Arya Atherosclerosis
Volume:3 Issue: 4, Winter 2008

Female carpet-weavers are vulnerable to vitamin D deficiency due to cultural, occupational and economic reasons. This case-control study was conducted to compare the frequency coronary artery disease (CAD) and its risk factors in relation with the seru vitaminD level in 260 female carpet-wearers and non-carpet-weavers in the villages across Isfahan Province in the centre of Iran. All postmenopausal women aged over 50 were matched for cultural and socioeconomic status. The participants underwent clinical examinations. Blood samples were obtained and electrocardiography was performed. When necessary, echocardiography and exercise test were also administered to diagnose heart disease. Dietary intake of vitamin D was determined by completing a semi-quantitative food frequency questionnaire. A questionnaire obtaining personal data and length of daily exposure to sunlight was also completed. The existence of CAD was determined using standardized WHO Rose questionnaire and/or the Minnesota electrocardiography coding system. Blood lipids and vitamin D levels were measured using an ELAN-2000 auto analyzer and radioimmunoassay, respectively. The results showed that only the frequency percentage of myocardial infarction(MI) in non-carpet-weavers was significantly higher than in female carpet weavers (P=0.001).The differences of age, serum vitamin D level, blood lipids, blood pressure and other variables were not significant (P>0.05). Neither was there any statistical association between serum vitamin D level and CAD risk factors, however, after adjustment for confounders (age, etc.), a direc relationship was observed between abdominal obesity as measured by waist-to-hip ratio (WHR)(WHR>1) and serum vitamin D level (OR=0.99, P>0.05). Carpet weaving had no effect on CADrisk factors (P>0.05). The findings of this study reveal no association between vitamin D and CAD.Further research is recommended into the possible relationship between CAD and vitamin D, as well as vitamin D receptor (VDR) gene polymorphisms responsible for genetic differences in vitamin D uptake by the bone.

This study was conducted to investigate pattern and risk factors associated with the location of atherosclerotic occlusive lesions in cerebral vessels. Previous studies of patients with stroke or transient ischemic attack (TIA) suggest that extracranial atherosclerosis is more common in the white race. Noninvasive techniques such as duplex ultrasound, transcranial Doppler (TCD), and magnetic resonance angiography (MRA) allow vascular assessment of a more representative proportion of the patients, compared to conventional angiography alone. We evaluated patients with cerebrovascular problems (stroke and/or TIA) during a period of 6 months, using duplex ultrasonography, TCD and MRA to detect significant stenosis according to standard criteria. Stenosis of extracranial and intracranial arteries was detected in 38% and 29% of cases, respectively. MCA was the most frequent involved intracranial artery (11% bilaterally and5% unilaterally). Intracranial lesions tend to be multiple. There was no significant difference between men and women in terms of frequency and distribution of stenosis. No correlation was found between opium use and stenosis. The women had significantly more poor windows than men (P<0.05). The extracranial stenosis was significantly more frequent than intracranial stenosis (P<0.01). The relations between hypertension and extracranial stenosis, and diabetes and MCA stenosis were statistically significant. TCD seemed to be a better technique for evaluating intracranial lesions in men than in women.

Diabetes is regarded as serious condition for both the individual and the society.Its rapidly increasing global prevalence is a significant cause for concern. One of the mostimportant reasons of mortality in diabetic patients is atherosclerosis. Many epidemiologic studies have shown that the total homocysteine concentration is a risk indicator for cardiovascular disease. Studies have shown that its concentration is increased considerably in diabetes mellitus.Epidemiological data indicate that the consumption of omega-3 unsaturated fatty acids (n-3FA) leads to a reduction in cardiovascular disorders and may protect against metabolic diseases.In recent years, many have studied omega-3 fatty acids but still, it cannot be used as anadditive. This study aimed to evaluate the effects of ω3 on homocysteine in type 2 diabetic patients. A randomized double blind placebo controlled clinical trial was conducted on 80type 2 diabetic patients aged 45-85 years with diabetes for at least 2 years. Anthropometric indices including body mass index (BMI) and medical history were obtained. Diabetic patients were randomly assigned to either the case or the control. Each subject received 3 capsules per day (omega-3 or placebo) for a period of 2 months. A sample of 10 ml blood was collected from each subject at the beginning and at the end of the study. Serum homocysteine was measured by Hitachi autoanalyzer with the Enzymatic Cycling method. Nutrient intake was estimated using 24-hour dietary recall questionnaire at the beginning and at the end of the trial for 2 days and analyzed by FPII. T-test was also used to compare the groups. Comparison of mean ± SD (standard deviation) of BMI and food intake did notshow any difference between the case and control groups. homocysteine levels were3.10 μmol/lit and 0.126 μmol/lit in the case and control groups, respectively, and the difference was significant. Omega-3 fatty acids supplementation (3 g/per day) in the form of capsules can decrease homocysteine content in diabetic patients.

Diabetes control is one of the main conflict issues in diabetes management.Scientists, recently, recommend [increasing low glycemic index (LGI) foods in dietary regimen.The effects of cooked lentil as a low glycemic index food on serum blood glucose and lipid profile among type 2 diabetic patients has been investigated in this study. In a randomized cross-over clinical trial which was performed on 30 patients with type II diabetes mellitus, subjects were randomly divided into 2 groups. Group A followed the normal diet and Group B followed normal diet with 50gm cooked lentil and 6gm canula oil substitute of 30gm bread and 20gm cheese. After 6 weeks, groups stopped their diets and put onwash out period for 3 weeks and later the diets where switched between the them. Diet continued for another 6 weeks. Anthropometric measurements, dietary intakes, serum lipids and glucose levels were determined at the beginning and the end of each test period. Data were analyzed by Food Processor II and SPSS-13. BMI, LDL_C, HDL_C, TG and serum Fructozamine were not significantly affectedby dietary regimens. But Total cholesterol and fasting blood glucose decreased significantly in regimen containing lentil (P<0.05). Consumption of cooked lentil as a LGI food in breakfast led to reduction of FBS and TC and improvement of glycemic control in type 2 diabetic patients.

Diabetic nephropathy is a serious complication of both type 1 and type 2 diabetes, and unless arrested, leads to end-stage renal disease. The aim of this study was to find the prevalence of kidney dysfunction in patients with diabetes mellitus and to determine its correlation with metabolic control. We randomly selected 1203 cases with diabetes mellitus presenting to the Institute of Endocrinology and Metabolism. Urinary protein and creatinine were determined in a sample of 24-hour urine collection by the enzymatic methods and spot urine dipstick blood urea nitrogen, serum creatinine, HbA1c and fasting blood glucose were assessed. In this study, 1203 patients (438 patients with type 1 diabetes mellitus [T1DM] and 777 with type 2 diabetes mellitus [T2DM]) were randomly selected. They consisted of 512 females and 721 males. Mean ± SD (standard deviation) of HbA1c was 7.9±3.4 in T1DM and 7.4±3.5 in T2DM. Based on HbA1c levels, good control was detected in 50.2% of patients, fair control in 20.4% and bad control in 29.4%. Of 1022 patients who were evaluated for proteinuria, 201 (19.7%) had albuminuria or clinical proteinuria. Of 931 patients, 19% had high levels of blood urea nitrogen and serum creatinine. End-stage renal disease (ESRD) was seen in 10 (0.8%) of all the cases. A statistically significant positive correlation was found between duration of DM, serum creatinine and 24-hour urinary protein (P< 0.001). We found a high prevalence of clinical proteinuria in diabetic patients. Duration of diabetes and poor metabolic control were identified as a strong predictors of kidney damage in patients with diabetes.

Dialysis patients have high mortality rate which half of them is due to cardiac arrhythmias. Some clinicians fear dialyzing patients because of new arrhythmias occurrence during dialysis which may cause sudden deaths. Controlling the most common arrhythmias and managing the causes can help to reduce the mortality in these patients. All patients who have done dialysis in two centers in Kerman were studied. The known cardiac patients and consumers of antiarrhythmia drugs were excluded. The patients were monitored 24 hours before dialysis and during dialysis. The Mean age of patients was 47.9 year. The most common arrhythmias found before and during dialysis Were PVC and PAC (64% and 40% respectively). The prevalence of AF rhythm was 2.7%. QT interval has no significant increase in dialysis patients. There was no significant relation between PAC and PVC numbers before and during dialysis. The prevalence of these arrhythmias did not have significant relationship with Ions changes, the duration and quality of dialysis, severity of anemia and also demographic factors. Arrhythmias rate did not increase during dialysis so the dialysis itself is not a leading risk factor for arrhythmias.

The study was conducted to define the determinants of suboptimal blood pressure (BP) control among hypertensive patients under treatment and explore a predictive model for detecting the patients at risk for increased BP. We enrolled 97 patients (40 males, 57 females) under treatment for hypertension between June 2006 and May 2007 in Shafa hospital, Kerman, Iran. BP was measured at clinic twice within 5-minute intervals. After setting up ambulatory blood pressure monitoring (ABPM), BP was measured at 30-minute intervals during the day and 60-minute intervals during the night. The frequency of increased BP (more than 140/90 mmHg) was included in a regression model as dependent variable and all the others such as age, sex, body mass index (BMI), drugs and baseline clinical measurements as the predictors. Increased BP was detected in 44% (95% CI: 38.79%-49.65%) of all measurements during 24-hour monitoring. The frequency of increased BP had a significant relationship with BMI (β=0.35, P=0.001). Clinic''s pulse pressure was a significant predicting factor for BP increase(P=0.02). BMI and pulse pressure are the best predictors for being hypertensive duringlifetime. Ineffective treatment of hypertension is frequent among the hypertensive patients.

Post-transplant diabetes mellitus (PTDM) contributes to the risk for cardiovascular disease and infection, reducing graft and patient survival. This study was conducted to identify incidence and risk factors for development of PTDM. We studied 50 non-diabetic adult dialyzed patients awaiting renal transplantationprospectively. Oral glucose tolerance test () was performed pre- and post-transplantation. The relation of age, weight (BMI), dialysis modality, family history of diabetes, duration of dialysis was assessed with occurring PTDM. Based on 1, 13 patients had unknown Diabetes Mellitus; however after transplantation only 9 of them had same results. Based on 2 6(16.22%) patients had actually PTDM. Age of patients with PTDM were significantly higher than those with normal test (43± 17 versus 31± 11 year old) (P<0.05). There was significant relation between duration of dialysis with PTDM (P<0.05), as normal was seen in 85.2% patients that dialyzed less than 1 year. There was no significant relation among dialysis modality and family history of diabetes and BMI with PTDM (P>0.05). Risk factors for diabetes in our study were age and duration of dialysis before transplantation. Then identifying them might allow modification of post transplant immunosuppressant with nondibetogenic agents in high risk patients.

This study was conducted to assess the relation of body mass index, serum lipids and dyslipidemia in parents and their children. This descriptive study was conducted on 211 students from Birjand junior highschools and their parents (211 mothers, 211 fathers) in 2007. The students were selected by multistage random sampling. Body mass index, total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured in students and their parents. There was a significant relation of BMI in parents and children. Fathers'' BMI had a significant relation with those of both boys and girls. There was a significant relation of total cholesterol and triglyceride between fathers and children in both in girls and boys. There was a significant relation of LDL-C between fathers and boys. In both parents HDL-C had significant relation with that in children, both in girls and boys. There was significant relation between hypercholesterolemia in fathers and low HDL-C in mothers and children (both boys and girls). There was significant relation of BMI and serum lipids and some forms of dyslipidemia in parents (especially fathers) and children. Hence, screening programs in children of high-risk parents are recommended.