عذرا رمضانخانی

Type 2 diabetes, as a complex disorder, is one of the most prevalent endocrine disorders.  Importantly, the extent of familial aggregation and heritability in Iran is unknown. The aim of the present study was to determine type 2 diabetes heritability in the Tehran families.

The current research comprises 1691 diabetic and 12050 non-diabetic individuals over 20 years who are participants in the Tehran Cardiometabolic Genetic Study (TCGS). In this research, the BGLR, gap, and S.A.G.E tools were used to conduct familial aggregation, family-based heritability, and segregation analysis.

Out of 13741 subjects, 45% were female, and 55% were male in 2594 constituent pedigrees. The results of intra-family correlation showed that there is a higher correlation among siblings (ICCbrother-sister = 0.26, ICCbrother-brother =0.16, ICCsister-sister =0.14) than mother-offspring (ICCmother-offsprings = 0.13) followed by father-son (ICCfather-son = 0.05). Besides, the results of logistic regression showed that the chances of developing diabetes are higher in people whose at least one parent had diabetes (OR=4.16). The heritability rate in this population was about 65% (SE=0.034). The segregation analysis showed that type 2 diabetes in this community follows a polygenic pattern.

The heritability of type 2 diabetes with a polygenic pattern in Iran is higher than the global average. Type 2 diabetes is transmitted equally to siblings, and in terms of family history, parents are the most important risk factor for the disease. According to the findings of this research, it is recommended to shift the level of prevention from the individual to the family level in society when making health-system policy decisions.

Corticosteroids are used for the management of allergic rhinitis. We compared the efficacy of systemic and local corticosteroid in symptom relief and serum IgE levels in patients with perennial allergic rhinitis.

A randomized experimental study design, (clinical trial) was used. 86 patients with a history of perennial allergic rhinitis were selected and randomly divided in two groups. For the first group systemic corticosteroids were given in the form of prednisolone tablet 5mg twice daily, (10mg/day), tapered every 3 days. For the second group, Beclomethasone nasal spray 50 µ g/puff was administered twice daily as two puffs in each nostril for three weeks. Rhinorrhea, nose and eye itching, sneezing, nasal obstruction and serum IgE before and after treatment, (3weeks) were evaluated and compared.

We found a significant decrease in serum IgE in both groups but the decrease was more marked with systemic corticosteroids (P<0.05). After therapy the percentage of sneezing and eye itching decreased significantly in the systemic corticosteroid group and percentage of rhinorrhea decreased significantly in the local corticosteroid group. Pre and post intervention evaluations showed improvement in all symptoms in systemic corticosteroid group and all symptoms except eye itching in local corticosteroid group.

The result of this comparative study showed that systemic corticosteroids are more efficient in improvement of sneezing and eye itching but local corticosteroids may have a better efficacy in the improvement of nasal obstruction.

Despite many studies on the effect of saturated fat and cholesterol intake on serum lipids, data on the combined effect of these two dietary components on serum lipoprotein response is very limited.

In this study, a representative sample of 443 subjects, aged 18 years and over, were included. Dietary intake was assessed by means of two 24–hour dietary recall questionnaires. Height and weight were measured and BMI was calculated. Total cholesterol, triglycerides and high density lipoprotein cholesterol levels were measured and serum cholesterol was calculated. Cholesterol intake ≥300 mg/day was defined as high cholesterol intake, and saturated fat intake ≥7% of total energy was defined as high saturated fat intake. Individuals were categorized into 4 groups, based on cholesterol and saturated fat intake each of these was assessed for 2 levels of serum lipids, normal and high. Pearson's correlation coefficient was used to detect confounding variables. Two-Way ANOVA was used to determine both the main effect of each of the two factors on lipids and their combined effect as well.

Mean age of subjects was 40.1± 14.6 y. The main effect of cholesterol and saturated fat intake on energy intake was significant. Subjects in whom cholesterol and saturated fat intake was normal had significantly less energy and fat intake than those who had high cholesterol and saturated fat intake (p<0.01). Saturated fat intake was seen to have a significant main effect on serum total and HDL cholesterol levels. Subjects who had a normal saturated fat intake, had significantly less serum total and HDL cholesterol than those who had high saturated fat intake (p<0.01 and p<0.05, respectively). Adjusted for age, sex and BMI, the main effect of cholesterol intake on HDL cholesterol was significant (p=0.05). Mean serum HDL was lower in subjects who had normal cholesterol intake than in subjects who had high cholesterol intake.

The present study shows that cholesterol and saturated fat intake had no combined effect on serum LDL cholesterol level, whereas cholesterol intake per se did affect serum HDL cholesterol level.