لیدا نوایی

There are various ways to treat H.pylori infection, such as triple-therapy and quadruple therapy for two weeks. However, these treatments have some side effects and Helicobacter pylori easily become resistant to these antibiotics. Some studies have confirmed a relationship between consumption of garlic and reduction in Helicobacter pylori infection, whereas some others have rejected this relationship. Therefore, this present study was performed to determine the effects of garlic on Helicobacter pylori infection. This trial was performed in a randomized, case-controlled design on outpatients diagnosed with Helicobacter pylori infection. The patients in the case group took four grams of garlic powder daily (two tablets each containing two grams of garlic powder) whereas the patients in the control group took two placebo tablets (each containing two grams of white flour). In order to confirm the presence of Helicobacter pylori infection, urea breath test was taken, and in order to examine the presence of inflammation and/or ulcer in stomach, esophagus and duodenum, upper endoscopy was performed at the beginning and the end of the study. At the beginning of this study, all the patients had positive urea breath test. At the end of this study, the results of urea breat*- test showed that Helicobacter pylori infection was negative in 87% of the case group and 73% of control group showing eradication of Helicobacter pylori infection. However, this difference was not significant statistically when compared to the control group (P= 0.36). These findings suggest that taking garlic powder along with prescribed antibiotics can help in reducing Helicobacter pylori infection.

In view of the importance of micronutrients in metabolism and their critical role in health improvement and due to the fact that no comprehensive information on biochemical status of micronutrients exists, this study was carried out to determine the deficiencies of serum iron, zinc and copper in Tehran district. 206 families including 612 subjects (320 subjects in the city and 292 subjects in villages), 265 males (43%) and 347 females (57%) aged 3 to 83 years and mean ± SD 39±19 years were randomly selected by cluster sampling. Individual questionnaires and demographic data were filled.Height and weight were measured and Body Mass Index (BMI) was calculated. Then 10 ml of blood samples were collected and serum iron, zinc and copper assayed by atomic absorption spectrophotometery. The results showed that the micronutrients deficiency was highly prevalent in Tehran. Mean serum iron was 114±45 µg/dl. No differences existed in mean concentrations between urban and rural areas. Mean serum copper was higher in the city compared to the villages (75±27 VS 67±23 µg/dl) while mean serum zinc was higher in rural 140±36 compared to urban areas 101±33 µg/dl. No one had zinc deficiency in rural areas while 19% of the city dwellers were zinc deficient. Iron deficiency was higher in urban compared to rural areas (6% and 3%). Rural subjects were more deficient in copper (68%) compared to urban subjects (55%). Percentage of zinc deficiency in males and females were similar. Iron deficiency prevalence was lower, while copper deficiency was higher in females compared to males. Iron and zinc deficiency were higher in older subjects, whereas copper deficiency was more prevalent in younger people. Because of the high prevalence of the deficiencies of these micronutrients, further surveys in other districts and studies on the etiology and curative measures are recommended.

Ulcerative colitis (UC) is a chronic inflammatory disorder of the colon of unknown cause that is associated with important nutrition deficiencies such as protein-energy malnutrition, vitamin and mineral deficiencies. Because no study has been carried out to date in Iran, the aim of this pilot study was the assessment of dietary intake of these patients. In this pilot study, 41 UC patients whose disease severity was mild or moderate were selected. Data about diet restrictions were collected via a questionnaire and dietary intake was assessed 3 times during a 2 month period with 30 days interval and 3-day food-recall (9days in general). Subjects were 26 men and 15 women and 65.9% patients avoided completely or limited milk intake. Dietary limitation about fruits and vegetables was 24.4 and 43.9 percent, respectively and legumes intake was 58.5%. Mean calorie intake in 41 patients was 2125.14±60.83 calories/day and in two groups, calcium and fiber intake was significantly less than the standard dietary recommendation. Dietary intake examination showed some deficiencies such as calcium and iron deficiency and fiber intake was low because the intake of fruits, vegetables and legumes was limited.

The etiological role of vitamin D deficiency in glucose tolerance and type 2 diabetes is well defined. it can reduce insulin secretion and, therefore, impair glucose tolerance. The present study was designed to determine the effects of vitamin D supplementation on insulin resistance in type 2 diabetic patients. This study was a double-bind clinical trial. Fifty-seven diabetic patients (34 males and 23 females) being treated with oral hypoglycemic agents who had normal serum calcium level, were enrolled in the study. The study was conducted in winter (when the vitamin D is in its lowest level in Iran). The patients were randomly divided into 2 groups and received 1500 IU/d oral vitamin D3 or placebo for 1 month. Fasting glucose, insulin, C- peptide, serum 25-hydroxy-vitamin D and Quantitative Insulin Sensitivity Check Index (QUICKI) were evaluated before and after the treatment. Measurement of energy, macronutrients, fiber, vitamin E, vitamin C, Magnesium, Zinc, Calcium and vitamin D status intake was performed in the onset, during and at the end of the study. The mean of primary serum level of 25-hydroxy-vitamin D was 10.42±10.67 ng/ml. 47 subjects (82.5%) out of 57 ones were vitamin D deficient. After the treatment, only 60% of patients in vitamin D-received group achieved normal level of 25-hydroxy-vitamin D. Fasting glucose and insulin decreased in vitamin D-received group, although it was not significant. Serum C-peptide level increased significantly in vitamin D-received group from 2.47±0.88 ng/ml (in pre-treatment stage) to 2.78±1.14 ng/ml (in post-treatment stage) (P<0.02). Serum Calcium level increased significantly in vitamin D-received group (P<0.04), however, it remained at a normal range. The mean of changes of QUICKI was significantly higher in vitamin D-received group than that of placebo group in post-treatment stage (P<0.03). It indicates that insulin resistance was reduced in this group. Results of this study suggest that vitamin D supplementation can reduce insulin resistance in type 2 diabetic patients and it should be, therefore, recomended to improve the control of diabetes, especially in winter.

Early diagnosis of diabetes can prevent many unwanted and irreversible consequences which require a lot of expenses as well as advanced treatment methods and experts. The present study set out to compare prevalence of diabetes in first degree relatives (FDR) of patients with type II diabetes mellitus (T2DM), glucose intolerants and controls. In This case-control research, 277 healthy subjects (129 males and 148 females) with the age of 11-95 were selected from among FDR in three groups, namely those with type II diabetes, glucose intolerants and controls and were evaluated in terms of diabetic condition. World health organization criteria were applied to recognize case(s) of diabetes and glucose intolerants. Odds ratio of being type 2 diabetic or IGT, in FDR of patients with T2DM and subjects with IGT, 5.261 compared to controls was (with 95% CI of 2.15-12.82). Prevalence of T2DM and IGT in both male and female FDR of patients with T2DM and with IGT, was significantly higher than that of controls (p< 0.005). Significantly higher prevalence of T2DM and IGT in FDR of patients with T2DM and with IGT, compared to controls, offers a very quick and cost-effective method of diagnosing covered cases of diabetes in country's health care systems.

Background & object: Diabetes mellitus is associated with a decrease in bone mineral content and increased urinary excretion of calcium and phosphate. In addition, there are abnormalities in calcium, phosphate, and vitamin D metabolism in diabetic patients. The objective of this study was to assess the serum calcium and vitamin D status in patients with type 2 diabetes mellitus. A total of 61 diabetic patients (35 male and 26 female), 35-65 years old, were studied in the middle of winter, at the seasonal nadir of 25 (OH) D levels. Serum levels of 25(OH) D < 20 ng/ml and of total calcium < 8.8 mg/dl were defined as vitamin D and calcium deficiencies, respectively. The mean serum 25(OH) D level was 10.87 ± 10.59 ng/ml. It was significantly lower in males than in females (p< 0.002). Forty-eight subjects (78.7%) were vitamin D-deficient and only 13 (21.3%) had normal serum vitamin D levels. The mean serum calcium level in the whole sample was 9.45 ± 0.23 mg/dl, which is in the normal range. The mean was higher in males than in females, but the difference was not statistically significant. Conclusion and suggestions: The results suggest that vitamin D deficiency might be prevalent in diabetic patients in Iran, it probably being markedly higher in males.

Due to high prevalence of diabetes and the importance of controlling biochemical parameters in diabetic patients and effect of Ramadan fasting on them, we conducted this study in diabetics of Islamshahr. Forty-nine volunteer diabetics (30 women and 19 men) aged 32-67 years (mean±SD: 47±9 years) were selected randomly. Each patient filled an individual questionnaire. Blood samples were taken 2 months before, during the last week of, and 2 months after Ramadan. RAXT auto-analyzer was used to test blood sugar, triglycerides, cholesterol, uric acid, urea and creatinin. Height and weight were measured and BMI was calculated. Blood pressure was obtained in sitting position. Paired t-test was used for analysis. Sixty-three percent of studied subjects had a positive family history. Mean BMI value was 29.6±4.8, 29.2±4.4 (P<0.005) and 29.1±14.3 (P<0.001, compare with before Ramadan) before, during and after Ramadan, respectively. Mean systolic blood pressure value was 139±23, 137±20 and 130±20 (Ns, compare with before Ramadan) before, during and after Ramadan, respectively. The prevalence of diastolic blood pressure more than 89 mmHg was lower during Ramadan in comparison with before and after it. Mean fasting blood sugar increased during Ramadan (202±76 mg/dL) in comparison with before (163 ± 53 mg/dL, P<0.0001) and after (186 ± 60 mg/dL, p<0.05) it. Mean serum triglycerides, cholesterol and uric acid decreased during Ramadan (243 ± 130 vs. 340 ± 228 mg/dL, p<0.005), (222 ± 43 vs. 258 ± 56 mg/dL, P<0.0001) and (4.5±1.4 vs. 4.9±1.2 mg/dL, P<0.003) in comparison with before it, respectively. During Ramadan, the prevalence of abnormal serum cholesterol concentration decreased to lower than half of its prevalence before it. Also, abnormal serum triglycerides was observed less during Ramadan. Any statistical difference was not detected in urea and creatinin before, during and after Ramadan. We concluded that Ramadan fasting is not harmful, but instead it is beneficial by reducing weight, blood pressure, serum cholesterol, triglycerides and uric acid for improvement of patients with diabetes type 2.

Obesity, hypertension and hyperlipidemia are risk factors of atherosclerosis, a major cause of mortality. There haven’t been enough epidemiologic studies on these risk factors, especially in rural populations. 2705 residents of Tehran Province villages, including 1296 (48%) men and 1409 (52%) women, all aged more than 30, were selected by multistage random sampling. Cholesterol, triglyceride and HDL were measured in a fasting blood sample and blood pressure, height and weight were determined. Waist to hip ratio (WHR) was used as an index of abdominal obesity. Women had a higher mean BMI (28.2±5.1) compared with men (25.4±3.9) (P<0.001). 24.3% of studied individuals had moderate to severe obesity. Mean diastolic and systolic blood pressures were 72±12 and 122±12mmHg, respectively and were higher in women. Altogether, 11.1% and 22.2% of individuals had diastolic and systolic hypertension, respectively. Mean triglyceride level was 191±151 with no difference between the sexes. Hypertriglyceridemia was present in 32.7% and hypercholesterolemia in 15.4% of individuals. Mean LDL level was higher in women (129±38.6 mg/dl in women vs. 118±35 mg/dl in men, P<0.001). There was no difference in the prevalence of obesity, LDL to HDL and cholesterol to HDL ratios between men and women. All variables except HDL increase with age. This increased continued to the age of 50 in the case of BMI and WHR, and to the 6th decade for lipids. Lipid and blood pressure levels increased with weight. 12.8% of obese individuals and 8.3% of non-obese individuals had diastolic hypertension. The figures for systolic hypertension in these two groups were 23.5% and 20%, respectively. Hypertriglyceridemia and hypercholesterolemia were seen more commonly in obese (42.5% and 16.5%, respectively) than in non-obese individuals (16.5% and 8.6%, respectively). Considering the remarkable increase in triglyceride, cholesterol, weight and blood pressure in studied individuals, it seems that more extensive studies on environmental factors, especially diet and exercise, and finding suitable solutions to prevent risk factors are necessary.

In our previous study in 1362, goiter was hyperendemic in Shahriar. Since iodized salt has been distributed in this region for 12 years, this study was performed to evaluate the effect of iodized salt on thyroid hormones, urinary iodine excretion and the grade of goiter in Shahriar region in 1374. 3164 persons including 58% females and 42% males were selected through random sampling. Grading of goiter was performed according to WHO’s classification, and urinary iodine was measured digestion method. The result were compared with those of the study performed in 1362. The prevalence of goiter in 1362 and 1374 was 50% and 40% in men, 70% and 51% in women and 60% and 47% in total community respectively (P<0.001). The decrease in the prevalence of goiter was observed specially in lower ages which was 23% vs 7% in younger than 6 years, 82% vs 46% in 6-12 years and 78% vs 66% in 13-18 years of age respectively (P<0.001). The decrease in the prevalence of goiter was observed specially in lower ages which was 23% vs 7% in younger than 6 years, 82% vs 46% in 6-12 years and 78% vs 66% in 13-18 years of age respectively (P<0.001). The mean urinary iodine excretion before and after using the iodized salt was 6.5±7.6 and 18.5±13.1 μg/dl (P<0.001). In 1362 study, 47.5% of the subjects had urinary iodine levels of 2 to 5 μg/dl while in 1374 study in 65% of subjects urinary iodine level has been 10 to 25 μg/dl. The mean level of thyroid hormones before and after using iodized salt were respectively: T4, 9.2±1.1 vs 9.3±1.9 μg/dl T3, 142±30 vs 154±42 ng/dl (P<0.001) and TSH, 1.8±1.1 vs 1.5±1.3 μU/ml (P<0.001). 1.5% of the subjects in 1362 and 4.5% in 1374 had T4 levels higher than 12.5μg/dl. T3 levels higher than 200 ng/dl were observed in 0.4% and 11.5% of the subjects before and after using iodized salt. TSH levels higher than 5μU/mL were observed in 0.6% and 1.9% of the subjects in 1362 and 1374 respectively. There was no change in positive cases of antithyroid antibodies. The number of hypothyroid and hyperthyroid cases were not considerable. The results of this study shows that the use of iodized salt causes a decrease in the prevalence of goiter, specially in lower ages and an increase in urinary excietion. The results also show that the use of iodized salt at the level of 40 ppm has no harmful side effects in this region.

Regarding the importance of cardiovascular disease in society health and with respect to known high risk of hyperlipidemia, hyperglycemia, obesity, and hypertension in these patients, and also regarding the lack of epidemiological studies in this field, specially in rural area, this study has been conducted on 2705 candidates over 30 years old [1296 males (48%) and 1409 females (52%)] by multiple-phase randomized sampling, in 100 villages. Serum level of cholesterol, triglyceride, HDL, and sugar were obtained on fasting blood samples. For diagnosis of diabetes and IGT, glucose tolerance test with 75 gr glucose was performed. Then blood pressure, body weight and height, and body mass index (BMI) have been measured. Waist/buttock ratio was considered as a factor for evaluating abdominal obesity. The mean BMI was 28.6 mg/dl). No significant variation has observed in LDL-C level. In the meantime, no significant differences have been noted in these factors in patients with incomplete remission, before and after the therapy. Regarding the fact that HDL-C, unlike TG and VLDL-C, is less influenced by diet and other factors such as stress; serial determination of HDL-C level is highly recommended in patients with ALL , in this way a powerful tool for evaluating the disease procedure along with chemotherapy efficacy would be achieved.  Moderate to severe obesity has been recorded in 34.7%, 37.1% and 22.3% of patients with diabetes, IGT, and normal individuals, respectively. The mean of waist/buttock ratio was higher in diabetic patients (p<0.001). Abnormal waist/buttock ratio makes individuals more susceptible to diabetes (2.9 times). One fifth of patients with diabetes have diastolic blood pressure more than 89 mmHg and half of them have systolic blood pressure of 139 mmHg and above, whereas these figures were 1/10 and 1/5 for normal individuals, respectively. The mean of TG was 322 ±282, 206± 178, and 178±124 mg/dl in patients with diabetes, IGT, and normal individuals, respectively. These differences were statistically significant (p<0.001). In diabetic patients, the prevalence of triglyceridemia was 2.1 times more than normal individuals and 1.6 times more than patients with IGT. Cholesterol level of 239 mg/dl and higher was recorded in 12.6% of normal individuals. Hypercholesterolemia makes patients more susceptible to diabetes (3.9 times). The mean of LDLcholesterol was recorded 145 ± 43.6, 134 ± 38.9, and 121 ± 36.1 mg/dl in patients with diabetes, IGT, and normal individuals, respectively (p<0.001). HDL-cholesterol below 35mg/dl was seen in 45.9% of diabetic patients. LDL/HDL ratio above 5 has been recorded in 17.8%, 19.3%, and 9% of patients with diabetes, IGT, and normal individuals, respectively. The prevalence of diabetes in patients with cholesterol/HDL ratio above 4.5 was 2.4 times more than patients with cholesterol/HDL ratio of 4.5 and below. Results have implied that obesity, hyperlipidemia, and hypertension are common findings in diabetic patients. Regarding its potential hazard, intervention in life style is strongly recommended.

Despite impressive progress in diagnosis, treatment and control of hypertension, this symptom is still one of the major causes of brain and kidney disease as well as cardiac insufficiencies. Since the control of blood lipids, glucose and body weight are highly important in the prevention and treatment of hypertensive drugs, this epidemiologic study was carried out in Islamshahr, 30 Km. to The Southwest of Tehran to investigate the relationship of hypertension with BMI, blood lipids and glucose.Out of 244000 inhabitants, 1919 (40% male and 60% female subjects) over 30 years of age were selected by step-wise random sampling in 17 districts of Islamshahr. A fasting blood sample was secured from each subject for cholesterol and triglyceride measurement. Another blood sample was collected two hours following on oral dose of 75 g. glucose. Height and weight were measured and BMI calculated. The subjects seated blood pressure was taken. Blood glucose was determined by orthotoluidine method. Triglyceride and cholesterol were measured by RA 1000 atUoanalyzer.Mean and SD systolic BP was 128±23 mmHg with no significant difference between males and females. Mean ±SD diastolic BP was 78 ± 13 mmHg in females who had significantly higher BP than males (78 ± 13 in females VS. 76± 13 in males P<0.003). Mean diastolic and systolic BP increased with age in both sexes, while diastolic hypertension remained static from the fifth decade on. Mean ±SD two-hour blood glucose in diastolically normal, mild and severe hypertension were 120±59, 133±64 and 150±94 mg/dl respectively. These figures, for systolic pressure were 117±55, 128±60 and 156±87 mg/dl respectively. Diastolic pressure was high in 19% of normal subjects, 34% of IGT and 34 % of diabetics (P < 0.01). The same figures for systolic pressure were 24, 42 and 51 % respectively (P < 0.01). Diastolic pressure in subjects possessing normal and abnormal serum triglyceride was 18 % and 27 % (P < 0.001) while systolic pressure was 24 % and 34% (P<0.001). In 19% of those having normal cholesterol levels and 26 % of those with abnormal cholesterol levels diastolic pressure was high (P < 0.001). For systolic pressure the same figures were 24 % and 34 % (P < 0.001). Prevalence of mild and severe obesity in subjects with diastolic and systolic hypertension were 46 and 41 % . Obesity together with hypertension were more pronounced in women than in men in that 13 % of females and 5.7 % of males having diastolic hypertension and 13.9% of females and 8.1 % of males having systolic blood pressure were obese.This survey points to the high prevalence of hypertension in people over 30 years of age. Higher diastolic blood pressue in women compared to men and the correlation between hypertension on the one hand and TG, cholesterol, blood glucose levels and obesity the other, merits attention and further studies.

The carbohydrate content in different foods may have different effects on postprandial blood glucose. Study was conducted to compare the glycemic effect of 50g carbohydrate in fruits (watermelon, Persian melon, grapes and pears) in normal, IGT and diabetic subjects. Thirty two subjects, 12 NIDDM, 12 IGT and 8 normals, with a mean age of 53±7 years were randomly selected. The subjects came to Varamin Health Centre 5 times in 2 to 4 days intervals. The subjects were divided in 5 group consumed one of the bread or fruit samples with 50g carbohydrate content. Blood samples were collected before and at 15, 30, 60, 120, 180 minutes after taking food. The blood glucose content was measured with autoanalyzer method. At the end of the experiment all the subjects received five different kinds of fruits or bread samples. The glycemic index of watermelon, Persian melon, grapes and pears were 47±22, 44 ±22, 47±26 and 43 ±22 respectively. No difference in glycemic index of different fruits was detected. Significant difference between glycemic index of diabetics and normal subjects was seen. A maximum and T maximum for bread, watermelon, melon, grapes and pears were 142±71, 83±50, 81±51, 78±48 and 75 ±58 mg/dl; and 50±18. 25±19, 35±22, 30±21, 27±20 minutes, respectively. White bread had later effect on rising blood glucose, but ultimately with a higher rate than fruits. The resutls of this study indicate that watermelon, Persian melon, grapes and pears have low glycemic index and can be recommended for use in diabetic meal plan.

Despite impressive progress in diagnosis. treatment and control of hypertension, this symptom is still one of the major causes of brain and kidney disease as well as cardiac insufficiencies. Since the control of blood lipids, glucose and body weight are highly important in the prevention and treatment of hypertensive drugs, this epidemiologic study was carried out in Islamshahr, 30 Km. to The Southwest of Tehran to investigate the relationship of hypertension with BMI, blood lipids and glucose. Out of 244000 inhabitants, 1919 (40% male and 60% female subjects) over 30 years of age were selected by step-wise random sampling in 17 districts of Islamshahr. A fasting blood sample was secured from each subject for cholesterol and triglyceride measurement. Another blood sample was collected two hours following on oral dose of 75 g. glucose. Height and weight were measured and BMI calculated. The subjects seated blood pressure was taken. Blood glucose was determined by orthotoluidine method. Triglyceride and cholesterol were measured by RA 1000 autoanalyzer. Mean and SD systolic BP was 128±23 mmHg with no significant difference between malcs and females. Mean ±SD diastolic BP was 78± 13 mmHg in females who had significantly higher BP than males (78 ±13 in females VS. 76±13 in males P<0.003). Mean diastolic and systolic BP increased with age in both sexes, while diastolic hypertension remained static from the fifth decade on. Mean SD two-hour blood glucose in diastolically normal, mild and severe hypertension were 120±59, 133±64 and 150±94 mg/dl respectively. These figures, for systolic pressure were 117±55, 128±60 and 156 ±87 mg/dl respectively. Diastolic pressure was high in 19% of normal subjects, 34% of IGT and 34% of diabetics (P<0.01). The same figures for systolic pressure were 24, 42 and 51% respectively (P <0.01). Diastolic pressure in subjects possessing normal and abnormal scrum triglyceride was 18% and 27% (P<0.001) while systolic pressure was 24% and 34% (P<0.001). In 19% of those having normal cholesterol levels and 26% of those with abnormal cholesterol levels diastolic pressure was high (P <0.001). For systolic pressure the same figures were 24% and 34% (P<0.001). Prevalence of mild and severe obesity in subjects with diastolic and systolic hypertension were 46 and 41%. Obesity together with hypertension were more pronounced in women than in men in that 13% of females and 5.7% of males having diastolic hypertension and 13.9% of females and 8.1% of males having systolic blood pressure were obese. This survey points to the high prevalence of hypertension in people over 30 years of age. Higher diastolic blood pressue in women compared to men and the correlation between hypertension on the one hand and TG, cholesterol, blood glucose levels and obesity the other, merits attention and further studies.

SUMMARY:

Due to the importance of coronary heart diseases in todaychr('39')s world and in view of the fact that hyperlipidemia, hyperglycemia and obesity are regarded as the main risk factors in these diseases and also considering the paucity of epidemiologic surveys in our society, this study was carried out in Islamshahr 30 Km to the southwest of Tehran. Out of 244000 population of the area, 2033 persons over 30 years of age were selected by stepwise random sampling. The subjects were 835 males (41 %) and 1198 females (59 % ) . A fasting blood sample was taken for glucose, cholesterol and triglyceride measurements. Another blood sample was also secured two hours following a 75 g oral glucose. Weight and height were measured and BMI calculated. WHO criteria for categorization of diabetes, IGT and nonnal was adapted. The results showed mean BMI in diabetics, IGT and normal subjects to be 29.7, 29.9 and 27.5 respectively. The increase in diabetics and IGT compared to normal subjects was statistically significant (P<0.001). Forty-two percent of the diabetics, 45 % of the IGT and 29% of normal subjects were moderately to severely obese. The percentage of obese women in the diabetic, IGT and normal group was higher compared to men. Mean cholesterol in diabetic, IGT and normal subjects was 273±64, 252±56 and 233±54 mg/dl respectively. The difference was statistically significant among the three groups (P<0.001). Of those with over 239 mg/dl cholesterol levels 11.6% were diabetic and 16.1 % were IGT, while in those with below 239 mg/dl cholesterol only 4.2% were diabetic and 9.6% were IGT. Percentage of women with over 239 mg/di cholesterol in diabetic and IGT groups was higher compared to men. Mean triglyceride of 358 ±279 mg/dl in diabetics showed an increase compared to 243 ± 144 in the IGT and 214± 167 in the normal subjects (P < 0.001). Of those with over 200 mg/dl triglyceride levels 11. 7% were diabetic and 16.4% were IGT, while in those with below 200 mg/di TG levels only 4.1 % were diabetic and 9.3% IGT. High TG levels (over 200 mg/di) were more prevalent in female diabetics than in the male ones. Our findings could be a confirmation of the fact that obesity and hyperlipidemia are associating factors in diabetes, necessitating interventional programs to rectify nutritional status, physical activity and community knowledge in this regard.

SUMMARY:

Due to the lack of information on diabetes prevalence and its precipitating factors and in view of the grave consequences of the disease, this study was carried out in 1993 to determine diabetes and IGT in Islamshahr, 30 km to the southwest of Tehran. Out of 244000 population in the district 2033 subjects over 30 years of age were selected hy stepwise randomized sampling. The subjects 835(41 %) were males and 1198 (59%) were females. In the first step fasting blood sugar and 2-hour glucose tolerance test was determined. In the second phase of the study which was carried out 9 months later, those with abnormal blood glucose test and some of the normal subjects underwent OGTT. The results showed 7.4% of the population (7. I% of men and 7 .6 % of women) to be diabetic. In 3.8% diabetes had been diagnosed but 3.6% were ignorant of their problem. Also 12.4% (8.9% males and 14.9% females) were IGT. Diabetes and IGT increased with age rising from 3.5 and 9.2% in the 30-39 year age group to 10.4 and 31.3 % in the 70-79 year group respectively. Fifty two percent of the diabetics and 23 % of the IGT subjects had a positive history of diabetes. In the second stage 50% of the IGT group were still IGT. Twenty-five percent had entered the diabetic stage and 25% showed normal blood glucose levels. Of the newly diagnosed diabetics in the first stage 72 % remained so in the second stage while 24 % were IGT and 3 % had normal blood glucose. Comparison of blood sugar based on WHO and NDDG showed 14% of the normal, 59.8% of the IGT and 11.8% of the new! y diagnosed diabetics as well as 28. 3 % of the whole subjects did not fall in any category of NDDG criteria. This study, therefore, shows high diabetes and IGT in the region, increase of diabetes with age and positive family history, based on our findings, only 2-hour glucose tolerance test is suggested as the criteria for diabetes and IGT diagnosis.