Utility of the Visceral Adiposity Index and Hypertriglyceridemic Waist Phenotype for Predicting Incident Hypertension

BACKGROUND: The aim of this study was to assess the utility of the visceral adiposity index (VAI) and the hypertriglyceridemic waist (HTGW) phenotype as possible hypertension (HTN) predictors in a high-risk population without diabetes and HTN. METHODS: Incident HTN over a 7-year follow-up was assessed among 1,375 first-degree non-diabetic and non-hypertensive relatives of consecutive patients with type 2 diabetes who were 30 to 70 years of age. HTN was defined as a blood pressure reading ≥140/90 mm Hg or the use of antihypertensive medications. We examined the incidence of HTN across VAI quintiles and four groups defined according to baseline fasting serum triglyceride (TG) levels and waist circumference (WC). RESULTS: The VAI and the HTGW phenotype at baseline were related to an increased risk for HTN. In comparison with the lowest VAI quintile, the highest VAI quintile showed a significant associated with HTN in an age- and gender-adjusted model (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.07 to 2.55). Those with HTGW were 2.3 times (OR, 2.27; 95% CI, 1.54 to 3.35) more likely to develop HTN than those with a normal WC and normal TG levels. CONCLUSION: Greater VAI values weakly predicted HTN, whereas the HTGW phenotype was a stronger predictor of incident HTN in an Iranian high-risk population.

Evaluation of peripheral arterial disease in prediabetes

The prevalence of prediabetes in the world continues to increase. These patients have elevated the risk of atherosclerosis. The current study was designed to assess the prevalence of peripheral arterial disease [PAD] and its related risk factors in prediabetes patients. This was the case-control study in which 135 adults in three groups: Diabetes, prediabetes, and normal were studied. We evaluated the prevalence of PAD through the measurement of ankle-brachial index [ABI]. All the patients were interviewed about demographic and medical data, including age, sex, disease duration, body mass index, hypertension [HTN], fasting blood glucose, hemoglobin A1C [HbA1C], lipid profile, and medication use. The prevalence of PAD in diabetes patients was higher than the normal group [8.5%vs. 0.0%] [P < 0.05], but the differences between prediabetes compared with diabetes and normal group were not significant. The mean level of ABI in normal, prediabetes, and diabetes group was [1.11 +/- 0.11], [1.09 +/- 0.12], and [1.05 +/- 0.03] respectively [P < 0.1]. There were marginally significant differences of ABI observed between the normal group and the diabetes group. The observed differences between groups in the ABI were significant after adjusting the effects of age and sex [P < 0.05]. There was an association observed between ABI and HbAlC in diabetes patients [r= 0.249, P < 0.01] and a significant association seen between PAD and HTN in the prediabetes group [P < 0.01]. Peripheral arterial disease is common in asymptomatic diabetes and prediabetes patients. Management of hypertensive prediabetes patients and early detection of PAD in this group as well as in asymptomatic patients is important

Association of polymorphism of Ser311cys paraoxonase-2 gene with type 2 diabetes mellitus in Iran

It is believed that paraoxonase-2 gene polymorphism is associated with type 2 diabetes. This study is aimed to investigate the association between paraoxonase-2 gene polymorphism and type 2 diabetes in an Iranian population. This study was performed on 200 individuals including 100 diabetics and 100 healthy subjects. Genomic DNA was extracted from peripheral blood leukocytes, and PCR-RFLP was carried out. Palindromic sequence in PON2 gene was recognized by Dde1 restriction endonuclease. In order to visualize restriction products, electrophoresis was carried out using polyacrylamide gel [8%] and ethidium bromide staining. The expected PCR product of 331 bp was obtained. Digestion of this product with DdeI showed four Ser homozygotes, three Cys homozygotes, and five Ser311 Cys heterozygotes. The gene frequency of Cys [C] in diabetic subjects was significantly higher than in healthy subjects. This study suggests that an association exists between Ser311 Cys polymorphism and type 2 diabetes mellitus

Cognitive processes and functions in patients with type 2 diabetes in comparison to pre-diabetic patients

Type 2 diabetes is an important risk factor for cognitive decline in diabetic patients. The main goal of this study was the assessment of memory, attention and visuospatial ability dysfunctions in patients with type 2 diabetes in comparison to pre-diabetic patients and normal subjects in Endocrine and Metabolism Center of Isfahan City from April 2011 to July 2011. The sample comprised of 32 patients with type 2 diabetes, 28 pre-diabetic patients and 30 healthy individuals. Memory, attention and visuospatial ability were assessed by Rey Complex Figure Test [RCFT], Paced Auditory Serial Addition Test [PASAT] and sub tests of Wechsler Adult Intelligence Scale-Revised [WAIS-R]. The pair wise comparisons of cognitive functions among three groups, suggesting a significant difference between diabetic and normal groups in PASAT3². PASAT2[2], RCFT [recall trial] and Symbol coding [P=0.003, P=0.009, P=0.010, and P<0.001, respectively]. But there was no difference in copy trial of RCFT and block design between two groups [P=0.170, P=0.490]. There was significant difference between pre-diabetic group and normal group in recall trial of RCFT [P=0.020], as well as significant difference between diabetes type 2 and pre-diabetic group in symbol coding [P=0.001]. There were significant differences in cognitive functions in patient with type2 diabetes, pre-diabetic patients and normal individuals. Thus monitoring neuropsychological status besides controlling levels of blood sugar in these patients is important

Sleep apnea symptoms in diabetics and their first degree relatives

Sleep apnea is associated with increased risk of diabetes mellitus. However, no studies have compared sleep apnea symptoms in diabetic patients and their first degree relatives. The purpose of our study was to investigate high risk for sleep apnea syndrome, in diabetics and their first degree relatives for prevention of diabetes in family. As a part of a cohort study, all of diabetic and their first degree relatives who came for glucose control in diabetes clinic were invited to take part in the survey. Two thousand, four hundred and sixty two individuals [82% of invited] agreed to fill out the Berlin and Epworth sleep questionnaire. Participants consisted of 2462 subjects of 15-70 years of age, both males and females with diabetes and family history of type 2 diabetes mellitus. A total of 1234 participants had diabetes and 11,231 were relatives of diabetic patients. High risk for sleep apnea regarding Berlin questionnaire and Epworth sleepiness scale, diabetic and relative were analyzed. Prevalence's of high risk for sleep apnea were higher among diabetics than relatives [P value<0.001]. In a multiple regression analysis, ''age, body mass index, education, high blood pressure'' were risk factor for sleep apnea symptoms while isolated blood glucose level was not by Berlin questionnaire. By Epworth sleep scale only education level was a risk factor for sleep apnea symptoms while isolated blood glucose level was not risk factor. Sleep apnea symptoms may not have significant difference between diabetics and their relatives. We need more study on sleep apnea in the family of diabetic patients. We hope that more studies on mentioned field may help prevention of diabetes in their family

Impact of exercise on affective responses in female adolescents with type I diabetes

Adolescent is a time of profound biologic, intellectual, psychological, and socioeconomic change that they will face a crisis. Therefore, compatibility may be exposed to many hazards, such as depression, anxiety, and other emotional problems. Nevertheless, a planned regular exercise enhances physical and mental health of adolescent female with diabetes. The aim of this study was to determine the effect of exercise on emotional reactions of female adolescents with type I diabetes. This study was a quasi-experimental research conducted in Endocrine and Metabolism Research Centre. A total of 72 patients were randomly allocated in the two groups. The intervention group did aerobic exercise for 45 minutes, while the control group did not aerobic exercise. Data were collected using a Symptom Checklist [SCL]-90 questionnaire. Data were analyzed and using descriptive and inferential statistics methods and SPSS software. The results showed that the mean score for physical symptoms, depression, obsession-compulsion, interpersonal sensitivity, aggression, phobia, paranoid ideation, psychosis, and anxiety in the test group significantly decreased after intervention than before intervention. The average score in the control group did not differ. The average total score of emotional reactions in the test group after the intervention decreased before the intervention significantly [P = 0.001]. However, in the control group, the mean scores did not differ [P = 0.97]. The findings showed that regular exercise is effective on affective responses of adolescent females with type I diabetes.

healing effect of teucrium polium in acetic acid-induced ulcerative colitis in the dog as an animal model

Inflammatory bowel diseases [IBD], which include ulcer-ative colitis [UC] and Crohn's disease [CD], are debilitating and chronic disorders with unpredictable courses and complicated treatment measures. Therefore, an efficient treatment protocol seems necessary as therapeutic prophylaxis for these disorders. This study aims to determine the healing effect of Teucrium polium [T. polium] in acetic acid-induced UC in an experimental dog model. From September to December 2010, eight male [20-25 kg] crossbred dogs were used for induction of UC by 6% acetic acid, tran-srectally. After one week, three biopsies [10, 20 and 30 cm proximal to the anal verge] were taken from the colon of each animal for histological studies. In the presence of UC, 400 mg/kg/day of T. polium extract was administered orally and transrectally [via enema] for 30 days in six of the dogs. The remaining two dogs were used as controls and did not receive T. polium. Multiple biopsies were taken 7, 14, and 30 days after discontinuation of T. polium in the same manner as before treatment. After administration of acetic acid, we noted the presence of multiple ulcers, diffuse inflammation, PMN infiltration in the lamina propria, glandular destruction and goblet cell depletion. Treatment with T. polium restored the colonic architecture with an increased number of healthy cells and a reduction in inflammatory cells. Damage of the surface epithelial cells and mucosal layer of the lumen were reversed, which lead to faster ulcer healing. T. polium may be a treatment choice for UC and can broaden the current therapy options for UC

healing effects of Teucrium polium in the repair of indomethacin-induced gastric ulcer in rats

To determine the healing effect of Teucrium polium [T. polium] in indomethacin-induced gastric ulcer in rats. In the fall of 2007, 250 Sprague-Dawley rats provided by the Shiraz University Laboratory Animal Center were divided into 4 equal groups including control [70 rats], and 3 experimental groups [60 rats each], and each group received different doses of T. polium. Ten rats were used to study the induction of gastric ulcer by indomethacin [25 mg/kg/stat]. After 24 hours, their stomachs were evaluated for any mucosal ulcer. The T. polium extract was administered orally, 24 hours after indomethacin administration. In the experimental group, 10 animals were sacrificed after 24, 48, and 72 hours, after administration of T. polium, and at one, 2, and 4 weeks, and in the control group identically after the administration of distilled water. In rats treated with indomethacin, multiple ulcers were evident. After 4 weeks of treatment with T. polium, more re-epithelialization, proliferation, mucosal hyperplasia, migration of the gastric epithelial cells, and decrease in inflammatory cells were observed. The T. polium reduced the ulcer indices by >50% after one week, >80% after 2 weeks, and >90% after 4 weeks. The healing effect of T. polium may be due to antioxidant activity along with the ability to modulate the mucin secretion, prostaglandin synthesis, and epidermal growth factor receptor expression. These results along with the non-toxicity properties of T. polium suggests it as a promising anti-ulcer compound

Association of body mass index and abdominal obesity with marital status in adults

Obesity continues to be an important public health problem worldwide. The objective of this study was to determine the association of body mass index and abdominal obesity with current marital status among the adult population of Iran. A nation-wide cross-sectional survey was conducted from December 2004 through February 2005.The subjects were selected by stratified probability cluster sampling through household family members in Iran. Weight, height, waist circumference, and marital status of 89,404 men and women aged 15 - 65 [mean: 39.2] years were recorded. Four classes of body mass index, i.e., <18.5, 18.5 - 24.9, 25 - 29.9, and ?30 kg/cm2, and three marital status, i.e., currently-, formerly-, and never-married were used. Abdominal obesity was defined as waist circumference ?102 cm in men and ?88 cm in women. The prevalence of overweight was twofold higher in married men [OR: 2.24; 95% CI: 2.08 - 2.41] and women [OR: 2.36; 95% CI: 2.20 - 2.53] than never-married men and women, even when age, educational level, leisure time physical activity, smoking habits, and place of residence were controlled. The multivariate OR of obesity was increased about threefold in married men [2.82; 95% CI: 2.51 - 3.18] and women [3.64; 95% CI: 3.31 - 3.99]. The prevalence of abdominal obesity was twofold higher among married men [2.02; 95% CI: 1.79 - 2.29] and about threefold higher among married women [2.87; 95% CI: 2.69 - 3.06]. The marital status appears to influence the likelihood of developing overweight, obesity, and abdominal obesity in both men and women in Iran

effect of silver nitrate, chloroformic garlic extract, and normal saline in induction of sclerosing cholangitis in rabbits

To evaluate the effects of 0.5% silver nitrate, 20% chloroformic garlic extract, and 0.9% normal saline in induction of sclerosing cholangitis in the bile ducts of rabbits. During a-6-months period from April to September 2006 in Shiraz University Laboratory Animal Research Center, we selected 3 equal groups of rabbits. We injected 0.5% silver nitrate, 20% chloroformic garlic extract, and 0.9% normal saline into the bile ducts of each group. The animals were euthanized, and autopsied after 4 months and the liver and bile ducts were removed and studied histopathologically. Cholangiography was undertaken to evaluate the presence and extent of any sclerosing cholangitis. Animals showed sclerosing cholangitis in silver nitrate group [7 [58%]], one [8%] in chloroformic garlic extract group and one [7%] in normal saline group. The difference between silver nitrate and chloroformic garlic extract groups were statistically significant and similar results were noticed between chloroformic garlic extract and normal saline groups. Twenty percent of chloroformic garlic extract had fewer complications such as sclerosing cholangitis, compared to other materials

Peripheral neuropathy in type 2 diabetes mellitus in Isfahan, Iran: prevalence and risk factors

To estimate the prevalence and risk factors of peripheral neuropathy [PN] in people with type 2 diabetes mellitus. 810 patients with type 2 diabetes [289 male and 521 female] from Isfahan Endocrinology and Metabolism Research Centre outpatient clinics, Iran, were examined. Part of the examination included an assessment of neurological function including neuropathic symptoms and physical signs, and nerve conduction velocity. The prevalence of PN was 75.1% [95% confidence interval [CI] 72.1, 78.0]. Peripheral neuropathy was associated with age, proteinuria, and duration of diabetes, insulin-treatment, and presence of retinopathy and ischaemic heart disease [IHD]. The age-adjusted prevalence rate of PN was 78% higher among patients with IHD, 64% higher among patients with any retinopathy, 66% higher among insulin-treated type 2 diabetes, and greater with duration of diabetes. Using a stepwise binary logistic regression model, age, duration of diabetes and proteinuria were significant independent predictors of PN. PN is a common complication in this population of Iranian type 2 diabetic patients. It increases with age, duration of diabetes and proteinuria

Comparison of insulin resistance in obese women with and without acanthosis nigricans

Acanthosis nigricans [AN] is characterized by hyperpigmented velvety plaques of body folds and neck. Insulin can have a role in the pathogenesis of this disease and hyperinsulinemia as a consequence of insulin resistance may stimulate the formation of the characteristic plaques of AN. In this study insulin resistance was compared in obese women with and without AN. Glucose tolerance test [GTT] and fasting blood insulin were measured in two groups of obese women [BMI>30 kg/m[2]] with AN [32 cases] and without AN [34 cases] and insulin resistance was determined using HOMA formula. The mean fasting blood insulin in two groups with and without AN were 15.5 +/- 8.5 and 12.2 +/- 4.1 micro IU/mL; respectively [P<0.05]. The mean of insulin resistance in two groups with and without AN were 3.5 +/- 1.9 and 2.6 +/- 0.9; respectively [P<0.05]. The results of GTT showed that the mean fasting blood sugar was 89.5 +/- 12 mg/dl and following using glucose were 144 +/- 7 mg/dl after 30 minutes, 132 +/- 45 mg/dl after 60 minutes, 107 +/- 30 mg/dl after 120 minutes in persons with AN and in the other group were 87 +/- 8, 130 +/- 3, 122 +/- 26 and 100 +/- 26 mg/dl; respectively. The difference between two groups was only significant after 60 minutes. Acanthosis nigricans maybe a marker of insulin resistance in obese women

effect of erythromycin and metoclopramide on improvement of constipation and glycenic control in type 2 diabetic patients: a comparative study

Constipation is the most common gastrointestinal complication in diabetic patients. Erythromycin mimics the effects of the gastrointestinal hormone Motilin in gastric contractile activity and insulin secretion. In this study, we compared the effects of Erythromycin and Metoclopramide on glycemic control and constipation in type 2 diabetic patients. As a clinical trial, thirty-nine type 2 diabetic patients with constipation were divided into two groups. Patients in group 1 [n=24] were treated with erythromycin [400 mg/day before sleep] and participants in the second group [n=15] received metoclopramide [10mg 3 times / day before each meal] for 3 months. FBS, 2hPP BS, HbA1c and the frequency of defecations during a week were measured and compared before and after the intervention. In Erythromycin treated group, 2hPP BS decreased from 199.7 +/- 47.0 before treatment to 174.0 +/- 46.3 after intervention [P=0.01] and a significant improvement in constipational symptoms was observed in both groups. It seems that Erythromycin not only can improve symptoms of constipation but may have a role in glycemic control in type 2 diabetic patients

[ prevalence of hypertension and dyslipidemia in newly diagnosed patients with type 2 diabetes mellitus]

Background: hypertension and dyslipidemia are common in patients with type 2 diabetes mellitus. The high prevalence of cardiovascular disease in diabetic patients is, in part, related to these two risk factors. This study was performed to determine the prevalence of hypertension and dyslipidemia in newly diagnosed patients with type 2 diabetes mellitus in Isfahan

Methods: in this cross - sectional study during 2001 - 2003, 310 newly diagnosed type 2 diabetic patients, in Isfahan endocrine and metabolism research center, were studied. Height, weight, blood pressure, Plasma lipid and lipoproteins, and HbA1c were determined for all subjects

Results: mean age at presentation was 48+/-9.83 years, and mean BMI was 28.4+/-4.62 Kg/m2. Hypertension was present in 32.9%, hypercholesterolaemia in 61.3%, hypertriglyceridaemia in 61.6%, high LDL in 77.3%, and low HDL in 67.8% of these patietns. The mean systolic and diastolic blood pressure were 119.08+/-16.59 and 70.02+/-14.02mmHg, respectively. The mean for total cholestrol was 216.10+/-43.65, for triglyceride 207.46+/-105.67, for LDL 124.73+/-31.45, and for HDL 43.11+/-9.29 mg/dl

Conclusion: hypertension and dyslipidemia are common in newly diagnosed type 2 diabetic patients. This fact demonstrates the importance of early interventions for proper diagnosis and treatment of these two risk factors in diabetic patients

Iodine repletion thyrotoxicosis and atrial fibrillation in Isfahan, Iran

Iodized salt was reintroduced in Iran in 1989. Just before distribution of iodized salt, thyrotoxicosis was observed in 3.7% of the patients with atrial fibrillation [AF] in university teaching hospitals in Isfahan, a centrally located city in Iran. As repletion of iodine may increase the rate of autoimmune thyroid diseases and toxic multinodular goiter, this study was designed to evaluate the rate of thyrotoxicosis in patients with AF in the same hospitals after about a decade of iodized salt consumption. In a case-control study with convenience sampling, 100 patients with AF and an equal number of age- and sex-matched subjects taking the same medications were selected as case and control groups, respectively, in university hospitals in 1997. Eight% of patients with atrial fibrillation had overt thyrotoxicosis versus one% in the control group [odds ratio=8.6, 95% CI= 6.5 to 10.7, P<0.02]. Thyrotoxicosis in patients with AF was 8 times higher than in the control group without AF. In comparison with the period before use of iodized salt, AF more than doubled [8% vs. 3.7%]. Conclusion:Thyroid function should be evaluated in all patients older than 40 years of age with AF. The benefits of iodine supplementation are great, but more attention should be paid to the complications of iodine repletion, including thyrotoxicosis and its frequent accompaniment, AF

Serum thyroid hormone and thyrotropin concentrations during Ramadan in healthy women

During the month of Ramadan Muslims abstain from food and drink from dawn until sunset. In order to study pituitary-thyroid function in Ramadan, serum concentrations of T4, T3, TSH and thyroglobulin and estimation of FT4I and FT3I were measured in 12 healthy women before Ramadan, and on days 1,5,10,15,20,25 and 29 of Ramadan and 10 days after fasting was terminated. There were significant decreases in serum T4 and T3 concentrations in the last week of Ramadan. However FT4I and FT3I were normal, suggesting that the decline in T4 and T3 were caused by decreased protein binding. Serum TSH and thyroglobulin were unchanged throughout the fasting period. We conclude that fasting during Ramadan does not cause alterations in the pituitary thyroid axis