Iranian Journal of

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Background: Metformin is usually using for glycemic control in type 2 diabetes mellitus. The drug is the first line for obese patients without renal or liver failure. Different pharmaceutical types of Metformin are available. As a clinical trial, we compared effects of Aria Metformin (product of Aria pharmaceutical company, Iran) with Merck Metformin or Glucophage (product of Merck pharmaceutical company, France), in diabetic patients.
Methods: This double blind randomized clinical trial study performed with 60 non- pregnant diabetic patients, in order to comparison of therapeutic effects of combination therapy (Glibenclamide + Metformin "Aria or Merck") in a 12 weeks period. We evaluated FBS, BS 2hpp, HbA1c, lipid profile, liver function tests, weight, BMI and common or uncommon side effects.
Results: Not only each of two pharmaceutical types of Metformin had the same therapeutic effects for controlling of glycemia, lipid profile and weight, but also there were not difference between them in side effects. Distention was the most common side effects of two types products (33%). There is not significant difference between them in common side effects. 70% of patients were satisfied with each two kinds of Metformin.
Conclusion: It seems, in view of beneficial therapeutic effects of Aria Metformin, low rate of side effects, and finally low cost, Aria Metformin is a good choice.

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Background: Use of medicinal plants for attenuation of hyperglycemia and restoration of lipids to normal levels is very important. The effect of oral administration of Vaccinium myrtillus (VM) on serum glucose and lipids in diabetic rats was investigated.
Methods: Female Wistar rats were divided into 4 groups: control, VM-treated control, diabetic, and VM-treated diabetic groups. The treatment groups received oral administration of plant-mixed food (6.25%) for 4 weeks. Serum glucose, triglyceride, total cholesterol, LDL- and HDL- cholesterol levels were determined before the study, and at 2nd and 4th weeks after the study.
Results: Serum glucose level in diabetic group increased 2 and 4 weeks after the experiment as compared to data one week before the study (P<0.001) and VM treatment of diabetic rats did have a significant hypoglycemic effect (P<0.01). In addition, triglyceride level in diabetic group increased 4 weeks after the experiment in comparison with related data one week before the study (P<0.05) and there was a significant lower level of triglyceride in VM-treated diabetic rats (P<0.05). Furthermore, there was no significant changes regarding serum total cholesterol, HDL- and LDL- cholesterol levels in treated diabetic group as compared to untreated diabetic group.
Conclusion: Oral administration of VM has a significant hypoglycemic effects and leads to an appropriate changes only in triglyceride level.

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Background: A unique subset of Individuals with normal body mass index (BMI= 18.5-24.9 kg/m2) and high body fat percentage (above 30% in women and 23% in men) that are termed as normal weight obese, are at increased risk for development of the metabolic syndrome and chronic diseases because the adipose mass and the excess of fat mass are an important source of proinflammatory cytokines. The aim of the present study was based on this hypothesis that women with high body fat percentage and normal body mass index are at increased risk for the metabolic syndrome in compared to healthy non obese women. Methods: This was as case-control study in which 40 obese women with normal weight (BMI= 18.5-24.9 kg/m2) and body fat percentage above 30% (FM> 30%) and 30 non-normal weight obese women (BMI= 18.5-24.9 kg/m2) and fat percentage less than 25% (FM <25%) who were matched for age (mean age = 28 years) recruited for this study. The components of metabolic syndrome including Anthropometric variables, blood pressure and fasting plasma concentrations of total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, glucose and insulin were measured. Results: The anthropometric measurements including waist and hip circumferences in NWO was higher than non-NWO (respectively 74.78±4.81 vs. 70.76±2.91 and 99.12±4.32 versus 93.16±2/91, Pvalue<0.001), while the waist-to-hip ratio did not differ between the two groups (p=0.448).Also no significant differences were observed in concentrations of total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, fasting plasma glucose, systolic and diastolic pressure between groups. Fasting serum insulin and insulin resistance was higher in NOW compared to non NWO (Pvalue<0.05) and insulin sensitivity in NWO was lower than non NWO (0.357 versus 0.374, pvalue = 0.043). Conclusion: Because of the higher serum insulin concentration and the lower insulin sensitivity, obese women with normal body mass index but high body fat percentage can be associated with a higher risk for metabolic dysregulation and metabolic syndrome compared to healthy women with the same body mass index and normal body fat percentage

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Background: The major cause of obesity is an imbalance between energy intake and energy expenditure and resting energy expenditure (REE) is the most important determining factor in metabolism because it can reduce obesity and body fat mass gain. Overt hypothyroidism is associated with a lower resting energy expenditure (REE). With treatment, the resting energy expenditure (REE) will be normal. But a group of patients with treatment and normal serum level of TSH and thyroid hormones, Continue to complain of the lack of improvement of Clinical signs of overt hypothyroidism. This study is designed whether patients that have Clinical signs of overt hypothyroidism in compared with patients without Clinical signs, resting metabolic rate, body composition and lipid profile are different or not.
Methods: This study is a descriptive and comparative study on 100 women with overt hypothyroidism are treated with levothyroxine. The patients were divided into 2 groups of 50 patients with and without clinical signs. All patients were matched for age and BMI and menstrual cycle. 2 groups regarding anthropometric measurements, resting energy expenditure (REE), body composition, thyroid hormones, lipid profile and diet were compared with each other.
Results: The average resting energy expenditure (REE) and adjusted of it for weight was significantly lower in the group with Clinical signs (Pvalue<0.03). But there was no significant difference between the 2 groups for the form of an adjustment for fat free mass (FMM) and FT3. The body fat mass (FM) was higher in the group with Clinical signs (Pvalue<0.005).But there was no significant difference between the 2 groups in the percentage of body fat mass and fat free mass (FMM). Serum levels of TSH, TF4, FT4, TT3, FT3, total cholesterol, HDL, LDL, there was no significant difference between the 2 groups. But the level of blood triglycerides (TG) in the group with Clinical signs was significantly higher than the group without Clinical signs (Pvalue<0.01).
Conclusion: Patients with Clinical signs, lower resting energy expenditure (REE) and fat mass (FM) and triglycerides blood (TG) is higher than in patients without Clinical signs.

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Background: Older people are vulnerable in terms of health status. The elderly`s Khuzestan due to the very warm weather of this region are more at risk for health problems. This study is a report on the health status of the elderly in Khuzestan province in 2012.
Methods: This is a Cross-sectional study, with multi-level proportional cluster Random sampling among people aged ≤ 60 years of Khuzestan province. Nutritional status was assessed by Mini Nutritional Assessment (MNA), depressed mood screening was conducted with Geriatric Depression Scale-15 questionnaire, activities of daily living was evaluated using KATZ ADL and Lawton Instrumental ADL tools.
Results: In this study, 387 people participated. The prevalence of hypertension, diabetes mellitus, depressed mood, and anxiety in the participants, were 38.8%, 28.6%, 34.9 and 38.7, respectively. Hearing loss reported in 33.9% and vision impairment was in 62.2% of the participants. Memory impaired founded in 14.9% of the participants.  4.3% of the elderly suffered from malnutrition and 48.3% were at risk of malnutrition. Dysfunction in ADL were existed in 13.9% and 30.3% of the participants had some degrees of dysfunction in IADL.
Poly pharmacy (consumed more than 3 medications) was observed in 36.5% of older adults in this province. The most common health services need was medical services at home and then transport services.
Conclusion: Although the health status of the elderly in Khuzestan province  generally was not worse than the average of Iran, it needs that a special pay attention in some areas, such as hypertension, diabetes, nutritional status and lack of independence in activities of daily living in this age group.
 

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Background: Improved in health condition, reduced fertility rates, and increased life expectancy has increased number and proportion of elderly population. This study was reported the health status of older population in North Khorasan province.
Methods: This is a cross-sectional study that enrolled 99 subjects (40 men and 59 women) ≥ 60 years by a multi-levels proportionate cluster random sampling method.
Required information was gathered by means of a demographic questionnaire. Mini Nutritional Assessment (MNA), Geriatric Depression Scale-15 (GDS-15), Katz's basic activity of daily living, and Lawton's instrumental activity of daily living were administered. Measurements of anthropometric and blood pressure were performed based on standard methods
Results: The prevalence of diabetes and hypertension in elderly, were 17.7% and 57.6%, respectively. Depressed mood was observed in 36.4% of the participants 36.4% of the participants and 18.2 percent of them reported that their health condition was bad. In addition, 73.5% of the elderly had complained about any bodily pain. As well as, 22.6% of the participants used opium at least once during the last year.
Conclusion: It seems that the health status of the elderly in North Khorasan province is not suitable in many indicators, such as hypertension, malnutrition, drug abuse and complaints of pain and their health status was worse than the national average of Iran. A special attention requires to the health status of elderly in this province .

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Background: The aging of the population is a great challenge of the public health in this century. The health promotion of the elderly people requires a comprehensive and accurate understanding of their health status.
Methods: This cross-sectional study has assessed the health status of 191 old people ≥ 60 in Sistan and Balouchestan province that selected by a multi-level cluster random sampling. General health data was collected using SF-36 questionnaire, nutrition status was assessed using Mini Nutritional Assessment (MNA), depression status was detected by the geriatric depression scale-15 (GDS-15), functional status was assessed using the activity daily living (ADL) and instrumental activity daily living (IADL) questionnaires, as well as, the information about demographic, history of diseases, vaccination, participation in social activities, and the utilization of elderly care services were evaluated by an approved questionnaire. History of hypertension was asked from the participants. Moreover the blood pressures of them were twice measured.
Results: The mean age of the participants was 69.81 (8.32) years. The health status was reported excellent and bad by 4.2% and 9.4% of the participants, respectively. The prevalence of fall in recent year, memory disorder, hearing and visual impairment, and malnutrition were 35.3%, 15.6%, 30.3%, 56.6%, and 8.9%, respectively. The prevalence of dependency in "activity of daily living" and "instrumental activity of daily living" were 25.8% and 58.2%, respectively.
Conclusion: It seems that the prevalence of malnutrition, impaired ADL and IADL, and memory impairment in the older population of Sistan and Baluchestan are above the national and global averages.
 

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Background: Elderly people need more receiving health services. Planning to provide services at regional and national levels requires information about the health status of the elderly. This study was performed to assess the health status of East Azarbaijan province.
Methods: In this cross-sectional study, 436 subjects were enrolled (180 men and 258 women) aged ≥ 60 years using multi-level proportioned cluster Random sampling from 19 cities of the province.
Data was collected by a demographic questionnaire , measuring  anthropometric characteristics, and blood pressure and  using "Mini  Nutritional Assessment" ,”Geriatric Depression Scale-15 ", “Katz’s Activity of daily living”,  and "Lawton’s Instrumental activities of daily living”.
Results: The mean age of the participants was 69.31 years.  The self-reported prevalence of diabetes was 34.2%. The prevalence of hypertension in the elderly was 52.5%. The most common complaint of the participants was pain (60.9%). Totally, 46.9% had a difficulty in walking, 44.3% visually impaired, and 26.4% suffered from hearing impairment. Moreover, 44.8% of sleep disorders was found. Also 26% of the participants had depressed mood.
Conclusion: Elderly residents of East Azerbaijan province, has probably a better health status than the average Iranian elderly. However, there is a high prevalence of hypertension and diabetes among older adults of this province that need to more pay attention.

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Background: Alborz Province is one of the provinces that accepted immigrants. Immigration has a profound effect on physical and mental health in elderly. This study was performed to assess the health status of Alborz province older population.
Methods: In this cross-sectional study, 235 subjects were enrolled (113 men and 122 women) aged ≥ 60 years using multi-level proportionated cluster random sampling that selected from 19 cities of this province. Data was collected by a demographic questionnaire, measuring anthropometric characteristics, and blood pressure and using "Mini Nutritional Assessment", ”Geriatric Depression Scale-15 ", “Katz’s Activity of daily living”, and "Lawton’s Instrumental activities of daily living”. Data was analyzed with spss21.
Results: The mean age of the participants was 68(6.00) years.  The prevalence of anxiety and depression among the participants was as 51.5% and 34%, respectively. At risk or malnutrition was observed in 27% of the participants and 54.5% had suffered dental problems and 49.8% also had problem in walking.
Conclusion: Overall, the health status of elderly people in the Alborz, perhaps slightly better than the national average, but the high prevalence of metabolic disorders also the high prevalence of depression and anxiety require serious intervention by policy makers to promote the health in elderly.

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Background: In this study, we investigated the diagnostic power of ultrasound in the diagnosis of malignancy in thyroid nodules in Iranian patients. For this purpose, we examined the relationship between ultrasound findings and pathology findings.
Methods: The present study is a retrospective study. The patients with a diagnosis of thyroid nodules who underwent ultrasound and FNA, were included in this study. To assess the relationship between the results of FNA and the ultrasound characteristics of nodules, we classified the results of FNA into malignant and benign groups and then compared ultrasound characteristics between the two groups. In cases which the FNA results were indeterminate (AUS/FLUS or FN/SFN), the postoperative pathology result was considered (if thyroid surgery was done and the result was available).
Results: In total, 201 nodules were included in this study. The results showed that hypoechogenicity, irregular/ill-defined margin, microcalcification, malignant flow pattern in Doppler sonography and concurrent cervical lymphadenopathy with suspicious features were significantly associated with malignant thyroid nodules. However, other ultrasound findings, such as the size and location of the nodule, presence of a cystic components within the nodule, the presence of a Halo sign, and the presence of a taller-than-wide shape, could not distinguish between benign and malignant nodules. Finally, the results of the present study showed that the accuracy of ultrasound in the diagnosis of malignancy in thyroid nodules is high.
Conclusion: This study suggests that the use of ultrasound can be very effective in diagnosing malignancy in thyroid nodules.

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Background: Sirtuin-1 is known as a key metabolic sensor in various tissues, including skeletal muscle and tissue, which can play a pivotal role in regulating glucose and lipid metabolism through diacetylase activity. The aim of the present study was to investigate the role of licorice extract and swimming exercise on SIRT1 signaling pathways in the soleus muscle of diabetes male rats.
Methods: The research is of an experimental and fundamental type, and the working method is an experimental work with a descriptive-solution nature. Fifty mice were bought and divided into 5 groups of 10. The main training program consisted of swimming in the rodent tank of the special swimming water tank for 6 weeks and 5 sessions per week. In order to induce diabetes in the mice, streptozotocin was injected. Seven days after the injection, the blood sugar of the mice was measured, and the mice with blood sugar more than 250 ml/dL were selected as diabetes samples. Licorice root extract was given to two groups of rats. In order to analyze, two-way analysis of variance was used using SPSS26 software.
Results: The results showed that the interaction effect of swimming training and consumption of licorice extract on SIRT1 signaling pathways is statistically significant (P= 0.002).
Conclusion: SIRT1 plays an important role in the control of glucose homeostasis. In fact, under certain conditions, the activity and expression level of SIRT1 gene decreases in different SI tissues due to its important metabolic role. Swimming training along with licorice supplement may be used for prevention and treatment of diabetes by positive regulation of SIRT1 gene expression.

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Background: Type 2 diabetes mellitus, like other inflammatory diseases, causes a change in the levels of pro-inflammatory (such as gremlin-1) and anti-inflammatory (such as pentraxin-3) markers. The aim of the present study was to compare the effects of 10 weeks of aerobic and resistance training on serum levels of pentraxin-3, gremlin-1 and insulin resistance in men with type 2 diabetes.
Methods: In this semi-experimental study, 29 men with type 2 diabetes in the age range of 25-45 years were selected and randomly divided into three groups: aerobic training, resistance training and control. Aerobic training program with an intensity of 55-75% of the maximum heart rate and resistance training with an intensity of 55-75% of one repetition maximum was implemented during 10 weeks and 3 sessions per week. Before and after the intervention period, serum levels of pentraxin-3, gremlin-1 were measured and also insulin resistance index was calculated.
Results: In both aerobic (P= 0.039) and resistance (P= 0.019) training groups, pentraxin-3 serum level increased significantly compared to the control group; but there was no difference between the two groups (P= 0.703). Also, serum levels of gremlin-1 and insulin resistance of the aerobic (P= 0.022 and P= 0.040, respectively) and resistance (P= 0.037 and P= 0.031, respectively) training groups showed a significant decrease compared to the control group; Although there was no difference between the training groups (P= 0.815 and P= 0.659, respectively).
Conclusion: This findings demonstrate that both types of aerobic and resistance training are equally effective in improving inflammatory markers and insulin resistance in type 2 diabetes patients.

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Background: Diabetes is a global epidemic and the most common metabolic disorder caused by impaired insulin secretion and glucose metabolism. The aim of this study was to investigate the effect of 8 weeks of aerobic training on serum levels of asprosin and insulin resistance index in diabetic rats.
Methods: The statistical population of this research included 40 10-week-old mice with an initial weight of 250 ± 20 grams, which were randomly divided into four groups (10 mice in each group): diabetic-exercise group (DT), diabetic group - Control (DC), healthy-training group (HT) and healthy-control group (HC) were divided. The program of aerobic exercises was performed for 8 weeks (5 sessions per week) in the form of running on a treadmill. Independent t-test and one-way analysis of variance (ANOVA) with Tukey's post hoc test were used to compare the groups. All data were analyzed at a significance level of 0.05 using SPSS-25 software.
Results: The results of the present study showed that streptozotocin injection induced diabetes in mice (P= 0.001). Induction of diabetes caused a significant increase in the serum levels of asprosin and insulin resistance in mice (P= 0.048 and P= 0.012, respectively). Eight weeks of aerobic training decreased the serum levels of asprosin and decreased insulin resistance in diabetic rats (P= 0.001 and P= 0.036, respectively).
Conclusion: Induced diabetes causes insulin resistance and increase in serum levels of asprosine, which can be improved by performing aerobic exercises.