Iranian Journal of

---

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.

---

Background: Cardiac X Syndrome is the occurrence of angina pectoris in spite of a normal coronary angiogram, probably due to a disorder of the cardiac sensory nervous system (pain perception). The insulin resistance (metabolic X) syndrome is an important determinant of coronary artery disease. There is a dearth of research on the association between insulin resistance and cardiac X syndrome. We compared the hormonal status of three groups of postmenopausal women: those with cardiac X syndrome, those with coronary artery disease, and healthy controls.
Methods: 149 postmenopausal women (age range 48-58 years), matched for duration of menopause, were recruited for this study. Gonadotrophin and fasting insulin levels as well as blood pressure and body mass index were measured in all three groups.
Results: LH, FSH, oestradiol and progesterone levels were similar in all three groups. Women in the first two groups (that is, those with angina pectoris regardless of the result of coronary angiography) had a significantly higher BMI than controls. Fasting insulin levels were significantly higher in the first two groups compared with controls (p<0.01). There was no difference in fasting insulin level between the normal and abnormal angiography groups. There was no significant correlation between fasting insulin and any of the other variables, even though the association between fasting insulin and BMI in the abnormal angiography-confirmed CAD group very nearly approached statistical significance (p=0.059).
Conclusion: Women with angina pectoris, regardless of the outcome of coronary angiography, have hyperinsulinism and a higher BMI than controls. It seems that hyperinsulinism is the fundamental mechanism by which both the cardiac X and metabolic X syndromes occur. Further research is needed to elucidate this matter.

---

Background: Diabetes is a hidden epidemic and the most common metabolic disorder in the world. Immune dysfunction (cellular and humoural) is one of the consequences of diabetes, including defects of phagocyte function, notably in chemotaxis, phagocytosis, and killing. Results of studies on phagocyte respiratory burst activity, however, have been contradictory. We studied the respiratory burst of peripheral blood neutrophils and monocytes separately in response to formyl-met-leu-phe (fmlp) and phorbol-12,13-myristate acetate (PMA).
Methods: 36 patients with type 2 diabetes (mean age 53±7 years) and 20 healthy controls (mean age 50±5 years) each provided a 15ml blood sample. Peripheral blood neutrophils and monocytes were separated and purified (>95%) using specific density gradients and short-term culture. We then separately assessed respiratory burst activity in response to fmlp and PMA by the semi-quantitative nitroblue tetrazolium (NBT) test.
Results: Following stimulation with PMA, diabetic neutrophils showed reduced respiratory burst activity compared with normal neutrophils (p=0.097). Following stimulation with fmlp, too, diabetic neutrophils showed reduced respiratory burst activity compared with normal neutrophils, which this time was statistically significant (p=0.027). There was no difference between diabetic and normal subjects with regards to monocyte response to either fmlp or PMA.
Conclusion: It appears that the diminished response and reduced effectiveness of the phagocyte system in people with diabetes can facilitate the onset, exacerbation, and persistence of infection.

---

Background: Diabetes type 1 is characterized by autoimmune destruction or primary dysfunction of pancreatic  cells. The more common form is the autoimmune type, which can be associated with other endocrine malfunction such as adrenal insufficiency and Hashimoto’s thyroiditis. Autoimmune thyroiditis is characterized by presence of anti TG, anti TPO and anti TSH antibodies in the plasma. This study has investigated the prevalence of autoimmune thyroid disorders in type 1 diabetic patients.
Methods: 200 type 1 diabetics and 200 age/sex matched non-diabetic controls were recruited. Blood samples were taken to determine serum levels of thyroid hormones (T3RU, T3, T4, and TSH) and antithyroid antibodies.
Results: TG-Ab and TPO-Ab levels were significantly higher (P<0.001) in diabetics compared to controls (mean TG-Ab: 955.7±495.5 in diabetics and 451.0±189.5 in controls mean TPO-Ab: 463.2±182.3 in diabetics and 112.4±38.3 in controls). Clinical and subclinical hyperthyroidism was four times more common in diabetics. Conclusion: It seems reasonable that type 1 diabetic patients, especially those at younger ages, be screened for thyroid hormones and anti-thyroid antibodies

---

Background: LDL oxidation plays a significant role in atherosclerosis process. Change in LDL type, occurring with physical activity, and the resulting decrease in LDL sensitivity to the oxidative process can protect the subject against atherosclerosis. This study has compared LDL sensitivity to oxidation in athletes and non athletes.
Methods: 14 male athletes (aged 482) and 14 male non athletes (aged 444) were recruited. 10 ml venous fasting blood was obtained from each subject. According to the PUHL guidelines, LDL sensitivity to oxidation was evaluated using conjugated diene method. Cholesterol and triglyceride were measured by enzymatic immunoassay. HDL-c was measured by precipitation method. LDL was calculated by Fried-Wald formula.
Results: LDLs from athletes’ sera were less vulnerable to oxidation than non-athletes’ sera. To say, mean lag time in athletes was 60.35 10 compared to 5610 in non athletes. This difference, however, was not statistically significant. A significant difference existed between the two groups with regard to HD L-c level (46.28 vs. 388.5 P 

---

Introduction: Urbanization, establishment of sedentary life style and unhealthy diet in association with environmental stress has led the cardiovascular risk factors to prevail in the metropolitan city of Tehran. Survey of lifestyle related cardiovascular risk factors is one of the priorities of Tehran university population laboratory in the 17th zone of Tehran.
Methods:1573 inhabitants of 17th zone of Tehran were recruited by one stage cluster random sampling according to the model of WHO MONICA project.
Results: 58.6% of men and 64% of women had BMI ≥ 25 kg/m2. 41.7% of men and 37.6% of women had hypertension. 8.9% of men and 12.2% of women had diabetes. 34.4% of men and 44.6% of women had total cholesterol ≥ 200 mg/dl. 34.1% of men and 32.6% of women had triglyceride ≥ 200 mg/dl. 34.7% of men and 4.2% of women were regular smokers. 21% of participants had positive family history of cardiovascular disorders.
Conclusion: The prevalence of hypertension in this region is high, that of dyslipidemia relatively lower than the other studies performed in Iran. The prevalence of Diabetes and overweight /obesity is high and comparable to other Iranian studies. It seems that the population of this zone is at high risk for stroke and then coronary heart disease. This fact must be considered in the future interventional programs to control cardiovascular risk factors in the region.

---

Celiac disease and typel diabetes mellirus have been linked to the same HLA markers and chromosomal loci, which may account for the concurrence of the two disorders in a significant number of patients. This study was designed to investigate the frequency of anti-gliadin antibodies, a marker for celiac disease, in diabetic patients.
Methods: In this study, 182 diabetic patients (52 with typel and 130 with type2 diabetes) were screened for anti-gliadin IgG by indirect immunofluorescence. Age range was 3-29.5 and 42-65 years for type 1 and type 2 diabetes groups.
Results: Anti-gliadin IgG was found in 1.9% and 1.5% of patients with type land type 2 diabetes. In Tehran, 0.02% of healthy blood donors have been reported to be seropositivitive for anti-gliadin IgG.
Conclusion: The prevalence of anti-gliadin seropositivity in type 1 and type 2 diabetics, was respectively 30 and 24 times higher than the general population of Tehran. This concurs with other reports indicating higher occurrence of celiac disease in diabetic populations. The rather low sensitivity and specificity (both around 80%) of the antigliadin antibody test has made it a suboptimal diagnostic test. However, it is quick and inexpensive and can be suitable for screening programs. We recommend the test in all at-risk populations including diabetics.

---

Background: Type 2 diabetic patients have 2 or 4 fold risk of coronary heart diseases. According to researches, all types of dyslipidemia independently have atherogenic properties so it seems small dense LDL has the most effects in this case. To investigate whether glycemic control, which is assessed by concurrent HbAlc, has any favorable impact on LDL size we determined the relation between LDL size and HbAlc in diabetics.
Methods: In this study, LDL size was determined by non-denaturing polyacrylamide gel electrophoresis in 81 type 2 diabetics 50 to 70 aged. BMI was calculated in all participants as weight (Kg) divided by height (m2). TG and HDL-C were measured using enzymatic kits. HbAlc was determined using immunoturbidometric method.
Results: Based on results obtained LDL size in diabetics was significantly correlated with TG (r=-0.281, P<0.05), sex (r=-0.276, P<0.05), HbAlc (r=-0.232, P<0.05) and HDL-C (r=0.215, P<0.01). In linear regression analysis TG (standardized =-0.192 p<0.054), HDL-C (standardized =0.214 p<0.05) and female sex (standardized =0.196 p<0.056) were the independent determinants of LDL size (although they showed borderline significance). HbAlc showed high co linearity with HDL-C and was excluded from the model.
Conclusion: HbAlc is inversely correlated with LDL size in diabetics. However it is not an independent predictor of LDL size. It is likely that decrease in HDL-C levels due to poor glycemic control results in decrease in LDL size.

---

Background: One of the most common complications of Diabetic Polyneuropathy (DPN) is decreased balance and Postural Control disorder. Balance has an important role in static and dynamic activities as a base of activities of daily living. The objective of this study was the evaluation and comparison of dynamic and functional balance in patients with DPN and healthy subjects.

Methods: In this study, dynamic and functional balance of 11diabetic patients with DPN (detected by Michigan questionnaire) and 11 healthy subjects were evaluated by Biodex Balance System (BBS) and Tandem Stance (TS) test in open and closed eyes conditions. The participants were matched by age and BMI. An independent t-test was used to compare balance parameters between patient and normal group. Furthermore, the correlation between dynamic balance parameters of BBS and TS tests were calculated using the Pearson’s Correlation Coefficient.

Results: The results of BBS in patients with diabetic peripheral neuropathy were significantly higher than normal subjects (P<0.05). The mean of time of TS test in diabetic group was significantly lower than healthy subjects (P<0.05). Also there was a significant (P=0.004) negative (r = 0.794) correlation between Medio-Lateral stability index (recorded from BBS) and TS with open eye, in diabetes group.

Conclusion: Older adults with DPN have an impaired functional balance in comparison with matched control subjects and this may expose the patients to danger of falling during daily activities.

---

Background: Because insulin therapy cannot properly control the progression of diabetes and its complications, other alternative therapies may be desirable. The aim of this study was to investigate the effect of resistance training and endothelial stem cell injection on skeletal muscle oxidant and antioxidant status in STZ-induced diabetic male rats.
Method: In this experimental study, 36 male Wistar rats (age 6 weeks) were divided into six groups of control (healthy), basal diabetic control, diabetic control, diabetes + stem cell injection, diabetes + resistance training and diabetes + stem cell injection + resistance training. In this study, rats became diabetic intraperitoneally using streptozotocin as a single dose of 40 mg/kg. Resistance exercises including climbing a one-meter ladder with weights hanging from the tail were performed for 17 sessions. 500,000 bone-derived stem cells were injected by a cell counter. The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in skeletal muscle tissue of rat were measured by using the kit and ELISA method.
Results: The results showed that the SOD level of rats in the resistance training and endothelial stem cell injection group was significantly higher than the diabetic control group (P<0.001). Also, the level of MDA rats in the resistance training and endothelial stem cell injection group was significantly lower than the control group (P<0.001).
Conclusion: Resistance training and endothelial stem cell injections can be considered as a non-pharmacological treatment to reduce skeletal muscle complications in type 1 diabetes.