مجله غدد درون ریز و متابولیسم ایران
سال سیزدهم شماره 1 (پیاپی 55، اردیبهشت 1390)

Probiotic yoghurt is considered a functional food and has beneficial effects on human health. In some animal studies, the effects of probiotics in decreasing plasma glucose and delaying the onset of hyperglycemia and insulin resistance have been reported. Considering the ever-increasing prevalence of type 2 diabetes, the aim of the present study was to investigate the effects of probiotic yoghurt on diabetes markers and insulin resistance in type 2 diabetic patients.

This double-blind, randomized clinical trial was conducted on 60 type 2 diabetic patients that had referred to endocrine and metabolism clinic of Sina hospital in Tabriz. Subjects in the intervention group consumed 300 grams of probiotic yoghurt daily, while those in the control group consumed 300 grams of conventional yoghurt daily for 6 weeks. Dietary intakes, anthropometric measurements, fasting blood sugar, insulin, glycosylated hemoglobin and insulin resistance were measured at baseline and at the end of the study. Paired Samples t-test and Analysis of Covariance were performed by SPSS software for statistical analyses.

Mean fasting blood sugar and glycosylated hemoglobin were significantly different between two groups after intervention (P<0.05). In the probiotic yoghurt consumption group, fasting blood sugar decreased significantly throughout the study (P<0.01), whereas, reductions in insulin concentration, glycosylated hemoglobin and insulin resistance in this group were not significant (P>0.05).

Considering the positive effect of probiotic yoghurt in reducing fasting blood sugar in type 2 diabetic patients, consumption of probiotics is recommended as auxiliary therapy in these patients.

According to some studies, sufficient breastfeeding may prevent β-cell infection and type 1 diabetes mellitus. This case-control study was designed to assess the relation between type 1 diabetes mellitus and nutrition patterns in the first 2 years of life and some demographic factors. One hundred children, from the Iranian Diabetes Association with type 1 diabetes, and 200 non-diabetic children from primary and guidance school from district 3,4 and 7 of Tehran, were assessed according to the easy sampling method. The data required were gathered using a demographic and nutritional questionnaire completed by the child's mother. For determining of the adjusted odds ratio, logistic regression was used. The percent of children who were exclusively breastfed, for less than 4 months, were higher in cases than controls, statistically significant (OR=5.60, P=0.008). There were significantly more mothers, whose weight gain during pregnancy was lower than mean weight gain (10.75kg), in the control group, (OR=0.52, P=0.04). Similar numbers of children consumed cow’s milk before age 1, in both the diabetic and non diabetic groups. According to our findings, exclusively breastfeeding for at least 4 months and lower maternal weight gain during pregnancy prevent type 1 diabetes mellitus, whereas early introduction of weaning food, consumption of cow’s milk and higher birth weight play no role in the development of type 1 diabetes.

The aim of this study was to investigate the effect of broccoli sprout powder (BSP) on fasting serum glucose (FBS) and lipid profiles in type 2 diabetic patients.

Sixty-three type 2 diabetic patients were randomized into three groups: 1)10g/d BSP, n=21, 2) 5g/d BSP, n=22 and 3) 5g/d placebo, n=20. Serum levels of FBS, total cholesterol (TC), triglycerides (TG), LDL-C, HDL-C were measured before and 4 weeks after intervention.

After 4 weeks, broccoli sprouts powder induced a significant (13.5%) decrease in TG concentration in group 1, as compared to controls (p<0.05). Higher mean concentration of HDL-C was observed after 4 weeks in group 1, compared to group 2 and controls (p<0.05). Atherogenic index of plasma was significantly, lower in group 1 as compared with other groups, after 4 weeks intervention (p<0.01). As compared to baseline, FBS and TC decreased significantly, 19.6% and 16.5% in group 1, and 12% and 12.5% in group 2, after 4 weeks. TC: HDL-C and LDL-C:HDL-C ratios significantly decreased, 12.3% and 10.6% in group 1 after 4 weeks (p<0.05).

Administration of broccoli sprout powder had favorable effects on lipid profiles, in type 2 diabetic patients.

Living with diabetes needs these individuals to have empowerment, which requires support of health professionals’. Unfortunately, data shows health professionals can often fail to fulfill their professional responsibility in facilitating the empowerment process in people with diabetes. Understanding the patient's initial response to diagnosis of diabetes is the first step to help them to control their illness. The aim of the study was to investigate and comprehens the patient's response to their diagnosis. This qualitative research study used in-depth interviews to collect data from 21 participants, selected by purposeful sampling. Data was analysed using constant analysis. Findings showed that the first response of people, on being given a diagnosis of diabetes, included fear of being perceived as different, and of losing control of their body and life, all of which was affected by enhancement of support, and awareness beliefs of the nature of disease. Diagnosis of diabetes is a stressful event for the patient and threatens their identity culturally and socially. Considering the close contact health professionals have with diabetic people, it would seem that the negative psychological effects of being diagnosed a diabetic could be ameliorated by increasing awareness and knowledge for both patient and caregivers empowering the former in disease management.

Studies have shown beneficial health effects of the Mediterranean diet, for instance, it’s associations with risk of chronic disease. In this study, the associations between of adherence to the Mediterranean diet and obesity and abdominal obesity were evaluated among Tehranian adults, participants of the Tehran Lipid and Glucose Study. Subjects, whose dietary intake were recorded at baseline, and were followed up for 6.7 years, were assessed. Dietary intake was assessed using two 24-h dietary recalls, and all subjects received scores between 0 to 10 points, based on the modified Mediterranean diet scales (MDS). The components of MDS were vegetables, fruits, legumes, nuts, fish, whole grains, refined grains, dairy, PUFA to SFA ratio, and red to white meat ratio. The mean±SD for age of participants was 36.7±12.3 years; 45.8 and 54.2% were men and women, respectively. After a follow-up period of 6.7 years, higher adherence to the Mediterranean diet was significantly associated with lower BMI in women (quartile 1: 28.4±0.2 in comparison to quartile 4: 27.7±0.3 kg/m2, P<0.05). After adjustment for BMI, physical activity, and smoking status, adherence to the Mediterranean diet was significantly associated with waist circumference in women (quartile 1: 90.1±1.8 in comparison to quartile 4: 89.0±1.9cm, P<0.05). No association was observed between adherence to MDS and BMI or waist circumference, in men. This study showed that in women, adherence to the Mediterranean diet had an inverse relationship with BMI and waist circumference.

The rising read in the prevalence of, non-communicable diseases makes assessment of its risk factors essential. Considering the importance of interventions targeting lifestyle modification for prevention of these diseases, the current study aimed to evaluate perceptions and experiences of Tehranian women regarding healthy nutrition. This is a qualitative study, conducted using the grounded theory approach. In total 8 semi-structured focus group discussions were conducted at the Tehran Lipid and Glucose Study (TLGS) unit, between 2008 and 2009. Participants were 102 women, aged 25-65 years, selected and recruited from the TLGS cohort. All interviews and focus group discussions were audio recorded and transcribed verbatim. Qualitative content analysis of the data was conducted manually according to the Strauss and Corbin analysis method and differences in in coding were resolved via discussions by at least three researchers. The conformability and credibility of the data were established. Using content analysis, “inefficient education”,” lack of access”, and “individual tastes and preferences” were identified as the barriers to healthy nutrition. Study results demonstrated the three main personal and environmental barriers for healthy nutrition as perceived by women. Understanding these barriers might facilitate the designing of effective preventive strategies, and implementation appropriate of interventions among Tehranians.

Defining dietary patterns by factor analysis is an alternative approach to dietary assessment. Our aim was to assess both the validity and reproducibility of major dietary patterns, based on data from obtained using a food frequency questionnaire (FFQ) among Tehranian women. Using random sampling of registries, women aged 18 to 45 years were selected. The first food frequency questionnaire (FFQ1) was completed by trained interviewers. We asked our subjects to record their diet, 2 days per month, during 1 year. At the end of the year, a second FFQ (FFQ2) was again completed by interviewers. By conducting factor analysis, dietary patterns were identified. Two factors were detected in the 3 sets of data. For assessing reproducibility, the Pearson correlation was assigned to detect the correlations between factor scores measured in FFQ1 and FFQ2. The reliability correlations for the factor scores between the 2 FFQs ranged from -0.05 to 0.11, for the 2 factors. The validity correlations for the factor scores between the FFQ1 and dietary records (ranged from -0.16 to 0.29, for the 2 factors) and between FFQ2 and dietary record (ranged from 0.02 to 0.11 for the 2 factors) were detected. Our results indicate that identification of dietary patterns, using a food frequency questionnaire, in this group was not a reproducible or valid method.

The aim of this experimental, cross-sectional study was to investigate the effect of one session of moderate and heavy resistance exercise on the acute and delayed responses of leptin, insulin, cortisol, testosterone and 24-hour energy expenditure in healthy men. Thirteen healthy men (age 37.5yr, body mass index 26.40kg/m2, body fat 22.46%) randomly participated in three exercise groups, the moderate resistance exercise (MR, 3 sets × 10 repetitions at 70 % 1 repetition maximum (1RM)), the heavy resistance exercise (HR, 3 sets × 10 repetitions at 80 % 1RM) and the controls(C). Blood samples were taken (after overnight fasting) before and immediately after exercise and after 4 and 9 hours of recovery. Serum leptin, insulin, cortisol and testosterone concentrations were measured using ELISA methods. After adjusting for percentage changes of plasma volume, serum leptin reduced immediately after exercise and control sessions but returned to primary levels after 9 hours of recovery (p<0.05). Immediately after exercise and control sessions, serum cortisol and testosterone decreased and serum insulin increased. No significant change was seen in 24-hour energy expenditure after MR and HR protocols. To conclude there were no meaningful acute and delayed effects of moderate and heavy resistance exercise on serum leptin, insulin, cortisol, testosterone and 24- hour's energy expenditure in healthy men.

Heat shock proteins act as guardians of cells. The stimulation of these proteins due to stress conditions that activates the cell protective mechanisms is essential. In this study, in order to assess the effects of lead, regular exercise endurance and HSP72 protein supplement Curcumin on the liver tissue, 48 mice were classified randomly into control groups 1) Base and 2) Sham and four experimental groups included 3) Lead, 4) Lead + endurance training, 5) Lead + Curcumin, 6) Lead + endurance training + Curcumin. Groups of 3 to 6 received 20 mg of lead; groups 5 and 6 in addition to lead received 30 mg/kg curcumin for 8 weeks and 3 days intraperitoneally. Furthermore, groups 4 and 6 performed progressive running training sessions, 15 to 22 m/min, for 25 to 64 min, five times a week; HSP72 level in homogenized liver tissue was measured by ELISA method. Data were analyzed by one way ANOVA test, P≤0.05. HSP72 and malondialdehyde levels in the lead group were significantly higher than the other groups, while superoxide dismutase and total anti-oxidative capacity were less than other groups. In contrast, HSP72 and malondialdehyde in the curcumin, endurance training and the combination groups were significantly lower than the lead groups. These findings suggest that healthy lifestyle, including aerobic exercise and anti oxidant supplements may have beneficial effects in preventing oxidative damage caused by lead.

This study in restigates the effect of one session of swimming and running training on hunger rate and ghrelin, insulin and cortisol hormones of the plasma in the healthy girls. Twelve girls participated in three modes of control, swimming and running training at 80-85% intensity of maximum heart rate, up to exhuastion. The hunger rate of the individuals before taking blood and eight hours after the training was assessed through appetite questionnaires. Blood samples were taken before, immediately after and two hours after the training sessions. No significant change was observed in the hunger rate immediately, or two and eight hours after the training after one session of swimming and running training whereas one session of swimming and running training increased ghrelin immediately and two hours after the training. Cortisol decreased in three stages, immediately and two hours after the training in comparison withbase line levels, a reduction lower than that of controls. One session of swimming and running training prevented any significant rise in insulin. Swimming and running training causes ghrelin to increase, but has no effect on hunger rate.

The purpose of this study was to compare fat and carbohydrate oxidation at different intensities of exercise until exhaustion, between professional and elite amateur cyclists. Forty-two professional cyclists (27.3± 4.2 yr) and 31 elite amateur cyclists (23.7±3.6yr) performed incremental exercise tests on a bicycle ergometer with 50 Watt increments, every third minutes until volitional exhaustion. Heart rate, the average volume of oxygen consumption, production of carbon dioxide and respiratory exchange ratio were measured during the rest time and the last 3 minutes of the exercise with working loads of 200, 300 and 400 Watts. The results showed that there was no significant difference in RER between the two groups at rest time and intensity of 200w, but at intensities of 300w and 400w, RER was significantly lower in professional cyclists (P=0.01). There was no significant difference between professional and elite amateur cyclists regarding the rate of fat and carbohydrate oxidation at different intensities of exercise. Also, there was no significant difference in the percentage of fat and CHO oxidation during the trials, between the two groups. With increasing exercise intensity, the fat oxidation rate decreased significantly (p=0.001); however between rest mode and intensity of 200w, the difference was not significant. The findings of present study suggest that although there is a little difference in fat and carbohydrate oxidation between professional and elite amateur cyclists, this small difference and the small amount of carbohydrates saved in professional cyclists leads to their superior performance.

The association of subclinical hypothyroidism and metabolic syndrome is debatable. We aimed to find out whether there was a correlation between subclinical hypothyroidism and or its components. Using the stratified, multistage probability cluster sampling method, with a probability in proportion to size procedure we randomly selected 1200 women, aged 18-45 years, from among reproductive aged women, living in urban areas of four randomly selected provinces of different geographic regions of Iran,. Each woman underwent an evaluation that included standardized history, physical exam, biochemical and hormonal assessment. Metabolic syndrome was defined according to the ATPΙΙΙ definition and subclinical hypothyroidism was diagnosed, based on serum concentration of more than the upper normal limit of TSH (mIU/l 4.5). The prevalence of metabolic syndrome in women with subclinical hypothyroidism was not significantly different in comparison to normal ones (19% vs. 16.8%), however the prevalence of two metabolic syndrome components (low HDL and high TG) was significantly more in those women. There was a negative significant association between serum concentration of TSH and HDL-C, after adjusting for age, BMI and HOMA-IR. Although this study did not find the relationship between subclinical hypothyroidism and metabolic syndrome, because of its correlation with some components of this syndrome, thyroid dysfunction can be considered as a risk factor for metabolic syndrome, and further investigations to confirm this are recommended.

Hypertension in children and adolescents is rare. Although there are many publications about hypertension in children suffering from pheochromocytoma or aldosterone producing tumors, there is limited data on hypertension in androgen or mixed hormone producing tumors of adrenal glands in pediatric groups. Paucity of data on this topic may be in part due to rarity of these tumors. The objective of this study was to shed more light on the prevalence of hypertension and its outcome in children and adolescents suffering from functional adrenal tumors. Nine patients, 5 girls and 4 boys, aged 2-16 years who were referred to the private office of one of the authors (A.A MG), or the department of endocrinology at Taleghani general hospital between 1985-2009 were studied. Imaging, and biochemical tests, using commercial kits, and histopathologic evaluation were done at the Taleghani hospital. All patients except one had hypertension. In three patients hypertension was severe and in one patient it had caused left ventricular hypertrophy. This is the first study dealing with the problem of hypertension in secreting adrenal tumors among pediatric and adolescents groups in Iran. Importance, clinical presentation and pathogenesis of hypertension in this unusual disease are discussed.