Journal of Inflammatory Diseases
Year:2008 | Volume:12 | Issue:1 (46)|Papers Count:21

Background: Interest in measuring of serum nitrite/nitrate (NOx) concentration has increased during recent years as there are reports indicating that NOx levels affected by some diseases.Objective: This study was aimed at determining the serum NOx levels in healthy subjects within the framework of a population-based study.Methods: This was a descriptive analytical study carried out within the framework of Tehran lipid and glucose study participant. Serum NOx concentration was measured in 3505 subjects aged 20 years and over. The exclusion criteria were high blood pressure, impaired carbohydrate metabolism, dyslipidemia, and renal dysfunction. Afterthat 786 non-smoker healty subjects were in cluded in the analysis. Serum NOx concentration was detennined in all samples obtained following an overnight fasting period. The serum level of NOx in different age groups was further compared. Later, comparison between the lowest and highest quartiles of NOx levels was performed for both genders. Findings: The mean±SD serum NOx concentration was 26.0±12.9 mmol/l with insignificant difference between men (25.6±11.8) and women (26.1±13.3 mmol/l).No age-related change in serum NOx concentration was observed in either sex. Women and not men with high serum NOx had significantly higher weight, waist circumferences, and systolic blood pressure even after adjustment for menopausal status (p<0.05).Conclusions: Based on data found in present study it seems that the serum NOx concentration in healthy subjects to be strongly controlled, thus, any significant change in serum level of NOx could be considered as a reflection of altered physiological status.

Background: High serum uric acid is associated with kidney damage manifested by glomerular sclerosis, hypertrophy and albuminuria in animal models.Objective: To evaluate the relationship between elevated serum uric acid and urinary albumin/creatinine ratio in type 2 diabetes.Methods: In this cross-sectional study, 290 patients (130 males and 160 females) with type 2 diabetes were recruited for measuring, cholesterol, triglycerides, uric acid and albumin/creatinine ratio (ACR). The data obtained for albumin/creatinine ratio were expressed as mean±SD or percentage and a P value  £0.05 was considered as significant. One-way analysis of variance and Pearson correlation coefficient were used for statistical studies.Findings: The mean ages of patients were 58.2±8.6 years. Uric acid levels for norrnalbuminuria, microalbuminuria and marcoalbuminuria were (5.1±0.7, 6.3±1.1, and 8.1±1.3 mg/dl, respectively). While the uric acid level in men was shown to have a positive correlation with natural logarithmic ACR [Ln (ACR)], ( d=0.53, p<0.05), a positive correlation with both triglycerides and Ln (ACR) was found among women (0=0.263, P<0.01).Conclusion: Based on our data, serum uric acid was found to be independently correlated with urinary ACR in patients with type 2 diabetes.

Background: Diabetes mellitus is the most common endocrine disorder causing micro- and macrovascular complications which could be prevented by good glycemic control. Considering many patients who become resistant to routine anti-diabetic drugs after few years, the administration of other drugs to reduce the level of glucose is an essential approach for a better glycemic control.Objective: The aim of this study was to compare the effects of fluoxetine and alprazolam added to regular anti-diabetic drugs on blood glucose in patients with type 2 diabetes.Methods: In this paralleled clinical trial, 66 uncontrolled type 2 diabetic patients referred to Yazd Diabetes Research Center were selected and received randomly either 20mg of fluoxetine or 0.5mg of alprazolam for 6 weeks. Mean FBS (fasting blood sugar), 2hpp (2 hours post-prandial glucose), HbAlc (Glycated Hemoglobin) and BMI (Body Mass Index) were measured before and after the study. Data were analyzed by Hest and paired Hest.Findings: The mean FBS, 2hpp, HbAlc and BMI were decreased after using fluoxetine by 27.5±7.5mg/dl 47.5±10.5, 1.5±0.5% and 2.2±0.8kg/m2 respectively (P=0.001). Also the mean FBS, 2hpp and HbAlc were decreased by 13.7±13.5mg/dl, 22.5±5.6 mg/dl and 0.5±0.3% following the administration of alprazolam (P=0.001). Similarly the mean BMI was increased by 0.3±1.5 kg/m2 this difference was found to be statistically insignificant (P=0.35).Conclusion: Both fluoxetine and alprazolam were useful for better control of blood glucose in diabetics who were free of diabetic complications; nevertheless, it seems that fluoxetine is more effective than alprazolam.

Background: Insulin resistance and glucose intolerance are commonly associated with liver cirrhosis. Resistance to insulin is an important prognostic factor in liver cirrhosis.Objective: To determine the relationship between insulin resistance and severity of liver cirrhosis. Methods: This was a descriptive-analytic study carried out on 76 patients with established liver cirrhosis in Booali hospital (Qazvin) in 2006 and 2007. Their fasting blood sugar, serum insulin level and oral glucose tolerance test (OGTT) were measured. Patients divided into three groups of A, B and C according to the child-pugh classification. Insulin resistance was determined by the homeostasis model assessment (HOMA-IR) in all patients. Data analysis was performed using t test, variance analysis, chi-square and Fisher's exact test.Findings: Cirrhosis was found to be strongly associated with insulin resistance (60.5%) and the values obtained for prevalence of insulin resistance for groups A, B, and C of Child-Pugh Classification were %31.6, %66.7 and %74.1, respectively. The relationship between IR and severity of liver cirrhosis was significant, statistically (p=0.01). Diabetes mellitus was diagnosed in 26 subjects (34.2%), impaired glucose tolerance in 24 (31.6%) and normal glucose tolerance in 26 (34.2%) using OGTT.Conclusion: Insulin resistance increased with stage of liver cirrhosis as defined by Child-Pugh score.

Background: Some evidences suggest a possible relationship between environmental stresses and the prevalence of metabolic syndrome (MS).Objective: To investigate the association between major stressful life events and the prevalence of MS.Methods: In this Cross-sectional study, the 35-55 years old first-degree relatives of type 2 diabetics were included. The questionnaires of stressful life events, physical activity and basic characteristics were completed. Also, the waist circumference, blood pressure, FBS, TG, Chol, and HDL were measured. MS was defined according to ATP III criteria and the number of stresses was compared between two groups of participants with and without MS.Findings: Among 439 participants, the prevalence of MS was 26.8%. The mean number of stresses in MS and non-MS groups were (3.82±2.67) and (3.14±2.35), respectively. The difference was found to be significant, statistically (P=0.036).Comparing the prevalence of MS in subjects with 8 or more stressful life events (46%) with those who experienced less than 8 stresses (23.4%) was indicative of a higher prevalence among the former (P=0.017).Conclusion: Considering the possible association between stresses and the prevalence of MS, which in turn increases the risk of heart diseases, educating high risk people on how to cope with stresses may be of benefit in CVD prevention.

Backgrounds: Lipoprotein (a) or Lp(a) is a cholesterol-rich particle with atherothrombogenic properties. Plasma level of Lp(a) varies in different populations, however, little data on normal range of Lp(a) lipoprotein among Iranian population is available.Objective: The aim of this study was to estimate the normal range of Lp(a) and also its relationship with other lipoproteins in a group of Iranian students.Methods: This was a cross-sectional descriptive analytical study carried outon 150 college students (88 females and 62 males) aged 19-30 (21.8±2.3) who were clinically healthy and coming from various regions of Iran. The fasting serum levels of Lp(a), lipids, lipoproteins, apolipoproteins, total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C), were determined by standard kits. Lp(a) and apo-B100 measurement was performed using electro-immunoassay, and apo-A1 by an immunoturbidimetric method. The data were further analyzed using SPSS, U- and t-tests to compare the variables and also the Pearson correlation test in determination of correlation between Lp(a) and other variables. A p-value of£0.05 was considered to be significant.Findings: Lp(a) with a mean of 19.46±19.44 mg/dl, did not showed any significant differences between males (16.33±18.79 mg/dl) and females (21.41±19.80 mg/dl). In addition, no statistically significant correlation was demonstrated between the serum Lp(a) levels and oher variables such as age, lipids, and lipoproteins. A serum Lp (a) level higher than 30 mg/dl was shown in 14% of males, 36.5% of females and 21.5% of the total subjects.Conclusion: The mean serum concentration of Lp(a) in the present study was relatively higher than the values found by most researchers. This might be an acceptable explanation to high incidence of cardiovascular disease in some Iranian populations.

Background: Ischemic heart disease is the most prevalent cause of mortality in women and change in lifestyle including better physical fitness could control this condition.Objective: To determine the relationship between physical fitness and obesity in women with coronary involvement.Methods: In this cross-sectional study, 113 women aged 40-60 with stable angina, were included. Demographic details and past medical history (hypertension, diabetes, and hyperlipidemia) were collected using a questionnaire. Also, the Duke Activity Scale questionnaire (including 12 questions) was completed for each patient. Later, a coronary angiography using Seldinger method was performed and the extent score determined. The body mass index was also calculated. Data were evaluated using SPSS/12, t-student test, and the correlation and regression analysis.Findings: The mean age, coronary involvement score, and the Duke Score were 50.18±8.71 years, 5.85±5.50 and 22.35±14.75, respectively. The coronary involvement score in women with diabetes, hyperlipidemia, and hypertension was higher than those without such complications (p<0/05). However, the activity scale was shown to have insignificant difference. In addition, there were significant differences between the scale of physical fitness and both the coronary score and the body mass index (P<0.0001, r=-0.33) and (P<0.02, r=-0.21), respectively. Nevertheless, no relationship between the obesity and coronary involvement was demonstrated (P>0.05).Conclusion: According to our data, we must have more attention on physical fitness in women beside other change in life style.

Background: Heart failure is the main cause of morbidity and mortality worldwide with poor prognosis. Two processes; inflammation and apoptosis, play major roles in the pathogenesis of heart failure with poor prognosis. Apoptosis can be discovered in different conditions within the myocardial tissues. One of the regulatory mechanisms of apoptosis is through Fas (CD95)/FasL system.Objective: Evaluating the level of soluble markers of Fas/FasL apoptosis system in patients with heart failure and its severity.Methods: This was a case-control study in which 85 patients with different functional class of heart failure and 25 healthy persons as control group were examined at Transplantation Institute of Moscow between the years 2004-2007. Evaluation of apoptosis markers was carried out by immunoferment analysis using an automatic analyzer (Personal Lab TM, Adaltis, Italy) and the Bender Med system kits, Austria.Findings: In patients with heart failure while the blood level of sFas was lower than that of healthy person, the sFasL was found to be higher compared to control group. Regarding the level of soluble forms of apoptotic markers of sFas/sFasL in HF, the sFas and sFasL levels were demonstrated to have an opposite association with the functional class of heart failure so that a negative relationship for sFas and a positive correlation for sFasL were found. At the same time, the sFas was shown to be weakly associated with ejection fraction whereas the sFasL demonstrated a reverse correlation (P<0.05). Conclusion: These markers could be used as complementary laboratory markers to assess the severity of heart failure and also the prognosis.

Background: Many reports indicate an idiopathic rise in sialic acid level after myocardial infarction (Ml). Such reaction attached to its correlation with both reactionary indices in the acute phase and fatty indices has been thoroughly studied and produced controversial findings. Hence, it is considered as an important diagnostic agent.Objective: To study the relationship between serum total sialic acid (TSA) level and several diagnostic markers including lactate dehydrogenase (LDH), creatine phosphokinase (CPK) and troponin in MI patients.Methods: This was a descriptive analytical study in which 30 patients with MI investigated. Blood samples were collected in three consecutive days following the occurrence of MI. Serum levels of TSA, CPK, and LDH were measured using spectrophotometric technique and troponin determination by ELISA. The data were investigated by SPSS using Hest and Pearson's correlation coefficient for further analysis.Findings: The serum levels of TSA and the target markers were considerably higher than recommended normal levels. There was a significant relationship between TSA and troponin (P=0.05, FO.47) at the first day and TSA and LDH at the second day (P=0.01, P<0.05).Conclusion: Regarding the results found in our study, higher level of TSA together with increase in concentration of several cardiac specific markers including troponin and LDH implies that it could be considered as an early diagnostic marker in cardiovascular diseases.

Background: High blood pressure is the most important modifiable risk factor of cardiovascular diseases. Objective: To compare the effect of two family-and individual-based interventions on blood pressure and lifestyle in subjects suffering from hypertension.Methods: This quasi-experimental study was conducted on 91 subjects with blood pressure³140/90 mmHg in Islam-Abad, Zanjan (Iran) during 2005-2006. The subjects were non-randomly assigned to either the family-based group (n=42) or individual-based group (n=49). Intervention included counseling to promote both lifestyle and medical aspects of secondary prevention. The data were analyzed using chi-square test, t-test, paired t-test, Mann-Whitney test, and Wilcoxon test.Findings: The mean systolic blood pressure decreased from 159/5±14/4 to138/3±12 and 157/6±21/6 to 132±20/9 in family-based group and in individual-based group, respectively. There was no significant difference in blood pressure between two groups after intervention (p=0.92). However, following intervention the mean blood pressure significantly decreased in both groups (P=0/0005).Also, the mean score of fruits and dairy product consumption and physical activity in subjects were significantly increased among two groups, post-intervention (p<0.0001).Conclusion: The results indicated that both methods with focus on physical activity and diet counseling followed by structured follow-up meeting could be considered as effective ways of controlling CVD risk factors.

Background: Maternal age is an important risk factor in gestational diabetes but there is controversy about determination of age cut off as a risk factor for its prevalence.Objective: To evaluate the prevalence of gestational diabetes and also the comparison of maternal age in healthy and gestational diabetic patients.Methods: This was a cross-sectional study in which the records of pregnant women referred to Javaheri hospital during 2003-2006 were investigated. The data were analyzed by SPSS and independent Hest.Findings: A total of 5107 pregnant women were evaluated during this time period and 170 cases found to suffer from gestational diabetes. The prevalence of gestational diabetes was 3.3% during the four-year study. The mean age of gestational diabetic group was 30.4±5 years and of normal women 27.5±5. There was a significant difference between two groups (p<0.001). Meanwhile, 90% of gestational diabetic women were above 24 year.Conclusion: According to this study and new guidelines, it is suggested that the age screening of gestational diabetes in pregnant women to be reviewed and replaced by the use of a recommended age base of 25 year or higher.

Background: At present, the prevalence of obesity among children and youngsters is rapidly increasing in developed countries. Few studies have been carried out on childhood obesity in Iran using standard references.Objective: Assessing the prevalence of obesity among school children in Neishabour using several references including Iranian reference, CDC 2000 and IOTF 2000.Methods: In a cross-sectional trial, 1471 students aged 6-12 were selected by a two-stage cluster sampling. Height and weight of students were measured and BMI was calculated. Obesity was defined as having a BMI³95th percentile of Iranian reference or CDC. Also, the students with BMI greater than IOTF values were identified as obese.Findings: The prevalence of obesity according to the Iranian reference, CDC and IOTF were 8.5% (CI 95%, 7.1-10.0%), 4.6% (CI 95%, 3.5-6.0%), and 7.3% (CI 95%, 6.0-9.0%), respectively. Using CDC reference, a significant difference in prevalence of obesity between girls and boys (5.8% vs. 3.1%) was found (p<0.05). When the Iranian reference was applied, the prevalence of obesity was shown to be significantly higher in boys aged 7 and 8 compared to girls (15.2% vs. 6.4% and 12.5% vs. 4.0%), respectively (p<0.05). Finally, the application of IOTF reference produced no significant difference in prevalence of obesity between girls and boys.Conclusion: As the results of different references in determining the prevalence of obesity were not the same, use of relevant BMI percentile is recommended.

Background: In observational studies, prolonged reduction in blood total cholesterol level is associated with lower risk of coronary heart disease however the results of clinical trials are controversial. During recent decades the role of antioxidants in preventing the initiation and progression of oxidative stress has been the focus of discussion.Objective: To systematically review and find the exact role of antioxidants in preventing atherosclerosis and secondary cardiovascular diseases (CVD).Methods: The Medline database through 1991-2007 was carefully retrieved and 37 relevant papers selected.Findings: There are conflicting results in clinical trials regarding the efficacy of antioxidant vitamin supplements in reducing the progression of atherosclerosis and CVD events.Conclusion: Owing to several different factors of patients such as age, sex, health conditions, study duration, and also the type of studies, it was concluded that the judgment on benefit of antioxidants is accompanied with poor clarity. Thus, further future studies are needed to address the efficiency of such medications in reducing the effect of these two risk factors on human.

The aim of present study was to determine the degree of knowledge and skills of diabetic patients on insulin self-injection procedure. This cross-sectional study was performed on 149 diabetic patients whose data were collected using a questionnaire for degree of knowledge and a check list for degree of insulin injection skill. The findings indicated that while only 27.5% of subjects were familiar with the proper knowledge, the degree of skills on self-injection procedure scored at proper (26/8%) and moderate (57/05%) levels among the patients. Statistically, significant relationships between knowledge and skills, skills and education level, and skills and job were found. The results highlight the areas where efforts to improve knowledge and practice may contribute to prevent the side effects of diabetes.