Iranian Journal of Diabetes and Lipid Disorders

STATISTICAL SERIES: THE ANALYSIS OF CONTINGENCY TABLES 2 (MEASURES OF ASSOCIATION)

Mohammad Asghari Jafarabadi

The P-Value cannot present a complete measure of association in medical studies considering the association between categorical variables. In such situations, measures are required to reveal the clinical importance of relation along with their statistical significance, as the effect size. This paper aims to introduce the measures of associations for categorical variables and inferences about them in these studies. Principles and method of calculating measures of associations and inference about them including confidence interval and hypothesis testing were presented to assess the relationship between qualitative variables for all types of medical studies taking into account relevant considerations. Additionaly, the method of reporting of findings were introduced in the context of contingency tables. To investigate the relationship between two binary qualitative variables, should be used the Odds Ratio in cross-sectional or case-control studies, the relative risk in cohort studies, and prevalence ratio in cross-sectional studies and risk difference in all type of studies along with their confidence intervals and/or their significance tests considering the independent or related groups of studies. Additionally, for bigger than 2 by 2 tables, the method of calculating of above mentioned measures considering a reference category and other measures such as Phi, Crammers V, contingency and uncertainty coefficients , Lambda, Gamma, Summers D, Kendals tau-b and tau-c would be recommended. In each of these situations, based on research based examples, calculations of tests were performed and their results were presented. To investigate the relationship between a set of risk factors and binary and multi-category qualitative variables, the introduced analyses are recommended considering the situation and purpose of the proposed study.

A REVIEW OF WEB-ASSISTED INTERVENTIONS FOR THE MANAGEMENT OF TYPE 2 DIABETES MELLITUS

Maryam Peimani

Background: Today, the internet has been emerged as a potentially effective medium for information exchange and in recent years, the use of web-based training programs has been steadily considered in the prevention and management of chronic diseases such as diabetes. This technology provides an opportunity to make health care more accessible for a large number of people and reduce costs. This review provides a descriptive discussion of web-based behavioural interventions for the management of type 2 diabetes mellitus. Methods: Systematic literature searches were performed using Medline, Embase, Psycinfo, Web of Science and Cochrane library to retrieve articles written in english and published between 2000 and 2012 which fulfilled all inclusion criteria. The search keywords were “diabetes” AND “intervention” AND (“internet OR web”). Only randomised controlled trials and quasi experimental studies were included in this review. Results: A total of 15 studies were reviewed. Goal-setting, personalised coaching, interactive feedback and online peer support groups were some of the successful approaches which were applied in e-interventions to manage type 2 diabetes mellitus. Strong theoretical background, use of other technologies and longer duration of intervention were proven to be successful strategies as well. Conclusion: The web-based interventions have demonstrated some level of favourable outcomes, provided they are further enhanced with proper e-research strategies.

ELECTROCHEMICAL IMMUNOSENSOR DEVELOPMENT USING MCM-41/ PVA AND AUNPS

Kobra Omidfar

Background: In this study, using anti-human serum albumin (HSA)-conjugated gold nanoparticles (AuNPs) as an electrochemical label and mobile crystalline material-41 (MCM-41)–polyvinyl alcohol (PVA) mesoporous nanocomposite as an immobilization platform, a new immunosensor was established. Methods: Field emission scanning electron microscopy (FESEM), cyclic voltammetry (CV), and differential pulse voltammetry (DPV) have been applied to determine the physicochemical and electrochemical properties of this hybrid film in immunosensor development. Results: A suitable attachment between HSA and MCM-41 and also a thick layer deposition of MCM-41–HSA–PVA film onto the electrode surfaces was observed by FESEM. DPV was employed for quantitative determination of antigen. Conclusion: In optimal conditions, this immunosensor could detect HSA in a high linear range (0.5– 200 µg ml -1 with a low detection limit of 1 ng ml -1 . This new strategy showed acceptable reproducibility, stability, and reliability and could also be applied to detect the other antigens.

HE EFFECT OF LOW INTENSITY RESISTANCE TRAINING ON SERUM OMENTIN-1 AND ADIPONECTIN CONCENTRATIONS IN STREPTOZOTOCIN-INDUCED DIABETIC RATS

Elahe Talebi-Garakani

Background: Adiponectin and omentin-1 are adipokines with insulin-sensitizing properties. The aim of this study was to investigate the effect of resistance training on serum levels of adiponectin and omentin-1 in Streptozotocin-induced diabetic rats. Methods: Twenty four male Wister rats (12-14 weeks’ old) were randomly divided into three groups: non-diabetic control, diabetic control, and diabetic training. The rats in diabetic training group were subjected to a resistance training program (3 days/wk, for 4 wk) consisted of climbing a ladder carrying a load suspended from the tail. Following four weeks resistance training serum glucose, insulin, lipid profile, adiponectin, and omentin-1 concentrations were measured. Results: Serum levels of omentin-1 and adiponectin were significantly lower in diabetic control group compare with non-diabetic control group (P<0.001). After 4 weeks of resistance training serum adiponectin levels was significantly higher in diabetic trained group compared with diabetic control group (P= 0.028), but we did not find any significant difference in omentin-1 levels between two diabetic groups. Morever, we did not find any significant difference in serum lipid profile among all groups. Four weeks resistance training did not change serum glucose and insulin concentrations in diabetic rats. Conclusion: This study indicated that resistance training could increase serum adiponectin levels in diabetic rats without significant changes in lipid profile, glucose, insulin, and omentin-1 concentrations. It seems low intensity and short term duration of resistance training had important roles in failure of significant changes of omentin-1, glucose, and insulin concentrations.

THE EFFECT OF ALTERNATE DAY FASTING ON WEIGHT, FOOD INTAKE AND FASTING BLOOD GLUCOSE LEVELS IN RAT

Fateme Mofidi

Background: Alternate Day Fasting (ADF) is one of dietary regimens in which food is available only every other day. Available limited evidence shows that this regimen may result in beneficial effects similar to classic caloric restriction, including weight loss and other associated useful effects of weight loss. Methods: Twelve week-old Wistar rats were obtained from animal house of Jundi Shapur University and fed a standard diet. Food was provided ad-libittum (AL) until 13 week of age. At that time rats were assigned to one of two groups: AL fed ad libitum or ADF, provided access to food every other day. Body weight was measured each week on the same day and time. Food intake was measured daily. Fasting blood glucose levels were measured before and after the intervention. Statistical tests performed as two-tailed and P value of less than 0.05 was considered as statistically significance level. Results: At the end of the intervention period body weight and food intakes of the (ADF) group were significantly lower than AL group (p<0.05) but there were not significant changes in fasting blood glucose levels. Conclusion: According to findings of this experimental study, ADF regimen could be used as an individualized eating strategy for weight loss but it could not have beneficial effects on fasting blood glucose levels.

EFFECT OF AEROBIC TRAINING AND PISTACIA ATLANTICA EXTRACT CONSUMPTION ON PANCREATIC Β-CELLS FUNCTION IN STREPTOZOTOCIN-INDUCED DIABETIC RATS

Marziyeh Saghebjoo

Background: Diabetes is considered as one of the health problems in all societies. Exercise training and drug interventions, especially herbal medicines, consider as approaches to improving diabetes. The objective of this study was to investigate the effect of 6 weeks of aerobic training and Pistacia atlantica extract consumption on pancreatic β-cells function in streptozotocin-induced diabetic rats. Methods: Thirty six male Wistar rats divided into five groups: normal control, diabetic control, diabetes+aerobic training, diabetes+extract, diabetes+aerobic training+extract. Diabetes was induced by intra-peritoneal injection of streptozotocin (40mg/kg). Exercise program was include 6 weeks of aerobic training on a treadmill (5 sessions per week, 40 minutes per session, with a speed of 20m/min and 5% incline). Extract groups were received Pistacia atlantica extract based on body weight, at the end of each training session. After 6 weeks of aerobic training and Pistacia atlantica extract consumption, plasma glucose and insulin levels were measured for determination of β-cells function (HOMA-B). Data were analyzed via ANOVA, with a significant level P<0.05. Results: HOMA-B index in diabetic control group was significantly higher than normal control group (P=0.0001). Also mean of HOMA-B index in diabetes+extract and diabetes+exercise training+extract groups was significantly lower than diabetic control group (P values 0.003, 0.001 respectively) and between mean of HOMA-B index in diabetic control group with diabetes+aerobic training group were observed no significant differences (P=0.052). Conclusion: The results of this study showed that Pistacia atlantica extract consumption, alone and along with aerobic training leads to significant improvement in pancreatic β-cells function in diabetic rats. Also extract consumption along with aerobic training in comparison to training alone has had greater impact on the improvement of pancreatic β-cells function. It seems that aerobic training along with the use of specific herbal plants can be considered as a complementary therapy in improvement of diabetics.

THE EFFECT OF 6 WEEKS ENDURANCE TRAINING ON GENE EXPRESSION OF NERVE GROWTH FACTOR IN SENSORY SPINAL CORD OF RATS WITH DIABETIC NEUROPATHY

Reza Gharakhanlou

Background: Diabetic neuropathy is one of the most common complications of diabetes mellitus, which is associated with a decrease in the synthesis and transport of neurotrophins . The aim of present study was to investigate the effect of endurance training on gene expression of nerve growth factor (NGF) in the sensory spinal cord of rats with diabetic neuropathy. Methods: Twenty eight adult male Wistar rats in the body mass range of 326.3±8.4 gr, randomly assigned in to four groups: diabetic control, diabetic training, healthy control and healthy training. For inducing diabetic neuropathy, after twelve hours of food deprivation, intraperitoneal injection of STZ solution (45 mg/Kg) method was used. Two weeks after STZ injection, the endurance training protocol was performed for six weeks and Twenty four hours after the last training session, rats were sacrificed. Gene expression of NGF in rat spinal sensory segments were measured with Real time technique. In order to determine the significant differences between groups and Interaction independent variables two way anova and LSD post hoc test were used. Results: Endurance training, resulted in a significant increase in gene expression of NGF in the rats. Also, in compare with diabetic control, training led to significant decrease in blood glucose levels in diabetic training group. Conclusion: Increased physical activity and exercise can strongly affect pathological factors associated with diabetic neuropathy by increasing nerve growth factor. It is recommended that for prevention of neurological complications and treatment of diseases associated with diabets exercise training could be used as a non-pharmachological treatment.

SUPPLEMENTED WITH COQ10: THE ROLE OF NITRIC OXIDE METABOLITES (NOX) ON BLOOD PRESSURE LEVELS IN TYPE 2 DIABETIC PATIENTS

Alireza Esteghamati

Background: CoQ10 is a lipid-soluble and a powerful antioxidant. Decreased level of this antioxidant was reported in many conditions like vascular, diabetes, high blood pressure and coronary artery diseases. With regards to increased oxidative stress in diabetes and its role in the development of high blood pressure, this study aimed to examine the effect of Q10 supplementation on blood pressure level and its relation to nitric oxide metabolites (NOx) level in type 2 diabetic patients. Methods: In this 12-week randomized controlled trial, T2D subjects received either placebo or coenzyme Q10 (100 mg twice a day). Anthropometric measures, blood pressure, biochemical analysis including NOx level, fasting blood glucose, glycosylated hemoglobin (HbA1c) and lipid profile were evaluated at the beginning and after the intervention. Results: The intervention resulted in a significant improvement in systolic blood pressure (115.3±27.61 versus 118.2±12.6 mmHg), diastolic blood pressure (77.1±8.22 versus 80.3±12.11mmHg), NOx (Pvalue=0.014) and HbA1c. Moreover Q10 supplementation resulted a significant decrease in elevated levels of cholesterol. Conclusions: In conclusion, CoQ10 supplementation (200 mg/day) for 12 weeks, significantly decreased systolic and diastolic blood pressure, NOx, HbA1c, total cholesterol and LDL-C in type 2 diabetic patients.