[Correlation between serum 25 hydroxy vitamin D level and plasminogen activator inhibitor 1 in type 2 diabetic patients]

Although Vitamin D deficiency is highly prevalent worldwide and has been suggested to be a contributory factor for cardiovascular disease in diabetes, the specific underlying mechanism is not known. It may be related to the effects of vitamin D deficiency on metabolic, inflammatory and hemostatic markers. Plasminogen activator inhibitor 1 is a known cardiovascular risk marker in diabetes. The aim of this study was to determine the association between 25 hydroxy vitamin D and PAI-1 in type 2 diabetic patients. One hundred-eighty patients with type 2 diabetes were selected, and the associations between PAI-1 and 25 hydroxy vitamin D level and other risk markers of cardiovascular disease including FBS, lipid profiles, HbA1C, creatinine and microalbuminuria were examined. There were no significant correlation between PAI-1 level and 25 hydroxy vitamin D level. PAI-1 was positively associated with fasting blood sugar and high density lipoprotein level, but no significant relation was found between PAI-1 level and other risk markers of cardiovascular disease. It seems that vitamin D deficiency is not related to PAI-1 level as a risk marker for cardiovascular disease in diabetes, but this observation remains to be confirmed by larger clinical studies

[Effect of calcitriol on glycemic and lipid control in type 2 diabetes]

Vitamin D deficiency is prevalent worldwide. Low 25 hydroxyvitamin D3 concentrations inversely associated with type 2 diabetes, metabolic syndrome and insulin resistance. The aim of this study was the evaluation of effects of oral 1, 25 [OH] 2D3[calcitriol] treatments on glycemic control and lipid profiles in patients with type 2 diabetes. This was an interventional study, conducted in Ghaem Hospital, Mashhad, Iran on 58 type 2 diabetic patients. Patients underwent calcitriol treatment with 0.5 microgram per day for 8 weeks. In all cases, clinical parameters including weight, systolic and diastolic blood pressure and laboratory parameters including levels of fasting blood glucose, insulin, lipid profile, calcium, phosphorous, HbA1C and insulin resistance [HOMA-IR] were measured, before and after the treatment period. The two sets of results were then compared with one another. Following treatment with calcitriol, FBS, HbA1C, Cholesterol, triglycerides and insulin resistance decreased but the changes were not significant [p>0.05]. LDL and diastolic blood pressure decreased significantly after treatment with calcitriol. [p=0.02 and 0.04 respectively]. Supplementation with active form of vitamin D did not have a significant effect on glycemic control but may be effective in control of hyperlipidemia and blood pressure in type 2 diabetic patients, findings which need to be confirmed in large randomized trials

Chronic granulomatous disease in a 23 year old man with misdiagnosis of tuberculosis

Chronic Granulomatous disease [CGD] is a rare immunodeficiency disorder characterized by recurrent infections with catalase positive bacteria. The cause is some defect in bactericidal activity of neutrophils and fungal organisms. In this study a 23 years old man with history of recurrent pulmonary and lymph node infection has presented. He was misdiagnosed for TB three times and received anti- TB treatment. Finally the Chronic Granulomatous was confirmed. This case study demonstrated that CGD should be considered in adults with unexplained recurrent infections to prevent wrong treatment due to misdiagnosis and to reduce the disease severity by prophylactic treatments

[ study of effects of insulin and ascorbic acid on Bcl-2 family expression in hippocampus of streptozotocin -induced diabetic rats]

Diabetes is a metabolic disorder that has been shown to adversely affect both the central and peripheral nervous system by increasing basal neuronal apoptosis. Since Bcl-2 protein family is considered to play a key role in the regulation of apoptosis, in the present study we have examined the effects of insulin and ascorbic acid on expression of Bcl-2 family members including Bax [pro-apoptotic] and Bcl-2 and Bcl-x[L] [anti-apoptotic] on hippocampus of STZ-induced diabetic rats. Five groups of six Wistar rats including one control group [C] and four diabetic groups [D, I, AA and I+AA] were used in this study. Diabetes was induced by injection of 60 mg/kg STZ [IP]. After six weeks, rats in group I were treated with insulin [4-6 U/kg/day Sc], rats in group AA were treated with ascorbic acid [200 mg/kg/day IP] and rats in group I+AA were treated with equal dosage of both insulin and ascorbic acid for two weeks. Rats in group D were treated with normal saline and considered as diabetic control group. Two weeks after treatment, expression of Bcl-2, Bcl-x[L] and Bax genes were measured at both mRNA and protein levels. In diabetic control rats [group D], Bax increased whereas Bcl-2 and Bcl-x[L] decreased at both mRNA and protein levels compared to group C [P<0.01, P<0.001 respectively]. Interestingly, treatment with insulin [group I], ascorbic acid [group AA] and insulin plus ascorbic acid [group I+AA] could reverse these changes both at mRNA and protein levels [p<0.001 for I and AA+I groups, p<0.05 [Bcl-2] and p<0.01 [Bcl-x[L]] for AA group]. It is concluded that insulin and ascorbic acid alone or together can inhibit apoptosis in STZ-induced diabetic rats' hippocampus through increasing the ratio of Bcl-2/Bax and Bcl-x[L]/Bax expressions. We suggest that inhibition of apoptosis may prevent cognitive dysfunctions induced by hippocampal damage in diabetic patients as well. In addition, further experimental studies will need to be performed to confirm such effects

[Evaluation of hypogonadism with Major Thalassemia]

Although new treatments have prolonged survival and improved quality of life in the patients with major Thalassemia, endocrine complications especially hypogonadotropic hypogonaidsm still occur. The objective of this study is to determine prevalence and risk factors of hypogonaidsm in 47 patients with major Thalassemia. 47 patients with Thalassemia major aged 14 years and older were studied. Those who had any other problems were omitted from this study. Serum level of LH, FSH, Testestrone, Estradiol were measured and correlation with parameters including duration of transfusion, duration and dose of Desferal treatment, Ferretin level and pertinent clinical findings was evaluated and compared in groups of patients with and without hypogonaidsm. Short stature and underweight was seen in 68/1% of patients. Mean hight was 151 +/- 10.2 and mean of weight was 43.5 +/- 8.4. Hypogonadotropic hypogonaidsm was seen in 63/8 %. The prevalence of hypogonaidsm was more in males than females [p= 0.025]. No significant correlation was found between duration of transfusion, duration and dose of Desferal treatment and Ferretin level with hypogonaidsm. Endocrin complications of Major Thalassemia is frequent and factors other than iron overload including zinc deficiency or genetic differences may influence susceptibility to hypogonaidsm