured after the exercise program and, data were analyzed using one-way ANOVA, with Pearson's correlation was used to identify any possible relationship among the assessed variables. Results: HMW adiponectin plasma concentrations increased significantly in the HI and MI exercise training groups (p<0.05). HMW adiponectin was also found to be inversely related to HOMA-IR (r = -0.37, p=0.003), insulin (r= -0.46, p=0.008) and testosterone (r = -0.38, p=0. 03). Conclusion: It can be concluded that exercise intensity appears to be an important parameter in increasing plasma HMW adiponectin levels in healthy male rats.

Introduction: Medicinal plants are known for their effects in attenuation of hyperglycemia and restoration of lipids to normal levels. In this study, the effects of oral administration of Crataegus spp (CS) branchlet on serum glucose, lipids, and beta cell density in diabetic rats were investigated. Materials and Methods: Male NMRI rats (n = 32) were divided into 4 groups, i.e. control, CS-treated control, diabetic, and the CS-treated diabetic groups. The treatment groups received oral administration of plant-mixed pelleted food (6.25%) for 6 weeks. Serum glucose, triglycerides, total cholesterol, LDL- and HDL- cholesterol concentrations were determined before the study, and 3 and 6 weeks after the study. Density of beta cells in in 4 groups was determined using the monochrome Gomori staining method. Results: Serum glucose concentration was significantly lower in the CS-treated diabetic group, compared to diabetics, 3 and 6 weeks after the study (p<0.05). In addition, there were no significant changes regarding serum total cholesterol, triglycerides, and HDL-cholesterol concentrations in the treated diabetic group as compared to the diabetic group. On the other hand, the treated diabetic group showed significantly lower levels of LDL-cholesterol as compared to the diabetic group (p<0.05). Regarding histology, beta cell density significantly decreased in diabetic rats, while CS treatment caused no changes. Conclusion: Oral administration of CS has a significant hypoglycemic effect and lowers serum LDL-cholesterol.

Introduction: Since all previous studies on the ameliorative effects of garlic in diabetic nephropathy have been conducted after diabetes induction, we decided to assess its preventive role on renal complications in diabetes. Materials and Methods: Forty male rats were divided into 5 groups as follows: 1- Group normal (N) 2- Group Normal+Garlic (N+G), received garlic juice for 6 weeks. 3- Diabetic (D) received STZ, 60 mg/kg BW /i.p. 4- Group diabetic+garlic before (D+Gb), received garlic juice for 3 weeks before STZ injection and continued for over three weeks. 5- Group diabetic+garlic after (D+Ga), three days after STZ injection, they received garlic juice for 3 weeks. Garlic juice was given by gavage (1ml/100g BW). Results: Diabetic rats showed significant increase in serum creatinine and urea, creatinine clearance (GFR), water intake, and decreased urinary urea to creatinine ratio (Ur:Cr), compared to the other groups (P<0.0001). Administration of garlic juice in diabetic rats restored these changes towards normal to some extent. Long-term consumption of garlic juice in group D+Gb caused significant improvement, compared to that seen in group D+Ga. Discussion: In this study, for the first time, we showed that administration of garlic juice before diabetes induction resulted in enhanced amelioration of renal complications compared to the group receiving it after induction, indicating that garlic juice can play both a preventive and a theraputic role in such patients.