فهرست مطالب mahin hashemipour

Considering the importance of the role of parents in the physical and mental health of children, especially in the face of chronic diseases, this research aimed to investigate the effectiveness of the mentalization promoting program for parents of children with type 1 diabetes (T1D) on parental stress.

The research method of this study is semi-experimental with a single-subject structure. The sample group was selected by purposive sampling and included four parents of 8-12-year-old children with T1D. The subjects participated in eight two-hour sessions of the mentalization promoting program for parents of children with T1D and completed the Parental Stress Questionnaire (PSI-SF) at baseline, during the intervention, after the intervention, and during follow-up stages to evaluate the effectiveness of this program on parental stress.

The data were analyzed using graphical analysis and the Reliable Change Index (RCI). The results showed that the proposed program, while having sufficient validity, was effective in reducing the stress of these parents, and the effectiveness continued in the follow-up phase.

Considering the credibility and effectiveness of the mentalization promoting program, it is suggested that this program be widely implemented to reduce stress and support parents of children with T1D. Furthermore, this program should be adapted and implemented for parents in stressful situations or those with children suffering from other chronic diseases.

This research was conducted with the aim of designing and validating the Mentalization promoting program for parents of a child with type 1 diabetes and investigating its effectiveness on parents' reflective Functioning and emotional-behavioral problems of the child.

A mixed method was used in this research. In the qualitative part, the mentalization problems of 18 children with T1D and 22 of their parents were extracted through the analysis of interviews with the method of transcendental phenomenology, and three general themes,18 main sub-themes and 50 sub-themes were obtained. Then, based on these themes and within the framework of the concepts of mentalization theory, a program to promote the mentalization of parents with a child with type 1 diabetes was designed. After confirming the content validity based on the CVI, with a semi-experimental method and a single-subject design of the type (A-B) with different subjects, 5 parents of children with diabetes who met the criteria for entering the research, were selected with a purposeful sampling method and participated in the program. The effectiveness of this program was assessed in four phases (baseline, during intervention, after intervention and follow-up) using the Child Behavior Checklist (CBCL) and the Parental Reflective Functioning Questionnaire (PRFQ) and indicators of program goals. Then data was checked based on visual analysis indicators.

The final outcome of this phenomenological study is the extraction of three general themes, including the underlying factors of breakdowns in mentalizing, types of common mentalizing problems, and the consequences of breakdowns in mentalizing which became the basis for design the program to promote the mentalization of parents with a child with type 1 diabetes The results showed that the designed program, while having sufficient validity, was effective in increasing the parents reflective Functioning and reducing the emotional-behavioral problems of the child, and this effectiveness continued in the follow-up phase.

Considering the validity of this program and its effectiveness, it is suggested that this program be widely implemented to help improve the physical and mental health of children with diabetes and their families, and also for children with other chronic diseases should also be adapted.

Previous evidence suggests that exposure to organochlorine pesticides (OCPs) may contribute to the development of type 2 diabetes.

The relationship between OCPs and type 1 diabetes (T1D) in children and adolescents is not well understood. We aimed to explore the association between organochlorine pesticide levels and T1D in this population.

In this case-control study, we included 147 newly diagnosed T1D cases and 147 healthy controls. Spot urine samples were collected from children under 15 years old in both groups to measure organochlorine pesticide levels. We analyzed six OCPs: β-HCH, heptachlor, aldrin, heptachloro epoxy, α-endosulfan, and p,p'-DDD, categorizing them into tertiles. We examined the relationship between urinary OCP levels and T1D, adjusting for age, sex, duration of breastfeeding, Body mass index (BMI), family history of diabetes, and five dietary patterns.

The average urinary concentration of p,p'-DDD was significantly higher in cases than in controls (0.15 (0.07 - 0.3) vs. 0.09 (0.04 - 0.2) μg/g creatinine, P < 0.001). After adjustments for age, sex, breastfeeding duration, BMI, family history of diabetes, and dietary patterns, a significantly positive association was observed between the highest levels of p,p'-DDD, and T1D (odds ratio (OR) = 4.9; 95% confidence interval (CI): 2 - 12.3). Additionally, participants in the middle tertile of urinary β-BHC had a higher OR for diabetes compared to those in the lowest tertile (OR = 2.9; 95% CI: 1.2 - 6.8). No association was found between other OCPs and T1D.

These findings highlight a potential role for p,p'-DDD, and β-BHC in the development of T1D, urging further investigation into the mechanisms of this association and potential preventive strategies in this area.

Congenital hypothyroidism (CH) is one of the most prevalent endocrine disorders in children. According to the literature, there is a high prevalence of other anomalies and syndromes in infants diagnosed with CH.

This study finds the prevalence of concurrent anomalies and the prevalence of each one.

This was a systematic review study based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA). The research question was the comparison of children with and without CH in terms of having extra-thyroidal congenital anomalies. A systematic literature search through PubMed, Science Direct, Scopus, and the Web of Science databases was done using the following key words: Congenital hypothyroidism, birth defects, congenital anomalies.

From the 655 initially retrieved articles, 24 articles remained, and 4 additional references were found by reviewing the references of the final articles. Finally, 28 articles were selected. The prevalence of extra-thyroidal anomalies ranged from 5% to 50% in girls and from 4% to 80% in boys. Meanwhile, 20% of the permanent CH patients and 13% of the patients with transient CH had extra-thyroidal congenital malformations. Cardiac anomalies were more prevalent in girls (female to male ratio=1.6 [0.7 to 5.5]), and urogenital anomalies were more reported in boys. Most of the studies did not report the association between non-thyroidal anomalies and thyroid stimulating hormone, gender, etiology of CH, and transient and permanent CH.

Congenital anomalies are more common in CH patients compared with the general population, even in the absence of congenital syndromes or chromosomal abnormalities. The most common anomalies are cardiac, craniofacial, urogenital, and nervous system.

Hyperinsulinism refers to improper insulin secretion in the presence of low plasma glucose, causing severe and persistent hypoglycemia in infants and children. The brain’s occipital lobe, which includes the visual and plays an essential role in visual perception is specifically sensitive to hypoglycemia-induced damage. The present study aims to investigate the visual perception in children suffering from hyperinsulinism and to compare it with the control group.

This cross-sectional control study, conducted in 2020 in Isfahan, Iran, involved 20 children aged 4-13 years with hyperinsulinism and 20 healthy children of the same age and gender for comparison. In both groups, the measuring instrument was the Test of Visual Perceptual Skills (non-motor) Third Edition.

The mean visual perceptual quotient in the case and control groups was 80.50±26.74 and 116.50±7.56 (p-value<0.001), respectively. The results overall indicated that children suffering from hyperinsulinism were weaker than healthy children in all areas of visual perception.

Based on the obtained results, it is recommended that children suffering from hyperinsulinism be screened regarding visual perceptual disorders since this screening may be helpful in initiating different rehabilitation programs among these patients.

There is an association between treatment options and growth in patients with mucopolysaccharidoses (MPS). The appropriate management of MPS is an essential factor for the growth of the patients.

This study aims to review systematically the available data on the growth status and related treatment factors in patients with MPS type I and MPS type II.

A systematic literature search was performed in PubMed, Scopus, and the Web of Science using related keywords by March 2023. In this systematic review, the primary outcome was determining the growth status (mainly height z-score) of patients with MPSI and MPSII from reviewed studies and its association with different treatment options. The author’s name, year of publication, country, type of MPS, growth status, treatment options, and any associations between growth status, disease, and treatment variables in the article were extracted. 

From the initially retrieved 743 references, 100 were removed due to being duplicates, 31 articles were evaluated by reading the full text, and finally 20 were included in the systematic review. Based on the analyses, treatment options improved growth in the MPS patients. Certain variables regarding the treatment were key factors, such as the age of treatment initiation, combination therapy, and human growth hormone therapy. Some factors related to the characteristics of the patients, including genotype (type of mutation) and disease severity, are also key factors. Patients with MPSI and MPSII had normal growth and height during the first years of life, but after 2-5 years, their growth rate decreases progressively.

The findings of this review indicated that growth impairment is common in patients with MPSI and MPSII. Treatment improved the growth development in these patients but not as much as expected. Some patients’ characteristics, such as disease severity and type of mutations, affect treatment efficacy and height gain. From treatment-related factors, the most important factor is the age of treatment initiation. Regarding other factors such as donor type, human growth hormone administration, and combination therapies, current findings are inconclusive, and more studies are needed.

Congenital hypothyroidism (CH) is one of the most treatable endocrine disorders in infants and children that can influence the function of many organs in the body. On‑time diagnosis and treatment can prevent the adverse effects of thyroid hormone deficiency on the child’s neurodevelopment. There are many challenges in screening, post‑screening, diagnosis, and managing this disorder. Therefore, this article aimed to mention updated information on this issue. Although there are different approaches for the treatment of hypothyroidism, the authors decided to create a national approach based on the conditions of our country.

Epidemiology of psychological problems of children with type 1 diabetes is particularly important due to the ever-increasing prevalence of its sufferers in the world and difficult and stressful conditions of living with this disease and also the long-term negative effects it can have on the physical, psychological, social, and spiritual development of people. Because knowing the current condition of these children is essential for any psychological planning and intervention; the present study was conducted with the aim of epidemiology of psychological problems of children with type 1 diabetes.

Methods and Materials:

 In this descriptive-cross-sectional study, 100 children aged 8 to 12 years with type 1 diabetes in Isfahan province who were cared for in medical centers of the University of Medical Sciences in 2022 were investigated. Psychological problems including emotional-behavioral problems were measured by Children's Behavior Inventory (CBCL). The data was analyzed through SPSS software version 26 and with descriptive (mean, standard deviation and percentage) and inferential (chi-square, one-sample t-test and one-way analysis of variance) indicators.

68.7% of children examined in this research had psychological problems at the clinical level (55.2%) or borderline (13.5%).Some psychological problems were significantly related to gender and economic and educational level of the family (p ≤ 0.05).

Children with type 1 diabetes have internalized psychological problems such as anxiety, depression, somatization, as well as externalized problems such as rule-breaking and aggressive behaviors at the clinical and borderline levels. It is necessary to design and implement a context by strengthening the relationship between the medical team and the consultants to facilitate the acceptance of life with diabetes and help the children and their families express emotions properly.

Considering the higher rate of suboptimal glycemic control in type 1 diabetic(T1DM) children and the increasing trend of T1DM in our community and worldwide and the role of glycemic control in preventing complications of the patients along with the lack of studies regarding the role of family socioeconomic status (SES) and its indicators in our community, we aimed to investigate the association between family SES and glycemic control in children and adolescents with T1DM in Isfahan, Iran.
In this cross sectional study, T1DM patients aged 1-18 years were enrolled. The patients were classified into two groups, with and without appropriate glycemic control, based on the mean of the last three HbA1c mean levels. The characteristics of the patients in different categories of family SES were compared and the associations were evaluated.
In this study 312 children with T1DM (156 with and without optimal glycemic control) and their families were evaluated. Low, moderate and high family SES was presented in 20.4%, 71.6% and 8% of the total population. Frequency of low SES was significantly higher in patients with poor glycemic control (P<0.001).There was significant positive association between family SES and appropriate glycemic control (P<001, OR=6.63, CI95%; 2.2-19.3).
Our findings indicated that in accordance with previous studies, the SES of Iranian families, assessed by multiple factors of parents’ and families’ characteristics, is associated with glycemic control of children with T1DM. These findings would be helpful for health care professionals to design more comprehensive programs based on the SES of the patients' families as well as healthcare policymakers to properly allocate resources in order to obtain more appropriate glycemic control for all patients with T1DM.

This systematic review and meta‑analysis aimed to overview the observational studies on the association of exposure to air pollution and type 1 diabetes mellitus (T1DM).

Based on PRISMA guidelines, we systematically reviewed the databases of PubMed, Scopus, Embase, and Web of Science databases to determine the association of air pollution exposure and T1DM. Quality assessment of the papers was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for observational studies. The odds ratios (OR) and their 95% confidence intervals (CI) were calculated to assess the strength of the associations between air pollutants (gases and particulate matter air pollutants including PM10, PM2.5, NO2, volatile organic compound, SO4, SO2, O3) and T1DM.

Out of 385 initially identified papers, 6 studies were used for this meta‑analysis. Fixed effects meta‑analysis showed a significant association between per 10 μg/m3 increase in O3 and PM2.5 exposures with the increased risk of T1DM (3 studies, OR = 1.51, 95% CI: 1.26, 1.80, I2 = 83.5% for O3 and two studies, OR = 1.03, 95% CI: 1.01, 1.05, I2= 76.3% for PM2.5).There was no evidence of association between increased risk of T1DM and exposure to PM10 (OR = 1.02, 95% CI: 0.99–1.06, I2 = 59.4%), SO4 (OR = 1.16, 95% CI: 0.91–1.49, I2 = 93.8%), SO2 (OR = 0.94, 95% CI: 0.83–1.06, I2 = 85.0%), and NO2 (OR = 0.995,95% CI: 1.05–1.04, I2 = 24.7%).

Recent publications indicated that exposure to ozone and PM2.5 may be a risk factor for T1DM. However, due to limited available studies, more prospective cohort studies are needed to clarify the role of air pollutants in T1DM occurrence.

Lipodystrophy is the most common complication of insulin injection that has not been studied yet in children with Type 1 Diabetes Mellitus (T1DM) in Isfahan. 

This study aimed to evaluate the prevalence of insulin injection-induced lipodystrophy based on related risk factors in children and adolescents with T1DM.

In this cross-sectional study, children and adolescents aged less than 18 years with T1DM who referred to the endocrinology clinic of Imam Hossein Hospital in Isfahan, Iran, in 2019 were enrolled. The baseline, anthropometric, and T1DM-related characteristics of the patients were recorded. Lipodystrophy was diagnosed by clinical examination. The characteristics of patients with and without lipodystrophy were compared. The association between lipodystrophy and disease-related factors was investigated.

In this study, 194 patients with T1DM (88 boys and 106 girls) aged 3 to 18 years were evaluated. Lipodystrophy was diagnosed in 91 patients (46.9%), of which 64 patients (33%) had grade 1, 24 patients (12.4%) had grade 2, and 3 patients (1.5%) had grade 3 lipodystrophy. There was a significant difference in the frequency of lipodystrophy based on age, BMI, patient education, parent education, insulin injection site, duration of diabetes, injection site change, needle change, insulin dose, HbA1c, and hypoglycemia (P<0.05). Regression analysis indicated that there is a significant association between the presence of lipodystrophy and HbA1c (P<0.001, t=7.20), insulin dose (P<0.001, t=4.47), BMI (P<0.001, t= -3.78) and duration of T1DM (P=0.002, t=3.15).

In this study, we reported a high prevalence of lipodystrophy among T1DM patients in Isfahan. From the studied risk factors, duration of diabetes, lower BMI, using a high dose of insulin, and uncontrolled diabetes (HbA1c>7) were the most important risk factors for lipodystrophy.

Due to chronic respiratory and gastrointestinal problems, growth failure is a common issue in patients with cystic fibrosis (CF). The present study aimed to investigate the prevalence of growth hormone deficiency (GHD) in CF children with stable gastrointestinal and respiratory conditions.

In this study, the growth indicators of all 4–16‑year‑old children referred to two CF clinics were monitored over 3 years. Children without severe gastrointestinal or pulmonary symptoms with weight <3% percentile or whose height increase were two standard deviations below their expected height growth over 6 months were selected for the growth hormone (GH) stimulation test by clonidine and L‑dopa test. Some of the children without CF, who were also referred for height growth disorders and matched the CF group, were considered the control group. They underwent the GH stimulation test, and the results were compared.

From 150 patients with CF, growth failure was observed in 24 patients with stable gastrointestinal and respiratory conditions; in 10 of them, the GH stimulation test was deficient. The prevalence of GHD was 6.6% in CF patients. In the control group of 30 children without CF, but with growth failure, the GH was deficient in nine cases, implying no significant difference with the case group (P = 0.37).

In our study, the prevalence of GHD was 6.6% in CF patients, whereas the prevalence GHD in the normal population of childhood is <1%. Therefore, further studies should be designed to investigate the cause of GHD in CF patients.

COVID-19 is an unknown and novel virus that creates a challenge with all comorbid conditions, including diabetes mellitus (DM). Although DM has not been determined as a definite risk factor for COVID-19 in childhood, clinicians should consider the potential association between DM and COVID-19. 

This study aimed to review COVID-19 and DM comorbidity in children.

ISI Web of Science, PubMed, and Google Scholar were investigated to find relevant articles regarding COVID-19 and DM.

Data revealed 50% higher fatal outcomes of COVID-19 in DM children than in healthy ones. Because of the importance of DM in children, it seems mandatory to consider type 1 diabetes and its consequences on COVID-19.

Understanding the pathophysiology of COVID-19 and its interaction with DM are helpful for better management of the disease. These considerations can help clinicians make better decisions about the treatment modalities, management, and diabetic ketoacidosis treatment.

We aimed to investigate the prevalence of nephrocalcinosis (NC) among children with diagnosed congenital adrenal hyperplasia (CAH). Our findings would be helpful for earlier diagnosis, management, and prevention of NC‑related complications.

In this cross‑sectional study, children with CAH, aged <18 years old who were regularly referred for follow‑up, were included. The information of the patients was extracted from their medical files, and they underwent renal ultrasonography for evaluation of the presence of NC.

From 120 studied patients with CAH, four patients (3.3%) had NC. The prevalence of NC was higher in males than females (P = 0.05). Mean age and age of CAH diagnosis had a trend to be lower in CAH patients with NC than those without. Regression analysis indicated significant association between NC and sex (P = 0.027, r = 2.24).

The results of this study indicated a 3.3% prevalence rate of NC for children with CAH. NC had a trend to be more prevalent in male children with CAH. Though it was not significantly different but given that the mean age and age at diagnosis of CAH in children with CAH and NC was lower that CAH patients without NC, it is suggested that in patients with CAH and NC other factors such as genetic background or unknown disease related factors are associated with hypercalcemia and NC.

Idiopathic short stature is a common cause for referral to children's endocrinology clinics. Despite the normal level of growth hormone, the level of insulin-like growth factor 1 (IGF-1) is low in some of these individuals, which is not well-defined. The aim of this study was to determine the effect of vitamin D on the level of IGF-1 in children aged 5 to 10 years with idiopathic stunting.

In a clinical trial study, 30 children aged 5-10 years with the diagnosis of idiopathic short stature were selected, and treated with 50000 vitamin D3 supplements every week for 8 weeks. Serum levels of vitamin D and IGF-1 were measured before and after intervention and compared.

Before and after intervention, mean serum levels of vitamin D were 17.03 ± 6.8 and 44.4 ± 9.2 ng/ml (P < 0.001), and mean serum level of IGF-1 were 17.9 ± 81.5 and 124.4 ± 37.4 ng/ml (P < 0.001), respectively. The level of IGF-1 significantly increased by vitamin D supplementation.

The present study showed that improvement of vitamin D deficiency led to increased level of IGF-1. It seems that in children with idiopathic short stature, the elimination of vitamin D deficiency can be effective in increased level of IGF-1.

Congenital hypothyroidism is one of the most common endocrine disorders in infants and children. Thyroid hormone effects the function of most organs of the body. In premature neonates, thyroid abnormalities are very common but transient. There is a significant difference between the appropriate time for screening in premature and term neonates and there are different viewpoints in treating hypothyroidism in prematurity. According to the probable exceptions in this issue, there is no definite guideline. Therefore, regarding this confusion, this guideline aimed to help clinicians for rapid on-time decision making.

Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder caused by impaired steroidogenesis. Glucocorticoid treatment with increased androgens may lead to cardiovascular and metabolic effects in these patients. In this study, we investigated the relationship between cardiovascular risk factors and androgen levels in children and adolescents with CAH due to 21 hydroxylase deficiency.

A cross‑sectional study of 78 patients (37 boys and 41 girls) with CAH aged 3–17 years. Anthropometric, body mass index (BMI), systolic (SBP), and diastolic (DBP) blood pressure were measured. Fasting blood glucose with plasma insulin and lipids were measured, and insulin resistance (HOMA‑IR) calculated using the homeostasis assessment model. Furthermore, testosterone, Dehydroepiandrosterone sulfate (DHEAS), and 17‑Hydroxyprogesterone (17OHP) were investigated.

The mean SBP and DBP were 112.01 ± 19.13 and 69.77 ± 7.56, respectively. The mean of HOMA‑IR in patients was 2.25 ± 1.46. The frequency of patients with overweight and High HOMA index were, respectively, 33.3% and 29.3%. The correlation analysis between clinical characteristics and androgen serum levels showed that DBP and BMI had a significant positive correlation with 17OHP. The median regression analysis showed, only DBP in the adjusted model had a significant positive effect with 17OHP level (P < 0.05), and no significant relationship was observed for other characteristics.

A significant association was found between BMI and DBP with serum concentrations of 17‑OHP, suggesting that elevated 17‑OHP can lead to an increased risk of cardiovascular disorders in children and adolescents with CAH.

Turner syndrome is the most common chromosomal X-linked disorder worldwide. This syndrome can be presented with diverse genotypes, and may be accompanied by various anatomical abnormalities. This study aimed to make a view to patients with Turner syndrome thorough ultrasound and echocardiographic evaluations.

The current study was conducted on 75 patients with Turner syndrome undergone karyotyping. Ultrasound study was performed to assess renal, hepatic, and thyroid anomalies. Echocardiography was done to evaluate cardiac anomalies.

The patients with Turner syndrome had the mean age of 15.29 ± 5.01 years, among which, 55 (73.3%) were 45X, 14 (18.6%) 45X/46XX, and 6 (8.0%) had structural X chromosome abnormality. Generally, 20 patients (26.6%) had anatomical urogenitory pathology, including horse-shoe kidney in 9 (12.0%), duplicated urinary collected syndrome in 8 (10.7%), and renal malrotation in 7 (9.3%) patients. Abnormal thyroid echo was found in 19 (25.3%), thyroid nodule in 21 (28.0%), and thyroid pseudonodule in 15 (20%) patients. 14 patients (18.6%) had hepatosteatitis. Echocardiographic studies revealed structural anomalies in 42 patients (56%) among which aortic bicuspid valve in 17 (22.6%) and coarectation of aorta in 10 patients (13.3%) were the most common ones, respectively.

A remarkable population of patients with Turner syndrome suffer from anatomical renal, thyroid, hepatic, and cardiac abnormalities.

Many studies who evaluated the outcome of the congenital hypothyroidism (CH) screening reported some intellectual and behavioral deficit despite early diagnose and treatment. The aim of the present study was to compare the intellectual and behavioral adjustment of CH children with controls.

This study was conducted among a group of 135 children aged 8‑‑12 years in Isfahan, including transient and permanent congenital hypothyroidism (TCH and PCH) and a matched group of their classmate. Demographic characteristics collected using a designed data collecting form completed by parents. Intellectual quotient (IQ) was evaluated using Wechsler Intelligence Scale for Children aged 6‑‑16 years (WISC‑III). Depression and anxiety were evaluated using The Children’s Depression Inventory (CDI) and the Multidimensional Anxiety Scale for Children (MASC), respectively. The SPSS software version 20.0 was used for data analysis. Nonparametric tests (Mann‑‑Whitney) were used to investigate the association between variables. A significant level of less than 0.05 was considered in all analyzes.

There was no significant difference in the IQ scores between PCH and TCH groups (P = NS). However, neither of them had intellectual disability (defined as IQ <70). IQ scores were significantly lower in PCH comparing to controls (P < 0.001). Total IQ and verbal IQ were significantly differenct between TCH and control group (P = 0.007 and P = 0.001). No significant difference was found in anxiety and depression scores between CH children and controls.

There is no significant difference in anxiety and depression scores between congenital hypothyroidism children and controls, although IQ scores in children with congenital hypothyroidism is lower than controls.

Given the fact that the quality of care of diabetic children and their mothers’ psychological health and family life quality have mutual effects on each other; in this study, we aimed to compare family life quality of type 1 diabetic (T1DM) patients with healthy children from the perception of their mothers. However, our findings would be helpful for further interventional studies in order to improve both diabetes management and psychological health of their parents.

In this case control study, mothers of children with T1DM, who referred to endocrine and metabolism clinics of Isfahan city, were enrolled. Demographic and familial characteristics of studied population were recorded. Family life quality was evaluated using Retting and Leichtentritt questionnaire and compared between two groups. The questionnaire consists of 32 items, which were representative of six resources including love, status, services, information, goods, and money.

In this study, 50 children with T1DM and 50 healthy children and their mothers were evaluated. Mean total score of family life quality and its resource classes were significantly higher in mothers of T1DM patients than mothers of healthy children (P < 0.05) except for love (P = 0.05).

The findings of this study indicated that the total family life quality score was significantly lower in families of diabetic patients than healthy children families from the perception of their mothers. Our results indicated that most of the family‑life‑related dimensions including attitude and service, services, information, goods, and money affected by the disease conditions and its related comorbidities.

Considering the increasing trend in the incidence of type 1 diabetes mellitus (T1DM), the identification of its environmental determinants, especially those related to the prenatal and lactation period, might ultimately result in primary prevention of the disease. We aimed to review the evidence of the association between mothers’ dietary components during pregnancy and/or lactation with T1DM.

 An electronic and comprehensive literature search was performed until August 2019 in the international databases, including Web of Science (ISI), PubMed, and Scopus, using the following keywords: type 1 diabetes mellitus, autoimmunity, mother, maternal, diet and lactation in different combinations. Papers related to the objectives of the study were selected.

Based on our review, the maternal consumption of meat, especially processed meat, was associated with increased risk of T1DM, whereas the maternal use of vegetables, potato, low-fat margarine, and berries showed protective effects against the development of T1DM in offspring. There was no significant association between the use of multivitamins and mineral supplements with T1DM, according to the available data. The results of the reviewed studies regarding the association between the maternal use of vitamin D, fatty acids, and coffee during pregnancy with T1DM were not consistent and conclusive.

Findings of this review indicate that the maternal consumption of some foods is associated with increased or decreased risk of T1DM. However, for some foods or dietary components, including coffee, vitamin D, and fatty acids, the results are not conclusive. We conclude that although maternal diet could influence the development of insulin autoantibodies (IA) and T1DM in offspring, there is no sufficient evidence for most nutrients, and available data are controversial, which should be dealt with in future cohort or interventional studies.

Maturity‑onset diabetes of the young (MODY) is a clinically and genetically heterogeneous group of diabetes characterized by noninsulin‑dependent, autosomal‑dominant disorder with strong familial history, early age of onset, and pancreatic beta‑cell dysfunction. Mutations in at least 14 different genes are responsible for various MODY subtypes. Heterozygous mutations in the hepatocyte nuclear factor 1 alpha (HNF1A) gene are responsible for the MODY3 subtype, which is a common subtype of MODY in different studied populations. To date, more than 450 different variants of this gene have been reported as disease causing for MODY3. This study was carried out to evaluate HNF1A mutations in Iranian diabetic families fulfilling MODY criteria.

Polymerase chain reaction and Sanger sequencing were performed. All the ten exons of the HNF1A gene were sequenced in ten families, followed by cosegregation analysis and in silico evaluation. Computational protein modeling was accomplished for the identified mutation.

MODY3 was confirmed in two large families by detecting a mutation (p.G253E) in coding regions of HNF1A. Compound heterozygous state for two common variants in HNF1A (p.I27 L and p.S487N) was detected in affected members of 5 families, and in one family, a rare benign variant in the coding sequence for Kozak sequence was detected. Two new nonpathogenic variants were found in noncoding regions of HNF1A.

It seems that HNF1A mutations are a common cause of MODY in Iranian diabetic patients. Identified common variants in heterozygous state can cause diabetes Type II in earlier ages. The role of rare variant rs3455720 is unknown, and more investigation is needed to uncover the function of this variant.

Considering the high prevalence rate of congenital hypothyroidism CH in Iran, an epidemiological study in each region would be helpful in understanding the etiology of the disorder and providing preventative strategies in this field. This study aims to determine the prevalence of CH in different cities of the Isfahan province.

This descriptive and retrospective study was conducted among 918 primarily diagnosed CH neonates, who have been identified through the neonatal screening program from 2009 to 2015. At the age of ≥3 years, treatment was discontinued for 4 weeks, and T4 and thyroid‑stimulating hormone were measured. Permanent (PCH) or transient (TCH) was determined from the results of the thyroid function tests.

From 389,101 screened neonates, 918 were diagnosed with primary CH. The overall prevalence rate of CH was 2.36 in 1000 live birth (ranged 1.58–7.22 in 1000 live birth in different cities). The highest prevalence rate of CH was reported in Ardestan, Khansar, Golpaygan, and Nain cities with prevalence rate of 4.86–7.22 in 1000 live birth and lowest prevalence occurring in Fereydan, Shahreza, Isfahan, and Mobarakeh cities with prevalence rate of 1.58–1.89 in 1000 live birth. In 392 cases which reached to 3 years of age, the rate of TCH was 47.45%. In Chadegan, Natanz, Fereydunshahr, Shahinshahr, Najafabad, Dehaghan, Borkhar, and Mobarakeh, the prevalence of PCH was <50%.

The current findings indicate that the incidence rate of both PCH and TCH are high in Isfahan province with significant variability in different cities which could be due to the role of different genetic, prenatal, and different environmental factors. These epidemiological data could be used as baseline date to design more etiological studies.

Congenital Hypothyroidism (CH) is the most common endocrine disorder and causes of preventable mental retardation in children. We aimed to review the reported CH-related risk factors systematically. In this review, all types of human studies on the risk factors related to the occurrence or high rate of CH were included. An electronic search was conducted in international and national electronic databases. The following keywords were used: “Congenital Hypothyroidism” AND “risk factor”. In this review, 373 papers (from PubMed: 199; Scopus: 36; ISI: 53, SID: 55, Ovid: 11; Science Direct: 19) were identified through electronic database search. A total of 98 articles were assessed for their eligibility, from which 60 qualified articles were selected for final evaluation. Most of the studies have cross-sectional, case-control, and prospective design. The current review was conducted and reported following the PRISMA (preferred reporting items for systematic reviews and meta-analyses) statement. Reported risk factors for transient CH were as follows; iodine deficiency and excess, prematurity, advanced maternal age, male gender, retinopathy of prematurity, twin pregnancy, maternal autoimmune thyroid disease, intrauterine growth retardation, and cesarean delivery. Reported risk factors for permanent CH with dysgenesis of the thyroid gland were as follows; female gender, familial history of CH, birth in geographical areas with a high rate of the disease, advanced maternal age, ethnicity (Caucasians), but not seasonality. Reported risk factors for permanent CH with dyshormonogenesis were a familial history of CH and origin of both parents from the high-risk geographical region. By using this information, we could plan more etiologic studies to investigate the pathogenesis of the disorder, design interventional studies for the known modifiable risk factors to reduce the rate of CH in our region. Also, for risk factors with limited evidence, more studies should be performed.

Diabetes mellitus is a chronic metabolic disorder caused by insulin secretion disorder. The aim of this study was to determine the distribution of diabetic nephropathy in children and adolescents with type 1 diabetes mellitus in Isfahan City, Iran. In this cross-sectional study conducted in 2018, in the Pediatric Endocrinology Clinic of Isfahan University of Medical Sciences, 301 patients under the age of 18 years with type 1 diabetes mellitus were selected Then, the ratio of microalbumin to random urinary creatinine, as a method for diagnosis of diabetic nephropathy, was measured, and its relationship with demographic characteristics, clinical history, hemoglobin A1c (HbA1c), and blood pressure was investigated. Of 301 patients, 12 (4%) had diabetic nephropathy. Among the studied variables, there was a significant relationship between nephropathy with blood glucose control (P = 0.020), mean HbA1c (P < 0.001), and mean systolic blood pressure (P < 0.001). The results of this study showed that the prevalence of diabetic nephropathy in children with type 1 diabetes mellitus in Isfahan was 4%, and some of risk factors such as proper control of blood glucose, systolic blood pressure, and HBA1C levels were significantly associated with it. Therefore, patients with type 1 diabetes mellitus should be monitored for risk factors of nephropathy.