مجله غدد درون ریز و متابولیسم ایران
سال شانزدهم شماره 4 (پیاپی 76، مهر و آبان 1393)

Diabetes is a chronic، progressive illness with the potential for debilitating physical and mental complications. Patients’ views about health، illness، control and treatment are predictive of the outcome of changes in lifestyle and treatment planning. The aim of this study was to explore diabetic women''s views about the disease and the consequences experienced due to diabetes. A qualitative approach، thematic analysis method، semi-structured interview study was conducted in Ahvaz in 2013. Forty diabetic women were interviewed individually using purposeful sampling. Interviews were recorded and typed verbatim and analyzed using constant comparison simultaneously with data collection. After collecting and analyzing the data، 117 initial codes، 14 second level codes and 3 main codes emerged. The main concepts were 1-different feelings about their health and illness status، 2- psychological and mental symptoms، 3- restrictions experienced due to the control and treatment of the disease. Diabetic women believed that diabetes is a serious illness and negative views about insulin were common. Subcategories were worried about hypoglycemia after insulin injections، fear of disability due to the disease، further progression of diabetes، fear and embarrassment of insulin injection and cost of follow-up and treatment of the disease. Negative attitudes towards diabetes were common. Contradictory patient views about health can play an essential role in self-care practice and since patients with diabetes experience many problems، a thorough underst anding of these can contribute to planning health care for these patients.

The effects of exercise training on GLUT4 protein expression have been examined in several studies whereas those of aerobic training along with the use of plant extracts on muscle GLUT4 protein expression are unknown. The aim of the present study was to investigate the effects of aerobic training and Pistacia athlantica extract on GLUT4 protein expression and glycogen level in the gastrocnemius muscle of diabetic rats. Forty-male Wistar rats were randomly divided into five groups: Healthy control، diabetic control، diabetic+aerobic training، diabetic+extract and diabetic+aerobic training+extract. The program included six weeks of aerobic training on the treadmill. Forty eight hours after last session of training and consumption the extract، the rats were anesthetized and gastrocnemius muscle was isolated for measurement of glycogen levels and GLUT4 protein expression. Data was analyzed by using one-way ANOVA test (P<0. 05). GLUT4 protein expression and glycogen levels in gastrocnemius muscle in diabetic+aerobic training+extract group were significantly higher than in the diabetic control group (P values 0. 001، 0. 02 respectively)، whereas these variables in the aerobic training and the Pistacia athlantica extract perse groups did not change compared to the diabetic control group. It seems that Pistacia athlantica extract along with specific exercises، compared to utilization of each of strategies perse، are more effective in increasing glucose transporter proteins and possibly improving insulin function.

The fast increasing prevalence of childhood obesity makes it necessary to prioritize effective treatment strategies to deal with this problem. The purpose of this study was to investigate the effectiveness of family-based cognitive behavioral therapy in weight reduction among children with obesity. A randomized controlled trial with pre-test، post-test، and follow-up assessments was conducted. Thirty children with obesity and Body mass index (BMI) ≥ 95th percentile for age and gender، were selected by convenience sampling from patients attending the Amirkabir Hospital and Morsali Clinic in Arak، and were randomly assigned to the experimental group (n=15) under administration of family-based cognitive behavioral therapy for a duration of six group sessions per week) and a control group (n=15). Patients were weighed at the beginning of each session and Body mass index (BMI) was measured for all participants in three phases of pre-test، post-test and follow-up. The results of analysis of variance with repeated measures indicated that this intervention was effective in reducing body mass index. According to the results، family-based cognitive behavioral therapy is an effective method for treating of childhood obesity، and may be applicable in future research and possible clinical applications in this field.

This study aimed to determine inefficiencies in current educational programs for promoting of healthy lifestyles and prevention of obesity from the perspective of adolescents and mothers. This was a qualitative study conducted based on a grounded theory approach. To collect data، 23 personal interviews and 12 semi-structured focus group discussions were conducted with overweight/obese adolescents and mothers who had at least one overweight/obese child. To maximize the variation of participants’ experiences with different socio-economic backgrounds، two demographically diverse areas from the north and south of Tehran were selected and followed with theoretical sampling. All the interviews and focus group discussions were audio recorded and transcribed verbatim. Data collection and analysis were done simultaneously، using the Strauss and Corbin analysis method. In the current study، inefficient education was explored using two main themes including “Single dimensional curriculum of schools” and “Inefficient public education”. The single dimensional curriculum of schools was found to be characterized by “lesson-based curriculum” and “burdensome educational programs” and the inefficient public education was characterized by “inappropriate content”، “lack of comprehensive educational program”، “inapp­ropriate ways of messaging” and “contradictory messages”. Based on the findings of this study، “single dimensional curriculum of schools” and “Inefficient public education” were the main correlates of inefficient education in our society، which led to obesity-related behaviors and consequently excessive weight gain in Tehranian adolescents. The results of this study may be effective in prioritizing and designing health promotion programs aimed at promoting healthy lifestyles and prevention of obesity in children and adolescents.

Epidemiological studies show that consumption of dairy products plays an important role in prevention and treatment of the metabolic syndrome (MetS). The objective of this study is to examine the relation between dairy intake with MetS and its components in Tehranian adolescents. In this cross-sectional study، 785 adolescents، aged 10 to 19 years، participants of the fourth phase of the Tehran Lipid and Glucose Study were selected. Usual dietary intake was assessed using a valid semi-quantitative food frequency questionnaire. Total dairy، low fat and high fat dairy، milk، yoghurt and cheese were and anthropometrics، biochemical measurements and blood pressure were assessed. MetS was defined according to the de Ferranti criteria. Mean age of subjects was 14. 8 ± 2. 9 years. The prevalence of MetS was 22. 2% (girls: 19. 5% and boys: 25. 2%). The most prevalent component for MetS among boys was high waist circumference (53. 4%) and among girls was low HDL-C (53. 1%). Energy density and intake of protein، total fat، saturated fat، cholesterol، calcium and phosphor were higher in the highest quartile of dairy consumption، than in the lowest quartile. After adjustment for confounders، odds ratios with 95% confidence interval for MetS in the highest quartiles of total dairy، low fat dairy، high fat dairy، milk، yoghurt and cheese were 0. 97 (0. 57-1. 66)، 1. 44 (0. 83-2. 49)، 0. 97 (0. 56-1. 67)، 0. 70 (0. 42-1. 18)، 1. 62 (0. 99-2. 64)، 0. 72 (0. 44-1. 18) respectively، compared to the lowest quartile. Results of this study do not support the hypothesis that consumption of dairy products protects against MetS and its components.

Menopause is defined as 12 months of constant amenorrhea in the absence of any pathology. Right now there is no definite test to predict menopause age and the ovarian reserve evaluations are mainly implemented on the basis of sonographic and hormonal measurements. The present study was conducted to determine and compare the menopausal age in women with polycystic ovarian syndrome (PCOS) and non PCOS women based on anti-mullerian hormone (AMH). The present study is an epidemiologic case- control research in which from among 1019 women aged 20-40years، 208 PCOS women and 811 normo-ovulatory controls were selected as the case and control groups respectively. Data collection was done through completing questionnaire، clinical examination and lab test measurements. After age and body mass index (BMI) matching، AMH levels in relation to age were displayed in an interactive graph and SPSS software version 21 was used for statistical analysis. Findings showed the mean age and BMI for case and control groups were 29. 75 years – 27. 1 (kg/m2) and 31. 62 years – 26. 1 (Kg/m2) respectively. Our results indicated significantly higher AMH levels in PCOS cases than in normal controls (P<0. 0001). The estimated menopausal age for PCOS and non PCOS women was 51 and 49 years respectively. To conclude PCOS patients reach menopause two years later than healthy women. If the length of reproductive period in these patients is higher than that the healthy women، it may be possible to use this period for increasing the fertility likelihood.

Fish are useful models for physiological studies in which using nutritional، growth and hormonal indices can lead to the understanding of several biological mechanisms in vertebrates. In this study، the effects of the addition of two amino acids، L-arginine and L-ornithine، to a commercial feed on the growth indices and the blood levels of insulin-like growth factor-I (IGF-I) of rainbow trout، Oncorhynchus mykiss were examined. The fish (average initial weight 45±4 g) were fed for 8 weeks with one of the following 4 dietary treatments: Commercial trout diet supplemented with 2% L-arginine- (T1) 2% L-ornithine- (T2) 2% L-arginine + 1% L-ornithine- (T3); 3% L-arginine + 1% L-ornithine- (T4) and the commercial feed without addition of the amino acids (controls). According to the results، maximum weight gain (268. 94±5. 84%) and specific growth rate (SGR) (2. 33±0. 05% day–1) were observed in the fish of group T3، while maximum hepatosomatic index (HSI) (1. 49±0. 04%) was recorded in group T4. These amounts were significantly higher than their counterpart indices of the control group (P<0. 05). Supplementing the feed with the amino acids، overall، increased IGF-I levels throughout the study period. At the end of the eighth week، in the T3 and control groups maximum and minimum IGF levels were 1180 pg/ml and 980. 35 pg/ml respectively. Results of this study showed the positive effects of providing fish diet with additional amino acids، especially a combination of arginine and ornithine، on growth promotion in rainbow trout.