مجله غدد درون ریز و متابولیسم ایران
سال سیزدهم شماره 2 (پیاپی 56، تیر 1390)

The increasing prevalence of childhood obesity and related disorders have become a major health concern, prompting calls for the intervention strategies. The aim of the present study is to describe trends in cardiovascular risk factors in Iran. Data on cardiovascular risk factors in 2000, 2003 and 2006 in a cohort of subjects, aged 2-17 years in the TLGS group were used. To assess secular trends, Body Mass Index, waist circumference, waist to hip ratio, systolic and diastolic blood pressure, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglycerides and fasting blood sugar were compared between the three phases. Waist to hip ratio in all age groups of boys increased significantly in phase two(P=0.01,0.0001,0.001 respectively). Also, blood pressure levels continued to decrease in all subjects. There were significant decreases in total cholesterol, low density lipoprotein and triglycerides in some groups. A significant increase was observed in waist circumference in 7-12 year old boys in phase two (P=0.0001, 0.001 respectively). The prevalence of overweight increased in boys in phase two (P=0.001) and in girls in phase three (P=0.05). Obesity increased significantly in boys in phase three (P=0.001) and in girls in phase two (P=0.001). Hypercholesterolemia increased in both sexes in phases two and three (P=0.001, 0.01 respectively) and HDL<35mg/dl increased in boys (P=0.001). Increase in cardiovascular risk factors in emphasizes the urgent need for interventions.

The aim of this study was to investigate the effects of lifestyle status on dyslipidemia which may be responsible for the metabolic syndrome. One hundred forty one males (n=47; mean ± SD: 43.7 ± 7.8 years of age) and females (n=94; mean ± SD: 43.7 ± 7.8 years of age) participated in this study. Each subject’s lifestyle status was assessed by self-administered questionnaires, based on Breslow’s lifestyle index and a composite dietary behavior score, obtained from self-reported responses to a 24-item food-frequency questionnaire, was used to categorize eating habits as more/less healthy. The results demonstrated a negative relationship between Breslow’s lifestyle index and physical fitness level and dyslipidemia (P<0.05). On the other hand, the results showed that less healthy diets were associated with total cholesterol, triglycerides and LDL-C. Multiple regression analysis demonstrated that food consumption patterns were independently associated with blood lipid profiles in females, while physical fitness level was independently associated with blood lipid profiles in males. In conclusion, unhealthy lifestyles may cause dyslipidemia, findings which present reasonable explanations for the relationships between lifestyles and lifestyles-related diseases.

This study, aimed to evaluate the ratio between Energy Intake and Resting metabolic Rate (EI/RMR) among female Tehranian adults, and to compare age and anthropometric and dietary characteristics between relatively under and over reporters. This cross-sectional study included 187 healthy women, aged 18 to 45 years. The EI/RMR ratio was used as an indicator of reporting accuracy, with EI/RMR<1.35 considered to represent under reporting, and EI/RMR ≥2.4 as over-reporting of EI. Data on age, antropometric and lifestyle variables were gathered by a second questionnaire designed for this survey. In addition dietary intake was assessed by a semi-quantitative 125 item food-frequency questionnaire. ANOVA was used for data analysis. EI/RMR was 1.6±0.6 (mean±SD). Thirty-five per cent of the subjects had EI/RMR <1.34, while 7% of the subjects showed EI/RMR>2.4. BMI correlated negatively (β=-0.199, P<0.01) with EI/RMR. Age, BMI, body weight, waist and RMR decreased significanlty with the increase in EI/RMR (P<0.01). The oldest age group (≥40) had lower EI/RMR values than the youngest age group (30>) (1.5 vs.1.8). Under-reporters consumed less fish, magarine, coffee, sweet and fat than did the other subjects. Under-reporting, rather than over-reporting of energy intake was predominant in this female population of Tehran. BMI was the most important factor affecting the reporting accuracy of energy intake.

Since monitoring and evaluation of diabetes and hypertension in individuals/the population greatly contribute to improving both clinical care and following identification of disease in the region and even the country, and to manage prevent and control diabetes and hypertension and their risk factors, the goal of this study was to compare disease status in rural areas of Fars province and rural areas of the EMRO region.

The current study is a descriptive-analytic cross sectional one that has been conducted in 2008 by randomized cluster sampling, based on data obtained from an extensive provincial screening plan for adults aged over 30 years in rural areas of Fars province. Based on these data, the prevalence of diabetes, hypertension and their risk factors were calculated and the relationship between diabetes and hypertension was determined by risk factors including age, sex, family history, and MI using Chi square and t-test and SPSS software version 17 and Minitab version, prevalences in 15 is rural areas were compared with the ones in EMRO region countries.

The prevalence of hypertension and diabetes rural areas of Fars province were calculated to be 21.8% and 11.14% respectively as compared with rural areas of EMRO region countries.The prevalence of diabetes was also lower on the average and the prevalence of obesity (BMI>30), was less than other countries in the region and Iran.

In general, although, the prevalence obtained in this study was lower than other regional countries, raising a wareness in high rish groups affected public commitment to basic information transmitting to high risk classes of the society should be taken into account and commitment by the health system administration and the government to sustain monitoring of health, to ensure curtailing the burden of diabetes and hypertension and associated risk factors among countries of the region.

Since sleeplessness and oversleeping are known to have adverse effects on human health, this study designed to compare sleep quality among non diabetic persons, those with impaired fast blood glucose and/or impaired glucose tolerance and diabetics. In a cross sectional study, 834 participants including 384 diabetics, 245 subjects with impaired fast blood glucose and/or impaired glucose tolerance) and 205 healthy persons were studied, and data was collected using standardized questionnaires and laboratory assessments. MANCOVA test was conducted to analyze the data using SPSS version 16. Of the participants, 73% were women. Mean±SDs of age and BMI were 48.4±8.6 years and 29.2±4.5, respectively. Mean±SD for sleep qualities were 6.5±3.6 in diabetics and 5.8±3.3 in the others. Sleep disturbance score was meaningfully related to sex, age, educational levels, depression score, and glycosilated hemoglobin. Sleep disturbances in diabetics, especially women were more prominent than non-diabetics and significantly related to depression scores. Sleep hygiene and mental status, depression in particular, play crucial roles in diabetics and diabetes-prone individuals.

Considering the controversial findings documented on the apolipoproteins A and B association as cardiovascular risk factors and the severity of CAD, this study evaluated the apoA and apoB association with severity of coronary artery disorders in an Iranian population. In a cross-sectional study 144 consecutive patients who were scheduled for coronary angiography, were divided into two groups according to severity of coronary stenosis (Mild, severe) and their medical histories and demographic data were collected. Before angiography, fasting blood samples were taken to measure fasting blood sugar, total cholesterol, triglycerides, and apoA and apoB. Based on their to angiography results, patients were divided groups one and two, with mild and severe coronary artery involvements, respectively Aplipoprotein levels and ratio were compared by Chi -square, Fisher, logistic regression and t-student tests in both groups. Mean age of groups one and two were 57.7±9.6 and 58.24±11.3 years respectively. Apoliprotein levels and apoA/apoB ratio had no significant association with severity of coronary artery disease involvements (p≥0.05), findings which remained after adjusting data for confounding variables (p≥0.05). Factors that affect the disease severity may differ from the etiological factors that cause the disease. Hence further studies on these are recommended.

Intracellular adhesion molecule-1 is one of the factors associating obesity and inflammatory lesions like atherosclerosis. This study examined the effects of resistance (R) and endurance (E) training on serum levels of sICAM-1 and lipid profiles in sedentary obese women. Participants included 24 (8 control, 8 RT and 8 ET) obese (BMI≥30) women, studied before and after 10 weeks of resistance training (40-60% of 1RM) and swimming endurance training (at 50-60% of HRmax), 3 days/week. Serum levels of sICAM-1, lipid profiles and anthropometric indices were measured at baseline and again 48 hours after training. Statistical analysis was done by paired t-test. ANOVA and Pearson correlation, and P value<0.05 was considered significant. Levels of sICAM-1 (P=0.042), cholesterol (P=0.006) and HDL-C (P=0.006) changed significantly following 10 weeks of endurance and resistance training compared to those of the control group. There was significant decrease in serum levels of sICAM-1 in the both RT (P=0.012, 21.7%) and ET groups (P=0.017, 18.4%). Although significant changes did not exist in lipid profiles after resistance training (p>0.05), TG (P=0.001), cholesterol (P=0.043) and HDL-C (P=0.002) changed significantly in the endurance training group. Hence there were significant correlations between the primary level of sICAM-1 and primary values of BF% (P=0.031), pelvic (P=0.005) and waist (P=0.006) circumferences following endurance training, whereas changes in the levels of sICAM-1 or lipid profiles and anthropometric markers did not correlate significantly in the resistance training group (p>0.05). Although decrease in sICAM-1 level may be associated with the beneficial effects of training on body composition or/and lipid profile, further studies are needed to elucidate the mechanisms responsible for the effects of resistance training on ICAM-1 level.

There is a lack of national/regional data on the relationship between breast cancer and thyroid diseases and the limited data available are controversial. This study was designed and conducted to investigate thyroid autoimmunity in women with newly diagnosed breast cancer. Methods and Materials: In a case-control study, 40 women with confirmed diagnoses of breast cancer and 40 age-matched healthy counterparts were recruited during a 12-month period from outpatient clinics of the Tabriz University of Medical Sciences. The case group were enrolled for the study before receiving treatment. Thyroid and physical examination was carried out in all participants and serum levels of TSH, FT4, ATPO and ATG were determined. The results were compared between two groups, and different histopathological subgroups of breast cancer. The mean age was 49.48±7.75 and 46.80±7.00 years in the case and control groups respectively. Thyroid and physical examination were normal in all participants. TSH, ATPO and ATG serum levels were comparable between the two groups; however, the median level of serum FT4 was significantly higher in the case group (1.20 μg/dl vs. 1.03 μg/dl; p<0.001). Increased levels of serum TSH and FT4 were found in 7.5% of the cases, while there were decreased levels in 2.5% of the cases, with no significant differences between the two groups. Thyroid tests were comparable between the different histopathological subtypes of breast cancer. No relationship was found between thyroid autoimmunity and breast cancer, a finding in concordance with some reports and in contrast with others. It seems that further studies with larger sample sizes are needed for conclusive findings.

Ghrelin, a peptide hormone secreted from the endocrine cells of stomach, affects appetite, energy consumption, weight, and body composition. Although the effects of endurance exercise on weight loss have been demonstrated, results on the impact of this exercise on ghrelin levels are controversial, and are from studies performed in athletes. The aim of this study was to investigate the response of serum ghrelin, growth hormone, and cortisol after a single session of aerobic exercise in young non-athlete male students. Sixteen non-athlete male students, randomly selected, performed a single session of aerobic exercise, including 3 consecutive- one mile running sessions with 3 minutes rest period at the end of each mile. The participants in this study had a mean age 22.7±2.1 years, weight 72.8±5.7 kg, height 177.9±5.7 cm, and body mass index 23.2±1.7. To determine levels of these hormones, plasma ghrelin, GH, insulin, and cortisol, blood samples were taken, using the ELISA method. The results of paired-samples t-test showed that the levels of growth hormone and ghrelin increased significantly in the plasma, whereas insulin and cortisol levels decreased (P<0.05). These data suggest that a single session of aerobic exercise can decrease energy reservoirs and increase ghrelin secretion in response to energy deficit to supply and balance the sources of energy loss. Therefore it is clear that activity duration is an important parameter in the increase in ghrelin levels in response to exercise.

Metabolic syndrome, a collection of risk factors for cardiovascular risk factors, refers to a cluster of symptoms, the simultaneous occurrence of which in a person is more likely than the occurrence of each perse. The criteria proposed by the International Diabetes Federation for the diagnosis of this syndrome include central obesity, increased triglycerides, decreased HDL-C, hypertension, and increased fasting blood sugar. Signs of metabolic syndrome can be determined through the interconnected physical and chemical changes in the human body, genetic and environmental factors. One of the most effective factors in metabolic syndrome is change in the lipid profiles. Based on the roles of apolipoproteins in lipid metabolism, the possibility of their role in metabolic syndrome has been documented. The aim of this review is to evaluate the genetic roles of apolipoproteins in metabolic syndrome. Overall, the evidence suggests that the apolipoproteins A particularly APOA5 more associated with this syndrome. On the other hand, despite the prominent role of apolipoprotein B in fat metabolism, there is no evidence on any correlation between B-100 apolipoprotein and lipoproteins such as HDL and triglyceride levels of the symptoms of metabolic syndrome.