مجله غدد درون ریز و متابولیسم ایران
سال بیست و سوم شماره 5 (پیاپی 119، آذر و دی 1400)

Prediabetes predisposes people to type 2 diabetes and cardiovascular diseases. This study investigated the relationship between dietary protein intake and its sources with prediabetes in Tehranian adult women.

This cross-sectional study was conducted between September 2020 and November 2020 in District 16, Tehran, by recruiting 82 women with prediabetes and 164 healthy women aged between 25 and 59 years. We used a 147-item Food Frequency Questionnaire to obtain information on food intake. The subjects’ weight, height, waist and hip circumference, and body mass index were determined, and their physical activity was assessed. Prediabetes was defined based on the American Diabetes Association criteria. The odds ratios (OR) of prediabetes were assessed among quartiles of dietary protein intake and its sources using conditional logistic regression after controlling for confounders.

The mean age of the case and control women were 40.4±10.2 and 40.9±8.4 years, respectively. The OR of prediabetes was significantly lower in participants with a higher intake of calories derived from proteins and nuts than in other participants (P<0.001). However, no statistically significant relationship was found between the quartiles regarding calories derived from carbohydrates, fats, and other protein sources.

The results showed that the percentage of calories derived from proteins and nuts had a significant relationship with prediabetes among women. However, no significant relation was found between other sources of protein and prediabetes.

Type 2 diabetes mellitus (T2DM) and thyroid disorders are common endocrine disorders. It seems that T2DM and thyroid gland dysfunctions are interlinked and influence each other. This study aimed to assess the prevalence of overt hypothyroidism (OH) and subclinical hypothyroidism (SCH) in type 2 diabetic patients admitted to Imam and Golestan Hospitals, Ahvaz, Iran.

This retrospective study was performed by studying the records of type 2 diabetic patients admitted to Imam Khomeini and Golestan Hospitals, Ahvaz, in 2020-2021. A total of 420 T2DM patients were evaluated using thyroid function tests, including thyroid-stimulating hormone (TSH). OH was considered at TSH levels of ≥ 10 mIU/mL and T4 below normal range, and SCH was considered at TSH levels of <5 mIU / mL and normal T4.

Of the patients, 34 (8.1%) had OH, and 61 (14.5%) had SCH. OH and SCH were more common in females than in males (P<0.0001). The frequency of OH and SCH was not significantly different based on age groups, weight groups, type of diabetes treatment, duration of diabetes, serum vitamin D level, hypertension, and dyslipidemia.

This study showed a high prevalence of OH and SCH in patients, particularly women, with T2DM. Therefore, patients, predominantly females, with T2DM should be routinely screened for hypothyroidism.

Exercise training has been suggested as a potential non-pharmacological strategy to prevent cardiovascular injuries. However, the role of exercise is controversial in preventing the progression of injuries caused by diabetic cardiomyopathy or their repairing. Therefore, this study aimed to evaluate the effect of aerobic exercise training on left ventricular apoptotic and antioxidant indices in a high-fat diet and streptozotocin-induced type 2 diabetic rat model.

  Twenty-four male Wistar rats, 7-8 weeks of age, were randomly divided into two groups of normal diet (n = 8, ND) and high-fat diet (n = 16, HFD). The high-fat diet rats were given a free diet containing 55% fat for four weeks. For diabetes induction, 30 mg/kg of streptozotocin (STZ) was injected intraperitoneally into obese rats. Diabetic rats were subdivided into two groups: control diabetic (n= 8, CD) and diabetic-training (n = 8, TD) groups. The training group performed aerobic exercises on a treadmill for four weeks. The normal diet and control diabetic groups did not receive any exercise training.

Diabetes caused left ventricular catalase activity (p=0.001) reduction and increased caspase-9 (p=0.001) and P53 (p=0.001). Exercise training increased the maximum oxygen consumption rate by 37% (p=0.003) in the diabetic rats. The TD group had lower HOMA-IR (p=0.01) and plasma glucose (p=0.003) than the CD group. Also, aerobic training increased catalase (p=0.01) but decreased caspase-9 (p=0.001) and P53 (p=0.005) in the diabetic rats.

Progressive aerobic exercise training can contribute to insulin resistance amelioration by increasing catalase activity and reducing apoptotic indices. Therefore, aerobic exercise training can be used as an effective non-pharmacological method of treating diabetic cardiomyopathy.

Mitochondrial function is regulated by the dark-light cycle under physiological and pathological conditions. Time-dependent exercise interventions may affect metabolic health in diabetic patients by regulating hyperglycemia. However, limited data are available about the correlation between the time of exercise and the regulation of muscle circadian rhythm in diabetes conditions. This study aimed to investigate the effect of time of exercise in the dark-light cycle on SIRT1 protein expression and the NAD+/NADH ratio in the gastrocnemius muscle of diabetic mice.

In this experimental study, thirty healthy male NMRI mice were randomly divided into three groups: control, diabetic, and diabetic+exercise. Type 2 diabetes was induced using a combination of a high-fat diet (five weeks) and streptozotocin injection (20 mg/kg body weight). Eight weeks of aerobic exercise with moderate intensity (5 days, 80-60 minutes) were performed on a treadmill at two times of the day, the early light phase (ZT3) at 9:00 AM and the early dark phase (ZT15) at 9:00 PM. Gastrocnemius muscles were collected at two times of the day, and SIRT1 protein expression was evaluated by Western blot analysis. The cellular NAD+/NADH content and glucose concentrations were measured using the colorimetric method. A two-way analysis of variance was used to analyze the data.

Eight weeks of aerobic exercise significantly increased SIRT1 protein and NADH levels (P<0.001) and improved hyperglycemia (P=0.005) only in the early dark phase. Aerobic exercise increased the NAD+/NADH ratio independently of time (P=0.003).

Proper exercise timing in the early dark, along with SIRT1 protein and NAD+ level circadian changes, may strengthen the effects of exercise and correct hyperglycemia more effectively.

Studies examining the effect of Empagliflozin in patients with type 2 diabetes have reported different results regarding the effect of this drug on electrolytes and lipid profiles. This study aimed to evaluate the effect of Empagliflozin on electrolytes and lipid profiles in patients with type 2 diabetes.

In this systematic meta-analysis, clinical trials published in the Web of Science, Scopus, PubMed, and Cochrane Library databases up to April 2022 were reviewed. Information on the mean and standard deviations of electrolytes, including phosphate, calcium, sodium, potassium, magnesium, and lipid parameters, including total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides, before receiving Empagliflozin was extracted from the selected studies and analyzed.

A total of seven clinical trials with 398 patients were analyzed. The sodium, potassium, phosphate, and magnesium levels remained unchanged or slightly changed after receiving different doses of Empagliflozin. Estimation of the standardized mean difference of calcium after receiving 10 mg of Empagliflozin was insignificant. The standardized mean difference in levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides was insignificant after receiving different doses of Empa gliflozin.

Administration of Empagliflozin in patients with type 2 diabetes does not affect phosphate, calcium, sodium, potassium, magnesium, total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. However, further research is needed due to the small number of studies and conflicting results on the issue.

The constantly increasing incidence of type 2 diabetes, probably due to obesity and sedentary life, has led to the increased incidence of macro- and microvascular diabetic complications such as nephropathy. Despite the prompt efforts to develop effective treatments for diabetes and slow the progression of its complications, it is still reported as the most common cause of chronic kidney disease in developed countries. Albuminuria has been widely accepted as the first sign of diabetic nephropathy and an independent factor for acute kidney failure. However, growing evidence suggests diminished kidney function and decreased glomerular filtration rate (GFR)in a significant number of non-albuminuric patients with type 1 or type 2 diabetes, known as non-albuminuric diabetic kidney disease (NA-DKD). This highlights the need for more research on reduced kidney function in non-albuminuric diabetic patients. The present study examined the known epidemiology, pathology, kidney prognosis, and mortality rate from NA-DKD compared to various types of albuminuria. The study also characterized the potential mechanisms of NA-DKD and discussed its future perspective.