The effect of resistant dextrin as a prebiotic on metabolic parameters and androgen level in women with polycystic ovarian syndrome: a randomized, triple-blind, controlled, clinical trial.

INTRODUCTION: Polycystic ovary syndrome (PCOS) is one of the most common abnormalities in women of reproductive age that can lead to a variety of metabolic and reproductive disorders. Studies reveal that a healthy diet is the most effective way for treating the risk factors associated with metabolic disorders and place greater emphasis on the consumption of prebiotic foods. The present study aims to determine the effect of resistant Dextrin on metabolic parameters, including lipid profile, fasting blood glucose (FBS) and high sensitivity C-reactive protein (hsCRP), and androgen levels, including serum levels of dehydroepiandrosterone sulfate (DHEA-S) and free testosterone, as the primary outcomes, and manifestations of PCOS including menstrual cycle irregularity and hirsutism, as the secondary outcomes. METHODS: This randomized, controlled, triple-blind, clinical trial was conducted on 62 women aged 18-45 in Tabriz, Iran, in 2016-2017. The participants were divided into a prebiotic group and a placebo group using block randomization. The prebiotic group consumed 20 g of resistant dextrin dissolved in a glass of water and the placebo group 20 g of maltodextrin also dissolved in a glass of water on a daily basis for 3 months. To measure the serum lipid profile, FBS, hsCRP, DHEA-S and free testosterone before and 3 months after the intervention, 5-ml blood samples were collected from the participants and analyzed using the ELISA method. The Ferriman-Gallwey scale for assessing hirsutism and a checklist for assessing menstrual cycle characteristics were completed before and 3 months after the intervention. A general linear model was used to analyze the data. RESULTS: No statistically significant differences were observed between the two groups in terms of sociodemographic characteristics and baseline values. 3 months after the intervention, based on the ANCOVA and after adjusting for the baseline values, the mean serum levels of LDL-C (adjusted mean difference = - 29.79; 95% CI = - 43.37 to - 16.21; P < 0.001), triglyceride (AMD = - 38.50; 95% CI = - 59.73 to - 17.28; P = 0.001), total cholesterol (AMD = - 29.98; 95% CI = - 40.14 to - 19.82; P < 0.001), FBS (AMD = - 11.24; 95% CI = - 15.43 to - 7.06; P < 0.001), hsCRP (AMD = - 1.75; 95% CI = - 2.92 to - 0.57; P = 0.004), DHEA-S (AMD = - 0.7; 95% CI = - 1.34 to - 0.13; P = 0.017) and free testosterone (AMD = - 0.32; 95% CI = - 0.56 to - 0.08; P = 0.010) revealed a statistically significant decrease in the intervention group compared to the placebo group, while the mean serum HDL-C showed a statistically significant increase in this group compared to the placebo group (AMD = 5.82; 95% CI = 2.27-9.37; P = 0.002). 3 months after the intervention, there was a significant difference between the two groups in terms of menstrual cycle intervals and hirsutism (P < 0.001). CONCLUSION: Resistant dextrin consumption can regulate metabolic parameters and androgen levels and manifestations including hirsutism and menstrual cycle irregularity in women with PCOS.

Effect of regular exercise training on changes in HbA1c, BMI and VO2max among patients with type 2 diabetes mellitus: an 8-year trial.

OBJECTIVE: The effects of regular exercise on the health promotion of patients with type 2 diabetes mellitus (T2DM) have been well documented. The present study investigated the long-term effects of regular exercise training on biological indicators among these patients. METHODS: In this quasi-experimental trial with pretest-post-test design, 65 patients with T2DM aged 33-69 years (experiment (35), control (30)) participated. After 8 years of conducting the program, the data on 30 patients (experiment (15), control (15)) were entered into analysis. The training program included aerobic exercise three sessions per week, 90 min, 50%-80% VO2max. Before and after the intervention, the biological indicators (hemoglobin A1c (HbA1c), body mass index (BMI) and VO2max) were measured. Data were analyzed using multivariate analysis of covariance. RESULTS: Our long-term exercise training program had a significant effect on HbA1C, BMI and Vo2max (P<0.05). Compared with patients in the control group, HbA1c was significantly reduced and BMI and VO2max were significantly improved among the experiment group. CONCLUSIONS: Long-term regular physical activity training was found to be helpful in improving glycemic control, body composition and cardiovascular fitness among patients with T2DM. Long-term continuous physical activity offsets the deteriorations of biological indicators found in the control group. Further research, with a particular focus on practical and real-world programming, is needed to determine the responsive health outcomes of such long-term programs on the patients.

Clinico-epidemiological factors of health related quality of life among people with type 2 diabetes.

AIM: To investigate the quality of life (QOL) and its clinical and epidemiological correlates among people with type 2 diabetes. METHODS: This cross-sectional study was conducted in Tabriz, Northwest of Iran, including a total of 394 people with type 2 diabetes using convenient sampling method from November 2014 to March 2015. General information including demographic, socioeconomic status and lifestyle factors were collected by trained interviewers. Clinical information was retrieved from clinic's record and QOL was assessed using the 26-item WHOQOL-BRIFE questionnaire. Univariate and multivariate linear regression were performed to assess the related factors and QOL dimensions. RESULTS: The mean of overall health related QOL was 52.11 ± 11.53 and the maximum and minimum dimensions were respectively seen in psychological (60.38 ± 14.54) and social (38.32 ± 16.94) dimensions. The results of multiple linear regression showed a significant overall relationship between HRQOL and age (b = -1.48%, 95%CI: -0.03 and -2.93) level of education (b = 4.12%, 95%CI: 2.73 and 5.5), number of comorbidities (b = -2.41%, 95%CI: -3.89 and -9.41), and level of income (b = 1.98, 95%CI: 0.05 and 3.9), functional limitation (b = -3.59, 95%CI: -2.26 and -4.92) and psychological distress (b = -2.02%, 95%CI: -2.83 and -1.21). Level of education, functional limitation, psychological distress were associated with the score of physical, mental and environmental dimensions, and number of comorbidities was associated with the score of physical and mental dimensions. CONCLUSION: Based on our findings, lifestyle modification and increasing facilities of clinics providing service can be effective steps to improve the QOL among people with type 2 diabetes.

Impact of prebiotic supplementation on T-cell subsets and their related cytokines, anthropometric features and blood pressure in patients with type 2 diabetes mellitus: A randomized placebo-controlled Trial.

BACKGROUNDS AND AIMS: Type 2 diabetic mellitus (T2DM) asone of the main causes of morbidity and mortality is associated with immune system disturbances and metabolic abnormalities. In the current study we aimed to evaluate the effects of oligofructose-enriched inulin on T-cell subsets and their related cytokines, anthropometric and metabolic parameters in patients with T2DM. METHODS: Forty-six diabetic females patients were randomly allocated into intervention (n=27) and control (n=22) groups. Subjects in the intervention group received a daily dose of 10g of oligofructose-enriched inulin and subjects in control group received a placebo for two months. Anthropometric variables, metabolic parameters including fasting serum glucose (FSG), hemoglobin A1c (HbA1c), lipid profile and blood pressure were measured at the beginning and after two months. Immune markers also included serum interleukin (IL)-4, IL-12 and interferon (IFN)-γ concentrations were assessed and CD3(+), CD4(+), CD8(+) and CD11b(+)T-cell counts were determined by flow cytometry at baseline and end of the trial. RESULTS: After two months intervention, significant improvements in anthropometric variables, blood pressure and serum lipids occurred in prebiotic-treated group (P<0.001). Serum IL-4, IL-12 and IFN-γ concentrationsalso significantly decreased in intervention group (P<0.001). No significant changes in CD3(+), CD4(+), CD8(+) and CD11b(+) T-cell counts were observed in treatment groups after intervention. CONCLUSION: The present study showed several beneficial effects of oligofructose-enriched inulin on the improvement of the glycemic status, lipid profile, and immune markers in patients with T2DM. Further studies are needed to confirming our findings and to better clarify the underlying mechanisms.

Effectiveness of Insulin Glargine on Recovery of Patients with Diabetic Ketoacidosis: A Randomized Controlled Trial.

BACKGROUND: Diabetic Ketoacidosis (DKA) is a major hyperglycemic emergency in diabetes mellitus (DM). The basic treatment is injection of Regular insulin (RI). This study was aimed to investigate the effects of insulin Glargine (GI) on recovery of patients with DKA. MATERIALS AND METHODS: A randomized clinical trial conducted on 40 patients (twenty patients in each group) with DKA. Both groups received standard treatment for DKA. Experimental group was given 0.4U/kg of GI within three hours of initiation of IV insulin infusion. RESULTS: The mean duration of acidosis correction time and recovery from DKA was 13.77±6.10 and 16.91±6.49 h in the intervention and control groups respectively (p=0.123). The mean dosage of RI until recovery from DKA was 84.8±45.6 in the intervention and 116.5±91.6 units in control groups (p=0.17). Hypokalemia occurred in three patients in intervention and four patients in control groups. In 35% of samples in intervention group and 51% in controls blood sugar was more than 10 mmol/l for 24 h after discontinuation of the insulin infusion (p=0.046). The mean duration of hospitalization was 5.1±1.88 in intervention and 5.9±2.19 d in control group (p=0.225). CONCLUSION: Adding GI to the standard treatment of DKA reduced average time of recovery from DKA, without incurring episodes of hypoglycemia and hypokalemia. This also reduced in the time of recovery from DKA, amount of required insulin and the duration of hospitalization. It seems that the non-significant difference in the time of recovery from DKA be related to the small sample size and study design. Further studies are recommended.

A combined continuous and interval aerobic training improves metabolic syndrome risk factors in men.

Individuals with metabolic syndrome have significantly higher risk of cardiovascular disease and type 2 diabetes leading to premature death mortality. Metabolic syndrome has a complex etiology; thus, it may require a combined and multi-targeted aerobic exercise regimen to improve risk factors associated with it. Therefore, the aim of this study was to evaluate the effect of combined continuous and interval aerobic training on patients with metabolic syndrome. Thirty adult male with metabolic syndrome (54±8 years) were randomly divided into two groups: test training group (TTG; n=15) and control group (CG; n=15). Subjects in TTG performed combined continuous and interval aerobic training using a motorized treadmill three times per week for 16 weeks. Subjects in CG were advised to continue with their normal activities of life. Twenty-two men completed the study (eleven men in each group). At the end of the study, in TTG, there were significant (for all, P<0.05) reductions in total body weight (-3.2%), waist circumference (-3.43 cm), blood pressure (up to -12.7 mmHg), and plasma insulin, glucose, and triacylglyceride levels. Moreover, there were significant (for all, P<0.05) increases VO2max (-15.3%) and isometric strength of thigh muscle (28.1%) and high-density lipoprotein in TTG. None of the above indices were changed in CG at the end of 16-week study period. Our study suggests that adoption of a 16-week combined continuous and interval aerobic training regimen in men with metabolic syndrome could significantly reduce cardiovascular risk factors in these patients.

Investigation of CTLA-4-318C/T gene polymorphism in cases with type 1 diabetes of Azerbaijan, Northwest Iran.

This study analyzed the association of CTLA-4-318C/T gene polymorphism with susceptibility, clinical course and laboratory findings of Type 1 diabetes (T1D). One hundred and fifty-three T1D patients and 189 healthy controls entered this study. CTLA-4-318C/T genotyping was performed by tetra-primer amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR) analysis. The allelic and genotypic frequencies of -318C/T gene polymorphism were similar in patients and controls. However, younger age, earlier age at onset, higher HbA1c levels, higher frequency of Glutamic acid decarboxylase antibodies (GADA) and Insulinoma Associated-2 Autoantibodies (IA-2A) were observed in T1D patient carriers of CT genotype. The current study demonstrates that although CTLA-4-318C/T polymorphism was not linked with a higher genetic risk for T1D, the presence of a CT genotype was associated with a younger age of onset, poor control of HbA1c level and positive anti-GAD or IA-2 serum autoantibodies in Iranian Azeri population.

Analysis of PTPN22 C1858T gene polymorphism in cases with type 1 diabetes of Azerbaijan, Northwest Iran.

BACKGROUND: Type 1 diabetes (T1D) is a T-cell mediated autoimmune multifactorial disease. The PTPN22 gene encodes an intracellular lymphoid-specific phosphatase (Lyp) that has been shown to play a negative regulatory role in T cell activation. OBJECTIVES: The aim of the present study was to find out associating the PTPN22 C1858T (R620W) polymorphism and T1D in the Azeri population from Northwest Iran. SUBJECTS AND METHODS: One hundred and forty-four T1D patients and 197 healthy controls entered this study. We used restricted fragment length polymorphism (RFLP) method to type PTPN22 C1858T polymorphism. RESULTS: There was no significant difference in distribution of genotype and allele frequencies of PTPN22 C1858T polymorphism between T1D patients and controls (P=1.000 for both comparisons and OR=0.91, 95% CI=0.25-3.26 for 1858T allele). However, T allele frequency was significantly increased in T1D patients with Hashimoto's thyroiditis (5.77%) compared with T1D only (0.43%, P=0.019). Moreover, there were no significant differences between studied parameters (including gender, age at onset and family history of T1D) and different genotypes of 1858 PTPN22 C/T polymorphisms in patients. Data showed a low frequency of the minor (T) allele by 1.4% in T1D and 1.5% in healthy individuals. CONCLUSIONS: The PTPN22 C1858T is not relevant in susceptibility to T1D in the Azeri population of Northwest Iran. Our data also indicate that T1D carriers of the T1858 allele could be at enhanced risk for other comorbid autoimmune disorders.

Age related secretary pattern of growth hormone, insulin-like growth factor-I & insulin-like growth factor binding protein-3 in postmenopausal women.

BACKGROUND & OBJECTIVES: After menopause in women, loss of bone density increases rapidly with estrogen deficiency. Evidence has revealed that this deficiency may be directly correlated with growth hormone (GH) level declining with age. The present study was designed to evaluate the age dependant patterns of GH, insulin-like growth factor-1 (IGF1-1) and insulin-like growth factor binding protein-3 (IGFBP-3) endogenous secretion in postmenopausal women. METHODS: During this prospective study in a 12-month period, 150 postmenopausal women were enrolled who were referred to the densitometry unit of bone research centre of Tabriz University of Medical Sciences for assessing bone mineral density. Serum levels of basal and clonidine stimulated GH were measured using radioimmunoassay while IGF-1 and IGFBP-3 were measured by ELISA. Post stimulation over 3 to 6 fold increase in GH over the baseline level was considered normal response and less increase was considered abnormal. RESULTS: There were no significant differences in the mean levels of GH0, GH60 and GH90 in different age groups of postmenopausal women. No significant difference in the mean IGFBP-3 and IGF-1 levels was seen in different age groups of postmenopausal women. The number of postmenopausal women with abnormal response to stimulation by clonidine in 61-70 and > 70 yr age groups was higher than in other groups (P< 0.05). INTERPRETATION & CONCLUSIONS: Despite the higher rate of abnormal response to stimulation by clonidine in women aged more than 60 yr, the current study showed no significant correlation between age, and the basal and stimulated GH secretion rate and serum levels of IGF-1 and IGFBP-3 in postmenopausal women.

Effect of Fenugreek Seeds on Serum Metabolic Factors and Adiponectin Levels in Type 2 Diabetic Patients.

This triple-blind randomized controlled clinical trial was conducted on 88 type 2 diabetic (T2DM) patients (males and females). Subjects in the fenugreek seed (n=44) and placebo (n=44) groups consumed 10 g/d of powdered whole fenugreek seeds or 5 g/d of wheat starch for 8 weeks. Fasting blood samples, anthropometric measurements and dietary records were collected at the baseline and at the end of the trial. Fenugreek seeds significantly decreased fasting blood glucose (P=0.007) and HbA1c (P=0.0001), serum levels of insulin (P=0.03), homeostatic model assessment for insulin resistance (P=0.004), total cholesterol (P=0.005) and triglycerides (P=0.0001) and increased serum levels of adiponectin (P=0.001) compared with placebo. No significant changes were shown in serum low-density lipoprotein cholesterol and high-density lipoprotein cholesterol in both groups. In conclusion, fenugreek seeds improved glucose metabolism, serum lipid profile and adiponectin levels in studied subjects, and may be useful in the control of diabetes risk factors in TD2M patients.

Familial dysbetalipoproteinaemia presenting with cauliflower xanthoma.

Familial dysbetalipoproteinaemia (FDL) is an inherited disorder in which both cholesterol and triglycerides are elevated in the plasma, pre-disposing the people to coronary artery disease and peripheral vascular disease. The disease is mostly manifested by xanthomas, which have variable forms according to lipid amounts in the plasma of the blood. Hereby, we report a 43-year-old man with FDL, presenting with a rare form of xanthomas calling "Cauliflower xanthoma" all over the body.

Correlation of Serum Free Carnitine with Serum Ferritin and Vitamin C Levels in Type II Diabetic Men.

BACKGROUND: Diabetes is a major health problem worldwide. Type II diabetic patients are reported to have higher ferritin and lower vitamin C concentrations. Considering the role of ascorbic acid in carnitine biosynthesis and the limited information on free carnitine correlations with ferritin and vitamin C levels in diabetic patients without microvascular complications, this case-control study was conducted to determine ferritin and vitamin C levels in hyperlipidemic-diabetic men comparing to healthy controls; the correlation of free carnitine with ferritin and vitamin C levels were also studied in these patients. METHODS: Thirty-five hyperlipidemic-diabetic and seventy healthy men, were included in the study by the convenience sampling method. Body Mass Index, blood pressure, fasting blood glucose, lipid profile, ferritin and vitamin C levels were assessed in both case and control groups; moreover, serum free carnitine was measured in both groups. Dietary assessments were performed using 24 hour recall and food frequency questionnaires. RESULTS: Blood pressure, fasting blood glucose, cholesterol, triglyceride, LDL, and HDL concentrations were significantly higher in the case group. Mean serum ferritin concentrations were higher in diabetics comparing to controls (93.22±0.27 vs. 44.66±4.23 µg/l); whereas, mean plasma vitamin C in these patients were lower than the healthy subjects (0.68±0.07 vs. 0.89±0.05). Positive correlations were observed between free carnitine and vitamin C levels. CONCLUSION: According to the results, it could be suggested that vitamin C supplementation in diabetic patients with hyperlipidemia might be useful. In addition, inclusion of serum ferritin assay in routine evaluation of diabetic patients could be beneficial.

Relation of ankle brachial index to left ventricular ejection fraction in non-diabetic individuals.

INTRODUCTION: Peripheral arterial disease is associated with an excessive risk for cardi-ovascular events and mortality. Peripheral arterial disease is usually measured with ankle brachial index (ABI). It is previously shown that the ABI would reflect LV systolic func-tion, as well as atherosclerosis; however, these results are not shown in non-diabetic indi-viduals. In this study, we aim to evaluate this relation in non-diabetic individuals. METHODS: In a prospective study, 73 non-diabetic individuals (38.4% male with mean age of 59.20±14.42 years) referred for ABI determination who had had the left ventricular ejection fraction determined using trans-thoracic echocardiography were studied. Participants were compared in normal and low ABI groups. RESULTS: The mean left ventricular ejection fraction (LVEF) was 52.34±7.69, mean ankle brachial index for the right leg was 1.08±0.13, and the mean ankle brachial index for the left leg was 1.07±0.12. Low ABI incidence was 12.32%. Individuals with low ABI significantly were older (p<0.001) and had lower left ventricular ejection fraction (p<0.001). ABI had significantly inverse corre-lation with LVEF (r=-0.53, p<0.001) and positive correlation with age (r=0.43, p<0.001). The ABI correlated inversely with LVEF in the patients with (r =-0.52, p=0.008) and without (r=-0.55, p<0.001) IHD. CONCLUSION: Results showed that ankle brachial index would be influenced by left ventricular ejection fraction in non-diabetics and to evaluate and monitor cardiovascular risk in patients these should be considered together.

Gastrointestinal signs and symptoms among persons with diabetes mellitus.

AIM: To determine the prevalence of gastrointestinal symptoms and signs among persons with diabetes mellitus in a specialist hospital. BACKGROUND: Gastrointestinal symptoms and signs are common among patients with diabetes mellitus. Morbidity from. PATIENTS AND METHODS: In this descriptive, cross-sectional study, subjects from the general population with diabetes (n=200) were recruited for this study. Subjects were randomly chosen from patients known to have diabetes, (type I&II), attending the diabetes clinic at Sina University Hospital, in Tabriz during 2003. The questionnaire recorded gastrointestinal symptoms among the subject population. RESULTS: 91% and 9% of patients had Type II and I diabetes, respectively. Sixty seven percent of them had poor controlled diabetes and only 3% had well controlled diabetes. Gastrointestinal symptoms and signs were reported in 92% of patients. The common GI symptoms were constipation (59.5%), followed by bloating (44%), abdominal pain (31%), dyspepsia (30%), and mass protruding through anus (22.5%). Abdominal tenderness on deep palpation was the commonest clinical sign (54%). GI symptoms were more prevalent in subjects aged 60-69 years (97.2%). Seventy four percent of patients with GI signs and symptoms had complications such as neuropathy 61.5% and retinopathy associated with neuropathy 38.5%. CONCLUSION: The prevalence of GI symptoms and signs in the population studies was higher than that reported from other populations, and there is a relationship between glycaemic control and complications of diabetes in diabetic subjects.

Grape seed extract to improve liver function in patients with nonalcoholic fatty liver change.

BACKGROUND/AIM: Therapeutic interventions in nonalcoholic fatty liver disease are limited, while anti-oxidative materials have shown benefits in animal models. This study aimed to evaluate grape seed extract as an anti-oxidative material in this process. Therapeutic effects of grape seed extract were evaluated in comparison to vitamin C in a double-blind setting. MATERIALS AND METHODS: Fifteen patients were enrolled in each group. Liver function tests were done; also, grade of steatosis and pattern of echogenicity of the liver were determined. Patients were followed up by the same evaluation repeated in first, second and third months. RESULTS: Mean age +/- standard deviation was 43.2 +/- 10.3 years. Grape seed extract (GSE) significantly improved the grade of fatty liver change; and resulted in significant decrease in alanine aminotransferase in patients receiving the concentrate compared to those receiving vitamin C independently, from the initial grade of steatosis. CONCLUSIONS: This study describes the beneficial effect of using grape seed extract for three months in patients with nonalcoholic fatty liver disease. These results may improve with a longer period of follow-up.

N-acetylcysteine improves liver function in patients with non-alcoholic Fatty liver disease.

BACKGROUND AND AIMS: Non-alcoholic fatty liver change is a common disease of the liver in which oxidative stress plays a basic role. Studies are largely focused on protecting the liver by means of anti-oxidative material. The aim of this study is to evaluate the role of N- acetylcysteine in the process of liver injury. METHODS: Thirty patients with non-alcoholic fatty liver steatosis were randomly selected to receive either N-acetylcysteine or vitamin C. Liver function tests (alanine aminotransfrase, aspartate aminotransfrase and alkaline phosphatase) were measured as well as the grade of steatosis, the pattern of its echogenicity, the span of the liver and the spleen and the portal vein diameter before the intervention. Patients were followed up using the same method of evaluation repeated in the first, second and third months. RESULTS: The mean age (SD) was 40.1(12.4) in patients receiving NAC and 46(10.4) years in patients receiving vitamin C (P = 0.137). NAC resulted in a significant decrease of serum alanine aminotransfrase after three months, compared to vitamin C. This effect was independent of the grade of steatosis in the initial diagnosis. NAC was able to significantly decrease the span of the spleen. CONCLUSIONS: N-acetylcysteine can improve liver function in patients with non-alcoholic fatty liver disease. Better results may be achievable in a longer follow up.

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

BACKGROUND AND OBJECTIVES: 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 disturbances in patients with beta-thalassemia major who were older than 10 years of age. PATIENTS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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.