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 6 24 gregorian 2017 6 24 14 3
en 28115967 10.5812/ijem.40283 Precision Medicine for Endocrinology Precision Medicine for Endocrinology editorial editorial Precision Medicine;Endocrinology;Personalized Medicine Precision Medicine;Endocrinology;Personalized Medicine http://www.endometabol.com/index.php?page=article&article_id=40283 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. Tel: + 98-2122409309 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. Tel: + 98-2122409309
en 27942261 10.5812/ijem.36080 Congenital Hypothyroidism: Optimal Initial Dosage and Time of Initiation of Treatment: A Systematic Review Congenital Hypothyroidism: Optimal Initial Dosage and Time of Initiation of Treatment: A Systematic Review review-article review-article Context

Appropriate management of neonates, tested positive for congenital hypothyroidism (CH), in particular, the initial dosage of levothyroxine and the time of initiation of treatment is a critical issue. The aim of this study was to assess all current evidence available on the subject to ascertain the optimal initial dose and optimal initiation time of treatment for children with CH.

Evidence Acquisition

In this study, all published research related to the initiation treatment dose and the onset time of treatment in congenital hypothyroidism were reviewed. The searched electronic databases included Medline, Science direct, Scopus EMBASE, PsycINFO, Cochrane, BIOSIS and ISI Web of Knowledge. Additional searches included websites of relevant organizations, reference lists of included studies, and issues of major thyroid and pediatrics journals published within the past 35 years. Studies were included if they were written in English and investigated levothyroxine dose or timing of treatment or both, used for the treatment of children with congenital hypothyroidism.

Results

Two thousand three hundred and seventy-four articles (excluding duplicates) were retrieved from the primary search. After reviewing the titles, abstracts and full-texts of studies, eventually, 22 studies were found that met our inclusion criteria. Amongst these, 17 and 12 evaluated outcomes of different treatment doses and treatment timing, respectively. Overall, the majority of these studies emphasized the initial high dose of levothyroxine and early treatment of newborns with hypothyroidism. There were, however, some studies that disagreed with increasing levothyroxine dose at initiation of treatment.

Conclusions

Considering the results of this review, apparently there is no difference in opinion regarding the early initiation of treatment, whereas determining the optimal dose of levothyroxine for start of treatment in CH patients still remains a controversial issue, demonstrating the need for further studies, despite the fact that use of high doses can lead to rapid normalization of biochemical indices, although this may cause complications.

Context

Appropriate management of neonates, tested positive for congenital hypothyroidism (CH), in particular, the initial dosage of levothyroxine and the time of initiation of treatment is a critical issue. The aim of this study was to assess all current evidence available on the subject to ascertain the optimal initial dose and optimal initiation time of treatment for children with CH.

Evidence Acquisition

In this study, all published research related to the initiation treatment dose and the onset time of treatment in congenital hypothyroidism were reviewed. The searched electronic databases included Medline, Science direct, Scopus EMBASE, PsycINFO, Cochrane, BIOSIS and ISI Web of Knowledge. Additional searches included websites of relevant organizations, reference lists of included studies, and issues of major thyroid and pediatrics journals published within the past 35 years. Studies were included if they were written in English and investigated levothyroxine dose or timing of treatment or both, used for the treatment of children with congenital hypothyroidism.

Results

Two thousand three hundred and seventy-four articles (excluding duplicates) were retrieved from the primary search. After reviewing the titles, abstracts and full-texts of studies, eventually, 22 studies were found that met our inclusion criteria. Amongst these, 17 and 12 evaluated outcomes of different treatment doses and treatment timing, respectively. Overall, the majority of these studies emphasized the initial high dose of levothyroxine and early treatment of newborns with hypothyroidism. There were, however, some studies that disagreed with increasing levothyroxine dose at initiation of treatment.

Conclusions

Considering the results of this review, apparently there is no difference in opinion regarding the early initiation of treatment, whereas determining the optimal dose of levothyroxine for start of treatment in CH patients still remains a controversial issue, demonstrating the need for further studies, despite the fact that use of high doses can lead to rapid normalization of biochemical indices, although this may cause complications.

Congenital Hypothyroidism;Starting Treatment Dose;Treatment Initiation Timing;Review Article Congenital Hypothyroidism;Starting Treatment Dose;Treatment Initiation Timing;Review Article http://www.endometabol.com/index.php?page=article&article_id=36080 Khaled Rahmani Khaled Rahmani Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Shahin Yarahmadi Shahin Yarahmadi Assistant Professor of Endocrinology, Department of Endocrinology and Metabolism, Ministry of Health, Tehran, IR Iran Assistant Professor of Endocrinology, Department of Endocrinology and Metabolism, Ministry of Health, Tehran, IR Iran Koorosh Etemad Koorosh Etemad Assistant Professor of Epidemiology, Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Assistant Professor of Epidemiology, Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Ahmad Koosha Ahmad Koosha Assistant Professor of Endocrinology, Department of Endocrinology and Metabolism, Ministry of Health, Tehran, IR Iran Assistant Professor of Endocrinology, Department of Endocrinology and Metabolism, Ministry of Health, Tehran, IR Iran Yadollah Mehrabi Yadollah Mehrabi Professor of Biostatistics, Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Professor of Biostatistics, Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Nasrin Aghang Nasrin Aghang NCD Expert, Department of Endocrinology and Metabolism, Ministry of Health, Tehran, IR Iran NCD Expert, Department of Endocrinology and Metabolism, Ministry of Health, Tehran, IR Iran Hamid Soori Hamid Soori Safety Promotion and Injury Prevention Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; \Safety Promotion and Injury Prevention Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2122432040 Safety Promotion and Injury Prevention Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; \Safety Promotion and Injury Prevention Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2122432040
en 27942262 10.5812/ijem.36317 Association Between Obstructive Sleep Apnea and Osteoporosis: A Systematic Review and Meta-Analysis Association Between Obstructive Sleep Apnea and Osteoporosis: A Systematic Review and Meta-Analysis review-article review-article Data Extraction

Primary outcomes were incidence, prevalence, or odds ratio of having osteoporosis, defined as bone mineral density T-score < -2.5 SD.

Results

Of 353 articles, 344 articles were excluded, 9 underwent full-length review and data were extracted from 7 studies consisting of 113,558 patients. Finally, 3 extracted studies were included in the meta-analysis of osteoporosis. Among cohort studies, the pooled odds ratio of osteoporosis in patients with OSA was 1.92 (95% confidence interval [CI]: 1.24 - 2.97) compared with controls. Among cross-sectional studies, odds of osteoporosis was higher in controls compared with patients with OSA (OR = 0.60, 95% CI: 0.42 - 0.87). In subgroup analysis by gender and study design, in both sexes, only cohort studies had higher odds of osteoporosis compared with controls.

Context

Hypoxia reduces osteoblast growth resulting in bone thinning and osteoporosis. Although obstructive sleep apnea (OSA) with recurrent hypoxia might be a contributing factor for osteoporosis development, whether OSA is a risk or protective factor for osteoporosis has not been demonstrated.

Conclusions

There was significant association between OSA and osteoporosis in studies with cohort design. Further prospective studies with large numbers of patients adjusted for the effects of age, sex, or BMI are required to comprehensively determine whether OSA is a risk factor for osteoporosis.

Data Sources

PubMed/MEDLINE and EMBASE databases

Study Selection

We completed a systematic review and meta-analysis of published observational studies that evaluated incidence or prevalence of osteoporosis or bone mineral density in obstructive sleep apnea compared with controls. Severity of OSA was characterized using the apnea-hypopnea index (AHI).

Objectives

This systematic review and meta-analysis evaluated the association between OSA and osteoporosis using published observational studies.

Data Extraction

Primary outcomes were incidence, prevalence, or odds ratio of having osteoporosis, defined as bone mineral density T-score < -2.5 SD.

Results

Of 353 articles, 344 articles were excluded, 9 underwent full-length review and data were extracted from 7 studies consisting of 113,558 patients. Finally, 3 extracted studies were included in the meta-analysis of osteoporosis. Among cohort studies, the pooled odds ratio of osteoporosis in patients with OSA was 1.92 (95% confidence interval [CI]: 1.24 - 2.97) compared with controls. Among cross-sectional studies, odds of osteoporosis was higher in controls compared with patients with OSA (OR = 0.60, 95% CI: 0.42 - 0.87). In subgroup analysis by gender and study design, in both sexes, only cohort studies had higher odds of osteoporosis compared with controls.

Context

Hypoxia reduces osteoblast growth resulting in bone thinning and osteoporosis. Although obstructive sleep apnea (OSA) with recurrent hypoxia might be a contributing factor for osteoporosis development, whether OSA is a risk or protective factor for osteoporosis has not been demonstrated.

Conclusions

There was significant association between OSA and osteoporosis in studies with cohort design. Further prospective studies with large numbers of patients adjusted for the effects of age, sex, or BMI are required to comprehensively determine whether OSA is a risk factor for osteoporosis.

Data Sources

PubMed/MEDLINE and EMBASE databases

Study Selection

We completed a systematic review and meta-analysis of published observational studies that evaluated incidence or prevalence of osteoporosis or bone mineral density in obstructive sleep apnea compared with controls. Severity of OSA was characterized using the apnea-hypopnea index (AHI).

Objectives

This systematic review and meta-analysis evaluated the association between OSA and osteoporosis using published observational studies.

Obstructive Sleep Apnea;Osteoporosis;Risk;Systematic Review;Meta-Analysis Obstructive Sleep Apnea;Osteoporosis;Risk;Systematic Review;Meta-Analysis http://www.endometabol.com/index.php?page=article&article_id=36317 Sikarin Upala Sikarin Upala Department of Internal Medicine, College of Physicians and Surgeons, Bassett Medical Center and Columbia University, New York, USA; Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand Department of Internal Medicine, College of Physicians and Surgeons, Bassett Medical Center and Columbia University, New York, USA; Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand Anawin Sanguankeo Anawin Sanguankeo Department of Internal Medicine, College of Physicians and Surgeons, Bassett Medical Center and Columbia University, New York, USA; Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; Department of Internal Medicine, Bassett Medical Center, 1 Atwell Road, Cooperstown, New York, USA. Tel: +1-6075474805, Fax: +1-6075476612 Department of Internal Medicine, College of Physicians and Surgeons, Bassett Medical Center and Columbia University, New York, USA; Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; Department of Internal Medicine, Bassett Medical Center, 1 Atwell Road, Cooperstown, New York, USA. Tel: +1-6075474805, Fax: +1-6075476612 Soontharee Congrete Soontharee Congrete Department of Medicine, St. Elizabeth's Medical Center, Boston, Massachusetts, USA Department of Medicine, St. Elizabeth's Medical Center, Boston, Massachusetts, USA
en 10.5812/ijem.32444 Effect of Infrared Radiation on the Healing of Diabetic Foot Ulcer Effect of Infrared Radiation on the Healing of Diabetic Foot Ulcer research-article research-article Background

Diabetic foot ulcer is a worldwide health care concern affecting tens of thousands of patients. If these ulcers left untreated, they can create severe complications.

Objectives

This study was designed to examine the effect of infrared radiation on the healing of diabetic foot ulcer.

Patients and Methods

This clinical trial was performed on 50 patients referred to Dr. Ganjavian hospital in Dezful city, Iran, with diabetic foot ulcer degree 1 and 2 (based on Wegener Scale). Sample size was determined based on relevant studies of the recent decade. Patients were classified into the intervention and control groups (n = 25 in each group) in terms of age, gender, degree of ulcer, ulcer site and body mass index. In this study, work progress was evaluated according to the checklist of diabetic foot ulcer healing evaluation.

Results

The results of the current study showed that there was a statistically significant difference in healing ulcers (P < 0.05) and mean healing time (P < 0.05) between the two groups.

Conclusions

Using the infrared plus routine dressing is more effective than using merely routine dressing.

Background

Diabetic foot ulcer is a worldwide health care concern affecting tens of thousands of patients. If these ulcers left untreated, they can create severe complications.

Objectives

This study was designed to examine the effect of infrared radiation on the healing of diabetic foot ulcer.

Patients and Methods

This clinical trial was performed on 50 patients referred to Dr. Ganjavian hospital in Dezful city, Iran, with diabetic foot ulcer degree 1 and 2 (based on Wegener Scale). Sample size was determined based on relevant studies of the recent decade. Patients were classified into the intervention and control groups (n = 25 in each group) in terms of age, gender, degree of ulcer, ulcer site and body mass index. In this study, work progress was evaluated according to the checklist of diabetic foot ulcer healing evaluation.

Results

The results of the current study showed that there was a statistically significant difference in healing ulcers (P < 0.05) and mean healing time (P < 0.05) between the two groups.

Conclusions

Using the infrared plus routine dressing is more effective than using merely routine dressing.

Diabetic Foot Ulcer;Infrared Radiation;Routine Dressing Diabetic Foot Ulcer;Infrared Radiation;Routine Dressing http://www.endometabol.com/index.php?page=article&article_id=32444 Ashrafalsadat Hakim Ashrafalsadat Hakim Nursing Care Research Center in Chronic Diseases, Department of Nursing, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Nursing Care Research Center in Chronic Diseases, Department of Nursing, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Ali Sadeghi Moghadam Ali Sadeghi Moghadam School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Abdalali Shariati Abdalali Shariati Department of Nursing, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran; Department of Nursing, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran. Tel: +98-6133738331, Fax: +98-6133738333 Department of Nursing, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran; Department of Nursing, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran. Tel: +98-6133738331, Fax: +98-6133738333 Hamid karimi Hamid karimi Department of Medicine, Dezful University of Medical Sciences, Dezful, IR Iran Department of Medicine, Dezful University of Medical Sciences, Dezful, IR Iran Mohamad Hossien Haghighizadeh Mohamad Hossien Haghighizadeh Department of Biostatistics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Department of Biostatistics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
en 28115966 10.5812/ijem.34889 The Effect of Walnut Oil Consumption on Blood Sugar in Patients With Diabetes Mellitus Type 2 The Effect of Walnut Oil Consumption on Blood Sugar in Patients With Diabetes Mellitus Type 2 research-article research-article Conclusions

Consumption of walnut oil (15 g/day for three months) was shown to improve blood glucose level but, no changes were noted for bodyweight and blood pressure in type two diabetic patients.

Results

The two groups were not significantly different for SBP, DBP, body weight, and Body Mass Index. HbA1c level decreased significantly in the experiment group by 7.86% ± 21.97 (P = 0.005) from 7.00 ± 1.08 before the intervention to 6.37 ± 1.29 after the intervention. Also, FBS level decreased significantly by 8.24% ± 16.77 (P = 0.001); from 158.37 ± 48.16 before the intervention to 137.91 ± 23.24 after the intervention in the experimental group. These changes in the control group were not significant.

Background

Prevalence of diabetes mellitus type 2 (DM) is increasing globally. Considering the potential role of poly-unsaturated fatty acids in prevention of DM type 2 and lipid profiles improvement, some studies have been carried out on walnut. However, there are no studies on control of blood sugar in DM type 2 patients using walnut.

Objectives

The current study aimed to evaluate the effect of walnut oil on blood sugar in DM type 2 patients.

Methods

This randomized control clinical trial was performed on 100 patients with DM type 2. For the experiment group (n = 50), walnut oil (15 g/day for three months) was added to their diet, while the control group (n = 50) did not undergo any interventions. Before initiation of the experiment and after the experiment, the systolic and diastolic blood pressure (SBP and DBP) levels, fasting blood sugar (FBS) and HbA1c were measured.

Conclusions

Consumption of walnut oil (15 g/day for three months) was shown to improve blood glucose level but, no changes were noted for bodyweight and blood pressure in type two diabetic patients.

Results

The two groups were not significantly different for SBP, DBP, body weight, and Body Mass Index. HbA1c level decreased significantly in the experiment group by 7.86% ± 21.97 (P = 0.005) from 7.00 ± 1.08 before the intervention to 6.37 ± 1.29 after the intervention. Also, FBS level decreased significantly by 8.24% ± 16.77 (P = 0.001); from 158.37 ± 48.16 before the intervention to 137.91 ± 23.24 after the intervention in the experimental group. These changes in the control group were not significant.

Background

Prevalence of diabetes mellitus type 2 (DM) is increasing globally. Considering the potential role of poly-unsaturated fatty acids in prevention of DM type 2 and lipid profiles improvement, some studies have been carried out on walnut. However, there are no studies on control of blood sugar in DM type 2 patients using walnut.

Objectives

The current study aimed to evaluate the effect of walnut oil on blood sugar in DM type 2 patients.

Methods

This randomized control clinical trial was performed on 100 patients with DM type 2. For the experiment group (n = 50), walnut oil (15 g/day for three months) was added to their diet, while the control group (n = 50) did not undergo any interventions. Before initiation of the experiment and after the experiment, the systolic and diastolic blood pressure (SBP and DBP) levels, fasting blood sugar (FBS) and HbA1c were measured.

Fasting Blood Sugar;Walnut Oil;Diabetes Mellitus Type 2 Fasting Blood Sugar;Walnut Oil;Diabetes Mellitus Type 2 http://www.endometabol.com/index.php?page=article&article_id=34889 Mohammad Javad Zibaee Nezhad Mohammad Javad Zibaee Nezhad Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Kamran Aghasadeghi Kamran Aghasadeghi Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Hossein Hakimi Hossein Hakimi Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Hassan Yarmohammadi Hassan Yarmohammadi Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IR Iran Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IR Iran Farzad Nikaein Farzad Nikaein Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IR Iran; Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-9175550409 Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IR Iran; Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-9175550409
en 27942263 10.5812/ijem.37123 The Association Between Physical Activity During Pregnancy and Gestational Diabetes Mellitus: A Case-Control Study The Association Between Physical Activity During Pregnancy and Gestational Diabetes Mellitus: A Case-Control Study research-article research-article Conclusions

The amount and intensity of physical activity during pregnancy is associated with a lower risk of gestational diabetes mellitus. As a result, the pregnant Iranian females have to be encouraged to do regular daily physical activity during pregnancy, if there is no specific contraindication to it.

Results

Females who had low total physical activity according to the pregnancy physical activity questionnaire during early pregnancy were at a significantly higher risk of developing gestational diabetes mellitus (OR = 4.12, 95% CI (2.28 - 7.43), P = 0.001) compared to the ones who reported higher levels of physical activity. Moreover, after adjusting for age, body mass index (BMI), gravidity and a family history of diabetes, females with low physical activity in the domain of transportation activity during 20 weeks of pregnancy were at a significantly higher risk of developing gestational diabetes mellitus. The statistical findings indicate that females with the low intensity of sedentary, light and moderate physical activity are at a higher risk of developing gestational diabetes mellitus (OR 2.32; 95% CI 1.21-4.43, P = 0.010, OR 6.26; 95% CI 2.95 - 13.30, P = 0.001 and OR 6.73; 95% CI 3.15 - 14.38, P = 0.001) compared to females with a higher intensity of sedentary, light and moderate physical activity.

Background

Gestational diabetes mellitus is one of the most common complications of pregnancy. Physical activity is associated with a lower risk of type 2 diabetes mellitus. A recent meta-analysis study suggested that more research is needed to investigate the type, duration and intensity of physical activity that can help to reduce the risk of gestational diabetes mellitus.

Objectives

The present study aimed to understand the association between physical activity and gestational diabetes mellitus through comparing the type and intensity of physical activity performed by pregnant females with gestational diabetes and healthy pregnant females in the first 20 weeks of their pregnancy.

Patients and Methods

In the current case-control study, 100 pregnant females with gestational diabetes mellitus as the case group and 100 pregnant females as the non-diabetic control group were recruited. The age range of the participants was 18 - 40 years with the gestation of 20 - 28 weeks. To diagnose gestational diabetes mellitus using the criteria introduced by carpenter and coustan females with abnormal glucose challenge test (> 140 mg/dL) were asked to perform the three-hour 100 g oral glucose tolerance test. The details of physical activity were collected by a modified version of the pregnancy physical activity questionnaire. Anthropometric and relevant data were recorded for all of the participants. Data were analyzed by SPSS version 21. Risk estimates were obtained by logistic regression and adjusted for confounders.

Conclusions

The amount and intensity of physical activity during pregnancy is associated with a lower risk of gestational diabetes mellitus. As a result, the pregnant Iranian females have to be encouraged to do regular daily physical activity during pregnancy, if there is no specific contraindication to it.

Results

Females who had low total physical activity according to the pregnancy physical activity questionnaire during early pregnancy were at a significantly higher risk of developing gestational diabetes mellitus (OR = 4.12, 95% CI (2.28 - 7.43), P = 0.001) compared to the ones who reported higher levels of physical activity. Moreover, after adjusting for age, body mass index (BMI), gravidity and a family history of diabetes, females with low physical activity in the domain of transportation activity during 20 weeks of pregnancy were at a significantly higher risk of developing gestational diabetes mellitus. The statistical findings indicate that females with the low intensity of sedentary, light and moderate physical activity are at a higher risk of developing gestational diabetes mellitus (OR 2.32; 95% CI 1.21-4.43, P = 0.010, OR 6.26; 95% CI 2.95 - 13.30, P = 0.001 and OR 6.73; 95% CI 3.15 - 14.38, P = 0.001) compared to females with a higher intensity of sedentary, light and moderate physical activity.

Background

Gestational diabetes mellitus is one of the most common complications of pregnancy. Physical activity is associated with a lower risk of type 2 diabetes mellitus. A recent meta-analysis study suggested that more research is needed to investigate the type, duration and intensity of physical activity that can help to reduce the risk of gestational diabetes mellitus.

Objectives

The present study aimed to understand the association between physical activity and gestational diabetes mellitus through comparing the type and intensity of physical activity performed by pregnant females with gestational diabetes and healthy pregnant females in the first 20 weeks of their pregnancy.

Patients and Methods

In the current case-control study, 100 pregnant females with gestational diabetes mellitus as the case group and 100 pregnant females as the non-diabetic control group were recruited. The age range of the participants was 18 - 40 years with the gestation of 20 - 28 weeks. To diagnose gestational diabetes mellitus using the criteria introduced by carpenter and coustan females with abnormal glucose challenge test (> 140 mg/dL) were asked to perform the three-hour 100 g oral glucose tolerance test. The details of physical activity were collected by a modified version of the pregnancy physical activity questionnaire. Anthropometric and relevant data were recorded for all of the participants. Data were analyzed by SPSS version 21. Risk estimates were obtained by logistic regression and adjusted for confounders.

Gestational Diabetes Mellitus;Physical Activity;Pregnancy Physical Activity Questionnaire;Risk Factors Gestational Diabetes Mellitus;Physical Activity;Pregnancy Physical Activity Questionnaire;Risk Factors http://www.endometabol.com/index.php?page=article&article_id=37123 Fatemeh Nasiri-Amiri Fatemeh Nasiri-Amiri Assistant Professor, Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran Assistant Professor, Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran Afsaneh Bakhtiari Afsaneh Bakhtiari Assistant Professor, Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran; Assistant Professor, Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran. Tel: +98-9113116889, Fax: +98-1132199936 Assistant Professor, Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran; Assistant Professor, Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran. Tel: +98-9113116889, Fax: +98-1132199936 Mahbobeh Faramarzi Mahbobeh Faramarzi Assistant Professor, Fatemeh Zahra Infertility and Reproductive Health Research Center, Department of Psychiatry, Faculty of Medicine, Babol University of Medical Sciences, Babol, IR Iran Assistant Professor, Fatemeh Zahra Infertility and Reproductive Health Research Center, Department of Psychiatry, Faculty of Medicine, Babol University of Medical Sciences, Babol, IR Iran Hajar Adib Rad Hajar Adib Rad Infertility and Reproductive Health Research Center, Health Research Institute, Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran Infertility and Reproductive Health Research Center, Health Research Institute, Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran Hajar Pasha Hajar Pasha Infertility and Reproductive Health Research Center, Health Research Institute, Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran Infertility and Reproductive Health Research Center, Health Research Institute, Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran
en 27942264 10.5812/ijem.37635 The Relationship Between Increased Epicardial Fat Thickness and Left Ventricular Hypertrophy and Carotid Intima-Media Thickness in Patients With Nonfunctional Adrenal Incidentaloma The Relationship Between Increased Epicardial Fat Thickness and Left Ventricular Hypertrophy and Carotid Intima-Media Thickness in Patients With Nonfunctional Adrenal Incidentaloma research-article research-article Conclusions

In this study we showed that EFT, measured by echocardiography is higher in subjects with AI when compared to healthy controls. epicardial fat thickness had the best independent correlation with AI in multiple logistic regression analysis. Incidentaloma is also associated with increased left ventricular mass index and CIMT. Adrenal incidentaloma patients may show early cardiac changes, such as increased left ventricular mass and increased CIMT.

Background

Emerging evidences indicate that patients diagnosed with Adrenal Incidentaloma (AI) may present cardiovascular complications. Epicardial fat thickness (EFT) has recently been described as a new risk factor and an active player in metabolic syndrome and cardiovascular disease.

Objectives

We aimed to evaluate the relationship between EFT and left ventricular hypertrophy and carotid intima-media thickness, which are both strong predictors of cardiovascular morbity and mortality, in patients with nonfunctioning AI.

Results

Epicardial fat thickness was significantly higher in patients with AI when compared to the control group (0.89 ± 0.32 cm vs. 0.74 ± 0.26 cm; P = 0.023). left ventricular (LV) mass index and median carotid intima-media thickness (CIMT) were also higher in subjects with AI than in controls (99.8 g/m2 vs. 86.9 g/m2; P = 0.024 and 7.5 mm (5.5 - 11.5) vs. 6.5 mm (4.5 - 9.5); P = 0.017). There was a positive correlation between EFT, LV mass index, EFT and CIMT (r = 0.315, P = 0.004; r = 0.363, P < 0.001; respectively).

Patients and Methods

We evaluated 51 patients (36 females and 15 males) diagnosed with AI and 35 (29 females, 6 males) age, gender and body mass index (BMI) matched healthy controls in terms of cardiovascular risk parameters. Epicardial fat was identified as the echo-free space between the outer wall of the myocardium and the visceral layer of the pericardium.

Conclusions

In this study we showed that EFT, measured by echocardiography is higher in subjects with AI when compared to healthy controls. epicardial fat thickness had the best independent correlation with AI in multiple logistic regression analysis. Incidentaloma is also associated with increased left ventricular mass index and CIMT. Adrenal incidentaloma patients may show early cardiac changes, such as increased left ventricular mass and increased CIMT.

Background

Emerging evidences indicate that patients diagnosed with Adrenal Incidentaloma (AI) may present cardiovascular complications. Epicardial fat thickness (EFT) has recently been described as a new risk factor and an active player in metabolic syndrome and cardiovascular disease.

Objectives

We aimed to evaluate the relationship between EFT and left ventricular hypertrophy and carotid intima-media thickness, which are both strong predictors of cardiovascular morbity and mortality, in patients with nonfunctioning AI.

Results

Epicardial fat thickness was significantly higher in patients with AI when compared to the control group (0.89 ± 0.32 cm vs. 0.74 ± 0.26 cm; P = 0.023). left ventricular (LV) mass index and median carotid intima-media thickness (CIMT) were also higher in subjects with AI than in controls (99.8 g/m2 vs. 86.9 g/m2; P = 0.024 and 7.5 mm (5.5 - 11.5) vs. 6.5 mm (4.5 - 9.5); P = 0.017). There was a positive correlation between EFT, LV mass index, EFT and CIMT (r = 0.315, P = 0.004; r = 0.363, P < 0.001; respectively).

Patients and Methods

We evaluated 51 patients (36 females and 15 males) diagnosed with AI and 35 (29 females, 6 males) age, gender and body mass index (BMI) matched healthy controls in terms of cardiovascular risk parameters. Epicardial fat was identified as the echo-free space between the outer wall of the myocardium and the visceral layer of the pericardium.

Adrenal Incidentaloma;Epicardial Fat;Atherosclerosis Adrenal Incidentaloma;Epicardial Fat;Atherosclerosis http://www.endometabol.com/index.php?page=article&article_id=37635 Nasiroglu Narin Imga Nasiroglu Narin Imga Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey; Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey. Tel: +90-5056492934, Fax: +90-3124263838 Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey; Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey. Tel: +90-5056492934, Fax: +90-3124263838 Ozgul Ucar Elalmis Ozgul Ucar Elalmis Ankara Numune Education and Research Hospital, Department of Cardiology, Ankara, Turkey Ankara Numune Education and Research Hospital, Department of Cardiology, Ankara, Turkey Mazhar Muslum Tuna Mazhar Muslum Tuna Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey Bercem Aycıcek Dogan Bercem Aycıcek Dogan Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey Deniz Sahin Deniz Sahin Ankara Numune Education and Research Hospital, Department of Cardiology, Ankara, Turkey Ankara Numune Education and Research Hospital, Department of Cardiology, Ankara, Turkey Dilek Berker Dilek Berker Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey Serdar Guler Serdar Guler Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey; Department of Endocrinology, Faculty of Medicine, Hitit University, Corum, Turkey Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey; Department of Endocrinology, Faculty of Medicine, Hitit University, Corum, Turkey
en 27942265 10.5812/ijem.38440 Correlations Between Changes in Undercarboxylated Osteocalcin and Muscle Function in Hypoparathyroidism Correlations Between Changes in Undercarboxylated Osteocalcin and Muscle Function in Hypoparathyroidism brief-report brief-report Results

The findings indicated that ucOC%/OC% was positively and significantly associated with percentage change in max force production during elbow extension (β = 0.28, P = 0.034), however, all other associations were non-significant.

Background

Muscles and bones are interconnected. Recent studies suggest that undercarboxylated osteocalcin from bone may affect muscle mass and strength. There are, however, no prospective human data on this relationship.

Methods

We previously treated patients with hypoparathyroidism with intact Parathyroid Hormone (PTH) or placebo in a six-month randomized, placebo-controlled trial and demonstrated a marked increase in undercarboxylated osteocalcin (ucOC) in the PTH-treated group. We therefore investigated if this increase correlated with changes in muscle mass, strength or function. Primarily, the muscle mass using Dual energy X-ray Absorptiometry (DXA) was measured and the maximal voluntary isometric muscle strength at the upper and lower extremities, using dynamometry, was assessed. Furthermore, repeated chair stands test, Timed Up and Go test were performed and postural stability using a stadiometer was assessed. Finally, the relationship between change in ucOC or the ratio of the changes in ucOC and total OC (ucOC%/OC%) and different measures of muscle function were analyzed, using regression analyses.

Conclusions

Given the number of statistical tests that were carried out, our one significant finding may represent a false positive. Thus the results do not support the role of ucOC in muscle function in humans with hypoparathyroidism. Our results are inconsistent with previous data from a human cross-sectional study; however, cross-sectional studies, do not allow for inference of causality. The analyses should be repeated in larger, randomized trials including healthy individuals.

Results

The findings indicated that ucOC%/OC% was positively and significantly associated with percentage change in max force production during elbow extension (β = 0.28, P = 0.034), however, all other associations were non-significant.

Background

Muscles and bones are interconnected. Recent studies suggest that undercarboxylated osteocalcin from bone may affect muscle mass and strength. There are, however, no prospective human data on this relationship.

Methods

We previously treated patients with hypoparathyroidism with intact Parathyroid Hormone (PTH) or placebo in a six-month randomized, placebo-controlled trial and demonstrated a marked increase in undercarboxylated osteocalcin (ucOC) in the PTH-treated group. We therefore investigated if this increase correlated with changes in muscle mass, strength or function. Primarily, the muscle mass using Dual energy X-ray Absorptiometry (DXA) was measured and the maximal voluntary isometric muscle strength at the upper and lower extremities, using dynamometry, was assessed. Furthermore, repeated chair stands test, Timed Up and Go test were performed and postural stability using a stadiometer was assessed. Finally, the relationship between change in ucOC or the ratio of the changes in ucOC and total OC (ucOC%/OC%) and different measures of muscle function were analyzed, using regression analyses.

Conclusions

Given the number of statistical tests that were carried out, our one significant finding may represent a false positive. Thus the results do not support the role of ucOC in muscle function in humans with hypoparathyroidism. Our results are inconsistent with previous data from a human cross-sectional study; however, cross-sectional studies, do not allow for inference of causality. The analyses should be repeated in larger, randomized trials including healthy individuals.

Clinical Trial;Undercarboxylated Osteocalcin;Muscle Function;Hypoparathyroidism Clinical Trial;Undercarboxylated Osteocalcin;Muscle Function;Hypoparathyroidism http://www.endometabol.com/index.php?page=article&article_id=38440 Torben Harslof Torben Harslof Department of Endocrinology and Internal Medicine, THG, Aarhus University Hospital, Tage-Hansensgade 2, Aarhus C, Denmark; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Tage-Hansensgade 2, Aarhus C, Denmark. Tel: +45-78467605 Department of Endocrinology and Internal Medicine, THG, Aarhus University Hospital, Tage-Hansensgade 2, Aarhus C, Denmark; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Tage-Hansensgade 2, Aarhus C, Denmark. Tel: +45-78467605 Tanja Sikjaer Tanja Sikjaer Department of Endocrinology and Internal Medicine, THG, Aarhus University Hospital, Tage-Hansensgade 2, Aarhus C, Denmark Department of Endocrinology and Internal Medicine, THG, Aarhus University Hospital, Tage-Hansensgade 2, Aarhus C, Denmark Leif Mosekilde Leif Mosekilde Department of Endocrinology and Internal Medicine, THG, Aarhus University Hospital, Tage-Hansensgade 2, Aarhus C, Denmark Department of Endocrinology and Internal Medicine, THG, Aarhus University Hospital, Tage-Hansensgade 2, Aarhus C, Denmark Bente L. Langdahl Bente L. Langdahl Department of Endocrinology and Internal Medicine, THG, Aarhus University Hospital, Tage-Hansensgade 2, Aarhus C, Denmark Department of Endocrinology and Internal Medicine, THG, Aarhus University Hospital, Tage-Hansensgade 2, Aarhus C, Denmark Lars Rejnmark Lars Rejnmark Department of Endocrinology and Internal Medicine, THG, Aarhus University Hospital, Tage-Hansensgade 2, Aarhus C, Denmark Department of Endocrinology and Internal Medicine, THG, Aarhus University Hospital, Tage-Hansensgade 2, Aarhus C, Denmark