The Associations between Bone Mineral Density and Oxidative Stress Biomarkers in Postmenopausal Women / 가정의학회지

Background@#Oxidative stress plays an essential role in bone health among postmenopausal women. This study aimed to compare the oxidative stress biomarkers among postmenopausal women aged 50–65 years with normal bone mineral density, osteopenia, and osteoporosis. @*Methods@#In this observational study, 120 women with normal bone mineral density, 82 with osteopenia, and 86 with osteoporosis were selected based on the densitometry data obtained from the dual-energy X-ray absorptiometry method. The serum total antioxidant capacity (TAC), superoxide dismutase (SOD) activity, and malondialdehyde (MDA) levels were measured using biochemical methods. A binary logistic regression model adjusted for confounders was used to estimate the risk of osteopenia and osteoporosis. The P-value of <0.05 was considered statistically significant. @*Results@#There were significant differences between the three groups in age, menopausal age, body mass index, and education (P<0.05). According to the binary logistic regression model, higher SOD activity and serum TAC levels were associated with a lower risk of osteoporosis (adjusted odds ratio [aOR], 0.991; 95% confidence intervals [CI], 0.986 to 0.996; and aOR, 0.373; 95% CI, 0.141 to 0.986, respectively). MDA was a significant risk factor for osteopenia in postmenopausal women (aOR, 1.702; 95% CI, 1.125 to 2.576). @*Conclusion@#Higher SOD activity and serum TAC levels in the studied postmenopausal women were associated with a significantly lower risk of osteoporosis. Moreover, the risk of osteopenia increased significantly with higher serum MDA levels.

[Comparison of glycemic control status before and after the use of artificial sweeteners with conventional nutrition in patients with type 2 diabetes]

Background and Objective: Artificial sweeteners are chemical or natural substances used in foods and beverages. The aim of this study was to compare the glycemic control status before and after the use of artificial sweeteners with conventional nutrition in type 2 diabetic patients

Methods: This quasi-experimental study was performed on 30 patients with type 2 diabetes [10 males and 20 females] whom referred to the endocrinology clinic in Tabriz in west of Iran. At the beginning of the study, patients were asked to refrain from using dietary supplements containing artificial sweeteners for three months and continue their usual diabetic diet. Then, each patient was received nutritional supplements containing artificial sweeteners including sugar, special biscuits and candy under a dietitian for three months

Results: Mean glucose level of fasting serum and serum glucose 2 hours after meals in patients during the second trimester increased significantly with the use of artificial sweeteners compared to the first three months [P<0.05]. The mean fasting glucose in patients with diabetes mellitus was 121.33+/-25.3 mg/dl at the end of the first trimester and it was 152+/-42 mg/dl at the end of the second trimester. The mean serum glucose level increased from 164.44+/-44.44 mg/dl to 222+/-7.2 mg/dl 2 hours after meals. The mean of HbA1C in the first trimester was 6.89+/-0.9% and in the second quarter it was 7.4+/-1%

Conclusion: The use of artificial sweeteners in diabetic patients may result serum glucose increase

Comparison of metformin and cyproterone-estrodiol compound effect on hs C-reactive protein and serum androgen levels in patients with poly cystic ovary syndrome

The aim of this study was comparison of the effects of Metformin and Cyproterone-estradiol compound on serum androgens and highly sensitive C-reactive protein levels. Sixty patients with Poly Cystic Ovary Syndrome [PCOS] were enrolled in this study conducted during a period of 16 months from December 2004 to March 2006. Thirty subjects were in each group and treated with Metformin one gram per day or Cyproterone-estradiol compound 21 days monthly and at the beginning and after 3 and 6 months, weight, height, testosterone, dehydroepiandrosterone sulfate [DHEA-S] and hs-CRP levels were measured. Mean age of patients was 23.5 +/- 8.7 years with the range of 15 to 49 years. In both groups significant decreases in DHEA-S levels and in Cyproterone-estradiol compound group a significant decrease in testosterone levels were seen after 6 months, but there were no significant decrease on hs-CRP levels. Comparison of two groups showed that there were no significant differences in the effects of these two drugs on serum testosterone, DHEA-S and hs-CRP levels. In our study the level of hs-CRP at the beginning of treatment were significantly higher in patients who were overweight and obese. Also we found that Cyproterone-estradiol compound causes significant decrease at the level of hs-CRP in overweight and obese patients. The results of this study are different from those of previous studies about beneficial effects of Metformin on hs-CRP levels but are similar to the results of studies that revealed probably obesity and overweight has important role in inducing inflammation and increasing CRP levels

[Evaluation of effective factors in decreased bone density in patient with osteoporosis and osteopenia]

Osteoporosis is the most common metabolic bone disease that characterized by reduced bone strength. The aim of this study was to evaluate the prevalence of effective factors in decreased bone density and secondary causes of osteoporosis. This descriptive cross sectional study was done on 105 patients [76 female and 29 male] suffering from osteoporosis, evaluated in the endocrinology Department of Sina hospital, Tabriz- Iran from March 2003 to March 2006. Past medical history clinical symptoms and biochemical results were of patients. Data analyzed using SPSS-14 and chi square test. Osteoporosis and osteopenia were seen in 55% and 45% of patients with reduced bone density, respectively. Daily calcium intake in patients with less than 400 mg, between 400-1000 mg more than 1000 mg were 63.8%, 31,9%, and 3.4%, respectively. The mean +/- SD of sera calcium and vitamin D level were 9.5 +/- 0.6 mg/dl, 45 +/- 37.1 nmol/l respectively. 61.2% of patients had vitamin D deficiency. 33% of patients had secondary osteoporosis. Among the patient with primary osteoporosis 11.3% afflicted to hyper claciuria. This study showed that decreasing bone density was more prominate in women. The rate of daily calcium intake among patients were low. It is suggested these patients osteoporosis could be prevented by consumption food nutrient rich in calcium and vitamin D supplementation

[Importance of OGTT for diagnosis of diabetes in thalassemia major patients]

Thalassemia major is a genetic disorder. Blood transfusion is critical for survival in these patients. Over the course of the past two and three decade's hyper transfusion therapy in these patients has increased significant improvement in life expectancy and quality of life. Unfortunately this type of therapy increased the frequency of complication due to iron overloud. The aim of this study was to evaluate the prevalencey of diabetes, impaired fasting glucose and impaired glucose tolerance in patients with thalassemia major, with 10-27 years of age in Tabriz. This descriptive study was done on 56 patients between 10-27 years of age with thalassemia major. The demographic informaiton theraputic regiment, the age of first trasfussion. The level of blood transfusion, the history and dosage of familial history of diabetes, Fe, TIBC, ferritin levels were assessed and recorded. For each patient glucose tolerance test, blood glucose level are performed. In this study prevalence of diabetes mellitus, impaired fasting glucose and impaired glucose tolerance test were found in 8.9%, 28.6% and 7.1% of patients respectively. This study showed that despite recent therapy with Desferal in the management of beta-thalassemia major, the risk of secondary endocrine dysfunction remains high. Prevalence of diabetes mellitus, impaired fasting glucose and impaired glucose tolerance test are greater than general population. Endocrine evaluation in patients with thalassemia major must be carried out regularly especially in those patients over the age of 10 years

cross-sectional study of metabolic and endocrine complications in beta-thalassemia major

Iron overload is a major problem in patients with beta-thalassemia major, and it has many structural and metabolic consequences. The aim of this study was evaluation of endocrine distturbances in patients with beta-thalassemia major who were older than 10 years of age. In this cross-sectional study, investigators collected demographic data and medical histories, as well as menstrual history in females, from the medical records of 56 patients with beta-thalassemia major. Patients were examined to determine their pubertal status and the standard deviation score for height for evaluation of short stature. For evaluation of glucose tolerance, a fasting blood glucose and oral glucose tolerance test were performed. Evidence for diabetes mellitus was based on American Diabetes Association and World Health Organization criteria. Serum levels of calcium, phosphorous, thyroid-stimulating hormone, free thyroxin, luteinizing hormone and follicular-stimulating hormone, and estradiol in girls and testosterone in boys were measured. The mean and standard deviation for age in the 56 patients [36 males and 20 females] was 15.62 +/- 4.44 years. Diabetes mellitus was present in 5 patients [8.9%], impaired fasting glucose was found in 16 patients [28.6%] and an impaired glucose tolerance test was found in 4 patients [7.1%]. Short stature [standard deviation score <-2] was seen in 25 [70%] boys and 14 [73%] girls. Impaired puberty was found in 40 patients [71%]. Hypocalcaemia and primary overt hypothyroidism were present in 23 [41%] and 9 patients [16%], respectively. Only eight patients [14.3%] had no endocrine abnormalities. Despite therapy with deferoxamine to treat iron overload, the risk of secondary endocrine dysfunction remained high. Hypogonadism was one of the most frequent endocrine complications. Impaired glucose tolerance, short stature, hypocalcemia, subclinical and overt hypothyroidism are also frequent

[Epidemiological study of familial diabetes type 2 in Tehran]

Background: diabetes type 2 is one of the most prevalent reasons of Hyperglycemia. Different areas experience varying degrees of epidemic intensity. Diabetes is one of the most important causes of death and disability in most countries and imposes heavy financial burdens on people and governments. Although much research has been conducted on its prevention and treatment. It has been recognized as a hereditary disease, the genes causing it or its mode of inheritance are not yet known. Because of the significant role they play in metabolism of glucose, several genes have suggested, but the main cause of the disease has not yet been identified. Our objective is to investigate the epidemic aspects of the hereditary diabetes in people aged 20 years and over

Methods: a cross sectional study was conducted on 14687 subjects, in the urban setting of east Tehran between 1379 and 1380. Of 407 families, 180 agreed to and completed related questionnaires and underwent the necessary tests 180 diabetic families, with at least one member suffering from diabetes type 2, were studied closely in order to clarify the degree of spread and family background. Analysis was performed using Chi Square and t-test

Results: of 1612 subjects, 497 had diabetes, including 802 women and 792 men [p<0. 001]. Most of the diabetics [approx. 79%] were between the ages of 41-70 years old with the highest [55.3%] and lowest [6.2%] rates in the age groups of 51-60 and 20-30 years respectively. Diabetes was more prevalent among siblings with 53% in comparison to the prevalence among offsprings-44%. The prevalence of Diabetes type 2 in first-degree relatives was more frequent between sister and brother [52.7%], followed by that between father and daughter [36%]

Conclusion: it is recommended that the related authorities implement strategies, including screening of families, with a view to identify those at risk and reduce related complications

[Prevalence of DM - IGT and IFG in first degree relative family members of type 2 diabetes in Tabriz. [Greater than 30 years]]

Background: type 2 diabetes is a hereditary disease but the inheritance and responsible genes have not been clearly clarified yet. According to the most studies, diabetes is one of the most common causes of mortality and morbidity in populations. Diabetes occurs in 30% of first degree family members of diabetic patients, But most people are not aware of their disease

Methods: we studied first degree relatives of type 2 diabetes and screened them for diabetes, IFG and IGT.174 families[1556 people] of Tabriz residents were studied, among them 1232 persons grater than 30 years were alive and FBS and OGTT were done in this group

Results: according to this study, 1232 persons were alive and 324 persons had died and DM was found in 343 [27.9%] and 82 [25.3%] of them respectively. We found 179 [14.5%] persons with IFG and 89 [7.2%] with IGT.The percent of diabetes in offspring and siblings were 32.9% and 22.1% respectively. The majority of patients had 41 - 50 years old. Risk of diabetes among offspring who had diabetes in both parents was more than the ones who had diabetic father or mother. In this study, women with diabetes were more than men [32.4% vs. 22.2% respectively]. The prevalence of Diabetes type 2 in first-degree relatives was more frequent between sister and brother [41.95%], followed by that between father and son [10.9%]

Conclusion: prevalence of diabetes in most populations is 8 - 10 %. If diabetes occurs in someone, risk of development of diabetes will increase to 30% in their family members. Therefore, screening must be done in all family members of diabetic patients to recognize the problem and to prevent from diabetes complication