Iranian Journal of Diabetes and Lipid Disorders

STATISTICAL SERIES: THE ANALYSIS OF CONTINGNCY TABLES 3 (MEASURES OF EFFECT AND AGREEMENT)

Mohammad Asghari Jafarabadi

In medical studies, measures are required to reveal the effect of exposures and interventions and also the precision of measurements. This paper aimed to introduce the measures of effect and agreement and inferences about them in these studies. Principles and method of calculating measures of effect and agreement and inference about them were presented for all types of medical studies taking into account the relevant considerations. To assess the effect of risk factors on outcomes in case-control and cohort studies, and to determine the relevant effect, the attributable risk and fraction in the exposed group and population were used along with their confidence intervals. Also the relative risk reduction, absolute risk reduction and number needed to treat were applied as the measures of effect of intervention in the interventional studies especially in trails. The sensitivity, specificity and related measures along with their confidence intervals were computed for diagnostic accuracy and screening studies. In addition it is needed to evaluate the precision of measurements using standard error of measurements, ICC, Altman and Bland’s limits of agreement and Lin’s concordance correlation coefficient for quantitative variables and using kappa and weighted kappa for nominal and ordinal variables. In each of these situations the results of research based examples were presented along with the methods of their calculations.To assess the measures of effect and agreement, the mentioned analyses are recommended considering the situation and purpose of the study.

THE RELATIONSHIP BETWEEN COPING STYLES WITH ADHERENCE IN TYPE 2 DIABETIC PATIENTS

Javad Javaheri

Background: Having high knowledge in patients is not sufficient for disease control and it is necessary to get more skills and capabilities that could be helping in confronting with diabetes associated stresses. This study is aim to assess the relationship between coping styles approaches with adherence to treatment in type 2 diabetic patients. Methods: In a cross sectional design 100 type 2 diabetic patients were selected by convenience route. Folkman and Lazaros as well as adherence to treatment questionnaires were filled by participants. Data was analyzed by SPSS software version 16, spearman correlation test and linear regression model were used for inferential statistics. Results: Problem and excitement oriented subscales were significant correlation. The correlation between problem oriented subscale and adherence was positive and significant (P<0.05) so that regression model showed as this subscale increase the adherence was increasing as well. The correlation between excitement oriented subscale and adherence was negative and significant (P<0.05) so that regression model showed as this subscale increase the adherence was decreasing. Conclusion: The results emphasized that there is significant correlation between copying styles and adherence to treatment in type 2 diabetic patients.

EFFECT OF TWELVE WEEKS OF AEROBIC TRAINING ON SERUM LEVELS OF VASPIN, FASTING BLOOD SUGAR, AND INSULIN RESISTANCE INDEX IN WOMEN PATIENTS WITH TYPE 2 DIABETES

Zeynab Nezamdoust

Background: This study was conducted to determine the effect of 12 weeks of aerobic training on serum levels of vaspin and glucose homeostasis variables in patients with type 2 diabetes. Methods: In this quasi-experimental study, 20 women with type П diabetes (mean±SD: age 43.30 ±3.02 yr, body mass index 27.089±3.23 kg/m2 and body fat 29.46 ±2.71%) were randomized into experimental (n = 10) and control (n = 10) groups. Experimental group performed twelve weeks aerobic training (3 times per week at an intensity of 75-85 % of maximum heart rate reserve). Blood samples were collected 24h before and 48h after the training. Data was analyzed by paired and independent samples t-test (P <0.05). Results: Results showed a significant decrease in serum levels of vaspin, fasting blood sugar and insulin resistance index (P value 0.001, 0.01 and 0.007 respectively) ) in experimental group and body weight, body mass index, percent body fat and waist to hip ratio significantly decreased in experimental group (P value 0.002, 0.01, 0.04 and 0.03 respectively). Conclusion: The results of this study showed that aerobic training along with decrease in body weight and percent body fat leads to significant decrease in serum levels of vaspin, fasting glucose and insulin resistance index, so can be considered as a complementary therapy method in patients with type 2 diabetes.

THE ROLE OF ATTACHMENT AND PARENTING IN OBESE ADULTS

Mohammad Ali Besharat

Background: The role of obesity and overweightness in emerging and enduring of serious medical and psychological disorders on one hand and the effect of psychological factors in obesity on the other hand, has made the surveys about psychological role in obesity of great importance. The aim of the present study was to compare the attachment styles and parenting styles of obese and non-obese adults. Methods: 144 individuals (72 obese patients: 48 females and 24 males) and (72 non-obese: 48 females and 24 males) participated in this study. Participants were asked to complete the Adult Attachment Inventory (AAI) and the Parental Authority Questionnaire (PAQ). Results: There was a negative relationship between secure attachment and Body Mass Index (BMI) of the obese patients, but no statistically significant relationship between insecure attachment styles (avoidant and ambivalent) was found. There was also a statistically significant relationship between the mean scores of secure and ambivalent attachment styles with BMI. Regarding the parenting styles and BMI, there was a statistically significant relationship between authoritative parenting style of the father and BMI, but no relation between authoritarian and permissive parenting styles was confirmed. Conclusion: Regarding the role of attachment styles and parenting styles of obese and non-obese adults, we can improve the physical and psychological public health of patients by changing the prevention and treatment protocols for the patients.

VISCERAL ADIPOSITY INDEX (VAI), AS THE BEST PREDICTOR OF INSULIN RESISTANCE AND METABLIS SYNDROME IN THE WOMEN WITH POLYCYSTIC OVARY SYNDROME

Fahimeh Ramezani Tehrani

Background: Considering the limited population-based studies and lack of a general consensus on the most sensitive and precise predictor of insulin resistance and metabolic syndrome in the women with polycystic ovary syndrome (PCOS), the present study was performed with the aim of comparing the validity of various available adiposity markers in these patients. Methods: In the national and population-based study of PCOS prevalence, 1772 girls and women, aged 18-45 years, were assessed for the diagnosis of PCOS based on Rotterdam criteria. Waist circumference, body mass index, waist to hip ratio, lipid accumulation product, visceral adiposity index (VAI) and homeostasis assessment model- insulin resistance (HOMA-IR) were calculated. The diagnosis of metabolic syndrome was based on Joint Interim Statement (JIS)criteria and HOMA-IR&ge 2.3 was considered as the resistance cutoff point. Results: In among different markers, VAI served as the best predictor of insulin resistance (sensitivity %60, positive predictive value %83) and metabolic syndrome (sensitivity %97, positive predictive value %95). ROC curve showed the cutoff points of 1.8 and 3.1 as the optimum values for insulin resistance and metabolic syndrome prediction, respectively. Conclusion: It seems that visceral adiposity index is a reliable marker for the screening of cardiometabolic disorders in the women with PCOS.

ASSOCIATION Of ASSESSMENT BETWEEN VAL109ASP OMENTIN GENE AND OBESITY IN IRANIAN WOMEN

Leila Kohan

Background: obesity is the major health problems affecting communities worldwide and the prevalence is rapidly rising. Obesity as a lifestyle-related factor increases the risk of many diseases. Omentin is a new adipocytokine that is abundantly expressed in visceral fat tissue and its expression levels reversely correlated with obesity. The purpose of this study was to investigate the association between Val109Asp genetic polymorphism of Omentin gene and obesity risk in women. Methods: This case - control study was done on 260 women, including 186 women with BMI<30 as a control group and 74 women with BMI&ge30 with obesity. Omentin genotypes were determined by the use of polymerase chain reaction (PCR) followed by restriction fragment length polymorphism (RFLP). The data were analyzed using the computer software SPSS for windows version17. Results: Genotype frequencies of the Asp/Asp, Asp/Val and Val/Val in the control group were 65.6%, 31.7%, 2.7% and obese patients were 51.4%, 39.2%, 9.5%, respectively. Comparison of genotype frequencies in the two groups showed that women with Val/Val genotype in compare to Asp/Asp had greater risk for complications of obesity (OR: 4.5, 95%CI: 1.3-14.9, P: 0.01). Conclusion: There is significant association between Val109Asp polymorphism in omentin gene and obesity in Iranian women.

COMPARISON OF ACUTE AEROBIC EXERCISE IN DIFFERENT INTENSITIES ON PLASMA VISFATIN CONCENTRATION IN TYPE 2 DIABETIC MALES

Hamed Rezaei Nasab

Background: The purpose of this study was to compare three intensities of acute aerobic exercise on plasma visfatin concentration in type 2 diabetic males. Methods: Ten men with type 2 diabetes (mean ± SD age 52.6 ± 3.6 years, height 171.3 ± 6.7 cm, Weight 87.58 ± 4.7 kg) participated in the study. In the first session, anthropometric measurements, body composition, and peak oxygen uptake (VO2peak) was measured in all subjects. In the next sessions, subjects completed three acute aerobic exercises on separate days in a crossover design. The three exercise trials performed at intensity of 40%, 60%, and 80% VO2peak after fasting for at least 10 hours. Energy expenditure was 300 kcal for each exercise trial. Blood samples before exercise, immediately after and 24 hours after exercise were collected for measuring visfatin, glucose and insulin. Results: The results showed no significance interaction (p>0.05) between exercise and sampling time. This analysis also revealed significance in the main effects (p>0.05) of the two factors (exercise and sampling time). Pearson correlation showed that there was significant relationship between visfatin and insulin (p<0.05). Conclusion: According to the present results, we can conclude that acute aerobic exercise at different intensities with 300 kcal energy expenditure will not change visfatin levels in type 2 diabetes.

MONGOLIAN SPOTS AND GANGLIOSIDOSIS GM1 DISEASE, A CASE REPORT AND LITERATURE REVIEW

Afsaneh Nekoee

Gangliosidosis GM1, is a lipid storage disorder due to deficiency of the lysosomal enzyme &beta-galactosidase. This deficiency leads to lysosomal accumulation of gangliosidosis GM1 to be, which contributes to swelling, cell damage and dysfunction of the organs. Gangliosidosis GM1a rare neurodegenerative disorder. Mongolian spots are significant clinical sign in some of the metabolic diseases, such as gangliosidosis GM1, but limited information is available. Hepatomegaly, hypotonia, edema, seizures, and skeletal malformations and Cherry red spot in the macula of the eye are of other symptoms of the disease. In this paper, we present a 10-month-old child with gangliosidosis GM1 type 1 with extensive mongolian spots who was referred the Hajar Medical Educational Therapeutic Center Shahrekord.