Iranian Journal of

---

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: 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.

---

It is estimated that up to 40-70% of obesities is attributable to genetic factors.  Monogenic forms of obesity are uncommon.  We present the first such reported case in Iran. The patient presented with a history of severe hyperphagia, rapid weight gain and recurrent infections.  He was born after a normal pregnancy in a highly consanguineous marriage.  His birth weight had been normal.  At age of 18 months he weighted 28 kg.  Apart from obesity and syndactyly of second/third digits in both feet there were no other abnormalities on physical examination.    His fasting serum leptin was 45 ng/ml.  Genotyping revealed 66-bp deletion in codon 514 of leptin receptor gene.

Unfortunately he developed another respiratory infection which was unresponsive to intensive treatment and died following a cardiorespiratory arrest. Genetic assessment is recommended in morbid obese patients especially those with a childhood onset.  Leptin receptor mutations can be associated with immune system deficiency and recurrent infections.

---

Background: The objective of the current study is to assess the effectiveness of Mobile Short Message Service (SMS) intervention on education of basic self-care skills in patients with type 2 diabetes. Moreover, we aimed to determine whether delivering individually-tailored educational messages can be more effective than general educational messages.

Methods: A total of 150 patients with diabetes type 2 were randomized into three groups: tailored SMS group, non-tailored SMS group, and the control group. Biochemical parameters including HbA1c, FBS, lipid profile were evaluated for the three groups at baseline and after 12 weeks. Moreover, self-care Inventory (SCI), Diabetes Management Self-Efficacy Scale (DMSES) and Diabetes Self -Care Barriers assessment scale for Older Adults (DSCB-OA) were completed. In the tailored SMS group, each person received 75% of their messages based on the top two barriers to adherence that they had experienced and reported in their scale. In the non-tailored SMS group, random messages were sent to every patient.

Results: After12 weeks, although HgA1c levels did not significantly change, significant decline was observed in FBS and mean BMI in both intervention groups. Mean SCI-R scores significantly increased and mean DSCB and DMSES scores significantly decreased in both tailored and non-tailored SMS groups. In the control group, mean SCI-R scores decreased and mean DSCB and DMSES scores significantly increased (P< 0.001).

Conclusion: Sending short text messages as a method of education in conjunction with conventional diabetes treatment can improve glycemic control and positively influence other aspects of diabetes self-care. According to our findings, sending SMS regularly in particular times appears to be as effective as sending individually tailored messages.