مجله غدد درون ریز و متابولیسم ایران
سال هجدهم شماره 3 (پیاپی 87، امرداد و شهریور 1395)

The aim of this study was to determine why Iranian endocrinologists choose endocrinology and to ascertain the advantages and limitations that they encounter.
A questionnaire including 3 open questions and one with 8 choices was sent to 157 endocrinologists, whose email was available in the list of the Iran Endocrine Society for analysis of responses to open questions.
Of the 157 endocrinologists, 81 (52%), - 42 females (52%) and 39 males (48%)- responded. Eighty-one percent wrote back saying they had selected internal medicine as a specialty because it is “the basic scientific principles of medicine”. Answers to the question “Why did you choose endocrinology?” were: “It has a constant process of thinking in diagnosis and treatment (69%), systematic and intellectual decision making (62%), the influence of a role model-a distinguished mentor (59%), interaction with other systems and organs (55%), motivation and the availability of updated data (55%)”. Endocrinologists believed that the major limitations of this subspecialty to be: “Excessive dependence on accurate laboratory procedures, not always available (62%) and lower income, as compared to other medical specialties (53%)”.
This study shows that despite the lower income, the rewards of choosing endocrinology, in particular its research and scientific evidence-based process of thinking, are major reasons why physicians choose this subspecialty. Availability of and accessibility to well-facilitated laboratories and higher incomes could minimize the challenges faced by physician endocrinologists.

Considering the remarkable increase in life expectancy among older people and lack of data on thyroid diseases in elderly Iranians, this study was designed to determine thyroid dysfunction in people, aged over 55 years.
This study was conducted on 819 Tehranian participants, aged over 55 years from the Tehran Thyroid Study, who were assessed every 3 years for serum free T4 (FT4) and TSH levels and were followed for 10.6 years. Data were analyzed by t test’ chi-square test, sig test and cox regression analysis.
Mean age of participants was 62.5±5.5 years. Of these 712 (86.9%) were euthyroid, 41(5%) had subclinical hypothyroidism (SCH), 19(2.4%) had overt hypothyroidism (OH), 34(4.1%) had subclinical hyperthyroidism and 13(1.5%) overt hyperthyroidism. Overall 13% of participants had thyroid dysfunction. The annual incidence rate of SCH and OH were 8.8 and 7.1 cases per 1000 people respectively. Multivariate regression analysis showed the risk of hypothyroidism in euthyroid people to be affected by TPO positivity [HR=1.9 (CI 95% 1.04-3.5)] and TSH>1.88 mlu/l [HR=8.1 (CI 95% 3.4-19)].
Concolusion: More than one-tenth of aged people have thyroid dysfunction. High TSH and TPO positivity are the most important risk factors of hypothyroidism in elderly people.

Decrement in balance control ability in individuals with diabetic neuropathy may affect their daily living activities and lead to hazardous consequences such as falls and foot ulcer. Thus, it is important to predict balance impairment in this population as early as possible. The aim of this study was to determine the association between the duration of diabetes and balance impairment in people with diabetic neuropathy.
Thirty diabetic patients, diagnosed with neuropathy participated in this study. We used a personal information questionnaire, Mini Mental State Examination questionnaire and the Berg Balance Scale (BBS) to evaluate basic medical status, cognitive function and functional balance, respectively. Univariate regression tests were used for statistical analysis.
Our findings showed a significant association between the duration of diabetes and balance control (p Diabetes duration is a significant predictor of balance impairment in people with diabetic neuropathy. It could be used as a very simple factor to predict possible future balance impairments in these patients.

Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder in the gynecological field and considering the importance of mental health, this study was designed to compare the prevalence of depression among women with PCOS and the control group.
The present cross sectional study was conducted as a case control research, which included 73 cases of PCOS and 116 healthy women (controls). Data was gathered in 2 sections, i. e.1. participant characteristics and 2. an assessment of their depression levels using the Beck questionnaire. Reproductive aged women (15-45 years old) completed the questionnaire. Statistics analysis was done using SPSS version 19.
Mean scores of depression was 11.8±9.6 and 8.6±8.2 in the case and control groups respectively, with a statistically significant difference (P Considering the higher prevalence of depression in PCOS patients, compared to controls, early screening and counseling are recommended to provide appropriate care for these affected women.

Polycystic ovarian syndrome (PCOS) is a proinflammatory state that underpins the development of metabolic aberration and ovarian dysfunction in the disorder. Chronic inflammation and increased levels of androgens in these patients and their impact on the immune system, may be able to disrupt antitumor activity and thus increase the risk of developing malignancies including ovarian cancer.
Peripheral blood mononuclear cells of 50 patients with PCOS and healthy controls were purified by Ficoll density gradient centrifugation. We then measured cell proliferation and concentrations of cytokines TNF-α at different time intervals (48 and 72 hours) after co-culture of ovarian (SKOV3, A2780) and breast (MCF-7, MDA-468) tumor cell lines with PBMC in indirect contact of transwell system.
Proliferative response of executive cells during stimulation with tumor cell lines after 48 hours was not statistically significant between patients and healthy controls. Between the 2 groups, proliferation rates at the end of 72h were significantly higher than after 48h (P Our findings confirmed that, compared to healthy individuals low levels of chronic inflammation in patients with PCOS exhibit increased proliferative response of immune cells and TNF-α levels. An increased risk of cancers in patients with PCOS however requires investigation of other aspects of anti-tumor responses in vitro, with larger sample sizes.

There is rising concern about the increasing prevalence of adolescent obesity in recent decades and despite many studies conducted to elucidate the biological factors of obesity, there is limited data on the psychological factors of obesity. The aim of this study was to investigate the role of body image dissatisfaction and mental health in prediction of obesity.
This study has a fundamental purpose and the method of data collection is correlational. In this study, 60 students (30 obese and 30 with normal weight) were selected by purposive sampling among the students of schools in Boukan city and the body image questionnaire and general health questionnaire (GHQ) were used to obtain relevant data. Data were analyzed by logistic regression.
Results showed that mental health and body image dissatisfaction negatively and significantly predict obesity.
Findings demonstrate that mental health and body image are factors affecting weight gain in adolescent girls, indicating that these variables need to be considered in therapy programs aimed at prevention of obesity.

The aim of this study was to investigate the effects of upper and lower body activities on fat and carbohydrate oxidation in the elderly.
Nine elderly men (age, 66.1±3.91y; body mass index, 25.09±2 kg/m²) participated voluntarily in this study. After determining the upper and lower body VO2max, subjects performed two interval exercise trials with one week interval. Interval exercise included 4 stages of 5-min activity respectively, at an intensity of 55, 60, 65, and 70% VO2max on hand ergometer and bicycle ergometer. Each stage was followed by 2.5 min of activity performed at 25, 30, 35, and 40% VO2max. Respiratory gases were collected before exercise at the 1st 10-min, 2nd 10-min, 3rd 10-min and 30-min recovery and used to calculate fat and carbohydrate oxidation.
Changes in fat oxidation during interval exercise with cycle ergometer was significantly (P Based on findings, there is more increase in fat and carbohydrate oxidation during lower body interval exercise in elderly individuals, compared to upper body exercise, and this type of exercise is recommended for better fat oxidation.

Leptin, an anti-obesity hormone, is also a regulator of the immune response which sends important signals regarding the metabolic status and immune system function. This hormone/cytokine can affect the secretion of acute phase proteins such as Interleukin-1 and TNF-α and facilitate communication between nutrition and Th1 immune response so that when the food intake reduces, plasma leptin levels decreases, leading to reduced function of the immune system. Increase in blood leptin levels in obesity makes the obese people more susceptible to cardiovascular diseases, autoimmune diseases and cancer. Previous researches demonstrate the important effects of leptin in metabolism, whereas more recent studies show that this molecule has an important role in many other key functions of body such as haematopoiesis, thermogenesis, reproduction, angiogenesis, homeostasis and immune system. This paper aims to review the most recent findings regarding the role of leptin in the pathology of autoimmune disease, in particular multiple sclerosis, psoriasis, autoimmune thyroid disease, lupus erythematosus, endometriosis and rheumatoid arthritis.