Iranian Journal of

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There are more than 140 million people with diabetes in the world. Iran’s share is estimated at 1.5 million people. The increasing prevalence of diabetes and the longer life expectancy of diabetic patients mean that an increasing number of patients with diabetes are undergoing surgery, and not just for diabetes and its complications, such as end-stage renal disease, retinopathy, peripheral vascular disease, and diabetic foot ulcers. The metabolic stress caused by general anaesthesia and the operation itself makes blood glucose control even more difficult. Stricter pre- and intra-operative glycaemic control reduces the risk of sepsis, cardiovascular events, disability and death, accelerates wound healing and decreases hospital stay. Improved outcome requires pre-operative ascertainment of the type of diabetes, quality of metabolic control, and detection of complications, as well as optimal metabolic and haemodynamic management during the operation. Local anaesthesia is the preferred option in this group of patients because it least interferes with metabolic control. The diet recommended to achieve normoglycaemia will depend on the type of diabetes, pre-operative glycaemic control, and the extent of the planned procedure. In all type 1 diabetic patients and type 2 diabetic patients on insulin or oral hypoglycaemic agents who are to undergo surgery under general anaesthesia, the glucose-insulin-potassium (GIK) regimen is the one recommended by most authors to achieve tight intra-operative blood glucose control, conditional upon blood glucose measurements being available every one or, at most, two hours. Intra-operative blood glucose levels in the 120-180mg/dl ranges are considered satisfactory. Failing this, it is recommended that 50% of the daily NPH requirement be given subcutaneously on the morning of the operation, together with an intravenous glucose infusion intra-operatively. Type 2 diabetic patients with unsatisfactory metabolic control, time permitting, should be admitted several days before the operation and switched to and stabilised on insulin.

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Background: Risk factors of cardiovascular disorders have been the subject of several studies. Recently, simultaneous high waist circumference (WC) and high serum triglyceride (Tg) has been proposed as a simple screening measure to predict non-traditional risk factors. This study has looked at the risk factors of cardiovascular disorders present in subjects with this phenotype.
Methods: Non diabetic females of age 18-65 years who had been enrolled in the Tehran Lipid and Glucose Study (TLGS) were recruited. Based on fasting Tg and WC, subjects fell into four categories: TgHWH ( Tg>160 mg/dl, WC>80 cm), TgHWL (Tg>160 mg/dl,WC<80 cm), TgLWH(Tg<160 mg/dl,WC>80 cm) and TgLWL (Tg<160 mg/dl,WC<80 cm). Cardiovascular risk factors including lipid profiles and anthropometric variables were compared between the categories. The prevalence of hypertension, LDL-C>130 mg/dl, total cholesterol>220 mg/dl and HDL- C<45 mg/dl were also determined in each category.
Results: 5630 subjects were studied. TgLWL and TgHWH constituted to 27.5 % and 31.9 % of subjects, respectively. Mean age of subjects dropping in TgLWL, TgLWH, TgHWL and TgHWH groups was 28±10, 39±12, 36+12 and 46±11, respectively and TgHWH subjects were significantly older than other groups (p<.001). Systolic and diastolic blood pressures, body mass index and WC were significantly higher in TgHWH. Significantly higher levels of total cholesterol, triglycerides and LDL-C and significantly lower level of HDL-C were found in the TgHWH group. The prevalence of subjects with four or more risk factors was 61.4% in TgHWH versus 1% in TgLWL group.
Conclusion: Parallel high waist circumference and high serum triglycerides (TgHWH) can find use as a simple screening measure to predict other risk factors of cardiovascular disorders.

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At least 2 million people are affected by type II diabetes mellitus in Iran. Neuropathy is one of the commonest complications of diabetes affecting the quality of life of patients and can result in foot ulcer and amputation. The current study aimed to examine possible factors that could alter development of diabetic neuropathy.
Methods: In this case-control study, 110 diabetic patients were selected from Shariati hospital diabetes clinic. Michigan Neuropathic Diabetic Scoring (MNDS) was used to distinguish cases from controls. The neuropathic status of patients was confirmed with EMG-NCV. Multiple factors were compared between the two groups including ACE-I consumption, blood pressure, serum lipid level, sex, smoking, method of diabetes control and its quality.
Results: Statistically significant relations were found between neuropathy and age, gender, quality of glycemic control and duration of diabetes (P values: 0.04, 0.04, 0.000 and 0.005, respectively). No correlation existed between atherosclerotic risk factors (high BP, hyperlipidemia, cigarette smoking) and diabetic neuropathy.
Conclusion: In this study, hyperglycemia was the only modifiable risk factor for diabetic neuropathy. Glycemic control can decrease the incidence of neuropathy and delay its progression leading to improvement in the quality of life in diabetics. Aged and male diabetic patients and those with poor diabetes control are groups in most need of regular foot exam and more practical educations.

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Depression is one of the most prevalent mental disorders in diabetics, which affects treatment course and disease prognosis. This study focuses on the association between diabetes and depression as well as depression and glycemic control.
Methods: 375 diabetic patients (type I and II) of diabetes clinic of Doctor Shariati Hospital and diabetes association of Iran participated in this cross-sectional study.Patients were screened for depression with Beck Depression Inventory. Then depressed subjects were
evaluated with DSM IV criteria for determination of the depressive disorders category.
Results: Depression was diagnosed with Beck Depression Inventory in 41.9% of patients. Of these patients major depressive disorder was defined in 23.7%, dysthymic disorder in 9.3% and association of two disorders in 0.8% of patients. Major depressive disorder was more prevalent in 31-59 year old group and dysthymic disorder in more than 60 year age group. Also depression was more prevalent in
women, diabetics with uncontrolled blood glucose and patients with diabetes complications.
Conclusion: Depression is a prevalent psychiatric disorder in diabetics, which is associated with female gender, poor glycemic control and diabetes complications. Therefore, glycemic control and prevention and treatment of diabetes complications can prevent depressive disorders in diabetics.

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Background: Currently different criteria are used to diagnose Gestational Diabetes. ACOG (American college of obstetric and Gynecology) accepted NDDG's (criteria National Diabetes Data Group) Criteria and ADA (American Diabetes Association) accepted Carpenter Caustan’s. Although both of these criteria have been achieved by O Salivan and Mahan’s reaserches, the number of patients has been diagnosed are different .The aim of this study was to compare Gestational Diabetes prevalence according to Carpenter Caustan’s and NDDG’s Criteria.
Methods: 1200 pregnant women were screened in a prenatal care clinic. Patients with definite diabetes were excluded. According to universal GDM screening method, for all of the patients GCT and GTT (if GCT > 130) were preformed. The results evaluated according to Carpenter Caustan’s and NDDG’s criteria. Results: In this screening, 377 participants had positive GCT, according to Carpenter and Caustan’s criteria 83 women (6.9%), and according to NDDG criteria 50 women (3.6%) had Gestational Diabetes Mellitus. If the cut of point of GCT was 140 mg/dl instead of 130 mg/dl, according to Carpenter and Caustan’s criteria 16 women (18.1%), and according to NDDG 4 patients (9%) were missed.
Conclusion: Regarding the significant difference between two methods in diagnosis of gestational diabetes mellitus, assessment of each method value in improving prognosis and outcomes is necessary. According to the results the cut of point of 130mg/dl, as recommended in previous studies, has more accuracy for screening.

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Background: Gliclazide is a second generation sulfonylurea which its efficacy and safety in the treatment of diabetes has been established. Diamicron MR (30 mg) is a new formulation of gliclazide with modified release which offer once daily dosage administration. This study was designed to assess the effect of combination therapy with diamicron and metformin in the treatment of type 2 diabetes. Methods: 16 patients with type 2 diabetes (2 males, 14 females) more than 35 years old who despite treatment with glibenclamide and metformin had poor diabetes control participated in this clinical trial.HbA1c, lipid profile, liver and renal function tests at the end of study were compared with before. Results: No significant changes was found in FBS, BS2hpp, lipid profile and renal and liver function tests at the end of study. Patients' weight was stable during the study.
Conclusion: Regardless of well efficacy of diamicron in the treatment of new diabetics cases, it is not recommended for patients with poor diabetes control despite of combination therapy with metformin and glibenclamide.

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Background: Cardiovascular disease is one of the major leading cause of death in Iran. There is a strong association between parental history of cardiovascular disease clustering of risk factors in the offspring. Detection and treatment of cardiovascular risk factors since childhood is essential to reduce the incidence of disease in adulthood. This study was performed to identify major cardiovascular risk factors in middle school-aged children and their parents in high risk compared to control families.
Methods: The middle schools of the 6th of Tehran were divided randomly into two groups. A total of 169 high-risk children with their families were recruited from the first group while 105 control children with their families were recruited from the second group of schools. Coronary risk factor survey was performed in the participants.
Results: Prevalence of increased total- and LDL-cholesterol and high FBS were higher in high-risk parents and children. Prevalence of increased BMI was higher in fathers and children of high-risk families. More fathers in high-risk families were smoker. The means of waist circumference and WHR were significantly higher in high-risk fathers. The means of total- and LDL- cholesterol were significantly higher both in parents and children of high-risk group. The means of FBS were significantly higher in fathers and offspring of high-risk families. Conclusion: Cardiovascular risk factors are more prevalent and clustered in high-risk families. Screening of these families is essential to prevent progression of cardiovascular disease since childhood and reduce its burden in adulthood.

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Background: The importance of feed controlling has been proved in metabolic control of diabetic patients. An appropriate metabolic control prevents later complications. Patients with diabetes mellitus are deprived from eating sweat foods. Considering the effect of different carbohydrates on blood sugar, physicians and patients confront a lot of questions about eating these foods. The aim of this study was to compare the effect of sugar cube and Date consumption on blood sugar in patients with type 1 diabetes.
Methods: As a clinical-trial, we selected 20 patients with type I diabetes mellitus sequentially. They were divided into two groups with 10 subjects in each group. The patient’s blood sugar was measured in 2 days with one week interval, before and after eating a Date (10gr) and a sugar cube (5gr). We measured blood sugar at 30, 60, 90 and 120 minutes after consumption. Data analysis was performed by SPSS software version 11, and the results were compared by paired t test.
Results: There was no significant difference between the blood sugar after eating Date and sugar cube. We also compared the surface under the curve of blood sugar after eating date and sugar cube in 2 hours, which was 1619.4 ± 614 mg.min/dL and 1572 ± 967 mg.min/dL for sugar cube and Date respectively, which the difference was not significant.
Conclusion: Rising in blood sugar after Date consumption has not significant difference in comparison with sugar cube consumption in patients with type I diabetes. So, eating Date in diabetic patients is not preferable to eating sugar cube.

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Background: To evaluate the role of lipid markers including total cholesterol (TC), LDL-C and HDL-C vs. lipid indices (TC/HDL-C, LDL-C/HDL-C and non-HDL-C) as short term predictors of cardiovascular outcomes in adults over 30 years.
Methods: As a nested case and control study, there were 207 CVD events among participants of Tehran Lipid and Glucose Study (TLGS) documented during 3 years of follow-up. Those cases that were free of CVD at baseline (132 subjects) were matched to 264 controls for age and sex. In all subjects, demographic and clinical data including blood pressure and anthropometric measurements as well as serum lipids, fasting and 2-hour glucose were available from the database of the TLGS. We estimated the relative risk (RR) for each lipid parameter in a multiple stepwise regression model after adjustment for family history of premature CHD, smoking, systolic and diastolic blood pressure, fasting and 2-hour plasma glucose and waist-to-hip ratio.
Results: The RRs associated with an increase of ≈1 SD of independent lipid predictors in the multivariate model were as follow: total cholesterol (RR=1.6 [1.2-2.0], SD= 1.3 mmol/L), LDL-C (RR=1.5 [1.1-2.0], SD= 1 mmol/L), non-HDL-C (RR=1.6 [1.2-2.1], SD= 1.2 mmol/L) and cholesterol/HDL-C (RR= 1.5 [1.1-2.0], SD= 1.8). The comparing of these four independent variables with ROC curve analysis showed that there was no significant difference in their predictive power for cardiovascular outcome. There was no association between HDL-C, triglyceride and LDL-C/HDL-C and CVD outcome in multivariate analysis.
Conclusion: This study showed that TC, LDL-C, non-HDL-C and TC/HDL-C have similar predictive values for short term prediction of CVD outcome. It seems TC may be a reasonable choice for short term prediction of CVD outcome, because of lower cost.

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Background: Kidney transplantation is one of the major progresses of medical science with many ethical debates. The shortage of organs and the increases in waiting list for cadaver transplantation has leaded to transplantation from living donors. In this article, we discuss the ethics of transplantation from living kidney donors.
Methods: For compiling this article, we searched in Pubmed and Ovid by the keywords of kidney transplantation, living donor, ethics.
Results: At the first, the history and statistics of kidney transplantation in Iran and other countries are reviewed. We discussed the living kidney transplantation regarding to principles of nonmaleficence, autonomy and justice. The ethical issues of different groups of living donors and the proponents and opponents opinions are expressed. Because of the importance of unrelated living donors, this group is discussed more briefly.
Conclusion: It is realistic to consider the living kidney transplantation as the last option. Arranging a legal and social organization to control the monetary relationship of the recipients and donors and to determine the preferences of kidney receipt in waiting list is reasonable. It is essential to increase the cadaver transplantation resources to decrease the need of kidney transplantation from living donors.

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Background: Nowadays, many progresses have been occurred in medical science and transplantation process. Transplantation is now a life- saving standard treatment for some end stage diseases. Although the organs from brain death donors, are the best resource for cadaverous transplantation, there are many controversies among physicians about it's definition. The other important issue in transplantation is disparity between the supply and demand of organs. Because of the increasing demand for cadaverous organs it is necessary to use some new methods to fascilitate the availability of these resources. What is noteworthy is that each of these methods has some essential ethical issues that should be observed. Surely regarding these issues would prevent the future harms to human being and society.
Methods: For compiling the article, we searched in pubmed and ovid databases for keywords of cadaverous transplantation, brain death, medical ethics, informed consent.
Results: In this article, after a review of transplantation statistics in Iran and other countries we presented a definition for brain death and some methods to expand donor pools. Then ethical views in brain death and informed consent process for cadaverous organs transplantation was discussed.
Conclusion: In using cadaverous organs for transplantation, informed consent and respect to autonomy are very important. All people in the society are authorized to accept or refuse organ donation after their death and , physicians can only encourage and support them.

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Background: Experimental studies have shown that walnut (Juglans regia) intake decreases the risk of coronary heart disease (CHD). Walnut decreases the levels of atherogenic lipids such as TG, LDL-C and VLDL-C. Mainly the effect is induced via 3- Poly Unsaturated Fatty Acids (3-PUFA). Walnuts are a rich source of these fatty acids, especially -Linolenic acid (C18:3 9, 12, 15).
Methods: We assigned 20 hypercholesterolemic male Rats (200-250g) to four groups, and fed with four diet concentration of oil extract Persian walnuts(J. regia)(Lavasanate) (w/w ) as complementary diet: control group (0% oil extract) and cases 5%(1g oil extract/1g weight/1 day) ,7.5%(1.5g oil extract/1g weight/1 day),10%(1g oil extract/1g weight/1 day) for eight weeks.
Results: Results revealed there is a positive effect on the decreasing of TG(14%) ,TC(7.8%) , LDL-C(11%),VLDL-C(12%) serum concentrations, with increasing consumption of oil extract Persian walnuts (5% ,7.5% and 10%).
Conclusion: In view of the positive effect of oil extract Persian walnuts (J. regia) consumption on decrease serum concentration of TG, TC, LDL-C and VLDL-C known as atherogenic lipids and lipoproteins, it may be suggested as a CHD protective dietary supplement.

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Background: Diabetes mellitus is an insidious disease which can affect different organs. One of the problems is resistant vaginitis, which is related to factors such as high blood glucose levels, allergy and atopia. One of the most common pathogens associated with this condition is Candida Albicans. Thus most physicians begin anti-fungal therapy in first visit even without documented evidence of fungal origin.
Methods: This descriptive analytical cross-sectional study was performed on 160 non-pregnant diabetic women in diabetes clinic of Shariati Hospital during a period of three years (2002-2005). Fasting and 2 hours postprandial blood glucose levels and HbA1C were measured and culture of vaginal discharge was performed. Fisher's exact test was used for statistical analysis.
Results: 71% of women had clinical vaginitis (fungal or bacterial) and 12.5% were diagnosed with Candida vaginitis. Microscopic findings were positive in 1.3 % of patients who had Candida vaginitis (16.7% of all patients). Culture of vaginal discharge revealed that the Candida was responsible of 4.4% of Candida vaginitis. Overlay, the prevalence of Candida vaginitis based on positive culture was 8.8 % in this study. There was significant statistical relationship between mean FBS and infectious vaginal culture. However, the difference was not significant between positive culture of Candida and age, controlled blood glucose, history of allergy, genital hygiene, occupation, level of education, kind of treatment , and type or duration of diabetes.
Conclusion: We suggest in the patients with positive signs of vaginitis, especially Candida vaginitis (even with positive smear) culture of vaginal discharge be carried out.

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Background: Diabetes is one of the chronic diseases need continual medical care and self care education, and nutritional therapy account as an integral part of dietary management. This study carried out to investigate the effect of diabetes dietary counseling on quality of life in type II diabetic patients.
Methods: As a Randomized Clinical Trial, 144 patients with type II diabetes aged 35-65 years were recruited from patients referred to Imam Hossein Hospital dietary clinic and randomly assigned in case and control groups. A dietary schedule consisting 50-60% carbohydrate, 10-20% protein and less than 30% fat was prescribed at the first orally in a 30-minute counseling session then in written form for case group, while the control group was left without any intervention. The quality of life score was estimated in both groups via using the Short-form 36-Item (SF-36), before dietary counseling and one mouth after the dietary counseling, and the quality of life score between both groups were compared. The data were analyzed using SPSS software. Results: Average age was 52.1±10 years. Before dietary counseling, the quality of life among 46% of subjects was assessed to be poor and 52% claimed their health status poorer than the last year. Independent-Samples T-Test with P<0.05 revealed significant difference in weight, systolic blood pressure, diastolic blood pressure, blood sugar before and after breakfast, blood cholesterol and triglyceride, after dietary counseling in both groups. Also, this test with P<0.05 revealed significant difference in the quality of life score in general and in each dimensions, after dietary counseling in both groups. Paired-Samples T-Test revealed significant increase in the quality of life score in general and in each dimensions on pre and post dietary counseling in case group, but didn’t observe in control group. Conclusion: According to the results, it was revealed that dietary counseling can promote the quality of life in patients with type II diabetes in all dimensions. So, it seems dietary counseling program is essential in prevention and decrease of type II diabetes complications.

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Background: Cardiovascular Diseases are becoming increasingly prevalent due to urbanization and industrialization of our country. Therefore Screening of the Cardiovascular Risk Factors is one of the most important health system priorities. The aim of this study was to evaluate a screening method implementing family history for cardiovascular risk factors.
Methods: We chose 10 Junior-high schools in the 6th district of Tehran using simple random sampling. Then a questionnaire asking about family history of cardiovascular disease in the first degree relatives (including grand parents) was distributed between them and was completed – with contribution of parents. Then high-risk and low-risk families were invited separately to Dr Shariati Hospital for further evaluation. SPSS software version 10 using student T-test, Chi-Square and descriptive tests were applied for data analysis
Results: Approximately 40% of families had positive family history (high risk). From this group, 72% participated for follow-up. From the low-risk group, only 34% participated. Total cholesterol and LDL-C levels were significantly higher in high risk (HR) group. FBS was also significantly higher in fathers and children of the HR group (P<0.05). High TC, LDL-C and FBS levels were more prevalent among the HR families (P<0.05). No significant differences were observed in age, BMI, BP, TG and HDL-C between the 2 groups.
Conclusion: Families with a history of cardiovascular disease participated in greater numbers in the screening process and the prevalence of risk factors in this group was significantly higher. The findings confirm the usability of family history in screening programs.

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Background: Type 2 diabetes mellitus is the most common type of diabetes which is triggered by various factors such as obesity, hyperlipidemia, hypertension, dietary habits and inheritance. With respect to geographic variation of diabetes prevalence, it is important to know the risk factors regionally.

Methods: As a case-control study, we looked for important risk factors of diabetes in our region. This study consisted of 400 individuals in case group and 400 individuals in control group. All these anthropometric measurements were calculated by standard methods. Blood samples taken from two groups were studied for TG, FBS, Cholesterol and HbA1c. Data are reported as the Mean±SD. P<0.05 was considered as statistically significant.

Results: There was no significant difference between two groups about mean age and sex ratio. Statistically significant difference were found for central obesity, hyperlipidemia, hypertension, polycystic ovarian syndrome (PCOS) and positive family history of diabetes in both groups (P<0.05).

Conclusion: The results showed that central obesity, hyperlipidemia, hypertension, PCOS and positive family history of diabetes are important risk factors of diabetes mellitus in Shiraz. In concordance with the results of this study, screening programme for that risk factor of diabetes in this region is suggested.

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Background: The prevalence of depression in diabetic patients is 2-3 times more than general population. The quality of life (QOL) and glycemic control are two important outcome measures of diabetes management. The aim of this research is to study the relationship between depression, glycemic control and QOL in a sample of Iranian diabetic patients.

Methods: One hundred diabetic patients who were referred to diabetes clinic of Dr. Shariati Hospital were included in the study consecutively. The depression subscale of Hospital Anxiety and Depression Scale (HADS-D) were used to determine depression. The World Health Organization Quality of life brief version questionnaire (WHOQOL-BREF) was used to measure QOL. The status of glycemic control was evaluated through measuring HbA1c. Other measured variables included:  demographic variables, smoking, diabetes type, body mass index, duration and complications of diabetes and previous history of depression. The linear regression method was implemented to analyze the data.

Results: Depression was observed in 28% of the patients. Glycemic control had a reverse significant correlation with diabetes complications. No significant relationship was found between HbA1c and scores of HADS-D. WHOQOL-BREF subscales scores had no significant relationship with glycemic control. There was a significant relation between scores of HADS-D and WHOQOL-BREF subscales.

Conclusion: Improving quality of life (QOL) is one of the main outcomes in the management of diabetes. According to the result of this study, depression had a prominent relationship with QOL. Thus, careful management of depression may be necessary to improve QOL of diabetic patients.

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Background: Cognitive and emotional deficits in alexithymia lead to various problems in somatic disorders and other medical conditions for example Diabetics. The aim of this study was to examine the effect of alexithymia on relationship between self-care and control of blood sugar in type 2 diabetes patients within the Iranian social and cultural context. Methods: The present study was a cross-sectional investigation. The study sample consisted of 100 (60 females and 40 males, aged 40 to 70 years) type 2 diabetic outpatients visiting Labbafinejad hospital during the year 2012. Measures for data collection included demographic, anthropometric and clinical questionnaires, the short scale for diabetes self-care activities and the diabetes-related quality of life. Blood tests were performed to obtain HbA1c levels and other laboratory measures related to the study. Data were analyzed using SPSS16 software. Results: Pearson product correlation results yielded significant negative associations between self- care activities and alexithymia as well as HbA1c levels in type 2 diabetes patients. Results of hierarchical regression analyses indicated that diabetes-related self-care activities explained 40% of HbA1c variance and alexithymia added explanatory variance above and beyond self-care, to jointly explain 58% of HbA1c variance. Conclusion: Based on the present findings, diabetes-related self-care and alexithymia predicted HbA1c levels in patients with type 2 diabetes. Given the evidence on the additive validity of alexithymia in the prediction of HbA1c levels found in the present study, attention to emotional competencies and disorders of Iranian diabetic patients may effectively contribute to their control of diabetes.

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Background: Vitamin D deficiency is associated with impaired insulin secretion, glucose intolerance and type 2 diabetes. This study was conducted to investigate the effects of supplementation with 50,000 IU vitamin D on improving serum vitamin D levels and insulin resistance in vitamin D insufficient or deficient type 2 diabetic patients. Methods: In this double blind randomized clinical trial, 81 type 2 diabetic patients with vitamin D levels between 10-30 ng/ml were randomly assigned to intervention (50,000 IU vitamin D3 once a week) and control (placebo once a week) groups according to gender. The study duration was 8 weeks. At the beginning and the end of study, blood samples were collected after 12 hours overnight fasting and fasting serum glucose, insulin and 25-hydroxyvitamin D were measured. Insulin resistance was obtained by HOMA-IR calculation. Results: After 8 weeks supplementation with vitamin D, 25-hydroxyvitamin D level was significantly increased and reached to normal levels in the intervention group. Fasting serum glucose and insulin concentrations and HOMA-IR were significantly decreased in the vitamin D group, but there were no significant changes in the placebo group. Conclusion: Supplementation with 50,000 IU vitamin D for 8 weeks compared to placebo can improve inadequate levels of vitamin D and glycemic indicators in vitamin D insufficient or deficient type 2 diabetic patients.

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Background: There is increasing interest about the relationship between metabolism, obesity and function of thyroid hormones in recent decades. This study aimed to determine the validity of a “thyroid and metabolism questionnaire” and its relationship with metabolism status and function of thyroid hormones. Methods: It was a descriptive cross-sectional study on 164 people aged 20-64 years who were selected randomly from nutrition clinic. “Thyroid and Metabolism questionnaire” including 25 questions were completed for everyone. Biochemical parameters including serum level of T3, T4 and TSH were measured. Resting energy expenditure [REE] was measured by indirect calorimeter. Results: The mean measured REE and calculated with Harris-Benedict formula were 1826.7 ± 475.34 and 2277.6 ± 454.54 kcal in men and 1410.8 ± 205.5 and 1670.73 ± 136.10 kcal in women respectively. The final score of this questionnaire had no significant association with measured REE. REE showed indirect relationship with serum level of T3, T4, T3/T4 and inverse relationship with TSH. Metabolism status of every participant was obtained via measuring and calculating REE with set and formula. The metabolism status of participants showed no agreements with metabolism status that predicted from “Thyroid and Metabolism” questionnaire. There was no significant association between metabolism status that was measured by indirect calorimeter and calculated from “Thyroid and Metabolism” questionnaire. From 25 questions of this questionnaire, only questions number 1, 4, 16 and 23 showed significant association with measured REE [P< 0.05]. Conclusion: Results of this study showed that “Thyroid and Metabolism” questionnaire had internal consistency, but not validity.