فهرست مطالب elham faghihimani

The Isfahan Thyroid Cohort Study (ITCS) is one of the few population-based epidemiological studies in Iran that investigates the prevalence and incidence of thyroid disorders including hypothyroidism, hyperthyroidism, goiter, nodule, and iodine status.

This cohort is located in Isfahan, Iran. The first phase was initiated in 2006 with 2523 participants (1275 males, 1248 females). The participants were selected using multi-stage cluster sampling from the general residents of Isfahan, Iran. The study had two phases (2006 and 2011) and its third stage is planned for 2020–2021.

The prevalence of thyroid function states was euthyroid (89.3%, 95% CI: 88%–90%), overt hypothyroidism (2.8%, 95% CI: 2%‒3%), subclinical hypothyroidism (5.8%, 95% CI: 4%–6%), overt hyperthyroidism (0.8%, 95% CI: 0.4%‒1%), and subclinical hyperthyroidism (0.99%, 95% CI: 0.6%–1%). Hypothyroidism and hyperthyroidism were significantly associated with goiter. The incidence of thyroid dysfunction was reported as follows: overt hypothyroidism (2.7, 95% CI: 1.6–3.7), subclinical hypothyroidism (20.6, 95% CI: 18–23), overt hyperthyroidism (1.9, 95% CI: 1–2.7) and subclinical hyperthyroidism (2.7, 95% CI: 1.6–3.7) per 1000 (person-year).

We assessed the prevalence and incidence of thyroid disorders in Isfahan in the first and second phase, respectively. We are conducting the third phase of the ITCS in order to study the associations between thyroid peroxidase antibody (TPOAb) level and environmental factors such as infection.

Diabetes mellitus (DM) is a chronic disease that affects public health. The prediction of blood glucose concentration (BGC) is essential to improve the therapy of type 1 DM (T1DM).

Having considered the risk of hyper‑ and hypo‑glycemia, we provide a new hybrid modeling approach for BGC prediction based on a dynamic wavelet neural network (WNN) model, including a heuristic input selection. The proposed models include a hybrid dynamic WNN (HDWNN) and a hybrid dynamic fuzzy WNN (HDFWNN). These wavelet‑based networks are designed based on dominant wavelets selected by the genetic algorithm‑orthogonal least square method. Furthermore, the HDFWNN model structure is improved using fuzzy rule induction, an important innovation in the fuzzy wavelet modeling. The proposed networks are tested on real data from 12 T1DM patients and also simulated data from 33 virtual patients with an UVa/Padova simulator, an approved simulator by the US Food and Drug Administration.

A comparison study is performed in terms of new glucose‑based assessment metrics, such as gFIT, glucose‑weighted form of ESODn (gESODn), and glucose‑weighted R2 (gR2). For real patients’ data, the values of the mentioned indices are accomplished as gFIT = 0.97 ± 0.01, gESODn = 1.18 ± 0.38, and gR2 = 0.88 ± 0.07. HDFWNN, HDWNN and jump NN method showed the prediction error (root mean square error [RMSE]) of 11.23 ± 2.77 mg/dl, 10.79 ± 3.86 mg/dl and 16.45 ± 4.33 mg/dl, respectively.

Furthermore, the generalized estimating equation and post hoc tests show that proposed models perform better compared with other proposed methods

Nearly two-third of the patients with type 2 diabetes have degrees of fatty liver; this may induce some side effects in them. This study aimed to find effect of salsalate on treatment of steatohepatitis and correlation of fatty liver with metabolic syndrome in the setting of impaired glucose metabolism.

In a double-blind randomized trial within two distinct groups, i.e., recently diagnosed diabetics and prediabetic cases allocated in two arms of the intervention to receive 3 g salsalate or placebo. All cases underwent glucose and lipid level studies and liver ultrasound study.

Out of 46 patients with diabetes, 34 (74%) had fatty liver in ultrasound; this ratio was 75% in 113 prediabetic cases. Relative frequency of fatty liver stages did not differ between diabetics and prediabetics. Within diabetics, mean aspartate aminotransferase (AST) level of fatty liver cases (23 ± 7 IU/dl) was higher than others (18 ± 3 IU/dl) (P < 0.05). Changes in transaminase levels following intervention did not significantly differ, comparing drug and placebo arms in two subgroups.

According to the findings, if diabetes could be assumed as the logical consequence of prediabetic state, it seems that fatty liver did develop before this preliminary status. In this study, salsalate could not change biochemical markers of fatty liver significantly.

Diabetes mellitus (DM) is the most common metabolic disease. In Iran, family medicine program has been started since the year 2005 with the goal of increasing in service quality and quantity. This study aimed to evaluate current health care services for patients with type 2 diabetes mellitus in rural areas of Iran.
This cross-sectional descriptive-analytic study was done in the year 2014 in 20 health houses under control of 7 secondary level health centers in Jarghoyeh region in southern part of Isfahan City, Iran. The data were collected randomly from 383 households with diabetes mellitus files using special checklists. These checklists were designed in accordance with health ministries for patients with diabetes mellitus. The collected data were analyzed via SPSS software using ANOVA, chi-square, and logistic regression tests.
Findings: None of the patients received advice care based on national protocols. Less than 6% of patients received 6-8 regular cares in the recent year. The mean values of hemoglobin A1C (HBA1C), systolic blood pressure, total cholesterol, low-density lipoprotein (LDL), triglycerides (TG), and body mass index (BMI) showed higher level in women than men. From all advised and key cares, blood pressure measurement in 81.6% and weight control in 80.5% were more favorable care services. There was significant relationship between foot examination, smoking status, and gender (P Health care services needed for patients with type 2 diabetes mellitus are less than national comprehensive prevention and diabetes control protocol in quality and quantity of cares in most of the cases.

Rapid increasing prevalence of diabetes mellitus is a serious health concern in the world. New data determined that the pathogenesis of diabetes mellitus is chronic low‑grade inflammation, resulting insulin resistance. Pomegranate seed oil (PSO) has anti‑inflammatory effects; though it may reduce insulin resistance and improve glycemia in diabetes mellitus. The present study has been designed to investigate the effects of PSO as a natural dietary component on metabolic state of patients with Type 2 diabetes mellitus.
In a randomized double‑blind clinical trial study, 80 patients (28 men) with Type 2 diabetes were randomly allocated to the intervention and control groups. The intervention group consumed PSO capsules, containing 1000 mg PSO twice daily (2000 mg PSO), whereas controls take placebo for 8 weeks. The participants followed their previous dietary patterns and medication use. Dietary factors and metabolic factors including lipid profile, fasting plasma sugar, and insulin and were assayed at the baseline and after 8 weeks.
Participants in two intervention and control group were similar regarding anthropometric and the dietary factors at baseline and after trial (P > 0.05). Mean level of total cholesterol, triglyceride, low‑density lipoprotein‑cholesterol, and high‑density lipoprotein was not different significantly between groups after trial (P > 0.05). Consumption of PSO did not significantly affect the levels of parameters such as fasting blood sugar (FBS), insulin, HbA1c, alanine transferase, and homeostasis model assessment‑insulin resistance.
Consumption of 2000mg PSO per day for 8 weeks had no effect on FBS, insulin resistance and lipid profile in diabetic patients.

In Asian population, diabetes mellitus is increasing and has become an important health problem in recent decades. In Iran, cardiovascular disease (CVD) accounts for nearly 46% of the total costs spent for diabetes‑associated diseases. Because individuals with diabetes have highly increased CVD risk compared with normal individuals, it is important to diagnosis factors that may increase CVD risk in diabetic patients. The study objective was to identify predictors associated with CVD mortality in patients with type 2 diabetes (T2D) and to develop a prediction model for cardiovascular (CV)‑death using a competing risk approach.

The study population consisted of 2638 T2D (male = 1110, female = 1528) patients aged ≥35 years attending from Endocrine and Metabolism Research Center in Isfahan for a mean follow‑up period of 12 years; predictors for different cause of death were evaluated using cause specific Cox proportional and subdistribution hazards models.

Based on competing modeling, the increase in blood pressure (BP) (spontaneously hypertensive rats [SHR]: 1.64), cholesterol (SHR: 1.55), and duration of diabetes (SHR: 2.03) were associated with CVD‑death. Also, the increase in BP (SHR: 1.85), fasting blood sugar (SHR: 2.94), and duration of diabetes (SHR: 1.68) were associated with other death (consist of cerebrovascular accidents, cancer, infection, and diabetic nephropathy).

This finding suggests that more attention should be paid to the management of CV risk in type 2 diabetic patients with high cholesterol, high BP, and long diabetes duration.

Vitamin D deficiency and insufficiency are recognized as a worldwide problem with serious consequences. Fortification of foods with Vitamin D is a certain approach to improve serum Vitamin D status if the stability of vitamin in the foodstuffs was controlled. The purpose of this study was to examine the stability of Vitamin D3 added to low‑fat yogurt and yogurt drink “Doogh” during the products shelf‑life.

Two kinds of Vitamin D3 , water‑ and oil‑dispersible forms, suitable for food fortification, were compared to find out whether they show different stability in the products. The products were packed in opaque or translucent containers. The content of Vitamin D3 was determined by high performance liquid chromatography method.

Vitamin D was not affected by the heat treatment(pasteurization) and other processes(homogenization and fermentation). Both water‑ and oil‑dispersible forms were stable during the shelf‑life of yogurt samples packed in opaque containers. The Vitamin D3 content of yogurt fortified with water‑dispersible form and packed in translucent containers was not stable during the shelf‑life and significantly reduced after 1, 2, and 3 weeks of storage compared to the day 0. The Vitamin D3 content of samples fortified with the oil‑dispersible form packed in the same container was only stable after 1‑week and significantly reduced after 2 and 3 weeks of storage. The Vitamin D3 content of Doogh packed in the opaque containers remained stable during the shelf‑life while it was not stable in the samples packed in translucent containers.

The results suggested that both forms of Vitamin D are suitable for fortification, and opaque container is a better choice for packaging of the product.

The globally increasing epidemic of diabetes will lead to serious problems including diabetic nephropathy and kidney diseases in near future. The first clinical diagnosable stage in a diabetic kidney disease is microalbuminuria (urinary albumin excretion of 30 - 300 g/24 hours).. This prospective cohort study investigated the risk factors of microalbuminuria in patients with type 2 diabetes who had been registered in endocrine and metabolism research center in Isfahan city, Iran..Patients and This prospective cohort study was performed on 90 diabetic type 2 patients with microalbuminuria, who were selected according to the consecutive sample selection method during 6 years. Data were collected through regular and systematic measurements of serum albumin as the response variable and body mass index, systolic and diastolic blood pressure, the duration of diabetes, glycosylated hemoglobin (HbA1c), total cholesterol, triglyceride (TG), fasting blood sugar (FBS), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) as the related factors. Non-normal mixed models were used to investigate the impact of effective factors on the amount of excreted serum albumin.. According to the deviance information criterion (DIC = 56.2), the non-normal mixed effects model with the skewed t distribution had a best fit and indicated that HbA1c, HDL and total cholesterol had a significant effect on the amount of albumin in urine (P < 0.05).. Using nonnormal mixed models may lead to the best results as compared to common normality assumption..

Diabetes mellitus is a metabolic disorder and its subsequent complications such as retinopathy, nephropathy, ulcers, disability, and amputation increase the burden of the disease. Patient knowledge-improving programs are employed to prevent disease progression and to improve the quality of life of the patients. In this way, we need to characterize the groups of patients in urgent need for more and rich-in-content programs. In the present study, we used piecewise regression to evaluate the trends of diabetic nephropathy prevalence in patients registered in the Sedigheh-Tahereh Research Center and to identify patients who were in need of more attention. Piecewise regression, used in this study, is a statistical method to identify change points, if any, in the trends of mortality rates, prevalence of a disease, or any other trends. Available information for 1,935 patients were retrieved from the database. Joinpoint program 3.5.3 and Statistical Package for the Social Sciences (SPSS) 20 was used to fit piecewise regression and obtain descriptive statistics, respectively. We assessed the trend of diabetic nephropathy in different groups of diabetic patients with respect to sex, blood pressure status, education, family history of diabetes, and age. The results showed an increasing trend in females, patients without family history of diabetes, and eover th recent years. The prevalence of diabetic nephropathy in patients with academic education was high. The groups with high prevalence or increasing trends need more preventive intervention and detailed assessment of the present trends. Exploring high-risk groups is beneficial for better policy-making in the future. However, discovering the reasons for the increased trend of the disease is really helpful in controlling diabetes complications.

This study was designed to examine the effects of purslane seeds on biomarkers of oxidative stress in type 2 diabetic patients. This cross‑over randomized controlled clinical trial was conducted on 40 patients with type 2 diabetes. Participants were randomly assigned to receive either 10 g/day purslane seeds with 240 cc low‑fat yogurt (intervention group) or only 240 cc low‑fat yogurt (as a control group) for 5 weeks. After a 2‑week washout period, subjects were moved to the alternate arm for an additional 5 weeks. At baseline and end of each study phase, fasting blood samples were collected to quantify biomarkers of oxidative stress. We observed a slight decrease in plasma total antioxidant capacity in both groups, however, between‑group changes were not significant (−2.67 vs. −2.95 µg/dL, P = 0.94). Plasma malondialdehyde in purslane group increased slightly, however, we observed no significant effect in the control group (1.62 vs. −0.47 µg/dL, P = 0.58). Although both groups had a slight reduction in plasma oxidized low‑density lipoprotein (ox‑LDL), we failed to find any significant effect of purslane on plasma ox‑LDL (−1.06 vs. −1.71 µg/dL, P = 0.85). This cross‑over clinical trial revealed that consumption of purslane seeds for 5 weeks in type 2 diabetic patients did not result in improved oxidative stress.

Diabetes mellitus is a metabolic disorder which its subsequent complications such as retinopathy, nephropathy, ulcers, disability, and amputation increase the burden of the disease. Patient-knowledge-improving programs are employed to prevent disease progression and to improve the patients’ quality of life. In this way, we need to characterize the groups of patients with urgent need for more and rich in content programs. In the present study, we used Piecewise regression to evaluate the trends in diabetic nephropathy prevalence among patients registered in Sedigheh-Tahereh Research Center and also identify patients needing more attention. This retrospective study was conducted on 1935 registered patients in the center during 1992-2010.Piecewise regression was fitted using Joinpoint program 3.5.3 to identify change points. The results showed an upward trend with 2 change points in females (p-value= 0.06). There was 1 change point with an increased trend in recent years in elderly patients, older than 70 years (p-value=0.038).The prevalence of diabetic nephropathy was in rise without any change point among patients with academic education. In addition, patients with family history of diabetes showed the decreased trend with 2 change points (p-value= 0.040). Hypertensive patients experienced a fall in the trend up to 1997 and then this reminded stable. Evaluating of a disease trend and its complications can lead to developing new theory and innovation. However, this is suggested to conduct further studies to exploring other subgroups and discovering the reasons for increased trend of disease in some subgroups.

Type 2 diabetes (T2D) is a multifactorial disease with susceptibility of several genes that are related to T2D. Insulin secretion pathway starts with potassium channels in pancreatic beta cells. KCNJ11 gene encodes ATP‑sensitive potassium channel subunits. Some studies suggested that KCNJ11 (E23K) mutation increases the risk of T2D. Therefore, present study was designed to investigate the association between E23K polymorphism of KCNJ11 gene and type 2 diabetes mellitus (T2DM) in the Iranian population.

The type of study was case‑control and 40 unrelated subjects, including 20 healthy controls and 20 diabetic patients were recruited (diagnosed based on American Diabetes Association criteria). Blood samples were used for isolation of genomic deoxyribonucleic acid (DNA). Having extracted the genomic DNA from human blood leukocytes by means of High Pure PCR Template Preparation Kit, PCR‑restriction fragment length polymorphism method was used to detect KCNJ11 E23K gene polymorphism. BanII restriction enzyme was used for digestion. Data were analyzed using Chi‑square or Fisher exact test or independent t‑test, as appropriate. P < 0.05 was considered.

We found that the carrier homozygous for KK genotype are susceptible to T2D (0.049) and in patients the frequency of K allele was higher than control subjects (0.048).

The present study suggests that KCNJ11 (E23K) gene polymorphism is associated with T2DM.

We are aware of limited data about the effects of purslane on diabetes. Earlier studies have mostly indicated the beneficial effects in animal models. This study aimed to evaluate the effect of purslane seeds on glycemic status and lipid profiles of persons with type 2 diabetes. This cross-over randomized controlled clinical trial was conducted on 48 persons with type 2 diabetes. Participants were randomly assigned to receive either g/day purslane seeds with 240 cc low-fat yogurt (intervention group) or only 240 cc low-fat yogurt (as a control group) for 5 weeks. After a 2-week washout period, subjects were moved to the alternate arm for an additional 5 weeks. At baseline and end of each phase of the study, fasting blood samples were collected to quantify plasma glucose levels, as well as serum insulin and lipid profiles. Within-group and between-group changes in anthropometric measures, as well as biochemical indicators, were compared using a paired-samples t-test. Mean age of study participants was 51.4 ± 6.0 year. We found a significant reduction in weight (−0.5 vs. 0.09 kg, P = 0.003) and body mass index (−0.23 vs. 0.02 kg/m2, P = 0.004) following purslane seeds consumption. Despite a slight reduction in fasting plasma glucose levels (−2.10 vs. −2.77 mg/dL, P = 0.90), we failed to find any significant effect on serum insulin levels and homeostatic model of assessment of insulin resistance score. Furthermore, purslane consumption decreased serum triglyceride levels (−25.5 vs. −1.8 mg/dL, P = 0.04) but could not affect serum high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total cholesterol levels. We observed a significant reduction in systolic blood pressure (−3.33 vs. 0.5 mmHg, P = 0.01) and a borderline significant decrease in diastolic blood pressure (−3.12 vs. −0.93 mmHg, P = 0.09) after purslane seeds intake. In summary, consumption of purslane seeds for 5 weeks in persons with type 2 diabetes might improve their anthropometric measures, serum triglyceride levels, and blood pressure. Further studies are required to determine the appropriate dosage for these patients.

To the best of our knowledge, no study has examined the effects of vitamin D-calcium co-supplementation on glycemic status and lipid profiles of vitamin D insufficient people with diabetes. This study was performed to assess the effects of vitamin D and calcium supplementation on metabolic profiles of vitamin D insufficient persons with type 2 diabetes. In a randomized placebo controlled clinical trial, a total of 118 persons with vitamin D insufficiency and type 2 diabetes were enrolled. Subjects were randomly assigned into four groups receiving: 1) 50000 IU/wk vitamin D+calcium placebo; 2) 1000 mg/d calcium +vitamin D placebo; 3) 50000 IU/wk vitamin D+1000 mg/d calcium; 4) vitamin D placebo +calcium placebo for 8 weeks. All participants provided three days of dietary records and three days of physical activity records throughout the intervention. Blood samples were taken to quantify metabolic profile sat study baseline and after 8 weeks of intervention. Calcium-vitamin D co-supplementation resulted in reduced serum insulin (-14.8±3.9 pmol/L, P=0.01), HbA1c (-0.70±0.19%, P=0.02), HOMA-IR(-0.46±0.20, P=0.001), LDL-(-10.3±0.1 mmol/L, P=0.04) and total/HDL-cholesterol levels (-0.91±0.16, P=0.03) compared with other groups. We found a significant increase in QUICKI index (0.02±0.01, P=0.004), HOMA-B (11.8±12.17, P=0.001) and HDL-cholesterol (0.46±0.05 mmol/L, P=0.03) levels in calcium-vitamin D group compared with others. Vitamin D supplementation led to a significant improvement in all biomarkers of glycemic status, except for fasting plasma glucose, compared with no-vitamin D group. Joint calcium-vitamin D supplementation might improve glycemic status and lipid profiles in vitamin D insufficient people with type 2 diabetes.

The prevalence of prediabetes in the world continues to increase. These patients have elevated the risk of atherosclerosis. The current study was designed to assess the prevalence of peripheral arterial disease (PAD) and its related risk factors in prediabetes patients. This was the case-control study in which 135 adults in three groups: Diabetes, prediabetes, and normal were studied. We evaluated the prevalence of PAD through the measurement of ankle‑brachial index (ABI). All the patients were interviewed about demographic and medical data, including age, sex, disease duration, body mass index, hypertension (HTN), fasting blood glucose, hemoglobin A1C (HbA1C), lipid profile, and medication use. The prevalence of PAD in diabetes patients was higher than the normal group (8.5%vs. 0.0%) (P < 0.05), but the differences between prediabetes compared with diabetes and normal group were not significant. The mean level of ABI in normal, prediabetes, and diabetes group was (1.11 ± 0.11), (1.09 ± 0.12), and (1.05 ± 0.03) respectively (P < 0.1). There were marginally significant differences of ABI observed between the normal group and the diabetes group. The observed differences between groups in the ABI were significant after adjusting the effects of age and sex (P < 0.05). There was an association observed between ABI and HbA1C in diabetes patients (r = 0.249, P < 0.01) and a significant association seen between PAD and HTN in the prediabetes group (P < 0.01). Peripheral arterial disease is common in asymptomatic diabetes and prediabetes patients. Management of hypertensive prediabetes patients and early detection of PAD in this group as well as in asymptomatic patients is important.

To the best of our knowledge, no study has examined the effects of vitamin D-calcium co-supplementation on inflammatory biomarkers and adipocytokines in vitamin D insufficient type 2 diabetics. This study was performed to assess the effects of vitamin D and calcium supplementation on inflammatory biomarkers and adipocytokines in vitamin D insufficient people with type 2 diabetes. Totally, 118 diabetic patients were enrolled in this randomized placebo controlled clinical trial. After matching for age, sex, body mass index, type and dose of hypoglycemic agents and duration of diabetes, subjects were randomly assigned into four groups receiving: 1) 50000 IU/wk vitamin D + calcium placebo; 2) 1000 mg/d calcium+vitamin D placebo; 3) 50000 IU/wk vitamin D + 1000 mg/d calcium; 4) vitamin D placebo+calcium placebo for 8 weeks. Blood sampling was done for quantification of inflammatory biomarkers and adipocytokines at study baseline and after 8 weeks of intervention. Joint calcium-vitamin D supplementation resulted in a significant reduction in serum leptin (changes from baseline: -92±19 vs. -9±18 ng/mL in placebo, P=0.01), IL-6 (changes from baseline: -4±1 vs. -3±1 pg/mL in placebo, P<0.001) and TNF-alpha concentrations (changes from baseline: -3.4±1.3 vs. 0.1±1.2 pg/mL in placebo, P=0.04) compared with placebo. Individuals who only received calcium supplements tended to have a greater decrease in serum hs-CRP levels compared with placebo after controlling for baseline levels (changes from baseline: -0.07±0.25 vs. 0.02±0.24 ng/mL in placebo, P=0.09). Joint calcium-vitamin D supplementation might improve systemic inflammation through decreasing IL-6 and TNF-alpha concentrations in vitamin D insufficient people with type 2 diabetes.

The beneficial effect of using nonacetylated salicylates such as salsalate on decreasing the speed of diabetes progression is a controversial issue. The aim of this study was to evaluate the effect of salsalate on metabolic-syndrome-associated parameters as well as the endothelial function of diabetic and impaired glucose tolerance patients. Patients were collected from Isfahan endocrinology research center referrals. Patients with impaired glucose tolerance diagnosis or newly diagnosed diabetes were enrolled in the study. Patients were randomized to receive 1.5 g salsalate (2 × 750 mg) BID or placebo twice a day for 3 months. After the mentioned period, all patients were recalled and complete examination was done; blood samples for biochemistry measurements were drawn (for measuring FBS, post prandial glucose, HbA1C, Total cholesterol, HDL, TG, LDL) and forearm flow-mediated dilation (FMD) was performed. Forty patients were enrolled, 32 patients (80%) were female. Mean age of patients was 47.15 ± 6.67 years. FBS (fasting blood sugar) was shown to be significantly different between intervention and control subjects before or after treatment. FMD increased significantly in the intervention group (P = 0.004). The study showed that salsalate decreased FBS levels of patients. It may also improve endothelial function as FMD increased significantly in the intervention group.

We are aware of limited data about the effects of purslane on diabetes. Earlier studies have mostly indicated the beneficial effects in animal models. This study aimed to evaluate the effect of purslane seeds on glycemic status and lipid profiles of type 2 diabetic patients. This cross-over randomized controlled clinical trial was conducted on 48 diabetic patients. Participants were randomly assigned to receive either 10 g/d purslane seeds with 240 cc low-fat yogurt (intervention group) or only 240 cc low-fat yogurt (as control group) for 5 weeks. After a 2-week washout period, subjects were moved to the alternate arm for additional 5 weeks. At baseline and end of each phase of study, fasting blood samples were collected to quantify plasma glucose levels as well as serum insulin and lipid profiles. Mean age of study participants was 51.4±6.0 y. We found a significant reduction in weight (-0.57 vs. 0.09 kg, P=0.003) and BMI (-0.23 vs. 0.02 kg/m2, P=0.004) following purslane seeds consumption. Despite a slight reduction in fasting plasma glucose levels (-2.10 vs -2.77 mg/dL, P=0.90), we failed to find any significant effect on serum insulin levels and HOMA-IR score after purslane seeds intake. Furthermore, purslane seeds consumption decreased serum triglyceride levels (-25.5 vs. -1.8 mg/dL, P=0.04) but could not affect serum HDL-, LDL- and total-cholesterol levels. We observed significant reduction in systolic blood pressure (-3.33vs. 0.5 mmHg, P=0.01) and a borderline significant decrease in diastolic blood pressure (-3.12 vs. -0.93 mmHg, P=0.09) after purslane intake. In conclusion, consumption of purslane seeds for 5 weeks in type 2 diabetic patients might improve their anthropometric measures, serum triglyceride levels and blood pressure. Further studies are required to determine the appropriate dosage for these patients.

Abnormalities in vascular reactivity due to factors like endothelial dysfunction are well recognized in type 2 diabetes. However, the effects of drugs like salsalate in decreasing the disease process especially on endothelial aspects are still controversial. The aim of this study was to evaluate the effects of this drug on some serum and endothelial factors of patients with the diagnosis of impaired glucose tolerance or new diabetic patients. Patients with the diagnosis of impaired glucose tolerance or new diabetic patients who were referred to Isfahan Endocrinology Research Center during February-June 2009 were recruited. After history taking and physical examination, blood samples were obtained to evaluate hemoglobin A1c (HbA1C), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), aspartate transaminase (AST), and serum insulin. Flow mediated dilation (FMD) was also assessed. Patients were randomly divided to receive 1.5 g salsalate (2×750 mg) or placebo twice a day for three months. After three months, blood sampling and FMD measurements were repeated. Before and after the intervention, the data was registered and analyzed. Overall, 40 patients including of 8 males and 32 females were recruited. The mean age of patients was 47.15 ± 6.67 years. Fasting blood sugar (FBS) and white blood cell (WBC) count decreased and C-reactive protein (CRP) level increased significantly after the intervention with salsalate. Moreover, FMD increased significantly in the intervention group (P = 0.004). Salsalate could be a tolerable drug in type 2 diabetes patients and may improve FBS level and endothelial function of these patients. However, its safety among these patients should be evaluated by more studies.

Nearly two-third of patients with type II diabetes have degrees of fatty liver; this may induce some side effects in them. This study aimed to find effect of salsalate on treatment of steatohepatitis and correlation of fatty liver with metabolic syndrome in the setting of impaired glucose metabolism. In a double-blind randomized trial within two distinct groups i.e. recently diagnosed diabetics and prediabetic cases allocated in two arms of the intervention to receive 3 g salsalate or placebo. All cases underwent glucose and lipid level studies and liver ultrasound study. Within 46 patients with diabetes, 34 (74%) had fatty liver in ultrasound; this ratio was 75 percent in 113 prediabetic cases. Relative frequency of fatty liver stages did not differ between diabetics and prediabetics. Within diabetics, mean AST level of fatty liver cases (23 ± 7 IU/dl) was higher than others (18 ± 3 IU/dl) (P < 0.05). Changes in transaminase levels following intervention did not significantly differ, comparing drug and placebo arms in two subgroups. According to the findings, if diabetes could be assumed as the logical consequence of prediabetic state, it seems that fatty liver did develop before this preliminary status. In this study, salsalate could not change biochemical markers of fatty liver significantly.

Several studies showed that obesity and fat deposition in the tissues along with inflammatory response may induce insulin resistance and finally type II diabetes. Salsalate can inhibit IKK and NF-KB inflammatory pathway. The aim of this study was to determine the efficacy of salsalate as an anti-inflammatory drug in blood glucose decrement of diabetics. This was a double blind case-control trial. Sixty newly diagnosed diabetic patients were randomized in the drug and the placebo groups. The drug group used were received 3g Salsalate per day (two 750 mg tablets every 12 hours orally) for one month. At baseline there was no significant differences between drug group mean fasting plasma glucose level (124 mg/dl) and placebo group (127 mg/dl) (P = 0.628). Twenty eight patients in drug group and 23 ones in placebo group finished the study. Salsalate had reduced significantly the fasting glucose in the drug group (20 mg/dl) in comparison to placebo group (P < 0.05). This study showed that using 3 grams of Salsalate for one month reduces 15.5% of baseline blood glucose level of diabetic cases. These acceptable results may open a new approach in the treatment of diabetes.