Iranian Journal of

---

Introduction: In this study, we compared the level of glycosylated haemoglobin in patients with essential hypertension and healthy controls.
Method: 70 non-diabetic patients with essential hypertension were recruited into the study along with 140 controls without any significant medical history. Persons with a history of metabolic disease, anaemia, renal disease, splenectomy, pregnancy, or on medication were excluded from the study. A blood sample was taken from each participant and immediately sent to the EEMRC laboratory, where fasting blood sugar and glycosylated haemoglobin levels were measured by the glucose oxidase and thiobarbituric acid (colorimetry) method, respectively. The unpaired t-test was used to compare means. A p-value of less than 0.05 was considered significant.
Results: Mean fasting blood glucose was 103.1±16.1mg/dl in the hypertensive group and 92±7mg/dl in controls (p<0.05). Mean glycosylated haemoglobin levels were 7.38±0.78% in the hypertensive group and 6.5±0.85% in controls (p<0.05). Conclusion: People with essential hypertension have a higher level of glycosylated haemoglobin than healthy controls.

---

Introduction: Anethum is an herbal medicine composed of the three plants species Anethum, Fumaria and Cichorium, and has been widely marketed and prescribed as lipid-lowering agent in Iran in recent years. No controlled clinical trial of this medicine has so far been carried out, however. We studied the efficacy and short-term side effects of Anethum in patients with isolated hypertriglyceridaemia.
Methods: 151 people (54 men and 97 women) with serum triglyceride ≥250mg/dl and serum cholesterol <240mg/dl were enrolled in this study. Participants were randomly assigned to one of four treatment groups: Anethum, nicotinic acid, clofibrate, and placebo. They were seen at the Doctor Shariati University Hospital lipid clinic once every two weeks. Serum lipid profile was measured at 2 and 4 months after start of therapy. Relevant patient details, including sex, body mass index, mean total cholesterol and high-density lipoprotein, cigarette smoking, previous myocardial infarction, physical activity, and oral contraceptive use were recorded before enrolment.
Results: Four months after treatment was started, serum triglyceride had decreased 12.5% in the Anethum group and 6.8% in the placebo group (p=0.999). During the same period, serum triglyceride had decreased 48.8% in the nicotinic acid group and 54.4% in the clofibrate group (p=0.006 with respect to both placebo and Anethum). Furthermore, the nicotinic acid group showed a 7.8% decrease in serum total cholesterol (p=0.009 with respect to the other three groups). HDL-C decreased 9.8% in the Anethum group, 17.5% in the nicotinic acid group, 8.1% in the clofibrate group, and 9.1% in the placebo group (p=0.149 between first three groups and placebo). 81.8% of the nicotinic acid, 57.1% of the clofibrate, 8.0% of the Anethum and 30% of the placebo group experienced side effects during the same period. The most common complaints in the Anethum were actually non-specific ones.
Conclusion: We conclude that Anethum does not exert any therapeutic effect on isolated hypertriglyceridaemia.

---

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.

---

Background: Diabetes type 1 is an autoimmune disease that is associated with other autoimmune disorders like Hashimoto thyroiditis. The purpose of this study was to determine the prevalence of autoimmune thyroid disease (ATD) in type 1 diabetic patients in the south of Iran (Bandar Abbas).
Methods: A cross-sectional study, was conducted 48 type 1 diabetics and 41 age and sex matched healthy controls were evaluated for the presence of ATD. Blood sample were collected from all of the subjects for the measurement of thyroid autoantobodies [anti thyroid peroxidase (anti-TPO) and anti thyroglobulin (anti-TG)], T3, T4, TSH, RT3U and HbA1c.
Results: Prevalence of positive anti-TPO and anti-TG was 29 % and 29% respectively in diabetic patients and 2% and 7% respectively in control group (P<0.05). The prevalence of ATD (positive anti TPO or anti TG) in diabetic patients and control subjects was 35% and 7% respectively (P<0.05). The prevalence of positive anti TPO and anti TG was higher in girls. There was no association between the prevalence of positive autoantibody and duration or age of onset of diabetes. 17.6% of diabetic patients with positive autoantibody had thyroid dysfunction (subclinical hypothyroidism and hyperthyroidism).
Conclusion: Regarding high prevalence of ATD in type 1 diabetic patients in Bandar Abbas (approximately 1 out of 3 patients), screening for ATD and thyroid dysfunction is recommended for all type 1 diabetic patiens and in those with positive autoantibody consecutively.

---

Background: During extrinsic coagulation pathway, a complex is developed between factor VII, calcium and tissue factor (a cell membrane lipoprotein that is exposed after cell injury). Factor VII needs calcium and vitamin K for its biologic activation. Coronary artery disease can be induced by increased level and activity of the coagulation factors VII, VIII and IX. In postmenopausal period, estrogen can decrease blood lipids and thereby decreases risk of coronary artery disease. However, the exact effects of the estrogen on the other predisposing factors of the coronary artery diseases are unknown. Our objective in this study was to evaluate the effects of oral hormone therapy regimen on fibrinogen and other coagulation factors.
Methods: 60 menopause women with history of hysterectomy were randomly allocated in 2 groups. One group was treated with conjugated estrogen 0.625mg/day and the other group was treated with conjugated estrogen 0.625mg/day and medroxy progesterone 2.5mg/day. Serum fibrinogen level and activity of coagulation factors VII, VIII and IX and blood lipids level were checked before and 3 months after treatment.
Results: In the estrogen alone treated group, mean of factor VII activity showed significant elevation 3 months after treatment as compared with prior to hormone therapy(p<0.05). There were no significant changes in means of coagulation factors VIII, IX activities and serum fibrinogen level in estrogen  medroxy progesterone treated patients before and after treatment (p>0.05). In both groups, honi1one therapy significantly decreased serum cholesterol level and LDL-C and increased HDL-C (p>0.00) but the serum triglyceride level was increased in the estrogen alone treated group.
Conclusion: Significant elevation of coagulation factors VII with significant elevation of serum triglyceride in estrogen treated patients is explainable. This study confirms that hormone therapy with this protocol does not change serum fibrinogen mean and activity of coagulation factor VIII and IX. This finding may be real or may be related to inadequacy of samples regarding the wide normal range of coagulation factors and serum fibrinogen. Studies with more prolonged follow-up or more samples are suggested.

---

Background: The goal of dietary recommendations in children with type 1 diabetes mellitus is to achieve moderate to good control of blood glucose regarding to decrease in diabetic long-term complications. Although educational programs on appropriate dietary habits are offered in Isfahan Endocrine and Metabolism Research Center for diabetic patients, there is no information about their dietary habits . This study has been performed to investigate dietary intake in children with diabetes mellitus type1 and to compare the results with that of non-diabetic ones.
Methods: A cross-sectional study was performed in two groups of healthy and diabetic children. Data were collected by questionnaire and interview. The validity and reliability of the questionnaire were determined by content validity and pilot study. Data were described and analyzed by t-student and Pearson correlation tests in four age groups, using SPSS software.
Results: Findings showed that in “A” age group the intake of total calorie and fiber, in “B” age group the intake of fiber, fat, protein, carbohydrate, sugar and SFA, also fat, protein, carbohydrate, sugar and SFA-derived calorie consumption, in “C” age group the intake of sugar and fiber, also PUFA and sugar-derived calorie consumption and in “D” age group the intake of fiber, total calorie, protein, carbohydrate and sugar were higher in diabetic children as compared with the control group.
Conclusion: In all subjects, the intake of carbohydrate and total fat was the same as standard recommendations, while protein intake was a little higher which increases the risk of diabetic nephropathy. In all study groups, fiber intake has been decreased with increasing the age, so it is suggested to have dietary educational programs for general population with the goal of changing the life style of people, which itself can result in less social isolation in school-aged diabetic children.

---

Background: Family satisfaction in subpopulations referred to the endocrine clinic including diabetic and non diabetic patients and their spouses are compared in the present study. This study also assesses the correlation between family satisfaction and variables such as age, sex, educational level, economic status, type of diabetes, duration of the disease, type of therapy and dosage of drugs. A comparison of the frequency of sexual dysfunction between diabetics and non-diabetic pairs was also done.
Methods: In this case- control study, 400 subjects were selected as simplified non-randomized method from outpatients referred to the Shahre Kord endocrine clinic in 2002. We assigned samples to group I (diabetic patients, n=100), group II (diabetic patients spouses, n=100), group III (non-diabetic patients, n=100) and group IV (non-diabetic patients spouses, n=100). Groups I and II were similar in sex, socioeconomic status and educational level. GRIMS family relationship questionnaire was used to evaluate family satisfaction.
Results: Family satisfaction for diabetics in comparison with non-diabetics (P=0.05), diabetics in comparison with their spouses (P=0.003), and non-diabetics in comparison with their spouses (p=0.002) were significantly less. There was no significant difference between family satisfaction in diabetic and non-diabetic patients spouses (p>0.05). Relative frequency of sexual dysfunction was 76% and 29% and relative frequency of decreased libido was 32% an 12%, in diabetic and non- diabetic couples, respectively. Family satisfaction was less in patients with diabetes type I and whom using higher dosage of drugs.
Conclusion: This study emphasized on the attention to the family as a part of approach to the diabetic patients. According to our results, it is recommended to focus the most attention in this field to the patients with type I diabetes and who consume more amounts of drugs.

---

Leptin is a 16-kD protein which is secreted from white adipocytes and, its discovery has generated enormous interest in the regulation of energy balance. Leptin has been implicated in the regulation of food intake, energy expenditure, and whole-body energy balance in animals and human. Plasma leptin levels correlate with fat storages and respond to changes in energy balance. It was initially proposed that leptin serves a primary role as an anti-obesity hormone, but this role is commonly thwarted by leptin resistance. The profound effects of leptin on regulating body energy balance, make it as a prime candidate for drug therapies of obesity in humans and animals. Despite the recent achievements in unearthing the role of leptin in the pathophysiology of obesity, many important questions still remained that must be responded. More studies with follow-up designs and genetic evaluations are warranted to understand the comprehensive role of leptin in human. In this letter we have a review of known effects of leptin on human obesity up to now.

---

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.

---

Background: Type 1 diabetes mellitus (T1DM) is an autoimmune disease in which T-cell mediated selective pancreatic β- cell destruction occurs. Half the risk of T1DM development is given by the HLA gene region while the remaining risk is assigned to non-HLA genes , probably those engaged in the formation of antigen interaction complex. The CD4 gene product, which is among the most prominent T-cell surface receptors with a key role in antigen processing, could be regarded as a strong candidate.
Methods: We investigated the possible association of the CD4 gene polymorphism with T1DM using the candidate gene approach. The pyrimidine- rich pentanucleotide repeat polymorphism residing in the promoter region of the CD4 gene was studied. In the present study 92 Iranian T1DM patients and 108 healthy matched control individuals were screened by PCR technique.
Results: The analysis of our results shows the protective association of CD4*A3 (RR= 0.159, 95% CI: 0.036-0.707 Pc=0.025) and the susceptible role of CD4*A5 (RR= 7.379, 95% CI: 1.630-33.414 Pc=0.010) with T1DM. Conclusion: Our results suggest that the certain CD4 alleles are associated either negatively or positively with T1DM in the Iranian population.

---

Background: Lipoprotein abnormalities have been identified among the several risk factors that could account for increases the risk of CVD in diabetes. Abnormal status of B-group and antioxidant vitamins in diabetes may illustrate the benefits of these vitamins supplementation on modification of lipid profiles.
Methods: As a randomized double blind placebo controlled clinical trial, 110 type 2 diabetic patients were randomly assigned to one of the five treatment groups and received one of the following supplements per day for a period of 2 months: 1) B-group vitamins including B2 (10 mg), B6 (10mg), B12 (200µg) and Folate (1000µg) 2) B-group vitamins and vitamin E (100mg) 3) B-group vitamins and vitamin C (200mg) 4) B-group vitamins, vitamins E (100mg) and C (200mg) and 5) placebo. Fasting blood samples at the beginning and at the end of 2 months trial were collected and analyzed for cholesterol, triglyceride, apolipoproteins A1 and B (apo A1 & B), vitamin E, folate, vitamin B12 in serum and vitamin C in whole blood. Differences in baselines models. Covariates and changes in variables during study were adjusted by analysis of covariance using general linear.
Results: No significant changes were found in mean serum apolipoproteins levels after 2 months of supplementation. Vitamin E variation showed significant positive correlation with variation in apo A1 (P=0.003) and apo B (P<0.001). In multiple regression analysis, serum vitamin E levels were an independent and important predictor of serum apoA1 and B levels (P=0.002 and P<0.001, respectively). Serum vitamin B12 variation was important predictor of serum apo B levels (P<0.05).
Conclusion: Serum vitamin E level is a good predictor of serum apo A1 and B levels. Further increases in dose of vitamin supplements and intervention period are recommended for obtaining the desirable modifications.

---

Background: It is well recognized that an increased body weight is often associated with increased blood pressure. Moreover, leptin an adipocyte-derived hormone is strongly suggested to have an important role in pathogenesis of the obesity. We aimed to evaluate the levels of serum leptin in association with obesity and hypertension in a sample of Iranian obese children.
Methods: Children from all the primary schools of a distinct of Tehran were screened for obesity. Children with a waist circumference equal to or above 90th percentile for their age and height were invited for the study. Anthropometric measurements were done and blood samples for fasting serum leptin levels were collected from 563 enrolled obese children. Multivariate linear regression analysis was used to evaluate relationship of various factors with obesity.
Results: Mean Serum leptin levels were 8.65 ±2.18 (ng/ml). Serum Leptin levels were higher in girls than boys (P=0.009). There were significant correlations between body mass index (BMI) and serum Leptin levels, child age, systolic and diastolic blood pressure. Systolic blood pressure and diastolic blood pressure lost their association with serum Leptin level in multivariate linear regression analysis.
Conclusion: BMI is independently associated with Leptin levels among obese children. This may affirm a role for this hormone in the pathogenesis of childhood obesity. It seems unlikely that plasma Leptin be a major mediator of association between obesity and hypertension. However, severe hyperleptinemia may act as a risk factor for increased blood pressure.

---

Background: Obesity is an escalating public health problem. It is a major risk factor for atherosclerosis, hypertension, and type 2 diabetes. Since circulating levels of the adipocytokins are associated with obesity and dyslipidemia, we investigated the relationship of plasma adipocytokine concentrations with VLDL apolipoprotein B (apoB)-100 kinetics in men.
Methods: Plasma adiponectin, leptin, resistin, interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) concentrations were measured using enzyme immunoassays and insulin resistance by homeostasis model assessment (HOMA) score in 41 men with BMI of 22–35 kg/m2. VLDL apoB kinetics were determined using an intravenous infusion of 1-[13C]leucine, gas chromatography–mass spectrometry, and compartmental modeling. Visceral and subcutaneous adipose tissue mass (ATM) were determined using magnetic resonance imaging, and total ATM was measured by bioelectrical impedance.
Results: In univariate regression, plasma adiponectin and leptin concentrations were inversely and directly associated, respectively, with plasma triglyceride and HOMA score. Conversely, adiponectin and leptin were directly and inversely correlated, respectively, with VLDL apoB catabolism and HDL cholesterol concentration (P < 0.05). Resistin, IL-6, and TNF-α were not significantly associated with any of these variables. In multivariate regression, adiponectin was the most significant predictor of VLDL apoB catabolism (P= 0.001) and, together with visceral ATM, was an independent predictor of plasma VLDL apoB concentration (P = 0.015) HOMA score was the most significant predictor of VLDL apoB hepatic secretion (P= 0.049). Leptin was not an independent predictor of VLDL apoB kinetics.
Conclusion: Plasma VLDL apoB kinetics may be differentially controlled by adiponectin and insulin resistance, with adiponectin regulating catabolism and insulin resistance regulating hepatic secretion in men. But leptin, resistin, IL-6, and TNF-α do not have a significant effect in regulating apoB kinetics.

---

Background: Assessing the trend of ischemic heart diseases and the process of acute coronary care is one of the most important tools in monitoring the programs dedicated to control of ischemic diseases. The current project was developed to assess the feasibility of using routine data registered in clinical records for coronary event registration according to the standards of WHO/MONICA project.
Methods: Hospital records of 320 cases with primary diagnosis of acute coronary syndrome (80 cases from each quarter, July 2003-4) were evaluated according to sufficiency of data. Data were evaluated according to “internal consistency”, “change in the proportion of missing data in the time periods” and “the proportion of insufficient data”.
Results: Available data of hospital records were not sufficient to determine the diagnosis in 0.7% of cases In addition, they were resulted in a probable diagnosis in 11.2% of coronary events. Median percents of missing data regarding the prescribed drugs before event was more than 10% in both fatal and non-fatal coronary events (score 1 of 4). Median percents of missing data regarding the ECGs, cardiac enzymes and cardiac resuscitation was lower than 5% in non-fatal coronary events and lower than 2% in fatal cases (scores 2 and 3 of 4 relatively).
Conclusion: The quality of available registered data in the evaluated clinical records was comparable with many reporting units of MONICA project. Using the available clinical records seems to be effective and feasible for systematic registration of cardiac events.

---

Background: Neuropathy is one of the most common and dangerous complications of diabetes. Diabetic neuropathy account as the most common cause of mortality among patients. Many studies suggest that neuropathy have a negative effect on quality of life. Although there is limited evidences about relationship between diabetic neuropathy and quality of life in Iran, so this study was conducted to investigate this interaction among a group of patients.
Methods: As a descriptive-analytical study, 304 diabetic patients with neuropathy was selected via convenience sampling method. The data were collected through interview and physical examination. The tool of data collection was the information sheet of medical records and questionnaire that consisted of three parts, demographic and disease characteristics, list of neuropathic complications of diabetes and questions about dimensions of quality of life. The reliability evaluated via test-retest method and validity assessed via content validity method.
Results: the results revealed that tingling (96.1%) and pain (92.1%) in the case of sensory neuropathy were the most common complains. Sexual dysfunction (72.4%) and gastrointestinal problems (70.4%) account the most common symptoms in view of autonomic neuropathy. The results revealed that quality of life among all patients was fairly desirable and there was a significant relationship between neuropathy and quality of life (P<0.001).
Conclusion: According to the findings of this study, there is a significant relation between neuropathy and quality of life in diabetic patients. Our results suggest that nurses and educational supervisors should pay attention to promote different dimensions of quality of Life in diabetic patients with neuropathy.

---

Background: Pregnancy is a condition that favors oxidative stress mostly because of the mitochondria-rich placenta. Transitional metals, especially Iron, which is particularly abundant in the placenta, are important in the production of free radicals. Also studies showed that free radicals has a role in GDM. This study was performed to compare Iron status between gestational diabetes mellitus (GDM) patients and control groups.
Methods: As a case- control study 34 women with GDM were compared with 34 Healthy women matched for referred center, age, parity and BMI. Iron status measurements including ferritin, serum iron, total iron binding capacity (TIBC), hemoglobin, MCV and MCH at 24-28 weeks of pregnancy were assessed and compared between two groups.
Results: In this study, concentration of serum ferritin, Iron, transferin saturation and hemoglobin, MCV and MCH were significantly higher in GDM group and TIBC was significantly lower in this group as compared with controls (P<0.05). No significant association was observed in other variables including familial history of diabetes and GDM
Conclusion: Our findings indicate an association between increased Iron status and GDM. The role of excess Iron from Iron supplementation in the pathogenesis of GDM needs to be examined.

---

Background: The aim of this study was to determine the level of agreement between the impaired fasting glucose (IFG) and abnormal glucose tolerance before and after application of the new IFG definition and to evaluate the impact of adding common clinical data on this agreement.
Methods: A cross sectional population based study was carried out in an Iranian urban population which enrolled 8766 men and women over 20 years. Fasting and 2-hour plasma glucose were measured in all subjects excluding those with previously diagnosed diabetes and fasting plasma glucose ≥126 mg/dl. The diagnostic parameters and kappa coefficient between the previous and revised definitions of IFG for detecting impaired glucose tolerance (IGT) and dysglycemia (IGT and diabetes) were calculated. Logistic regression and ROC curve analysis were used to determine the independent clinical risk factors and their optimal cut-points associated with IGT and dysglycemia. Results: After using the new criteria, sensitivity of IFG for detecting IGT or dysglycemia increased but specificity and positive likelihood ratio (LR+) decreased and the κ slightly improved (0.16 to 0.29 for IGT and 0.24 to 0.35 for dysglycemia). Adding the clinical data to the revised criteria considerably improved the agreement between IFG with IGT and dysglycemia (κ increased from 0.286 to 0.470 for IGT and from 0.354 to 0.574 for dysglycemia). This also increased the LR+ from 3.86 to 14.5 and from 4.46 to 17.4 respectively for detecting IGT or dysglycemia.
Conclusion: The new IFG definition in combination with common clinical risk factors most likely predicts IGT and dysglycemia.

---

Background: Diabetes mellitus can have variable and sometimes profound effects upon the oral tissues. It has been shown that uncontrolled or poorly controlled diabetics have particularly a greater incidence of severe recurrent bacterial or fungal infections and periodontal diseases. The purpose of this study was to determine thee relationship between oral manifestations in diabetic patients and duration of disease, and glycemic control.
Methods: We studied 116 diabetic outpatients referred to Diabetes Clinic of Shahid Bahonar Hospital of Kerman Province. We evaluated the following parameters: dental caries, periodontal status, xerostomia, burning sensation and mucosal alterations. We also recorded information about history of diabetes and glycemic control. Data were subjected to SPSS and X, t- test.
Results: The most frequent alterations in this study were gingivitis (96.3%), periodontitis (90.2%), and xerostomia (97.24%). Burning sensation and periodontal diseases were significantly correlated to duration of diabetes (P=0.002, P=0.012 respectively).The results of the present study showed that periodontal diseases occur more frequently in moderately and poorly controlled diabetic patients than in those with good glucose control, but this difference was not statistically significant.
Conclusion: In this study, dry mouth and periodontal diseases are common complaints among diabetic patients. Therefore management of oral diseases in diabetic patients should include a comprehensive evaluation of salivary function and periodontal status.

---

Background: Metformin is used in treatment of non-insulin-dependent diabetes mellitus (NIDDM). The present study was aimed to study the pharmacokinetic and pharmaco-dynamic of metformin 500 mg tablet in healthy volunteers.
Methods: The test and reference metformin hydrochloride 500 mg tablets were administered to 12 healthy volunteers in a cross-over study. Metformin serum concentration and decrease in blood sugar levels (dBSL) were used for study of pharmacokinetic and pharmacodynamic.
Results: There was no correlation between phramacodynamic and pharmacokinetic para-meters. Also there was no increase in dBSL-(AUC0-12) with increase metformin serum concentration-time. The results of our study show that both products could be bioequivalent according to serum concentration and not blood sugar data.
Conclusion: There was no concentration – effect (dBSL) correlation for both products. Metformin didn’t decrease the blood glucose in healthy volunteers. In some volunteers there was no increase in blood sugar after meal and dextrose 20% oral solution administration which could be related to decreased absorption of glucose from gastrointestinal tract caused by metformin.

---

Background: Cardiovascular disease including hypertension are complications of long-standing diabetes. A few Studies had shown the positive effects of L-carnitine on hypertension. In this study, the possible effects of L-carnitne on nitric oxide (NO) levels and angiotensin-converting enzyme (ACE) activity in serum as well as systolic blood pressure (SBP) in diabetic and normal rats were studied.

Methods: In this study forty rats were used in four groups including non-treated control (C), L-carnitne treated control (CT), diabetic (D) and L-carnitne treated diabetic (DT). Diabetes was induced in rats by injection of stereptozotosin. Both of C & D groups had a free access to food and water and CT & DT groups were received daily dose of L-carnation in drinking water. At the end of 12 weeks SBP, serum NO and ACE activity were measured.

Results: Systolic blood pressure was significantly decreased in DT group compared to D group. Serum ACE activity was also significantly decreased in DT group compared to D group and the serum NO levels were significantly increased in DT & CT groups compared to D & C groups respectively.

Conclusion: Finally it could be concluded that L-carnitine may reduce SBP in diabetic rats via elevation of serum NO levels and reduction of serum ACE activity.