Iranian Journal of Diabetes and Lipid Disorders

The Effect of High-Intensity Interval Training on Plasma Irisin Levels and Glycemic Indices in Obese and Type 2 Diabetic People: A Systematic Review and Meta-Analysis

Omid Zafarmand

Background: Irisine is a new myokine that is released from the membrane protein fndc5 and has positive effects on metabolism. The aim of the present study was to investigate the effect of high-intensity interval training on plasma irisin levels and glycemic indices in obese and type 2 diabetic people.
Methods: A systematic search of published English and Persian articles was conducted from PubMed, Web of Science, Scopus, SID, and Magiran databases up to 20 November 2024. The mean difference and 95% confidence interval (CI) were calculated using a random-effects model. Heterogeneity was assessed using the (I2) test and publication bias was assessed using visual analysis of funnel plots and Egger's test.
Results: A total of 11 studies and 264 obese and type 2 diabetic subjects were included in the present meta-analysis. The results showed that high-intensity interval training significantly increased irisin [WMD = 1.448 ng/ml (2.280 to 0.616), P= 0.001], significantly decreased glucose [WMD = -12.127 mg/dl (-24.180 to -0.074), P= 0.049] and insulin resistance [WMD= -1.275 (-0.567 to -1.983), P= 0.001] compared to the control group in obese and type 2 diabetic subjects. While insulin [WMD= -0.249Iu/ml (3.402 to -3.901), P= 0.894] was not significantly reduced.
Conclusion: Overall, the findings of the present meta-analysis indicate that high-intensity interval training plays an effective role in irisin, glucose, insulin, and insulin resistance to high-intensity interval training. High-intensity interval training increases irisin, decreases glucose, insulin, and insulin resistance in obese and diabetic individuals. Lifestyle modification and exercise training are preferred treatment strategy in obese and type 2 diabetic people.

The Association of Psychological Distress and Psychological Distress Tolerance in Children with Type 1 Diabetes: A Cross-Sectional Study

Leila Mohammadifard

Background: With the increasing prevalence of diabetes in children and the resulting mental pressures, attention to these patients has become a health priority in the world. Psychological distress is one of the problems of these patients that affects different aspects of their lives. It seems that enduring psychological distress can affect the psychological problems of these patients. Therefore, the present study was conducted with the aim of determining the relationship between psychological distress and tolerance of psychological distress in children with diabetes in Zahedan city.
Methods: This was a cross-sectional study. The samples included 200 children with pediatric diabetes referred to the diabetes clinic of Ali Ibn Abi Talib (AS) hospital in Zahedan and met the inclusion criteria. The data collection tool included the demographic information form and Kessler's psychological distress and Gaher's distress tolerance questionnaires, which were completed by interviewing the child. Descriptive and analytical data analysis was done using spss27 software.
Results: 52.6% of all subjects studied were girls and the average duration of infection was 22.6 months. A significant relationship was found between psychological distress and tolerance of psychological distress (r = -0.65 p < 0.001).
Conclusion: The findings showed that there is a significant and inverse correlation between psychological distress and distress tolerance. In other words, the higher the psychological distress tolerance, the less distress a person experiences. Therefore, it seems that in order to enjoy higher mental health in these patients, attention should be paid to improving their distress tolerance.

Synergistic Reno-Protective Effects of Valproate Sodium and Metformin in Diabetic Nephropathy Mice Model Through Attenuating the Expression of Pro-Inflammatory and Enhancing the Expression of Sirt-1 and Bcl-2

Parisa Saberi-Hasanabadi

Background: Diabetes is the most common metabolic disease resulting from a relative deficiency of insulin secretion or action. This study aimed to evaluate the synergistic inhibitory effects of valproate sodium (VPS) and metformin (MET) on alloxan-induced diabetic nephropathy and to understand the mechanism of their effect on the expression pathway of inflammatory genes, Sirt-1 and Bcl-2.
Methods: Female mice (C57BL/6) were induced to have diabetes by intraperitoneal injection of a single dose of alloxan (120 mg/kg). Diabetic mice were treated with three doses of sodium valproate (10, 20, and 40 mg/kg) and a single dose of metformin (200 mg/kg) for a period of 28 days. The expression of inflammatory genes and histological changes in the kidneys of the mice were evaluated for a period of 28 days.
Results: The hyperglycemia induced by alloxan-induced diabetes was significantly reduced after a 28-day course of valproate sodium administration (P < 0.05). Combined treatment of sodium valproate with metformin significantly reduced the expression of inflammatory genes in the kidney tissue of diabetic mice. A significant increase in the expression of Sirt-1 and Bcl2 was observed in diabetic mice receiving valproate sodium and metformin compared to the diabetic group. Treatment of diabetic mice with valproate sodium and metformin prevented the adverse histopathological changes caused by renal nephropathy, which was accompanied by normal glomerular capillary size and reduced dilatation of the urinary tract compared to diabetic mice.
Conclusion: It can be concluded that MET and VPS in combination can prevent alloxan-induced diabetic nephropathy through attenuating inflammatory pathways and decreasing inflammatory genes expressions together probably with the suppression of oxidative stress, inflammation and apoptosis.

Modulation of Oxidative Stress Through TNFα/SIRT1/NRF1 Signaling Pathway and Kidney Function by Aerobic Exercise with Different Slopes in Chronic Kidney Disease (CKD) Mice

Farzaneh Taghian

Background: The purpose of the research was to compare the effect of two types of aerobic exercise—with and without incline—on the modulation of oxidative stress and kidney function in chronic kidney disease (CKD) mice.
Methods: A total of 24 two-month-old female C57b16 mice weighing 25±26.1 grams, were randomly divided into four groups: healthy control, CKD-affected mice, CKD mice undergoing aerobic exercise without incline, and CKD mice undergoing aerobic exercise with incline. To induce CKD, they received adenine powder at a concentration of 0.2% mg/kg for four weeks. The training groups performed eight weeks of treadmill training (five sessions per week), whit one group exercising on a 20-degree incline and the other on a zero-degree incline. After the last training session, blood samples were collected to measure blood urea nitrogen, urea and glutathione concentration using the ELISA method. The expression levels of the SIRT1, NRF1 and TNF-α genes were measured using qPCR (Real-Time PCR) technique. For statistical analysis, a one-way ANOVA test and Tukey's post hoc test were employed, with a significance level set at P≤ 0.05.
Results: The results showed that the induction of CKD caused a significant increase in blood urea nitrogen and a significant decrease in glutathione concentration compared to the healthy control group (P< 0.05). Conversely, in the exercise groups, there was a significant increase in glutathione concentration and a significant decrease in blood urea nitrogen (P< 0.05). The expression level of SIRT1 and NRF1 in the slope training group increased significantly, while the expression level of TNF-α decreased significantly (P< 0.05).
Conclusion: Exercises performed on an incline moderates oxidative stress through the TNFα/SIRT1/NRF1 signaling pathway, improving glutathione concentration and blood urea nitrogen levels in mice with chronic kidney disease. Furthermore, the effects of incline exercise were found to be superior to those of exercise without incline.

The Effects of 12 Weeks of Pulsed Magnetic Therapy and Multicomponent Exercise on Bone Markers and Serum Concentration of Sclerostin in Type 2 Diabetic Patients with Osteoporosis

Khosro Jalali Dehkordi

Background: The current study aimed to ascertain the impact of pulsed magnetic therapy, multicomponent exercise, and a combination of both modalities on bone markers type 2 diabetic patients with osteoporotic.
Methods: In a randomized controlled clinical trial study, 56 older patients with type 2 diabetic osteoporosis (age: 68.18±3.67 yr; weight: 78.13±7.65 kg, body mass index: 28.40±1.76 kg/m2) were randomly assigned to either the multicomponent exercise + Full-body pulsed electromagnetic field (MCEx+PEMF, n= 18) multicomponent exercise + placebo full-body PEMF (MCEx+PPEMF, n=17) and a full-body PEMF alone (PEMF, n= 21). PEMF was applied for the whole body using a full-body mat three times per week, 60 minutes for 12 weeks, with a multicomponent exercise protocol that includes flexibility, aerobic exercise, strengthening, weight-bearing, and balance exercises followed by whole-body vibration (WBV) training. The body composition, bone mineral density (BMD), bone metabolism markers (phosphorus, calcium, sclerostin, osteocalcin, Bone-specific alkaline phosphatase (BALP)) before and after the intervention. The data were analyzed using the dependent t test and the two-way repeated measures ANOVA at the level of less than 0.05.
Results: After 12 weeks of intervention, there is a significant difference in the serum levels of bone mineral density and bone metabolism markers (phosphorus, calcium, sclerostin, BALP) between the groups (P< 0.05). However, the bonferoni post-test showed an increase in serum levels of BMD, phosphorus, sclerostin, BALP with a significant decrease in calcium in the MCEx+PEMF group in compared to alone PEMF group.
Conclusion: The findings showed that the PEMF rehabilitation method combined with multicomponent exercise is more effective and safer than exercise or PEMF only for improving BMD and bone metabolism markers in the type 2 diabetic population with osteoporosis. Therefore, exercise rehabilitation clinics should be encouraged to consider exercise rehabilitation as a treatment method for type 2 diabetic patients with osteoporosis. More studies with long-term follow-up should be considered to confirm these findings.

The Effect of Aerobic Exercise and Fenugreek Supplementation on C-reactive Protein and Some Hematology Indices of Inactive Women

Sajad Arshadi

Background: Considering the negative effects of inactivity and increasing fat mass in inactive people, the aim of this study was to investigate the effect of six weeks of aerobic exercise along with the consumption of fenugreek seeds supplementation on C-reactive protein and some blood parameters in inactive women.
Methods: 40 subjects were randomly assigned to 4 groups: exercise and fenugreek (n=10), exercise and placebo (n=10), fenugreek (n=10), placebo (n=10). Two exercise groups participated in the aerobic exercise program for 6 weeks, 3 sessions per week, and each session lasted from 20 to 30 minutes. Subjects consumed 500 mg of fenugreek seeds or placebo (starch) daily after breakfast. The blood samples of the subjects were collected from the vein of the right hand of the subjects in a sitting position. In order to analyze the data, Shapiro-Wilk test, correlated t-test, and Benferroni's post hoc analysis of covariance test were used for natural data at the significance level of p<0.05.
Result: The results showed that aerobic exercise combined with fenugreek seeds supplementation had a decreasing effect (p=0.001) on the response of C-reactive protein (CRP) in inactive women, and an increasing effect on the amount of platelets in inactive women (p=0.003). It had an increasing effect on the amount of red blood cells in inactive women (p=0.003) and a decreasing effect on the amount of white blood cells (p=0.03).
Conclusion: Aerobic training with fenugreek seeds leads to a decrease in C-reactive protein and a decrease in white blood cells and an increase in platelets and red blood cells. These changes reduce the inflammatory condition and increase the immune system and better oxygen supply to the tissues and optimal metabolism of inactive women.

Comparison of the effect of high-dose versus the recommended dose of vitamin D supplementation on serum 25(OH)D levels in osteopenic women over 50 years old

Hamidreza Aghaei meybodi

Background: Vitamin D (vitD) deficiency is common in Iran. Although there are several studies on therapeutic doses of vitD, the optimal dose is to be evolved. we compared the effects of high dose supplemental vitamin D versus its recommended dose on the serum level of 25(OH)D.
Methods: This clinical trial was performed at Endocrine & Metabolism Research Institute in Shariati Hospital, Tehran, Iran within 2008-2009. The subjects were osteopenic women older than 50 years who had been referred to Bone Densitometry laboratory. They were received either (group P) 50000u vitD3 weekly for 3 months then monthly for another 9 months, or (group M) 800u vitD3 daily for one year. 1000 mg calcium carbonate was given to both groups. Serum 25(OH)D, calcium, phosphorus, and PTH was checked at base, 3rd, 6th and 12th month. 24h Urine for calcium was collected before and at the end of trial.
Result: Serum 25(OH)D level was significantly higher in group P at 3rd month (P< 0.05), but it gradually declined and there was not statistically difference to group M. PTH decreased in both groups. Urine calcium to creatinine ratio did not rise in both groups.
Conclusion: vitD supplement at doses of 50000u weekly for 3 months then monthly for another 9 months as compare to 800u vitD3 daily for one year increases serum 25(OH)D at higher level without causing hypercalcemia and hypercalciuria, but it seems that more frequent doses in monthly period would be required to maintain the optimal 25(OH)D level.

Investigation of NUDT15 Allele Frequency in a Group of Iranian Population

Mandana Hasanzad

Background: Pharmacogenomics (PGx), as a growing field of personalized medicine, aims to optimize the efficacy and safety of medications by studying the association between germline genetic variations and drug responses. The present cross-sectional study aims to evaluate the allele frequency of the NUDT15 genetic variant in the Iranian population to provide insights into personalized treatment decisions in the Iranian population.
Methods: A representative sample set of 1142 unrelated healthy Iranian individuals aged 18 and older genotyped using the Infinium Global Screening Array-24 BeadChip.
Results: We identified a pharmacogenetic variant with minor allele frequency (MAF) ≥1% among the present studied population which may explain the substantial variability in drug response phenotypes among different populations
Conclusion: The results of our study revealed significant genetic variation among Iranian populations that could significantly influence clinical decision-making. This study shows the frequency pattern of the effective variant of NUDT15 in determining the phenotype in Iranian population.