مجله غدد درون ریز و متابولیسم ایران
سال بیست و چهارم شماره 3 (پیاپی 123، امرداد و شهریور 1401)

Diabetic retinopathy is one of the most important complications of type 1 and 2 diabetes, which is the most important cause of blindness in people aged 20 to 74. This study aimed to determine the prevalence of retinopathy in newly diagnosed type 2 diabetes mellitus at the Diabetes Center of 5th Azar Hospital in Gorgan.

A total of 260 patients with newly diagnosed type 2 diabetes in the Diabetes Center of 5th Azar Hospital were included in this cross-sectional descriptive study. Demographic information, fasting blood sugar (FBS), and glycosylated hemoglobin (HbA1c) were collected from the patients' files.The results of ophthalmic examinations of the patients, including examination of the fundus, corneal sensation and eye pressure were also recorded and collected. Data analysis was carried out in SPSS16 software using the independent t-tests, Chi-square test, and analysis of variance at significance level of 0.05.

The prevalence of diabetic retinopathy was 34.23% (89 people), of which 68.5% (61 people) had mild non-proliferative retinopathy. Age (P=0.044), HbA1c (P=0.014), and FBS (P=0.032) had a statistically significant association with diabetic retinopathy. Also, the increase in eye pressure was significantly higher in patients with diabetic retinopathy than in those without diabetic retinopathy (P=0.001).

Considering the high prevalence of retinopathy among type 2 diabetic patients, the examination and follow-up of diabetic patients can be an effective factor in reducing diabetic retinopathy.

This study aimed to investigate the relationship between the consumption of refined and whole grains and the risk of the metabolic syndrome in adults.

In this prospective study, the consumption of whole and refined grains was assessed in 1452 subjects who participated in the Tehran Lipid and Glucose Study using a valid and reliable food frequency questionnaire. Metabolic syndrome components were defined based on the Adult Treatment Panel criteria. The Cox regression model was used to investigate the relationship between the consumption of various types of cereals and the components of the metabolic syndrome.

The median of whole grains consumption was 121.7 g per day, and the average consumption of refined grains was 202.2 g per day. Refined grains have a significant and positive association with increased serum triglycerides (risk ratio [RR], 1.03; CI, 1.31-2.18), and abdominal obesity (RR, 1.33; CI, 1.02-1.75) blood pressure (RR, 1.33; CI, 1.01-1.75), and reduction of high-density lipoprotein (HDL; RR, 1.52; CI, 1.25-1.84) after adjustment for confounders. The consumption of whole grains had no relationship with the components of the metabolic syndrome.

Reducing the consumption of refined grains can prevent the occurrence of metabolic syndrome components.

This study aimed to investigate the effect of aerobic training (AT) and aged garlic extract (AGE) supplementation on plasma fetuin-A levels and insulin resistance.

Forty male Sprague-Dawley rats were exposed to high-fat (n=32) and standard (n=8) diets for 9 weeks. Obesity induced in the high-fat diet group and they were divided into 4 subgroups: the obese control (OC), supplementation with AGE, AT, and supplementation with AGE+AT; interventions were performed for 8 weeks in this group. The rats of the group fed with a standard diet (C) continued the diet for 8 weeks. The AGE supplementation was fed to rats once daily at a dose of 600 mg/kg by gavage. Aerobic training included running on a treadmill 5 days a week. Blood samples were collected and plasma levels of fetuin-A, insulin, and glucose were measured 48 hours after the last interventions and after 12 hours of fasting.

Plasma fetuin-A levels showed a significant reduction following all interventions (AGE, AT, AGE+AT) compared to the OC group (26.38±4.42, 19.8%, 22.87±3.50, 30.5%, 17.21±2.20, 47.7%, respectively, compared to 32.93±6.56; P=0.020, P=0.001, P=0.001, respectively). Plasma insulin also showed a significant decrease following all interventions (1.04±0.13, 33.3%, 0.73±0.15, 53.2%, 0.66±0.13, 57.6%, respectively, compared to 1.56±0.13; all interventions P=0.001). Plasma glucose showed a significant decrease only following AGE+AT (112.65±6.20 compared to 127.60±7.85, 11.7%; P=0.001). Insulin resistance also showed a significant decrease following all interventions (0.31±0.04, 36.7%, 0.22±0.04, 55.1%, 0.18±0.04, 63.2%, respectively, compared to 0.49±0.04; all interventions P=0.001).

Both supplementation with AGE and AT seem effective in reducing plasma fetuin-A and improving insulin resistance. However, AT alone and the combination of AT+supplementation with AGE showed more effects compared to supplementation with AGE.

Lifestyle modification through dietary interventions and exercise training is the main approach to treating nonalcoholic fatty liver (NAFLD). The aim of this study was to investigate the effect of high-intensity interval training (HIIT) with Portulaca oleracea supplementation on liver X receptor α (LXRα) and peroxisome proliferator-activated receptor γ (PPARγ) in the liver tissue of rats with NAFLD.

In this experimental study, 30 male rats with a weight range of 160-185 g were divided into 2 main groups: NAFLD (n=25) and healthy control (n=5). Nonalcoholic fatty liver was induced in rats with 12 weeks of a high-fat diet. Five rats were sacrificed to confirm the establishment of NAFLD, and the remaining rats were divided into 4 subgroups: fatty liver control (n=5), P. oleracea supplement (n=5), HIIT (n=5), and HIIT+P. oleracea supplement (n=5). Rats in supplementation groups were given 400 mg/kg/day of dissolved P. oleracea powder. HITT consisted of 5 sessions a week of running with an intensity of 90% of maximum speed for 8 weeks. At the end of the study, LXRα and PPARγ ​​levels in liver were measured.

LXRα values were significantly lower in the HIIT+P. oleracea (P=0.002, effect size=0.63), HIIT (P=0.017, effect size=0.43), and P. oleracea groups (P=0.009, effect size=0.44) than in the fatty liver control group. LXRα values were significantly lower in the HIIT+P. oleracea group than in the HIIT (P=0.030) and P. oleracea groups (P=0.030). PPARγ values were significantly lower in the HIIT+P. oleracea (P=0.002, effect size=0.83), HIIT (P=0.030, effect size=0.60), and P. oleracea groups (P=0.004, effect size=0.71) than in the fatty liver control group. PPARγ values were significantly lower in the HIIT+P. oleracea group than in the HIIT group (P=0.030).

HIIT with P. oleracea supplementation may be effective in the treatment of NAFLD disease by reducing LXRα and PPARγ and improving the regulation of fat production pathways in the liver.

Paraquat triggers oxidative stress and apoptosis. This study aimed to explore the effects of 7-week aerobic training and piperine supplementation on oxidative stress markers of brain tissue in male Wistar rats exposed to paraquat.

Forty-eight adult rats were divided into 6 groups: 1) sham, 2) paraquat (negative control), 3) paraquat+training, 4) paraquat+training+piperine, 5) paraquat+piperine, and 6) paraquat+vitamin E. Aerobic training included 7 weeks of walking on a treadmill, 5 sessions per week for 30-40 minutes per session with 10 to 18 m/min. The paraquat was prepared at a dose of 5 mg/kg body weight; it was injected intraperitoneally 3 times a week. The animals were fed daily on piperine supplementation (20 mg) and vitamin E (20 mg/kg body weight). Oxidative stress markers, including malondialdehyde (MDA) and glutathione (GSH) levels, were measured in samples obtained from the brain hippocampus tissue.

The MDA concentration was significantly higher in the negative control group (2.20±0.24) than in the sham (0.54±0.16), paraquat + training (1.64±0.25), paraquat+piperine (1.57±0.24), paraquat+training+piperin e (1.16±0.18), a nd p araquat+vitamin E groups (1.43±0.15; P<0.001). However, the GSH concentration was significantly lower in the negative control group (1.63±0.20; P<0.001) than in sham (3.59±0.65), paraquat+training (1.94±0.25), paraquat+piperine (2.28±0.34), paraquat+training+piperine (3.20±0.39), and paraquat+vitamin E groups (2.08±0.31).

The use of training alone and training with piperine supplementation can be considered a new strategy to prevent paraquat-induced neurotoxicity.

Adopting diabetes self-care behaviors to control blood glucose is essential, but adherence to them has been challenged due to restrictions related to Covid-19. These restrictions have negatively impacted the psychosocial condition of individuals with diabetes, which could lead to poor self-care. Accordingly, this study aimed to explore the experiences of individuals with type 2 diabetes regarding self-care behaviors and diabetes management during the COVID-19 pandemic.

This qualitative study was conducted using conventional content analysis, the data of which were collected through interviews with people over 18 years of age with type 2 diabetes who were selected from the Endocrinology Clinic of Erfan Hospital in Tehran. Using telephone and WhatsApp, semi-structured interviews were conducted with 20 participants (15 women). Content analysis was done using the constant comparative method, and the open and axial coding method was applied. The data were manually coded, and the main themes and categories emerged from data.

Two main themes emerged from the data: 1) challenges and limitations toward diabetes self-care and 2) facilitators of efficient self-care. Challenges and limitations included 4 sub-themes: Inevitable lifestyle changes, psychosocial problems, limited/lack of access to health care services and medication, and adverse physical effects. Facilitators had 2 sub-themes: improved individual capability and maintaining social interaction.

Our findings indicated that inevitable lifestyle changes, limited access to health care, and adverse psychosocial consequences were the most critical challenges for diabetes management during the COVID-19 pandemic. Improving stress management skills and effective coping strategies can facilitate the adoption of self-care behaviors.