مجله دانشکده پزشکی اصفهان
پیاپی 576 (هفته چهارم تیر 1399)

Given the high prevalence of chronic renal failure worldwide, and the fact that kidneys are the major means of magnesium excretion from the body, it is speculated that the incidence risk of magnesium balance disorder would be high in patients under peritoneal dialysis. The aim of the present study was to evaluate the mentioned patients’ magnesium level and specify the effective factors in this regard.

The present cross-sectional study was performed on 210 patients undergoing peritoneal dialysis that referred to Alzahra and Khorshid hospitals in Isfahan City, Iran. Patients’ demographic data such as age, sex, education status, cause of failure, type of comorbidity, duration of dialysis, and type of dialysis solution were recorded. In addition, the patients’ serum levels of magnesium, calcium, parathyroid hormone, and KT/V renal levels (in which K was dialyzer clearance of urea, T was dialysis time, and V was the volume of distribution of urea in patient's total body) were also assessed.

The patients’ mean magnesium level was 2.39 </em>± </em>0.39 mg/dl. There was no significant difference in the magnesium level between the men and women. Moreover, no significant difference was observed among the administrations of various dialysis solutions including dextrose 1.5%, 2.5%, and 4.25% as well as icodextrin 7.5% (P > 0.05). However, hypertension had a significant inverse effect with magnesium level (coefficient effect : -0.100; P < 0.05).

According to the results of the present study, the magnesium level was normal in patients under peritoneal dialysis. However, hypertension had a significant reverse effect on magnesium level, which was lower in patients with hypertension.

There is little information on the effects of exercise in polluted air and vitamin C intake on plasma factors. The aim of this study was to investigate the effect of twelve weeks of aerobic training in polluted air and vitamin C supplementation on serum levels of endothelin-1 and nitric oxide in Wistar rats.

50 male Wistar rats were randomly divided into five groups of training, training-supplementation, training-pollution, training-pollution-supplementation, and control. Training protocol consisted of aerobic training for 40 minutes with intensity of 65%-80% of maximal speed for 12 weeks and 5 sessions per week. The amount of vitamin C consumed in each rat was 20 mg/kg/day used orally. Plasma levels of endothelin-1 and nitric oxide were measured at the end of the study. Data were analyzed using one-way analysis of variance.

Endothelin-1 levels significantly increased in polluted air groups; vitamin C was able to decrease endothelin-1 levels (P < 0.05). The level of nitric oxide increased significantly in training in polluted air groups. These results were significantly different from the training-pollution-supplementation group (P < 0.05).

According to the results of this study, vitamin C intake is effective in decreasing plasma levels of endothelin-1 during exposure to air pollution. The effect of exercise and polluted air on nitric oxide was significant, and vitamin C alone reduced nitric oxide in training in polluted air group.

Qualified care and decreased blood sugar can prevent or suspend the side effects in patients with type 2 diabetes mellitus. The present study aimed to determine the state of glycemic control and related factors in patients with type 2 diabetes mellitus in the post-diagnosis care period using generalized estimator equations (GEE) model.

In this historical cohort study, data from 500 patients with type 2 diabetes mellitus that were under care in health centers in Golestan Province, Iran, were collected for three years (2013-2014). For each individual, the biological markers [fasting blood sugar, non-fasting blood sugar, and glycated hemoglobin (HbA1c)] outside the standard cut-point were counted as the response variable (called the "count of abnormal markers"). This variable could have numbers from zero to three. A higher number indicated less glycemic control.

The mean age of the patients was 45.2 years, and 58.8% were women. The "count of abnormal markers" variable had a very slow downward trend over three years. The results of the model showed that associated significant factors with increasing "count of abnormal markers" included short duration of care (b = 0.77), no family history of diabetes (b = 0.47), low age of diagnosis (b = -0.06), obese-overweight (b = 0.03), having a history of hyperlipidemia (b = 0.31), and having insulin therapy (b = 0.24).

According to the results, glycemic control does not show the desired condition, and in addition to continuous care and more strictness of patients, their weight, blood lipids, and insulin treatment should be controlled as well.