مجله غدد درون ریز و متابولیسم ایران
سال بیست و دوم شماره 6 (پیاپی 114، بهمن و اسفند 1399)

The American Medical Association (AMA) defines "disease" based on three features, including a defect in the normal function of any part of the body associated with specific signs and symptoms and leading to morbidity. Obesity can be considered a disease because there are some abnormalities in the regulation of appetite and function of the endocrine system, leading to abnormal energy balance and the accumulation of adipose tissue manifested as higher levels of body mass index (BMI) and central obesity indices. This condition is associated with an increased risk of diabetes, cardiovascular diseases, cancer, sleep apnea, arthralgia, walking disability, and many other complications. Obesity results from the interaction of genetic and environmental factors leading to energy imbalance and fat deposition. This condition eventually promotes abnormal endocrine and inflammatory responses and arouses severe complications. Obesity is a debilitating disease that, other than metabolic complications, would emerge as gastrointestinal reflex, osteoarthritis, psychiatric disorders such as anxiety, depression, decreased physical activity, and decreased quality of life. On the other hand, about 5-10% weight loss decreases many obesity-related complications; hence, obesity seems to be a real, complex disease that occurs in the context of a person's genetic predisposition and a combination of inflammatory, hormonal and behavioral factors. Similar to other chronic diseases such as diabetes, a fundamental plan is necessary to prevent its increasing incidence and treat it with effective medications.This article is the counterpart of another article (Whether obesity is a disease? It is too early to say yes) in this issue.

Obesity is an increasing health problem worldwide, accounting for many comorbidities. Many experts believe that preventive and therapeutic strategies cannot be practical if obesity is not recognized as a disease. Accordingly, a majority of organizations and authorities agree with classifying obesity as a disease. However, it is not really known whether obesity is a disease. There is no doubt that excessive obesity is a disease; however, this debate focused on milder classes of obesity, which are more common and involve varying degrees. The study dealt with this issue by adopting three different approaches, showing the impossibility of answering this question based on scientific and legal approaches. In the utilitarian approach, it is necessary to first examine areas affected by this issue and then consider the specific conditions of each country, including the healthcare system's approach, in each area. Experts in various fields need to comment on the benefits and harms of labeling obesity a disease, depending on the specific circumstances of each community, to determine whether it is benefical to the greater good to accept obesity as a disease. Therefore, this issue will remain open for discussion.
This article is the counterpart of another article (Is Obesity a Disease? Yes) in this issue.

Obesity and a sedentary lifestyle are associated with oxidative stress and its resulting diseases. However, previous studies have indicated that regular exercise training plays a vital role in reducing obesity-induced oxidative and diseases. Accordingly, this study aimed to investigate and compare the effects of concurrent training order on oxidative stress biomarkers in sedentary obese women.

In this quasi-experimental study, 45 sedentary obese women (25-40 years) were randomly assigned to the control (control; n=15), resistance+endurance training (R+E; n=15), and endurance+resistance training (E+R; n=15) groups. The 12-week concurrent program was performed three sessions a week. Each session consisted of endurance training on Treadmill (intensity 55-75% HRmax), and strength training (intensity: 55-75% 1RM). The blood samples and body composition of all participants were measured before and after the training program. Moreover, the collected data were analyzed using the analysis of covariance and Bonferroni tests.

The results indicated that twelve weeks of exercise training intervention significantly decreased MDA and increased the concentrations of SOD and TAC in obese women (p<0.05). However, no significant difference was observed between the two E+R and R+E groups (p>0.05).

The findings indicated that concurrent training (independent of the exercise order) is an effective therapeutic method in modulating oxidative stress in sedentary obese women.

Kidney failure is one of the mainlate complications of diabetes so that more than half of patients waiting for a kidney transplant are suffering from diabetes as well. This study aimed to determine the effect of education underpinned by the health belief model on kidney care behaviors in type 2 diabetic patients.

This quasi-experimental study was performed on 88 type 2 diabetic patients, who were selected using the cluster sampling method and were randomly divided into experimental and control groups (44 patients per group). The required data were collected using a valid and reliable questionnaire underpinned by the health belief model and fasting blood sugar of patients before training for both groups, and then the experimental group was then trained for one month based on the health belief model and again after three months. Kidney and fasting blood care behaviors were measured, and the collected data were analyzed using chi-squared test, paired sample t-test, independent sample t-test, and ANCOVA.

Three months after the educational intervention, the performance of diabetic patients regarding the prevention of renal complications increased significantly in the intervention group (p<0.001), and the fasting blood sugar index decreased slightly.

This study showed that  after training diabetic patients and having active follow-ups and efforts to facilitate patients' perceived barriers, their skills in kidney health-related behaviors can be improved to reduce the incidence of complications in patients.

Given the importance of adhering to health-promoting behaviors by patients with diabetes and the need to detect factors affecting the adoption of this behavior, this study aimed to assess the health-promoting behaviors and relevant factors among Type 2 Diabetic Patients in Asadabad, Iran.

This cross-sectional study included 427 type 2 diabetic patients referred to the diabetes clinic of Ghaem hospital in Assadabad. The data collection tool was a two-section questionnaire addressing the participants’ demographic information and Type 2 Diabetes Mellitus Health Promotion. Data analysis was performed with SPSS software version 16 using descriptive and analytical statistics. In this study, p<0.05 was set as the significance level.

The participants’ mean score of total health-promoting behaviors was 51.95±10.03. Of the six dimensions, the highest mean score was obtained for stress management and enjoy-life, and the lowest mean score was related to risk-reducing and health responsibility. There was a significant relationship between total health-promoting behaviors with age, years spent with diabetes, level of education, employment status, family income status, and body mass index.

The diabetic patients’ health-promoting behaviors were not at an acceptable level; hence, it is necessary to develop and implement various health education and health promotion interventions to improve the health-promoting behaviors of diabetic patients by focusing on the low-level dimensions and factors associated with such behaviors.

Hypertension is a significant public health problem. This study aimed to determine the efficacy of hypertension self-management behaviors promotion programs among patients in southwest Iran.

The present study was a quasi-experimental study performed among patients with hypertension in the villages of Shadegan County, in southwest Iran, from May to October, 2019. The participants were randomly assigned to the intervention and control groups (n=355 per group) and were followed up for three months. The educational intervention was developed based on the constructs of the theory of planned behavior. Data were collected using interviews with participants in the form of a written questionnaire. The collected data were analyzed in SPSS software version 16 using independent sample t-test, chi-squared test, and Multivariate Analysis of Covariance (MANCOVA).

The findings of MANCOVA analysis showed that the program implementation had a significant effect on attitude, subjective norms, perceived behavior control, behavioral intention, and hypertension self-management behaviors of the patients in the intervention group (p<0.001).

The implementation of an educational intervention based on the theory of planned behavior among patients with hypertension effectively promoted self-management behaviors such as hypertension control.

Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy. The present study aimed to determine the diagnostic value of the CD10 marker in differentiating PTC from its benign mimicries (i.e. different types of goiter).

In this cross-sectional study, the paraffin-embedded blocks of 70 patients referred to Rouhani Hospital in Babol with a thyroid nodule based on pathologic report and review were divided into two groups, including 35 benign and 35 malignant lesions. The participants’ demographic information (namely age and gender) and ultrasound results (size and number of nodules) were recorded in the study checklist. Thyroid paraffin-embedded blocks and stained slides of all patients were collected from the archive and, after reviewing the slides, they were examined immunohistochemically for the CD10 marker.

We evaluated 70 patients in both benign and malignant groups and assessed the status of the CD10 marker. The mean age was 49.3±9.08 years in the benign group and 45.6±16.1 years in the malignant group. Regarding the participants’ gender, in each group, nine patients were male, and 26 patients were female. Classic PTC was noticed in 26 patients and there were the follicular variants of PTC in nine patients. The CD10 positivity was significantly correlated with several nodules (p=0.030), whereas the nodule size and CD10 positivity were not significantly different between the two groups (p=0.310). The diagnostic value of the CD10 marker in differentiating PTC and benign thyroid lesions was not significantly correlated in terms of nodule size (p=0.310), and there was a statistically significant relationship between age (p=0.005) and gender (p=0.03) with the number of nodules (p=0.030).

According to the study results, the diagnostic value of the CD10 marker in differentiating papillary thyroid carcinoma from the goiter subtypes is statistically significant.

Obesity, a chronic disease, is associated with comorbidities such as diabetes, hypertension, cardiovascular diseases, metabolic syndrome, and stroke. In this context, the consumption of natural weight-loss ingredients as alternative obesity treatments has been increasing because of the common idea indicating that they as natural products pose no risks to human health. (Simultaneously with the widespread prevalence of obesity; the use of herbal slimming products as an alternative treatment for obesity has increased. Because, the general belief is that plant products are safe for human health.) The analyses (analysis) of phytotherapeutic formulations showed increasing numbers of counterfeit drugs, as adulterants, withdrawn from the market due to significant side-effects and a high potential for addiction threatening public health. Because the drugs used in the products are not listed on the labels, consumers do not become aware of the risks. (Because the active ingredients in these products are not listed on the label, consumers remain unaware of their risks and side effects.) These products can cause serious health side-effects due to accidental abuse, overuse, or interaction with other drugs. The illegally added adulterants are commonly including stimulants (ephedrine, caffeine), anorexic (amphe tamine and its analogs), antidepressants (sibutramine, fluoxetine), anxiolytics (benzodiazepines), diuretics (bumetanide), laxatives (phenolphthalein), rimonabant, orlistat, and thyroid hormones. This review study aimed to describe various categories of synthetic drugs frequently added illegally into natural weight loss products as adulterants,