مجله غدد درون ریز و متابولیسم ایران
سال بیست و سوم شماره 6 (پیاپی 120، بهمن و اسفند 1400)

Type 2 diabetes is one of the most prevalent chronic diseases in the world, and its proper control is necessary to prevent complications. This study aimed to investigate the prevalence of uncontrolled diabetes, and its predictors in diabetic patients admitted to comprehensive health care centers in Isfahan.

A total of 265 patients with type 2 diabetes covered by comprehensive health care centers in Isfahan were included in this cross-sectional study using random sampling. Demographic data, lifestyle, self–care, and quality of care were collected. Glycated Hemoglobin A levels were also measured, and levels above 7% were considered uncontrolled diabetes. The logistic regression test was used to determine the contribution of different factors in diabetes control.

The prevalence of uncontrolled diabetes in the studied patients was 45.3%. The adjusted odds ratio of uncontrolled diabetes in those taking insulin was 3.46 compared with patients receiving only oral medication (p=0.002). Also, the adjusted odds ratio of uncontrolled diabetes was more than five years in those whose duration of diabetes was 3.27 compared to others (p <0.001).

Considering the high prevalence of poor glycemic control in patients with type 2 diabetes, the doctors of comprehensive health care centers must pay special attention to patients diagnosed for about five years and people who use insulin. Reconsidering the type and dose of the medicine for these patients may be helpful.

Gestational diabetes mellitus (GDM) is associated with several consequences during pregnancy and later life. Few studies have focused on social factors related to gestational diabetes using combined indicators.

The data of the Hoveyzeh cohort study were used in this study. The studied population was women aged 35-70 from Hoveyzeh County, who were enrolled in the study between May 2015 and August 2017. Socio-economic status was investigated based on education level, occupation, wealth index, and Townsend's deprivation index. SPSS software was used for data analysis. To this end, normality, chi-square, and means comparison tests were used. Also, household asset status was determined using principal component analysis (PCA), and logistic regression was used to control confounding factors.

A total of 5477 participants had experienced one or more pregnancies. The prevalence of gestational diabetes among the participants was 4% (221/5477). Also, GDM had a prevalence of 4.9% and 2.7% in urban and rural women, respectively (p<0.001). The logistic regression test results showed that literacy level, urbanization, and the wealth index were significantly correlated with the prevalence of gestational diabetes.

The overall prevalence of gestational diabetes was relatively low among the participants. The higher prevalence of gestational diabetes in urban, more educated, and wealthier women can be due to differences in nutritional status, less physical activity, and more screening in these populations. Prospective studies are suggested to better understand the impact of social factors on the occurrence of gestational diabetes.

Mitochondrial dynamic disorders are attributed to many diseases such as diabetes. MFN2 and OPA-1 proteins are the main regulators of fusion, and DRP1 is the essential protein regulating mitochondrial fission. Increasing or decreasing the expression of relevant genes will cause an imbalance between these two processes. This study evaluated the effect of six weeks of aerobic training on mitochondrial levels of the OPA-1 quadriceps muscle in Streptozotocin-induced diabetic rats. 

In this study, 32 rats were randomly divided into four groups (n=8): healthy-control, healthy-exercise, diabetes-control, and diabetes-exercise. The animals ran on a treadmill according to the endurance training protocol five sessions per week for six weeks. Diabetes was induced by injecting Streptozotocin (50 mg/kg) solution. After the last training session, the rats were anesthetized by intraperitoneal injection of ketamine (90 mg/kg) and xylazine (10 mg/kg), and quadriceps muscle tissue was removed and maintained according to standard conditions. One-way ANOVA test was used to compare the groups at a significance level of 0.05, and the Tukey post hoc test was used to examine the differences between the means of the two groups.

Induction of diabetes significantly reduced OPA-1 levels in the quadriceps muscle tissue of the diabetic rats (p=0.012). Also, six weeks of aerobic training significantly increased the OPA-1 protein level in the quadriceps muscle of the trained diabetic rats (p=0.016).

Induced diabetes reduces the OPA-1 protein level, but aerobic exercise increases its level in diabetic rats, leading to increased fusion and thus improved mitochondrial function in the muscle tissue of rats.

The stage of community readiness to make changes or accept childhood obesity prevention programs has an essential role in the eventual success and sustainability of such programs. The current study aims to review the background of community readiness and investigate its importance in planning and implementing childhood obesity prevention programs.

The literature search in this scoping review was conducted in English databases, including PubMed, Scopus, and Web of Science. The keywords were “community-based study," “community readiness," “community preparedness," “community readiness model," “childhood obesity,” and “prevention program." Finally, 36 studies were selected based on the inclusion and exclusion criteria.

The community readiness model (CRM) is the most frequently used conceptual framework for assessing the community’s readiness for a specific issue or problem. Studies have shown that cross-sectional community readiness assessment is a common tool in community-based childhood obesity prevention programs. It is also shown that findings on readiness in childhood obesity prevention interventions have been used with three main objectives including assessing intervention effectiveness, providing evidence-based planning services to adopt appropriate strategies and actions, and identifying community capacity and its changes.

Assessing the stage of community readiness before developing lifestyle interventions, to prevent and control childhood obesity and conduct appropriate interventions for its improvement, is critical for the potential success and effectiveness of such interventions.

This study aimed to evaluate the effect of exercise on serum levels of leptin and adiponectin in obese children and adolescents.

A systematic search of the published Persian- and English-language studies from PubMed, Web of Science, SID, and Magiran databases was done using related keywords up to February 2022. After selecting articles based on the inclusion criteria, a result meta-analysis was performed. Effect size (SMD) and 95% confidence interval (CI) were calculated using a random-effects model. Also, the I2 test was used to determine the heterogeneity, and the Funnel plot test and Egger’s test were used to determine publication bias.

The results of 24 studies on 985 obese children and adolescents showed that exercise caused a significant decrease in serum leptin [SMD=-0.94 (CI:-1.25 to -0.62) p=0.001] but a significant increase in serum adiponectin [SMD=0.85 (CI:0.48 to 1.22) p=0.001]. Also, the meta-regression results showed that the duration and effect of exercise were not significantly correlated with serum leptin levels in obese children and adolescents (r=-0.03, P=0.13) but were significantly correlated with serum adiponectin levels in obese children (r=-0.07, P=0.001).

The present study results showed that both types of exercises (resistance and aerobic) reduced the circulating levels of leptin but increased adiponectin in obese children and adolescents.

Osteoporosis is humans' most common bone tissue disease that causes bone fractures. Based on the evidence, a combination of genetic and environmental factors, hormonal disorders such as estrogen deficiency, malnutrition, inflammatory factors, drugs, and physical inactivity are related to the pathogenesis of this disease. The present study aimed to review the effects of androgens and some endocrine diseases associated with androgen excess on bone health. PubMed and Scopus databases were searched to retrieve related articles, using the following keywords (“polycystic ovary syndrome” OR PCOS OR “cushing syndrome” OR “congenital adrenal hyperplasia” OR CAH) AND (Bone OR fracture OR osteoporosis OR osteopenia). Androgens are essential for the growth and maintenance of bone mass. Despite the positive effects of androgens on bone, a decrease in bone mineral density, osteoporosis, and an increased risk of fractures have been reported in patients with endocrine diseases exposed to androgen excess, including polycystic ovary syndrome, congenital adrenal hyperplasia, and cushing's syndrome. Decreased bone quality in these patients can be due to other associated factors, such as insulin resistance, obesity, increased inflammatory factors, gut microbiota dysbiosis, glucocorticoid therapy, and increased cortisol levels. In addition, long-term exposure to supraphysiologic doses of androgens may adversely affect bone health in these patients. Therefore, bone health in these patients should be carefully monitored, and preventive or therapeutic interventions should be taken for osteoporosis and fractures.