International Journal of Endocrinology and Metabolism
Volume:4 Issue: 3, sep 2006

This study was carried out to determine the im-portance of type 2 Diabetes mellitus as a risk fac-tor for osteoporosis in postmenopausal women. This study was con-ducted in 2004 on 40 diabetic and 40 healthy postmenopausal women attending the endocrine clinics in Zanjan. These two groups were matched in terms of age, length of their meno-pausal period and body mass index. Serum cal-cium, phosphorus, alkaline phosphatase and es-tradiol were measured in all cases and bone den-sities at three sites (Femoral neck, lumbar spine and forearm) were evaluated with dual X-ray ab-sorptiometry (DXA). All data were analyzed us-ing t-test, analysis of variance, chi-square and multiple regression tests. The frequency of osteoporosis and os-teopenia in diabetic women were not signifi-cantly different from non-diabetics. The mean bone density in the femoral neck was higher in the diabetic group (0.806±0.13 gr/cm2 vs 0.726 ± 0.15 gr/cm2), (p: 0.002). In the diabetic group there was a negative correlation between bone density and length of menopause in the femoral neck (r:-0.49, p:0.004), lumbar spine (r:-0.58, p: 0.005) and mid radius (r:-0.37, p: 0.03). The rela-tionship between BMI and bone density was significant in the femoral neck (r: 0.55, p: 0.01) in diabetic women. In diabetic women, the higher the HbA1c the lower the bone density in lumbar spine. Although the level of HbA1c as a marker of blood glucose control has a relation-ship with lumbar spine density in diabetics, dia-betes type 2 is not a risk factor for osteoporosis. Hence measures should be taken individually similar to non diabetic patients, for screening, diagnosis and management of osteoporosis in diabetes type 2.

The main objective of this study was to evaluate the nutritional related lifestyle patterns of newly-diagnosed type 2 Diabetes Mellitus pa-tients in the City of Ahvaz, Iran. One hundred and one type 2 Diabetic subjects who had been referred to the Ahvaz Diabetes Center completed the knowledge, attitude and practice (KAP), food frequency, lifestyle and anthropometric ques-tionnaires in a cross – sectional study. Variables collected were socio-economic status, blood lip-ids and sugar levels, anthropometric indices, daily activity patterns, dietary habits, nutritional knowledge and medical histories. The percent of body fat (BF%) was measured using bioelectrical impedance analysis (BIA) method and obesity was defined according to this variable. Mean of the subjects’ age was 52±9.6 years (67% female). Based on the BF%, more than 60% of women and about half of the men were overweight and / orobese. As a criterion for metabolic syndrome, 88.2% of women and 21.2% of men had abdominal obesity. Thirty-one per-cent of the subjects consumed hydrogenated fats, and 25% consumed dry fruits as sweeteners. Moreover, 69% of subjects had no information on starchy foods glycemic index. Half of the sub-jects were diagnosed as hypercholesterolemic, 57% had TG levels above the recommended lev-els, and 8 percent had hypertension. The prevalence of overweight, cen-tral obesity, hypercholesterolemia, and hyper-triglyceridemia in type II diabetic patients was high with trunk adiposity being more prevalent in females. Patients need to be educated on how to prevent this risk factors and healthier nutri-tional lifestyles.

Data available implies that certain systemic chronic inflammatory disorders and a few pul-monary diseases affect testosterone (T) biosyn-thesis. The status of free testosterone (FT) has not yet been determined in sulfur mustard(SM) induced chronic persistent asthma in Iranian vet-erans for the long term effects. The aim of the study was to assess the status of FT levels on SM induced asthma patients and to compare it with that of non-exposed asthmatics and healthy sub-jects; our goal was also to determine the fre-quency of hypogonad hypogonadism in the tar-get population. Marerials and Protocol of study was based on random selection of target population using a self-report questionnaire, physician di-agnosed asthma, and ratification of SM expo-sure. Two control groups, age and sex-matched, were enrolled accordingly as the non-exposed asthma and healthy subjects respectively. Serum samples of FT, Follicole Stimulating Hormone (FSH), and Luteinizing Hormone (LH) were measured and documented. Forty-three male, war veterans, exposed to chemical warfare were enrolled as the case group, mean age 53.95±6.80 years. The mean se-rum FT levels were 15.70±10.54 pg/mL, the levels of 32.6% of subjects being below the lower nor-mal range. The mean serum values of FSH, LH, and were 11.91± 9.21 mIu/mL, and 10.33±7.46 mIu/mL, respectively. There were 64 non-chemical asthmatics in the patient group, mean age 52.67±6.44 years. Mean FT levels were 16.97±10.15 pg/mL; 22.2% of the asthma control group had low FT levels. The healthy control group had 46 subjects. The mean FT levels were 22.73±8.30pg/mL. The ANOVA and post hoc (Tukey HSD) tests were used to compare the means of groups. Significant differences were observed between the case and non-exposed asthma groups and the healthy control group. The high significance of low FT was notable in the case and asthma control groups. The results may partly be due to the long term toxic effects of SM on testosterone biosynthesis. Further investigation is strongly recommended.

The existence of an association between glu-tamic acid decarboxylase 65 antibodies (GADA) and/or IA2 antibodies and sarcoidosis was evaluated. 78 patients with docu-mented sarcoidosis, divided according to the presence (N=37) or absence (N=41) of autoim-mune manifestations were evaluated for GADA and IA2 antibodies using, a radioligand assay with human recombinant 35S-labeled GAD65 and IA2 respectively. Two patients with GADA (2.6%) and one (1.3%) with IA2ab, both in the group of pa-tients with autoimmunity associated sarcoidosis were found. The GADA positive patient had manifest Type 1 diabetes that succeeded sarcoi-dosis. IA2 ab-positivity was seen among patients with isolated sarcoidosis. GADA and IA2ab fre-quencies were not increased compared to refer-ence subjects (2-3%). No clear association between sar-coidosis and GADA and/or IA2ab was found. In patients with sarcoidosis, GADA seem to be as-sociated with type 1 diabetes or other autoim-mune manifestations rather than with sarcoido-sis per se.

In the last decade, explosion in therapeutic op-tions for management of type 2 diabetes mellitus (DM) have increased significantly with advances in recombinant DNA technology, molecular bi-ology, clinical chemistry; analogs of insulin have replaced animal insulin, and may displace NPH, regular lente, ultra lente, insulin’s. Analogs such as insulin glargine, insulin lispro, insulin aspart, and insulin glulisine are becoming mainstream therapy for even type 2 DM Besides oral hypo-glycemic agents i.e., sulphonyl ureas, biguanides and thiazolidinediones, newer insulin analogs and non-insulin antidiabetics are in various stages of development. Incretin analogs, amylin analogs, combined P PAR-γ and α agonists, islet-neogenesis gene-associated protein (INGAP) are most prominent amongst these. This review fo-cuses on pramlintide, an amylin analog, GLP-1 agonists and exenatide, an exendin 4 analog re-cently approved for use in type 2 diabetes by US FDA. Newer insulin delivery methods and drugs have also been reviewed.

McCune-Albright syndrome is a rare disease de-fined by two of the three classical findings of polyostotic fibrous dysplasia, café au lait spots, and endocrine abnormalities, the most common being precocious puberty. This disease manifests in a mosaic pattern, signifying the sporadic de-velopment of disease during embryogenesis. Re-cent literature has characterized the pathogenesis of this disease, which results from a mutation in the GNAS gene that causes a persistent activa-tion of the G stimulatory-alpha subunit of the G protein cellular signaling complex. This causes a ‘gain of function’ in the cells affected. This paper describes three cases of McCune Albright’s syn-drome and reviews the recent literature regard-ing the pathogenesis of each of the classical find-ings.

The aim of this paper is to present the case of a 15.5 year old girl with primary hyperparathy-roidism (PHPT) with symptoms of bone pain that appeard 2-3 years prior to admission; she had suffered bone fracture six months earlier and had high serum calcium, very high serum PTH and low serum phosphorous levels, all re-sults being in agreement with PHPT. The diagnosis was confirmed by imaging studies with 99m TC-Sestamibi scan, showing an ade-noma in parathyroid tissue. The adenoma was removed by surgical operation. After surgery the patient was treated by high doses of calcium and vitamin D to avoid postoperative hypocalcemia.