مجله غدد درون ریز و متابولیسم ایران
سال سیزدهم شماره 6 (پیاپی 60، اسفند 1390)

Hypertension during pregnancy (HDP) is a gestational disease that occurs mainly among nul‌liparous women, Studies show conflicting results of its complications later in life. We hence aimed to assess metabolic and cardiovascular complications subsequent to preeclampsia in a cohort study.

Normotensive women, participants of the Tehran Lipid Glucose Study (TLGS) were selected and categorized in two groups: Group 1: 226 women with previous preeclampsia as the case group, and 226 age-BMI matched women without preeclampsia as the controls. Groups were followed 10 years and were compared for cardiovascular and metabolic disorders.

The incidence rate of type 2 diabetes mellitus in the case group was 3-fold higher than in controls (37.2% vs 12%). Incidence rates for hypertension and dislipidemia in the case group were also significantly higher than in controls (41.1 vs 19.5% for hypertension and 87.2 vs 66.3% for dislipidemia). Values for systolic blood pressure, fasting blood sugar and high-density lipoprotein (HDL) differed in phase 3 in the two groups.

Women with previous preeclampsia were at high risk of cardiovascular and metabolic disorders. Counseling, screening and providing health care can reduce their complications of preeclampsia, later in life.

Quality of life, considered an indication of quality of health care, is an essential part of health care programs for controlling disease. Although the evaluation of quality of life in Iran dates back to 40 years ago, it is yet in its infancy as there is limited data available in this field. The present research deals with the effects of diabetes on the quality of life of adolescents in different areas including the rate of life satisfaction and concern about the future. In this descriptive-analytic research, 100 diabetic adolescents referred to the Zahedan diabetes centre were studied. A 52 item DQOLY questionnaire was used to collect data, which was analyzed using the independent T-test and variance analysis. Results revealed lower scores in adolescents’ responses, their main problem being parent control and the effects of diabetes on their activities. The maximum average score was for adolescents’ satisfaction of life quality (52.6 ± 14.58). The 10-12 year age group was more affected by disease in their personal activities, a difference that was statiscally significant (P=0.004). Statistical tests also showed a significant difference for the average score of the diabetic adolescents in terms of the effect of parents’ education on adolescents’ satisfaction of life quality and parent control (P=0.0001). Results indicated that diabetic children and adolescents have difficulty in their social activities, and they are influenced by parent control, a finding more prominent in 10-12 year olds. It is hence suggested that this age group, especially in the groups with low economic status, must be provided with special care through training, counseling and intervention.

Increased risk of cardiovascular events could be mediated by alterations in systolic and diastolic cardiac function and left ventricular hypertrophy(LVH) in individuals with the metabolic syndrome (MetS). This study was aimed to evaluate the effects of the MetS on these disorders.

This case control study was conducted on a subsample of the Isfahan cohort study (ICS) participants. Based on the files of ICS participants, 520 people with and without MetS were selected by randomized stratified sampling. After baseline assessments (taking medical history and physical, ECG and lab exams) echocardiography was performed for participants.

Four handred and sixty-eight people (participation rate: 90%) took part in this study. Univariate analysis revealed that diastolic dysfunction (in both genders), and LVH in women were significantly different in both the with and without MS participants. Systolic dysfunction (in both genders) and LVH (in men) were the same. Multivariate analysis revealed that age over 65 years [OR (95% CI): 14.5(6.2-33.9)], body mass index 25 [OR (95% CI): 2.6(1.4-4.6)], hypertriglycidemia [OR(95% CI): 2.4(1.2-4.8), and being female [OR (95% CI): 14.3(5.0-50.0)] and] predicted diastolic dysfunction and LVH, respectively. None of the MS variables studied played a predictive role in systolic dysfunction.

This study did not confirm the role of MetS in structural or functional cardiac dysfunction, whereas other factors including age, being overweight or female and hypertriglicidemia could play a predictive role in these dysfunctions.

Diabetes is a most common chronic disease. Gestational diabetes is one type of diabetes that starts during pregnancy. Saliva sampling as a simple diagnostic method can reflect the serum changes. Antioxidants, especially micronutrient and toxic metals, can influence diabetes pathogenesis and its complications. According to the limited studies available in this field, the aim of this study is to evaluate salivary chromium and cadmium levels in pregnant women with gestational diabetes mellitus, in comparison with non-diabetic pregnant women.

This case control study was conducted between 2009 to 2011 in Hamadan city. Samples of 5cc unstimulated saliva from 35 gestational diabetes mellitus and 35 non diabetic pregnant women of a same age range were collected. Chromium and cadmium was measured by the atomic absorption method. Data were analyzed by t-test using SPSS software.

cadmium level was higher than in the control group (P=0.001), but Chromium showed a nonsignificant decrease (P=0.254).

Results of this study show chromium and cadmium levels differed between gestational diabetes mellitus and non diabetic pregnant women, a difference that was statistically significant for cadmium, and saliva sampling can be used instead to measure these metals.

Obesity is a polygenic disorder and a risk factor for type 2 diabetes (T2D). The E23K variant of KCNJ11gene is responsible for reduction in electrical excitability of pancreatic β- cells contributing to the impairment of insulin secretion, a common dysfunction in obese T2D individuals due to increase in KATP channel activity in the presence of LC-CoAs. Several studies have reported the association of the E23K variant with T2D and obesity in different populations. The aim of this study was to investigate the association of the E23K variant with progression of T2D among obese individuals in a population of Guilan in the north of Iran. Two case-control association studies were performed using 210 T2D and non-diabetic-obese individuals as well as 536 T2D and non-diabetic subjects without obesity. MGB TaqMan assay by Real time PCR (ABI 7300) was applied for genotyping of samples. According to allele frequency, there were no significant differences between diabetic and non-diabetic obese subjects or between non-obese individuals with and without T2D. With genotype frequency comparison, in obese subjects there was significant difference between diabetic and non diabetic individuals in a recessive genetic model [OR=4.4 CI 95 %(0.98-19.96) P=0.024]. However, in non-obese individuals, there was no significant difference in diabetic and non diabetic subjects. This study reports that the E23K variant is associated with progression of T2D in obese individuals. More investigations in larger popula‌tions with insulin measurment are recommended.

The aim of this research was to determine the efficacy of therapeutic interventions applied to children with congenital hypothyroidism by evaluating of the growth status of the children and comparing the percentiles of their height, weight and head circumference with normal infants reported by WHO. In this prospective cohort study, 760 congenitally hypothyroid neonates diagnosed and followed up during the CH screening program in Isfahan were enrolled. The 3rd (i.e. Z score of -2), percentile for height, weight and head circumference of both sexes was determined and compared with the corresponding WHO values. Chi-square and one sample proportion statistical test using SPSS statistical software were used for analyzing data. The percentiles of weight, height and head circumferences of the patients studied were statistcally different from WHO values (P<0.01). The relative frequency ≤-2 Z scores for height in both male and female CH patients reached to between 3% and 9% at 5 years of age respectively. The relative frequency of ≤ -2 Z scores for head circumference reached to <3% at 3 years of age in both sexes. While the weight showed a decreasing trend during the treatment period, it was not significant below 3%. Therapeutic interventions lead to children having normal physical development in terms of height, weight and head circumference, but the catch up time was earlier for head circumference and later for weight.

Protein-energy malnutrition is one of the most prevalent complications in hemodialysis patients and is directly associated with low quality of life in these patients. This study was performed to evaluate energy and protein intake and some related factors in hemodialysis patients referred to Imam Khomeini hospital in Tehran. This cross-sectional study was performed on 114 hemodialysis patients. A twenty four hour recall for 3 days was used to evaluate the patients’ diet. Food Processor II (FP II) was employed to calculate the amount of energy and protein intake, defined in comparison with the dietary allowance of hemodialysis patients. Energy and protein intakes per day were below those than recommended in 94.1% and 86.1% of the hemodialysis patients studied, respectively. There was a significant negative relationship between age and energy intake (r=-0.3, P=0.002). Mean energy and protein intakes in men (1320±63.58 Kcal/day, 54.81±2.25 g/day, respectively) were significantly higher than in women (982.63±51.8 Kcal/day, 43.57±2.6 g/day, respectively) (P=0.001 and P=0.004, respectively). Mean energy and protein intake did not differ significantly between the two groups with dialysis duration less and/or more than 3 years, and between the groups with and/or without comorbidity. According to the present study, protein-energy malnutrition had a very high prevalence in hemodialysis patients studied.

The purpose of this research was to determine level of physical activity, calcium intake, calcium sources and anthropometrical variables in young college females. According to the information obtained using a physical activity questionnaire, the subjects were divided to 3 groups (active, hypoactive, inactive). In this cross-sectional study 160 young females (aged 20/51±1/4 yrs mean + SD) participated. Levels of physical activity and calcium intake were determined by a questionnaire and body composition was determined using the Bioelectrical ImPedance (BIA) method. Results indicated that only 22/5% of subjects were active and that calcium intake of female students was less than the recommended daily allowance (RDA). There was a significant association between physical activity and all anthropometrical variables except for BMI. There was also a significant relationship between calcium intake and with lean body mass (P=0/024, r= 0/17), calcium from dairy sources with lean body mass (P=0/022, r= 0/18) and calcium from cereal sources with body fat percent (P=0/026, r= -0/17). There was significant difference in lean body mass, body fat percentage and fat distribution in the groups regarding levels of physical activity (P<0/05). Lean body mass in the active group was significantly higher than in the active group but fat percentage and fat distribution was less than the hypoactive and inactive groups (P<0/05). The results of this study indicate although the active group compared to the hypoactive and inactive groups had good physiological, anthropometrical and nutritional status, it unfortunately constitutes a low percentage of individuals and hence the level of physical activity, nutritional patterns and lifestyles of female students should be monitored.