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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Background: We estimated the prevalence of angina pectoris (AP) and myocardial infarction (MI) in the hyperlipidaemic population of Bushehr using the ROSE questionnaire and ECG changes using the Minnesota code.
Methods: 1036 residents of Bushehr (in southern Iran), aged 30-64 years, were enrolled as part of a 2-year cross-sectional prevalence study of diabetes mellitus and other risk factors for coronary heart disease. All participants completed a ROSE questionnaire and underwent 12-lead electrocardiography. ECG strips were interpreted according to the Minnesota code. The criteria for diagnosing AP was grade 1 or 2 on the angina pectoris diagnostic scale, and for MI, code 1.1 of the Minnesota code or a history of myocardial infarction. Results: The crude prevalence of hypercholesterolaemia was 47.6%, and its age-adjusted prevalence 50.3% in women and 43.9% in men. Mean serum cholesterol was 204.2±49.5mg/dl in women and 195.0±46.1 in men (p=0.003). The prevalence of AP was 4.9%, which, after adjustment for age, came to 5.6% in men and 4.6% in women. The prevalence of AP was 6.3% in subjects with high cholesterol and 3.6% in subjects with normal cholesterol levels (p<0.05). There was a strong association between AP and hypercholesterolaemia in men (p<0.0005). The crude prevalence of MI was 4.1% in subjects with hypercholesterolaemia and 0.9% in subjects with normal cholesterol (p<0.05). In multivariate analysis, MI was correlated with hypercholesterolaemia in both sexes (p<0.05). Similarly, MI in both men and women was associated with diabetes, and in men alone with hypertension (p<0.05). Conclusion: It is imperative to reduce the average cholesterol level of the population of Bushehr in order to decrease the incidence of AP and, ultimately, MI. Interventions to improve people s lifestyle are of one of the effective measures that may be used in this regard.

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Insulin resistant states are emerging rapidly and lots of efforts have gone into understanding their pathogenesis and major metabolic consequences. Hypertriglyceridemia, a major complication of this metabolic syndrome, seems to be caused by overproduction of lipoproteins (LPs) containing apo B that are rich in triglycerides. Some in vitro and in vivo models have been introduced so as to understand mechanisms governing lipid metabolism in insulin resistance states. Human and animal studies have suggested a key role for overproduction of VLDL in hypertriglyceridemia and dyslipidemic states. Recently, we have employed a diet-induced animal model of insulin resistance (hamster fed with fructose) in our laboratory in order to examine the relationship among development of insulin resistant state, impaired metabolism of LPs and overproduction of LPs containing apo B. These experiments have indicated that insulin resistant states occur along with overproduction of VLDL containing apoB105 from liver and enteral LPs rich in apo B 48. In insulin resistant states, decreased metabolic signaling to liver and intestine seems to play a critical role in overproduction of LPs. We have also been recognized a number of intracellular factors which may regulate VLDL production. This article reviews recent advances in the area the hypothesis indicating that a complex interaction exist between increased free fatty acids flow from peripheral tissues to the liver and intestine (caused by hyperinsulinemia) and prolonged lipogenesis has also been expounded.

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Introduction: Hyperlipidemia is a major cardiovascular risk factor. This survey has been performed to determine the prevalence of hyperlipidemia in the 17th zone of Tehran.
Methods: 1573 individuals 25-64 aged were recruited from the inhabitants of the 17th zone of Tehran through one stage cluster sampling. Standard questionnaires were filled out for all of the participants. Lipid profile was categorized according to the NCEP:ATP III criteria.
Results: 59% had ideal cholesterol levels, 27.1% borderline and 13.9% had high cholesterol levels. Hypercholesterolemia was more prevalent in women than men. 55% had ideal LDL-cholesterol level. Prevalence of hyper-LDL (>160mg/dl) was 2.3%. Hyper LDL was more prevalent in women than men (p<0.001). Prevalence of hypo-HDL was 13.8% and it was more common in men than women (p<0.001). 33.4% had high triglyceride levels.
Conclusion: Prevalence of dyslipidemia in this area of Tehran is not as high as that obtained from other urban studies. This fact should be considered in the future interventional programs which focus on noncommunicable disease management.

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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.

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Background: Coronary heart disease is the leading cause of death in many nations. .Hyperlipidemia with elevated serum total cholesterol, LDL cholesterol and triglyceride are known as cardiovascular risk factors. HDL cholesterol is considered to be a protective factor. Any effort for management of dyslipidemia directly reduces cardiovascular mortality and morbidity and cause increasing public health .The ignorance of the extent and impact of hyperlipidemia prompted us to determine the prevalence of hyperlipidemia in Rafsanjan urban population over than 20 years old.
Methods: In this study 247 men and 244 women were evaluated for serum total cholesterol , LDL cholesterol , HDLcholesterol and triglyceride levels.Blood samples were obtained at morning, after 14 hours fasting and for data analysis SPSS-11 soft ware was used. Results: Mean age of subjects was 38.35±13.14 years.High cholesterol level was present in 20.6%, LDL levels were high in 10.8% , 5.7% had elevated level of triglyceride and 8.4% of participants had low HDL cholesterol. Total cholesterol , LDL cholesterol and triglyceride levels were significantly increased by age and HDL levels were also decreased by age.
Conclusion:According to our finding about 29% of studied population had at least one lipid abnormality and this important finding showed very high prevalence of dyslipidemia and requires specific attention and planning.

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Background: Previous clinical and experimental studies suggest the valuable effect of antioxidants on lipids status. The present study was designed to investigate the efficacy of silymarin treatment as an antioxidants on lipids profile in type II diabetic hyperlipidemic patients. Methods: A 4-month randomized double blind clinical trial was conducted in 54 non-insulin dependent diabetic hyperlipidemic patients in a two well – matched groups. First group (n=29) received 200mg silymarin tablet 3 times a day plus standard therapy, while the control group (n=25) received placebo tablet 3 times a day plus standard therapy. The patients were visited monthly and fasting blood glucose, total cholesterol, LDL, HDL cholesterol, triglyceride, SGOT and SGPT were determined at the beginning and at the end of the study after four months.
Results: Results revealed that in silymarin treated patients, fasting blood glucose, LDL and total cholesterol, triglycerid, SGOT, SGPT and glucose level at the end of the study were significantly decreased as compared to beginning of the study. In placebo treated patients fasting blood glucose level at the end of the study were significantly increased as compared to beginning of the study.
Conclusion: In conclusion, the silymarin as an herbal antioxidant have beneficial effects on reducing glucose and lipids profile in type II diabetic patients

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Background: Hypertension and dyslipidemia are common in patients with type 2 diabetes mellitus. The high prevalence of cardiovascular disease in diabetic patients is, in part, related to these two risk factors. This study was performed to determine the prevalence of hypertension and dyslipidemia in newly diagnosed patients with type 2 diabetes mellitus in Isfahan.
Methods : In this cross – sectional study during 2001 – 2003, 310 newly diagnosed type 2 diabetic patients, in Isfahan endocrine and metabolism research center, were studied. Height, weight, blood pressure, Plasma lipid and lipoproteins, and HbA1c were determined for all subjects.
Results: Mean age at presentation was 489.83 years, and mean BMI was 28.44.62 Kg/m2. Hypertension was present in 32.9%, hypercholesterolaemia in 61.3%, hypertriglyceridaemia in 61.6%, high LDL in 77.3%, and low HDL in 67.8% of these patietns. The mean systolic and diastolic blood pressure were 119.0816.59 and 70.0214.02mmHg, respectively. The mean for total cholestrol was 216.1043.65, for triglyceride 207.46105.67, for LDL 124.7331.45, and for HDL 43.119.29 mg/dl.
Conclusion: Hypertension and dyslipidemia are common in newly diagnosed type 2 diabetic patients. This fact demonstrates the importance of early interventions for proper diagnosis and treatment of these two risk factors in diabetic patients.

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Background: Polycystic ovary syndrome(PCOS) is the most endocrinopathy in women and the most common causes of anovulatory infertility. Women with this disorder moreover the common manifestations such as,irregular menses, hirsutism and infertility, are susceptible to serious consequences like increase risk of endometrial carcinoma, dyslipidemia, hypertention, glocose intolerance, diabetes, cardiovascular problems and probably breast cancer. This study was conducted to demostrate the demographic, clinical,metabolic and hormonal conditions of the PCOS patients. Methods: A case-control study was performed on females with PCOS age group 15-40 years referring to endocrine and gynecology clinics. A control healthy woman was selected for each patient. The diagnosis of PCOS was made based upon the prescence of chronic anovolation and hyperandrogenemia .Other causes of hyperandrogenism were excluded by appropriate clinical and laboratory evalution .In all patients with PCOS and control women, appropriate medical history was taken and physical examination was done.Blood pressure ,body weight, height ,BMI,waist/hip ratio,score of hirsotism,acne, and other signs of androgen excess were determined.A venous blood sample were obtained at morning after 12_14hours fasting for measuring FBS, TG, Chol., LDL, HDL and hormonal profile,souch as:PROL,17_OH Progestrone,Te,DHEA-S and TSH.Case of late onset adrenal hyperplasia ,hypotyroidism and pituitary prolactinoma were excluded.The diagnosis of dyslipidemia was made upon the base of NCEP guidelines.Data was analyzed with Mann_Whitney U,T tests and Fisher’s and Chi_Square Tests with SPSS-11. Results: Mean age were similar in both patients and controls.Mean of BMI and diastolic pressure were significantly higher in PCOS women in comparison with controls . Hirsutism and oligomenorrhea were the most frequent clinical features(72.7% and 69.1% respectively). SerumTG level was significantly higher in PCOS women in comparison with controls.There were no significant difference in FBS,Chol,LDL and HDL between patients and controls. The prevalence of high triglyceride ,high cholesterol and high LDL levels were significantly higher in PCOS women in comparison with controls,but there were no significant difference in the prevalence of IFG and low HDL levels. The prevalence of high TG and high Chol level were significantly higher in obese PCOS women in comparison with non obese patients.There was no significant difference in the prevalence of high LDL and low HDL levels between obese and nonobese patients. Serum level of total Testostrone was significantly higher in PCOS women in comparison with controls.There were no significant difference in serum levels of DHEA-S,17-OH Progestrone, Prolactine and TSH between patients and controls. Conclusion: The prevalence of obesity and dyslipidemia were higher in PCOS women in comparison with healthy women. For obese women with PCOS ,behevioral weight management is the main component of overall treatment strategy and these patients counseling about the importance of life style management ,diet and exercise shoud be emphasized. The patients should screened for dyslipidemia, diabetes and hypertension. In this study there was no significant difference in FBS between two groups and IGT and DM may be better detected by OGTT. In all PCOS women for detecting dyslipidemia a fasting lipid profile is indicated

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Background: Cardiovascular diseases are the first cause of death in Iran and hypercholesterolemia is one of the most important risk factors. This problem could be partially managed by dietary modifications such as supplementation of diet with dairy products and probiotic bacteria. The aim of this study was to comprise the effect of consuming a probiotic yoghurt and ordinary yoghurt on serum cholesterol levels in mild to moderate hypercholesterolemia.
Methods: This randomized cross-over trial was conducted on 14 healthy subjects aged 40-65 years with total serum cholesterol 200-300 mg/dl. We asked the subjects to avoid consumption of yoghurt for a two-week pre-study period and add 300 g/day of milk to their diet. Then they were randomly allocated to 2 groups to receive either 300 g of ordinary yoghurt (fermented with S.thermophilus and L.bulgaricus) or probiotic yoghurt (fermented with a starter composed of L.acidophilus and B.lactis plus bacteria in ordinary yoghurt) for 6 weeks as substitution for milk. After a wash-out period of 7 weeks, the cross-over was made (those consuming probiotic yoghurt, changed to ordinary yoghurt and vice versa) and the study lasted for another 6 weeks. Anthropometric measurements, a 3-day dietary recall and blood lipid tests were done at the beginning (after a 2-week elimination period of yoghurt from diet) and at the end of each period.
Results: Comparison of weights, BMIs and dietary confounding factors during the period of consuming ordinary yoghurt and probiotic yoghurt, did not show any significant differences. Consumption of probiotic yoghurt in comparison with ordinary yogurt caused a significant decrease in total serum cholesterol (P=0.049). Comparison of other blood lipid criteria did not show any significant differences between these two periods.
Conclusion: Consumption of the yoghurt containing two probiotic bacteria, L.acidophilus and B.lactis, in comparison with ordinary yoghurt causes reduction in total serum cholesterol in mild to moderate hypercholesterolemia.

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Background: a variety of studies have noted seasonal variation in blood lipid levels, yet the mechanism for this phenomenon has not been clear. This leads to significant difference in prevalence of lipid disorders in different seasons.
Methods: A cross sectional study conducted on 6894 individuals (2890 men and 4004 women) aged 20-64 years who participated in the 1st phase of Tehran Lipid and Glucose study from March 1999 to September 2001. The mean level of plasma lipid values was compared between seasons by ANCOVA after adjustment for age, physical activity, smoking, BMI and waist-to-hip ratio. The sex specific prevalence of lipid disorders in summer and winter was calculated.
Results: 58% of participants were women. The mean age of men and women was 38.3±11.3 and 39.4±11.6 respectively (P=0.13). There was a significant seasonal variation in serum total cholesterol, LDL-C and HDL-C in men (P<0.05) with a peak in winter and a trough in summer (P<0.05). In women, only triglyceride levels showed significant seasonal variation characterized by increase in summer and decrease in winter (P<0.05). In men, there was 26.2% increase in prevalence of hypercholesterolemia (>240 mg/dl) in winter compared to summer (P<0.05). The corresponding increase in level of high risk LDL-C (≥160 mg/dl) was 26.7% and 24.9 % in men and women respectively (P<0.05). There was 23.8% decrease in the prevalence of hypertriglyceridemia (>200 mg/dl) in winter compared to summer in women (P<0.001).
Conclusion: This study confirms seasonal variation in blood lipid levels and suggests greater amplitude in seasonal variability in men than women. On the other hand, the increase in the prevalence of high risk LDL-C in both genders in winter should be considered in patients screening and follow-up strategies.

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Background: To evaluate the role of lipid markers including total cholesterol (TC), LDL-C and HDL-C vs. lipid indices (TC/HDL-C, LDL-C/HDL-C and non-HDL-C) as short term predictors of cardiovascular outcomes in adults over 30 years.
Methods: As a nested case and control study, there were 207 CVD events among participants of Tehran Lipid and Glucose Study (TLGS) documented during 3 years of follow-up. Those cases that were free of CVD at baseline (132 subjects) were matched to 264 controls for age and sex. In all subjects, demographic and clinical data including blood pressure and anthropometric measurements as well as serum lipids, fasting and 2-hour glucose were available from the database of the TLGS. We estimated the relative risk (RR) for each lipid parameter in a multiple stepwise regression model after adjustment for family history of premature CHD, smoking, systolic and diastolic blood pressure, fasting and 2-hour plasma glucose and waist-to-hip ratio.
Results: The RRs associated with an increase of ≈1 SD of independent lipid predictors in the multivariate model were as follow: total cholesterol (RR=1.6 [1.2-2.0], SD= 1.3 mmol/L), LDL-C (RR=1.5 [1.1-2.0], SD= 1 mmol/L), non-HDL-C (RR=1.6 [1.2-2.1], SD= 1.2 mmol/L) and cholesterol/HDL-C (RR= 1.5 [1.1-2.0], SD= 1.8). The comparing of these four independent variables with ROC curve analysis showed that there was no significant difference in their predictive power for cardiovascular outcome. There was no association between HDL-C, triglyceride and LDL-C/HDL-C and CVD outcome in multivariate analysis.
Conclusion: This study showed that TC, LDL-C, non-HDL-C and TC/HDL-C have similar predictive values for short term prediction of CVD outcome. It seems TC may be a reasonable choice for short term prediction of CVD outcome, because of lower cost.

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Background: Type 1 diabetes or insulin dependent diabetes mellitus is an autoimmune disease probably caused by various factors such genetics, environmental stresses, viral infections and diet. The disease is associated with damage to pancreatic insulin-producing β cells. Many researches have been performed to study the therapeutic effects of herbal medications on diabetes mellitus. The protective effects of some plants such as Cuminum cyminum, Trigonella foenum-graecum, Saliva sclarea, Allium ampeloprasum etc in diabetes induced rats were reported. Dill with the scientific name of Anethum graveolens, is a plant from umbellifera. This family which contains flavonoid compounds.
Methods: In this research, effects of hydroalchoholic extract of this plant on blood glucose level, lipids and lipoproteins in Alloxan-induced diabetic rats was investigated. Fifteen adult male rats, weighing 200-250 gr, were used in three five member groups. Rats in the control group, received physiological serum. as intraperitoneal (IP). In diabetic control group (DCG), diabetes was induced using Alloxan monohydrate at a dose of 120 mg/kgbw. In addition to diabetes induction just like DCG, the treated diabetic control group (TDCG) rats were dosed with 300 mg/kgbw hydroalcoholic Anethum graveolens extract. All rats received all materials via intraperitoneal injection (IP). 48 hours after the last IP, blood sample was taken from each animal via cardiac puncture to measure blood factors.
Results: The results indicated significant reduction in glucose, total cholesterol, triglyceride, LDL and VLDL levels in TDCG rats compared to DCG rats. Due to the use of dill extract, HDL level was significantly increased.
Conclusion: Effect of Anethum graveolens is related to antioxidant compounds. This compounds affect glucose absorbtion and beta cells regeneration. The results of this research indicate that using hydroalcoholic extract of Anethum graveolens could effectively decrease blood sugar levels.

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Background: Dyslipidemia accounts as a major risk factor for cardiovascular diseases. The aim of this survey was to determine the prevalence of dyslipidemia among relatives of patients with premature coronary artery disease (PCAD).
Methods: As a cross-sectional study 232 first degree relatives of patients with PCAD were recruited. A questionnaire was filled out by all of the participants all of them undergone physical examination and blood sampling. Lipid profile was categorized according to the NCEP: ATPIII criteria.
Results: Total Cholesterol>200 in 29.7%, LDL>160 in 10.3%, HDL<40 in 12.9%, TG>200 in 32.8%, ApoB100>130 in 14.2%, Apo A1<90 in 1.7% and LP(a)>30 in 47% of participants were seen. Serum levels of TG were significantly higher in men than women levels of HDL and ApoA1 were lower in men than women. The Prevalence of dyslipidemia among relatives was 59.6%.
Conclusion: In view of high prevalence of Dyslipidemia among relatives of PACD patients, active interventions in order to primary prevention of cardiovascular diseases via exact screening is recommended.

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Background: Experimental studies have shown that walnut (Juglans regia) intake decreases the risk of coronary heart disease (CHD). Walnut decreases the levels of atherogenic lipids such as TG, LDL-C and VLDL-C. Mainly the effect is induced via 3- Poly Unsaturated Fatty Acids (3-PUFA). Walnuts are a rich source of these fatty acids, especially -Linolenic acid (C18:3 9, 12, 15).
Methods: We assigned 20 hypercholesterolemic male Rats (200-250g) to four groups, and fed with four diet concentration of oil extract Persian walnuts(J. regia)(Lavasanate) (w/w ) as complementary diet: control group (0% oil extract) and cases 5%(1g oil extract/1g weight/1 day) ,7.5%(1.5g oil extract/1g weight/1 day),10%(1g oil extract/1g weight/1 day) for eight weeks.
Results: Results revealed there is a positive effect on the decreasing of TG(14%) ,TC(7.8%) , LDL-C(11%),VLDL-C(12%) serum concentrations, with increasing consumption of oil extract Persian walnuts (5% ,7.5% and 10%).
Conclusion: In view of the positive effect of oil extract Persian walnuts (J. regia) consumption on decrease serum concentration of TG, TC, LDL-C and VLDL-C known as atherogenic lipids and lipoproteins, it may be suggested as a CHD protective dietary supplement.

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Background: Type 2 diabetic patients have higher risk for death from coronary heart diseases than non-diabetic patients. Studies have revealed showed intensive treatment of hyperglycemia only have a small effect on CVD risk. Other risk factors such as Lipid abnormality play a leading role in the increased CVD risk associated with diabetes. The aim of this study was to assess the quality of lipid control and treatment in type 2 diabetic patient with dyslipidemia. 

Methods: We studied Data from 602 type 2 diabetic patients who had at least four regular clinic visits every year for medical care in outpatient clinics of Isfahan Endocrinology and Metabolism Research Center, 1999-2003. Patients for Classified in three groups according to lipid levels as low, moderate and high risk. ADA )American Diabetes Association) standard criteria were used for appropriate lipid control.

Results: The mean age, duration of diabetes, HbA1c and BMI were 52.2±9.5 years, 6.8±4.6 years, 9.2±1.7% and 29.4±4.2 Kg/m2 respectively at initial registration. Eighty four percent of patient had LDL cholesterol above 100 mg/dl and 71% had triglyceride level >150 mg/dl, of these patients 47.8% and 41.6% had high risk levels and only 12.4% taking statins and 21.5% taking fibrate for treatment  at end of study. Among hyperlipidemic patients levels of LDL-C decreased from 170.8±35.6 mg/dl to119±30.20 (p < .001), triglyceride decreased from 273.8±126 to225.2±97 mg/dl (P<0.004) and HDL-C increased from 43.3±10.6 to 48.4±14.1mg/dl ((P<0.6). Percentage change of lipid level was -35.8%, -17.7% and +7.3% respectively. At the end of fallow-up 50.4% of patients treated with statins and 14.7% with fibrate. Finally, overall control of cholesterol and triglyceride in patients with dyslipidemia was 30% and 37% respectively.

Conclusion: Our findings showed that many of type 2 diabetic patients with dyslipidemia have inadequate control of lipid and lipoprotein. The prevalence of cardiovascular events due to hyperlipidemia in type 2 diabetic patients is high. This fact demonstrates the importance of early interventions for control and treatment these risk factors for prevention of cardiovascular complication in this patients.

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Background: The prevalence of Diabetes mellitus as the most common metabolic disorder of human is progressively increasing. Dyslipidemia is common among diabetic patients characterized by elevated plasma TG, LDL-C and reduced HDL-C levels which increase risk of cardiovascular events. Fish oil supplement which contains omega-3 has been proposed to correct the atherogenic lipid profile associated with diabetes mellitus. Doubt remain whether the net effect of fish oil supplement on lipid profiles are beneficial in diabetes. We therefore performed this randomized double-blind clinical trial to investigate this.

Methods: Ninety six patients with type 2 diabetes mellitus were randomized assigned to take 3 times daily supplementation (capsule) with either fish oil or corn oil for 8 weeks (48 patients in each group). At begining also end of study we measured laboratory variables (FBS, TG, Total cholesterol, LDL and HDL) in both groups.

Results: At begining of the study demographic and laboratory measurements were similar in both groups (P>0.05).At 8^th weeks there  were  no statistically  significant  differences  in variables  measured except for  LDL and HDL in fish oil  group that leads to increase and decrease respectively. Although both groups show improvement in LDL / HDL and Total cholesterol / HDL ratios but mean charges were statistically significant in fish oil as compared with corn oil group. (P=0.001, P=0.005 respectively).

Conclusion: Fish oil supplement showed statistically significant improvement in LDL/HDL, Total cholesterol/HDL ratios as compared with corn oil. This may leads to decrease cardiovascular events.

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Background: Only limited data are available on the benefits of fruits and vegetable consumption on CVD risk factors. The aim of this study was to examine whether and to what extent intake of fruits and vegetables are inversely associated with cardiovascular (CVD) risk factors in adults.                                                           

Methods: In this population-based cross-sectional study a representative sample of 840 Tehranian adults (361 men and 479 women) aged 18-74 years were randomly selected in 1998. Usual dietary intake was assessed with the use of food frequency questionnaire. Portion sizes of consumed foods were converted from household measures to grams and analyzed by using Nutritionist III software designed for Iranian foods. Subjects were categorized based on category cut-points. : 0-1.9, 2-2.9, 3.0-3.9, and>=4 servings/d.

Results: In multivariate logistic regression after adjusting for confounders, dietary fruits and vegetable were found to be significantly and inversely associated with CVD risk factors. Adjusted odds ratio for high LDL concentrations were 1.00, 0.88, 0.81, 0.75(P for trend < 0.01) in first model which was adjusted for age, body mass index (BMI), energy intake, smoking status, dietary cholesterol, and prevalence of diabetes mellitus and coronary artery disease, a trend which was not appreciably altered by additional adjustment for education, physical activity, and saturated, polyunsaturated, total fat, Potassium and vitamin C intakes. This association was observed across categories of smoking status, physical activity, and tertiles of the Keys score.

Conclusion: Consumption of fruits and vegetables more than 4 servings a day is associated with lower concentrations of total cholesterol and LDL-C and with decrease in the risk of cardiovascular diseases.