Evaluation of levels of uric acid and lipid profile in hospitalized patients with diabetes.

OBJECTIVE: Diabetes is the most common metabolic disorder that leads to various complications, and among these complications, disruption in the lipid profile and serum uric acid (SUA) is one of the significant cases that can lead to the deterioration of the health status of patients with diabetes. So, we aimed to evaluate the level of SUA and lipid profiles in patients with diabetes. A total of 230 patients with diabetes who were admitted to Razi Hospital, Rasht, Iran, were enrolled in this study. Demographical data and clinical characteristics of the patients include gender, body mass index (BMI), duration of diabetes, history of smoking, FBS, HbA1c, SUA, Creatinine (Cr), Cholesterol (Chol), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG), retinopathy, hypertension, ischemic heart disease (IHD), and microalbuminuria were recorded. All data were analyzed using the SPSS version 21 by a significant level < 0.05. RESULT: According to our results, 70 were male, and 160 were female, with a mean age of 57.36 ± 8.05 years and a mean BMI of 28.10 ± 4.62. The most frequent comorbidities were hypertension, 67%. The serum level of FBS, HBA1c, SUA, Cr, Chol, LDL, HDL, and TG were 191.47 ± 71.66 mg/dL, 7.94 ± 1.21 mg/dL, 5.65 ± 1.95 mg/dL, 0.94 ± 0.16 mg/dL, 167.28 ± 45.22 mg/dL, 95.91 ± 37.03 mg/dL, 39.78 ± 10.44 mg/dL, and 186.75 ± 76.65 mg/dL, respectively. Only UA had a significant relationship with TG level (P < 0.05).

Preventable Prenatal and Neonatal Risk Factors of Type 1 Diabetes in Childhood.

Background: Childhood type 1 diabetes mellitus (T1DM) is an autoimmune disease which is increasing in incidence, but little is known about the events that trigger the autoimmune process. Most of the time, these processes begin in prenatal and natal periods; therefore, this study aimed to investigate the prenatal and neonatal risk factors of T1DM in childhood. Methods: This case-control study has been performed on children with T1DM who referred to the 17th Shahrivar children's hospital. The control group consisted of healthy siblings of the case group. Data were gathered using a form that included maternal and neonatal characteristics. Data were reported by descriptive statistics in SPSS 19. To investigate the effect of quantitative and qualitative variables on the development of T1DM, logistic regression and Chi-square tests were used, respectively. Results: Birth weight, birth height, and maternal weight gain during pregnancy had a significant relationship with T1DM (odds ratio [OR] = 1.23, 2.57, and 1.14, respectively). In addition, there was a significant relationship between gestational hypertension (OR = 5.27), neonatal jaundice (OR = 3.42), cesarean section (OR = 2.06), and being non-first-born child (OR = 2.32) and T1DM. Also, premature rupture of membrane, maternal urinary tract infection, and nonexclusive breastfeeding had a significant association with T1DM (OR = 4.37, 3.94, and 2.30, respectively). There were no statistically significant differences between maternal age, sex, neonatal respiratory disease, prematurity, and neonatal infections and T1DM (P > 0.05). Conclusions: Prenatal and neonatal risk factors can have a significant role in the occurrence of TIDM. Therefore, considering these risk factors can have a preventive effect on T1DM.

Assessment of the work ability related factors in diabetic patients.

Diabetes is a common disease all around the world. Diabetes can reduce work and job restrictions. The aim of this study was to assessment of work ability (WA) related factors in diabetic patients. All demographic, occupational, and clinical information of 176 diabetic patients who were referred to the Razi hospital Rasht, Iran, in 2021 was collected. Also, the WA questionnaire for patients with a score from 7 to 49 was completed. The mean score of WA in patients was 28.8. 46.6%, 28.4%, 22.2%, and 2.8% of patients had weak, moderate, good, and excellent WA, respectively. There was a significant association between age, body mass index (BMI), marital status, education, habitat, health insurance status, type of job, job satisfaction status, work shift, underlying disease, history of diabetes, complications of diabetes, fasting blood sugar (FBS), hemoglobin A1c (HbA1C), and WA of patients (P < 0.05). Analysis showed that the variables of job satisfaction and the presence of diabetes complications were significantly associated with the WA. Nearly half of the diabetic patients had weak WA, in which demographic, occupational, and diabetes related factors were associated with weak WA.

The relationship between glycated hemoglobin A1c levels and exacerbation status in the patients with chronic obstructive pulmonary disease.

OBJECTIVE: This study was performed in Razi Hospital, Rasht, Iran, between March 2016 and August 2018 on a population of chronic obstructive pulmonary disease (COPD) patients (56 as COPD exacerbation group and 56 as COPD stable group). Study variables include age, sex, occupation, body mass index (BMI), cigarette consumption, duration of COPD, annual hospitalization, dyspnea, glycated hemoglobin (HbA1c), FEV1, and FEV1/FVC indices. RESULT: The mean age of the participants was 63.92 ± 10.75 years. There was a significant difference in the hospitalization between the patients with both exacerbation and normal state of COPD (P ≤ 0.001). HbA1c in the patients with exacerbation of COPD was significantly higher than stable status (P = 0.001). Logistic regression showed that HbA1c levels and hospitalization were predictors of exacerbation of COPD. HbA1c levels were statistically significant in terms of hospitalization in patients with COPD exacerbation. There was a significant difference between the HbA1c levels and MMRC in patients with COPD. The percentage of HbA1c was associated with exacerbation of COPD and HbA1c is a good predictor of disease severity in patients with COPD. It also shows that patients with COPD exacerbation and severe COPD are at the higher risk of hyperglycemia.

HOMA-IR index in non-diabetic patient, a reliable method for early diagnosis of liver steatosis.

Background: NAFLD is one of the most common liver diseases in the world. HOMA-IR as an indicator of insulin resistance is commonly used in clinical trials in NAFLD patients. The aim of this study was to evaluate the application of HOMA-IR index in the diagnosis of NAFLD. Methods: This study was performed on 54 patients with NAFLD and 54 non-NAFLD patients that referred to Razi Hospital in Rasht during 2019-2020. FibroScan was used to diagnose NAFLD in the patient group and ultrasound was used to rule it out in the control group. Metabolic and hepatic parameters were measured for each patient. Data were entered into SPSS 22 software and the necessary analyses were performed. Results: The mean age of the subjects in the study was 44.01±13.12 years and ranged from 18 to 75 years. 72.2% of people affected by NAFLD were men (p <0.001) .The optimal cut-off point for HOMA-IR in NAFLD was 1.65 with a sensitivity of 89.7% and a specificity of 76.9% in men and 1.90 with a sensitivity of 86.7% and a specificity of 82.9% in women. Overall, the optimal cut-off point for HOMA-IR in NAFLD was 1.75 with a sensitivity of 87.0% and a specificity of 81.5%. In addition, the results showed that there was no significant relationship between steatosis and hepatic fibrosis with HOMA-IR index. Conclusion: The results showed that HOMA-IR can be used as a reliable criterion for early detection of NAFLD.

The Cutoff of Gonadotropins for Close Evaluation of Cardiometabolic Risk Factors in Turner Syndrome.

Background: Turner syndrome is a common genetic disorder in females. It is a disorder characterized by variable number of clinical features, so it needs a multidisciplinary approach for care. Therefore, we aimed to define the cutoff of gonadotropins for close evaluation of cardiometabolic risk factors in Turner syndrome. Methods: This is a case-control study on 31 patients with Turner syndrome and 31 healthy individuals. Clinical examination including blood pressure measurement and systems evaluation was performed. Laboratory testing, which included 12-h fasting, assessed lipid profile, glucose, and serum gonadotropin. Results: Turner syndrome had a higher BMI, systolic, and diastolic blood pressure than the normal group (P < 0.001) Patients with Turner syndrome had significantly higher total cholesterol, low-density lipoprotein, triglyceride, and TG-to-high-density lipoprotein ratio compared to the healthy individuals (P < 0.05). With increasing LH and FSH, BMI values, systolic blood pressure, and total cholesterol increased significantly (P < 0.001). Serum TG levels in Turner syndrome were only positively correlated with LH and not correlated with FSH. The cutoff point of LH and FSH for triglyceride in upper 75 percentile were 31 (sensitivity = 38.1%, specificity = 80%) and 48 (sensitivity = 61.9%, specificity = 70%), respectively. Conclusions: Based on dyslipidemia and lower level of ejection fraction, considering cardiometabolic risk factors in lower age groups in Turner syndrome can be recommended.

Dermoscopic Findings of Alopecia in Patients with Hypothyroidism.

Background: Thyroid hormones are essential for the growth and maintenance of hair follicles. Numerous studies have evaluated the relationship between thyroid disorders and hair loss. However, no study has assessed the dermoscopic results in patients with hypothyroidism and hair loss. Objectives: This study aimed to investigate dermoscopic findings of alopecia in patients with hypothyroidism. Methods: This analytic cross-sectional study was performed on patients with hair loss referred to dermatology clinics of Guilan University of Medical Sciences, Iran. Hypothyroid patients and an equal number of euthyroid individuals were compared. After recording the demographic and clinical characteristics, all patients were subjected to hair dermoscopy. Results: A total of 164 patients with and without hypothyroidism with hair loss were studied. The frequency of hair shaft abnormalities (P < 0.001) and vellus hair (P < 0.001) significantly differed between the two groups. Dermoscopic findings related to scale abnormalities (P = 0.002) and their perifollicular type (P < 0.001) significantly differed between the groups. Vascular changes (P < 0.001), perifollicular concentric type (P = 0.012), and interfollicular red loops type (P = 0.005) were significantly higher in patients with hypothyroidism. Also, based on the multiple logistic regression model, the chance of abnormalities of the hair shaft, scales, and vascular changes increased by 3.24, 2.73, and 3.53, respectively, in hypothyroidism compared to euthyroidism. Conclusions: Regarding the promising results of this study, we could detect possible dermoscopic signs of inflammation in hypothyroid patients with hair loss. Further investigations are needed because there is a shortage of evidence on this novel diagnostic method.

Diabetic foot care: knowledge and practice.

BACKGROUND: Diabetic foot ulcers (DFUs) are common problems in diabetes. One of the most important factors affecting the quality of diabetes care is knowledge and practice. The current study aimed at determining the knowledge and practice of patients with diabetes regarding the prevention and care of DFUs. METHODS: The current analytical, cross sectional study was conducted in Guilan Province (north of Iran) on 375 patients registered in the medical records as type 2 diabetes mellitus. Demographic characteristics, knowledge, and practice of participants were recorded in a questionnaire during face-to-face interviews conducted by the researcher. Descriptive and inferential statistics were performed using SPSS version18. RESULTS: The mean score of knowledge was 8.63 ± 2.5 out of 15, indicating that the majority of participants had a poor knowledge (84.8%). The mean practice score was 7.6 ± 2.5 out of 15, indicating that a half of them had poor performance (49.6%). There was a significant and direct correlation between knowledge and practice. Knowledge level, place of residence, marital status, and history of admission due to diabetic foot were predictors of practice score. CONCLUSIONS: According to the low level of knowledge and practice in patients with diabetes regarding the prevention and care of DFUs, and considering the significant relationship of some demographics of patients with knowledge and practice scores, a targeted educational program is needed to promote knowledge of patients with diabetes.

The relation between changes in thyroid function and anthropometric indices during long-term follow-up of euthyroid subjects: the Tehran Thyroid Study (TTS).

OBJECTIVE: Uncertainties exist regarding the causal relationship between thyroid function tests (TFT) within the euthyroid range and anthropometric measures. This longitudinal cohort is aimed to examine the relationship between the two conditions. SUBJECTS AND METHODS: Euthyroid participants of Tehran Thyroid Study (TTS) attending phase I (1999-2001) were included in this study and were followed up to phase IV (2008-2011). TSH and free T4 (fT4) levels as well as weight (Wt), waist circumference (WC), hip circumference (HC) and waist-to-hip ratio (WHR) were measured at both phases. RESULTS: 971 women and 784 men were included in the analysis. During 9.7years of follow-up, increases in TSH levels, Wt and WHR as well as a decrease in fT4 level were observed. Multivariable regression analysis showed a significant relationship between TSH changes and alterations in WC in women (ß=0.69, P=0.021) and men (ß=0.61, P=0.038). Moreover, a significant negative association of ΔfT4 with changes in weight was documented (ß=-0.49, P=0.001 in women and ß=-0.56, P<0.001 in men). Additionally, we found a negative relationship between ΔfT4 and ΔHC in men (ß=-0.36, P=0.001). CONCLUSION: In both genders, there was a positive relationship between changes in TSH and waist circumference and conversely a negative association of changes of fT4 levels with weight over time.