International Journal of Endocrinology and Metabolism
Volume:6 Issue: 2, jun 2008

This study aimed at investigating whet-her oral medroxyprogesterone acetate (MPA) or micronized progesterone (P) combined with micronized estradiol (E2) adversely affect endothelial function in postmenopausal women. Randomized, double-blind, crossover trial of MPA or micronized P with oral E2 treatment in menopausal women. Flow-mediated, endothelium-dependent vasodilation of the brachial artery was not sig-nificantly affected by short-term administration of E2 alone or E2 combined with cyclic MPA, or E2 combined with cyclic P. Short-term oral E2 treatment of postmenopausal women alone or with cyclic oral MPA or oral P did not affect flow-mediated en-dothelium-dependent vasodilation.

Although the decline in sex steroid levels, particularly estradiol, may be largely responsible for age-related bone loss and osteoporotic fractures in older women, the insulin-like growth factor (IGF) system may also play a key role. This study aimed at evaluating the relation between the secretory status of growth hormones (GH), insulin-like growth factor I (IGF-I) and In-sulin-like growth factor binding protein 3 (IGFBP3) and bone mineral density (BMD) in postmenopausal women. In a descriptive cross-sectional study, 150 postmenopausal healthy women were selected from among 1328 patients, referred to Tabriz Sina Hospital for bone densi-tometry, and divided into three groups according to their bone mineral density (BMD) (normal, os-teopenic and osteoporotic). The GH response to provocation by clonidine was assessed in all pa-tients. One hundred and fifty patients with a mean age of 65.6±6.6 years, were enrolled in this study. The impaired GH response to provocation by clonidine was significantly more common in the group with osteoporosis compared to their healthy and osteopenic counterparts (72% vs. 56% and 44%, respectively; p=0.018). Mean levels of serum IGF-I and IGFBP3 were not signifi-cantly different in healthy, osteopenic and os-teoporotic patients (55.4±20.7 μg/L, 57.5±21.7 μg/L, and 56.7±19.2 μg/L; p=0.880 and 2648.3±786.4 ng/ml, 2374.0±707.2 ng/ml, and 2613.5±1023.6 ng/ml; p=0.217, respectively). There was no strong cor-relation between the level of serum IGF-I or IGFBP3 and T-Score (r=-0.026, p=0.753 for IGF-1 and r=0.046, p=0.575 for IGFBP3). The results of this study showed that the defective release of GH is more prevalent in postmenopausal women suffering from osteoporosis; such a defect was not observed regarding serums of IGF1 and IGFBP3. Prescription of supplementary doses of synthetic GH might be beneficial in this population.

IGF-1), leptin, and cortisol concentrations in maternal and umbilical cord vein and to investi-gate the relationship between these values and fetal growth in appropriate for gestational age (AGA) and small for gestational age (SGA) neo-nates. In a case-control study, maternal and umbilical cord venous samples were collected from 25 SGA neonates and 25 AGA neonates in the obstetric ward at Hafez Hospital, Shiraz, Iran, between 2004 and 2005. Serum levels of IGF-1, leptin, and cortisol were measured by specific radioimmunoassay using commercial kits. Mean maternal age was 25.38±5.22 years (range 17-38 yr) and mean gestational age was 37.92±1.79 weeks (range 34-41 weeks). Mean con-centration of leptin and IGF-1 in cord blood was lower in SGA as compared with AGA neonates (p<0.012 and p<0.001, respectively). Maternal se-rum concentration of IGF-1 and cortisol were lower in SGA neonates (p<0.032 and p<0.011, re-spectively), however there was no significant difference in the concentration of maternal leptin levels between the two groups. A correla-tion was observed between the head circumfer-ence of neonate and maternal cortisol levels in the SGA group (p<0.01). Low IGF-1 and leptin concentra-tions in cord blood and low maternal serum con-centration of IGF-1 and cortisol are associated with growth retardation in SGA as compared to AGA neonates. Also maternal cortisol level plays an important role in intrauterine brain de-velopment of SGA neonates.

Carpal tunnel syndrome (CTS) is the most com-mon type of peripheral nerve entrapment and is a significant cause of morbidity; this syndrome has a higher incidence in diabetic patients. It has been suggested that insulin has an effect on nerve regeneration similar to that of nerve growth factor (NGF). Hence we aim to evaluate the effectiveness of local insulin injection on the median nerve in patients with type 2 diabetes mellitus who have mild-to-moderate carpal tun-nel syndrome. We carried out a single-blind randomized controlled trial (RCT) study in 50 patients, using a simple sampling and a ran-dom allocation of these 50 patients, of whom 20 had bilateral mild-moderate CTS, into two groups; 35 women and 15 men, aged between 43 to 60 years old, resulting in 70 hands, were cate-gorized into two groups. At baseline, we injected NPH insulin (10 U) directly into the carpal tun-nel in group 1 and performed physiotherapy for the other group (group 2). Two weeks later, NPH insulin (10 U) was again injected into the carpal tunnel, while physiotherapy was continued for group 2. Electrodiagnostic studies were carried out for these both groups before and 4 weeks af-ter the last injection and physiotherapy, and pa-tients were followed up for 6 weeks. In both groups, decrement of distal mo-tor latency (DML) of the median nerves was sta-tistically significant, as was the increment of the sensory nerve conduction velocity. Also the dec-rement of pain, paresthesia, numbness, weak-ness/clumsiness and nocturnal awaking was sta-tistically significant in both groups; however there was no significant difference between two the groups. Local insulin injection is an effec-tive and safe treatment for carpal tunnel syn-drome in type 2 diabetic patients as physiother-apy.

The main goal of this study was to evaluate the effect of age and body mass index (BMI) on ovar-ian reserve markers in fertile Iranian women. One hundred fifteen fer-tile women were included in this cross-sectional study conducted from May 2005 until December 2006 in the Arash Hospital, Tehran. A transvagi-nal ultrasound examination and blood test were carried out between the third and fifth day of their menstrual cycle (follicular phase). The ovarian volume was measured and total antral follicles (AFC) were counted. Hormonal markers such as FSH, LH and estradiol were measured. Age had positive correlation with FSH (r = 0.819, P <0.01) and FSH/LH (r = 0.452, P <0.01). Meanwhile age had negative correlation with to-tal ovarian volume (r=-0.835) and AFC (r=-0.924) P value < 0.01. Age had no effect on LH and es-tradiol levels (P > 0.05). Comparison of ovarian reserve markers between the four age subgroups (25-30, 31-35, 36-40 and 41-45 years) showed the FSH level, total ovarian volume and AFC had significant differences between these groups, while LH and estradiol did not different be-tween subgroups. Meanwhile BMI had moderate positive correlation with FSH (r = 0.35, P <0.01) and LH (r=0.30, P <0.01) and moderate negative correlation with estradiol (r=-0.20, P<0.05), total ovarian volume (r=-0.31) and AFC (r=-0.41) by P <0.01. In multivariate analysis after adjustment of age, BMI as an independent factor had no ef-fect on ovarian reserve markers. AFC had the best correlation with age, followed by ovarian volume, FSH level and FSH/LH, making it a better predictor of ovarian response than BMI.