مجله غدد درون ریز و متابولیسم ایران
سال بیست و سوم شماره 1 (پیاپی 115، فروردین و اردیبهشت 1400)

Recent studies show that exposure to heavy metals can affect thyroid function. This study aimed to assess heavy metals in breast milk during the first few days postpartum and their relationships with hyperthyrotropinemia in neonates.

In this case-control study, 82 mother-infant pairs, consisting of 21 pairs (neonates with hyperthyrotropinemia) in the case group and 61 pairs (healthy neonates) in the control group, were assessed at 3-5 days postpartum. Thyrotropin concentrations >5 mIU/L in the heel blood sample were considered as hyperthyrotropinemia. In the case group, thyrotropin concentration was also measured in the venous blood sample for confirmation. At the same time, to assess mercury (Hg), lead (Pb), and cadmium (Cd) concentrations, a breast milk sample was collected from each mother.

The median (interquartile range, IQR) thyrotropin concentrations in the heel blood sample of healthy neonates and neonates with hyperthyrotropinemia were 0.90 (0.40-1.85) and 6.80 (5.70-8.80) mIU/L, respectively (P<0.001). This value was 5.50 (5.00-6.75) mIU/L in the venous sample of neonates with hyperthyrotropinemia. None of the heavy metals in breast milk showed a significant correlation with thyrotropin concentration in the heel blood sample. However, there was a significant correlation between the concentration of Pb in breast milk and thyrotropin level in the venous blood sample (r=0.478, P=0.029). No correlations were observed between breast milk Hg and Cd concentrations and venous thyrotropin level.

The present findings indicate that the concentration of Pb in breast milk correlates with neonates' thyroid function. However, further studies with larger sample sizes are needed to confirm our results.

The World Health Organization Package of Essential Noncommunicable Disease Interventions (WHO-PEN) enables the prevention, early detection, and management of cardiovascular disease, diabetes, chronic respiratory disease, and cancer. Ira-PEN is the adapted WHO-PEN program for the Iranian population, which started in 2015 as a pilot program in four cities (Naghadeh, Maragheh, Shahreza, and Baft). Then, it was implemented throughout the country. We aimed to investigate the prevalence of cardiovascular risk factors in men and women referred to the health centers.

This study used data for people over 30 years old in the pilot areas in 2016 and 2017. The 10-year cardiovascular risk was determined with SIB software, as an integrated health information system, using the WHO/ISH risk chart. Individuals were classified into four risk categories: low (<10%), medium (10-20%), relatively high (20-30%), and high (>30%).

Among 160,223 subjects (58.1% female), the prevalence (95%CI) of diabetes in men and women was 8.5% (8.3-8.8) and 12.9% (12.7-13.1), respectively, and about one-third of diabetes cases were unknown. The prevalence of hypertension in men and women was 15.6 (15.3-15.9) and 23.2 (22.9-23.5), respectively. The unknown hypertension cases included 40% and 20% of men and women, respectively. Around 9% of men and 15.7% of women had hypercholesterolemia. More than 4% of men and around 5% of women had a risk of ≥10%.

Women are referred to the health centers more than men, and it seems that high-risk women refer to these centers for their diseases. Considering the high risk of morbidity and mortality due to cardiovascular diseases in men, we recommend encouraging and following men to control their risk factors.

Diabetes is the most common metabolic disease globally, and its control is not effective without changing the lifestyle. Therefore, this study aimed to investigate the effect of lifestyle modification education on the blood sugar of diabetic patients.

This quasi-experimental interventional study was performed in 2017 among diabetic patients referred to the Urmia Diabetes Association. We randomly divided 74 patients into the intervention and control groups (37 patients in each group). Demographic characteristic forms and blood sugar control checklists were used to collect information. Educational interventions were performed in eight sessions of 1.5 hours during two months for the intervention group. Descriptive statistics, independent t-test, and paired t-test were used to analyze the data. SPSS software version 16 was used for data analysis, and the difference was considered significant at a level of less than 0.05.

The mean age of the subjects was 48.9±10.8, and the majority (75.6%) were women. Before the study, the mean blood sugar level of patients was 241 mg/dl with a standard deviation of 54.6 mg/dl. The mean blood sugar level was not different between the groups before the intervention but, after the intervention, it was significantly lower in the intervention group (p-value=0.01).

Lifestyle modification education can significantly reduce the average blood sugar of people with diabetes.

Gestational diabetes mellitus (GDM) is one of the most common metabolic disorders firstly diagnosed in pregnancy. Periodontal infection is also a localized and chronic inflammation that can trigger the systemic inflammatory response, and some believe it is associated with GDM. There is insufficient evidence to support a link between periodontal disease and GDM. This prospective study aimed to determine the relationship between periodontal disease and GDM.

This cohort study was performed in the Prenatal Clinic of Rouhani Hospital in Babol from September 2018 to September 2019. The periodontal status of pregnant women in terms of bleeding on probing (BOP), periodontal pocket depth (PPD), clinical attachment loss (CAL), and gingival index (Loe & Silness) at 12 to 24 weeks of gestation by one dentist was examined in the same clinic to diagnose periodontitis cases. Then, at 24 to 28 weeks of gestation, GDM was evaluated based on the 75 g glucose tolerance test.

The incidence of GDM was higher in women with periodontitis (P<0.001). The raw relative risk of GDM was 11.94 (CI 95%: 6.21-54.77, P<0.001). The relative risk, adjusted for body mass index, waist circumference, number of pregnancies, and number of deliveries, was 11.23 (CI 95%: 6.20-12.58, P<0.001). The mean GI, CAL, BOP, and PPD were higher in pregnant women with GDM than in the healthy group (P<0.05).

To prevent GDM, the early detection and treatment of periodontitis should be a priority in prenatal care, even before pregnancy.

Despite the higher prevalence of kidney dysfunction in females, the effects of nitrate have mainly been studied in males. This study aimed to determine the effects of long-term sodium nitrate administration on kidney function in normal adult female rats by assessing estimated Glomerular Filtration Rate (eGFR), serum urea, and serum creatinine.

Female Wistar rats were divided into two groups (n = 10 per group). The control group received tap water, and the nitrate group received tap water containing 100 mg/L sodium nitrate for nine months. Bodyweight, serum urea, and serum creatinine were measured at the beginning and end of the study, and eGFR was calculated. The nitric oxide metabolites (NOx) levels were also measured at the end of the study in serum and kidney tissue.

The body weight, serum urea, and creatinine levels of rats in the control group were significantly higher, and eGFR was significantly lower at the end of the study compared to the beginning of the study. Nitrate administration for nine months prevented increases in body weight, serum urea, and creatinine and decreases in eGFR. Nitrate-treated female rats also had higher NOx levels in serum and kidney tissue.

Nitrate administration improved kidney function in female normal adult rats. These beneficial effects may be associated with increased serum and kidney levels of NOx.

Obesity is caused by excessive accumulation of subcutaneous and visceral white adipose tissue and an imbalance between energy intake and consumption. Because the prevalence of obesity is increasing worldwide, prevention methods have become particularly important. In new anti-obesity strategies, in addition to limiting energy intake and increasing its consumption, energy dissipation in the form of heat or thermogenesis is considered. Because thermogenesis occurs primarily in brown adipose tissue (BAT), identifying BAT provides an opportunity to design an anti-obesity drug intervention by increasing energy expenditure and thermogenesis. Understanding the molecular and cellular pathways and regulatory factors, including non-coding RNAs involved in the thermogenesis process in BAT, is a crucial strategy for therapeutic applications against obesity and obesity-related diseases. Non-coding RNAs, including miRNAs and lncRNAs, are essential regulators in biological processes. Besides, miRNAs are a group of small non-coding RNAs with vital regulatory roles in regulating gene expression. Recent studies have also shown that BAT-specific non-coding RNAs play a key role in regulating the function of brown adipogenesis, browning of white adipose tissue (such as beige adipogenesis), and brown thermogenesis. In this study, miRNAs and lncRNAs related to genes involved in brown adipose tissue and thermogenesis were investigated. These miRNAs and lncRNAs may be used in the future as biomarkers and therapeutic targets for the prevention and treatment of obesity and obesity-related diseases.

Vitamin D deficiency is a prevalent health problem all over the world. It is estimated that more than half of the Iranians are vitamin D deficient. Evidence has shown that adequate vitamin D levels are required for skeletal health through calcium and phosphorus homeostasis and play an essential regulatory role in extra-skeletal organs. However, there are several controversies and unanswered questions regarding diagnosis, evaluation, treatment, and even optimal serum levels of vitamin D. In this review study, we will discuss current evidence regarding the evaluation and treatment of vitamin D deficiency, emphasizing studies in the Iranian population. We also discuss how to achieve and maintain the optimum serum levels of vitamin D. This study concluded that according to the high prevalence of vitamin D deficiency in Iran, it is necessary to measure vitamin D serum levels in high-risk individuals. In the face of vitamin D deficiency, the initiation of treatment with a loading dose of vitamin D is recommended, followed by maintenance doses. Besides, malabsorption syndromes should be considered in people without increased serum levels despite the regular consumption of vitamin D. Moreover, calcitriol should not be used for the treatment of vitamin D deficiency in the general population.