مجله غدد درون ریز و متابولیسم ایران
سال چهاردهم شماره 6 (پیاپی 66، بهمن 1391)

The aim of this study is to evaluate anti-thyroid drugs, radioactive iodine and surgery for treatment of patients with hyperthyroidism. Medical records of 1022 patients who referred to endocrinology clinic between 1999 to 2005 were evaluated. Demographic information, onset of disease, thyroid gland weight based on to clinical examinations before and after treatment, thyroid function tests, onset for relapse, onset for hypothyroidism, and side effect for treatment methods were recorded. Statistical analysis was done. For Grave's disease, after long term treatment with anti thyroid drugs and a 31±16 month follow up, there were 39.6% euthyroid cases without side effects; after treatment with radioactive iodine and a 30±11 m follow up there were 18% and after treatment by surgery and a 13 m follow-up there were 7% cases, difference was statistically significant (P<0.001). In TMNG, there were 33% euthyroid cases after treatment with iodine radioactive; and a 29±19 months follow up and after surgery there were 29% after 18±12 months of follow up. There were no significant changes (P=0.363). Surgery complications were 36%. In patients with toxic adenoma, there were 70% euthyroid cases after treatment with radioactive Iodine and a 27±10 m follow up, and for surgery there were 75% such cases after 16±8 months of follow up (P=0.502). Surgical complications were not seen in patients treated for toxic adenoma. The first step in the treatment of Grave's is long-term treatment with anti-thyroid drugs. In TMNG, radioactive iodine therapy is preferred, because of the high rate of complications effects for surgery.

Diabetic ketoacidosis (DKA) is a major cause of morbidity and mortality in diabetic patients. The aim of this study is to provide comparative information and to determine the common precipitating factors, clinical manifestations, and outcome of diabetic ketoacidosis in children and adult diabetic patients. Data retrieved from case records, of 300 randomly selected children and adult diabetic patients with DKA admitted in Nemazee Hospital, Shiraz, Iran between March 2007 and March 2011 with respect to precipitating factors, clinical features, osmolality, blood glucose, serum electrolytes, and arterial PH at admission, and their outcomes were analyzed and compared. The mean age of the study population was 19.59±17.45 y. Thirty four percent with new-onset diabetes presented with diabetic ketoacidosis. The most precipitating events identified were infection, and insulin omission. The mean blood glucose, serum potassium, serum sodium, osmolality, and pH at admission were 524±184 mg/dL, 4.76± 1.1 mEq/L, 135.8± 10.38 mEq/L, 311±18 mOsm/L, and 7.10±0.16, respectively. Hyponatremia and hyperkalemia occurred in 45.1% and 19.9%, respectively. Severe acidosis was much more common in younger than older individuals the typical symptoms including polydipsia and polyuria, nausea and vomiting, abdominal pain, and body weight loss. Mortality rate was 5%, the most common cause of death being uncontrolled infection. Results showed that infection and insulin omission are the major identifiable causes of DKA, which compared to its adult form is a much more common problem amongst pediatric admissions.

Cardiovascular diseases rank first among causes of death in Iran and most other countries. Determination of the risk factors of these diseases and their importance in the incidence of myocardial infarction is very important in formulating preventive programs for these diseases. This study was designed to evaluate the relationship between the risk factors of heart diseases and the time to event for myocardial Infarction using the Weibull model. In the TGLS study, 5183 men and women, aged over 30 years, without cardiovascular disease from the East of Tehran were studied. Data were analyzed using Weibull distribution and Cox proportional hazard models. During 6.5 years of follow up, a total of 83 new cases of MI (53 men and 30 women) accured. Cumulative incidence of MI was 0.0025. The Weibull multivariate regression model, showed significant relationships between FBS, sex, SBP and smoking and MI Wiebull regression models, showed that FBS levels over 126 mg/dl, adjusted for age, sex, LDL, SBP, DBP, HDL and TG, decrease time to MI by 2.87 compared to normal persons. Variables of FBS, age, sex, LDL, SBP, DBP, HDL, TG, and smoking are the most important predictive factors of Myocardial Infarction.

This study aimed at assessing the association of HDL-C level with nutritional factors and anthropometric indices in subjects with low HDL-C levels.

This descriptive analytical cross-sectional study was conducted on 138 overweight adults with HDL-C < 40 mg/dL. After 14-h fast, HDL-C levels were measured. Physical activity level, fat mass, lean mass, height, weight, waist and hip circumference were measured using standardized protocols, and body mass index, waist-to-hip ratio, and waist-to-height ratio were calculated. Dietary intakes were assessed using three 24-h dietary recalls.

The mean±SD age of participants (61% males) was 46.6 ±13.6 years. After adjustment for confounding factors, no significant association between HDL-C level and intakes of energy or, macro-and micro nutrients were observed. Among the nutritional factors studied, intakes of total polyunsaturated fatty acid (β= 0.213, P=0.012), linoleic acid (β= 0.148, P=0.046), alpha linolenic acid (β= 0.136, P=0.044) and docosahexaenoic acid (β= 0.165, P=0.035) were found to have significant positive associations with HDL-C levels. Also linear regression analysis showed an inverse association between HDL-C levels and weight (β= -0.224, P=0.041), waist circumference (β= -0.187, P=0.050) and waist to hip ratio (β= -0.236, P=0.036).

HDL-C level had significant associations with some of the dietary and anthropometric factors.

Self-efficacy beliefs are the predicting indices of a wide range of health behaviors. The present study was conducted to study the relationship between weight-efficacy of life style and overweight and obesity. In this case-control study, 101 individuals with BMI ≥ 25 as the obese group and 101 persons with BMI between 18-25 as the normal group were selected using convenience sampling from among the administrative staff in Zahedan University of Medical Sciences in 1391. Data was gathered using the "Weight-Efficacy of Life style questionnaire", the reliability of which had been evaluated by test–retest and its validity was assessed using different methods such as factor analysis, convergent and divergent validity. Data were analyzed by spss software (version 15) and using t test, ANOVA and logistic regression tests. Mean scores of Weight-Efficacy of Life style in three settings of social pressure, access to food and positive emotions in the obese group were higher than those of the normal group. Weight- Efficacy of Life style in the obese group compared to the normal weight individuals is low, especially in the three settings of social pressure, access to food and positive emotions. Enhancing and supporting the self efficacy in weight loss programs seem to be of crucial importance.

Inter cellular adhesion molecule -1 (ICAM-1) is an important new factor which can predict cardiovascular disease (CVD). Accordingly, the purpose of this study was to investigate the correlation between plasma concentrations of inter cellular adhesion molecule–1 (ICAM-1) and cardiorespiratory fitness and anthropometric indices as noninvasive methods. From all among the male and female university personnel, 127 (72 men and 55 women) healthy and nonsmoker subjects (age: 36.62±5.7 years, VO2max:27.32±6.72 ml/kg.min) were selected using a medical questionnaire. Anticubital veinblood samples were taken in fasting status at rest. VO2max was then evaluated on a treadmill with gas analyzer and measurement of anthropometric factors (BMI, WHR and PBF) were measured in all the subjects in the laboratory. Serum ICAM-1 were measured by ELISA method. In women, controlling for their menstrual cycle, blood sampling was taken in follicular phase (3-8 days after onset of their menstrual period) and VO2max test was performed in 3-9 days (i.e., in the luteal phase). Data were analyzed using the Pearson correlation and multinomial regression. The results showed that there were no significant correlations between ICAM-1 and VO2max, BMI, or PBF (P>0.05), wheares there was a signicant positive correlation between WHR and ICAM-1 in middle aged individuals (P=0.01). In addition, because of a strong correlation observed between VO2max and WHR (P=0.00), this factor could be used with WHR for more complete models in predicting the plasma concentration of ICAM-1. Findings showed that visceral fat tissue, compared to other factors, is more effective in predicting ICAM-1 concentrations.

The purpose of this study was to investigate the effects of low and high intensity aerobic exercises on energy intake, appetite and energy-regulating hormones. Sixteen sedentary women (age 22.50±1.46 yr, height 160±4.30 cm, weight 57.83±4.25 kg, fat percent 28.26±1.79) were randomly divided into two groups, of low (55% MHRR for 45 min/day) and high (75% MHRR for 30 min/day) intensity. All subjects participated in two experimental durations, two days apart; five days control with no exercise, and five days exercise. Subjects dietary intakes were recorded using a food diary and self-weighed intakes during each of the five days. The visual analogue scale (VAS) was completed at each morning in a fasted state. Levels of acylated ghrelin, insulin, leptin, and glucose were measured in the morning on the 6th day in fasting status after control and exercise conditions. No significant changes were found in absolute and relative energy intakes, level of acylated ghrelin and leptin between the two durations (p>0.05). However, insulin concentration reduced significantly after the exercise duration in the low-intensity exercise group (p=0.007). Also, the desire to eat (p=0.02) and prospective food consumption (p=0.03) increased significantly during exercise days in the high-intensity exercise group. Exercise-induced energy deficits were compensated by 23% and 14% in low and high-intensity exercise groups respectively. Five consecutive days exercise with low and high intensities do not create a negative energy balance and it is recommended that women need to increase energy expenditure and decrease energy intake concurrently for weight control.

Oxymetholone is an active nutritional anabolic steroid – androgenic which can result in some abnormalities such as lung cancer, ovarian cycle irregularity and liver cancer. The aim of this study is to investigate oxymetholone induced complications in levels of testosterone, LH, FSH hormones in mature progeny male rats, whose mothers were treated by oxymetholone during different pregnancy and lactation periods. In this study we used fifty six female rats and fourteen male rats aged 110-120 days, weighing were approximately 200±20g. The animals were divided into groups including control, solvent 1 (pregnancy- 21 days), solvent 2 (pregnancy- lactation- 42days) solvent 3 (lactation – 21 days), experimental 1 (pregnancy 21 days) experimental 2 (pregnancy- lactation- 42 days), and experimental 3 (lactation-21 days). Solvent groups used DMSO with 99.5% concentration and experimental groups used oxymetholone with 10 mg/kg concentration by intra peritoneum method. Hormone concentrations were measured by the radio immunoassay method. The rate of LH indicated significant decrease in experimental groups of pregnancy-lactation and lactation. FSH levels in the experimental groups of pregnancy-lactation and lactation and also testosterone in the experimental groups of pregnancy-lactation decreased compared to the control group. Oxymetholone in these doses most probably results in decreased LH, FSH and testosterone concentrations, leading to disturbances in the reproductive system of wistar.

On the 25th anniversary of the Chernobyl power plant accident, interest was rekindled by the recent Japan nuclear disaster, and the medical consequences from the fall out are once again under scrutiny. In a nuclear power plant, the fuel, is an isotope of either Uranium or Plutonium. In the event of an accident, radioactive elements escape into the environment. By far the most dramatic accidents occurred at the Chernobyl nuclear power plant in 1986 and at the Fukushima nuclear power plant of Japan on March 11, 2011. A major health hazard of a nuclear accident is childhood thyroid cancer which can be avoided if stable iodine is administered as prophylaxis during the hours immediately following the accident and particularly in young children. Early administration of iodine is critical because it is not as useful if taken six hours after radiation exposure. Prior to 1986 the usefulness of this prophylaxis was controversial since there was limited data on is potential carcinogenic risks. At present, however there is no doubt that prophylaxis with potassium iodide (KI) with limited consumption of contaminated food is not harmful and useful if administered promptly.