فهرست مطالب maryam tabesh

Metabolic syndrome (MetS) is one of the world’s largest health epidemics, and its management is a major challenge worldwide. The aim of this 10‑year follow‑up study was to assess the most important predictors of MetS persistence among an Iranian adult population.

In this cohort study, 887 out of 2000 participants with MetS aged 20–74 years in the central part of Iran were followed‑up for about 10 years from 2005–2006 to 2015–2016. MetS was defined based on the criteria of NCEP‑ATP III adopted for the Iranian population. Cox proportional hazards regression was conducted to evaluate the predictors of MetS persistence in crude‑ and multivariate‑adjusted models.

Our analyses showed that 648 out of 887 participants (73%) completed the follow‑up and 565 (87.2%) of them had persistence of MetS after 10‑year follow‑up. There was a significant association between age, weight, body mass index, triglyceride, and waist circumference in participants who had MetS compared to those without MetS after 10‑year follow‑up (P < 0.05). There was a direct association between increases in the mean changes of systolic/diastolic blood pressure, waist circumference, and low HDL‑C and risk of MetS persistence after adjusting the model for sex and age in the total population (Ptrend < 0.05). The trends were the same for women except in diastolic blood pressure. After adjustment for potential confounders, the risk of MetS persistence in men was significantly higher than women (HR = 1.98, 95% CI: 1.38–2.85, Ptrend = 0.001).

Most of the risk factors of MetS were positively associated with persistence of MetS. Therefore, modification of lifestyle is recommended to reduce MetS.

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.

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.

Although، most of the experimental studies demonstrated that conjugated linoleic acid has effects on metabolic syndrome، but the number of human studies in this area are limited and the result of these studies are controversial. This systematic review was conducted to summarize the literature from clinical trials and experimental studies regarding the effect of each conjugated linoleic acid (CLA) isomers on component of metabolic syndrome. Relevant studies were identified by searching scientific databases of PubMed and ISI during 2000 until 2012. Clinical trials and experimental studies regarding the effect of 9 cis، 11 trans and 10 trans، 12 cis and mixed CLA on component of metabolic syndrome including insulin resistance، obesity، dyslipidemia and hypertension were included in this systematic review. From 320 articles that were found in this area، 24 articles that had the inclusion criteria were selected. Most of the experimental studies have shown that conjugated linoleic acid can improve insulin resistance and lipid profile in animals، whereas clinical trials could not demonstrate this effects of CLA on humans. Each isomers of CLA have different effects، that is، 9 cis، 11 trans have role in reducing insulin resistance and improving lipid profile and 10 trans، 12 cis isomers have role in improving hypertension.

The prevalence of obesity and associated chronic disease such as diabetes is rapidly increasing in all part of the world. The World Health Organization has predicted that between 1997 and 2025 the number of diabetic patients will increase from 143 million to about 300 million. In diabetic patients, oxidative stress leads to non‑enzymatic glycosylation of proteins such as hemoglobin and albumin, these proteins can play a significant role in pathogenesis of diabetes and development of chronic disorders in diabetic patients. Antioxidant nutrients can reduce the chronic disorders and complications of diabetes by inhibiting the oxidative reactions. Some important antioxidant such as vitamin A, vitamin C, vitamin E and selenium occur in vegetables and fruits. Our objective of this study was investigation of the relationship between vegetables and fruits intake ssand glycosylated hemoglobin (HbA1C) values in diabetic patients. One hundred and five diabetic patients participated in this cross‑sectional study. The patients were referred to health center in Khomeini shahr. Glycosylated hemoglobin (HbA1C) values were measured by chromatography method. Data on dietary intake and vegetables and fruits consumption were obtained from validated food frequency questionnaires. The unadjusted mean glycosylated hemoglobin (HbA1C) is significantly associated with the amount of vegetables and fruits intake (P = 0.014), but the relationship between consumption of fruits and HbA1C is not significant and the relationship between consumption of vegetables and HbA1C was roughly significant (P = 0.049). There were no significant relationship between vegetables and fruits intake and lipids profiles, BUN/creatinine and 24 h urinary protein (P > 0.05). Intake of vegetables and fruits may reduce the glycosylated hemoglobin, therefore choosing the appropriate diet with high fruits and vegetables may help to develop antioxidant defense and reduce the HbA1C in diabetic patients but it did not have any impact on lipids profiles, BUN/creatinine and urine protein 24 h.

Diabetes is considered as a major metabolic disease with high rates of mortality. This study was performed to assess the effects of low and high energy dense vs diets on anthropometric measures، glycemic index، and lipid profiles of type 2 diabetic women. In a randomized controlled parallel design clinical trial، a total of 60 diabetic women [age: 30-60 years; body mass index (BMI) > 25 kg/m2] participated. After matching for age، BMI، and menopausal status، subjects were randomly assigned to consume either a low energy dense [charbohydrate: 65% and fat: 25% of total energy]، high energy dense (charbohydrate: 55% and fat: 35%)، or normal-energy-dense diets (charbohydrate: 60% and fat: 30%) for 8 weeks. Compliance was assessed through a 3-day dietary record during the intervention. Anthropometric measures، plasma glucose and serum insulin، and lipid profiles were evaluated on fasting state at baseline and at the end of the intervention. Difference in dietary energy density did not result in different changes in weight and BMI between groups. Mean change in weight and BMI were almost -3 kg and 1-1. 5 kg/m2 for all groups. Consumption of high energy dense diet resulted in significantly lower serum triglyceride levels compared to low and normal energy dense diets (-41. 16 vs. 2. 56 and 14. 64 mg/dL، P = 0. 01). Within-group differences revealed significant effect of low energy dense diet on serum low density lipoprotein and total cholesterol levels (-13. 25 mg/dL، P = 0. 004 and -17. 68 mg/dL، P = 0. 003 respectively). No overall significant differences in fasting plasma glucose and serum insulin levels were observed between the 3 groups. Consumption of a high energy dense diet might reduce elevated serum triglyceride levels among Iranian women with type 2 diabes. However، adherence to a diet rich in fruits and vegetables might improve serum low density lipoprotein and total-cholesterol levels of these patients.

Back ground: Nowadays diabetes is considered as the most common metabolic disorder and an important cause of morbidity and mortality worldwide. Diabetes has not definitive treatment but the progression of the disease and its related complication could be prevented properly by proper diet. The aim of current study is to determine the relation between fruit and vegetable consumption and physical activity and the level of glycosylated hemoglobin in type 2 diabetic patients. In this cross-sectional study 105 diabetic patients referring to khomeynishahr diabetes center in 2010 were selected by simple sampling method. General profile and food intake of studied population was assessed by a general questionnaires and Food Frequency Questionnaires (FFQ). Blood sample was obtained for measurement of glycosylated hemoglobin level. Collected data was analyzed by SPSS and Nutritionist4 softwares. Increasing consumption of 10 grams of vegetables alone or 10 g increase in consumption of fruit and vegetables simultaneously decrease glycosylated hemoglobin level 0.03% and 0.02%, respectively.(P=0.049,P=0.014) Diabetic patients with high level of fruit and vegetable intake had lower level of glycosylated hemoglobin.