International Journal of Endocrinology and Metabolism
Volume:20 Issue: 2, Apr 2022

 Thyrotoxicosis may be associated with a better sense of well-being than in the euthyroid state, though this is not widely recognised.

 A comprehensive literature search in PubMed and Google Scholar, was performed to identify studies investigating factors influencing well-being, mood, and psychological features associated with elevated thyroid hormones.

Enhanced well-being associated with thyrotoxicosis has been described, although the evidence is observational and anecdotal.

Enhanced well-being associated with thyrotoxicosis is probably experienced in a minority of patients and may explain why some seek overtreatment with thyroid hormones and report significant improvement on larger than physiological thyroid hormone replacement regimens. It may also explain why some patients with hyperthyroidism (usually due to Graves’ disease) are reluctant to adhere to anti-thyroid medication.

Hypocalcemia is highly prevalent in Coronavirus disease 2019 (COVID-19). There is limited evidence about the course and roles of different parameters in the occurrence of new or worsening hypocalcemia.

This prospective longitudinal study was conducted on hospitalized COVID-19 patients in Qazvin, Iran, in 2021.

Serum levels of calcium, albumin, parathormone (PTH), 25(OH)D (vitamin D), magnesium, and phosphate were assessed on the first day (time one), as well as fourth to sixth days (time two) of hospitalization. Paired t-test, McNemar’s test, and multivariate logistic regression test were used to compare data at two times and evaluating the independent roles of different variables in the occurrence or worsening of hypocalcemia.

Out of a total of 123 participants, 102 patients completed the study. The mean serum calcium level significantly decreased from 8.32 ± 0.52 mg/dL to 8.02 ± 0.55 mg/dL at time two compared to time one (P < 0.001). Also, we witnessed new or worsening hypocalcemia at time two in 44 (55%) patients with normal serum calcium or mild hypocalcemia at time one (P < 0.001). The PTH level decreased from 42.17 ± 27.20 pg/mL to 31.28 ± 23.42 pg/mL (P < 0.001). The decrease in albumin and PTH levels was an independent significant factor in the occurrence or worsening of hypocalcemia at time two (OR = 1.27; 95% CI: 1.10 - 1.46; P = 0.001 for each 1 g/L decrement albumin and OR = 1.29; 95% CI: 1.03 - 1.62; P = 0.026 for each 10 pg/mL decrement PTH). Vitamin D deficiency or changes during hospitalization did not have a significant role in new or worsening hypocalcemia.

Decreased PTH secretion and hypoalbuminemia have significant roles in the occurrence of new or worsening hypocalcemia during hospitalization due to COVID-19.

Adequate health literacy could lead to self-care behaviors among patients with type 2 diabetes (T2D). Although there is an instrument for measuring the health literacy of diabetic patients, there is no Persian version of the instrument in Iran.

The aim of this study was to translate the Chinese Health Literacy Scale for Diabetes (CHLSD) and evaluate the psychometric parameters of the Iranian version.

In this methodological study, using a standard forward-backward translation procedure, the original English language version of the questionnaire was translated into Persian. Face and content validity steps were performed for psychometric measurements. To perform construct (convergent) validity, a cross-sectional study was carried out with the participation of T2D patients admitted to the diabetes clinic (aged over 25 years old). To test the reliability, internal consistency was assessed by Kuder-Richardson (K-R) coefficient, and a test-retest was performed by Spearman correlation coefficient.

A total of 283 patients with T2D (mean age: 52.4 years and standard deviation: 11.5) were included in the study. The factor loadings of the variables were checked by calculating the correlation value of the characteristics of a construct with that construct, whose value was greater than 0.4. The K-R coefficients for the whole instrument and its four subscales (remembering, application, analysis, and comprehension) were 0.8, 0.71, 0.73, 0.87, and 0.89, respectively. Re-testing of the instrument with an interval of two weeks indicated the acceptable stability of the instrument (ICC ≥ 0.8).

Our findings showed that the Iranian version of CHLSD is a valid and reliable instrument for measuring the health literacy in diabetic patients.

Body image is known as an important factor affecting different aspects of adolescents’ health; however, its relationship with lifestyle, body mass index (BMI), and health-related quality of life (HRQoL) in Iranian adolescents has not been addressed in a conceptual model.

This study aimed to investigate the network relationship among body image, lifestyle, BMI, and HRQoL in adolescent boys and girls.

The present study examined 760 adolescents (15 - 18 years) from Tehran. Adolescents reported their weight and height, according to which the participants’ BMIs were calculated. The adolescents’ body image, lifestyle, and health-related quality of life were assessed using a set of questionnaires, including the Iranian Body Image Scale (IBIS), Modifiable Activity Questionnaire (MAQ), Eating Habits Checklist, Eating Attitudes Test (EAT-26), and Pediatric Quality of Life Inventory (PedsQLTM).

The participants’ mean age and BMI were 16.5 ± 1.0 years and 22.4 ± 4.6 kg/m2, respectively. More than one-third of boys (39.9%) and less than a quarter of girls (22.6%) were overweight/obese. In the final model, body image was significantly and directly associated with physical activity, disordered eating, eating habits, and HRQoL in both genders (P < 0.05). Moreover, body image was directly correlated with screen time in boys (P = 0.012) and BMI in girls (P = 0.001). Body image was indirectly correlated with BMI regarding the mediating role of disordered eating in girls. Moreover, body image was indirectly associated with HRQoL regarding the mediating role of physical activity and eating habits in both genders and screen time only in boys.

The network relationships among body image, lifestyle, BMI, and HRQoL revealed a gender-specific pattern among the study population. Body image was a significant determinant of lifestyle and HRQoL in both genders and excessive weight in girls. The present findings would contribute to designing and implementing relevant health promotion interventions.

Osteoporosis-pseudoglioma syndrome (OPPG) is a rare autosomal recessive disorder characterized by severe osteoporosis and eye abnormalities that leads to vision loss. In this study, we report the outcome of a short period of treatment with teriparatide in one patient with OPPG.

The patient was a 17-year-old girl who suffered a bone fracture at the age of two and was diagnosed with OPPG at the age of three. Genetic testing was performed for the patient, and a novel homozygous nonsense mutation (c.351G>A) in exon 2 of the LRP5 gene was reported. She was treated with pamidronate, but the bone fracture increased, and the disability progressed. Therefore, at the age of 11 years and nine months, teriparatide was administered subcutaneously at a dose of 20 micrograms per day for four consecutive months. After the treatment with teriparatide, physical activity was achieved, and no further fractures were observed besides the gradual rise in bone mineral density (BMD) (LS spine from 0.532 to 0.711 gr/cm2 and 0.372 to 0.635 gr/cm2 in femur neck).

In children and adolescents diagnosed with OPPG who do not respond to other conventional therapies, short courses of teriparatide therapy may be helpful.

Embryonic life is a critical period for the formation of the ovaries in mammals, and the intrauterine environment may affect the ovarian reserve.

The present study aimed to investigate the impact of prenatal D-galactose exposure on ovarian reserve in female rat offspring in their later life.

In this study, ten pregnant Wistar rats were randomly divided into two groups, in one group, rats fed with 35% D-galactose-enriched food from the third day of pregnancy to the end of pregnancy period) and in the other group, rats were fed with a standard diet throughout the pregnancy. Female offspring (prenatally gal-exposed rats and controls (non-exposed rats)) were examined in terms of hormonal levels (anti-Mullerian hormones (AMH), follicle-stimulating hormone, and estradiol (E2)), as well as ovarian histology at 45-50, 105-110, and 180-185 days of their age.

The number of primordial follicles, in a time-dependent manner, was significantly decreased in the prenatally gal-exposed rats compared to controls (P value=0.002). In addition, reduction in AMH (3.25 vs. 7.5 ng/ml; P = 0.000) and E2 levels (7.9 vs. 19.5 mIU/ml; P = 0.000), on the other hand, increase in FSH levels (6.5 vs. 0.8 mIU/ml) were observed in gal-exposed rats compared to controls, at 45-50 days of age.

The present study concludes that prenatal exposure to D-galactose negatively affects ovarian reserve in female rats in their later life. However, further investigation is needed to confirm our findings and explore underlying mechanisms.

This study was performed to investigate whether social support and other psychological predictors were associated with physical activity during the prolonged social isolation due to the coronavirus disease 2019 outbreak in Iran.

This cross-sectional study was performed on 494 individuals with type 2 diabetes (T2D) in a diabetes specialty clinic. The questionnaire package comprised five parts, including sociodemographic and clinical characteristics, physical activity level, diabetes-specific social support, feelings of isolation, and diabetes-related distress. Clinical and hemoglobin A1c data were obtained from electronic medical records. Descriptive statistics, Pearson’s chi-square test, and multivariable logistic regressions were conducted to analyze the data.

Approximately 71% of the participants participated in low/insufficient levels of physical activity. The participants who received support from family/friends (odds ratio [OR] = 1.77; 95% confidence interval [CI]: 1.47 - 2.74), diabetes care team (OR = 1.42; 95% CI: 1.15 - 1.77), and neighbors (OR = 1.53; 95% CI: 1.20 - 2.08) were more likely to have sufficient physical activity than those who did not receive these supports. There was also an association between physical activity behavior with feelings of isolation and diabetes distress.

This study points to the importance of social support as an amplifier mechanism for the maintenance of physical activity behavior in individuals with T2D during critical times.

Metabolic syndrome is a cluster of elements linked with type 2 diabetes mellitus and cardiovascular disease (CVD). The early detection of individuals at the risk of developing metabolic syndrome can prevent the development of type 2 diabetes mellitus and CVD.

This study aimed to evaluate the association of the lipid accumulation product (LAP) and triglyceride-glucose (TyG) index with metabolic syndrome among young adults.

This cross-sectional study included 300 young adults within the age range of 20 - 40 years. Metabolic syndrome was defined according to modified National Cholesterol Education Program Adult Treatment Panel III guidelines. The LAP and TyG index were calculated. Multivariate logistic regression and receiver operating characteristic curve analyses were performed to assess the association of the LAP and TyG index with metabolic syndrome.

The LAP and TyG index were significantly associated with metabolic syndrome (P < 0.05). The LAP showed the highest area under the curve (0.882 and 0.905 in male and female subjects, respectively), followed by the TyG index (0.875 and 0.886 in male and female subjects, respectively, at P < 0.0001. The cut-off values for the LAP were 45.65 in males with a sensitivity and specificity of 80% and 46.91 in females with a sensitivity and specificity of 88%. The cut-off points for the TyG index were 8.63 in males with 80% sensitivity and 78.9% specificity and 8.54 in females with 83.3% sensitivity and 79.6% specificity.

The LAP and TyG index are significantly associated with metabolic syndrome in young adults. As simple and inexpensive markers, they can be used to identify individuals with metabolic syndrome with high sensitivity and specificity.