Iranian Journal of

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Background:Obesity is a serious public health problem in developing countries due to its association with the cardiovascular risk factors. Childhood obesity is responsible for a number of different complications both during childhood and adulthood. The aim of the present study was to determine the cardiovascular risk factors in overweight and obese Iranian children.
Methods: We screened 13086 children aged 7-12 years by measuring waist circumference. Those with a waist circumference ≥61 cm were selected for further evaluation. Anthropometric measurements were done and blood samples were taken from 563 enrolled overweight/obese children (284 boys and 279 girls). We determined cardiovascular risk factors (including fasting total cholesterol, LDL-C, HDL-C, triglycerides, blood pressure). In addition we measured the fasting blood sugar, insulin, apo-A , apo-B and leptin levels.
Results: Only 2.7% of overweight or obese children had no risk factors. While, 20.6% had one and 70.85% had two or more risk factors. The prevalence of high total Cholestrol levels was 42.6%. HDL-C showed an acceptable level in 92.4%of children .There were strong correlations between BMI and serum apoB and leptin levels (p<0.005).
Conclusion: The high prevalence of cardiovascular risk factors in overweight and obese Iranian children emphasizes the need for prevention and control of childhood obesity from early childhood in our country.

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Background: Global distribution of diseases in recent years has shown that health problems are no longer limited to the geographical borders of a country but are a global. Establishing international research collaboration has been highlighted as an appropriate strategy for confronting health problems. The possibility of exploitation of human subjects and also research capacity in developing countries particularly by pharmaceutical companies has caused concerns about the nature of such kind of research collaborations. In many countries general ethical guidelines help researchers and ethics committees to deal with the issue. However lack of expertise in general as well as ethical guidelines to address externally-sponsored research in particular, exposed human subjects to greater harm and has ignored ways of guarantying their benefits.
Methods and Results: In view of experiences of clinical trials which have been conducted in Africa and Asia by developed countries, this paper focuses attention of researchers and health policy makers on externally-sponsored researches. By reviewing the international ethical guidelines, the paper argues for the development of national ethical guidelines in order to protect human subjects as well as national interests.

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Background: Leptin is an adipocyte- derived hormone that plays an important role in the pathogenesis of obesity. Obesity is associated with insulin resistance and hyperinsulinemia. Insulin resistance is one of the factors which have been suggested to affect leptin serum levels. There are few studies evaluating the relation between leptin level and insulin resistance in childhood and adolescence obesity. The aim of the present study is to investigate this relationship in Iranian obese children. Methods: We screened 13089 primary school students aged 7-12 years. Children were divided to overweight and normal based on the recently published National Center for Health Statistics growth charts. The number of children which were overweight was 498, of whom 347 subjects particiated in the study. Fasting blood glucose, insulin and leptin levels were measured and homeostasis model assessment (HOMA) of insulin resistance (HOMA-IR) and fasting glucose to insulin ratio (FGIR) were calculated and compared between two groups. Results: Serum leptin levels were significantly higher in overweight compared to normal group. (11.58±8.1 and 8.1±5.2 respectively p<0.05). Before adjustment for BMI, there was a significant correlation between leptin and fasting insulin, HOMA –IR index and FGIR. (r=0.1, p< 0.05, r=0.1 , p<0.01, r=0.07, p<0.05 respectively). After adjustment for BMI, no significant correlation was found (r=0.097, p=0.20). Conclusion: The relation between leptin and insulin resistance was weak and disappeared after adjustment for BMI. It seems that many other factors including BMI and total fat amount may affect this relationship. Further studies in this field are required.

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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: 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.

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Background: In the event of damage to the skin, the epidermis of which goes to the disintegration of the body, is a wound that is common in diabetics. The purpose of this study was to evaluate Effect of alcohol extract of Nigella Sativa on wound healing in diabetic male rats
Methods: In this study 48 male Wistar rats were divided into 4 groups (control, sham, experimental, empirical two) were tested. The extra pawn injured area of 3 cm to the left of the spine created. Wound healing was examined macroscopically.
Results: The streptozocin diabetic wound healing compared to the control group later showed and wound healing in experimental groups treated with alcohol extract of Nigella Sativa was faster than the control group.
Conclusion: The results showed that the alcohol extract of Nigella Sativa skin accelerate wound healing in normal and diabetic samples.
 

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Background: Diabetes produces free radicals and damages the liver. The aim of this study was to investigate the effects of Rosmarinus Officinalis leaf hydroalcoholic extract on histopathology and enzymes activity of liver in alloxan induced diabetic rats.
Methods: In this study, 50 adult male Wistar rats weighing 200 to 250 grams, were divided randomly into 5 groups of 10; non-diabetic control, diabetic control and 3 experimental groups (diabetic rats treated with the dosage of 50mg/kg, 100mg/kg and 200mg/kg rosemary leaf extract intraperitoneally for 14 days).
Diabetes was induced in rats by intraperitoneal injection of a single dose 120 mg/kg alloxan was done. At the end of the treatment period, blood samples were taken from the left ventricular heart of mice and aspartate aminotransferase (AST / SGOT), alanine aminotransferase (ALT / SGPT) and alkaline phosphatase (ALP) in serum were measured. Immediately liver was removed and histological samples were fixed in 10% formalin and then stained with hematoxylin-eosin technique (H & E).
Results: In diabetic rats, unlike control mice, the liver enzymes (AST, ALT and ALP) increases, because of damage of liver tissue (p<0.01).
The level of liver enzymes (AST, ALT and ALP) in rats treated with doses 50mg/kg, 100mg/kg and 200mg/kg of rosemary leaf extract showed a significant reduction in these enzymes compared to control diabetes (p<0.01).
Conclusion: Histological studies showed reduced inflammation in the liver lobule and the port in the experimental groups. The third experimental group had greatest impact on reducing liver inflammation and space ports showed lobule. Histologically, tissue changes were in line with biochemical changes.
The effects of Rosmarinus Officinalis leaf hydroalcoholic extract because of its high antioxidant properties, reduce free radicals and inflammation of the liver damage caused by diabetes by inhibiting the enzyme is reduced.

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Background: Increased expression of HDAC5 reduces the expression of GLUT4 in slow-twitch fibers, and this mechanism has not been studied in diabetes. Therefore, the purpose of study was to investigate the effect of six weeks endurance training on protein levels of GLUT4 and HDAC5 in soleus muscle in diabetic rats.
Methods: For this purpose, 32 male Wistar rats (weight: 245±9.4 g) were randomly divided into 4 groups: diabetic, diabetic and training, training, and control. At 8 weeks of age, diabetes was induced by streptozotocin. The endurance training was carried out five times per week for 6 weeks. 24 hours after the completion of the protocol, the mice were sacrificed and their soleus muscle was extracted. Then, the protein levels of GLUT4 and HDAC5 were measured using ELISA method. One-way ANOVA was used to analyze the data at a significant level of P<0.05.
Results: Results showed significant differences between control and training (P=0.008), training and diabetic training (P=0.004), and training and diabetic (P=0.0005) groups in GLUT4 levels. But, in HDAC5, results showed that there is not significant differences only between control and training groups (P=0.99), and there are significant differences among other groups (P<0.05). Also, there is a significant inverse relationship between the protein levels of GLUT4 and HDAC5 (P=0.012, r =-0.439).
Conclusion: It seems that six weeks moderate intensity endurance training increases protein levels of GLUT4. But endurance training only can decreases protein levels of HDAC5 in diabetes.

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Background: Fetoin-A and -B are hepatokines that are related to type 2 diabetes. The aim of the present study was to investigate the effect of a period of resistance and endurance training with Ursolic acid consumption on the levels of Fetoin-A and -B in the liver tissue of elderly diabetics.
Methods: Fifty six 21-month-old male diabetic rats were randomly divided into seven equal groups of control (C), Ursolic acid supplement (UA), supplement+resistance exercise (UA+R), supplement+endurance exercise (UA+E), Resistance training (R), endurance training (E) and sham group (D). Resistance training protocol with intensity of 60% MVCC, 14-20 times of ladder climbing with one minute rest between each effort and endurance training including running on Treadmill at high intensity 60-75% and low intensity 30-40% of maximum speed for five days per week for eight weeks. Supplemented groups received 500 mg/kg UA in combination with a high-fat meal.
Results: Fetoin-A level was significantly decreased in UA, E, UA+E groups (p≤0.05) and only in R and UA+R groups, there was no significant decrease. Also, The amount of Fetoin-B in diabetic rats in the UA, E, R, UA+E groups decreased significantly (p≤0.05) and only in the UA+R training group there were no significant changes. The amount of Fetoin-A and Fetoin-B was significantly different between E and R and UA+R and UA+E groups (p≤0.05), which the largest decrease was in the UA+E group.
Conclusion: Considering the beneficial effects of exercise training as well as UA supplementation on hepatokines, it seems that the simultaneous application of two interventions of exercise training and UA supplementation has a more therapeutic effect on the hepatic hepatokines of diabetics.

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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.
 

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Background: Obesity is a multifactorial disease whose incidence and burden on societies around the world is increasing. Sexual performance in these patients is an important aspect that is often ignored. Therefore, the aim of the present study was to investigate the effect of a period of endurance training along with electrical stimulation on the gene expression of some sex markers in testicular tissue of fasted obese rats.
Methods: In this experimental study, with a control group of 40 male Wistar rats (8 weeks old, weighing 200±19 grams), after induction of obesity and weight gain, randomly divided into 5 groups of 8: control, fasting-obese, fasting-endurance exercise, fasting-electrical stimulation and Fasting-endurance training-electrical stimulation were divided. Intervention groups for a period of 4 weeks under endurance sports activity (with a speed of 10 to 20 m/min and duration of 20 to 40 minutes), electrical stimulation (foot shock device for 0.5 mA and 20 minutes) and fasting (8 to 16 hours) were placed. After exercise and anesthesia, tissue sampling was done and after molecular processes, gene expression was measured using Real time-PCR machine. For data analysis, two-way analysis of variance test was used at a significance level of P< 0.05 and GraphPad software.
Results: The results showed that endurance training led to a significant increase in the expression of 5αR and aromatase genes in fasting obese rats compared to the obese group (P= 0.0001). Also, electrical stimulation and its combination with endurance training led to a significant increase in the expression of 5αR gene (P= 0.0001), but this increase was not significant in Aromatase gene (P= 0.377).
Conclusion: It seems that endurance training and electrical stimulation during fasting by increasing the expression of 5-alpha reductase and aromatase genes in obese samples is effective in their sexual health and leads to its improvement. Also, a combination of electrical stimulation and exercise can have positive effects on this process, but more studies are needed.