فهرست مطالب

International Journal of Endocrinology and Metabolism
Volume:19 Issue: 1, Jan 2021

  • تاریخ انتشار: 1399/11/13
  • تعداد عناوین: 8
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  • Majid Valizadeh, Farhad Hosseinpanah*, Fahimeh Ramezani Tehrani, Hengameh Abdi, Ladan Mehran, Farzad Hadaegh, Atieh Amouzegar, Farzaneh Sarvghadi, Fereidoun Azizi Page 1

    Context: 

    Gestational diabetes mellitus (GDM) is an important endocrine disorder in perinatology, associated with several maternal and neonatal complications. Development of national guidelines can inform clinicians, health policymakers, and researchers about the most recent evidence and practical issues of diagnosis and management of GDM.

    Objectives

     We aimed to develop clinical practice guidelines for the diagnosis and management of GDM in Iranian pregnant women.
    Evidence Acquisition: The Iranian Endocrine Society constituted a task force, consisting of obstetrician-gynecologists, endocrinologists, a clinical nutritionist, a clinical epidemiologist, and a librarian, to review the published literature and propose national guidelines for the diagnosis and management of GDM. The consensus was reached on all recommendations in several group meetings with a majority decision. The evidence and recommendations were graded according to the American College of Physicians’ Guideline Grading System.

    Results

     The proposed guidelines included recommendations for screening, diagnosis, and management of GDM in Iran.

    Conclusions

     By using an evidence-based approach, these national GDM guidelines can address important clinical issues in the diagnosis and management of Iranian women with GDM.

    Keywords: Iran, Disease Management, Screening, Guideline, Gestational Diabetes Mellitus GDM
  • Zahra Bahadoran, Parvin Mirmiran, Khosrow Kashfi, Asghar Ghasemi Page 2

    Publishing in peer-reviewed high-quality journals is a gold standard method for disseminating scientific work. Choosing the right journal is one of the most important and difficult aspects of publishing research results. Submitting to an inappropriate journal is one of the most common reasons for fast rejection of manuscripts, resulting in time wasted by the authors and journals’ editors. Here, we discuss important factors that should be considered for choosing the right journal to get your work published successfully and effectively. The most important factors for journal targeting are: (1) The journal’s characteristics, including its scientific prestige, performance, publishing model, acceptance possibility, and specialty; (2) the manuscript’s characteristics, including its relevance to the journal’s aim and scope, its intrinsic value, meaning the novelty of the research, soundness of the methodology, potential impact in the field, and its implication; and (3) authors’ priorities and limitations.

    Keywords: Publishing, Scientific Writing, Medical Journal
  • Bita Faam, Ata A .Ghadiri, MohammadAli Ghaffari, Mehdi Totonchi, Layasadat Khorsandi Page 3
    Background

     Oxidative stress is commonly accrued in thyroid tissue during hormone synthesis.

    Objectives

     We aimed to examine oxidative stress in patients with thyroid cancer, benign thyroid nodules, and healthy individuals.

    Methods

     In this study, 138 individuals were involved. Among the selected participants, 108 had thyroid nodules, including 30 papillary thyroid cancer (PTC), 30 follicular thyroid cancer (FTC), six anaplastic thyroid cancer (ATC), 12 medullary thyroid cancer (MTC), and 30 benign nodules. In addition, 30 individuals were selected as a healthy control group. The levels of total antioxidant capacity (TAC) and total oxidant status (TOS) of thyroid tissue were measured using the ELISA method, and the oxidative stress index (OSI) was calculated.

    Results

     The TAC level was significantly lower in MTC and FTC subtypes than in controls. The TOS level was considerably higher in the MTC group than in the control and benign nodule groups. The TOS level was not changed in other groups. The OSI was considerably higher in MTC and FTC subtypes. The TAC and OSI in benign nodules were significantly lower and higher than those of controls, respectively. The OSI was higher in female patients than in males.

    Conclusions

     The OSI can be considered a diagnostic biomarker for benign nodules and MTC. The diverse oxidative stress status between genders may be related to the elevated cancer incidence in females.

    Keywords: Cancer, Oxidative Stress, Thyroid Nodule, Oxidative Marker
  • Dasari Mani Deepthi, Suresh Vaikkakara *, Avinash Patil, Sandeep Ganta, Alok Sachan, Katakam Raghavendra, Vinapamula S Kiranmayi, Amit Kumar Chowhan Page 4
    Background

     Glycated hemoglobin (HbA1c) levels are dependent not only on the average blood glucose levels over the preceding 2 - 3 months but also on the turnover of erythrocytes. Hyperthyroidism is known to be associated with an increase in erythrocyte turnover that may falsely lower the HbA1c in relation to the level of glycemia.

    Objectives

     To assess the impact of medical correction of hyperthyroidism on HbA1c, independent of changes in the fasting plasma glucose and 2-hour post-oral glucose tolerance test plasma glucose.

    Methods

     Adult patients with overt hyperthyroidism (n = 36) were tested for their hemoglobin, reticulocyte percentage, HbA1c and fasting and post-oral glucose tolerance test (OGTT) 2-hour plasma glucose, both at baseline and following at least three months of near normalization of serum thyroxin on Carbimazole treatment.

    Results

     Correction of hyperthyroidism in 36 patients was associated with an increase in the hemoglobin (P = 0.004) and a rise in HbA1c (P = 0.025), even though no significant change was observed in both the fasting (P = 0.28) and post OGTT two-hour plasma glucose (P = 0.54). Also, the proportion of patients with HbA1c ≥ 5.7% rose from 3/36 to 10/36; P = 0.016, while the proportion of patients with either abnormal fasting or abnormal post OGTT 2-hour plasma glucose or both did not show any significant change (P = 0.5). The sensitivity of HbA1c to diagnose prediabetes increased from 20% to 50% post- treatment.

    Conclusions

     Glycated hemoglobin is falsely low in relation to glycemia in patients with untreated hyperthyroidism.

    Keywords: HbA1c, Hyperthyroidism, Carbimazole
  • Shahin Yarahmadi, Nasrin Azhang, Mahmood Salesi, Khaled Rahmani * Page 5
    Background

     Congenital hypothyroidism (CH), as one of the most common endocrine disorders, is a preventable cause of mental retardation.

    Objective

     This study aimed to identify familial-related risk factors for CH in Iranian newborns.

    Methods

     A population-based case-control study was performed on the National Registry System of patients with CH in Iran. In this study, 906 controls and 454 cases were studied for one year. Familial related factors were investigated using logistic regression models. Population attributable fraction (PAF) was also calculated for each significant risk factor.

    Results

     Using multivariate analysis, an increased risk for CH was observed in patients with congenital anomalies (odds ratio (OR): 5.77, 95% confidence interval (CI): 2.37 - 14.01), history of mental retardation in family (OR:2.10, 95% CI: 1.15-3.83), mother’s hypothyroidism during pregnancy (OR: 2.01, 95% CI: 1.33 - 3.03), intra-family marriage (OR:1.49, 95% CI: 1.18 - 1.89), gestational diabetes (OR: 1.69, 95% CI: 1.09 - 2.63), having a hypothyroid child in the family (OR: 2.48, 95% CI: 1.39 - 4.42), and twins or more (OR: 2.61, 95% CI: 1.31 - 5.21). The highest PAF among familial-related risk factors for CH is related to the intra-family marriage (14.9%).

    Conclusions

     This study revealed that familial-related risk factors and consanguine marriages play an essential role in the high incidence of CH in Iran. About 15% of CH in Iran could be attributed to intra-family marriage alone.
     

    Keywords: Congenital Hypothyroidism, Familial Risk Factor, Population Attributable Fraction, Newborn Screening Program, Intra-family Marriage
  • Saeed Erfanpoor, Koorosh Etemad, Sara Kazempour, Farzad Hadaegh, Jalil Hasani, Fereidoun Azizi, Donna Parizadeh, Davood Khalili * Page 6
    Background

     The burden of chronic kidney disease (CKD) is on the rise worldwide; diabetes and hypertension are mentioned as the main contributors.

    Objectives

     The current study aimed to investigate the multiplicative and additive interaction of diabetes and hypertension in the incidence of CKD.

    Methods

     In this population-based cohort study, 7342 subjects aged 20 years or above (46.8% male) were divided into four groups: no diabetes and hypertension; diabetes and no hypertension; hypertension and no diabetes; and both diabetes and hypertension. The multivariable Cox regression was used to determine the effect of diabetes, hypertension, and their multiplicative interaction on CKD. The following indices were used to determine the additive interaction of diabetes and hypertension: the relative excess risk of interaction, the attributable proportion due to interaction, and the synergism index.

    Results

     Diabetes and hypertension had no significant multiplicative interaction in men (hazard ratio of 0.93, P value: 0.764) and women (hazard ratio of 0.79, P value: 0.198); furthermore, no additive interaction was found in men (relative excess risk due to interaction of 0.79, P value: 0.199; attributable proportion due to interaction of 0.22, P value: 0.130; synergy index of 1.44, P value: 0.183) and women (relative excess risk due to interaction of -0.26, P value: 0.233, attributable proportion due to interaction of -0.21, P value: 0.266; synergy index of 0.48, P value: 0.254).

    Conclusions

     This study demonstrated no synergic effect between diabetes and hypertension on the incidence of CKD.

    Keywords: Chronic Kidney Disease, Diabetes, Hypertension, Interaction
  • Abbas Rahimi, Roghayeh Shahbazi, Pooneh Nikuei, Sanaz Soleimani, Azadeh Moradkhani, Ali Atashabparvar, Farnaz Khajehrahimi, Ghazal Zoghi, Masoumeh Kheirandish Page 8
    Introduction

     Primary hyperparathyroidism (PHPT) is a rare condition in the pediatric population. Parathyroid carcinoma (PC) is a very uncommon cause of PHPT, accounting for < 1% of pediatric PHPT cases. It is challenging to distinguish between parathyroid adenoma (PA), the most common cause of PHPT, and parathyroid carcinoma. In this report, we described a young female who presented with a history of progressive limping and was finally diagnosed with PC.

    Case Presentation

     A 15-year-old girl presented with progressive limping and bone pain for 8 years. She was referred by an orthopedic surgeon because of elevated intact parathyroid hormone (iPTH) for further evaluation. Physical examination revealed a large, firm, and non-tender neck mass, left hip tenderness, and limited range of motion. The initial biochemistry tests showed a borderline high calcium level of 10.8 mg/dl, an elevated iPTH level of 2876 pg/mL, and a decreased phosphorus level of 2.4 mg/dL. The 99mTechnetium (Tc) sestamibi scan displayed early intense activity in the right thyroid lobe persisting in the three-hour repeat scan, compatible with a parathyroid lesion. The patient underwent right-sided neck exploration and parathyroidectomy. Intraoperative and pathology findings confirmed the diagnosis of PC. Immunohistochemistry (IHC) staining revealed creatine kinase (CK) and CD31 in endothelial cells of the tumor. Ki67 staining was also positive in 2% - 3% of tumor cells. The whole exome sequencing (WES) study was negative for cell division cycle 73 (CDC73) and multiple endocrine neoplasia 1 (MEN1) genes.

    Conclusions

     PC should be considered as a differential diagnosis of PHPT in the pediatric population, even in the presence of mild hypercalcemia.

    Keywords: Pediatrics, Hypercalcemia, Primary Hyperparathyroidism, Parathyroid Carcinoma, Neck Mass
  • Mohammadreza Rezaeipour * Page 9