Tehran University Medical Journal

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Background: In 2-4% of couples in fertile ages, recurrent pregnancy loss (RPL) occurs which consisted one out of 300 pregnancies. The aim of this study was to comparison insulin resistance (IR) in patients with RPL to normal individuals.
Materials and Methods: In a case-controlled, prospective study, 49 non-pregnant, non-diabetic women with early RPL as the case group and 49 non-pregnant, non-diabetic women without RPL who had at least one live infant as the control group, and were matched by age, weight, and height, were enrolled. In both groups fasting insulin and glucose levels were measured and insulin resistance, which was defined as a fasting insulin (FI) level ≥20 microU/mL or a fasting glucose to insulin ratio (FGI ratio) of <4.5, was calculated.
Results: The RPL and control groups were similar with respect to age, BMI, fasting glucose levels and glucose to insulin ratios. FI was significantly higher in RPL group than control group (15.20±5.82 vs. 12.23±5.64 microU/mL). Also the frequency of patients with high FI (FI≥20µU/ml) in RPL group was significantly higher than in control group (22.45% vs. 6.12%, Odds Ratio=4.44, Confidence Interval 95%=1.15-17.07). Among the RPL group, 24.49% demonstrated insulin resistance, whereas only 8.16% of the matched controls were insulin resistant (Odds Ratio=3.65, Confidence Interval 95%=1.08-12.26). The RPL and control groups had similar in frequency of low FGI ratio. Also there was no significant difference between mean of FGI ratio in patients with fewer than 12 weeks miscarriage compared to over 12 weeks in RPL group.
Conclusion: Women with RPL have a significantly increased prevalence of insulin resistance when compared with matched fertile controls. It's recommended that in all women with RPL the glucose and insulin measurement should be carried.

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Background: Pre-diabetes is a high risk condition for developing type 2 diabetes mellitus and cardiovascular disease. The target of this study is evaluation of incidence rate of pre-diabetes and its risk factors in a long- term follow up in the Tehran Lipid and Glucose Study.

Methods: The Tehran Lipid and Glucose Study is a prospective study being accomplished on a characteristic sample of the Tehranian residents at District 13, targeted determining the prevalence and incidence of non-communicable diseases and their risk factors. Four phases of the study have been implemented, including three-year periods from 1999 to 2011. From an overall of 12808, twenty years old and older people at baseline, after excluding participants who did not have the necessary conditions, analyses were accompanied on a 2597 male and 3282 female to estimate pre-diabetes incidence and detect their risk factors.

Results: In men with incident pre-diabetes, age, fasting plasma glucose, 2-hour post-challenge plasma glucose and body mass index in addition to a positive family history of diabetes and <12 years of education were associated to a developed risk of rising pre-diabetes, but intervention and being single had a significant caring effect.

In women with pre-diabetes, 2-hour post-challenge plasma glucose, triglycerides to high density lipoprotein-cholesterol ratio, waist-to-height ratio, fasting plasma glucose and a helpful family history of diabetes increased risk of pre-diabetes, however being divorced/widowed had a slighter risk. Potential risk factors for evolving combined impaired fasting glucose and impaired glucose tolerance were higher fasting plasma glucose, 2-hour post-challenge plasma glucose, body mass index and triglycerides to high density lipoprotein-cholesterol ratio, but bigger hip circumference had a caring effect.

Pre-diabetes incidence rate was computed 46.1 per 1000 person-years in men and 36.8 per 1000 person-years in women.

Conclusion: The study showed that the incidence of diabetes and its variants in the Iranian people is high.