International Journal of Endocrinology and Metabolism
Volume:4 Issue: 1, Mar 2006

Recently a variety of studies reported high prevalence of vitaminD deficiency in adult individuals in different countries and several previously published studies have linked obesity to a poorer vitamin D status, in which serum 25- OHD levels are inversely correlated with body fat. The aim of the present study was to evaluate prevalence of vitamin D deficiency and its relationship with nutritional status among women of reproductive age in the city of Tabriz. This was a cross-section study conducted on 252 reproductive, 15-49 year- old women of the city of Tabriz, randomly selected from among the general population. From each subject 5 mL vein blood was obtained and serum levels of calcium, phosphor, alkaline phosphatase, and vitamin D were measured Lev- els of <5 ng /mL were considered as severe deficiency, 5- 9.90 ng/ mL as moderate, and 10- 20 ng / mL as mild. A demographic questionnaire was completed; weight and height were measured us- ing seca scale and cotton ruler. Body mass index was calculated based on weight and height. Vi- tamin D was measured by radioimmunoassay. The results indicated that vitamin D deficiency in women was as follows: severe vita- min D deficiency 15.1%, moderate deficiency 15.5%, and mild deficiency 33.7%. Of these women 3.7% were underweight and 59.8% had different stage of obesity. Only 37.5% had BMI within normal range. There was a significant correlation between serum levels of vitamin D and weight and age (r = 0.16, p= 0.01 and r = 0.19, p= 0.003). There was no significant association between BMI and serum vitamin D level. Based on this study, it is speculated that vitamin D deficiency is prevalent in the women of Tabriz. No relationship was found between vitamin D and nutritional status. Therefore, interventions such as education and sun exposure are recommended for the health promotion of these women..

This study was carried out to determine the prevalence of microalbuminuria in type 2 diabetes and their relationship with risk factors. The study was performed at the outpatient diabetes clinic of Ardabil. We selected patients who had no evidence of proteinuria in urinalysis and without abnormal serum blood urea nitrogen (BUN) and creatinine. The patients were directed to provide timed 24 hour urine samples for assessment of urinary albumin twice in a period of 2-3 months. In the course of processing case histories the factors considered were duration of diabetes, hypertension history, smoking habits and number of visits during the previous year. Laboratory investigations included FBS, HbA1c, Tg, Cholesterol (Total, HDL, LDL), BUN and creatinine. The prevalence of microalbuminuria (AER 31-299 mg/24 hr) was 30.5%. Significant differences were found with regard to duration of diabetes (p<0.01), hypertension (p<0.0001) and smoking habits (p<0.05) and the mean value of fasting plasma glucose (171±71 v.s 138±48, p=0.01) and triglyceride, (247±142 v.s 201±105, p=0.05). HbA1c levels (7.3±1.3 v.s 6.5±1.3, p=0.01) were significantly high in patients with microal- buminuria as compared to patients with nor- moalbuminuria, serum cholesterol; HDL and LDL showed no significant difference. Microalbuminuria was a major problem in our patients. Hypertension, smoking, poor glycemic control, duration of diabetes and serum levels of triglyceride were risk factors for development of microalbuminuria..

Ahigh frequency of endocrine autoim munity and gastrointestinal immune reactivity has been reported in sarcoidosis. The aim of the present study was to determine the immunogenetic background of sarcoidosis focusing on the associated autoim- mune manifestations. A total of 66 (38 males, 28 females) and /65 (37 males, 28 females) Cauca- sian patients with documented sarcoidosis diag- nosed at the Department of Pulmonary Medi- cine, Malmö University Hospital were genomi- cally typed for DRB1/DQB1. The frequencies of HLA-DRB1*02 (p=0.004), DRB1*14 (p=0.022), DQB1*0602 (p=0.027), DQB1*0503 (p=0.022), were signifi- cantly increased in the whole group of patients with sarcoidosis as well as in sarcoidosis associ- ated with autoimmune manifestations compared to healthy controls. Significant associations of HLA- DRB1*02 and *14 and DQB1*0602 and *0503 with sarcoidosis were found, particularly apparent in the subgroup with associated autoimmune mani- festations. Different immunogenetic profiles may thus exist in sarcoidosis indicative and/or causative of distinct clinical subgroups. HLA class II presentation of a putative sarcoidosis- specific antigen might be of vital importance in sarcoidosis, deciding the direction of the sarcoid disease and eventual associations with it. Whether the above mentioned HLA class II hap- lotypes and/or their linked genes, alone or in unison with HLA class I, are organ- or disease- specific remains to be determined..

The original studies of Albright and Reifenstein characterized primary hyperparathyroidism as a disease of bones and stones”. The disease at present is recognized most frequently as a totally asymptomatic condition, detection being based on the finding of hypercalcemia in the routine screening of serum calcium levels. The purpose of this cross sectional clinical case study was to analyze the clinical, biochemical, radiological, and pathological features of the disease in Irani- ans and to compare these features with those of patients from western countries. From 1985 through 2002, sixty-two patients with primary hyperparathy- roidism were studied from the north-western part of Iran. In addition to routine studies, the following evaluations were conducted; 1) meas- urements of serum calcium, phosphorous, alka- line phosphatase, creatinine and electrolytes; 2) X-rays of skull, hands, clavicles, pelvis, vertebral bones, abdomen, long bones, and dental film of lamina dura, and 3) Intravenous pyelogram and/or ultrasonography of kidneys. PTH was measured in only 29 patients because of lack of reliable laboratory methods during the earlier Correspondence: Amir Bahrami; Departments of In- ternal Medicine and Surgery Tabriz University of Medical Sciences, Tabriz, Iran, Address: P. O. Box 51335 – 1896, Tabriz, I.R.Iran E-mail: t.u.end.d@tbzmed.ac.ir years of the study. Surgery was performed in all subjects and they were followed postoperatively. There were 52 females and 10 males, with a female to male ratio of 5.2:1, and an age range of 13 to 71 years with a mean age of 38/6 years. The peak incidence in both sexes was in the 4th decade. The vast majority of patients in this series presented with symptoms referable to skeletal involvement. Fifty-eight (93.5%) patients suffered from bone pains, deformities, patho- logic fractures, and localized bone tumors. Renal colic was a less frequent complaint; only in 4 pa- tients (6.4%) clinical renal disease led to the di- agnosis of hyperparathyroidism. No patient was asymptomatic. Fifty-four patients had persistent hypercalcemia. In 3 patients hypercalcemia was intermittent and 5 patients were normocalcemic. Mean serum calcium concentration was 11.2 mg/dl (range 9.3-15.6 mg/dl). A high proportion of the patients, 49 of 62, had low serum phospho- rus level. Mean serum phosphate concentration was 2.1 mg/dl (range 1.4-3.6 mg/dl). Interestingly, all 5 normocalcemic patients were hypophos- phatemic. Serum alkaline phosphatase level was elevated in 56 patients, and PTH concentration was high in all the 29 patients in whom it was measured. All patients displayed some ra- diologic changes. Subperiosteal resorption of phalanges and/or distal clavicles was the most frequent (43/62) radiologic finding. Salt and pepper appearance on skull x- rays, brown tumor 20 A. Bahrami et al. in pelvis, metacarpals, and long bones were other common radiologic features. Pathologic fractures were found in 32 patients, including vertebral collapse in 3 patients. The pathologic findings were single adenoma in 54 patients, double adenoma in 3 subjects, hyperplasia in 4 patients (2 patients with MEN –1 and one with MEN-2), and parathyroid carcinoma in 1 patient. This study shows that advanced bone disease is the most frequent clinical pres- entation of hyperparathyroidism in Iranians. Routine serum calcium measurement is recom- mended at least in high-risk patients, in particu- lar for females in their 4th – 5th decades of life..

Exercise is a deterrent of cardiovascular disease and atherosclerosis, but the mechanisms by which exercise reduces atherogenic risk remain unknown. The aim of the present study was to investigate the effects of chronic exercise and/or high cholesterol diet on primary antioxidant enzymes and plasma total antioxidant capacity in Dutch rabbits. 60 male Dutch white rabbits were divided into four groups: The normal diet control (NC), normal diet with exercise (NE), high-cholesterol diet control (HC) and high cholesterol diet with exercise (HE). Animals in high cholesterol diet groups were fed 2% cholesterol rabbit chow for 8 weeks. Animals of exercise groups ran on a treadmill at 0.88 km/h for 10 –60 min/day, 5 day/week, and 8 weeks in total. At the end of experiments, blood samples were drawn from vena cavae and were used for determination of Glutathione Peroxidase (GPX), Superoxide Dismutase (SOD) and Catalase (CAT) activities in red cells, plasma Total Antioxidant Capacity (TAC), Malondialdehyde (MDA) and serum cholesterol profile Thoracic aorta and carotid arteries were isolated for histological examination to evaluate atherosclerosis. We found that 8 weeks of chronic exercise reduced atherogenic diet-induced atherosclerotic lesions in all arteries along with positive changes in cholesterol profile especially increase of serum HDL-C level. Plasma MDA and TAC concentrations were enhanced by exercise in the both normal and hypercholesterolemic groups. Erythrocyte catalase activity was increased significantly by chronic exercise (P<0.05), whereas total SOD activity rose with exercise only in the control group. Surprisingly, GPX activity was significantly decreased in response to exercise in the control group and also in the high cholesterol diet group. It is speculated that exercise is an appropriate method for prevention and regression of atherosclerosis that accompanies enhancement of plasma TAC and positive changes in serum cholesterol profile; the exercise effects on red cell antioxidant activities is however more limited in hypercholesterolemic animals as compared to normal ones possibly in part because of alterations in the ability to adapt to exercise– induced oxidative stress in the high cholesterol diet..

This study aims at analyzing the outcomes of transsphenoidal surgery in 35 patients of Cushing’s disease (CD), the highest number of patients seen during 11 years from one center in Iran. Retrospective data from case records of all patients were retrieved. The diagnosis of CD was based on clinical presentation, hormone studies, adrenal and pituitary imaging, and thoracic imaging as and when considered appropriate. Age, sex, clinical parameters, laboratory investigations, intra-operative findings, post-operative complications, duration of hospital stay and follow up observations were evaluated using appropriate statistical methods. Of 35 patients, 26 were female and 9 male with a mean age of 28±10 years. The most frequent presenting symptom had been obesity (57%) which was present for 30±29 months. Four patients had macroadenoma and the other 31 (86%) had microadenoma. All patients were operated by transsphenoidal route; there were no intra-operative complications. Two patients had temporary CSF rhinorrhea and 9 had temporary diabetes insipidus in the post-operative period without any need for surgical intervention. Eight patients were lost to follow up and the remaining 27 were followed for 22±23 months (minimum 3 months and maximum 8.5 years). Remission was achieved in 32 patients (88%), while the.

Amiodarone, an effective iodine-rich antiarrhythmic drug, frequently causes either changes in thyroid function testsor clinical thyroid dysfunction. Both amiodarone-induced thyrotoxicosis (AIT) and amiodarone-induced hypothyroidism (AIH) have an overall incidence of approximately 1418%, and AIT being most common in iodine-deficient areas, AIH in iodine-sufficient areas. Both dysfunctions may develop either in apparently normal thyroid glands or in glands with preexisting abnormalities (either nodular goiter or thyroid autoimmune disease). The most important pathogenic mechanisms of AIT include excess iodine-induced thyroid hormone synthesis (type I AIT) and amiodarone (or iodine)related destructive thyroiditis (type II AIT), but mixed forms involving both pathogenic mechanisms are likely more frequent than previously believed. AIT is a therapeutic challenge, because rapid restoration of euthyroidism is warranted in patients with underlying cardiac disorders. Treatment of choice for type I AIT is represented by the concomitant administration of thionamides and potassium perchlorate, whereas steroids are the most useful tool for type II AIT. Mixed (or, better, undefined) forms of AIT should be treated with a combination of thionamides, potassium perchlorate and glucocorticoids. Radioiodine therapy is usually not feasible owing to low thyroidal radioiodine uptake due to iodine load, while thyroidectomy can be performed in cases resistant to medical therapy or in those patients requiring a rapid control of thyrotoxicosis after a short course with iopanoic acid to restore normal serum T3 levels. Thyroid ablation is usually required in type I and undefined AIT, also because this allows safe reinstitution of amiodarone treatment, if needed; follow-up without treatment is sufficient in most patients with type II AIT, who usually remain euthyroid or may develop hypothyroidism after reexposure to iodine load..