[Cardiovascular risk factors in first relative member of patients with polycystic ovarian syndrome in Shiraz, Iran]

There is a genetic background for polycystic ovary syndrome [PCOS]. Due to increase metabolic disorders, lipoproteins, impaired glucose tolerance, and hypertension in PCOS patients, this study was done to determine the cardiovascular risk factors in first relative member of patients with polycystic ovarian syndrom in Shiraz, Iran. This case - control study was carried out on 107 parents and siblings of women with PCOS as cases and 107 non-PCOS parents and siblings of women as controls in Shiraz, Iran during 2007-08. Demographic characteristic, BMI, obesity and blood pressure were recorded for all subjects. Serum lipoproteins including total cholestrol, triglyceride, LDL, HDL and fasting blood sugar were measured in cases and controls. Data were analyzed using SPSS-16.5, independent t-test, Chi-Square and Kappa tests. 35.3%, 26.5%, 11.76% and 5.8% of fatheres in cases were considered as overweight class I, class II, class III of obesity, respectively when compared to controls. This differecne was significant [P<0.05]. Waist -hip ratio in mothers in cases [25.6%] and controls [17.9%] were higher than 0.85. Waist -hip ratio among the sisters in case and control groups were 23.5% and 17.6%, respectively [P<0.05]. Hypertension was observed in 12.2% of cases and 3.7% of controls. This difference was not significant. High level of triglyceride were determined in 14.94% of cases and 6.5% of controls. A significant correlation was found between BMI and diabete II in case and control groups [P<0.05]. Disorder in glucose tolerance test [GTT] in case and control goups were 19.62% and 7.47%, respectively [P<0.05]. The obesity was found in 18.7%, 6.54% in cases and controls with disorder in GTT [P<0.05]. This study showed that obesity, central obesity, high level of serum lipoproteins and hypertension among first relative member of patients with PCOS are significantly higher than the controls

[Prevalence of various phenotypes of polycystic ovarian syndrome among high school girls of Shiraz [2009]]

Polycystic ovary syndrome [PCOS] is the most common endocrine disorder in women and cause of infertility due to lack of ovulation. The symptoms of PCOS are observed during puberty and it is assumed that the weight gain during this period to be associated with this syndrome. To determine the prevalence of phenotypes of polycystic ovary syndrome in adolescents in Shiraz. This was a cross-sectional study in which 3190 female adolescents aged between 14 to 18 years, randomly selected from high schools in Shiraz, were studied. Diagnosis of PCOS was achieved through taking history and examination based on presence of oligomenorrhea [six times menstrual cycles or less in one year], clinical signs of hyperandrogenism including hirsutism [Ferriman-Gallway scores of 6 or more], severe acne, male pattern hair loss, and ultrasonography. The hormone dehydroepiandrostandion sulfate levels were measured for all subjects. Data were analyzed using the chi square test and Fisher's t exact-test. The prevalence of PCOS phenotypes were as follows: clinical hyperandrogenism and oligomenorrhea 19.9% [29 cases], clinical hyperandrogenism and polycystic ovary 30.8% [45 cases], oligomenorrhea and polycystic ovary 29.5% [43 cases], and clinical hyperandrogenism with oligomenorrhea and polycystic ovary 14.5% [21 cases]. The frequency of highest levels of dehydroepiandrostandion sulfate was observed in patients with oligomenorrhea and hyperandrogenism. The risks of sex hormones turmoil, psychological effects of skin symptoms [acne and hirsutism], and numerous side-effects of this syndrome make it necessary to perform an early investigation in target population

[Effects of treatment with oral calcitriol on plasma glucose and insulin levels in non-insulin dependent diabetes mellitus patients]

Type-2 diabetes is a major metabolic disease with many signs and symptoms, such as hyperglycemia; disorders in protein, carbohydrate and lipid metabolism; and partial or total insulin deficiency. It is accompanied with pancreatic beta-cell malfunction, reduced insulin sensitivity, and systemic inflammation. There is some evidence indicating a role of vitamin D in maintaining glucose tolerance and normal secretion of insulin. The objective of the present study was to assess the effects of calcitriol on the plasma insulin and glucose levels in non-insulin dependent diabetes mellitus patients. Seventy subjects [35 males and 35 female] with type-2 diabetes, aged 30-75 years old, were divided into 2 groups - an intervention and a control group. The intervention and control groups received, daily for 12 weeks, two 0.25-mcg calcitrio-capsules [0.5 mcg calcitriol] and 2 placebo capsules, respectively. Fasting blood samples were taken at the beginning and at weeks 6 and 12 for measuring glucose, insulin, and glycosylated hemoglobin [HbA1C]. The fasting plasma glucose level did not change noticeably at weeks 0, 6 or 12 in the intervention group, while it increased significantly [p = 0.03] in the control group. The insulin level increased significantly in both the experimental [p = 0.002] and control [p = 0.0002] groups. Similarly, there were increases in the HbA1C concentration in the experimental [p = 0.013] and control [p = 0.0004] groups at week 12, as compared to baseline values. Also there was an increase in insulin resistance in both groups [p= 0.023 and 0.0001 for experimental and control groups, respectively]. Finally, HOMA-% beta, which is an indicator of the activity of the pancreatic beta-cells, remained unchanged in the controls, while it increased significantly in the experimental group [p = 0.009]. Calcitriol at a daily dose of 0.5 mcg has no lowering effect on blood glucose in type-2 diabetic patients, although it may prevent its elevation. The findings further show that calcitriol dose not bring about a reduction in insulin resistance; however, it improves pancreatic beta-cell functioning, thereby increasing insulin secretion

Assessment of zinc concentration in random samples of the adult population in Shiraz, Iran

Zinc is an essential micronutrient for human health. However, little is known about concentration of this mineral among Iranian population. This study was carried out to determine the current zinc status, evaluate the impact of certain factors like age, sex and Body Mass Index [BMI], and to verify the prevalence of zinc deficiency among Iranian adult population in Shiraz, southern Iran. Serum samples from 374 randomly selected healthy individuals living in Shiraz, Iran, aged 19-82 years [143 males, 231 females] were collected and the serum zinc concentration was measured by Flame-Atomic Absorption Spectrometry. We considered the subjects with serum zinc concentration less than 100 microg/dl as zinc deficient. The serum zinc levels in females were lower than those of males with no statistically significant difference. Serum zinc concentrations were unrelated to age and BMI. It also did not change among different ages and BMI intervals. About 42.5% of our cases had serum zinc concentration below the cut off value of 100 microg/dl in the serum. Designing appropriate strategies for overcoming this public health problem is necessary

Prevalence of metabolic syndrome among adults in a rural area

Metabolic syndrome [MS] is a risk factor for type 2 diabetes mellitus and cardiovascular disease. Limited information is available about the prevalence of the metabolic syndrome in rural areas of Iran. A total 1402 adults [1042 females and 360 males], aged between 18-90 yrs, participated in a community-based cross-sectional study. Prevalence of metabolic syndrome was determined by the definition of the National Cholestrol Education Program Adult Treatment Panel III [NCEP ATPIII], and results were compared with those based on the revised ATPIII and International Diabetes Federation [IDF] definitions. Overall prevalence of ATP III defined metabolic syndrome was 25.6% compared to 29% and 33% using the revised ATP III, IDF definition respectively. The results of multiple logistic regression model showed after adjusting for age, sex, Body Mass Index [BMI], marital status, and education level, there was no difference between men and women for metabolic syndrome [P=0.2] by ATP III and revised ATP III definitions while prevalence of metabolic syndrome was 1.97 times greater in women versus men [95% Cl: 1.4 - 2.7, p< 0.001] by the IDF-definition. Sex-adjusted prevalence of metabolic syndrome [by three definitions] increased 1.05%, for each one year increase in age [95% Cl: [1.04-1.06]]. In the current study, low serum High Density Lipoprotein Cholesterol [HDL-C] was the most common component of metabolic syndrome, while high fasting plasma glucose was the least common. These results show that the metabolic syndrome is prevalent in rural areas and interventional strategies should be considered for weight reduction and treating components of metabolic syndrome in this population

Persistence of goitre in children post-salt iodization in Islamic Republic of Iran: autoimmune status

We evaluated the prevalence of autoimmune thyroiditis in a random sample of 1188 schoolchildren aged 8-13 years with normalized iodine intake in the Islamic Republic of Iran. The prevalence of goitre was 39.6%; the majority had palpable but non-visible goitre. Of a subsample of 500 children, median urinary iodine excretion [18/8 microg/dL] indicated normal iodine intake. Thyroid peroxidase [TPO] antibody was positive in 3.7% of children and was significantly correlated with the prevalence of goitre and hypothyroidism. No correlation was seen between urinary iodine excretion and positive TPO antibody, mean TPO antibody, hypothyroidism or prevalence of goitre. Autoimmune thyroiditis explains some cases of goitre but other goitrogenic factors need to be evaluated

[Prevalence of autoimmune thyroiditis in school children 10 years after normalized iodine intake]

Iodine deficiency has been identified as a significant public health problem in Iran. The main strategy for control of iodine deficiency was country wide salt iodination. 10 years after starting this program, goiter is still endemic in some school children. The most important differential diagnosis is autoimmune thyroiditis. The aim of the present study was to evaluate prevalence of autoimmune thyroiditis in school children with normalized iodine intake. 1188 school children, aged 8-13 years, were selected by cluster random sampling to evaluate prevalence of goiter. From a total of 1188, 500 school children were chosen to assess urinary iodine excretion, free T4, free T3, TPO anti body [TPOAb] and TSH. Goiter was endemic in 39.6%[95% CI 36/3%-41/7%] but majority of them had grade I thyromegaly. Median urinary iodine excretion [18/8 microg/ dl] indicated normal iodine intake. Mean [95%CI] free T4, free T3 and TSH concentration were 13.1[12.8-13.3] pg/ml, 3.7[3.6-3.8]pg/ml and 2.5 [2.2-2.8] IU/ml respectively. TPOAb was positive in 3.7% of children with a higher prevalence in girls[P< 0.001]. The prevalence of hypothyroidism and hyperthyroidism was 9% and 0.2% respectively but only 0.8% of school children had TSH>10. There was a significant relationship between detection of positive TPOAb, prevalence of goiter and hypothyroidism; however no relation was seen between urinary iodine excretion status and detection of positive TPOAb, hypothyroidism and prevalence of goiter. Despite median urinary iodine excretion being normal, persistence of goiter suggested presence of goiterous factors; alhought the autoimmune mechanisms of thyroid may to some extent autoimmune of thyroid explain some part of the goiter prevalence it is however necessary to evaluate other factors

Comparison of validity of decision rules in identifying primary osteoporosis in post menopausal women: a comparison

Clinical decision rules have been designed and developed to assist physicians in identifying the patient with osteoporosis. The aim of this study was to evaluate the performance of three decision rules in an Iranian post menopausal population. Three osteoporosis risk indices, the osteoporosis self assessment tool [OST], osteoporosis risk assessment instrument [ORAI], and the body weight criterion for 5573 out patients without any risk factors for secondary osteoporosis or receiving active bone medication and with negative history of prior fragility fraction were calculated. BMD at spines and femoral neck were measured via dual x-ray absorptiomety and the patients categorized to normal, osteopenic and osteoporotic according to WHO criteria. The sensivity, specifity, positive predictive value negative, predication value and area under receiver operating curve in identifying the osteoporotic women were determined for each decision rule and compared. In this study, the prevalence of osteoporosis was 30.8%, 20% in lumbar spines and neck of femur, respectively. The sensivity of these risk indices in indentifying women with osteoporosis ranged from 70% to 84/1% and the specificity ranged from 44.6-65.6%. The area under curve [ROC] in identifying those patients with osteoporosis was significantly better for OST [0.75] and ORAI [0.74] compared with the body weight criteria [0.66]. The negative predicative value ranged from 80% to 93%, while positive predication values ranged from 33% to 54%. Our data provide evidence showing OST, ORAI to be useful clinical tools, assisting clinicians in making decisions regarding which women need to be to referred for BMD testing but more evidence however needed is to confirm validity of body weight criterion

[Prevalence of goiter and iodine deficiency ten years after salt iodinezation in school children [8-13 years old] in Marvdasht]

Iodine deficiency was endemic in Pars province since several years. Mandatory production of iodinized salt for household use was started from 1994. The aim of this study was to evaluate the prevalence of goiter, urinary iodine excretion in school children ten years after starting the program. A cross sectional study in which 1188 school children, aged of 8 - 13 years, from Marvdasht city were chosen by random cluster sampling for evaluation of goiter prevalence according to WHO classification. Of these this 1188 school children, 500 persons were selected for evaluation of urinary iodine excretion [UIE] by digestion method, difference in UIE was assessed among different age groups, goitrous and non goitrous school children. Following the assessment, goiter was found to be still endemic in school children [39.6%] but majority of them had gradel goiter. Median urinary iodine [95% Cl] excretion levels in boys and girls and total number of school children were 17 micro g/dl [13.1-20.9], 22.4 micro g/dl [20.4-24.1] and 18.8 micro g/dl [16.1-21.5] respectively. Differences in UIE between two sexes were significant [P < 0.001] but differences among age groups were not significant. The UIE levels in goitrous and non goitrous school children were 18 micro g/dl [16.4-19.9] and 20 micro g/dl [17.1-22.9] respectively, with no statistically significant difference. Prevalences of school children with urinary excretion in normal, above normal and below normal ranges were 29.5%, 47.5%, 23% respectively, meanwhile less than 13% had urinary iodine excretion < 5 micro g/dl. We conclude that the iodine intake is sufficient but persistent, albeit, reduced prevalence of goiter in spite of adequate iodine supplementation suggests the existence of additional causes in goiterogenesis. It is necessary to consider the role of other factors in persistence of goiter