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Volume 63, Issue 4 (7-2005)
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.
Volume 63, Issue 4 (7-2005)
Background: We conducted this study To find relationship between maternal glucose challenge test (GCT) levels and fetal body weight (BW).
Materials and Methods: We analyzed five hundred women with singleton pregnancy, who had GCT at 24-28 week during pregnancy. All of them had no history of hypertension and diabetes mellitus or other medical disease before pregnancy or during previous pregnancy, and all of them had weight gain appropriate with their pre pregnancy body mass index (BMI). Also nobody had history of drug abuse or smoking. In this descriptive–analytic survey, maternal age, gravidity, BMI,GCT level ,gestational age (GA) , sex of neonate, rout of delivery , newborn weight and apgar score were evaluated .The student’s T-test and logistic regression were used for statistical analysis. We used Pearson coefficient and receiver operating characteristic (ROC) curve and chi-square test for determination GCT threshold.
Results: We found rate of small for gestational age (SGA) in newborns statistically was significant, who their maternal GCT level was ≤ 80mg/dl, P value: 0/018, specificity 89%, sensitivity 58% and confidence interval: 95% (0/162-0/545).
Conclusion: Low GCT level has association with SGA and can be used as a predictive test and may be an indication for dietary intervention.
Volume 64, Issue 3 (5-2006)
Background: Hyperglycemia is a metabolic response to surgical stress. In this study, patients’ blood glucose changes were measured before, during and after elective eye surgeries under general anesthesia, with two methods: glucometer and glucose oxidase enzyme lab assay. Probable influencing factors and the correlation rate of these two methods were evaluated.
Methods: This analytic cross – sectional original study was performed on 230 American Society of Anesthesiologists (ASA) Class 1or 2 non–diabetic patients. All the patients underwent a similar general anesthesia and their blood glucose levels were measured simultaneously with two cited methods on three occasions.
Results: In all cases, post-surgery blood glucose in comparison to pre-surgery levels increased significantly in both methods irrespective of independent variables of the study. Considering these independent variables, increase in blood glucose levels was significant in most of the patients. The mean increase in blood glucose post-surgery in comparison to pre–surgery, measured with lab assay, had significant statistical correlation with the type of eye surgery but not with other variables like age, gender and duration of surgery. Correlation of the two methods were also partially significant statistically.
Conclusion: Considering the results of this study and the fact that blood glucose changes under general anesthesia is usually unrecognized clinically, we recommend blood glucose measurement in non–diabetic patients during long surgeries. It is advantageous to use Accu–chek (Sensor model) glucometer for this purpose.
Volume 64, Issue 4 (7-2006)
Background: The aim of this study was to determine the effect of two different regimes, containing different carbohydrate to protein ratios on performance, serum glucose and insulin after exercise in soccer players in Tehran Iran.
Methods: Nineteen male soccer players under training [age = 17/5 +/- 1.5 (SE) yr] were selected and completed two sequential trials separated by 1 week, in a paired cross-over study design. In each trial, subjects after running to fatigue received one of three regimes, using a random- order design as follows: HPRO ( CHO 56%, PRO 19% & fat 25% of total energy) HCHO ( CHO 64%, PRO 11% & fat 25% of total energy) or control ( CHO 60%, PRO 15% & fat 25% of total energy). The calorie of 3 regimes were equal. After consumption of meal up to120 min, blood was obtained before and at intervals. After 3 hours athlete performance was measured.
Results: The study indicates no significant difference in the serum insulin and glucose response among three regimes (P > 0.05). There was no difference in performance between three regimes after 3 h (p > 0.05).
Conclusion: The results suggest that post exercise regimes have no influence on performance, serum glucose and serum insulin. Thus total energy content and carbohydrate content may be important in recovery after exercise.
Volume 66, Issue 4 (7-2008)
Background: Hyperglycemia after acute stroke is a common finding that has been associated with an increased risk of death. For the last several years, it was believed that post-stroke hyperglycemia may worsen brain infarction in animal models. According to previous studies, the anti-inflammatory effect of insulin has a protective role on ischemic tissues. Glucose-insulin-potassium (GIK) infusions can be safely administered to acute stroke patients with mild to moderate hyperglycemia producing a physiological but attenuated glucose response to acute stroke, the effectiveness of which remains to be elucidated. In this study, we compared the effects of GIK infusion vs. placebo in ischemic stroke patients.
Methods: In this double blind randomized controlled trial, the intervention group consisted of 48 patients who received GIK infusion for 24 hours and the control group included 50 patients who received normal saline infusion for 24 hours. All patients had been admitted to Shariati Hospital during the first 24 hours after the onset of ischemic stroke. At one and three months after the treatment, patients were examined for morbidity and mortality using the Bethel and Modified- Rankin-Scale (MRS) questionnaires.
Results: GIK infusions significantly reduced plasma glucose concentrations. Statistically significant differences between the two groups were observed for disability and mortality. However, in spite of the protective effects of insulin and adverse effect of hyperglycemia in ischemic tissues, we observed no significant therapeutic effect from the GIK solution on patient outcome.
Conclusions: Although hyperglycemia following acute stroke has been associated with subsequent mortality and impaired neurological recovery, the maintenance of euglycemia in the acute phase has not been shown to improve prognosis. According to this study, GIK infusion has no significant clinical benefit on the outcome of stroke patients. Thus, we cannot recommend routine use of GIK infusion in post-stroke hyperglycemia as an adjuvant treatment for ischemic stroke.
Volume 67, Issue 11 (2-2010)
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Background: Diabetes and dysglycemia have a high prevalence in
Iranian population but the information about their impact on the cardiovascular
disease (CVD) risk is scarce in this population. This study aimed
to determine the risk of CVD according to glucose tolerance status.
Methods: We ascertained cases with incident CVD in a
population of 1752 men and 2273 women, 40 years old and over and free of CVD at the
beginning of study, during a follow up with a median of 7.6 years. To
calculate hazard ratio (HR) for CVD, we controlled traditional risk factors, including
age, body mass index, waist, total cholesterol, HDL-cholesterol, triglycerides,
systolic blood pressure, diastolic blood pressure, education, smoking,
hypertension medication, lipid lowering medication and family history of
premature CVD and diabetes.
Results: Cardiovascular events
occurred in 197 men and 143 women. Its incidence density was 11.8 per 1000 person-years
(95%
confidence interval: 10.6 to 13.1) totally. Multiple adjusted HR in women with
known diabetes was 3.88 (95%CI: 2.40 to 6.27) and with newly diagnosed was 2.34 (95%CI: 1.39 to 3.95) and the
corresponding values for men were 1.72 (95%CI: 1.00- 2.95) and 1.52 (95%CI: 1.01- 2.31) respectively. Impaired fasting glucose and impaired
glucose tolerance increased 56% the risk of CVD in women (HR:
1.56 with 95% CI, 1.00 to 2.45), just in
the age adjusted model.
Conclusion: All diabetic patients should receive primary
prevention for CVD
intensively, regardless of whether they are newly diagnosed or are known cases
specially, females who have abnormal glucose metabolism.
Volume 71, Issue 1 (4-2013)
Background: Probably L-Carnitine can induce increasing of Pyruvate dehydrogenase activity, decreasing of lactic acid production and performance improvements due to the reinforcement of long chain fatty acid oxidation and stabilize of Coenzyme A (CoASH) to free Coenzyme A (COA). Based on this, the aim of this study was to investigate the effect of acute L-Carnitine supplementation on blood lactate, glucose, VO2max and anaerobic power in trained men.
Methods: Sixteen trained men (aged 19-23) volunteers from University of Guilan, facul-ty of Physical Education and Sport Sciences participated as subjects in this investiga-tion. Subjects divided to aerobic (A) and anaerobic (An) group randomly. In a double blind design, subjects participated in two separated tests by one week. Subjects ingested 3 grams of L-Carnitine supplementation or placebo (maltodextrin) 90 minute before aerobic and anaerobic exercise. For aerobic activity used shuttle run 20 meter and for anaerobic activity used RAST test. Blood samples were collected 5 minute prior at rest and 4 minute post tests. Participants were asked in the morning to obtain fasting blood samples and perform tests. A t-test was used to detect differences between supplementa-tion and placebo groups in each exercise.
Results: L-Carnitine group ((A) 141.25±20.62 and (An) 145.38±55.47) significantly had lower lactate concentration than placebo ((A) 151.00±20.85 and (An) 152.50±28.59) after tests (P≤0.05). L-Carnitine group ((A) 136.00±19.74 and (An) 115.50±13.64) had significa-ntly higher blood glucose compared to placebo ((A) 121.62±15.65 and (An) 110.12±12.63) too (P≤0.05). Also, VO2max, mean and maximum anaerobic power in L-Carnitine group were significantly more than ones in placebo (P<0.05).
Conclusion: These findings indicate that acute oral supplementation of L-Carnitine can induce fatigue decreasing and improvement of aerobic and anaerobic performance.
Volume 73, Issue 12 (3-2016)
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.
Volume 75, Issue 9 (12-2017)
Methods: The present study was conducted ecologically and descriptively-analytically on 59745 neonates with G6PD deficiency in Fars province, Iran from April 2011 to March 2015. To determine the defect, a point fluorescence test and Kimia commercial kit (KimiaPajoohan Co., Tehran, Iran) were used. To determine the areas with malaria, factors associated with malaria-causing cells in Fars province, including the presence of carriers, the presence of malaria, the incidence of new malaria and the presence of malaria activated sites were studied. The incidence of defect was calculated using the statistical method of estimating the annual incidence rate. ArcGIS software, version 10.3 (ESRI, Redlands, CA, USA) was used to provide geographic mappings and distribution patterns in malarious areas.
Results: The total incidence of G6PD deficiency in newborns was estimated as 15.58 per 100 live births, including 16.25 for boys and 14.85 for girls. The incidence of this defect in malaria-prone areas was higher than other areas. As a region was more malaria-prone, the incidence of G6PD deficiency increased too, which was statistically significant (P= 0.039).
Conclusion: Based on the findings of this study, Fars province is among areas with high incidence of G6PD deficiency. The incidence of G6PD deficiency in malaria-prone areas of Fars province, Iran, is higher than other regions, which indicates better survival of patients against malaria in the past.
Volume 76, Issue 7 (10-2018)
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.
Volume 79, Issue 9 (12-2021)
Methods: This cohort study was performed based on the information of the Isfahan Diabetes Prevention Plan (IDPs). This project was implemented from April 2004 to March 2018 in the clinics of the Endocrine and Metabolism Research Center of Isfahan. The subjects in this study include 1228 pre-diabetic patients who participated in this project. Demographic and clinical variables of patients including blood sugar and lipid-blood variables were obtained using a questionnaire and laboratory measurements. Also in this study, the number of clinical variables was recorded 3 times. Data analysis was performed using the latent class growth trees model in R software version v4. (R v4.1.0)
| Results: The mean (standard deviation) age of participants was 44 (6.86) years. Subjects were classified into two classes of low-risk impaired blood sugar (n=1165) and high-risk impaired blood sugar (n=63) based on the trend of changes in blood sugar levels. Blood sugar levels were reported in the first class (104.28) and the second class (132.41). Conclusion: In the present study, it was concluded that there is a significant relationship between the incidence of diabetes and the different classes formed based on the course of changes in blood sugar of at-risk individuals. Therefore, by classifying people at risk, the incidence of this disease can be predicted and thus prevented. Also,measures such as managing the blood sugar and lifestyle variables of pre-diabetic patients through nutrition counseling classes and regular periodic tests can be used to reduce the incidence of diabetes in the future is used in people with pre-diabetes who are at high risk for the disease. |
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Volume 80, Issue 1 (4-2022)
Methods: This experimental study was conducted between May and September 2016 at Baqiyatallah University of Medical Sciences. In this study, there were 48 8-week-old male Wistar rats (mean weight 250±20) that were randomly divided into four groups: basic control, 12-week control, diabetes, diabetes and moderate continuous training. Diabetes was induced by injection of streptozotocin solution. The training protocol consisted of continuous aerobic training for 12 weeks, five sessions per week in the form of running on a treadmill. After sampling, real-time PCR expression was used to measure gene expression. Statistical analysis was performed by SPSS software, version 22 (IBM SPSS, Armonk, NY, USA) and graphs were drawn using GraphPad Prism, version 8, (GraphPad Software, USA).
Results: According to the results, there was a significant increase in RBP4 in the diabetic group compared to other groups. compared to the two groups of diabetes and diabetes, along with moderate continuous training, RBP4 gene expression was less expressed in diabetic training. Regarding GLUT4, there was a significant difference between diabetes and diabetes groups with training. Also, the expression of the GLUT4 gene in the diabetic group with training was higher than the other groups. According to this study, it was shown that moderate-intensity continuous training somehow reduces the negative effects of diabetes on metabolism and health by activating various cellular and molecular pathways and mechanisms.
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Conclusion: the present study showed the effect of moderate-intensity continuous training on the expression of RBP4 and GLUT4 genes in soleus muscle which can be effective in glucose uptake. It was also shown that moderate-intensity continuous training can minimize the complications of diabetes by reducing RBP4 gene expression.
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Volume 81, Issue 2 (5-2023)
Methods: The present study is a descriptive study that evaluated the results of CSF analysis in 56 children with febrile seizures admitted to Imam Sajjad Hospital in Yasouj from March 2012 to 2013. In the present study, CSF analysis was performed in children with a diagnosis of febrile seizures. In order to collect information from a pre-designed form that includes demographic information (age and gender), degree of fever, and information related to CSF indices including WBC, PMN and levels of protein and glucose in CSF, which have been extracted and recorded, statistical methods are used in this study to express descriptive statistics such as mean, standard deviation, number, percentage, etc.
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Results: 56 children with a diagnosis of convulsive fever with a mean age of 21.4±14 months were evaluated. 37.5% (21 individuals) of the study population were females and 62.5% (53 individuals) were males. Among them, 33 individuals had low-grade fever and 23 individuals had high-grade fever. In 10.7%, the number of WBCs was more than 5. The amount of protein obtained was in the normal range, between 20 and 50 mg/dl, in 57.1% of cases. However, a significant percentage (39.3%) of CSF liquid protein was below 20 mg/dl. CSF fluid glucose levels were within the normal range at 91.1%.
Conclusion: Based on the results of this study, febrile seizures may be associated with low protein levels in the CSF. However, due to the limited sample size in our study, similar studies with higher sample sizes are recommended. |
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