IRANIAN JOURNAL OF ENDOCRINOLOGY AND METABOLISM (IJEM)
Year:2020 | Volume:22 | Issue:2|Papers Count:7

Introduction: Neonatal hypothyroidism, a preventable cause of mental retardation, has a high prevalence in Iran. Considering the high prevalence of the transient form of this disease, which recovers within 4-6 months after birth, it is important to determine factors that can differentiate between permanent and transient hypothyroidism in Iran. Materials and Methods: In this retrospective cohort study, neonates born in 15 selected provinces of Iran in 2011 were included. The evaluated information in this study included cumulative data, routinely collected in the national screening program for congenital hypothyroidism. Results: A total of 598 (57. 1%) infants were diagnosed with permanent congenital hypothyroidism, and 449 (42. 9%) infants were diagnosed with transient congenital hypothyroidism. Based on the ROC curve analysis, serum thyroid-stimulating hormone (TSH) levels above 20 mU/L predicted permanent cases with 75. 2% sensitivity and 82% specificity. Also, serum thyroxine (T4) levels below 8. 2  g/dL predicted permanent cases with sensitivity of 72. 1% and specificity of 64%. Overall, a serum TSH level! 20 mU/L, a serum T4 level "8. 2  g/dL, parental consanguinity, and family history of thyroid diseases increased the risk of permanent hypothyroidism, respectively. Conclusion: The serum levels of T4 and TSH are the most important prognostic factors for the prediction of permanent congenital hypothyroidism. Although it is not possible to make a definitive early diagnosis, we may be able to differentiate the transient form more quickly, with greater sensitivity and specificity, by conducting larger studies and advanced modeling; this would help medical teams discontinue long-term treatments for transient cases and reduce the financial and emotional burdens on families.

Introduction: Due to the current unpredictable changes following the global coronavirus disease (COVID-19) pandemic, significant changes have taken place in the healthcare systems. Most of the clinical and evidence-based care services for patients with diabetic foot has been disrupted. Therefore, many patients with diabetic foot ulcers cannot receive the necessary care, despite its great significance. All healthcare providers, including physicians and nurses, have difficult tasks and responsibilities during the COVID-19 crisis. Although patients with diabetic feet are at risk of infection, hospitalization, amputation, and death, they must remain out of hospitals, and distance educational and therapeutic services must be provided for them. This study aimed to introduce and describe the recommendations of the International Working Group on the Diabetic Foot (IWGDF) for the care of patients with diabetic feet during the new COVID-19 pandemic.

Introduction In Iran, cardiovascular disease is the leading cause of mortality, accounting for 46% of all deaths. Iran’s Package of Essential Noncommunicable Diseases (IraPEN) program was adapted from the comprehensive World Health Organization (WHO) PEN program with a ten-year risk calculation approach for cardiovascular diseases to control the main risk factors for noncommunicable diseases in Iran. This study aimed to examine the client's adherence to the visitation schedule recommended by health centers in IraPEN, based on their cardiovascular risks. Materials and Methods: The pilot IraPEN program was established in four cities of Naqadeh, Maragheh, Shahreza, and Baft from 2016 to 2018, and this program is still ongoing. In this program, the risk of cardiovascular disease is calculated by SIB, as a comprehensive electronic health record system, with the help of the WHO risk assessment chart. Individuals were divided into four groups in terms of risk: low, medium, relatively high, and high. In the present study, 160, 833 individuals were followed-up over a year to measure the number of timely visits to receive primary healthcare services in the pilot phase of the program. Results: Adherence was low in all four evaluated cities. The overall adherence rate was 19. 73% in this study, and timely referral was higher in women than men (21. 98% vs. 16. 37%). The rate of adherence in low-risk individuals (<10%) was higher after the first visit and decreased after the second visit. In individuals with relatively high and high risks (20-30% and! 30%, respectively), adherence was low after the first visit, but increased after the second and third visits. Conclusion: Among the participants of this study, the rate of adherence to the referral time recommendations was low. Also, this rate was lower in men than women, which shows that men paid less attention to their health status and care proceedings. Overall, there is a need for further training in the pilot cities of the program to clarify the importance of healthcare services and improve adherence to the proposed schedules.

Introduction: Scientific publications are among the most important indicators for evaluating the development of scientific fields in different countries. The present study aimed to evaluate Iranian scientific publications in the field of endocrinology and metabolism. Materials and Methods: Documents for analysis included all Iranian scientific publications in the field of endocrinology and metabolism, published in the Web of Science. Data analysis was conducted based on the “ result analysis” section of Web of Science and descriptive statistics. Results: The total number of Iranian endocrinology and metabolism papers was 4318, involving 2051 organizations, 79 countries, and 10, 677 contributing authors. The average number of citations was 8. 51 per document. The Iranian publications in the field of endocrinology and metabolism in 2019 were ranked 19th in the world, the second in the Middle East, and the eighth in Iran’ s medical field. Azizi was the most prolific and the most cited author. The United States had the greatest cooperation with Iran. Most scientific documents were articles. Tehran University of Medical Sciences and Isfahan University of Medical Sciences accounted for the highest number of publications and citations, respectively. Also, the "Annals of Nutrition and Metabolism" and "Biological Trace Element Research" had the largest number of published and cited articles, respectively. Conclusion: The growth of Iranian scientific publications in the field of endocrinology and metabolism is considerable; however, the promotion of their scientific rank in terms of quantity and quality requires more careful planning.

Introduction: Oral contraceptives (OCs) have been recommended as the first-line drug therapy for polycystic ovary syndrome (PCOS). This study aimed to compare the effectiveness of Desoceptive and Etisterone OCs on the clinical, hormonal, and metabolic parameters of patients with PCOS over six months. Materials and Methods: In this randomized clinical trial, 200 patients with PCOS were randomly assigned to one of the intervention groups: Desoceptive (ethinyl estradiol+desogestrel) and Etisterone (ethinyl estradiol+cyproterone acetate). The outcomes of interest included the androgenic profile, Ferriman-Gallwey score, and anthropometric and metabolic parameters. Results: After 3-6 months of treatment with OCs, there were no significant differences in the levels of androgens, including the free androgen index, sex hormone-binding globulin, total testosterone, and dehydroepiandrosterone sulfate between patients treated with Desoceptive and Etisterone. The results also showed no significant differences between the two groups in terms of the Ferriman-Gallwey score and anthropometric parameters. After 3-6 months of treatment, patients treated with Desoceptive had lower serum triglyceride levels than those treated with Etisterone (regression coefficient:-32. 3; 95% CI:-56. 4,-8. 2; P=0. 009 and regression coefficient:-33. 5; 95% CI:-57. 6,-9. 4; P=0. 006, respectively). Moreover, the results showed that three months after treatment, patients treated with Desoceptive had higher levels of low-density lipoprotein (LDL) than those treated with Etisterone (regression coefficient: 12. 3; 95% CI: 0. 5, 24. 1; P=0. 040), while after six months of treatment, the LDL level was not significantly different between the two groups. Conclusion: Based on the present findings, use of OCs, containing antiandrogenic and androgenic progestins for 3-6 months, did not significantly change the hormonal profile or anthropometric and hirsutism parameters. OCs containing Desogestrel were associated with a more significant decrease in the triglyceride level, while OCs containing cyproterone acetate were associated with a more significant increase in LDL.

Introduction: Vaspin is an adipokine that reduces insulin resistance and obesity. There is little evidence suggesting an association between diet and plasma vaspin levels, and no studies have investigated the vaspin gene expression. The current study aimed to investigate the association of dietary fatty acid (FAs) intake with vaspin gene expression in visceral and subcutaneous adipose tissues (ATs) among obese and non-obese individuals. Materials and Methods: Visceral and subcutaneous ATs were obtained from 50 obese and 47 non-obese individuals with a body mass index (BMI)  30 and BMI <30kg/m2, respectively, who underwent open abdominal surgery. The dietary intake was evaluated using a validated food frequency questionnaire, and the daily intake of FAs, including total dietary fat, saturated FAs, monounsaturated FAs, and polyunsaturated FAs, was calculated. The relative expression of vaspin gene in ATs was measured by real-time polymerase chain reaction (PCR) using SYBR® Green. Results: The mean± SD of BMI in obese and non-obese subjects was 41. 4± 5. 87 and 24. 8± 2. 86 kg/m2, respectively. Comparison of vaspin gene expression in visceral and subcutaneous ATs of obese and non-obese individuals. showed higher expression leveles in the subcutaneous AT of obese individuals (P<0. 034). In obese subjects, the dietary intake of polyunsaturated FAs (r=0. 28, P=0. 05) had a marginally significant positive association with vaspin gene expression in the visceral AT. Conclusion: The results of the present study showed that vaspin gene expression was only higher in the subcutaneous AT of obese individuals as compared to non-obese subjects. There was no significant association between dietary FAs and vaspin gene expression. Therefore, further extensive studies are necessary to determine the underlying mechanism of the effect of vaspin on insulin resistance and to illustrate the possible role of dietary FAs in this regard.

Introduction: Childhood obesity can be the cause of many obesity-related diseases in adulthood. This study aimed to investigate the effect of eight weeks rope training on the plasma level of angiopoietin-4 (ANGPT4), interleukin-6 (IL-6), and lipid profile of overweight students. Materials and Methods: A sample of 39 overweight students, with the mean body mass index (BMI) of 24. 09± 3. 20 kg/m2 and the mean age of 10. 77± 1. 11 years, was selected and randomly divided into two intervention (n=20) and control (n=19) groups. The intervention group performed rope exercises for eight weeks, three sessions per week (40 minutes per session). Blood samples were collected and ELISA assay was performed to measure the biochemical variables, and analysis of covariance was used to analyze the data at a significance level of P<0. 05. Results: Eight weeks of rope training resulted in an increase in ANGPT4 (P=0. 006) and a decrease in IL-6 level (P=0. 001) in overweight children. Cholesterol (P=0. 03) and blood triglyceride (TG) (P=0. 05) levels significantly decreased in the intervention group, but there was no significant difference in the low-density lipoprotein (LDL) and high-density lipoprotein (HDL) levels between the two groups. Eight weeks of rope training had a significant effect on the waist-to-hip ratio (WHR) of overweight children (P=0. 001), whereas BMI changes were not significant (P=0. 18). Conclusion: It seems that exercise training in obese children, by improving ANGPT4 and decreasing cholesterol and TG levels, improves the body metabolic status and WHR.