Iranian Journal of

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Background: Studies of the metabolic effects of Ramadan fasting on patients with type 2 diabetes mellitus are inconclusive.
Methods: Fifty-seven volunteers with type 2 diabetes underwent anthropometric and biochemical evaluation before and on the 14th and 28th days of Ramadan. Biochemical markers were measured by standard laboratory methods. Anthropometric measurements followed WHO criteria. Statistical analysis was by ANOVA for repeated measurements and Friedman’s two-way ANOVA, using SPSSv6 software.
Results: Daily cholesterol intake increased in all subjects (p<0.03). Body mass index increased (p<0.03) in women, but body mass index (BMI) and waist-to-hip ratio both decreased (p<0.01) in men. Blood pressure, fasting blood glucose and serum fructosamine did not change during the study. Plasma insulin (p<0.05), C-peptide (p<0.01) and insulin resistance (p<0.01) decreased only in men. Total and LDL cholesterol increased significantly in all subjects during the study.
Conclusion: Ramadan fasting does not alter carbohydrate metabolism or tissue insulin sensitivity in type 2 diabetes patients, given appropriate dietary education and rescheduling of oral hypoglycaemic medication. Lipid profile is unfavourably altered due to changes in both diet and biochemical response to starvation. Anthropometric indices improve in men but not women, possibly because of reduced physical activity in the latter.

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Introduction: In order to determine the relationship between serum lipid profile and diabetes mellitus as well as other cardiovascular risk factors, we carried out a cross-sectional study of 1255 oil industry workers at the Kharg Island oil terminal.
Methods: Increased levels of total cholesterol (TC≥200mg/dl), triglyceride (TG≥200mg/dl), and low-density lipoprotein (LDL≥130mg/dl) were seen in 32.7%, 39.5% and 18.5% of the workers, respectively. Decreased levels of high-density lipoprotein (HDL<40mg/dl) were seen in 13.1% of workers. 61.3% of the workers had a body mass index (BMI) ≥25kg/m2. Visceral obesity (waist circumference >100cm) was seen 32.4% of workers.
Results: There was a direct and significant relationship between TC levels and BMI (p<0.001), and between TG levels and BMI (p<0.0001). The same correlation existed between waist circumference and both TC (p<0.02) and TG (p<0.06). There was also a direct correlation between LDL levels and waist circumference (p<0.04). 10.6% of workers had some disorder of glucose metabolism. There was a direct correlation between diabetes and both TC and HDL levels (p<0.04 and p<0.05, respectively). 42.4% of workers smoked and 57.4% had a sedentary lifestyle. There was a trend toward lower blood glucose and cholesterol levels as the level of physical activity increased (p=0.1 and p=0.08, respectively). There was a significant difference between blue- and white-collar workers in the prevalence of excess weight, visceral obesity, diastolic hypertension, diabetes and cigarette smoking, but not serum lipid profile and level of physical activity.
Conclusion: The significant prevalence of dyslipidaemia and other cardiovascular risk factors in the oil workers of Kharg Island requires systematic preventive interventions to reduce cardiovascular mortality and morbidity in this population.

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Introduction: In patients with type 2 diabetes, triglyceride (TG) is usually increased, HDL decreased, and LDL normal. This pattern is associated with an increased risk of coronary heart disease. More recently, dense-particle LDL has been identified as an important risk factor for coronary heart disease.
Methods: 298 patients with type 2 diabetes attending the diabetes clinic at Doctor Shariati University Hospital underwent anthropometric and biochemical assessment. Anthropometric measurements followed WHO criteria. Biochemical indices (apoB100, TG, cholesterol, LDL, LDL particle size, HDL, and apoA1) were measured using standard laboratory methods. One-way ANOVA was used to analyse data with SPSSv6 software.
Results: Mean patient age was 55±13.2 years. Mean duration of diabetes was 9.5±6.1 years. The majority of patients were moderate to severely overweight. 73.2% of patients had some form of hyperlipidaemia. 20.7% had isolated hypertriglyceridaemia, 21% isolated hypercholesterolaemia, and 31.5% mixed hyperlipidaemia. Mean apoA1 concentration was higher than normal in this group, and mean apoB100 concentration lower. LDL particle size generally followed a small and dense pattern.
Conclusion: This study shows that LDL particles in both men and women with type 2 diabetes undergo both qualitative and quantitative changes. 35.5% of patients had smaller, denser LDL particles than normal. It appears that dyslipidaemia and B-pattern LDL particles are important risk factors for atherosclerosis in this group.

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Introduction: There is as yet no consensus as to the effect of Ramadan fasting on fasting blood glucose. We carried out a study to help clarify the situation.
Methods: This was a semi-experimental (pre- and post-) study of 115 healthy volunteers (67 men and 48 women), who fasted for at least 25 days during Ramadan. Blood samples were taken 7 days before Ramadan (at 7am after a 8-hour overnight fast), and on the 14th and 28th days of Ramadan (1 hour before sundown). The mean duration of daily fasting was 11.5±0.5 hours. Plasma glucose was measured by an enzymatic assay. Statistical analysis was by the paired-t and ANOVA functions on SPSS10.0 software.
Results: Fasting plasma glucose in the group as a whole decreased from 88.4±9.0mg/dl pre-Ramadan to 75.4±15.3mg/dl on day 14 and 62.9±7.7mg/dl on day 28 (p<0.001). Both men [87.5±8.8mgdl (pre-Ramadan)  60.8±6.4mg/dl (day 28)] and women [89.7±9.3mgdl (pre-Ramadan)  65.7±8.4mg/dl (day 28)] experienced a significant decrease in fasting plasma glucose levels (p<0.001 in both). There was a reduction in calorie intake during Ramadan in every volunteer (p<0.001), and there was a direct correlation between reduction in calorie intake and fasting plasma glucose (p<0.01).
Conclusion: Fasting plasma glucose decreases with Ramadan fasting and is associated with a reduction in calorie intake. The decrease in plasma glucose does not seem to be accompanied by any serious adverse effects in healthy volunteers, however.

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Hyperlipidemia is a major risk factor for cardiovascular diseases (CVDs). A hundred and sixty six people die each day due to cardiovascular diseases in Iran which accounts for 12500 annual deaths. Several studies have revealed that changes in lifestyle are keys to the prevention of CVDs. This urges the role of continuous and comprehensive educational programs, which should be designed and performed by medical staff specially education nurses.In this study the effect of patient education thorough group discussion or an educational booklet is
compared on knowledge and practice of patients with hyerlipidemia.
Methods: This was an interventional study. Participants were randomly assigned to the "interactive discussion" group or "booklet" group. Knowledge and practice of participants in both groups were assessed before and after intervention using a standardized questionnaire. A total number of 304 patients with hyperlipidemia were studied which were equally divided into "booklet" or "Interactive
discussion" groups.
Results: "Interactive discussion" group showed %27 rise in knowledge and practice. This figure was %26 in the "booklet" group and no significant difference was observable.
Conclusion: It was concluded that interventional sessions and educational booklets had comparable efficacies. We suggest that these sessions be held on regular Intervals so as to achieve better results.