International Journal of Endocrinology and Metabolism
Volume:4 Issue: 4, des 2006

The predisposition to type 2 diabetes is pro-grammed early in life and genotypes promoting survival during nutritional adversity could in-crease the risk of type 2 diabetes. The insulin gene and variation in the insulin gene variable number of tandem repeats (VNTR) polymor-phism has been suggested to modify birth size and diabetes susceptibility. We assessed the associa-tion between the insulin gene VNTR genotypes, early growth and glucose and insulin metabo-lism in adult life in 488 subjects participating in the Helsinki Birth Cohort Study. Body size at birth did not differ signifi-cantly between the INS VNTR genotypes. One additional type III allele was associated with a 13 g decrease (95% CI 55 to 81 g; p=0.7) in birth weight. Fasting glucose concentration was high-est in the carriers of the III/III genotype. The cumulative incidence of type 2 diabetes did not differ between the genotypes. Interactions be-tween birth size and insulin VNTR genotype in relation to fasting glucose (p for interaction = 0.08 for birth weight, p=0.05 for birth length) and 2-hour insulin (p for interaction =0.04) were ob-served. These interactions between body size at birth and genotype reflect interactions be-tween the insulin VNTR gene and the intra-uterine environment. Our findings are consistent with the hypothesis of developmental plasticity, where one genotype can give rise to different phenotypes dependent on the early environ-ment.

The role of Oxytocin (OXT), found in the cerebrospinal fluid (CSF), circulation and umbilical cord blood, in regulation the timing and initiation of labor and puerperal complications is controversial. This study was designed to clarify the possible role of maternal and fetal OXT in the onset of labor and puerperal complications by comparing the parameters in two groups of pregnant women undergoing cesarean section (CS) after the onset of labor, or elective CS. In this study, OXT levels were measured in plasma, CSF and umbilical cord in two groups of pregnant women who underwent CS, one group with the onset of labor and the other without it. Puerperal complications were detected and the results of both groups were compared. No significant differences were noticed between the two groups in the plasma, CSF, and umbilical cord levels of OXT (p>0.05). The amount of postoperative hemorrhage and intensity of after pain in the group with the onset of labor were less than those without labor (p<0.05). In the group with contractions the uterine involution time and lochia were less than in the other group (p<0.05). The results of this study showed that there were no differences in maternal and neonatal OXT concentrations among the groups. It was also concluded that onset of labor reduced puerperal and neonatal complications

Lipoprotein (a(is a major and independent risk factor for cardiovascular disease. The patho-genicity of Lp(a) as a risk factor may depend upon its Lysine binding site(LBS) activity. It is suggested that non enzymatic glycation of Lp(a) resulting from high plasma glucose level found in diabetic patients may be one of the factors contributing to the severity of this disease. The purpose of this research was to study the effect of glycation on Lysine binding site activity of lipoprotein(a). Lp(a) was glycated by in-cubation of 100 ml serum in vitro with 0.25 to 350 mmol of glucose for 10 days at 37oC. Glycated Lp(a) was separated by using m–aminobronate affinity column chromatography and Lysine binding site properties of the glycated Lp(a) were compared with native Lp(a) by using lysine sepharose affinity chromatography. Glucose uptake by Lp(a) was linear as a function of concentration and time up to 7 days for all given concentrations. Glycation increased the negative charge of Lp(a) as monitored by electrophoresis and increased the affinity of Lp(a) for Lysine sepharose affinity column chromatography. Chemical modification induced by glycation of lp(a) affected its lysine binding site activity and increased LP(a) lysine positive sub-species. Therefore it is suggested that nonenzy-matic glycation of Lp(a) may contribute to pre-mature atherogenesis of patients with diabetes mellitus by increasing its LBS activity. and di-verting lipoprotein catabolism from non-athero genic to atherogenic pathways.

The incidence of Type 2 diabetes is on the rise and along with this increase there is a growing interest in the efficacy of antioxidant vitamin therapy in the treatment of this malady. In this case-control study, the levels of antioxidant vitamins retinol, α-tocopherol and ascorbic acid were measured with HPLC and colorimetric method, in plasma and mononuclear leukocytes of patients with di-agnosed Type 2 diabetes(n=62). We observed significantly lower ascor-bic acid levels in mononuclear leukocytes in our study group when compared to controls. While these results are not defini-tive, we believe they do indicate that further studies are needed to include a larger segment of the population and an evaluation of dietary in-takes and habits.

To determine whether children with growth hor-mone deficiency (GHD) have lower mean serum bicarbonate concentrations than do children with short stature due to other causes. We evaluated one hun-dred short stature children, aged 5 to 15 years, at-tending the children''s endocrine clinic at Mo-tahari clinic, Shiraz, Iran, over a 6 month period. Demographic data and clinical features were re-corded, laboratory investigations were per-formed, and bone ages were calculated. GHD was defined as serum GH concentration ≤10 ng/ml in response to L-dopa and clonidine, in addition a thorough work-up was performed to exclude any other known clinical conditions that might lead to growth retardation. Thirty one patients (31%) had GHD, 69 (69%) were not GH deficient, and one case had panhypopituitarism. Serum bicarbonate concen-trations were significantly lower in GHD com-pared with non-GHD patients (15.68±2.79 versus 17.98±3.79 mEq/l, P=0.003). On the other hand, 52 (75%) GHD subjects and 22 (71%) non-GHD had arterial blood pH values below 7.35, the differ-ence not being statistically significant. All GHD patients had abnormal serum bicarbonate levels versus 87% of non-GHD cases (P<0.05). GHD and non-GHD groups were comparable regard-ing mean age, sex, height SDS, BMI, severity of bone age delay, fasting blood sugar, serum corti-sol level, and thyroid function test results. The lower plasma bicarbonate con-centrations in patients with GHD as compared to with idopathatic short stature patients demon-strate a possible role for growth hormone in the modulation of acid-base homeostasis.

Agranulocytosis is an uncommon but most seri-ous adverse side effect of thiouracil. It has been reported to affect 0. 3% – 0. 6% of patients treated with thiourea–derivates. Both methimazole (MMI) and propylthiuracil (PTU) can cause agranulocytosis. Some data indicate that low doses of MMI are associated with lower preva-lence of agranulocytosis than either high-dose MMI or conventional doses of PTU. The aim of the present study was to determine the fre-quency of thionamide-associatied agranulocyto-sis and to clarify the role of clinical factors such as gender and age of patient, duration of antithy-roid therapy, dosage and type of thionamide used, in the development of agranulocytosis. The medical records of all patients with hyperthyroid disease, treated with either MMI or PTU in endocrine clinics, were reviewed retrospectively with regard to agranulocytosis, patient age and sex, duration of antithyroid therapy, diagnosis, dosage, and type of thionamide used. Between April 1985 and September 2004, a total of 21, 800 patients with hyperthyroidism due to Gravesُ disease or toxic multinodular goiter received long term treat-ment (mean duration of treatment of 15. 78. 4 months) with either MMI or PTU at endocrine clinics of Tabriz University of Medical Sciences. Of these, 20, 840 (95. 6%) patients were treated with MMI and the remainder 960 (4. 4%) received PTU. Classic agranulocytosis, defined as se-vere neutropenia, accompanied by serious symp-toms and signs of infection developed in seven cases, 5 in MMI group and 2 in PTU treated pa-tients. Thus the overall prevalence of thioma-mide–associated agranulocytosis in this study is about 0. 03 percent. There was no significant dif-ference between mean ages of patients with and without agranulocytosis (42. 2±14. 8 vs 45. 4±13. 7 years). In the majority of cases, agranulocytosis occurred during the first 2 months of treatment. There was no case with agranulocytosis among 15, 412 individuals treated with low doses of MMI (< 20 mg/day). In conclusion the majority of cases of agranulocytosis occurred within the first few weeks of initiation of antithyroid therapy. This side effect may occur at any times, regardless of patient age, gender or duration of treatment. It seems that the likelihood of agranulocytosis is diminished at low doses of MMI.

Throughout the last two decades, significant ad-vances have been made in oocyte cryopreserva-tion and over 150 babies have been born from fertilized frozen-thawed oocytes. Oocyte cryo-preservation is analogous to semen cryopreser-vation for men. It is potentially the best way to preserve female fertility and offers important benefits to unmarried women or young girls at risk of losing ovarian function as a result of sur-gery or cancer chemotherapy, women who work with toxins or teratogens, and women who are concerned about age-related infertility. Many women today are involved with education or de-veloping their careers and for majority of them, being married and having children may not be feasible until they are in their late 30s and early 40s. In all of these cases, oocyte cryopreservation may be an appropriate solution. On the other hand, cryopreserved oocytes of infertile couples that have completed their families could be an important source of oocyte donation to help other couples. In addition, oocyte cryopreserva-tion presents an attractive alternative to embryo storage, which is often fraught with religious, ethical, and legal complications. While oocyte cryopreservation success has increased overtime, the pregnancy rates remain low and there is still concern about the safety of the procedure.

Spontaneous hyperstimulations syndrome had been reported in women with hypothyroidism, and polycystic ovary syndrome. This report de-scribes a case in which a naturally conceived pregnancy was associated with spontaneous ovarian hyper stimulation and hypothyroidism.1-4 We treated our case by levothyroxine. Within 2 weeks a remarkable improvement was observed, with resolution of ascites and decrease in serum TSH level. The hormonal tests for thyroid func-tion were normal 3 months after treatment. Pregnancy was allowed to proceed under close maternal and fetal surveillance. The mother’s progress was then followed at normal antenatal check-ups and no serious com-plications developed. Ten weeks after delivery ovarian cysts regressed completely. Thyroid hormone replacement seems to be the best therapeutic approach, but in some patients the complete resolution of the ovarian cysts does not take place after being euthyroid.