مجله غدد درون ریز و متابولیسم ایران
سال دهم شماره 2 (پیاپی 38، تیر 1387)

Physical activities have beneficial effects on type 1 diabetes patients, who are often exempted from sport activities, due to general concerns about the possible side effects of diabetes. The aim of this study was to evaluate the effect of 8-weeks of regular physical activity on blood glucose, body fat percent, maximal oxygen uptake (Vo2max) and risk factors of cardiovascular diseases in type 1 diabetes patients. Twenty non-active patients, ranging in age from 15-25 years, participated in an 8-week regular physical activity program. Training consisted of 45-60 minutes aerobic exercises (60-80% Heart rate reserve) three times a week. Blood samples, body fat percent, maximal oxygen uptake were obtained before and after the 8-week training period. The fasting blood glucose, HDL-c, LDL-c levels and BMI did not change (p>0/05), but the BF%, TG, BPs, BPd and HR rest levels decreased and Vo2max level increased (p<0/05). Eight weeks of regular physical activity had a positive effect on some physiological factors (BF%, TG, BPs, BPd, HR of rest and Vo2max) but had no effect on other factors such as fasting blood glucose, HDL-c, LDL-c and BMI.

Liver steatosis causes progression in liver damage and accelerates liver fibrosis. There is lack of data in Iran regarding the prevalence and risk factors of fatty liver in carriers of HBV. The current study was performed to assess the prevalence and risk factors of fatty liver in carriers of HBV in Iran. This study was conducted between 1995 and 2006, as a cross sectional study, on 1120 asymptomatic HBV carriers, selected from the hepatitis clinic of the Tehran Blood Transfusion Organization. Age, sex, marital status and paraclinacal data including CBC, LFT, PT, lipid profile, FBS, and alcohol consumption were recorded using a checklist. Fatty liver, found in 106 subjects, showed a significant correlation with sex (p=0.001), job (p=0.01), cigarette smoking (p=0.009), and previous history of liver disease (p=0.007) liver disease also had a significant correlation with Hg levels (p=0.001), AST (p=0.001), ALT (p=0.001), total bilirubin (p=0.004), direct bilirubin (p=0.032), and TG (p=0.002). FBS and total cholesterol levels were not significantly correlated with fatty liver (p>0.05). Fatty liver is seen in 10% of asymptomatic HBV carriers considering the negative impact of fatty liver on liver damage, it is essential to screen HBV carriers for the presence of fatty liver. Male, smokers, and those with disturbances in lipid profile are at a higher risk.

The Rostral Ventromedial Medulla (RVMM) is one of the nuclei controlling cardiovascular system. This study was performed to delermine the effects of 17β-estradiol (E), on the GABA and Glutamate cardiovascular responses of RVMM of female rats Experiments were performed on 40 anaesthetized and paralyzed rats, divided into two groups of ovarictomized (OVX) and ovarictomized-estrogen treated (OVX+E) rats. Drugs (50 nl) bicuculline methiodide (BMI) an antagonist GABAA receptor (1 mM), phaclophen an antagonist GABAB receptor (5mM), and kynurenic acid a nonselective antagonist glutamate receptors (5 mM), were microinjected by micropipette into the RVMM using stereotaxic system. Blood pressure and heart rate were recorded before and throughout each experiment. The means of maximum changes of mean arterial pressure and heart rate were compared between groups of OVX and OVX+E and saline using ANOVA. In the OVX+E group, estrogen decreased the mean arterial blood pressure (P<0.05) and heart rate (P<0.001) compared to those of OVX group. Microinjection of BMI resulted in an increase of heart rate (HR) with no significant effect on the blood pressure (BP) in both OVX and OVX+E, but the increase of HR was significantly higher than in the OVX+E group (p<0.05). Microinjection of phaclophen and kynurenic acid had no significant effect on HR and BP in either the OVX or the OVX+E group not did microinjection of saline have any significant effects on HR and BP. The present data suggest that estrogen decreased the mean arterial blood pressure and heart rate, and in the RVMM of female rats augments the inhibitory effect of the GABAergic system on the heart rate via the GABAA receptors.

Pareneteral vitamin D3 administration, a common practice in Iran, is usually used based mainly on clinical symptoms or serum mineral disturbances. Since studies about the effects and side effects of parenteral vit D3 preparations are limited, this study was designed to evaluate the effect of different intramuscular vitamin D3 dosage on serum 25(OH)D levels. In this study, 54 health voluneers were selected, and randomly assigned to 4 groups, based on their serum vitamin D3. Mean body mass index, age and sex frequency were not significantly different between groups. Mean serum 25(OH)D levels before injections were 27.24±21.30, 25.21±17.09, 24.70±16.8 and 25.10±14.48 ng/mL in groups I to IV respectively. Vitamin D3 was injected in dosages of 300/000, 600/000, 900/000 units and placebo in groups I-IV respectively. 25(OH)D levels were determined before, and at 2 weeks, 2 months and 4 months after injection. Serum 25(OH)D levels before injection were significatly higher compared to levels assessed 2 and 4 months after injection. At the end of study, in groups I to III, mean serum 25(OH)D levels in group I to IV were 48.20±28.32 ng/mL, 65.46±33.52 ng/mL, 72.90±37.68 ng/mL, and 14.38±11.14 ng/mL respectively. Frequency of vitamin D hypervitaminosis in groups I, II and III was 9%, 38% and 40% respectively. Usage of parenteral vit D3, especially dosages higher than 300/000 IU, is associated with a high risk of vitamin D hypervitaminosis.

The aim of this study was to estimate the prevalence of overweight and obesity in high school students in Birjand. This cross- sectional study was performed in 2005 in Birjand, on 2230 students (1115 boys and 1115 girls), 15-18 years old. Subjects were selected via a step wise random sampling from four districts of Birjand. Overweight and obesity was defined based on the 85th and 95th percentiles of body mass index for age and sex, respectively, as proposed by CDC in 2000. The overall prevalence rates of overweight and obesity were 6.1% and 2.3%, respectively. The prevalences of overweight were 5% in high school boys and 7.1% in girls the prevalences of obesity were 2.8% in boys and 1.8% in girls of high schools. Overweight and obesity increased with the higher educational levels of father and mother, working fathers and private schools. According to this study, prevalences of overweight and obesity in Birjand adolescents are lower than in other areas of Iran it is however necessary to perform further similar researches periodically in this area, to confirm these results.

There is no convincing evidence about the role of vitamin C in preventing exercise induced oxidative stress. The aim of this double blind randomized controlled trial was to determine the effect of vitamin C supplementation on oxidative stress, following 30 minutes of moderate intensity exercise. Forty-nine healthy, young female university students were randomly assigned into the 500 mg/day vitamin C supplement (n=25) and the placebo (n=24) groups for two weeks. Before supplementation and on the day after the intervention period, fasting blood samples were taken. Then all participants ran (5-6 km/h) for 30 minutes. A third set blood samples were taken at the end of exercise. Plasma malondialdehyde (MDA) and vitamin C were measured with the HPLC method. Plasma total glutathione was measured with the glutathione assay kit. No significant differences were observed in the demographics, vitamin C intakes before intervention between groups at baseline. Plasma MDA levels decreased and plasma total glutathione increased significantly in both groups. No significant differences were observed between groups after exercise. There were significant differences in plasma vitamin C concentrations after intervention and exercise between groups. Vitamin C supplementation (500 mg/day) for two weeks does not affect oxidative stress markers following moderate intensity exercise in healthy young women.

In 2003, the American diabetes Association (ADA) recommended that the definition for a cut off of impaired fasting glucose (IFG) should be changed to 100- 125 mg/dl. This study has examined the effect of different cut points for IFG on diabetes incidence in Tehran's urban population. A total of 4929 (non-diabetic adults), aged 20-86 years, participants of the Tehran Lipid Glucose Study, were followed for diabetes incidence (based on FBS and glucose tolerance tests) for 3.5 years and were divided into various groups, normoglycemia < 100, original IFG 110-125, added IFG 100-110 and new IFG100-125 mg/dL. Odds ratio for diabetic incidence after adjustment for confounding factors with logistic regression model was measured. The mean ages were 42.9±13.7 (minimum 20 & maximum 86 years old) 59.1% of participants were female (n= 2916). Prevalences of original IFG, added IFG and new IFG were 3.7% (n=183), 11.8% (n= 584), 15.5% (n= 767) respectively. At the end of study, 188 cases (3.8%) were diabetic. Incidence of diabetes in the normoglycemia, original IFG, added IFG and new IFG groups were 1.8% (n= 76), 26.2% (n= 48), 11% (n= 64), and 14.6% (n= 112) respectively. Odds ratios for diabetes incidence after adjustment for age/sex and confounding factors compared with normglycemia, diabetes incidence were 11.4 (7.4-17.6), 4.7 (3.3-6.8), 6.3 (4.5-8.5) for original IFG, added IFG, and new IFG respectively. The new IFG definition does not appear to have enhanced ability to predict diabetes incidence compared to the original IFG definition.

Osteoporosis is a life threatening disease. One of the important etiologies of osteoporosis is low calcium intake from daily dietary intakes, making calcium salt administration in pharmacological form or as a food additive highly recommendable as a protective mechanism againt this disease, especially in women. Calcium acetate is a water soluble agent whereas calcium carbonate (which is routinely used in pharmacological forms of calcium salts) is not easily dissolved in water hence we decided to compare the bioavailability of calcium carbonate to that of calcium acetate. During a clinical trial study, 20 normal female volunteers with the appropriate inclusion criteria were enrolled. On the day of study, fasting urine specimens were collected from all subjects, and 2 hours after a meal, a solution of calcium carbonate was administered to all participants and then, again, urine specimens were collected after 4 hours. After a 10 day washout period, this test was repeated with calcium acetate. The results were analyzed with paired t test. The mean increase in urine calcium was 38.55 ± 6.1 mg and 36.33 ± 6.14 mg after administration of calcium carbonate or calcium acetate respectively. There was no statistically significant difference between calcium absorption from calcium carbonate and calcium acetate. Regarding the beneficial effects of calcium acetate as a soluble salt, in comparison with calcium carbonate and based on the results of this study indicating the similarity in calcium absorption from these two salts, calcium acetate can be administered as an appropriate substance for prevention and treatment of osteoporosis. Indeed it can be used in enriching the liquid comestibles.

Ocular complications are the most important impediment that result from uncontrolled blood sugar among diabetics. For eye care, patients need to be educated on how to control their blood sugar and increase their behavioral preventive skills. The purpose of this study was to determine the effects of educational program based on the BASNEF (Belief, Attitude, Subjective Norm, Enabling Factors) Model on Diabetic (Type II) eye care in Nader Kazemi Clinic, Shiraz City. This is a perspective and quasi-experimental intervention study, the research population being type II diabetics, between the ages of 40 and 65 years, having had diabetes for over 5 years. During the first visit of the subject's eyes exam, 68 of 215 patients, diagnosed with ocular complications, were eliminated from the study. Finally, 100 diabetic patients, fufilling the inclusion criteria, participated in the study, and were randomly divided to two groups, experimental and controls. The instruments for data collecting were a questionnaire established based on the BASNEF Model, a check list related to patient practice on the basis of self reporting, a check list for recording the patient's HbA1c and FBS levels, and the ophthalmologist's eyes exam report as well. All groups completed the questionnaires and check lists, and ophthalmic eye examination results were documented before and three months after intervention. The patients of the experimental group participated in 6 educational session classes during the one month of intervention and again two months after, with 2 session meeting classes as the follow up of intervention. The data were collected and analyzed by SPSS computer software. Our findings indicated that mean scores of BASNEF Model variables (beliefs, attitudes, subjective norm, enabling factors) were significantly increased in the experimental group compared to the controls after intervention. Also, behavioral eye care, rate of HbA1c (before intervention as 8.65% after three months 7.47%) and FBS levels (before intervention 207.08, after three months 124.2) improved significantly among the experimental group, compared to control group. Applying the BASNEF Model is very effective for developing an educational program for diabetics, in order to control their blood sugar and enhancing behavioral eye care. Besides such programs, follow up education on controlling and monitoring is highly recommended.

The many advantages of exclusively breast feeding infants are documented breast-feeding enhances the growth and development of breast fed infants. The impact of Ramadan fasting by breast-feeding mothers on the growth parameters of exclusively breast-fed infants is still not clear. The aim of this study was to evaluate the impact of maternal fasting during Ramadan on the growth parameters of their exclusively breast-fed infants. This cohort study was performed throughout Ramadan and for five months after, on healthy, exclusive breast-fed infants (n=116), aged between 15 days to 6 months, assigned into two groups, based on their mothers fasting: Control group (n=80) and fasting group (infants with fasting mothers: n=36). All infants underwent periodic physical examinations twice in Ramadan, 3 times in the second month and then twice monthly in next 4 months. The infant’s growth status was evaluated by calculating each growth parameters (weight, height, head circumference) as a percentage of the median value for age, based on appropriate growth charts. The mean age of infants in the case group was 3.43 ± 1.38 and in the control group was 2.31±1.45 months, age being significantly different between the two groups (P<0.05). Fifty-four (46.6%) were boys and this proportion was the same in both groups (P>0.05). According to the repeated measures ANOVA, all growth parameters increased during the study period (P< 0.05) but the rate of increaseing was the same for both groups (P>0.05). Ramadan fasting by breast-feeding mothers did not adversely affect on the growth parameters of exclusively breast-fed infants.

Carbohydrate contents of different foods may have different effects on postprandial blood glucose. This study was done to measure and compare glycemic indices and some nutrients in three types of rices. This study was conducted to compare the glycemic effects of 50g carbohydrate in the Basmati, Kazemi and Sorna Perl types of rice in normal subjects. Thirty healthy subjects (13 male and 17 female), aged between 20-40 years, were selected, and were evaluated 4 times at 1 week intervals. On the first day, all subjects consumed 50 gram glucose they were then divided into 3 groups. Each group consumed one of the 3 rice types, with 50g carbohydrate content each week. Blood samples were collected before and at 15,30,60 and 120 minutes, after taking glucose and rice. At the end of the experiment, all subjects received all three kinds of rice and the GI was calculated for each rice as the ratio of the incremental area under the 3- hour glycemic response curve to rice, to the incremental area under the 3- hour glycemic response curve to sugar. The glycemic indices of Sorna Pearl, Kasemin and Basmati were 52/2±5/1, 67/6±13 and 61/2±6/1 respectively, the GI of Sorna perl being lower than the others (p<0/05). Maximum changes of blood sugar for Sorna Perl, Kasemi and Basmati were 21/8±12, 27/4±6 and 31/7±5/9 mg/dl respectively. The results of this study indicate that in healthy of the 3 types of rice cnsumed subjects Sorna Perl had the lowest GI and GL.

Obesity is a main public health problem worldwide and obese individuals are at high risk for developing micronutrient deficiencies. One of these micronutrients is magnesium, which is a cofactor for more than 300 enzymes in the body. The aim of this study was to investigate serum magnesium concentration and its relationship with body composition in obese and non obese women. Eighty-two reproductive age women (42 obese women and 40 non obese women) participated in this study. Body composition was analyzed by HUMAN – IMPLUS. Serum calcium, magnesium and phosphorous levels were measured colorimetricaly and serum alkaline phosphatase was measured by enzymatic method. Basal concentration of serum magnesium in obese women was significantly lower than in non obese women(P<0.05). There was a significant negative relationship between serum magnesium and BMI, kilograms of body fat, body fat percent and waist circumference and a significant positive relationship between serum magnesium and percent of fat free mass however, this was not shown for obese and non obese women separately. Prevalence of magnesium deficiency was not significantly different between two groups. Obese women have lower serum magnesium than non obese women. Hence these individuals need to improve their dietary magnesium intake.