Iranian Journal of Endocrinology & Metabolism
Year:2023 | Volume:25 | Issue:3|Papers Count:9

Introduction: Non-alcoholic fatty liver disease (NAFLD) is currently the most frequent chronic liver disease affecting individuals of all age groups and is associated with type 2 diabetes mellitus (T2DM). The present study aimed to determine the frequency of NAFLD in adult patients with T2DM and some associated risk factors. Materials and Method: This descriptive cross-sectional study was conducted on patients diagnosed with T2DM at Golestan Hospital in Ahvaz, Iran, in 2020. All participants underwent abdominal ultrasonography to diagnose NAFLD and measure its grade. All the relevant clinical and biochemical characteristics were measured. Results: A total of 186 diabetic patients, including 75 women (40. 32%) and 111 men (59. 68%), with a mean age of 46. 85±10. 50 years, participated in this study. Ultrasound results revealed that all patients with T2DM (100%) had NAFLD, with 51 (27. 42%) having fatty liver grade 1, 105 (56. 45%) having grade 2, and 30 (16. 13%) having grade 3. The severity of fatty liver in ultrasonography was directly and significantly correlated with smoking (P<0. 001), weight (P<0. 001), body mass index (BMI) (P<0. 001), glycemic control (P=0. 032), and high-density lipoprotein-cholesterol (HDL-C) level (P=0. 001). Conclusion: Our results indicated that NAFLD was highly prevalent among patients with T2DM in our study population, and all patients exhibited varying grades of NAFLD. This finding demonstrates the importance of screening T2DM patients for NAFLD and the management of related risk factors in routine clinical settings.

Introduction: Diabetic foot ulcers are among the most challenging and expensive wounds. Untreated diabetic foot ulcers significantly impact patients’ quality of life. Nurses play a comprehensive and central role in preventing, providing care for, and managing diabetic foot ulcers. Materials and Method: The current research is a descriptive cross-sectional study of the type of clinical audit based on the National Institute for Health and Care Excellence (NICE) model, which was conducted in the hospitals affiliated with Shahid Beheshti University of Medical Sciences in 2022-2023. In order to collect data, a checklist was designed by the researcher. Data were analyzed using descriptive statistics and SPSS software Version 20. Results: In this research, the general performance of nurses in caring for diabetic foot ulcers in older adult patients hospitalized in academic hospitals was evaluated at poor and very poor levels. In the observation area, 38. 7% were at a poor level,in the touch area, 82. 1% were at a very poor level,in the evaluation area, 86. 8% were at a very poor level,and in the implementation and registration area, 89. 6% were at a poor level. Conclusion: Nurses significantly fall below the standards of care in managing, treating, and evaluating diabetic foot ulcers. Providing appropriate training programs can enhance nurses’ skills and clinical competence, reduce complications, and improve the quality of nursing care for diabetic foot ulcers.

Introduction: Diabetes mellitus (DM) and polycystic ovary syndrome (PCOS) are rising health issues. Evidence highlighted the potential for an increased risk of PCOS among females with DM across various locations and ethnicities. This study aimed to investigate the prevalence of PCOS among Iranian females with and without DM. Materials and Method: In this population-based cross-sectional study, eligible females were selected from participants of the Tehran Lipid and Glucose Study (TLGS). For this study, females with complete data were selected from Phase VI (2016–2018) of TLGS. The logistic regression model was used. Results: At first, 4435 women with definite information about PCOS status were included, women with unclear diagnoses of DM and PCOS were excluded, and finally, 2867 were included in the study. Then, they were divided into two categories, Under 40 years and over 40 years. Among females without DM aged <40 years, 28. 3%, and among those with DM aged <40 years, 53. 7% had PCOS. Among participants with DM, PCOS patients were younger and had better fasting blood glucose levels. Using logistic regression for PCOS risk from a logistic regression model in participants, it was found that among patients with and without DM, increasing age decreased the odds of PCOS by 85% and 42%, respectively. On the contrary, among participants without DM, a family history of DM increased the risk of PCOS (odds ratio [OR] = 1. 22, 95% confidence interval [CI] = 1. 006 to 1. 49, p=0. 04). Conclusion: The prevalence of PCOS was not significantly different between subjects with and without DM in our population.

Prediabetes (Pre-DM), an intermediate dysglycemia characterized by isolated impaired fasting glycemia (i-IFG), isolated impaired glucose tolerance (i-IGT), or combined IFG-IGT, affects about 30% of middle-aged adults. Pre-DM increases the risk of developing type 2 diabetes (T2D), cardiovascular diseases, and death. Little is known about the possible factors affecting the likelihood of Pre-DM regression/progression. This study aimed to review the current evidence obtained from observational studies and clinical trials investigating the association of dietary factors with either the progression of Pre-DM to T2D or its regression to normoglycemia. Observational studies’ findings imply the protective effects of dairy products, fruits, and vegetables and adherence to healthy dietary patterns like the Mediterranean diet and those with a low-glycemic index (GI) against Pre-DM progression, favoring its regression to normoglycemia. The findings of clinical trials indicate that compared to common therapeutic approaches, lifestyle interventions, including dietary modifications and adherence to healthy dietary patterns, have similar/superior significant and sustained effectiveness in delaying or preventing Pre-DM progression. Dietary modifications focusing on restricted energy intake aiming to favor at least a 5% body weight (BW) loss or maintain the ideal BW, diets with higher protein and fiber content, and adherence to low-GI and Mediterranean diets may increase the chance of Pre-DM regression and returning to normoglycemia.

Diabetes is a significant global health issue, often linked to disturbances in restoring balance following postural disorders. Individuals with diabetic neuropathy, are 15 times more prone to injuries such as falls, fractures, sprained ankles, and bruises when walking and standing, compared to those with diabetes who do not have neuropathy. Therefore, preventing falls is an issue that deserves special attention in the care of individuals with diabetic neuropathy. In the present study, various articles on the relationship between diabetic neuropathy and reactive balance control disorders were reviewed in PubMed, Scopus, ScienceDirect, Iran Medex, Magiran, and Google Scholar databases. Based on the results obtained from the studies, individuals with diabetic neuropathy exhibit greater postural fluctuation and slower speed, as well as a longer delay, in initiating balance responses to postural disturbances compared to individuals with diabetes who do not have neuropathy. The studies conducted so far on the control of reactive balance in individuals with diabetic neuropathy have determined that the disruption of automatic postural responses can lead to postural instability and limitations in the daily activities of this group of patients. It is suggested that preventive solutions and appropriate training programs be specifically designed for these patients to enhance automatic postural responses and reduce the risk of falling and injury.

Introduction: Fat infiltration into the muscles and the accumulation of intramuscular adipose tissue (IMAT) are associated with the development of insulin resistance, which tends to increase with aging and metabolic disorders. In contrast, exercise training may lead to a decrease in IMAT. Therefore, the present meta-analysis aims to investigate the effect of exercise training on IMAT in individuals with various health conditions and ages. Materials and Method: A comprehensive search was conducted in the Web of Science, Scopus, and PubMed databases from their inception to October13 2023. The inclusion criteria for the meta-analysis included studies investigating the effect of exercise training with an intervention lasting more than two weeks, measuring IMAT values, involving human subjects of any gender, age, or health status. Standardized mean difference (SMD) and 95% confidence intervals (CIs) were used to calculate the effect size using random-effect model. Results: Thirty-four interventions derived from a total of 24 studies comprising 1091 subjects were included in the present meta-analysis. The results showed that exercise significantly reduced IMAT tissue with a large effect size [(SMD=-0. 67), CI= 0. 42 to 0. 93]. Additionally, body weight, body fat percentage, and blood glucose levels significantly decreased. Conclusion: These findings suggest that regardless of the type of exercise, health status, and age of subjects, exercise training is an effective intervention to reduce IMAT, which may play effective significant role in improving metabolic status.

According to the World Health Organization (WHO) reports, cardiovascular diseases are the leading causes of death worldwide. Cardiac hypertrophy is associated with underlying disorders such as diabetes and hypertension. Cardiac hypertrophy is characterized by an increase in the size of cardiomyocytes, high cardiac expression of fetal genes, excessive protein synthesis, and interstitial fibrosis, leading to contractile dysfunction and heart failure. Various mediators, such as cytokines, adhesion molecules, cytoskeleton proteins, adrenergic system activity, natriuretic peptides, changes in energy metabolism, and oxidative stress, are involved in the induction of cardiac hypertrophy. Regarding the clinical importance of cardiac hypertrophy, the development of animal models may culminate in progress in finding novel therapeutic methods for improving heart failure and reducing cardiac disorders. Diabetic models with cardiac hypertrophy can be induced by high-fat/high-sugar diets, toxins such as streptozotocin, and genetic manipulation through induced mutation of leptin or leptin receptor genes. Diet-induced and mutation-induced diabetic models are more likely to show cardiac hypertrophy, while diet-induced diabetic models are particularly suitable for research on lifestyle-related diabetes in humans. Nevertheless, the findings obtained from animal models evaluating diabetic-induced hypertrophy in humans have limitations that require further research to develop new animal models.

Subclinical hypothyroidism is one of the common thyroid disorders in women with polycystic ovary syndrome, which can lead to adverse outcomes. This review explored the effects of subclinical hypothyroidism on the clinical and biochemical features and complications of polycystic ovary syndrome. In this review, the keywords of hypothyroidism, subclinical hypothyroidism, polycystic ovary syndrome, metabolic syndrome, and diabetes were searched in the PubMed, Web of Science, Google Scholar, Scientific Information Database, and Magiran database to gather relevant publications up until May 2023. According to available evidence, adipose tissue disorders, inflammation, glucose absorption and production disorders, and insulin secretion disorders may lead to insulin resistance. Insulin resistance, in turn, predisposes to the occurrence of cardiometabolic and fertility disorders. There is no evidence supporting the exacerbation of clinical symptoms, such as hirsutism, menstrual disorders, and biochemical manifestations, but several pieces of evidence have noted that the probability of lipid and glycemic disorders in individuals with polycystic ovary syndrome may increase in the presence of subclinical hypothyroidism. Also, some studies have pointed out a high risk of fertility complications when polycystic ovary syndrome coincides with subclinical hypothyroidism. When managing the symptoms and complications of polycystic ovary syndrome, more attention should be paid to the potential adverse effects of concurrent subclinical hypothyroidism and related metabolic complications.

Introduction: Cancer is one of the most complex challenges because tumor cells can evade the host immune system and adapt to different conditions. The present review aims to explore the immune system and how different immune cells and mediators contribute to the development and progression of thyroid cancer. Materials and Method: Data were collected and summarized from research on the immunology of thyroid cancer and immune responses that play a crucial role in cancer development and may help diagnose malignant tumors. The data were collected from the Scientific Information Database (SID), Magiran, PubMed, Scopus, ISI Web of Science, and Google Scholar databases. Articles were reviewed without a time limit, and finally, 99 articles that were most relevant to the goals of this study were selected. Results: The molecular patterns of cytokines and chemokines play a key role in explaining the immune system’s role in tumor initiation and progression. Different cells are also filtered into the thyroid tumor, and the balance between their antitumor and tumor-stimulating activity may be involved in the prognosis of cancer. Conclusion: The cells and mediators of the immune system in the microenvironment surrounding the tumor play a crucial role in the development and progression of malignancy. Accurate knowledge of the tumor microenvironment and its effective elements can help determine patients’ clinical condition and treat thyroid cancer.