Comparing the association of two metabolic syndrome definitions, NCEP ATP III and IDF, with the risk of developing atherosclerotic cardiovascular disease: An analytical cross-sectional study.

INTRODUCTION: Atherosclerotic cardiovascular diseases (ASCVD) are significant sources of mortality and morbidity with substantial economic implications and preventive measures play key roles in this regard. Metabolic syndrome (MetS) is a common condition, and its association with ASCVD and mortality has made it clinically important. However, controversies persist regarding the best definition for MetS. Here in, we investigated the ability of the International Diabetes Federation (IDF) and the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) in the prediction of ASCVD incidence. METHODS: We conducted an investigation on individuals diagnosed with MetS as part of the "Kerman Coronary Artery Diseases Risk Factor Study" (KERCADRS). This study was a cohort study conducted on a population aged 15-75 years residing in Kerman, Iran to assess the risk of ASCVD. We employed ACC/AHA ASCVD Risk Estimator for predicting ASCVD occurrence in the future and then compared the results with different definitions of MetS including IDF and NCEP ATP III. RESULTS: Patients with MetS consistent with NCEP ATP III had higher ASCVD risk scores than those with IDF (10.63 ± 10.989 vs. 9.50 ± 9.357). NCEP ATP III had better overall performance in terms of specificity, accuracy, sensitivity and positive and negative predictive values especially in higher ASCVD risk score categories. The agreement between IDF and NCEP ATP III was none to slight (Cohen's Kappa <0.2) except for IDF in the group of ASCVD >30%, which revealed no agreement (Cohen's Kappa = 0). CONCLUSION: NCEP ATP III has better overall performance compared to IDF. The ability of NCEP ATP III increases as the ASCVD risk score goes higher. IDF may be useful in primary screening and patients with lower ASCVD risk scores.

Prevalence and 5-year incidence rate of dyslipidemia and its association with other coronary artery disease risk factors in Iran: Results of the Kerman coronary artery disease risk factors study (Phase 2).

BACKGROUND: Dyslipidemia (DL) is an important risk factor of coronary artery disease (CAD). We evaluated DL prevalence and its 5-year incidence rate in southeastern Iran, to assess the severity and growth rate of this CAD risk factor in the region. MATERIALS AND METHODS: This study was a part of the Kerman CAD Risk Factors Study Phase 2 (2014-2018) among 9996 individuals aged 15-80 years, from whom 2820 individuals had also participated in Phase 1 (2009-2011). In mg/dl, cholesterol ≥240 and/or low-density lipoprotein cholesterol ≥160 and/or high-density lipoprotein cholesterol <40 for men and <50 for women and/or triglyceride >200 were defined as DL. RESULTS: The lipid profile of 9911 persons was analyzed. Overall 19.6% had borderline cholesterol and 6.4% suffered from hypercholesterolemia. 56.6% of the population (62.5% of females vs. 48.5% of males) suffer from DL, from whom 73.4% were undiagnosed. Female gender, advanced age, obesity, hypertension, diabetes, anxiety, and depression predicted DL in the study population. The prevalence of DL was significantly lower in Phase 2 (56.6%) compared to Phase 1 (81.4%). The prevalence of undiagnosed DL (UDL) and diagnosed DL (DDL) was 40.7% and 16.2%, respectively. The 5-year incidence rate of DL was 2.58 persons/100 person-years (3.24 in females vs. 2.20 in males). CONCLUSION: Although there were promising signs of a reduction in DL and increase in DDL in the last 5 years, a high percentage of the population have DL yet, from whom mostly are undiagnosed. DL was significantly associated with other CAD risk factors. Therefore, the health-care management system should improve its strategies to reduce the health burden of DL.

Practical Focus on American Diabetes Association/European Association for the Study of Diabetes Consensus Algorithm in Patients with Type 2 Diabetes Mellitus: Timely Insulin Initiation and Titration (Iran-AFECT).

BACKGROUND: The aim of this study was to evaluate the safety and effectiveness of insulin glargine in a large population from a variety of clinical care in Iranian people with type 2 diabetes mellitus (T2DM) and to measure the percentage of patients achieving glycosylated hemoglobin (HbA1c) <7% by the end of 24 weeks of treatment in routine clinical practice. METHODS: This study was a 24 week, observational study of patients with T2DM, for whom the physician had decided to initiate or to switch to insulin glargine. The safety and efficacy of glargine were assessed at baseline and at week 24. RESULTS: Seven hundred and twenty-five people with T2DM (63% female) including both insulin naïve and prior insulin users were recruited in this study. The mean age of the participants was 54.2±11.2 years, and the mean HbA1c level was 8.88%±0.93% at baseline. By the end of the study, 27% of the entire participants reached to HbA1c target of less than 7% and 52% had HbA1c ≤7.5%. No serious adverse event was reported in this study. Furthermore, overall hypoglycemia did not increase in prior insulin users and the entire cohort. In addition, body weight did not change in participants while lipid profile improved significantly. CONCLUSION: Treatment with insulin glargine could improve glycemic control without increasing the risk of hypoglycemic events in people with T2DM. In addition, a significant clinical improvement was observed in lipid profile.

Family history of diabetes and the risk of gestational diabetes mellitus in Iran: A systematic review and meta-analysis.

OBJECTIVE: Gestational diabetes is the most prevalent metabolic disorder being firstly diagnosed during pregnancy. The relationship between the family history of diabetes and the gestational diabetes mellitus (GDM) has been investigated in several primary studies with a number of contradictions in the results. Hence, the purpose of the present study is to determine the relationship between the GDM and the family history of diabetes using the meta-analysis method. METHOD: All published papers in main national and international databases were systematically searched with some specific keywords to find the related studies between 2000 and 2016. We calculated the odds ratio (OR) with 95% confidence interval (CI) in analysis for each study using a random-effect and Mantel-Haenzel method. We also determined heterogeneity among these 33 articles and their publication bias. RESULTS: We entered 33 relevant studies of 2516 articles into the meta-analysis process including 2697 women with family history of diabetes mellitus as well as 29134 women without. Of them, 954 and 4372 subjects developed GDM respectively. Combining the results of the primary studies using the meta-analysis method, the overall odds ratio of family history for developing GDM was estimated as of 3.46 (95% CI: 2.80-4.27). CONCLUSION: This meta-analysis study revealed that the family history of diabetes is an important risk factor for the gestational diabetes mellitus.

Prevalence of dyslipidemia and its association with other coronary artery disease risk factors among urban population in Southeast of Iran: results of the Kerman coronary artery disease risk factors study (KERCADRS).

BACKGROUND: Despite the importance of identifying and screening dyslipidemia to prevent coronary artery diseases CAD(Coronary Artery Disease), little information is available on dyslipidemia in our large area. So the present study aimed to assess the management status of lipid abnormalities and its association with other CAD risk factors in an urban population of southeast of Iran. METHODS: This cross-sectional study was a part of the Kerman coronary artery disease risk factor study KERCADRS (Kerman coronary artery disease risk study) as a population-based, epidemiological research among 5900 individuals aged 15 to 75 years who were residents of Kerman city, the largest city in Southeast of Iran. Lipid profile was assessed using enzymatic laboratory methods. RESULTS: In total, 5558 persons from 5899 participants were assessed in whom 45.1 % were male and 54.9 % female. Overall 20.9 % had borderline level of cholesterol (200-239 mg/dl) and 8.7 % suffered from hypercholesterolemia (≥240 mg/dl). The prevalence of undiagnosed dyslipidemia (UDL) was 16.8 % and of diagnosed dyslipidemia (DDL) was 13.2 % that both UDL and DDL were more prevalent in women. Also, UDL was more revealed in third and fourth age decades. Advanced age, anxiety, obesity (BMI ≥30 Kg/m2), and family history of dyslipidemia predicted dyslipidemia in study population. CONCLUSION: The overall prevalence of UDL was higher than of DDL, and was significantly influenced by advanced age, anxiety, obesity, and family history of dyslipidemia. The data showed that our health care management system should improve its strategies to reduce the burden of this important CAD risk factor.

Overweight and obesity prevalence and its predictors in a general population: A community-based study in Kerman, Iran (Kerman coronary artery diseases risk factors studies).

BACKGROUND: The aim of this study was to present age-sex standardized prevalence of overweight and obesity as well as central obesity and its associated variables in an adult population of Iran. METHODS: Around 5900 adult individuals aged 15-75 years enrolled to the study from 2009 to 2011 applying randomized cluster household survey in Kerman, southeastern of Iran. Overweight was defined as body mass index (BMI) 25-29.9 kg/m2, obesity was considered as BMI ≥ 30 kg/m2, and central obesity was regarded as waist circumference (WC) > 88 cm for women and 102 cm for men. RESULTS: The overall age-sex standardized prevalence of overweight, obesity and central obesity was 29.6% (29.5% men, 29.7% women), 13.0% (9.3% men, 16.9% women) and 14.4% (7.5% men, 21.5% women), respectively. "Overweight/obesity" increased by age, [adjusted odds ratio (AOR): 7.9 95% confidence interval (CI): 5.8, 10.7)] for 65-75 years old, 11.7 (95% CI: 9, 15.3) for 55-65 years old, 10.1 (95% CI: 7.8, 13) for 45-54 years old compared with the first age group), female gender [AOR: 1.5 (1.3, 1.8); P < 0.001], higher education (AOR > 1.5 compared with illiterate individuals; P < 0.001), and low physical activity [AOR: 1.4 (95% CI: 1.1, 1.8); P = 0.006] and decreased by smoking [AOR: 0.4 (95% CI: 0.3, 0.6); P < 0.001] and opium using [AOR: 0.5 (95% CI: 0.4, 0.7); P < 0.001]. Female gender [AOR: 4.1 (95% CI: 3.3, 5); P < 0.001], advanced (AOR > 7 for age groups ≥ 35 years old; P < 0.001) positively, while smoking [AOR: 0.6 (0.4, 0.8); P = 0.004] negatively were the most significant predictors for abnormal WC. CONCLUSION: Our data reveal that overweight and obesity affected almost half of the adult population (43.0%), and central obesity was around 15.0%, which reflect the high prevalence of this abnormality. In addition, several demographic, social and lifestyle factors were associated with obesity. Appropriate interventions and strategies with a concentration of the general population are needed to deal with its potential subsequent consequences.

Common autoimmune biomarkers, thyroid hormonal abnormalities, and beta cells dysfunction in patients with latent autoimmune diabetes in adults with type II diabetes mellitus.

AIM: Latent autoimmune diabetes in adults (LADA) is autoimmune diabetes with a slow progression characterized by the presence of antibodies associated with Type I diabetes. The present study aimed to assess autoimmune characteristics in patients with LADA in Iran. We attempted to obtain a clear view of autoimmune conditions in LADA among our population. METHODS: This study was sourced from the population-based survey of KERCARDS aiming assessment of cardiovascular risk factors among a great sample of Iranian population who were resident in Kerman, a great province in southern Iran. Among all diabetic patients who were negative for Anti Glutamic Acid Decarboxylase (GAD) antibody test, 120 were selected as the controls and among 80 patients who were positive for this test diagnosed as LADA, the recorded files of 57 patients were complete considered as the cases. RESULTS: The level of thyroxin is significantly lower in patients with LADA compared with the controls so 73.7% and 45% of patients had normal level of thyroxin, respectively. Also, those with LADA had considerably lower levels of both thyroid peroxydaseantibody (TPO-Ab) and C-peptide when compared with non-LADA group. Using multivariate analyses and with the presence of baseline variables including gender, age, and duration of disease, the diagnosis of LADA was associated with lower serum levels of Anti-TPO, C-peptide, and thyroxin, but not associated with the level of Anti-TTG in serum. CONCLUSION: LADA patients may face with lower serum levels of C-peptide and thyroid-specific antibodies indicating insulin therapy requirement and authoimmune fundaments of the disease, respectively.

Applying the Framingham risk score for prediction of metabolic syndrome: The Kerman Coronary Artery Disease Risk Study, Iran.

BACKGROUND: There has been a few studies about the predictability of metabolic syndrome (MetS) based on the Framingham risk score (FRS) as a tool for predicting the risk of 10-years cardiovascular diseases (CVD) in Iranian population. The aim of this study was to compare the risk stratification obtained with the FRS and MetS in a cohort of the Iranian population. METHODS: In this population-based study Kerman Coronary Artery Disease Risk study, Iran, MetS was diagnosed as defined by the revised National Cholesterol Education Program definition criteria (ATPIII) and the FRS was calculated using a computer program, previously reported algorithm. RESULTS: Overall, the prevalence 10-years risk of CVD for patients with MetS was significantly different with those without MetS (74.3 vs. 86.4% for low-risk patients, 18.1 vs. 12.3% for intermediate-risk people, and 7.6 vs. 1.3% for high-risk individuals) (P < 0.001). The frequency of intermediate-risk and high-risk for 10-year CVD in men with MetS (39.5 and 18.3%, respectively) was considerably higher than women with MetS (3.2 and 0.1%, respectively). Using multiple logistic regression, the odds ratio of MetS in intermediate-risk and high-risk FRS group was 1.7 and 6.7, respectively (P < 0.001). CONCLUSION: Significant association between the presence of MetS and high risk for CVD based on FRS was revealed in both men and women indicating a good concordance between MetS and FRS in predicting the risk of CVDs. However, the odds ratio of the development of risk of cardiovascular events among women was higher than men with MetS.

Association between opium use and metabolic syndrome among an urban population in Southern Iran: Results of the Kerman Coronary Artery Disease Risk Factor Study (KERCADRS).

BACKGROUND: Along with the established effects of opium on metabolic parameters, stimulatory or inhibitory effects of opium on metabolic syndrome are also predictable. This study aimed to examine the association of opium use with metabolic syndrome and its components. METHODS: This study was conducted on 5332 out of 5900 original sample participants enrolled in a population-based cohort entitled the Kerman Coronary Artery Disease Risk Study in Iran from 2009 to 2011. The subjects were divided into three groups of "non-opium users" (NOUs = 4340 subjects), "former opium users" (FOUs = 176 subjects), and dependent and occasional people named "current opium users" (COUs = 811 subjects). Metabolic syndrome was defined according to two International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) definition criteria. RESULTS: The overall prevalence of IDF defined-metabolic syndrome among NOUs, FOUs, and COUs was 36.4%, 27.3%, and 39.0%, respectively; which was significantly higher in the COUs group (P = 0.012). However, no significant difference was revealed across the three groups in prevalence of NCEP defined-metabolic syndrome (NOUs = 37.2%, FOUs = 30.1%, and COUs = 39.6%, P = 0.058). The odds for IDF defined-metabolic syndrome was higher in both COUs [odd ratio (OR) = 1.28, P = 0.028)] and FOUs (OR = 1.57, P = 0.045) compared with NOUs as the reference adjusting gender, age, body mass index, and cigarette smoking. However, the appearance of NCEP defined-metabolic syndrome could not be predicted by opium use. CONCLUSION: Opium use can be associated with an increased risk for metabolic syndrome based on IDF criteria and thus preventing the appearance of metabolic syndrome by avoiding opium use can be a certain approach to preventing cardiovascular disease.

Age and gender differences in the clustering of metabolic syndrome combinations: A prospective cohort research from the Kerman Coronary Artery Disease Risk Study (KERCADRS).

BACKGROUND: The features of metabolic syndrome (MetS) and its components are now different in Iran compared to western countries. AIMS: The aim of this study was to provide estimates of the prevalence of the different MetS combinations in younger and older men and women in Iran. METHODS: A detailed interview regarding social demographics risk profile, and components of MetS was administered according to the Kerman Coronary Artery Disease Risk Study (KERCADRS) as population-based, epidemiological research among a cohort of 6000 individuals that residence in Kerman city. RESULTS: The overall prevalence of MetS was 25.2% in men and 42.5% in women considering the International Diabetes Federation (IDF) criteria and 31.0% in men and 38.0% in women when the National Cholesterol Education Program (NCEP) definition was applied. MetS was significantly more prevalent in females, using both definitions. The prevalence of MetS increased with age in both gender when both syndrome criteria were considered. The prevalence of different combinations of the syndrome by both definitions peaked in the age range 51-60 years among both men and women. The appearance of each component was observed earlier in women than men. CONCLUSION: The prevalence of the MetS in the State of Kerman, a great province in the south-east of Iran is estimated as 35.0%, higher than in most developed countries and some other Middle-East regions, with generally higher prevalence rates for women. The prevalence of MetS increases with age in both genders with earlier appearance in men.

Plasma cystatin-C and risk of developing gestational diabetes mellitus.

AIMS: Cystatin-C, a low molecular weight protein, is effectively applied to evaluate the risk of developing renal insufficiency, cardiovascular disorders, neural defects, and inflammatory states. However, the role of this biomarker to monitor different pregnancy-related complications remains controversial. MATERIALS AND METHODS: In the present study, we compared serum cystatin-C concentration between pregnant women with gestational diabetes mellitus (GDM) and healthy pregnant women to assess value of this biomarker to predict presence of GDM in these women. The study consisted of 60 consecutive pregnant women (30 women suffered GDM and 30 healthy pregnant women) enrolled in Afzalipour hospital in Kerman, Iran in 2012. Fasting blood sample was collected to perform measurements on plasma glucose, lipids, serum creatinine, and C-cystatin. Serum cystatin-C level was quantified using ELISA techniques. RESULTS: Unadjusted comparison of cystatin-C level between the two study group showed no significant discrepancy between them so that the level of this biomarker in GDM group was 593.00±204.81 mg/L and in healthy group was 531.67±87.52 mg/L (P=0.137); while in multivariable linear model with the presence of associated variables, GDM was a main determinant for increased level of cystatin-C (standardized beta of 0.355, P-value of 0.014). CONCLUSION: Gestational age was also identified to be another indicator of elevated cystatin-C. In final, our study showed that cystatin-C can be a reliable, useful and promising marker of GDM appearance in pregnant women.

Inadequate control of diabetes and metabolic indices among diabetic patients: A population based study from the Kerman Coronary Artery Disease Risk Study (KERCADRS).

BACKGROUND: The goal of diabetes control should be feasible in order to minimize the risk of its adverse events and to reduce its burden and cost on patients. The current study aimed to assess the status of glycemic control in male and female patients with Type 2 Diabetes Mellitus (T2DM) in Kerman, Iran. METHODS: In the present study, 500 T2DM (300 women and 200 men) from the Kerman Coronary Artery Disease Risk Study (KERCADRS), a population-based study from 2009 to 2011, were selected. Patients were >18 years old, had Fasting Blood Sugar (FBS) higher than 126 mg/dl, and had been through treatment for their diagnosed disease. All participants underwent Glycosylated Hemoglobin (HbA1c) analysis. HbA1c less than 7% was considered as good glucose control. Other metabolic indices based on American Diabetes Association (ADA) target recommendations were considered. RESULTS: The mean level of HbA1c in total subjects was 8.56 ± 4.72% that only 31.66% of men and 26.00% of women had controlled level of HbA1c. Total cholesterol less than 200 mg/dl was reported in 64.50% of men and 44.00% of women, High Density Lipoprotein (HDL) more than 40 mg/dl was revealed in 20.50% of men and 34.67% of women, and Low Density Lipoprotein (LDL) less than 100 mg/dl was reported in 41.50% of men and 25.33% of women. In multivariate logistic regression model, longer duration of disease and higher Waist Circumference (WC) were positively associated with uncontrolled diabetes status. CONCLUSION: The findings of the present study revealed that diabetes control in T2DM was inadequate. Changing the policy of treatment in individual patient and establishing better diabetes clinic to decrease the frequency of uncontrolled T2DM are crucial. Paying attention to other affecting metabolic components such as WC in the process of T2DM management is important.

The association of insulin-like growth factor-1 with severity of coronary artery disease.

AIM: Insulin-like growth factor-1 (IGF-1) has been identified as a valuable indicator for impaired glucose tolerance, and its relationship with the presence of coronary atherosclerosis has been also suggested. A few studies have assessed the relationship between IGF-1 level and severity of atherosclerosis. In the present study, the relationship between IGF-1 and coronary artery disease (CAD) was examined with particular attention to the association between this parameter and Gensini score as a good angiographic marker for determining extension and severity of CAD. METHODS: One hundred and seven patients with suspected CAD consecutively referred for selective coronary angiography at the Shafa Hospital in Kerman between April and September 2010 were prospectively enrolled. Total IGF-1 was measured using radioimmunoassay methods (Diagnostics Systems Laboratory, Iran). Selective coronary angiography was performed for all study patients and the Gensini score is computed by assigning a severity score to each coronary stenosis according to the degree of luminal narrowing and its importance based on location. RESULTS: According to the Spearman correlation analysis, total IGF-I was directly correlated with Gensini score (Spearman's rho = 0.362, P = 0.041). Total IGF-I was slightly related to the number of involved coronary vessels (P = 0.058). Relation between age-adjusted and sex-adjusted mean total IGF-I levels with Gensini score remained significant (P = 0.046); however, the association between IGF-1 and the number of diseased vessels lost statistical significance after this adjustment. CONCLUSION: IGF-1 appears as a positive indicator for severity of CAD assessed by the Gensini score, and thus its concentration may be an important indicator for assessing the extent of coronary artery involvement.

Modulation of coronary artery disease risk factors by menopausal status: A population based study among Iranian women (KERCADRStudy).

BACKGROUND: Menopause is now viewed as a risk factor for coronary heart diseases (CHD). There is a scarcity of evidence concerning the effects of menopause on coronary artery disease (CAD) risk factors. The present study aimed to evaluate the effects of menopausal status on CAD risk factors. METHODS: The present study was designed as part of the Kerman coronary artery disease risk study (KERCADRS) that was a population-based study among a cohort of 6000 individuals aged 15 to 75 years in Kerman, Iran. Only women aged 35 to 60 years were enrolled. Participants were categorized according to reproductive age into the three groups of premenopausal, perimenopausal, and postmenopausal states. RESULTS: The premenopausal status was accompanied with lower levels of triglyceride (TG), cholesterol, fasting plasma glucose (FPG), and blood pressure compared with the other two groups (P < 0.001). In addition, women in the postmenopausal group had higher levels of low-density lipoprotein (LDL) in comparison with the other two groups (P < 0.001). After adjusting for age, total cholesterol and LDL levels were significantly higher in the postmenopausal group compared with the other two groups (P < 0.05). In addition, total cholesterol and LDL levels, and systolic blood pressure were statistically different according to menopausal status after adjustment for both age and body mass index (P < 0.05). CONCLUSION: The increased risk of cardiovascular disease in postmenopausal period can be explained by elevated levels of lipid profile and increased systolic blood pressure, regardless of effects of advanced age or other anthropometric parameters.

Role of gamma-glutamyl transferase (GGT) in diagnosis of impaired glucose tolerance and metabolic syndrome: a prospective cohort research from the Kerman Coronary Artery Disease Risk Study (KERCADRS).

AIMS: The important role of raised serum gamma-glutamyl transferase (GGT) for predicting diabetes mellitus and insulin resistance is clear; however relationship between increased level of GGT and impaired glucose tolerance (IGT) is now hypothesized. We aimed to show the importance of GGT measurement in diagnosis of IGT. MATERIALS AND METHODS: Two hundred persons were randomly selected from the Kerman Coronary Artery Disease Risk Study (KERCADRS), as a population-based study. All participants underwent GGT analysis test, besides measuring risk factors and components of metabolic syndrome (MS). RESULTS: The increase in GGT was correlated with increased prevalence of IGT and MS and its different components. In multivariable analysis, a high GGT was positively associated with the presence of IGT after adjustment for age, sex and MS diagnostic criteria. The area under curve (AUC) for GGT was 0.722 for discriminating IGT from normal condition, and 0.847 for discriminating MS from normal status. In ROC curve analysis, the optimal cut-off value for GGT to discriminate IGT from normal condition was 20.5 IU with the sensitivity of 71.6% and the specificity of 66.1%. The best cutoff value for GGT to discriminate MS from normal condition was also 16.5 IU with the sensitivity and specificity of 78.4% and 78.4%, respectively. CONCLUSION: The measuring GGT can be a sensitive method for early diagnosis and predicting IGT and MS from normal condition. Because this diagnostic test is a low-cost, highly sensitive, accurate and frequently used laboratory test, its measurement is recommended as a useful marker of both IGT and MS.

Increased carotid artery intima-media thickness in pregnant women with gestational diabetes mellitus.

BACKGROUND: Pregnant women with previous gestational diabetes mellitus are at increased risk of progressive carotid artery disorders. The current study evaluated carotid intima-media thickness (IMT) in pregnant women with gestational diabetes at two time points of mid-term and full-term pregnancy to determine whether gestational diabetes mellitus causes increased IMT. METHODS: This cross-sectional study carried out at Afzalipour Hospital (Kerman, Iran) between 2009 and 2010, recruited 50 women who were at high risk of gestational diabetes during pregnancy and had an oral glucose challenge test (OGCT) as screening for gestational diabetes. B-mode ultrasound scans were performed at baseline and at two time points of mid-term pregnancy (20 to 24 weeks) and full-term pregnancy (36 to 38 weeks) on all the participants. The mean IMT of common carotids and internal carotid arteries from two walls (near and far walls) at four different angles was assessed. RESULTS: An overall comparison between the impaired OGCT test group and the control group revealed significant differences in carotid IMT in the mid-term (0.65 ± 0.07 vs. 0.59 ± 0.06 mm; p value = 0.002) and full-term (0.65 ± 0.05 vs. 0.59 ± 0.04 mm; p value < 0.001) pregnancy; however, the trend of the changes in carotid IMT during mid to full-term pregnancy was insignificant in each group (p value > 0.05). CONCLUSION: Carotid IMT was significantly higher in the women with gestational diabetes than that in the normoglycemic group in different trimesters. This finding denotes that atherosclerosis might start years before the diagnosis of gestational diabetes in vulnerable women.

Determination of oxidative stress status and concentration of TGF-beta 1 in the blood and saliva of osteoporotic subjects.

Preliminary reports indicate the influence of oxidative stress and interleukins, particularly TGF-beta1, in maintenance of bone mass. This study was designed to determine any possible variations of cellular lipid peroxidation, the total antioxidant power, and concentration of TGF-beta1 in blood and saliva of osteoporotic subjects in comparison to healthy people. Blood and saliva samples of 22 osteoporotic women and 22 age-matched healthy women were collected. Samples were analyzed for thiobarbituric acid-reactive substances (TBARS) as a marker of lipid peroxidation, ferric reducing ability (total antioxidant power, TAP), and concentration of TGF-beta1. The blood and saliva TAP (mean +/- SD) of osteoporotic subjects was significantly lower than that of healthy controls (606.65 +/- 119.13 vs. 665.64 +/- 63.73 mmol/L and 560.43 +/- 84.70 vs. 612.05 +/- 81.5, respectively). Blood and saliva TBARS (mean +/- SD) of osteoporotic subjects were significantly higher than those of healthy controls (0.30 +/- 0.04 vs. 0.26 +/- 0.04 and 0.23 +/- 0.03 vs. 0.16 +/- 0.04 micromol/L, respectively). Concentrations of TGF-beta1 (mean +/- SD) in plasma and saliva of osteoporotic subjects were not different in comparison to healthy subjects. Results indicate that persons with osteoporosis have an increased oxidative stress that is not accompanied by changes in TGF-beta1 levels. Use of supplementary antioxidants in osteoporotic patients may be helpful.