International Journal of Endocrinology and Metabolism International Journal of Endocrinology and Metabolism Int J Endocrinol Metab http://www.endometabol.com 1726-913X 1726-9148 10.5812/ijem en jalali 2017 5 28 gregorian 2017 5 28 14 2
en 27679648 10.5812/ijem.33997 Lipodistrophy and Associated Risk Factors in Insulin-Treated People With Diabetes Lipodistrophy and Associated Risk Factors in Insulin-Treated People With Diabetes article-commentary article-commentary Insulin;Needles;Lipodystrophy Insulin;Needles;Lipodystrophy http://www.endometabol.com/index.php?page=article&article_id=33997 Sandro Gentile Sandro Gentile Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy Felice Strollo Felice Strollo Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy; Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy; Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy Antonio Ceriello Antonio Ceriello Department of Endocrinology, Hospital Clinic de Barcelona, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigacion Biomedica en Red de Diabetes y Enfermedades Metabolicas Asociadas (CIBERDEM), Barcelona, Spain Department of Endocrinology, Hospital Clinic de Barcelona, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigacion Biomedica en Red de Diabetes y Enfermedades Metabolicas Asociadas (CIBERDEM), Barcelona, Spain
en 27679652 10.5812/ijem.36091 Care of the Athlete With Type 1 Diabetes Mellitus: A Clinical Review Care of the Athlete With Type 1 Diabetes Mellitus: A Clinical Review review-article review-article Conclusions

Managing T1DM in the context of exercise or athletic competition is a challenging but important skill for athletes living with this disease. A proper understanding of the hormonal milieu during exercise, special nutritional needs, glycemic control, necessary insulin dosing adjustments, and prevention/management strategies for exercise-related complications can lead to successful care plans for these patients. Individualized management strategies should be created with close cooperation between the T1DM athlete and their healthcare team (including a physician and dietitian).

Results

The majority of current literature available exists as recommendations, review articles, or proposed societal guidelines, with less prospective or higher-order treatment studies available. The available literature is presented objectively with an attempt to describe clinically relevant trends and findings in the management of athletes living with T1DM.

Evidence Acquisition

PubMed searches were conducted for “type 1 diabetes mellitus AND athlete” along with “type 1 diabetes mellitus AND exercise” from database inception through November 2015. All articles identified by this search were reviewed if the article text was available in English and related to management of athletes with type 1 diabetes mellitus. Subsequent reference searches of retrieved articles yielded additional literature included in this review.

Context

Type 1 diabetes mellitus (T1DM) results from a highly specific immune-mediated destruction of pancreatic β cells, resulting in chronic hyperglycemia. For many years, one of the mainstays of therapy for patients with T1DM has been exercise balanced with appropriate medications and medical nutrition. Compared to healthy peers, athletes with T1DM experience nearly all the same health-related benefits from exercise. Despite these benefits, effective management of the T1DM athlete is a constant challenge due to various concerns such as the increased risk of hypoglycemia. This review seeks to summarize the available literature and aid clinicians in clinical decision-making for this patient population.

Conclusions

Managing T1DM in the context of exercise or athletic competition is a challenging but important skill for athletes living with this disease. A proper understanding of the hormonal milieu during exercise, special nutritional needs, glycemic control, necessary insulin dosing adjustments, and prevention/management strategies for exercise-related complications can lead to successful care plans for these patients. Individualized management strategies should be created with close cooperation between the T1DM athlete and their healthcare team (including a physician and dietitian).

Results

The majority of current literature available exists as recommendations, review articles, or proposed societal guidelines, with less prospective or higher-order treatment studies available. The available literature is presented objectively with an attempt to describe clinically relevant trends and findings in the management of athletes living with T1DM.

Evidence Acquisition

PubMed searches were conducted for “type 1 diabetes mellitus AND athlete” along with “type 1 diabetes mellitus AND exercise” from database inception through November 2015. All articles identified by this search were reviewed if the article text was available in English and related to management of athletes with type 1 diabetes mellitus. Subsequent reference searches of retrieved articles yielded additional literature included in this review.

Context

Type 1 diabetes mellitus (T1DM) results from a highly specific immune-mediated destruction of pancreatic β cells, resulting in chronic hyperglycemia. For many years, one of the mainstays of therapy for patients with T1DM has been exercise balanced with appropriate medications and medical nutrition. Compared to healthy peers, athletes with T1DM experience nearly all the same health-related benefits from exercise. Despite these benefits, effective management of the T1DM athlete is a constant challenge due to various concerns such as the increased risk of hypoglycemia. This review seeks to summarize the available literature and aid clinicians in clinical decision-making for this patient population.

Type 1 Diabetes Mellitus;Exercise;Hypoglycemia;Hyperglycemia Type 1 Diabetes Mellitus;Exercise;Hypoglycemia;Hyperglycemia http://www.endometabol.com/index.php?page=article&article_id=36091 William B. Horton William B. Horton Department of Medicine, University of Mississippi Medical Center, Mississippi, United States; Department of Medicine, University of Mississippi Medical Center, 2500 N State Street, Jackson, Mississippi 39216, United States. Tel: +1-6019845601, Fax: +1-6019846665 Department of Medicine, University of Mississippi Medical Center, Mississippi, United States; Department of Medicine, University of Mississippi Medical Center, 2500 N State Street, Jackson, Mississippi 39216, United States. Tel: +1-6019845601, Fax: +1-6019846665 Jose S. Subauste Jose S. Subauste Department of Medicine, University of Mississippi Medical Center, Mississippi, United States; Division of Endocrinology, University of Mississippi Medical Center, Mississippi, United States; Department of Medicine, G.V. Montgomery VA Medical Center, Mississippi, Jackson, United States Department of Medicine, University of Mississippi Medical Center, Mississippi, United States; Division of Endocrinology, University of Mississippi Medical Center, Mississippi, United States; Department of Medicine, G.V. Montgomery VA Medical Center, Mississippi, Jackson, United States
en 27679651 10.5812/ijem.35424 Recurrence of Hyperparathyroid Hypercalcemia in a Patient With the HRPT-2 Mutation and a Previous Parathyroid Carcinoma in Hyperparathyroidism-Jaw Tumor Syndrome Recurrence of Hyperparathyroid Hypercalcemia in a Patient With the HRPT-2 Mutation and a Previous Parathyroid Carcinoma in Hyperparathyroidism-Jaw Tumor Syndrome case-report case-report Conclusions

The recurrence of hyperparathyroid hypercalcemia in HTP-JT syndrome after an initial total parathyroidectomy is a well-known condition necessitating careful management, an evaluation of any underlying genetic abnormality, and a family examination. A surgical treatment and surveillance of calcium and PTH measurements are necessary to prevent a recurrence.

Introduction

Cancer in the parathyroid gland is rare, but parathyroid cancer is occasionally seen in relation to genetic abnormalities. Due to a limited amount of evidence, the optimal handling of these cases is not clear. Furthermore, the presence of a malignant parathyroid tumor is rarely known at the time of the initial operation; therefore, re-operations are often necessary. The aim of this study was to present the case of a patient with a previously diagnosed jaw tumor and parathyroid carcinoma that presents as a recurrence of hyperparathyroid hypercalcemia.

Case Presentation

A 41-year-old patient who was already diagnosed with a parathyroid carcinoma and a jaw tumor caused by a CDC73 mutation, presented with biochemical evidence of increasing parathyroid hormone (PTH) and calcium levels after a previous total parathyroidectomy. The patient’s ionized calcium increased to 1.55 mmol/L and PTH increased to 16.0 pmol/L. A previous genetic analysis revealed a mutation in the CDC73 gene. There was no family history of hyperparathyroidism. We performed a sestamibi scintigraphy and an 11-C methionine (MET) positron emission tomography (PET) scan that showed a recurrence on the left side of the trachea. The patient underwent a third neck operation for the removal of a tumor on the left side of the trachea. The pathology report revealed that the tumor was a lymph node metastasis from the previous parathyroid carcinoma. The patient is currently enrolled in our follow-up regime. Hyperparathyroidism-jaw tumor (HPT-JT) syndrome is a rare autosomal dominant disorder characterized by a parathyroid adenoma or carcinoma, fibro-osseous lesions (ossifying fibroma) of the mandible and maxilla, and renal cysts and tumors. This autosomal dominant familial cancer syndrome has been reported with a variable and incomplete penetrance, and up to 10% of gene carriers do not show any clinical manifestations. Here we present a patient’s case and discuss the literature related to this condition.

Conclusions

The recurrence of hyperparathyroid hypercalcemia in HTP-JT syndrome after an initial total parathyroidectomy is a well-known condition necessitating careful management, an evaluation of any underlying genetic abnormality, and a family examination. A surgical treatment and surveillance of calcium and PTH measurements are necessary to prevent a recurrence.

Introduction

Cancer in the parathyroid gland is rare, but parathyroid cancer is occasionally seen in relation to genetic abnormalities. Due to a limited amount of evidence, the optimal handling of these cases is not clear. Furthermore, the presence of a malignant parathyroid tumor is rarely known at the time of the initial operation; therefore, re-operations are often necessary. The aim of this study was to present the case of a patient with a previously diagnosed jaw tumor and parathyroid carcinoma that presents as a recurrence of hyperparathyroid hypercalcemia.

Case Presentation

A 41-year-old patient who was already diagnosed with a parathyroid carcinoma and a jaw tumor caused by a CDC73 mutation, presented with biochemical evidence of increasing parathyroid hormone (PTH) and calcium levels after a previous total parathyroidectomy. The patient’s ionized calcium increased to 1.55 mmol/L and PTH increased to 16.0 pmol/L. A previous genetic analysis revealed a mutation in the CDC73 gene. There was no family history of hyperparathyroidism. We performed a sestamibi scintigraphy and an 11-C methionine (MET) positron emission tomography (PET) scan that showed a recurrence on the left side of the trachea. The patient underwent a third neck operation for the removal of a tumor on the left side of the trachea. The pathology report revealed that the tumor was a lymph node metastasis from the previous parathyroid carcinoma. The patient is currently enrolled in our follow-up regime. Hyperparathyroidism-jaw tumor (HPT-JT) syndrome is a rare autosomal dominant disorder characterized by a parathyroid adenoma or carcinoma, fibro-osseous lesions (ossifying fibroma) of the mandible and maxilla, and renal cysts and tumors. This autosomal dominant familial cancer syndrome has been reported with a variable and incomplete penetrance, and up to 10% of gene carriers do not show any clinical manifestations. Here we present a patient’s case and discuss the literature related to this condition.

Parathyroid Cancer;Jaw Tumor;Hyperparathyroidism Parathyroid Cancer;Jaw Tumor;Hyperparathyroidism http://www.endometabol.com/index.php?page=article&article_id=35424 Marco Mele Marco Mele Department of Surgery P, Breast and Endocrine Unit, Aarhus University Hospital, Aarhus, Denmark; Department of Surgery P, Breast and Endocrine Unit, Aarhus University Hospital, Aarhus, Denmark Department of Surgery P, Breast and Endocrine Unit, Aarhus University Hospital, Aarhus, Denmark; Department of Surgery P, Breast and Endocrine Unit, Aarhus University Hospital, Aarhus, Denmark Lars Rolighed Lars Rolighed Department of Surgery P, Breast and Endocrine Unit, Aarhus University Hospital, Aarhus, Denmark Department of Surgery P, Breast and Endocrine Unit, Aarhus University Hospital, Aarhus, Denmark MarieLouise Jespersen MarieLouise Jespersen Department of Pathology, Aarhus University Hospital, Aarhus, Denmark Department of Pathology, Aarhus University Hospital, Aarhus, Denmark Lars Rejnmark Lars Rejnmark Department of Endocrinology and Internal Medicine MEA, Aarhus University Hospital, Aarhus, Denmark Department of Endocrinology and Internal Medicine MEA, Aarhus University Hospital, Aarhus, Denmark Peer Christiansen Peer Christiansen Department of Surgery P, Breast and Endocrine Unit, Aarhus University Hospital, Aarhus, Denmark Department of Surgery P, Breast and Endocrine Unit, Aarhus University Hospital, Aarhus, Denmark
en 27679647 10.5812/ijem.28422 Comparison of Metabolic and Hormonal Profiles of Women With and Without Premenstrual Syndrome: A Community Based Cross-Sectional Study Comparison of Metabolic and Hormonal Profiles of Women With and Without Premenstrual Syndrome: A Community Based Cross-Sectional Study research-article research-article Conclusions

There was a significant association between PMS scores and the prevalence of metabolic syndrome. Further studies are needed to confirm and validate the relationships between lipid profile abnormalities and metabolic disorders with PMS.

Objectives

This study was designed to investigate the association of hormonal and metabolic factors with PMS among Iranian women of reproductive age.

Materials and Methods

This study was a community based cross-sectional study. Anthropometric measurements, biochemical parameters, and metabolic disorders were compared between 354 women with PMS and 302 healthy controls selected from among 1126 women of reproductive age who participated in the Iranian PCOS prevalence study. P values < 0.05 were considered significant.

Results

Prolactin (PRL) and triglycerides (TG) were significantly elevated in women with PMS, whereas their testosterone (TES), high density lipoprotein (HDL) and 17-hydroxyprogesterone (17-OHP) levels were significantly less than they were in women without the syndrome (P < 0.05). After adjusting for age and body mass index (BMI), linear regression analysis demonstrated that for every one unit increase in PMS score there was 12% rise in the probability of having metabolic syndrome (P = 0.033).

Background

Premenstrual syndrome (PMS) is reported by up to 85% of women of reproductive age. Although several studies have focused on the hormone and lipid profiles of females with PMS, the results are controversial.

Conclusions

There was a significant association between PMS scores and the prevalence of metabolic syndrome. Further studies are needed to confirm and validate the relationships between lipid profile abnormalities and metabolic disorders with PMS.

Objectives

This study was designed to investigate the association of hormonal and metabolic factors with PMS among Iranian women of reproductive age.

Materials and Methods

This study was a community based cross-sectional study. Anthropometric measurements, biochemical parameters, and metabolic disorders were compared between 354 women with PMS and 302 healthy controls selected from among 1126 women of reproductive age who participated in the Iranian PCOS prevalence study. P values < 0.05 were considered significant.

Results

Prolactin (PRL) and triglycerides (TG) were significantly elevated in women with PMS, whereas their testosterone (TES), high density lipoprotein (HDL) and 17-hydroxyprogesterone (17-OHP) levels were significantly less than they were in women without the syndrome (P < 0.05). After adjusting for age and body mass index (BMI), linear regression analysis demonstrated that for every one unit increase in PMS score there was 12% rise in the probability of having metabolic syndrome (P = 0.033).

Background

Premenstrual syndrome (PMS) is reported by up to 85% of women of reproductive age. Although several studies have focused on the hormone and lipid profiles of females with PMS, the results are controversial.

Metabolic Syndrome;Premenstrual Syndrome;Testosterone;Hypertension;Prolactin Metabolic Syndrome;Premenstrual Syndrome;Testosterone;Hypertension;Prolactin http://www.endometabol.com/index.php?page=article&article_id=28422 Somayeh Hashemi Somayeh Hashemi Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Fahimeh Ramezani Tehrani Fahimeh Ramezani Tehrani Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P. O. Box: 193954763, Tehran, IR Iran. Tel: +98-2122409309, Fax: +98-2122402463 Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P. O. Box: 193954763, Tehran, IR Iran. Tel: +98-2122409309, Fax: +98-2122402463 Nader Mohammadi Nader Mohammadi School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Marzieh Rostami Dovom Marzieh Rostami Dovom Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Farahnaz Torkestani Farahnaz Torkestani Faculty of Medicine, Shahed University, Tehran, IR Iran Faculty of Medicine, Shahed University, Tehran, IR Iran Masumeh Simbar Masumeh Simbar Department of Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Fereidoun Azizi Fereidoun Azizi Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
en 28058053 10.5812/ijem.32156 Survival Regression Modeling Strategies in CVD Prediction Survival Regression Modeling Strategies in CVD Prediction research-article research-article Conclusions

Herein we have described the Stata package “adpredsurv” for calculation of the Nam-D’Agostino X2 goodness of fit test as well as cut point-free and cut point-based NRI, relative and absolute IDI, and survival-based regression analyses. We hope this work encourages the use of novel methods in examining predictive capacity of the emerging plethora of novel biomarkers.

Background

A fundamental part of prevention is prediction. Potential predictors are the sine qua non of prediction models. However, whether incorporating novel predictors to prediction models could be directly translated to added predictive value remains an area of dispute. The difference between the predictive power of a predictive model with (enhanced model) and without (baseline model) a certain predictor is generally regarded as an indicator of the predictive value added by that predictor. Indices such as discrimination and calibration have long been used in this regard. Recently, the use of added predictive value has been suggested while comparing the predictive performances of the predictive models with and without novel biomarkers.

Results

The command is adpredsurv for survival models.

Materials and Methods

We have written Stata commands that are intended to help researchers obtain the following. 1, Nam-D’Agostino X2 goodness of fit test; 2, Cut point-free and cut point-based net reclassification improvement index (NRI), relative absolute integrated discriminatory improvement index (IDI), and survival-based regression analyses. We applied the commands to real data on women participating in the Tehran lipid and glucose study (TLGS) to examine if information relating to a family history of premature cardiovascular disease (CVD), waist circumference, and fasting plasma glucose can improve predictive performance of Framingham’s general CVD risk algorithm.

Objectives

User-friendly statistical software capable of implementing novel statistical procedures is conspicuously lacking. This shortcoming has restricted implementation of such novel model assessment methods. We aimed to construct Stata commands to help researchers obtain the aforementioned statistical indices.

Conclusions

Herein we have described the Stata package “adpredsurv” for calculation of the Nam-D’Agostino X2 goodness of fit test as well as cut point-free and cut point-based NRI, relative and absolute IDI, and survival-based regression analyses. We hope this work encourages the use of novel methods in examining predictive capacity of the emerging plethora of novel biomarkers.

Background

A fundamental part of prevention is prediction. Potential predictors are the sine qua non of prediction models. However, whether incorporating novel predictors to prediction models could be directly translated to added predictive value remains an area of dispute. The difference between the predictive power of a predictive model with (enhanced model) and without (baseline model) a certain predictor is generally regarded as an indicator of the predictive value added by that predictor. Indices such as discrimination and calibration have long been used in this regard. Recently, the use of added predictive value has been suggested while comparing the predictive performances of the predictive models with and without novel biomarkers.

Results

The command is adpredsurv for survival models.

Materials and Methods

We have written Stata commands that are intended to help researchers obtain the following. 1, Nam-D’Agostino X2 goodness of fit test; 2, Cut point-free and cut point-based net reclassification improvement index (NRI), relative absolute integrated discriminatory improvement index (IDI), and survival-based regression analyses. We applied the commands to real data on women participating in the Tehran lipid and glucose study (TLGS) to examine if information relating to a family history of premature cardiovascular disease (CVD), waist circumference, and fasting plasma glucose can improve predictive performance of Framingham’s general CVD risk algorithm.

Objectives

User-friendly statistical software capable of implementing novel statistical procedures is conspicuously lacking. This shortcoming has restricted implementation of such novel model assessment methods. We aimed to construct Stata commands to help researchers obtain the aforementioned statistical indices.

Added Predictive Ability;Calibration;Integrated Discrimination Improvement;Net Reclassification Improvement;Software;Stata Added Predictive Ability;Calibration;Integrated Discrimination Improvement;Net Reclassification Improvement;Software;Stata http://www.endometabol.com/index.php?page=article&article_id=32156 Mahnaz Barkhordari Mahnaz Barkhordari Department of Mathematics, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, IR Iran Department of Mathematics, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, IR Iran Mojgan Padyab Mojgan Padyab Centre for Population Studies, Ageing and Living Conditions, Umea University, Sweden Centre for Population Studies, Ageing and Living Conditions, Umea University, Sweden Mahsa Sardarinia Mahsa Sardarinia Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Farzad Hadaegh Farzad Hadaegh Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Fereidoun Azizi Fereidoun Azizi Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Mohammadreza Bozorgmanesh Mohammadreza Bozorgmanesh Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-2122409301, Fax: +98-2122402463 Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-2122409301, Fax: +98-2122402463
en 27761143 10.5812/ijem.33273 Altered Concentrations of Copper, Zinc, and Iron are Associated With Increased Levels of Glycated Hemoglobin in Patients With Type 2 Diabetes Mellitus and Their First-Degree Relatives Altered Concentrations of Copper, Zinc, and Iron are Associated With Increased Levels of Glycated Hemoglobin in Patients With Type 2 Diabetes Mellitus and Their First-Degree Relatives research-article research-article Background

The altered levels of some essential trace elements and antioxidant minerals have been observed in diabetic patients.

Objectives

The aim of the present study was to compare the concentrations of essential trace elements, copper (Cu), zinc (Zn), and iron (Fe) in the serum of patients who have type 2 diabetes mellitus (T2DM) with those of their non-diabetic first-degree relatives (FDR) and control subjects. The association between glycated hemoglobin (HbA1c) and levels of metals was also evaluated.

Patients and Methods

We studied 46 subjects with T2DM, 46 FDR, and 50 control subjects matched for age and sex. Serum concentrations of Cu, Zn, and Fe were measured by colorimetric kit. Fasting blood glucose (FBG) and HbA1c were assayed using the standard kit.

Results

An imbalance in the levels of the studied metals was observed in both patients with T2DM and FDR. We found significantly decreased levels of Zn and higher levels of Cu and Fe in the patients with T2DM and FDR when compared with the control subjects (P < 0.05). HbA1c levels were positively correlated with Cu and Fe and inversely correlated with Zn in the patients with T2DM and FDR (P < 0.05).

Conclusions

The patients with T2DM and FDR had altered contents of Cu, Zn, and Fe that might be a predisposing factor to the development of diabetes in future or vice versa the result of diabetes development. Impaired metabolism of these elements may contribute to the augmented risk of developing type 2 diabetes mellitus later in the life of their first-degree relatives.

Background

The altered levels of some essential trace elements and antioxidant minerals have been observed in diabetic patients.

Objectives

The aim of the present study was to compare the concentrations of essential trace elements, copper (Cu), zinc (Zn), and iron (Fe) in the serum of patients who have type 2 diabetes mellitus (T2DM) with those of their non-diabetic first-degree relatives (FDR) and control subjects. The association between glycated hemoglobin (HbA1c) and levels of metals was also evaluated.

Patients and Methods

We studied 46 subjects with T2DM, 46 FDR, and 50 control subjects matched for age and sex. Serum concentrations of Cu, Zn, and Fe were measured by colorimetric kit. Fasting blood glucose (FBG) and HbA1c were assayed using the standard kit.

Results

An imbalance in the levels of the studied metals was observed in both patients with T2DM and FDR. We found significantly decreased levels of Zn and higher levels of Cu and Fe in the patients with T2DM and FDR when compared with the control subjects (P < 0.05). HbA1c levels were positively correlated with Cu and Fe and inversely correlated with Zn in the patients with T2DM and FDR (P < 0.05).

Conclusions

The patients with T2DM and FDR had altered contents of Cu, Zn, and Fe that might be a predisposing factor to the development of diabetes in future or vice versa the result of diabetes development. Impaired metabolism of these elements may contribute to the augmented risk of developing type 2 diabetes mellitus later in the life of their first-degree relatives.

Copper;Zinc;Iron;HbA1c;Type 2 Diabetes Mellitus;Relatives Copper;Zinc;Iron;HbA1c;Type 2 Diabetes Mellitus;Relatives http://www.endometabol.com/index.php?page=article&article_id=33273 Somayeh Atari-Hajipirloo Somayeh Atari-Hajipirloo Department of Biochemistry, Urmia University of Medical Sciences, Urmia, IR Iran Department of Biochemistry, Urmia University of Medical Sciences, Urmia, IR Iran Neda Valizadeh Neda Valizadeh Department of Endocrinology and Metabolism, Urmia University of Medical Sciences, Urmia, IR Iran Department of Endocrinology and Metabolism, Urmia University of Medical Sciences, Urmia, IR Iran Mohammad-Hassan Khadem-Ansari Mohammad-Hassan Khadem-Ansari Department of Biochemistry, Urmia University of Medical Sciences, Urmia, IR Iran Department of Biochemistry, Urmia University of Medical Sciences, Urmia, IR Iran Yousef Rasmi Yousef Rasmi Department of Biochemistry, Faculty of Medicine, Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmi, IR Iran Department of Biochemistry, Faculty of Medicine, Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmi, IR Iran Fatemeh Kheradmand Fatemeh Kheradmand Department of Biochemistry, Faculty of Medicine, Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmi, IR Iran; Department of Biochemistry, Faculty of Medicine, Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia, IR Iran. Tel: +98-4432770397, Fax: +98-4432780801 Department of Biochemistry, Faculty of Medicine, Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmi, IR Iran; Department of Biochemistry, Faculty of Medicine, Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia, IR Iran. Tel: +98-4432770397, Fax: +98-4432780801
en 27679649 10.5812/ijem.34312 The Impact of Vitamin D Supplementation on Post-Partum Glucose Tolerance and Insulin Resistance in Gestational Diabetes: A Randomized Controlled Trial The Impact of Vitamin D Supplementation on Post-Partum Glucose Tolerance and Insulin Resistance in Gestational Diabetes: A Randomized Controlled Trial research-article research-article Background

Hypovitaminosis D has been associated with the development of gestational diabetes mellitus (GDM) in many observational studies.

Objectives

We report the first study of the impact of prenatal vitamin D supplementation on postpartum dysglycemia in GDM patients in a randomized clinical trial.

Patients and Methods

Women with GDM at 12 - 32 weeks of gestation were assigned randomly to either the intervention group (in which serum 25-hydroxy vitamin D [25OHD] levels were measured immediately, n = 48) or the control group (in which the serum was stored and assayed at 6 - 12 weeks post-partum, n = 48). Participants with initial serum 25OHD < 30 ng/mL in the intervention group were instructed to take a total of 700,000 IU vitamin D3 during pregnancy. The primary outcomes were fasting plasma glucose (FPG), insulin, 2-h post 75 g glucose load plasma glucose (2-hPLG), homeostasis model assessment of insulin resistance (HOMA-IR), HbA1C, and 25 OHD at 6 - 12 weeks after delivery.

Results

The mean ± SD of serum 25OHD in the intervention group raised dramatically from 14.6 ± 6.3 to 32.4 ± 14.4 ng/mL, whereas no significant change occurred in the control group (from 17.7 ± 6.1 to 19.3 ± 9.6 ng/mL, P < 0.001). Thirteen participants developed dysglycemia in each group. Mean FPG, 2-hPLG, and HOMA-IR were not significantly different between the groups. There was no significant difference between the groups for maternal and neonatal outcomes.

Conclusions

Although the high vitamin D supplementation dose in the present study (compared to the 400 IU/day dose usually recommended for pregnancy) safely increases the serum 25OHD, in GDM cases, the higher dose does not affect the plasma glucose level or insulin resistance at short term follow-up after delivery.

Background

Hypovitaminosis D has been associated with the development of gestational diabetes mellitus (GDM) in many observational studies.

Objectives

We report the first study of the impact of prenatal vitamin D supplementation on postpartum dysglycemia in GDM patients in a randomized clinical trial.

Patients and Methods

Women with GDM at 12 - 32 weeks of gestation were assigned randomly to either the intervention group (in which serum 25-hydroxy vitamin D [25OHD] levels were measured immediately, n = 48) or the control group (in which the serum was stored and assayed at 6 - 12 weeks post-partum, n = 48). Participants with initial serum 25OHD < 30 ng/mL in the intervention group were instructed to take a total of 700,000 IU vitamin D3 during pregnancy. The primary outcomes were fasting plasma glucose (FPG), insulin, 2-h post 75 g glucose load plasma glucose (2-hPLG), homeostasis model assessment of insulin resistance (HOMA-IR), HbA1C, and 25 OHD at 6 - 12 weeks after delivery.

Results

The mean ± SD of serum 25OHD in the intervention group raised dramatically from 14.6 ± 6.3 to 32.4 ± 14.4 ng/mL, whereas no significant change occurred in the control group (from 17.7 ± 6.1 to 19.3 ± 9.6 ng/mL, P < 0.001). Thirteen participants developed dysglycemia in each group. Mean FPG, 2-hPLG, and HOMA-IR were not significantly different between the groups. There was no significant difference between the groups for maternal and neonatal outcomes.

Conclusions

Although the high vitamin D supplementation dose in the present study (compared to the 400 IU/day dose usually recommended for pregnancy) safely increases the serum 25OHD, in GDM cases, the higher dose does not affect the plasma glucose level or insulin resistance at short term follow-up after delivery.

Gestational Diabetes, Blood Glucose;Vitamin D;Insulin Resistance;Post-partum Period;Cord blood;Glucose Tolerance Test Gestational Diabetes, Blood Glucose;Vitamin D;Insulin Resistance;Post-partum Period;Cord blood;Glucose Tolerance Test http://www.endometabol.com/index.php?page=article&article_id=34312 Majid Valizadeh Majid Valizadeh Zanjan Metabolic Disease Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran Zanjan Metabolic Disease Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran Zahra Piri Zahra Piri Student Research Committee, School of Medicine, Zanjan University of Medical Sciences, Zanjan, IR Iran; Student Research Committee, School of Medicine, Zanjan University of Medical Sciences, Zanjan, IR Iran. Tel: +98-9128205320, Fax: +98-2433770815 Student Research Committee, School of Medicine, Zanjan University of Medical Sciences, Zanjan, IR Iran; Student Research Committee, School of Medicine, Zanjan University of Medical Sciences, Zanjan, IR Iran. Tel: +98-9128205320, Fax: +98-2433770815 Farnaz Mohammadian Farnaz Mohammadian Division of Obstetrics and Gynecology, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, IR Iran Division of Obstetrics and Gynecology, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, IR Iran Koorosh Kamali Koorosh Kamali Zanjan Metabolic Disease Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran Zanjan Metabolic Disease Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran Hamid Reza Amir Moghadami Hamid Reza Amir Moghadami Laboratory of Vali-e-Asr Hospital, Zanjan University of Medical Sciences, Zanjan, IR Iran Laboratory of Vali-e-Asr Hospital, Zanjan University of Medical Sciences, Zanjan, IR Iran
en 27679650 10.5812/ijem.34676 Comparison of the Vitamin D Status of Children Younger and Older Than 2 Years in Tehran: Are Supplements Really Necessary? Comparison of the Vitamin D Status of Children Younger and Older Than 2 Years in Tehran: Are Supplements Really Necessary? research-article research-article Conclusions

The vitamin D levels of children aged more than 2 years are lower than those of children aged less than 2 years. Thus, prescribing vitamin D-containing supplements in children older than 2 years may be beneficial.

Results

The final study consisted of 286 children, 140 males and 146 females, with a mean age of 4.46 ± 2.82 yr. Of these, 218 (76.22%) children, with a mean age of 5.09 ± 2.82 yr, had vitamin D deficiency, and 76 children (23.78%), with a mean age of 2.58 ± 1.88 yr, had normal vitamin D levels (P = 0.001). The mean level of vitamin D was 29.71 ± 14.42 ng/mL in 88 (30.8%) patients up to 2 years and 17.11 ± 14.02 ng/mL in 198 (69.2%) patients older than 2 years (P = 0.0001).

Background

Vitamin D is a vital lipid-soluble vitamin in the body, helping the growth and development of bones. Vitamin D deficiency in children has several adverse effects. The most important preventative factor is determining the deficiency at an early stage and prescribing vitamin D-containing supplements.

Objectives

To investigate the vitamin D status of children younger and older than 2 years and determine the utility of prescribing vitamin D supplements.

Patients and Methods

Three hundred healthy children who attended the pediatric clinic for routine assessments were enrolled in this study. Their parents were asked to complete a questionnaire, which included questions about demographics, nutrition, and supplements. Blood levels of vitamin D, calcium, and phosphorus were then measured.

Conclusions

The vitamin D levels of children aged more than 2 years are lower than those of children aged less than 2 years. Thus, prescribing vitamin D-containing supplements in children older than 2 years may be beneficial.

Results

The final study consisted of 286 children, 140 males and 146 females, with a mean age of 4.46 ± 2.82 yr. Of these, 218 (76.22%) children, with a mean age of 5.09 ± 2.82 yr, had vitamin D deficiency, and 76 children (23.78%), with a mean age of 2.58 ± 1.88 yr, had normal vitamin D levels (P = 0.001). The mean level of vitamin D was 29.71 ± 14.42 ng/mL in 88 (30.8%) patients up to 2 years and 17.11 ± 14.02 ng/mL in 198 (69.2%) patients older than 2 years (P = 0.0001).

Background

Vitamin D is a vital lipid-soluble vitamin in the body, helping the growth and development of bones. Vitamin D deficiency in children has several adverse effects. The most important preventative factor is determining the deficiency at an early stage and prescribing vitamin D-containing supplements.

Objectives

To investigate the vitamin D status of children younger and older than 2 years and determine the utility of prescribing vitamin D supplements.

Patients and Methods

Three hundred healthy children who attended the pediatric clinic for routine assessments were enrolled in this study. Their parents were asked to complete a questionnaire, which included questions about demographics, nutrition, and supplements. Blood levels of vitamin D, calcium, and phosphorus were then measured.

Vitamin D;Children;Sunlight Exposure;Supplements Vitamin D;Children;Sunlight Exposure;Supplements http://www.endometabol.com/index.php?page=article&article_id=34676 Mohammad Torkaman Mohammad Torkaman Department of Pediatrics, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Department of Pediatrics, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Hassan Abolghasemi Hassan Abolghasemi Department of Pediatrics, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Department of Pediatrics, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Susan Amirsalari Susan Amirsalari New Hearing Technologies Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran New Hearing Technologies Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Fatemeh Beiraghdar Fatemeh Beiraghdar Department of Pediatrics, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Department of Pediatrics, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Shahla Afsharpaiman Shahla Afsharpaiman Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Zohreh Kavehmanesh Zohreh Kavehmanesh Department of Pediatrics, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Department of Pediatrics, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Mohammad Hossein Khosravi Mohammad Hossein Khosravi Students’ Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Baqiyatallah Hospital, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2188620826 Students’ Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Baqiyatallah Hospital, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2188620826
en 27761144 10.5812/ijem.37018 Obesity Paradox and Recurrent Coronary Heart Disease in a Population-Based Study: Tehran Lipid and Glucose Study Obesity Paradox and Recurrent Coronary Heart Disease in a Population-Based Study: Tehran Lipid and Glucose Study research-article research-article Background

Although current data shows a positive association between obesity and development of coronary heart disease (CHD) in general population, there is limited data on the important protective role of central or general obesity in patients with prevalent CHD or the “obesity paradox”, from this region.

Conclusions

Results of this study demonstrated an apparently protective effect for overweight in comparison with normal weight against long-term recurrent CHD in patients with history of CHD.

Results

During a median follow-up of 8.44 years, 169 new cases of CHD occurred (incidence density of: 54.53 per 1000 person-years). The incidence of recurrent CHD was higher in the normal BMI compared with overweight and obese categories (68.71, 47.56 and 54.46 per 1000 person-years, respectively). In multivariable models, using the forward stepwise selection approach, compared to the overweight group (0.48 95% CI, 0.30-0.80), the obese group (0.55 95% CI, 0.28-1.06) lost its significant protective effect.

Patients and Methods

The study was conducted on 440 adults, aged ≥ 30 years, with a history of CHD at baseline who attended the first (1999 - 2001) or second (2001 - 2003) phases of the Tehran Lipid and Glucose Study and had at least one year of follow-up until March 31, 2010. Cox proportional hazard models were used to evaluate the association among various BMI groups and recurrent CHD incidence.

Objectives

The objective of the present investigation was to describe the relationship between BMI categories and the recurrence of CHD in patients with a history of CHD using data from a large population-based study, the Tehran lipid and glucose study (TLGS).

Background

Although current data shows a positive association between obesity and development of coronary heart disease (CHD) in general population, there is limited data on the important protective role of central or general obesity in patients with prevalent CHD or the “obesity paradox”, from this region.

Conclusions

Results of this study demonstrated an apparently protective effect for overweight in comparison with normal weight against long-term recurrent CHD in patients with history of CHD.

Results

During a median follow-up of 8.44 years, 169 new cases of CHD occurred (incidence density of: 54.53 per 1000 person-years). The incidence of recurrent CHD was higher in the normal BMI compared with overweight and obese categories (68.71, 47.56 and 54.46 per 1000 person-years, respectively). In multivariable models, using the forward stepwise selection approach, compared to the overweight group (0.48 95% CI, 0.30-0.80), the obese group (0.55 95% CI, 0.28-1.06) lost its significant protective effect.

Patients and Methods

The study was conducted on 440 adults, aged ≥ 30 years, with a history of CHD at baseline who attended the first (1999 - 2001) or second (2001 - 2003) phases of the Tehran Lipid and Glucose Study and had at least one year of follow-up until March 31, 2010. Cox proportional hazard models were used to evaluate the association among various BMI groups and recurrent CHD incidence.

Objectives

The objective of the present investigation was to describe the relationship between BMI categories and the recurrence of CHD in patients with a history of CHD using data from a large population-based study, the Tehran lipid and glucose study (TLGS).

Body Mass Index;Obesity;Overweight;Recurrent Coronary Disease;Cohort Study Body Mass Index;Obesity;Overweight;Recurrent Coronary Disease;Cohort Study http://www.endometabol.com/index.php?page=article&article_id=37018 Samaneh Asgari Samaneh Asgari Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Maryam Barzin Maryam Barzin Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Farhad Hosseinpanah Farhad Hosseinpanah Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P. O. Box: 19395476, Tehran, IR Iran. Tel: +98-2122432500; +98-9123431927, Fax: +98-2122416264 Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P. O. Box: 19395476, Tehran, IR Iran. Tel: +98-2122432500; +98-9123431927, Fax: +98-2122416264 Farzad Hadaegh Farzad Hadaegh Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Fereidoun Azizi Fereidoun Azizi Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Davood Khalili Davood Khalili Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran