Association between maternal and cord blood thyroid hormones, and urine iodine concentration with fetal growth.

OBJECTIVES: We planned to evaluate the association of fetal and maternal thyroid hormones and maternal iodine status with neonates' anthropometric parameters. METHODS: In this cross-sectional study, levels of thyrotropin were measured in maternal serum in the first trimester of pregnancy, and thyrotropin (TSH) and free thyroxin (fT4) were measured in cord blood serum samples at birth. Urinary iodine concentration (UIC) levels in random urine samples of mothers were measured in the third trimester of pregnancy. The relationship between UIC and thyroid hormone levels of mothers with neonates' anthropometric birth parameters of neonates was evaluated. RESULTS: One hundred eighty-eight mother-newborn pairs completed the study. Mean (SD) of cord blood TSH (CB-TSH), cord blood-free thyroxin (CB-FT4) values, and maternal TSH (M-TSH) levels were 8.8 (7.3) mIU/L, 1.01 (0.2) ng/dL, and 2.2 (0.9) mIU/L, respectively. After adjusting for confounders, there was a positive significant association between female neonate length and maternal TSH and log log-transformed CB TSH (LN_CB-TSH) (p<0.05). Median UIC (Q1-Q3) was 157 (53-241) µg/L, and there was no association between birth weight, birth length, and head circumferences of neonates and mothers' UIC (p>0.05). CONCLUSIONS: We found a positive correlation between maternal TSH in the first trimester of pregnancy and the birth length of newborns, and a negative correlation was observed between CB-TSH and birth length in girls, but it did not provide conclusive evidence for the relationship between maternal and neonatal thyroid hormone levels and birth weight. There was no association between maternal UIC levels in the third trimester and birth anthropometric parameters.

Quality of Life in Patients with Phenylketonuria: A Systematic Review.

The impact of phenylketonuria (PKU) on Quality of life (QoL) has been a topic of interest in recent research. This article reviews current researches on the impact of PKU on QoL. The review examines factors that may influence QoL, such as age, metabolic control, and treatment adherence. In this systematic review study, relevant articles were identified using a search strategy built with the keywords phenylketonuria, PKU, or hyperphenylalaninemia (or their synonyms) and QoL in Web of Science, Scopus, and PubMed databases. After identifying the articles, duplicates, reviews, scientific abstracts, articles published in languages other than English, and non relevant studies were excluded. The search strategy identified 951 records from databases, and after excluding duplicates, irrelevant studies, and those published in non English languages, 26 records were left that contained data on 1816 patients with PKU/hyperphenylalaninemia. The studies included both children/adolescents and adults. Overall, the studies found that the QoL of PKU patients was comparable to normative data, but some aspects such as emotional health and school functioning were lower. Metabolic control was found to significantly correlate with QoL. Younger patients and men had better QoL in several studies, while late treated patients and those with lower education had worse outcomes. It is concluded that QOL in patients with PKU is similar to the general population. However, given the chronic nature of the condition, it is important to pay special attention to their QoL. Poor QOL is associated with female gender, lower education, older age, and poor metabolic control.

Final height in children and adolescents with type 1 diabetes mellitus: A systematic review and meta-analysis.

PURPOSE: Considering the high prevalence of type 1 diabetes mellitus (T1DM) together with the importance of improved physical growth and the significance of promoting healthcare quality among T1DM children, this meta-analysis aims to determine mean final height in this population group. METHODS: We systematically searched PubMed, EMBASE, Web of Science, Scopus, and Cochrane databases for all studies published until May 2023 and reviewed references of published articles. Meta-analytic procedures were used to estimate the effect size (mean final height Z-score) among T1DM children in a random effects model. Significance values, weighted effect sizes, 95% CIs, and tests of homogeneity of variance were calculated. The included studies consisted of data from 3274 patients. RESULTS: The mean final height Z-score for T1DM children was -0.201 (n = 25 studies, 95% CI: -0.389, -0.013; I2 = 97%), -0.262 in males (n = 20 studies, 95% CI: -0.539, 0.015, I2 = 97.1%), and -0.218 in females (n = 18 studies, 95% CI: -0.436, 0, I2 = 94.2%). The non-significant negative association between age at diagnosis, HbA1c levels, and final height Z-score is suggested by the findings of the univariate meta-regression. CONCLUSION: Our findings indicated that children with T1DM have impaired linear growth and that monitoring of growth in these patient populations is an important issue in the management of T1DM. Due to a scarcity of studies providing data on the relationship between uncontrolled diabetes (increased HbA1c) and early diagnosis and final height, further investigation is warranted to determine whether there is indeed a correlation. Consequently, any conclusion regarding the association between uncontrolled diabetes (elevated HbA1c), early diagnosis of T1DM, and the increased risk of impaired linear growth or final height remains uncertain.

Hypothyroidism in First-Degree Relatives of Neonates with Congenital Hypothyroidism: Is there an Association?

Background: Recent studies have shown an increased incidence of congenital hypothyroidism (CH), especially in the middle-east region. The exact etiology is unknown; however, it has been related to several factors, the most noticeable being the high prevalence of transient CH (TCH), parental consanguinity, and the history of hypothyroidism in relatives. We sought to determine the impact of hypothyroidism in the relatives of patients with the observed trend. Methods: We included all patients with primary CH detected through the Newborn Screening (NBS) Program from 2007 to 2016. We analyzed the impact of consanguinity relationship, parental and siblings' thyroid function, second-degree relatives' thyroid function, parental educational level, age, and maternal gestational diabetes on the development of permanent CH (PCH) and TCH. Results: A total of 1447 consecutive eligible patients were recruited during the study period. Of this number, 1171 (81%) were diagnosed with CH: 623 (53.2%) had PCH and 548 (46.8%) had TCH. Six hundred thirty-three (54.1%) participants were men, and 814 (69.5%) had a history of relatives' hypothyroidism. Our data analysis revealed a significant difference regarding the male gender, having a history of relatives' hypothyroidism, and parental hypothyroidism compared to TCH ones (P < 0.05). Patients with a history of relatives' hypothyroidism had significantly higher PCH than TCH (P < 0.0001). However, consanguineous marriage was not comparable in patients regardless of their history of relatives' hypothyroidism (P-value >0.884). Conclusions: Our findings indicated the role of the history of hypothyroidism in neonates' relatives in the evolution of the PCH. Meanwhile, consanguineous marriage did not impress the development of PCH and TCH.

Assessment of Vascular Indices by Abdominal Aortic Ultrasonography in Preterm Neonates with Bronchopulmonary Dysplasia.

Preterm infants with bronchopulmonary dysplasia (BPD) frequently encounter systemic hypertension, yet the underlying cause remains elusive. Given the absence of prior investigations concerning the correlation between systemic hypertension and aortic thickness, we undertook this study to assess and juxtapose diverse vascular indices amidst preterm neonates with BPD, preterm neonates lacking BPD, and healthy neonates, utilizing abdominal aorta ultrasonography. This cross-sectional study encompassed 20 preterm neonates, 20 preterm neonates with BPD, and 20 healthy neonates, meticulously matched for sex and postnatal age. Comprehensive demographic, anthropometric, and clinical evaluation data were documented. The neonates underwent abdominal aortic ultrasonography for comparative evaluation of aortic wall thickness and vasomotor function across the three groups. The study revealed that neonates with BPD exhibited a notably higher average systolic blood pressure than preterm and term neonates (P < 0.05). Conversely, echocardiographic parameters such as input impedance, and arterial wall stiffness index displayed no substantial variance among the three groups (P > 0.05). The mean (SD) aortic intima-media thickness (aIMT) for preterm neonates with BPD, preterm neonates, and term neonates were 814 (193.59) µm, 497.50 (172.19) µm, and 574.00 (113.20) µm, correspondingly (P < 0.05). Furthermore, the mean (SD) pulsatile diameter for preterm neonates with BPD, preterm neonates, and term neonates were 1.52 (0.81) mm, 0.91 (0.55) mm, and 1.34 (0.51) mm, respectively (P < 0.05). Following adjustment for birth weight, sex, and gestational age at birth, the study identified a noteworthy correlation between aIMT and BPD. The investigation concluded that the mean aortic intima-media thickness (aIMT) was significantly elevated in preterm neonates with BPD, signifying a potential early indicator of atherosclerosis and predisposition to future heightened blood pressure and cardiovascular ailments. Consequently, the study postulates that aIMT could be a consistent and well-tolerated marker for identifying BPD patients at risk of developing these health complications.

Relationship between vitamin D levels and age of menopause and reproductive lifespan: Analysis based on the National health and nutrition examination survey (NHANES) 2001-2018.

OBJECTIVES: To determine the association between serum vitamin D levels and age at menopause and reproductive lifespan in a group of US postmenopausal women. STUDY DESIGN: Data from 6,326 postmenopausal US women in the National Health and Nutrition Examination Survey (NHANES) database 2001-2018 were obtained. Weighted multinomial logistic regression models were used to obtain odds ratios (OR) and 95% confidence intervals (CI). Statistical analyzes were performed using SAS (version 9.4; SAS Institute), and complex survey designs were considered. RESULTS: Vitamin D deficiency was associated with a higher likelihood of early menopause (OR = 1.34, 95% CI: 1.15, 1.58; p = 0.008) and lower odds of late menopause (OR = 0.79, 95% CI: 0.52, 0.95) in the unadjusted model but not in the adjusted model. Lower vitamin D levels were associated with a higher risk of a shorter reproductive lifespan. The strongest association was seen in the first tertile of vitamin D deficiency (OR = 1.54; 95% CI: 1:29-1:83). After adjustment, the associations were somewhat weakened but remained statistically significant. CONCLUSIONS: The results of this study suggest that vitamin D deficiency and inadequacy might be associated with earlier age at menopause. It may also reduce the reproductive lifespan in women. Given the cross-sectional nature of the NHANES dataset, these results should be interpreted with caution due to temporality bias. Menopausal age is a multifactorial phenomenon, and the identification of factors and their interactions should be evaluated in future studies.

Childhood Obesity Is Associated With Subclinical Left Ventricular Dysfunction Detected by Speckle Tracking Echocardiography.

Childhood obesity is related to cardiac structural and functional changes, increasing the risk of heart disease. Sixty normotensive children were assigned based on body mass index (BMI) into normal weight, overweight, and obese groups and examined by two-dimensional speckle tracking echocardiography (2D-STE). Weight (P = .001) and BMI (P = .001) differed significantly among the 3 groups. Left ventricular (LV) strain (P = .001) and strain rate (P = .002) in overweight and obese children (P = .001) were significantly lower compared to normal weight group. LV mass in obese children was notably larger compared to overweight children (P = .047). LV strain was associated with age (P = .031), weight (P = .001), and height (P = .022). There was an association between LV strain rate with weight (P = .001) and between left atrial area and height of children (P = .007). Obesity in normotensive obese children is associated with subclinical alteration of LV dimension and myocardial longitudinal strain recognized by 2D-STE.

Association of Polycyclic Aromatic Hydrocarbons Urine Metabolites with Type 1 Diabetes.

Purpose: Polycyclic aromatic hydrocarbons (PAHs) are believed to be a possible factor in the development of cancer, ischemic heart disease, obesity, and cardiovascular disease. The objective of this study was to explore the association between certain metabolites of urinary PAH and type 1 diabetes (T1D). Methods: In Isfahan City, a case-control study was carried out involving 147 T1D patients and an equal number of healthy individuals. The study measured the levels of urinary metabolites of PAHs, specifically 1-hydroxynaphthalene, 2-hydroxynaphthalene, and 9-hydroxyphenanthrene, in both the case and control groups. The levels of these metabolites were then compared between the two groups to assess any potential association between the biomarkers and T1D. Results: The mean (SD) age of participants in the case and control groups was 8.4 (3.7) and 8.6 (3.7) years old, respectively, (P > 0.05). In terms of gender distribution, 49.7% and 46% of participants in the case and control groups were girls, respectively (P > 0.05). Geometric mean (95% CI) concentrations were: 36.3 (31.4-42) µg/g creatinine for 1-hydroxynaphthalene, 29.4 (25.6-33.8) µg/g creatinine for 2-hydroxynaphthalene, and 72.26 (63.3-82.5) µg/g creatinine for NAP metabolites. After controlling for variables such as the child's age, gender, maternal and paternal education, duration of breastfeeding, exposure to household passive smoking, formula feeding, cow's milk consumption, body mass index (BMI), and five dietary patterns, it was observed that individuals in the highest quartile of 2-hydroxynaphthalene and NAP metabolites had a significantly greater odd ratio for diabetes compared to those in the lowest quartile (P < 0.05). Conclusion: Based on the findings of this study, it is suggested that exposure to PAH might be linked to an increased risk of T1D in children and adolescents. To clarify a potential causal relationship related to these findings, further prospective studies are needed.

Trends in incidence rates of childhood type 1 diabetes mellitus: A retrospective study in Isfahan province, Iran.

AIMS/INTRODUCTION: We aimed to determine the incidence trend of childhood type 1 diabetes mellitus in Isfahan province over a period of 12 years. MATERIALS AND METHODS: In this retrospective study, children aged <20 years at the time of type 1 diabetes mellitus diagnosis, from March 2007 to March 2019, were included. The crude and adjusted incidence rate of type 1 diabetes mellitus is calculated as the number of cases per 100,000 person-years by the period. The cumulative, age- and sex-specific incidence rates were also calculated. Age-specific incidence rates were calculated for age and sex groups. RESULTS: A total of 1,954 (983 boys and 971 girls) cases of type 1 diabetes mellitus were identified. The mean age at diagnosis in all studied populations was 9.89 (standard deviation 4.76). There were no significant differences between the proportion of boys and girls in different years (P = 0.12) and different age groups (P = 0.19). The average annual percent change of incidence rate for the total population, for girls and boys, was 6.9%, 6.7% and 6.3% respectively. The type 1 diabetes mellitus incidence rate had a significant trend to be increased from 2007 to 2019 (P < 0.001, t = 3.6). CONCLUSION: Our findings showed that currently our region is considered a region with a high incidence rate of type 1 diabetes mellitus. Although we have had fluctuations in the incidence rate over the 12 years, the overall trend is increasing.

Association between Sleep Duration and Early Pubertal Timing in Children and Adolescents: A Systematic Review and Meta-analysis.

BACKGROUND: Early puberty increases the risk of diverse health outcomes during adolescence and beyond. Several studies have explored the links between short sleep duration and early puberty worldwide. OBJECTIVE: The current systematic review and meta-analysis aimed to evaluate the association between sleep duration and early pubertal timing based on published evidence systematically. METHODS: We searched important electronic databases for articles that reported the association between childhood sleep duration and puberty timing up to October 2020. A total of 848 papers were identified from the databases and manual search. Finally, 10 studies including 23752 participants were included in the meta-analysis. We calculated the pooled effect sizes using a random or fixed effects model as appropriate. RESULTS: There was a significant inverse association between sleep duration and the risk of early puberty, longer duration of sleep was associated with 0.34% decreased odds of early puberty (OR = 0.66, 95% CI = 0.58-0.77, I2 = 96.6%). In a subgroup analysis, when pubertal status was assessed by physical examination compared with Pubertal Development Scale (PDS) or Sexual Maturation Scale (SMS), the associations between sleep duration and age of puberty were attenuated. The pooled OR (95% CI) of studies measuring pubertal timing by PDS/SMS and Tanner stage were 0.50(0.37-0.69) and 0.91(0.77-1.09), respectively. When pooling effect sizes was limited to studies that had BMI level adjustment, the association of sleep duration and early puberty was not statistically significant anymore (OR = 0.95, 95% CI = 0.89-1.01). CONCLUSION: Longer sleep duration is associated with a lower risk of early puberty in children. The association between sleep duration and risk of early puberty may be modified by other factors such as BMI. To clarify the effect of sleep duration on the risk of early puberty in children, further prospective studies are needed.

The association between Sodium Urinary Discharge (FENa) and growth parameters in pediatrics with cystic fibrosis.

BACKGROUND: Given the association between chronic sodium losses and growth parameters and establishment of normal weight gain and linear growth in patients with cystic fibrosis (CF), in this study, we aimed to evaluate the sodium status in Iranian CF patients and its association with their growth parameters. METHODS: In this prospective cross-sectional study, 44 children with CF were included. Serum and urinary sodium and creatinine levels were measured in patients, and the fractional excretion of sodium was calculated. The patients categorized in groups with FENa <0.5%, between 0.5% and 1.5% and >1.5%. Growth parameters were compared in the group, and its association with FENa level was evaluated. RESULTS: In this study, 44 (27 boys and 17 girls) children with CF were included. Mean age of the studied population was 55.63 (33.2) months. In the studied patients with CF, 90.9% had a z score of -2_+2 (normal range) for BMI, 72.7% for weight, and 70% for height. From children with CF, 18 (40.9%) had FENa less than 0.5, 17 (38.6%) had FENA between 0.5-1.5, and 9 had FENa >1.5. From studied patients with CF, 16 (88.9%) had normal serum Na levels, but the FENa was ≤0.5. Based on the Spearman correlation test, there was not any significant correlation between FENa classification and the Z score of weight (P=0.92), height (P=0.83), and BMI (P=0.99). CONCLUSION: Our findings indicated that most patients with a low level of FENa had normal serum sodium levels. We did not find a significant association between FENa and growth parameters. The association had a trend to be significant for BMI. It is suggested that it may be due to appropriate follow-up of the studied population. However, it is recommended to plan more studies by including healthy subjects to obtain results that are more accurate.

Cognitive function in untreated subjects with mild hyperphenylalaninemia: a systematic review.

BACKGROUND: This systematic review study aims to evaluate the cognitive function of patients with mild hyperphenylalaninemia (mHPA) without treatment. METHODS: A systematic literature search was done from the 1st of May to the 30th of July in 2021 on published studies. The search strategy was ((hyperphenylalaninemia) OR (phenylketonuria) AND (cognition)). We use PubMed, Scopus, and the Web of Science databases. Studies which reported their findings regarding the cognitive function of patients with mHPA (screening serum phenylalanine > 120 and < 600 µmol/L) were included and reviewed. RESULTS: From initially retrieved 2805 studies, finally, 15 studies (10 on untreated patients with Phe levels below 360 µmol/L, 7 on untreated patients with Phe levels between 360 and 600 µmol/L, four 120-600 µmol/L) were selected. Most of the studies used the Wechsler Intelligence Scale for IQ evaluation, two (2/15) of them used the Stanford-Binet test and two used both tests. Four studies have reported a worse cognitive outcome compared to the control group, and in one study, relative defects in attention and working memory were reported. Other studies have reported normal IQ levels and no significant cognitive defects. CONCLUSION: It is suggested that Phe levels between 120 and 360 µmol/L are generally safe. Some studies showed that untreated patients with higher levels might show some degrees of cognitive impairment. In conclusion, current knowledge is insufficient to state that treatment is not required for HPA patients to preserve their cognitive status, especially in patients with Phe levels of 360-600 µmol/L. Further studies with a larger sample size and standardized cognitive function evaluation tools are needed.

Clinical, laboratory and imaging characteristics, and outcomes of hospitalized children with suspected COVID-19 infection: A report from Isfahan-Iran.

Background: The aim of this study was to evaluate the clinical, laboratory and imaging characteristics, and outcomes of hospitalized children with suspected COVID-19 infection in Isfahan. Materials and Methods: In this cross-sectional study, all children aged < 15 years, who hospitalized as suspected case of COVID-19 were enrolled. During this study, all demographic, clinical, laboratory, and imaging characteristics as well as follow-up data and outcomes of the hospitalized children were recorded by pediatric residents using a questionnaire. The findings of studied populations in the two groups of definite/or suspected and negative COVID-19 patients were compared. Results: During 6 months' period, 137 children with suspected COVID-19 infection were evaluated. Mean age of studied population was 4.3 (0.38) years. The most common symptoms in order were fever, cough, dyspnea and diarrhea. The most common computed tomography scan findings were bilateral ground glass and subpleural involvements. The rate of mortality was 7.3%. COVID-19 polymerase chain reaction test was positive in 22% of the patients. Based on the specialist's diagnosis, 30/25 patients were definite/or suspected to COVID-19 and reminder (79) were negative. O2 saturation <90%, was significantly higher in children with definite/or suspected diagnosis for COVID-19 (46.7% vs. 22.4%, P < 0.05). Dyspnea and shivering were significantly higher in children with definite/or suspected diagnosis for COVID-19 than those negative for COVID-19(P < 0.05). Mean duration of hospitalization was significantly associated with level of lactate dehydrogenase (P < 0.05). Conclusion: The clinical, laboratory, and imaging findings of our studied population were similar to other studies, but outcome was not similar which may be due to our studied population (inpatients cases). It is suggested that a better understanding of the infection in children may give important insights into disease pathogenesis, health-care practices, and public health policies.

Prevalence of Nonalcoholic Fatty Liver Disease in Children with Renal Failure Underwent Treatment with Dialysis.

Background: In this study, we aimed to investigate the prevalence of nonalcoholic fatty liver disease (NAFLD) in children with renal failure under treatment with dialysis and its association with biochemical measurements. Methods: In this cross-sectional study, children aged less than 18 years with chronic kidney disease (CKD) who were under treatment with dialysis at least 3 months ago were enrolled. To evaluate fatty liver in those patients who had no recent liver ultrasonography (last 6 months), liver ultrasonography was performed. The characteristics of patients with renal failure with and without NAFLD based on the ultrasonographic evaluation were compared. The association between NAFLD and the studied variables was evaluated. Results: In this study, 39 children (31 males and 8 females) with renal failure who underwent treatment with dialysis were included. From the studied population, six (19.4%) had NAFLD based on ultrasonographic evaluation. There were no differences between renal failure patients with and without NAFLD regarding the biochemical and anthropometric characteristics (P > 0.0). Conclusions: The prevalence of NAFLD in our studied children with renal failure who underwent treatment with dialysis was like the general population and it was not associated with the biochemical and anthropometric characteristics of the patients. Given the importance of NAFLD in renal failure patients as well as its subtle nature, it is recommended to screen patients with CKD for NAFLD.

Prevalence of nephrocalcinosis in children with congenital adrenal hyperplasia.

Background: We aimed to investigate the prevalence of nephrocalcinosis (NC) among children with diagnosed congenital adrenal hyperplasia (CAH). Our findings would be helpful for earlier diagnosis, management, and prevention of NC-related complications. Materials and Methods: In this cross-sectional study, children with CAH, aged <18 years old who were regularly referred for follow-up, were included. The information of the patients was extracted from their medical files, and they underwent renal ultrasonography for evaluation of the presence of NC. Results: From 120 studied patients with CAH, four patients (3.3%) had NC. The prevalence of NC was higher in males than females (P = 0.05). Mean age and age of CAH diagnosis had a trend to be lower in CAH patients with NC than those without. Regression analysis indicated significant association between NC and sex (P = 0.027, r = 2.24). Conclusion: The results of this study indicated a 3.3% prevalence rate of NC for children with CAH. NC had a trend to be more prevalent in male children with CAH. Though it was not significantly different but given that the mean age and age at diagnosis of CAH in children with CAH and NC was lower that CAH patients without NC, it is suggested that in patients with CAH and NC other factors such as genetic background or unknown disease related factors are associated with hypercalcemia and NC.

The Association between Exposure to Air Pollution and Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis.

Background: This systematic review and meta-analysis aimed to overview the observational studies on the association of exposure to air pollution and type 1 diabetes mellitus (T1DM). Materials and Methods: Based on PRISMA guidelines, we systematically reviewed the databases of PubMed, Scopus, Embase, and Web of Science databases to determine the association of air pollution exposure and T1DM. Quality assessment of the papers was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for observational studies. The odds ratios (OR) and their 95% confidence intervals (CI) were calculated to assess the strength of the associations between air pollutants (gases and particulate matter air pollutants including PM10, PM2.5, NO2, volatile organic compound, SO4, SO2, O3) and T1DM. Results: Out of 385 initially identified papers, 6 studies were used for this meta-analysis. Fixed effects meta-analysis showed a significant association between per 10 µg/m3 increase in O3 and PM2.5 exposures with the increased risk of T1DM (3 studies, OR = 1.51, 95% CI: 1.26, 1.80, I 2 = 83.5% for O3 and two studies, OR = 1.03, 95% CI: 1.01, 1.05, I 2 = 76.3% for PM2.5). There was no evidence of association between increased risk of T1DM and exposure to PM10 (OR = 1.02, 95% CI: 0.99-1.06, I 2 = 59.4%), SO4 (OR = 1.16, 95% CI: 0.91-1.49, I 2 = 93.8%), SO2 (OR = 0.94, 95% CI: 0.83-1.06, I 2 = 85.0%), and NO2 (OR = 0.995,95% CI: 1.05-1.04, I 2 = 24.7%). Conclusion: Recent publications indicated that exposure to ozone and PM2.5 may be a risk factor for T1DM. However, due to limited available studies, more prospective cohort studies are needed to clarify the role of air pollutants in T1DM occurrence.

Effects of Two Different School-Based Training on Serum miR15b Expression and Lipid Profile of Adolescents with Obesity.

Background: Some circulating microRNAs, such as miR15b, are predictors of diseases associated with adulthood obesity. This study aimed to evaluate the effect of two selected school-based and high-intensity interval training (HIT) on miR15b expression and lipid profile of obese adolescents. Methods: Thirty-eight adolescent males (12 ± 1 years) with obesity (body mass: 74.7 ± 13.2 kg, body mass index (BMI): 26.0 ± 2.3 kg/m2, and body fat (BF): 27.2 ± 3.6%) were randomly assigned to the following based on the age-related body mass index: (i) HIT (n = 13), (ii) school-based exercises (SBE, n = 13), and (iii) control (n = 12) groups. Mir15b was extracted using the RT-PCR system, and lipid profile was studied using the enzymatic colorimetric method before and after 12 weeks. Three training sessions were held each week during the course. Results: Following the exercise interventions, in both training groups, miR15b (HIT: -63.8 vs. SBE: -56. 7%; P = 0.001), cholesterol (HIT: -8.8 vs. SBE: -9.2%; P = 0.025), and low-density lipoproteins levels (SBE: -13.1 vs. -20.8%; P = 0.48) decreased; however, the peak oxygen uptake of subjects increased (HIT: 4.0 vs. SBE: 4.0%; P = 0.003). However, there were no significant differences in triglyceride (HIT: -16.9 vs. SBE: -8.3%; P = 0.134), and high-density lipoprotein (HIT: 3.1 vs. SBE: 4.8%; P = 0.479) levels between both intervention and control groups (P > 0.05). Conclusions: The results showed that both types of exercises had almost similar effects on reducing miR15b expression and improving the lipid profile. Hence, based on the difficult nature of HIT for children with obesity, further use of school-based exercises is suggested.

Factors related to glycemic control in children and adolescents with type 1 diabetes mellitus in Isfahan, Iran.

PURPOSE: Glycemic control is traditionally evaluated by monitoring of hemoglobin A1c (HbA1c). This study aims to explore factors related to glycemic control among pediatrics with type 1 diabetes mellitus (T1DM). METHODS: This cross-sectional study was conducted among 454 students aged 6-18 years with T1DM in 2018. Demographic and disease related information were collected by a validated questionnaire. Generalized Linear Models (GLM) were used to investigate the association of explanatory variables with HbA1c concentration. RESULTS: The mean (SD) age of the participants was 11.7(± 3.3) years. The overall prevalence of suboptimal glycemic control was 85.5% (HbA1c ≥ 7%). Results showed that post pubertal children experienced a significant decrease in HbA1c levels compared to prepubertal children (ß =-0.83, p = 0.003). Underweight children had an increase of 1.32% in HBA1c concentration compared with normal weight children (ß = 1.32, P = 0.007). We also found that participants with passive smoking had higher HBA1c levels than those without (ß = 0.536, P = 0.022). CONCLUSIONS: The results indicated that age, BMI and passive smoking and were significantly associated with HbA1c levels. It is suggested that glycemic control is related to multiple factors and the interaction of these factors with each other may have positive or negative effects on it which should be investigated in future studies. Improved understanding in this area could lead to prevention of deterioration in glycemic control.

Isfahan Thyroid Cohort Study (ITCS).

BACKGROUND: The Isfahan Thyroid Cohort Study (ITCS) is one of the few population-based epidemiological studies in Iran that investigates the prevalence and incidence of thyroid disorders including hypothyroidism, hyperthyroidism, goiter, nodule, and iodine status. METHODS: This cohort is located in Isfahan, Iran. The first phase was initiated in 2006 with 2523 participants (1275 males, 1248 females). The participants were selected using multi-stage cluster sampling from the general residents of Isfahan, Iran. The study had two phases (2006 and 2011) and its third stage is planned for 2020-2021. RESULTS: The prevalence of thyroid function states was euthyroid (89.3%, 95% CI: 88%-90%), overt hypothyroidism (2.8%, 95% CI: 2%‒3%), subclinical hypothyroidism (5.8%, 95% CI: 4%-6%), overt hyperthyroidism (0.8%, 95% CI: 0.4%‒1%), and subclinical hyperthyroidism (0.99%, 95% CI: 0.6%-1%). Hypothyroidism and hyperthyroidism were significantly associated with goiter. The incidence of thyroid dysfunction was reported as follows: overt hypothyroidism (2.7, 95% CI: 1.6-3.7), subclinical hypothyroidism (20.6, 95% CI: 18-23), overt hyperthyroidism (1.9, 95% CI: 1-2.7) and subclinical hyperthyroidism (2.7, 95% CI: 1.6-3.7) per 1000 (person-year). CONCLUSION: We assessed the prevalence and incidence of thyroid disorders in Isfahan in the first and second phase, respectively. We are conducting the third phase of the ITCS in order to study the associations between thyroid peroxidase antibody (TPOAb) level and environmental factors such as infection.

The association between familial and environmental factors and prevalence of congenital hypothyroidism in center of Iran.

The aim of this current study is to investigate the association between familial and environmental factors and prevalence of congenital hypothyroidism (CH) in Isfahan province. In this retrospective cohort study, data of the neonates referred for CH screening in different cities of Isfahan province were evaluated. Data regarding air and soil (lead, cadmium) pollutants were collected. The spatial association between mentioned environmental pollutants and prevalence of CH in different cities of Isfahan province was evaluated by using GIS software, and multilevel linear regression was used for evaluating the levels of environmental pollutants and neonates' serum TSH. During the study period, 389,945 neonates were screened, from which 934 diagnosed with CH (1 in 417 neonates).The prevalence rate of CH was ranged from < 20 in 10,000 live births to > 45 in 10,000 live births in different cities of Isfahan province. There was no any significant association between level of soil lead and cadmium and air pollutants with prevalence of CH in different cities of Isfahan province (P > 0.05).There was a significant positive association between soil cadmium and air pollution evaluated by air quality index (AQI) and level of screening serum TSH in CH patients. Considering the significant association between cadmium and AQI with first serum TSH, it is inferred that the interaction of genetic, autoimmune, familial, and environmental factors with each other could influence on neonatal thyroid function. It seems that the role of some mentioned component is more prominent which should be investigated in future researches.