IRANIAN JOURNAL OF ENDOCRINOLOGY AND METABOLISM (IJEM)
Year:2000 | Volume:2 | Issue:3(SN 7)|Papers Count:12

In our previous study in 1362, goiter was hyperendemic in Shahriar. Since iodized salt has been distributed in this region for 12 years, this study was performed to evaluate the effect of iodized salt on thyroid hormones, urinary iodine excretion and the grade of goiter in Shahriar region in 1374. 3164 persons including 58% females and 42% males were selected through random sampling. Grading of goiter was performed according to WHO’s classification, and urinary iodine was measured digestion method. The result were compared with those of the study performed in 1362. The prevalence of goiter in 1362 and 1374 was 50% and 40% in men, 70% and 51% in women and 60% and 47% in total community respectively (P<0.001). The decrease in the prevalence of goiter was observed specially in lower ages; which was 23% vs 7% in younger than 6 years, 82% vs 46% in 6-12 years and 78% vs 66% in 13-18 years of age respectively (P<0.001). The decrease in the prevalence of goiter was observed specially in lower ages; which was 23% vs 7% in younger than 6 years, 82% vs 46% in 6-12 years and 78% vs 66% in 13-18 years of age respectively (P<0.001). The mean urinary iodine excretion before and after using the iodized salt was 6.5±7.6 and 18.5±13.1 µg/dl (P<0.001). In 1362 study, 47.5% of the subjects had urinary iodine levels of 2 to 5 µg/dl while in 1374 study in 65% of subjects urinary iodine level has been 10 to 25 µg/dl. The mean level of thyroid hormones before and after using iodized salt were respectively: T4, 9.2±1.1 vs 9.3±1.9 µg/dl; T3, 142±30 vs 154±42 ng/dl (P<0.001); and TSH, 1.8±1.1 vs 1.5±1.3 µU/ml (P<0.001). 1.5% of the subjects in 1362 and 4.5% in 1374 had T4 levels higher than 12.5µg/dl. T3 levels higher than 200 ng/dl were observed in 0.4% and 11.5% of the subjects before and after using iodized salt. TSH levels higher than 5µU/mL were observed in 0.6% and 1.9% of the subjects in 1362 and 1374 respectively. There was no change in positive cases of antithyroid antibodies. The number of hypothyroid and hyperthyroid cases were not considerable. The results of this study shows that the use of iodized salt causes a decrease in the prevalence of goiter, specially in lower ages and an increase in urinary excretion. The results also show that the use of iodized salt at the level of 40 ppm has no harmful side effects in this region.

Thyroid dysfunction, specially hypothyroidism is associated with an increased risk of atherosclerosis, which is attributed to impaired metabolism of atherogenic lipids and lipoproteins. Human paraoxonase (PON) is an HDL-associated enzyme which is believed to protect lipoproteins against oxidative modification. We have studied the status of lipids, apolipoproteins, and activity of paraoxonase enzyme in 14 hypothyroid (7 females and 7 males), 8 hyperthyroid (4 females and 4 males), and 32 euthyroid subjects (18 females and 14 males). Apolipoprotein (apo) concentrations were measured in a fasting serum sample by immunoturbidometric assay and paraoxonase/arylesterase activities by spectrophotometric assay of p-nitrophenol/phenol production following addition of paraoxon/phenylacetate. Hypothyroid subjects had significantly higher levels of total cholesterol (204±69 vs 171±37, p<0.05) and low-density lipoprotein cholesterol (LDL-c) (115±49 vs 82±34, P<0.05) and lower levels of high-density lipoprotein cholesterol (HDL-c) (52±15 vs 63±17, P<0.05) than euthyroid controls. The ratios of TC/HDL-c (4.0 ± 1.3 vs 2.9 ± 1, P<0.01) and LDL-c/HDL-c (2.3 ± 0.8 vs 1.5 ± 0.8, P<0.01) were significantly higher in hypothyroid subjects than in controls. As compared to healthy controls, hyperthyroid subjects had lower levels of HDL-c (50±10 vs 63±17, P<0.05) and lower activity of paraoxonase enzyme (27±14 vs 66±41, P<0.01). No significant difference was observed between the hypo- and hyperthyroid subjects with euthyroid controls in serum levels of total cholesterol(TC), triglycerides(TGs), apo A-I, apo B, and arylesterase activity. Serum concentration of TSH had a significant positive correlation with TC and LDL-c, serum T3 was negatively correlated with TC and apo B and serum T4 level was negatively correlated with TC and LDL-c Significant negative correlation was observed between serum T4 and paraoxonase activity (r=-0.3, P<0.05). The results demonstrate that both hypothyroidism and hyperthyroidism are associated with atherogenic lipid profiles. Correlation between thyroid hormones, paraoxonase enzyme activity, and lipid levels confirms the role of thyroid hormones in the metabolism of lipids and their associated enzymes. The higher LDL oxidation previously observed in hyperthyroid subjects can be attributed to decreased HDL paraoxonase activity.

This study was performed to assess the prevalence of overweight and obesity in an adolescent population in Tehran and to determine possible association with energy and nutrient intake and distribution of energy over the day. A cross-sectional study on 177 boys and 244 girls between 10-19 years old was performed. Overweight and obesity were defined by using recommended body mass index (BMI) cut-off values for adolescents. Total energy intake, percent of energy derived from protein, carbohydrate and fat and percent of energy supplied by each meal and snack were assessed by means of two 24-hour dietary recalls. Prevalence of overweight and obesity was 10.7 and 5.1 in boys and 18.4 and 2.8 in girls, respectively. The composition of diet was not different between overweight/obese and normal weight subjects. BMI was related to breakfast energy percentage in girls (r=-0.18, P<0.01), with total energy intake in boys (r=0.23, P<0.01), and with lunch energy percentage in both sexes. In boys (r=0.16, P<0.05) and in girls (r=0.22, P<0.01), high prevalence of overweight and obesity among adolescents was seen. In boys some relationship between total energy intake, distribution of energy over the day and BMI was seen. In girls BMI was only related with distribution of energy over the day.

Chronic renal failure causes variation of different serum hormone level. Testosterone shows decrement and PTH shows increment in CRF. In this study serum levels of thyroid hormones (T3, T4) of 57 hemodialyzed patients with CRF, have been determined before and after hemodialysis. This study showed that before hemodialysis, the thyroid hormone levels in CRF patients with comparison to normal individuals are low, but after hemodialysis they increase significantly.

Carcinoid tumor is the most common tumor of the appendix which is usually found incidentally. A 5-year period investigation of the pathological specimens of the affiliated hospitals of Shaheed Beheshti University of Medical Sciences were studied. A total number of 7447 appendectomy specimens were found; 2730 cases women and 4717 cases men with female to male ratio of 1:1.7.Eighteen cases of carcinoid tumors were discovered. Seven of carcinoid cases were in females and eleven in males with female to male ratio of 1:1.5. The age of carcinoid patients were between 10-75 with average of 31 years. Prevalence of carcinoid in our cases studied was 0.24 percent which is lower that than reported in literature.

Thyroid function disorders (hypothyroidism and hyperthyroidism) are relatively common, and more frequently seen in females than in males. They have significant cardiovascular effects and often simulate cardiac diseases, specially hyperthyroidism that can induce and aggravate CAD, CHF and AF. Cardiac diseases and hyperthyroidism have some similar symptoms and signs, so clinical diagnosis of latter in the presence of the former is difficult. We evaluated 382 patients admitted to CCU of Modarres and Taleghani hospitals. After signing informed consent, TRH test was performed on all of them, clinical data including symptoms, signs, cardiac diagnosis and diagnostic methods, were evaluated too. Of these 382 patients, 186 (%48.7) were in Modarres and 196 (%51.3) in Taleghani hospital. Mean age of patients was 60.5±11.3 year. 164 (%42.9) were female and 218 (%57.7) male. History of thyroid disease was found in %10.7. %47.1 of patients had cardiac diagnosis of unstable angina, %17.8 AMI and %15.2 CHF. These ratios were similar in two hospitals. 27 (%6.3) of these 382 patients had thyroid function disorders including 9 (%2.4) hyperthyroidism and 15 (%3.9) hypothyroidism, of these 7 (%29.2) were female and 17 (%70.8) male, and only 3 (%13) had history of thyroid disease. 8 of 9 patients with hyperthyroidism were in Taleghani (%4.1 hyperthyroidism) and 1 in Modarres (%0.5 hyperthyroidism) (P<0.02) and all patient were male. 10 of 15 patients with hypothyroidism were in Taleghani (%5.1 hypothyroidism) and 5 (%2.7 hypothroidism) in Modarres hospital (P<0.35). 7 (%46.6) were female and 8 (%53.4) male. The prevalence of hypothyroidism in patients ≤50 year old (%9.6) was higher than that in patients 51-71 year old (%3.75) (P<0.07) but conversely the prevalence of hyperthyroidism in patients 51-71 year old (%4.2) was higher than in patient ≤ 50 year old (%0). 48 (%12.8) of all admitted patients had noncardiac disease and %10.4 of them had thyroid function disorders, %6.2 hypothyroidism and %4.2 hyperthyroidism. This research revealed that thyroid function disorders are relatively common in CCU-admitted patients and also more common in patients ≤ 50 year old. Hypothyroidism was more common than hyperthyroidism and hyperthyroidism more frequent in males than in females.

Phyical activity is considered to be effective in prevention and modification of diabetes melitus. The aim of this study was to evaluate physical activity in women with NIDDM who referred to Endocrine and Metabolism Research Center. In an analytic-descriptive study ,135 women with NIDDM chosen by simple sampling method were evaluated using the World Health Organization (WHO) questionnaire. Total physical activity, household physical activity, job related physical activity, physical activity in leisure time and walking in minute per week were measured. These data were compared with physical activity in American women. P<0.05 was considered statistically significant. The mean and standard deviation for age, BMI and weight was 49.6±10.23 years, 28.8±4.97kg/m2 and 69.36±12.55 kg respectively. The results showed that 90% of samples were inactive in leisure time. The minute spared for physical activity in leisure time and job related per week, was significantly lower than American women. The household physical activity in minutes per week was higher than American women, although 99.3% of household activity was light and very light. We conclude that minutes spared for physical activity which is useful for control of weight, lowering adiposity and increasing fitness was very low in our participants. The findings from this study suggest that improvement in physical activity behavior in women particularly in leisure time is essential.

Human body weight, in addition to height, age, and sex, is under the influence of body frame. One of the best ways to determine the body frame size is measuring the right elbow breadth, the distance between the two epicondyles of the elbow. The chances of the thickness of the subcutaneous fat of this anatomic region is unremarkable. We studied elbow breadth of 373 medical students (126 females and 247 males). The body frame is small when the elbow breadth in under 15 percentile, medium when it is between 15-85, and large when elbow breadth is above 85 percentile. The females with small body frame have elbow breadth <54mm, with medium body frame have elbow breadth between 54mm and 61mm, and large body frame have elbow breadth >65mm. The males with small body frame have elbow breadth <65mm, with medium body frame have elbow breadth between 65mm and 72mm, and large body frame have elbow breadth >72mm. In conclusion, there is significant differences between the elbow breadth of males and females in all the three classes of body frame. The elbow breadth of our subjects is significantly less than American people. In respect to elbow breadth, the similarity of our female subjects with the American women is more than the similarity of our males with the American men.