مجله غدد درون ریز و متابولیسم ایران
سال چهاردهم شماره 2 (پیاپی 62، تیر 1391)

Obesity is associated with an adverse cardiovascular risk profile. In developing countries, including Iran, the effects of this cardiovascular risk profile have been overlooked. While there is evidence that Asian countries will experience a similar epidemic of cardiovascular risk factors to that observed in Western populations, few studies have comprehensively assessed this association in Iran. The objective of this study was to assess association between obesity and cardiovascular disease (CVD) risk factors among Tehranian women (TLGS). For this cross sectional study, a representative sample of 5648 women, aged 18-69 years, was selected from Tehran Lipid and Glucose Study. Systolic and diastolic blood pressure (SBP and DBP), weight and height were measured and body mass index (BMI) was calculated. Serum cholesterol (chol), triglycerides (TG) and high density lipoprotein (HDL-C) were measured and serum low density lipoprotein (LDL-C) was calculated. Both descriptive and statistical analysis methods were applied and the logistic regression model was used for adjustment of background variables. A high prevalence of obesity (29.1%) was found when BMI, TG, chol, LDL-C, SBP and DBP increased and the average level of HDL-C decreased slightly with advancing age. Compared with normal-weight women, obese women had greater risk of high TC (OR= 3.19, CI=2.63-3.87), high LDL-C (OR=1.87, CI=1.59-2.19), high Chol (OR=2.15, CI=1.85-2.49), low HDL-C (OR =1.41, CI=1.3-1.52), high systolic blood pressure (OR= 3.19, CI=2.63-3.87), and high diastolic blood pressure (OR=3.81,CI=3.04-4.78). The high prevelance of obesity and risk factors of non-communicable disease necessitates implementation of effective prevention and health promotion programs for women in Tehran.

This cross-sectional was conducted to investigate the association between dietary protein content and animal to plant protein intake ratio and the risk factors of metabolic syndrome in Tehranian adults. This study was conducted using data from adults aged 19-70 years, who participated in third phase of Tehran Lipid and Glucose study. Dietary data were collected using a validated semi-quantitative food frequency questionnaire with 168 food items. Total dietary protein, and intake of protein from animal and plant sources were estimated. The association between total protein and animal to plant protein intake ratio with metabolic syndrome risk factors was determined by multivariate linear regression models with adjustment for confounders. In the present study, 45% of participants were men. Mean ages of men and women were 40.5±13.6 and 38.6±12.8 y, respectively. The mean protein intakes were 13.7 and 13.6% of energy in men and women, respectively. There was an independent inverse association between protein intake and animal to plant protein intake ratio, in women. Fasting glucose was positively associated with total protein intake and inversely associated with animal to plant protein ratio, in both men and women. There was positive association between protein intake and HDL-C. There was an inverse association between protein intake and diastolic blood pressure in women. Amount and type of dietary protein, independent the risk factors of energy density, dietary fat, carbohydrate and fiber, are associated with metabolic syndrome.

Production of female sex hormones by the ovaries ceases gradually after natural menopause and abruptly following surgical menopause. The purpose of this study was to compare the effects of menopause on the metabolic syndrome, serum lipids, blood sugar and blood pressure. Study subjects were selected from among 5191 women, aged 20-60 years, who participated in the Tehran Lipid and Glucose Study. For our study 375 natural menopause and 71 surgical menopause were followed for 9 years. Data were collected using questionnaires. Changes in metabolic and biochemical profiles of these two groups of women during follow-up were compared with each other. In this study metabolic syndrome was diagnosed in 28.7% women after natural menopause and in 32.5%, following surgical menopause. Average systolic blood pressure in the naturally menopause was higher than in surgically menopause women, adjusted for variable pre-menopausal, BMI and age, which was statistically significant. Average blood sugar in surgically menopause was higher than in naturally menopausal females, and was statistically significant. Compared with the naturally menopausal, women it seems that those who become menopausal following surgery have more a higher incidence of metabolic disorders, indicating that such disturbances should be considered before any surgery resulting in the loss of ovaries.

In overt hyperthyroidism, although impaired glucose tolerance has long been observed as a frequent complication, the impact of subclinical hyperthyroidism on glucose metabolism is unclear. Therefore, we compared glucose tolerance tests in patients with subclinical hyperth­yroidism and a group of healthy controls.

Forty- five patients with a drug history of therapy with Levothyroxine and 14 healthy controls were enrolled and T4, T3, T3RU, TSH were measured prior to and TSH again after intravenous injection of 250 µg TRH. Oral glucose tolerance test was performed after 7 to 11 days. The data obtained for patients with subclinical hyperthy­roidism and euthyroid healthy controls were compared.

Twenty-five patients and one control had subclinical hyperthyroidism based on basal TSH. Basal glucose concentrations were not significantly different between the subclinical hyperthyroidism and euthyroidism group. Plasma glucose levels (milligrams per dl ± SEM) at 90 and 120 minutes after ingestion of glucose were significantly higher (p=0.005 and p=0.06 respectively) in the subclinical hyperthyroid (SHR) patients (162 ± 17, 146 ± 16 respectively) compared to euthyroid (EU) normal subjects(101±7 and 94±5 respectively). SHR patients showed higher postprandial glucose concentrations (area under the curve, AUC90, 120 18072±4779 and 18130±1758 mg/dlmin ± SEM respectively) versus EU normal subjects (AUC90, 120 1045±516, 13360 ± 643 mg/dl min ± SEM, P= 0.026, 0.018 respectively).

Subclinical hyperthyroidism results in glucose intolerance despite normal fasting plasma glucose, findings that recommend oral glucose tolerance tests for SHR patients.

The purpose of this study to investigate the relationship between Body Mass Index (BMI) and depression and mental health status in nursing students of the Jiroft nursing college. This is a descriptive-analytic study, conducted on a group of 173 nursing students of the Jiroft nursing college in 1387. Data were collected using a demographic questionnaire, the Beck Inventory depression and General Health Questionnaire (GHQ). Weight and height were measured without shoes and wearing light clothes. BMI was calculated by kg/m2. SPSS software and t test, Pearson correlation, Chi-score and logistic regression was used for data analysis. Of the total population, 77/4% of samples were female and 22/6 % were male. The mean age of samples was 21±1/9, mean BMI was 22/4 ±3/5. 16.6 % of subjects were low weight, 10.6 % over weight and 2.3% were obese. Data revealed a significant positive correlation between depression scores and body mass index scores(R=0/204, P<0/01). There was not significant correlation between GHQ and body mass index scores(R=0/108, P>0/157). Data also revealed that BMI is significantly related to depression [OR=1/1 CI95%=1/02-1/20] and place of residence [OR=6/86 CI 95% =2/38-19/78] among females, but not in males. It seems that enhancing mood and mental health status can reduce overweight in female nursing students of the Jiroft nursing college.

The fast invereasing trend of adolescent obesity is causing concern in developing countries such as Iran, making Identification of the related factors assential for its control and prevention. The aim of this study was to explain the phenomenon and the factors from the view of obese adolescent girls of urban. For this qualitative study, ten focus group discussions were used to collect data from 32 obese girls, aged 12-16 y. All group discussions were recorded and analyzed and classified immediately after focus group discussions. Results showed teens to be dissatisfied with their current situation and obesity; although they had positive attitudes towards some basic food groups and to physical activity, they did not have the necessary motivation and self-efficacy for weight control. In their opinion, parents, teachers, peers and mass media played a significant role in the adoption of nutritional behaviors. Educational programs need to be implemented for health promotion and behavioral changes. Using group discussions, the findings of this study can be effective in designing interventions to change lifestyles and prevent obesity in adolescents.

Introduction and To evaluate the association of superficial, deep and total subcutaneous fat with coronary artery disease. This is a cross-sectional study, conducted on 122 patients with stable angina pectoris (SA). Fasting blood samples were taken to measure levels of fasting blood sugar (FBS), total cholesterol (TC), low- and high-density lipoprotein cholesterol (LDL-C, HDL-C), and triglycerides (TG). Systolic and diastolic blood pressure were measured for all patients, and coronary angiography was performed to detect coronary artery involvements; based on angiography results, participants were divided to patients with (n=73) and without coronary artery disease (n=50). Three days later patients underwent abdominal computerized scan (CT) to determine superficial, deep and total subcutaneous fat. To evaluate the possible correlation between superficial, deep and total subcutaneous fat and coronary artery disease, pearson correlation test was used initially and then linear regression test was used for adjusting age and sex as well as history of hypertension, diabetes mellitus and dyslepidemia. Of one hundred and twenty-two patients, mean age of 52.5±7.6 y, 73 patients had coronary artery involvements superficial (β=1, P=0.94) and deep (β=1, P=0.91). After adjusting for age and sex as well as history of hypertension, diabetes mellitus and dyslepidemia, no significant association was found between CAD and subcutaneous fat tissue. No association was found between different kinds of subcutaneous fat and coronary artery disease.

Oxidative stress elevation has an important role in pathogenesis of diabetes and its side effects. Increased oxidative stresses and antioxidant defense dysfunction are usually seen in diabetes mellitus patients. The aim of this study was the comparative evaluation of saliva antioxidants in type 1 diabetic subjects with a healthy group, because compared to blood sampling, saliva is a non invasive and simple method.

In this case control study, 20 insulin dependent patients and 20 healthy controls (12 female - 8 male, age range 30-40 years) were studied. From each person 2-3 cc of saliva was collected by the Navazesh method. Enzyme activity of super oxide dysmotase, peroxidase and uric acid were measured with Randox and santinel kits by spectrophotometric assay. The data were analyzed with SPSS software, using t Test, P<0.05 being considered significant.

Super oxide dysmotase had showed a statistically significant difference between the two groups patients, (8.74± 8.75 U/ml) in and controls (7.04± 17.95 U/ml). Peroxidase and uric acid were higher in patients than in controls but the difference was not statistically significant. There was positive relation between HbA1c and super oxide dysmotase, peroxidase and uric acid, p=0.003, 0.291, 0.105 r=0.629, 0.244,0.374 respectively. A statistically significant relation also was observed between super oxide dysmotase and HbA1c (p=0.003).

In this study some salivary antioxidants levels were higher in insulin dependent diabetic patients and this may be related the control and severity of disease, which needs further studies to be clarified.

Most antidiabetic agents have side effects and over one-third of patients with diabetes mellitus use some types of complementary and alternative medicines. Herbs are most commonly used to treat diabetes. In this study the effect of we investigated the Glycogol (Diabetan) pill, a blend of Saliva officinalis, Trigonella foenum and Ginseng, on blood glucose levels of diabetic patients. In a double-blind clinical trial, conducted in 2010, 80 diabetic patients referred to endocrine and metabolism clinic in Shahrekord (Iran) were selected and randomly designated into two groups of cases and controls. The case group received Glycogol and the control group received placebo tablets, three times a day for three months. Glycosylated hemoglobin, lipid profile, fasting blood sugar (FBS) and 2 hours postprandial (2hpp) glucose were measured at the beginning and every 2 weeks, for three months. Hepatic enzymes were also evaluated and the results of the two groups were compared. In Glycogol treated patients, compared to controls, 2hpp blood sugar and cholesterol levels were significantly decreased (P<0.05). There were no significant changes in glycosylated hemoglobin and FBS between the two groups. Results showed that glycogol tablets might be beneficial in diabetic patients to reduce 2hpp and cholesterol. More investigations however are needed to ensure the benefits of its long term usage in these patients.

Environmental temperature has a significant effect on human physiological response to physical activity. Therefore, the purpose of this study was to explore the changes in levels of cortisol and lactate of athletes’ blood after one exercise session in cold, warm and natural environments. Ten young male athletes (22±2 years; 67.4±2.7 kg) ran on a treadmill for 1h with 60% VO2max in conditions of natural (22±1˚c, 50±5 RH), cold (3±1˚c, 50±2 RH) and warm (35±1˚c, 50±5RH) environments. Blood samples were collected to measure lactate and cortisol, before, after exercise and at 2h recovery. In addition, body temperature, pressure scale and water consumed by athletes water during exercise were measured. In order to analyze data, Repeated Measure and Bonferroni tests at the significant level of p<0.05 were utilized. Amounts of cortisol and lactate increased significantly after exercise, in all these conditions (p<0.0001). Lactate levels increased significantly after exercise in a warm environment, compared to cold and natural environments (p<0.0001). In addition, cortisol increased significantly in a warm environment in comparison to cold (p=0.037) and natural (p=0.016) environments. Significant differences were observed in cortisol and lactate levels after a rest between excercise in warm and natural environments (p=0.036, p=0.007). Exercise causes accumulation of lactate and release of cortisol in the three environments. It seems that exercise in a warm environment, in comparison with colder environments, causes greater increases in body and muscle temperature, physical pressure, cardiovascular changes, and hence prevents their to returning initial levels during the recovery period.

Lipocalin-2 has recently been identified as a novel adipokine, the concentration of which is positively associated with low grade inflammation, obesity, hyperglycemia and the metabolic syndrome. However, there is limited information available regarding the effect of exercise on Lipocalin-2 levels. The purpose of this study was to investigate the effect of one session exercise on adipose tissue Lipocalin-2 gene expression in diabetic rats. Twenty male Wister rats (160 ± 5 g) after diabetic induction were randomly divided into four groups, three exercise and one control. The training groups performed one exercise session on a motor-driven treadmill (45 min, 20 m/min). Animals in each groups were anesthetized immediately, 4h and 24h after exercise, respectively, and sampling was performed to assess adipose tissue Lipocalin-2 a gene expression, liver glycogen concentration, and plasma glucose and lipid profile levels. Adipose tissue Lipocalin-2 gene expression decreased 4h and 24h after exercise, whereas plasma HDL and Non-Esterified Fatty Acid levels increased and liver glycogen decreased immediately after exercise. The decline of Lipocalin-2 gene expression after exercise may be an indication of the anti-inflammatory effect of exercise in diabetic rats. However further research is necessary in order to understand the mechanisms involved mechanisms.

Resistance exercise training represents an effective interventional strategy to augment muscle mass, strength, and function in diabetes. It has been demonstrated that IL-15 (Interleukin-15) can act as an anabolic factor for skeletal muscle, influencing protein metabolism. It has also been suggested that IL-15 could regulate peripheral glucose metabolism. Our aim was to investigate whether resistance training has any effect on IL-15 expression and protein of skeletal muscles in rats with diabetes. Rats were divided into the control, the training, and the streptozotocin induced diabetic and diabetic training groups. Training groups performed resistance training exercise which consisted of climbing a 1 m ladder with weight added to the tail. IL-15 Gene expression of soleus and Flexor Hallucis Longus muscles was analyzed using real time. Skeletal muscle protein of IL-15 was measured by ELIZA method. The results of this study indicate that resistance training provided an anabolic stimulus sufficient to maintain the Flexor Hallucis Longus muscle mass of the diabetic training group. IL-15 mRNA levels in soleus were increased in the diabetic training group. Protein levels of IL-15 increased in the training and diabetic training groups in both skeletal muscles. Having a high content of mitochondria and relying on an oxidative pathway, soleus muscle was found to be more affected by diabetes. The lack of correlation of IL-15 mRNA and protein levels is partly due to transcriptional and translational blocks, which are present in the IL-15 gene sequence.