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Background: Neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) are twoinflammatory disorders of the central nervous system with different pathogenesis. The aim of thisstudy is to evaluate endocrinopathy in these patients. Methods: By convenient sampling method, 20MS, 20 NMOSD and 20 normal age and sex matched as control were enrolled in this study. Hormonalassay including TSH, free T3, free T4, , FSH, prolactin, cortisol, IGFI, thyroid-stimulating hormone(TSH), free T3, free T4, luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin,cortisol, insulin-like growth factor I (IGF-I), urine specific gravity and anti-aquaporin immunoglobulinG (AQP4-IgG) level was measured. Also adrenocorticotropic hormone (ACTH) stimulation test wasdone for MS and NMOSD patients. Results: Hypothyroidism was prevalent and found in 30% of MS,40% of NMO patients, and only 9.5% of the controls. We detected greater rate of hypothyroidism inNMO patients compared to control (p=0.027). Mean level of anti-thyroglobulin antibody in MS andNMOSD patients was higher than control (p=0.037). One patient in MS group, 6 in NMOSD and 11control had IGFI level lower than lower limit of their age groups (p=0.001).Conclusions: Although the result of this study did not support significant hypothalamic-pituitary axisendocrinopathy in NMOSD compared to MS and controls, there is a higher prevalence of some hormonalabnormalities, especially thyroid dysfunction in NMOSD cases, that needs more clinicians’ attention.
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To determine the prevalence of fractures and associated risk factors in healthy Iranian children and adolescents
Methods: In this cross sectional population based study, 478 healthy Iranian children and adolescents aged 9-18 years old participated. Baseline data and bone mineral content and density have been determined. One questionnaire was completed for all individuals including previous history of fracture, its location, and level of trauma. Albumin, calcium, phosphorus, alkaline phosphatase, and vitamin D levels were measured
Results: We found a prevalence of 12.9% for fracture. [34.5% for girls and 65.5% for boys]; about 71% suffered long bone fracture with distal forearm as the most common site. Totally 58% of the boys and 54% of the girls had fracture with low-energy trauma. The fracture group had lower bone mineral apparent density in the lumbar spine [0.19+/-0.04 vs. 0.20+/-0.03, p=0.04], lower serum albumin [4.6+/-0.5 vs 4.8+/-0.4, p=0.02], and higher serum alkaline phosphatase level [446+/-174 vs. 361+/-188, p=0.02] compared with non-fracture subjects. By logistic regression analysis, we found a significant association for sex, and bone mineral content of the lumbar spine with fracture [p=0.003, p=0.039]
Conclusion: Compared to other studies, our subjects had lower rate of fracture. We found an association between low bone density and fracture in children and adolescents. This finding has important implications for public health. Further research may contribute to recognition of preventive measures
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Background: Use of glucosamine as an alternative treatment for osteoarthritis is becoming more frequent, including in those who have diabetes at the same time. The results from in vitro and animal studies propose that glucosamine may inversely affect glucose metabolism. However, the recommended dose of oral glucosamine in healthy people or diabetics did not have such effects consistently. The aim of the present study was to assess the effect of glucosamine on glycemic control and insulin resistance in type 2 diabetic patients
Methods: Fifty-four patients with type 2 diabetes participated in this randomized, double-blind, placebo-controlled study. The participants were assigned to receive 1500 mg glucosamine hydrochloride or placebo for 12 weeks. After determining their baseline characteristics, body mass index and dietary intake components, fasting blood glucose and fasting insulin were measured at weeks of 0, 8, and 12. Indices of insulin function including quantitative insulin sensitivity check index [QUICKI] and homeostasis model assessment of insulin resistance [HOMA-IR] were calculated by specific formulas. Independent t-test and general linear model repeated measures were used to analyze the data
Results: In the glucosamine group, the means of fasting blood glucose and insulin were 107.31 +/- 24.07 mg/dl and 8.75 +/- 4.37 [micro]u/ ml, respectively at baseline, which reached 112.38 +/- 31.50 and 9.10 +/- 4.17 at week 12. In the placebo group, the mean for fasting blood glucose and insulin were 103.84 +/- 24.15 and 9.79 +/- 4.02 at the beginning of the study, which reached to 111.40 +/- 26.43 and 8.58 +/- 3.68 at week 12. The results showed that there were no significant differences in fasting blood glucose, insulin, HOMA-IR and QUICKI indices at all the studied time points [weeks of 0, 8 and 12] within or between the groups
Conclusion: Twelve weeks of a normal recommended dose of glucosamine supplements may not have adverse effects on glycemic control and insulin resistance in type 2 diabetic patients
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Statement of the Problem: Cardiovascular disease and osteoporosis are major health dilemmas. Osteoporotic patients frequently display vascular calcification that consequently increases the cardiovascular morbidity and mortality
Purpose: This study aimed to investigate the relation of osteoporosis, vascular calcification [atheroma, intima-media thickness [IMT]] and elongated styloid process [ESP] in a sample of osteoporotic and normal female individuals
Materials and Method: This study recruited 78 women who were assessed for bone mass density [BMD]. Sample included individuals with normal BMD [n=13, 17%], osteopenia [n=36, 46%], and osteoporosis [n=29, 37%]. The presence of atheroma and IMT was examined using color Doppler ultrasonography [CD-US]. In addition, digital panoramic radiographs [PRs] were obtained to assess ESP
Results: In this study, 55 subjects [70%] with low BMD exhibited at least one side ESP. Femoral BMD decreased significantly in subjects with ESP [p= 0.03]. Bilateral ESP was correlated with the presence of atheroma [p= 0.029]. The CIMT was greater in patients with ESP, although the relation was not significant
Conclusion: The obtained data suggest referring the aged individuals with ESP for BMD assessment and individuals with low bone mass and ESP for more cardiovascular risk assessment
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Background: Diabetes Mellitus [DM] is closely associated with reduction of antioxidant defense system. In the present study, we investigated the antioxidant effect of quercetin supplementation on the glycemic control, lipid profile and oxidative stress indices in patients with type 2diabetes
Methods: Forty seven patients with type 2 diabetes, aged 30-60 years old, were randomly assigned to supplement their daily diet with either an oral quercetin [250 mg/d] or identical placebo [cellulose] capsules for 8 weeks. The supplements were provided to the patients biweekly. Anthropometric data as well as glycemic indices, lipid profile and oxidative stress parameters of blood samples were determined at the baseline and endpoint of the study
Results: Dietary quercetin supplementation significantly improved the total antioxidant capacity [TAC] in the intervention group, when compared to the placebo group [P=0.043]. It also resulted in a statistically significant reduction in serum concentration of atherogenic oxidized LDL [ox-LDL] [P<0.001]. However, the 8-week supplementation of this natural flavonol neither altered glycemic parameters [FBS, serum insulin and glycosylated Hb [HbA1c] level] nor lipid profile and insulin function measurement in diabetic patients [P>0.05]
Conclusions: Oral quercetin supplementation was beneficial in improving the antioxidant status of patients with type 2 diabetes while having no other significant effect on glycemic control and lipid profile; however, conducting further studies, using different doses, on the glycemiccontrol and/or hyperlipidemia of thepopulation seems to be valuable
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Background: Hyperthyroidism is associated with liver oxidative stress causing liver dysfunction in many hyperthyroid patients. The hepatoprotective effect of Satureja Khuzestanica Essential Oil [SKEO], as herbal origin antioxidant and anti-inflammatory agent on the hyperthyroidism induced hepatotoxicity and oxidative stress is investigated
Methods: Adult male sprague dawley rats were divided into categories of; control [group C], hyperthyroid [group H], hyperthyroid with olive oil [group H+O], hyperthyroid with vitamin E [group H+E], hyperthyroid with SKEO [group H+S], combination of hyperthyroid with vitamin E and SKEO [group H+S+E]. Hepatoprotective and antioxidant properties of SKEO with or without vitamin E in hyperthyroid rats were then investigated
Results: Serum Aspartate Transaminase [AST] and Alanine Transaminase [ALT] activities reduced significantly in H+O, H+E, H+S and H+S+E groups in comparison with hyperthyroid rats. Enzymes activities returned to normal in H+S+E group. Hepatic Malondialdehyde [MDA] was reduced in H+E, H+S and H+S+E groups in comparison with hyperthyroid rats. The most significant MDA reduction was in the H+S+E group. Glutathione Peroxidase [GPx] and Glutathione Reductase [GR] activities increased in H+E, H+S and H+S+E groups in comparison with group H. The largest increment in GPx and GR activities were in the H+S+E group. Glutathione level did not change in any group in comparison with the control group
Conclusion: Administration of SKEO has hepatoprotective effect in hyperthyroid rats and is more effective when used in combination with vitamin E
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Type 2 diabetes [T2D] is a chronic metabolic disorder in which beta-cells are destroyed. The islet amyloid polypeptide [IAPP] produced by beta-cells has been reported to influence beta-cell destruction. To evaluate if IAPP can act as an autoantigen and therefore, to see if CD8+ T-cells specific for this protein might be present in T2D patients. Peripheral blood mononuclear cells [PBMC] were obtained from human leukocyte antigen [HLA]-A2+ T2D patients and non-diabetic healthy subjects. Cells were then screened for peptide recognition using ELISPOT assay for the presence of IFN-gamma producing CD8+ T-cells against two HLA Class I-restricted epitopes derived from IAPP [IAPP5-13 and IAPP9-17] and common viral antigenic minimal epitopes Flu MP 58-66, CMV495-503, EBV280-288 and HIV77-85 as controls. A total of 36.4% of patients and 56.2% of healthy subjects showed a response against IAPP5-13 peptide. No significant difference in response against this peptide was noted between the patients and the healthy donors. With respect to peptide IAPP9-17, although healthy subjects showed a higher mean number of spot forming cells than the patients, the difference was not significant; 36.4% of patients and 37.5% of controls responded to this peptide. The response of healthy subjects to the common viral peptides was stronger than that of the patients, though the result was not significant. It is unlikely that IAPP would be a target for CD8+ T-cells in diabetic patients; however, the trend observed toward a lower response of T2D patients against IAPP and common viral peptides may imply a decreased immune response in these patients
Subject(s)
Humans , Male , Female , CD8-Positive T-Lymphocytes , Insulin-Secreting Cells , Diabetes Mellitus, Type 2/immunology , Evaluation Studies as Topic , Peptide Fragments , HLA-A Antigens , B-LymphocytesABSTRACT
Background: The dramatic increase in the incidence of diabetes and its associated complications require a natural and safe solution to control and delay such complications. The present study tested the hypothesis that probiotics may affect biochemical indices of diabetic patients
Methods: Thirty four types 2 diabetic patients aged between 25 to 65 years, and diagnosed with diabetes for less than 15 years were selected for this single- blinded clinical trial. Using balanced block random sampling, the patients were divided into two groups of intervention [probiotics] and placebo. Blood samples tested for baseline glucose, insulin, TG, total cholesterol, LDL-C, HDL-C, malondialdehyde, high sensitive CRP [hs-CRP] and IL-6. After six weeks of experiment, fasting blood samples were re-tested and the data obtained were analyzed using SPSS software
Results: There were no significant differences between anthropometric data including body mass index and waist to hip ratio in placebo and treatment groups. There was no significant difference in FBS, Serum TG concentration total cholesterol and LDL-C levels between placebo and treatment groups. HDL-C levels were slightly elevated after probiotic treatment, which were not statistically significant. Insulin, MDA and IL-6 levels were reduced and high sensitive CRP hs.CRP levels were elevated, although, not statistically significant
Conclusion: The result of this study indicates a non- significant declining trend in the level of TG, MDA and IL-6 and insulin resistance after consumption of probiotics
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Androgenic alopecia is one of the most common dermatological disorders. Hormonal and genetic factors determine the incidence of alopecia, j Androgenic alopecia is the most common form of hair loss. It is progressive and symmetric in both sexes. The aim of this study was to determine the prevalence of androgenic alopecia in 14- to 18-year-old female high school students in Shiraz. This cross-sectional study was conducted on 3190 14- to 18-year-old female high school students in Shiraz. A questionnaire was designed to collect personal information and record clinical features of androgenic alopecia. Moderate and severe hair losses were defined as alopcia. For evaluation of alopecia associated with polycystic ovary syndrome, total and free testosterone blood levels were measured and abdominal ultrasound was performed. The collected data were described and analyzed through performing chi-square, Fisher's exact and and t tests using SPSS. 135 [4.2%] of participants had moderate to severe alopecia according to Ludwig's classification. No statistically significant correlation was observed in the mean of eather total or free testosterone levels between patients with androgenic alopecia, and those without [P>0.05]. There was no statistical significant association between alpocia and polycystic ovary existence [P=0.2]. This study did not show a statistically significant relationship between patients with alopecia and androgenic hormones and polycystic ovary syndrome
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WHO reports indicate no iodine insufficiency in Iran, however, goiter is still endemic in Fars Province. This study evaluates the role of thyroid autoimmunity in the evolution of endemic goiter. A total of 516 permanent residents of Akbarabad County of the Kavar area in Fars Province, Iran were selected by simple random sampling. Patients with thyroid malignancy and dysfunction, and those who consumed drugs affecting thyroid function were excluded. After signing a written consent form and undergoing a thyroid examination, 5 cc of blood were drawn to measure free T[3] and T[4] [RIA], TSH [IRMA], and anti-thyroid peroxidase [competitive RIA] levels. Moreover, samples of 50 cc morning urine were collected for the measurement of urinary iodine excretion [UIE; chloridric acid digestion]. Data were analyzed by SPSS [version 13]. P<0.05 was significant. The prevalence of goiter was 38.4% by WHO classification. The prevalence of children with UIE 2- 4.9 micro g/dL was 5.8%, which indicated sufficient iodine intake. Goiter was more prevalent in females, as well as in patients with positive anti-TPO or higher TSH titers [P<0.01]. The prevalence of positive anti-TPO was higher in goiterous patients than healthy persons [P=0.002], which increased with an increase in age, grade of thyromegaly of TSH [P< 0.02]. Regression analysis showed the odds ratio for diagnosing goiter in females was 2.4 [P<0.001], in those with positive anti-TPO it was 1.87 [P=0.03] and in those with TSH>5.2 mlU/mL the odds ratio was 2.74 [P=0.01]. In adolescents compared to children the odds ratio was 0.36 [P=0.01] and the odds ratio in adults to children was 0.33 [P=0.001]. This study indicates that despite normal UIE, goiter is endemic in Akbarabad Country. Some degree of goiter endemicity may be due to thyroid autoimmunity
Subject(s)
Humans , Male , Female , Poverty Areas , Thyroid Diseases , Rural Population , Rural Health , Autoimmunity , Cross-Sectional StudiesABSTRACT
Emerging data suggest a significantly increased prevalence of low bone mineral density [BMD] in men and women with multiple sclerosis [MS] compared to age matched controls. This study was performed to evaluate bone mineral mass in patients with MS in comparison to healthy age-and sex matched controls and to determine association of glucocorticoid use or ambulation ability with changing in bone mass in these individuals. Eighty two patients with MS and 328 age-sex matched healthy controls participated in the study. The Kurtzke expanded disability status scale [EDSS] was used to evaluate disability and functional capacity. Bone mineral density was measured using Dual X-ray absorptiometry. Serum calcium, phosphorus and 25[OH] vitamin D levels were assessed. The MS patients had significantly lower BMD at the lumbar spines, neck and total femur compared to age-sex matched controls. EDSS scores were inversely correlated with total femur and spinal BMD. There was a negative correlation with cumulative steroid dose and BMD only for femoral neck. BMD was significantly lower in MS patients. Decreased ambulatory status and glucocorticoid usage were associated with low BMD in MS patients. These patients should be encouraged to increase mobility and to have protective measures to maintain bone mass
Subject(s)
Humans , Male , Female , Glucocorticoids/adverse effects , Glucocorticoids , Bone Density/drug effects , Bone Diseases, Metabolic , Mobility Limitation , Absorptiometry, Photon , Calcium/blood , Phosphorus/blood , Vitamin D/bloodABSTRACT
Type 2 diabetes mellitus is the most common type of diabetes which is triggered by various factors such as obesity, hyperlipidemia, hypertension, dietary habits and inheritance. With respect to geographic variation of diabetes prevalence, it is important to know the risk factors regionally. As a case-control study, we looked for important risk factors of diabetes in our region. This study consisted of 400 individuals in case group and 400 individuals in control group. All these anthropometric measurements were calculated by standard methods. Blood samples taken from two groups were studied for TG, FBS, Cholesterol and HbA1c. Data are reported as the Mean +/- SD. P<0.05 was considered as statistically significant. There was no significant difference between two groups about mean age and sex ratio. Statistically significant difference were found for central obesity, hyperlipidemia, hypertension, polycystic ovarian syndrome [PCOS] and positive family history of diabetes in both groups [P<0.05]. The results showed that central obesity, hyperlipidemia, hypertension, PCOS and positive family history of diabetes are important risk factors of diabetes mellitus in Shiraz. In concordance with the results of this study, screening programme for that risk factor of diabetes in this region is suggested
Subject(s)
Humans , Risk Factors , Diabetes Mellitus/epidemiology , Case-Control StudiesABSTRACT
The relationship between diabetes and serum insulin and Zinc [Zn] levels is complex with no clear cause and effect relationships. Since Zn plays a clear role in the synthesis, storage and secretion of insulin as well as conformational integrity of insulin in the hexametric form, the decreased Zn, which affects the ability of the islet cell to produce and secrete insulin, might then compound the problem, particularly in type 2 diabetes. The aim of this study was to determine the changes of plasma Zn in patients with type 2 diabetes mellitus and healthy control in Shiraz city. As a case-control study, we determined the serum Zn levels by atomic absorption spectrophotometer, blood HbA1c levels with columnar chromatographic method and Glucose, by enzymatic colorimetric method in auto analyzer. Data are reported as the Mean +/- SD and P<0.05 was considered as statistically significant. Results of this study revealed that levels of Zn in serum of diabetic patients is lower than in the healthy control in Shiraz city [P<0.05]. With respect to the result of this study, dietary educations about consuming enriched Zn foods such as sea foods and corn in diabetic patients is necessitated
Subject(s)
Humans , Zinc/blood , Case-Control Studies , Insulin/bloodABSTRACT
A successful kidney transplantation [KT] corrects the main metabolic abnormalities responsible for secondary hyperparathyroidism [HPT]. Nonetheless, after several months, many patients keep abnormally high parathyroid hormone [PTH] levels and/or become hypercalcemic with persistent HPT. In the present survey, the frequency of high PTH levels and the influence of certain important factors on its evolution among patients with successful KT were investigated within three months posttransplantation. A total of 126 patients, who had successful KT, entered the study between 2000 and 2002. On the day of operation and three months later, demographic data and serum calcium, phosphorus, albumin, creatinine, and immunoreactive PTH [iPTH] [by IRMA] were checked. Hypercalcemic patients, at third month, were followed up for one year after transplantation. With respect to the post-KT iPTH level, patients were divided into two groups; those with iPTH above and below 60 pg/mL. The importance of several factors on the evolution of hyperparathyroidism was determined. Sequential changes in serum calcium were also assessed in hypercalcemic patients up to one year after transplantation. Twenty-one [16.6%] out of 126 patients had a post-KT serum calcium of >10.8 mg/mL. Post-KT iPTH value of > 60 pg/mL was found in 9 [7.1%] out of the 126 cases. There was a statistically significant relationship between the age of patients and duration of dialysis and a post- KT high PTH level [P < 0.001]. Other risk factors did not seem to have a significant correlation with the post-KT high PTH level. In all hypercalcemic patients, PTH levels normalized but hypercalcemia persisted in 14 [88%] out of 16 patients up to 1 year after transplantation. Increased age of the patient as well as the duration of dialysis had significant influences on development of persistent HPT, three months posttransplantation. We believe that it is better to transplant the patients as soon as possible, in order to prevent the devastating complication of persistent HPT and hypercalcemia