مجله غدد درون ریز و متابولیسم ایران
سال پانزدهم شماره 3 (پیاپی 69، شهریور 1392)

Our objective was to study the association between inflammatory markers and the metabolic syndrome and body mass index in adults.

This case control study was conducted on 80 subjects with metabolic syndrome as cases and 160 controls without metabolic syndrome. The metabolic syndrome in patients was defined based on Adult Treatment Panel III. Anthropometrics، biochemical profiles، and inflammatory markers (high sensitive C reactive protein and serum amyloid A) were documented.

The study included 39 women and 41 men with metabolic syndrome as cases، and 78 women and 82 men in the control group، with average ages of 41. 4±8. 3 and 41. 3±7. 7 years، respectively. In subjects with the metabolic syndrome، high sensitive C reactive protein and serum amyloid A concentrations were higher than in those without the metabolic syndrome. In women of both the case and control groups، high sensitive C reactive protein concentration was positively associated with body mass index. In women without metabolic syndrome a positive association was found between serum amyloid A and body mass index. In men with metabolic syndrome، a positive association was found between high sensitive C reactive protein and waist circumference.

High sensitive C reactive protein concentration increased in subjects with the metabolic syndrome and was positively associated with BMI in women and with waist circumference in men.

Nuts are one of the most healthy food groups، but due to their fat content and high energy density their consumption is mostly restricted for weight control. The aim of this study was to assess the association between nuts consumption and abdominal obesity، overweight and obesity. In this cross-sectional study، data were collected on 550 female adolescents، aged 15-18 years، selected by multistage cluster random sampling from Najafabad high schools. Anthropometric measurements were obtained using standard methods. Intakes of nuts and other food groups were evaluated by a semi quantitative food frequency questionnaire. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ) questionnaire. Other required variables were collected by general questionnaires. Abdominal obesity was defined on basis of the 75th Waist circumference percentiles for Iranian children and adolescents. Overweight and obesity were defined on the basis of International Obesity Task Force (IOTF) cut-points. The pre­valence of abdominal obesity and overweight or obesity were 48. 9 and 25. 7 percent respectively. Mean and median intakes of nuts in this community were 22. 36 and 10. 35 gr/day respectively. After controlling for potential confounders، the subjects in the top quartile of nut consumption were less likely to have overweight and obesity [odds ratio (OR): 0. 25; 95% CI: 0. 11-0. 54] and abdominal obesity (OR: 0. 54; 95% CI، 0. 28-1. 03)، compared to those in the lowest quartile. Consumption of nuts was associated with lower risk of abdominal obesity، overweight and obesity. The results of this study suggest that incorporating nuts into diets might help weight control.

The study compared the effectiveness of three methods of green tea extract consumption، aerobics and a combination of these two methods، on the chemerin level and insulin resistance in obese women. This semi-experimental study was conducted in 1391 in Isfahan on 36 females aged 33. 63±4. 78 years with BMI 33. 80±4. 11 kg/m2، selected and grouped randomly into four groups the aerobic exercise، green tea extract، combined (green tea extract along with aerobic exercise) and the control group. The aerobic training program included three sessions per week for 12 weeks; the green tea extract group consumed 500mg green tea extract capsule for 12 weeks، three times a day after meals، and the third group underwent a combination of aerobic exercise and consumption of green tea extract. Body composition، glucose، insulin and chemerin level were measured in all four groups before and after intervention. Insulin resistance index (HOMA-IR) was calculated by the relevant equation. Analysis of variance (ANOVA) was used for between group comparisons (significance level P<0. 05). Results showed that after 12 weeks، in the exercise group no significant differences in weight، BMI، fat percent، WHR، serum levels of chemerin، insulin، glucose and insulin resistance index (P>0. 05). All three methods reduced body composition، although not significantly. Increasing the exercise intensity or duration could lead to more desirable results. Regarding other exercise variables there was no significant change between groups، but these results need to be interpreted cautiously as the motivation and diets of participants were not controlled.

At present، non-alcoholic fatty liver disease (NAFLD) as the hepatic manifestation of the metabolic syndrome is the most common chronic liver disease. Although there is no cure for it yet، it is considered a priority among approaches for lifestyle modifications. This study was aimed to investigate the effect of moderate-carbohydrate، low-calorie diet in patients with NAFLD. A total of 19 overweight or obese subjects with NAFLD were studied for 6 weeks in a randomized controlled clinical trial. A low-calorie moderate-carbohydrate diet (55% energy from carbohydrate) was designed based on dietary habits، age، gender، height and weight of patients. At beginning and end of the study، biochemical parameters including fasting glucose، liver enzymes، insulin، triglycerides، total cholesterol، high-density lipoprotein (HDL-C) and low-density lipop­rotein (LDL-C) cholesterol were assessed and height، weight and blood pressure were measured. Data were analyzed by SPSS software. The average age was 38. 94±8. 56 years and body mass index (BMI) was 29. 44±2. 88 kg/m2. After six weeks of dietary intervention، weight، fasting glucose levels and enzyme aspartate amino transferase (AST) decreased significantly and HDL cholesterol increased. Hepatic ultrasound findings also showed a relative improvement in 6 patients، and one patient who had a complete remission، statistical significance borderline (p=0. 055). The findings of the present study suggest the role of carbohydrate in low-calorie diets، which significantly improved metabolic status of the liver in NAFLD patients، in more than one third of the subjects over a period of 6 weeks.

The purpose of the present study was to determine the effect of endurance training accompanied by fasting and a period of detraining on serum leptin and fructosamine in overweight men. Twenty-one healthy male subjects (Mean±SD; age 25. 2±3. 7 years; weight 78. 3±12. 7 kg; BMI 26. 1±3. 7) voluntarily participated in the study and were divided into the fasting (F) and endurance training+ fasting (F+ET) groups. The F+ET group performed a training program on treadmills for four weeks، 3 times per week during Ramadan. The energy expenditure in each exercise session during at the first week of Ramadan was 500 Kcal and increased to 800 Kcal per session by the last week of Ramadan. At the end of Ramadan، the F+ET group stopped training and fasting and underwent 2 weeks of detraining، and the F group returned to a normal diet during this period. Anthropometric characteristics were measured and three blood samples were taken before، at the end of Ramadan and after detraining. Data were analyzed by using repeated measures of ANOVA with a between group factor. The between-group comparison showed that changes in serum leptin and fructosamine were not significantly different between the two groups (p>0. 05). Furthermore، serum leptin and fructosamine levels did not change (within-group comparison) in the F and F+ET groups (p>0. 05). Based on the findings of the present study it could be concluded that compared to fasting per se، combining endurance training and fasting do not induce more changes in leptin and fructoseamine.

Adiponectin can influence glucose and lipid metabolism and body weight. As thyroid hormones play an important role in general metabolism and body weight regulation، changes in serum levels of adiponectin in thyroid dysfunctions are likely. The current study aimed at evaluating the association between serum adiponectin level and thyroid dysfunction in subclinical hypothyroid and hyperthyroid individuals. This study was performed on 68 subclinical hypothyroid and hyperthyroid subjects (in equal groups) and 34 euthyroid who referred to the Research Institute for Endocrine Sciences، Shahid Beheshti University of Medical Sciences. In all participants، serum levels of adiponectin، TSH، FT3، FT4، insulin، glucose، lipid profiles and BMI were assessed. Serum adiponectin، FT3، FT4 and TSH were measured by ELISA، Electrochemiluminescence and Immunoradiometric assay (IRMA)، respect­tively. Data were analyzed by T-test، One-Way ANOVA and Pearson correlation using SPSS 16. Serum concentrations of adiponectin in both the hypothyroid and hyperthyroid groups (11. 91±5. 02 and 11. 87±5. 84 ng/ml، respectively) were remarkably lower than the control group (15. 13±5. 88 ng/ml)، (P<0. 05). There was no significant correlation between serum levels of adiponectin and TSH، FreeT3، FreeT4، or BMI. Decrease in serum levels of adiponectin in hypo- and hyperthyroid individuals may indicate a significant association between adiponectin concentrations and thyroid dysfunction.

Congenital hypothyroidism causes irreversible، irreparable damage and lifelong complications such as mental retardation. Using the Health Belief Model questionnaire، this study aimed to determine the effect of a health education program on mother’s participation for neonatal hypothyroidism screening program. In the current interventional study، 46 pregnant women from three Health-medicine centers were randomly assigned to an intervention group and 46 pregnant women from three other health centers were assigned to the control group. The Health Belief Model questionnaire assessed perceived susceptibility، perceived severity، perceived benefits، perceived barriers، and cues to action. For measuring the scientific validity of the designed tool، there was an expert panel، and for reliability we used Cronbach’s Alpha. This questionnaire was completed by both groups before educational intervention. The educational intervention consisted of 4 educational sessions، implemented for the intervention group. After the training، the questionnaire was completed again by both groups. Data analyzed with SPPS software using χ2 and ANCOVA. There were statistically significant deferencse between the two groups regarding the perceived susceptibility، severity، benefits and cues to action scores after the training sessions (p<0. 001). The difference in mean barrier scores of the two groups was not statistically significant after the training sessions (p=0. 16). Timely referral by mothers for neonatal hypothyroidism screening was higher in the intervention group (p<0. 001). The study indicated that educational programs based on Health Belief Model assessment are effective in timely participation of mothers for neonatal screening and its use is strongly recommended in screening programs.

Unhealthy nutrition plays an effective role in increasing non-communicable diseases. The aim of this study is to assess the experiences of patients with cardiovascular disease (CVD) risk factors، and healthcare providers working in diabetes unit of health centers، to ascertain the defeaminants of nutritional behavior based on the Health Belief Model. This qualitative study utilized the content analysis approach، conducted over a six month period in 2012، at the diabetes units of health centers، associated with Alborz University of Medical Sciences، located in Karadj- Iran. The data was collected based on individual semi-structured interviews with 50 patients and 12 healthcare providers in the diabetes unit. Data analysis was performed simultaneous with data collection، using the content analysis directed method. Analysis of the data resulted in finding 54 primary codes، all of which were placed into pre-determined categories of the Health Belief model، including threat perceived، benefits and barrier perceived، self efficacy and social support. Most patients were unable to follow healthy diets on a regular or continuous basis. Study results demonstrate the determinants of nutrit­ional behavior as perceived by patients and healthcare providers and can help program planners in designing programs to select the most appropriate methods and applications to address these determinants in order to reduce unhealthy nutritional behavior and to eventually prevent CVDs.

Hirsutism is a common endocrine disorder among reproductive women. There is no clear definition and criterion for the clinical evaluation and diagnosis of hirsutism. The aim of present study is to introduce a simpler diagnostic method on the basis of modified Ferriman- Gallwey (mF-G) system، which examines fewer body areas، but with the same sensitivity، spec­ificity and positive predictive value (PPV). A one thousand women، aged 18-45 years، participants of the Tehran Lipid and Glucose Study، were recruited by random systematic sampling. Data were collected by a questionnaire and clinical examination. The total mF-G score was calculated and ROC curve was drawn for subsets of areas. The new cut-off points were calculated for those subsets with optimal sensitivity، specificity، positive and negative predictive value and concordance percentage. The subset of 5 areas of the lips، chin، thighs، upper and lower abdomen (cut-off point 5)، had sensitivity and specificity of 97/5% and 89/9% (R²= 0/92%، P<0. 0001) respectively، and was the nearest subset to mF-G method. The subset of lip، abdomen and thighs (cut- off point 4) was 91/5% sensitive and 92% specific، with the highest PPV (72/2%) and concordance percentage (91/9%) with the golden standard (mF-G score ≥ 8). Using the 3 area subset of lip+ lower abdomen+ thighs serves as a simple and more accepted method for hirsutism assessment and can be used in wide epidemiologic studies.

The purpose of this study was evaluating the effect of obesity and weight reduction induced by endurance training on UCP3 mRNA expression in C57BL/6 mice. Twenty-four C57BL/6 mice consumed a high-fat diet، while 6 (NB Group) were fed a normal chow for 12 weeks. After the fattening period، 6 obese mice (OB Group) were sacrificed. Twelve mice trained 5 sessions per week for 12 weeks on a rodent treadmill with high (HI Group) (~75% VO2max) and/or low intensity (LI Group) (~50% VO2max) during a training period. The control group (OC Group) was kept inactive in the cages till the end of the period. Body weight was measured and recorded weekly. UCP3 mRNA expression was measured in gastrocnemius muscle using Real Time-PCR method and plasma FFA concentrations were measured using the ELISA method. In the training groups، weight reduction was significant in the 8th week (p<0. 05). Average relative UCP3 mRNA expression was significantly lower in the HI and LI groups، than in the OC group (0. 5±0. 25 and 1. 04±0. 96، respectively، vs. 2. 58±0. 57 arbitrary unit; p<0. 05). Plasma FFA conce­ntrations were significantly lower in the HI and OB groups compared to the LI group (p<0. 05). When energy intake and consequently body weight increases، UCP3 increases to extend the thermogenesis and fatty acid oxidation’s process. In contrast، UCP3 downregulates with exercise-induced weight loss in order to counteract this process.