Tehran University Medical Journal

Background: Metabolic syndrome (MetS) is characterized by a combination of cardio-metabolic risk factors. Given that genetic factors have been shown to contribute to individual susceptibility to MetS, the identification of genetic markers for disease risk is essential. Recent studies revealed that rs780094 and rs1260326 of glucokinase regulatory gene (GCKR) are associated with serum triglycerides, plasma glucose levels and metabolic syndrome. The aim of this study was to investigate associations of GCKR gene variants with metabolic syndrome and its components.
Methods: This case-control study was conducted from April to August 2017. In this study, 8710 adults (3522 males and 5188 females), over 19 years, were randomly selected from the Tehran Lipid and Glucose Study (TLGS) population. Based on joint interim statement (JIS) criteria, the subjects were divided into two groups: case and control. Genotyping was performed by HumanOmniExpress-24 v1.0 BeadChips (Illumina, San Diego, CA, USA).
Results: Allele frequencies were in conformity with Hardy-Weinberg equilibrium. Comparisons of allele frequencies by the Chi-square test revealed that frequencies of TT genotype of both polymorphisms were significantly higher among patient group than healthy group. Logistic regression analysis with adjustment for age, gender and CRP revealed that the GCKR polymorphisms (rs1260326: odds ratio 2.7, 95% CI 1.6-4.6, rs780094: odds ratio 2.5, 95% CI 1.5-4.2) were significantly associated with MetS. Frequency of TT genotype was more in persons who had C-reactive protein (CRP) levels above 3 mg/l. The minor T allele of both polymorphisms was significantly associated with increases in the blood serum concentration triglyceride and to a decrease in fasting plasma glucose levels.
Conclusion: The results of our study indicated that, rs780094 and rs1260326 common polymorphisms of the GCKR gene were associated with serum triglycerides levels, fasting plasma glucose levels, and metabolic syndrome in a sample of the Tehranian population (TLGS), as it was already confirmed the inverse effect of this polymorphisms on triglycerides and glucose levels in previous studies.

Background: Sigmoid volvulus is a rare complication in pregnancy. The clinical presentation is similar to that of non-pregnant volvulus, although the symptoms can be masked by the enlarged uterus and physiological changes during pregnancy and it can be challenged and delayed in diagnosis and treatment. Delay in diagnosis can also lead to ischemia, necrosis and perforation of the intestine, which can have adverse maternal and fetal outcomes.
Case Presentation: A primigravid woman with gestational age of 31 weeks was admitted to a 3^rd level center with abdominal pain and abdominal distention. From the beginning of pregnancy, the patient complained of bloating and epigastric pain, And had used herbal medicine for defecation. The patient's constipation had worsened since six days before admission to the hospital. She had no vomiting and her general condition was good. Abdominal Supine X-rays were reported completely dilated sigmoid and she was treated with a possible diagnosis of ileus. Due to the progression of symptoms and abdominal distension, rectosigmoidoscopy was performed for her, and scattered mucosal erythema was seen. Discoloration of the purple mucosa was seen from a distance of about 35 cm from the annulus and the secretions inside the sigmoid lumen were seen as blood. Ischemic necrosis and sigmoid volvulus were strongly suggested for the patient and she was immediately transferred to the operating room. The abdomen was opened with a midline incision. A 30 weeks uterus was seen and sigmoid volvulus was confirmed. Detorsion and colostomy were done. Due to the unprepared intestine and the possibility of leakage from the site of anastomosis, sigmoidectomy was not performed. After 4 days, the patient was discharged in a good general condition and became a candidate for sigmoid colon resection after delivery.