Iranian Journal of

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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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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: 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: 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: 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: There are growing concern globally regarding fast food consumption and its related cardiometabolic outcomes. In this study we investigated whether fast food consumption could affect the occurrence of metabolic syndrome after 3-years of follow-up in adults or not. Methods: This longitudinal study was conducted in the framework of Tehran Lipid and Glucose Study on 1476 adults, aged 19-70 years old. The usual intakes of participants were measured using a validated semi-quantitative food frequency questionnaire at baseline. Biochemical and anthropometric measurements were assessed at baseline (2006-2008) and 3 years later (2009-2011). Multiple logistic regression models were used to estimate the incidence of the MetS in each quartile of fast food consumption. Results: The mean age of participants was 37.8±12.3 years old, and the mean BMI was 26.0±4.5 kg/m2 at baseline. Participants in the highest quartile of fast food consumption were significantly younger (33.7 vs. 43.4 years, P <0.01). Higher consumption of fast food was accompanied with more increment in serum triglyceride levels after the 3-year follow-up (10.6±2.3 vs. 4.4±2.3 percent in the fourth and first quartile, respectively, P<0.01). After adjustment for all of the potential confounding variables, the risk of metabolic syndrome, in the highest quartile of fast foods compared with the lowest, was 1.85 (95% CI= 1.17-2.95). Conclusion: We demonstrated that higher consumption of fast foods had undesirable effects on metabolic syndrome after 3-years of follow-up in Iranian adults.