مجله غدد درون ریز و متابولیسم ایران
سال هفدهم شماره 4 (پیاپی 82، مهر و آبان 1394)

No study has yet been conducted evaluate the factors influencing the growth of patients with congenital hypothyroidism (CH), in Iran. The high prevalence of this disease in Iran, particularly in Isfahan, made it necessary to investigate biomedical diagnostic and early treatment factors potentially affecting growth status among patients with CH. In this prospective cohort study, 760 CH neonates (born 2002-2010), diagnosed and followed up (minimum 1, maximum 5 years) during the CH screening program in Isfahan were enrolled. Height, weight and head circumferences of the patients, during follow up and in subsequent periods, were measured. Diagnostic and therapeutic factors included serum T4 and TSH concentration at diagnosis and after treatment initiation, age at onset of therapy, initial dosage of levothyroxine and age at first normalization of T4 and TSH. Quantile regression for longitudinal data was used for investigating the effects of main factors determining growth development. R free software was used for analyzing data. Longitudinal growth in height and weight was significantly correlated with age at onset of therapy and initial dosage of treatment (p<0.01), while head circumference was associated only with initial dosage (P<0.05). Increase in weight and head circumference were affected by serum TSH concentration at diagnosis (p<0.05), and age of T4 normalization also had significant impact, on some of the proposed quantiles, i.e. weight (p<0.05), height (p<0.01) and head circumference (p<0.001). Among the factors studied, initial dosage of treatment and age at onset of therapy seem to be more important factors for growth development, suggesting that more optimal outcomes are possible through earlier treatment and appropriate levothyroxine dosage.

Leptin is a polypeptide produced by many cells, including adipocytes and appetite regulation is one of the most important functions. This hormone is a molecule with high potential to participate in a wide range of physiological and pathological functions that increase during pregnancy. During labour, leptin levels increase significantly, which can explain the difference between maternal serum leptin levels in vaginal delivery and cesarean section. Therefore, In this study, we compared maternal serum leptin levels during the third trimester of pregnancy and postpartum in the two groups of women delivered by vaginal delivery and caesarean section. In this a nested case-control study of 166 pregnant women, maternal serum leptin levels at 28-32 weeks gestation and the first 24 hours after birth were measured. Data were analyzed by using the t-test, Fisher and Chi-square tests. Test results indicated a significant difference in serum leptin levels in both women before and after vaginal delivery and elective caesarean delivery (P>0.001) and (P=0.004) respectively. Maternal serum leptin levels in the first 24 hours after birth in the two groups showed significant difference (P>0.001). Maternal serum leptin levels were significantly higher after vaginal delivery than after cesarean section. Given the widespread effects of leptin on maternal and neonatal outcomes, vaginal delivery is recommended as the preferred method.

Metabolic syndrome (MetS) is a cluster of interrelated risk factors for cardiovascular disease (CVD) and diabetes. The aim of this study was to investigate the effect of the healthy diet with sesame seed consumption on anthropometric indices, lipid profile and atherogenic index of plasma (AIP) in overweight and obese women with MetS. In this clinical trial, 51 overweight and obese women with MetS were given recom­mendations for a healthy diet with (n=22) and without (n=24) supplementation 50 g/day of sesame seed powder for 6 weeks. Weight, Body Mass Index (BMI), waist circumference, waist circumference to height ratio, percentage of body fat mass, LAP (Lipid Accumulation Product) and serum levels of triglycerides (TG), total cholesterol (TC), LDL-C, HDL-C, LDL-C/HDL-C ratio, TC/HDL-C ratio and AIP were determined at baseline and at the end of the study. Reductions in weight, waist circumference, and BMI were not significant at end of study. Also, no significant differences were observed in other anthropometric indices. The reductions in lipid profile and AIP were not significant. Findings, HDL-C showed no significant increase. Daily consumption of 50 g sesame seed for 6 weeks had no effect on the anthropometric parameters, lipid profile or AIP in women with metabolic syndrome. However, more investigations are necessary to confirm these findings.

The association between body composition and the hormones has been explored in a limited number of studies. Hence, this study was performed to examine the association between body composition and serum level of leptin among children. This cross-sectional study was conducted among 111 students aged 6-10 years, who were selected from 20 elementary schools in Tehran. We measured fasting plasma leptin by radioimmunoassay. The bioelectrical impedance was used to determine the subject's body fat mass (FM), fat free mass (FFM) and their distribution in the body. The subject's physical activity and sleep were recorded for a week by an accelerometer (Actigraph). Results of this study showed no significant difference between boys and the girls regarding the level of leptin, FMI (Fat Mass Index, calculated using FM divided by height squared) and FFMI (Fat Free Mass Index, calculated using FFM divided by stature squared) (P>0.05). FMI and FFMI in girls were not significantly associated with leptin whereas in boys, leptin was significantly associated with FMI (&beta=-0.32, P=0.0001) and FFMI (&beta=-0.28, P=0.01) after adjusting for age, physical activity, sleep, dietary intake, and watching TV and computer games. Leptin may influence the gender-related differences of body composition during childhood in boys. Further studies are needed to confirm our findings.

Psychological factors such as negative emotions play an important role in the management of diabetes mellitus one of the most common chronic diseases. The purpose of this study was to investigate the effectiveness of emotion regulation training in improving emotion regulation strategies and glycemic control in patients with type II diabetes. This quasi-experimental study had a pretest-posttest design. The study population included 40 patients with type II diabetes, selected by convenience sampling from the Samen Alaemmeh charity center and randomly divided in two, the experimental and the control, groups (n=20 each). Subjects in both groups completed the Garnfski`s Cognitive Emotion Regulation Questionnaire (2001, CERQ) both pretest and posttest, and Hb (A1C) was also measured at these times in both groups. Eight 90 minute sessions of emotion regulation group therapy were conducted in eight weeks. Data were analyzed by covariance analysis method with software spss-18. Data analysis showed that emotion regulation strategies and glycemic control in the experimental compared to the control group, at posttest were decreased (p<0.05). Based on the results of this study, emotion regulation training could be an effective method for improvement of emotion regulation problems and glycemic control in patients with type II diabetes.

Preptin is a recently isolated peptide hormone that is co-secreted with insulin from the pancreatic beta-cells. The aim of this study was to compare the effects of aerobic exercise and caloric restriction on serum preptin levels and HOMA-IR in sedentary obese women. Forty women who referred to home health centers were divided into four groups for 16 weeks of follow up: Aerobic exercise (experimental group 1), caloric restriction (experimental group 2), aerobic exercise with caloric restriction (experimental group 3) and the control group. Training programs in experimental group 1 consisted of aerobic training and running on a treadmill for 105.183±5.63 minutes, 4 times a wk. In experimental group 2, subjects followed a diet with caloric restriction equivalent to physical activity energy expenditure. Subjects in the experimental group 3 used a training program similar to experimental group 1 for 66.85±5.34 minutes, 3 times a wk and received a diet with half the amount of caloric restriction of experimental group 2. Weight, BMI and WHR showed significant reduction in the experimental groups. Serum preptin levels were decreased by 21.97%, 28.32% and 27.11% in experimental groups 1, 2 and 3 respectively. HOMA-IR was decreased significantly in the 3 groups. Significant correlations were seen between changes of preptin and changes of weight, WHR and HOMA-IR (p<0.05). Considering the relationship between preptin and insulin resistance and the influence of aerobic exercise and caloric restriction, preptin may play an effective role in weight management and prevention of diabetes.

The direct relationship between inflammation and resistance to insulin has been well codumented. It also has been demonstrated that the aim of this study was to evaluate the effect of eight weeks aerobic interval training on adiponectin serum levels, lipid profiles and HS-CRP in women with type II diabetes. In this study, 18 patients with type II diabetes were enrolled in two groups (experimental and control). The experimental group underwent aerobic interval training and pedaling on the ergometer bicycle with 65 to 80 percent of their maximum leg power, three times a week for eight weeks. Blood samples were obtained in two pre-test and post-test steps to measure the adiponectin serum levels and HS-CRP by the ELISA method and lipid profiles using biochemical methods. Statistical analysis showed that after eight weeks of aerobic interval training, adiponectin serum levels, lipid profiles and HS-CRP of the experimental group showed no significant differences in comparison with the controls (p>0.05). Results indicate that in women with type II diabetes, aerobic interval training, three times a week, for eight weeks with 65 to 80 percent of maximum leg power, improves resistance to insulin but, has no effect on adiponectin serum levels, lipid profiles and HS-CRP.

The aim of present study was to investigate the interaction of aerobic training and calorie restriction on levels of adiponectin isomers in serum and abdominal fat depots in obese male rats. Forty-eight wistar male rats were used as the study sample. Blood and tissue samples were collected at the 1st, 18th and 28th weeks. After baseline sampling, the remaining 40 rats were randomly divided into control and high-fat-diet groups. The high-fat-diet group received their regimen for 18 weeks and were then randomly divided into the negative energy balance (NEB) and high-fat-diet (HFD) subgroups. NEB group alternately underwent 25% calorie restriction or aerobic training (running) with an intensity of 70 to 75% of vo2max for 10 weeks. Compared to the standard diet, HFD feeding increased weight and decreased retroperitoneal adipose tissue adiponectin level at the 18th and 28th weeks (P<0.05). In comparison to the HFD, group negative energy balance in obese male rats, caused weight control with significant increase in serum levels of total and high-molecular-weight adiponectin as well as adiponectin levels in retroperitoneal and mesenteric fat depots (P<0.05). Also insulin resistance index in line with serum concentrations of insulin, glucose and triglycerides were decreased in negative energy balance, compared to the high-fat-diet group (P<0.05). This study indicates that even with simultaneous consumption of high-fat-diet, combination of aerobic training and calorie restriction can increase concentrations of adiponectin in serum and abdominal fat depots of obese male rats, and aligned with it improves lipid and metabolic profiles.