مجله غدد درون ریز و متابولیسم ایران
سال بیست و دوم شماره 1 (پیاپی 109، فروردین و اردیبهشت 1399)

Liver disorders in patients with type 2 diabetes (T2D) are mostly associated with higher serum levels of liver enzymes. This study aimed to investigate the effect of nitrate administration on the serum levels of alanine amino transferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) in rats with T2D.

In this study, 24 male Wistar rats were divided into four groups: control, control+nitrate, diabetes, and diabetes+nitrate. T2D was induced using a combination of high-fat diet and injection of low-dose streptozotocin (30 mg/kg). The rats in the nitrate-treated groups received sodium nitrate (100 mg/L in drinking water) for six months. The serum levels of ALT, AST, and ALP were measured at the beginning of the study and at three and six months after nitrate administration.

Diabetic rats showed increased levels of ALT, AST, and ALP in the serum at six months. Nitrate decreased the serum level of ALT by 17.6% (65.7±4.8 vs. 55.8±2.3 UI/L; P=0.0659), AST by 52.2% (161.3±13.3 vs. 106.0±6.1 UI/L; P<0.0001), and ALP by 15.1% (606.2±35.5 vs. 514.4±12.6 UI/L; P=0.0339) within six months.

Long-term and low-dose nitrate administration improved the liver function of rats with T2D, as reflected by the reduced serum levels of ALT, AST, and ALP.

Extensive research suggests a common hypothesis regarding the protective role of total high-density lipoprotein-cholesterol (HDL-C) against cardiovascular disease (CVD). This hypothesis indicates an inverse relationship between CVD and high HDL-C levels. Various mechanisms, such as reverse cholesterol transport, besides anti-inflammatory and antioxidant functions, indicate HDL-C as one of the potential predictors of CVD risk. Therefore, it is important to be familiar with different methods of HDL-C measurement and to evaluate their advantages and disadvantages. In this study, after reviewing the nature, function, and protective role of HDL-C against CVD, the HDL-C measurement methods were evaluated. Also, some interfering molecules due to interventions and some strategies to reduce interference were discussed. It seems that the increased use of homogenous measurement methods is related to some disadvantages, such as high cost, manual separation, time-consuming design, and structure manipulation, in first- and second-generation chemical methods, as well as methods based on physical properties. On the other hand, targeted assessment of HDL-C function and protective role can be a novel approach to predict the risk of CVD. However, all of these methods require further improvement and optimization.

Thyroid Stimulating Hormone Receptor (TSH-R) autoantibodies are the main cause of Graveschr('39') disease and its external thyroid manifestations such as ophtalmopathy and dermatopathy. These antibodies are functionally different and are commonly called TSH receptor antibodies (TRAbs). In fact, TRAbs are a set of autoantibodies including TSHR-stimulating antibodies (TSAbs), TSHR- blocking antibodies (TBAbs), and neutral antibodies. The measurement of TRAbs is clinically important and various commercial tests with high sensitivity and specificity are available for diagnostic purposes. If the diagnostic purpose of the TRAbs assay is the non-functional evaluation of autoantibodies, competitive binding immunoassays are used.  These methods are based on the ability of TRAbs in patient’s sample to compete and prevent ligand binding (TSH or anti-TSHR monoclonal antibodies) to the receptor. TSAbs and TBAbs appear to have common overlapping epitopes of the TSH-binding site which hinders them to be differentiated by competitive TRAbs assays. On the other hand, if the diagnostic purpose is to evaluate antibody function and differentiate between TSAbs and TBAbs, cell-based bioassays are used. The basis of these methods are the use of living cells to evaluate the function of autoantibodies and distinguish TSAbs and TBAbs based on the increase and decrease of the intracellular Cyclic adenosine monophosphate (cAMP). Since TSAbs and TBAbs have different pathogenic roles with different clinical symptoms and require different treatment protocols, differential diagnosis of TSAbs and TBAbs is of great clinical importance. In this review, different generations of competitive binding immunoassays and cell-based bioassays in the order of evolution, have been discussed.

Primary eye care is the most important element in the prevention of retinopathy. The present study aimed to assess the prevention of retinopathy in type 2 diabetic patients, based on the theory of planned behavior.

This descriptive analytical study of need assessment was carried out on 94 random patients with type 2 diabetes, who were referred to a diabetes clinic in Arak. Data were collected using a valid and reliable questionnaire, based on the theory of planned behavior, as well as fasting blood sugar (FBS) and glycated hemoglobin (HbA1c) tests. The collected data were analyzed in SPSS.

The mean age of the patients was 58.35±7.55 years, and the mean time from diagnosis was 8.1±4.15 years. The mean and standard deviation of FBS and HbA1c were 161.1±34.72 and 7.38±1.435, respectively.There was a significant correlation between perceived behavioral control (r=0.38, P=0.001) and HbA1c level in patients (r=0.41, P=0.001), while there was no significant correlation with FBS. Considering the linear regression of attitude constructs, behavioral intention and perceived behavioral control explained 28% of variance in behavior.

By assessing the factors influencing the behavior of diabetic patients to prevent retinopathy, implementation of empowerment programs based on self-management behaviors is suggested in diabetic patients.

Diabetes is a metabolic disease with an increasing prevalence. Therefore, it is important to identify the factors associated with this disease. This study aimed to determine the association of food insecurity, psychological factors, and social support with gestational diabetes in pregnant women in Ilam Province, Iran.

In this cross-sectional study, a total of 734 pregnant women at the gestational age of 24-28 weeks were selected. Sampling was performed in March-November 2016 in health centers of Ilam Province by cluster sampling method. The data collection tools included the demographic and midwifery, economic and social status, stress, anxiety, depression, domestic violence, social support, and food insecurity questionnaires. Data analysis was performed in SPSS version 16, using descriptive and analytical methods (single and multiple logistic regression analyses).

Overall, 9.8% of the subjects had gestational diabetes, and 35.1% reported food insecurity. The study of stress, anxiety, and depression showed mild stress (61.1%), mild anxiety (63.4%), and mild depression (62.8%) in the majority of subjects. Also, 251 (34.2%) subjects had high social support. After controlling for the effects of midwifery factors, demographic characteristics, and other independent variables, the results of multivariate regression analysis did not indicate any significant difference in terms of food insecurity, psychological factors, and social support between the two groups (P<0.05).

Although gestational diabetes is very common, there was no significant association between gestational diabetes and food insecurity, psychological factors, and social support. Considering the small number of studies in this field, further research is needed to confirm this relationship.

Polycystic ovary syndrome can result in poor quality of life due to different reasons. Therefore, attention to perceived social support and its associated factors can be beneficial for these patients. This study aimed to determine the level of perceived social support and its predictors in women with polycystic ovary syndrome.

This cross-sectional study was performed on 181 women with polycystic ovary syndrome, referred to Firoozabadi Hospital and Firoozgar Hospital in Tehran, Iran, using continuous sampling. Data were collected using a demographic questionnaire and Zimet’s Multidimensional Scale of Perceived Social Support. The collected data were finally analyzed in SPSS version 22.

The mean score of perceived social support was 5.18±1.01, and the mean scores of its domains including family, friends, and significant others were 5.58±1.40, 4.38±1.55, and 5.58±1.28, respectively. Perceived social support was significantly correlated with the husband’s satisfaction with the woman’s body and appearance, marital status, drug use, and having a companion. According to the multiple linear regression model, marital status (P=0.005), drug use (P=0.003), and having a companion (P=0.006) were significantly correlated with the mean perceived social support. These variables predicted 12% of the total score of perceived social support.

The present results showed that perceived social support is associated with the husband’s satisfaction with the womanchr('39')s body and appearance, marital status, drug use, and having a companion to communicate with. Overall, attention to these influential variables in the design of counselling and training programs, along with other treatment methods for women with polycystic ovarian syndrome, is essential.

This randomized controlled clinical trial aimed to investigate the effects of dairy product consumption on fasting blood glucose, insulin resistance, blood pressure, and lipid profile in patients with type 2 diabetes.

Ninety-one diabetic patients were randomly assigned to one of the following three groups: group A, <1 serving of dairy products per day; group B, 2-3 servings of dairy products per day; and group C, 4-5 servings of dairy products per day. The biomarkers of fasting blood glucose, insulin resistance, blood pressure, and lipid profile were measured at baseline and after eight weeks of intervention.

The Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) score and systolic blood pressure decreased significantly in participants, who consumed 4-5 servings of dairy products per day, compared to the other groups. However, no significant difference was observed in the lipid profile, fasting blood glucose level, weight, waist circumference, or blood pressure between the study groups (P>0.05 for all).

The consumption of 4-5 units of high-fat dairy products per day, with a fat content of 2.5%, improved insulin resistance and decreased systolic blood pressure in patients with type 2 diabetes. However, further clinical trials over a longer period of time are needed (Clinical Trial Registry No.: IRCT201207261640N8).

Combined oral contraceptives (COCs) are commonly considered as the first-line treatment for polycystic ovary syndrome (PCOS). This study aimed to compare the effects of COCs with respect to their progestin component on the clinical, hormonal, and metabolic outcomes of women with PCOS. Data were extracted by searching PubMed, Scopus, EMBASE, and Google Scholar, without any time limitations (until 2020). All studies assessing the effects of COCs on PCOS patients of childbearing age were reviewed and discussed. Based on the findings, different types of COCs can improve hyperandrogenism and regulate the menstrual cycle by suppressing gonadotropins and increasing sex hormone-binding globulin. Compared to COCs containing androgenic progestins (e.g., desogestrel and levonorgestrel), COCs containing anti-androgenic progestins (e.g., cyproterone acetate and drospirenone) could reduce androgen deprivation through specific mechanisms. However, the available evidence does not support the superiority of these anti-androgenic compounds in improving the clinical manifestations of hyperandrogenism. While all COCs may be associated with lipid disorders, drospirenone-containing compounds seem to be associated with the fewest disorders. Also, as COCs may result in metabolic disorders, especially dyslipidemia, it is necessary to periodically measure metabolic parameters in COC-consuming patients.