Evaluation of foot self-care status and foot screening problems in patients with diabetes in Iran: a national multicenter study.

BACKGROUND AND PURPOSE: The lack of timely foot care among individuals with diabetics often lead to ulceration followed by infection and amputation. This study aimed to evaluate the foot self-care status and foot screening practices among patients with type 2 diabetes in various cities across Iran. METHODS: The cross-sectional descriptive study was performed on patients with type 2 diabetes in 10 main cities of Iran. The information about demographic and lifestyle factors, diabetes history, and diabetic foot self-care (DFSQ) was assessed. Additionally, the neurological and vascular condition of the foot were screened by Inlow's 60-Second Screen. RESULTS: The study included 1094 diabetic patients with, with a majority being female (64.8%) and married (92.5%). The average age of the participants was 57.6 ± 10.21 (mean ± SD), and the mean duration of diabetes was 11.56 ± 7.41 years. Based on Inlow's 60-Second Screen criteria, 58% of the patients should undergo yearly foot ulcer screening, 47% exhibited peripheral neuropathy, and 37% were found to have inappropriate footwear. CONCLUSION: The high prevalence of peripheral neuropathy observed in approximately half of the participants across different regions of Iran underscores the importance of continuous patient education regarding foot care and appropriate footwear. Furthermore, regular foot ulcer screenings, following the recommended intervals outlined in Inlow's screening protocol, should be implemented to effectively manage diabetic foot complications.

High frequency of metabolic syndrome in adult Zoroastrians in Yazd, Iran: a cross-sectional study.

BACKGROUND: Metabolic syndrome (MS) is a cluster of metabolic disturbances, and its prevalence is increasing worldwide. MS exhibits variations among ethnic groups. Zoroastrianism is an ethnic minority which has maintained its isolation and endogamy up to now. So, we evaluated the frequency of MS in Zoroastrians of Yazd, Iran. METHODS: In this cross-sectional study, participants aged ≥30 years were selected using a systematic random sampling. Weight, height, body mass index (BMI), waist circumference (WC), hip circumference (HC), waistto- hip ratio (WHR) and blood pressure (BP) were measured using standard methods. Also, blood levels of glucose, triglycerides (TG), total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), urea, creatinine and uric acid (UA) were measured. Both revised National Cholesterol Education Program Adult Treatment Panel III (ATPIII) and Joint Interim Statement (JIS) criteria were used to diagnose the MS. RESULTS: The mean±SD age of the participants (n=403) was 56.9±12.8 years. The frequency of MS was 69.7% and 74.9% based on JIS and ATPIII criteria, respectively; this was significantly different by age, marital status, job, educational level, and menopausal status (p<0.05). The most prevalent abnormal parameters of MS according to ATPIII and JIS criteria were high WC (95%) and low HDL (87.9%), respectively. Mean LDL, systolic BP, WHR, UA, urea, and creatinine were different between men and women. The difference between the age groups was statistically significant for BMI, systolic BP, diastolic BP, TG, WHR and urea (p<0.05). CONCLUSION: This study showed a high frequency of MS in Zoroastrians of Yazd, Iran.

Effect of pan retinal photocoagulation on the serum levels of vascular endothelial growth factor in diabetic patients.

This study tests the hypothesis that subjects with proliferative diabetic retinopathy (PDR) have a detectable rise in levels of serum vascular endothelial growth factor (VEGF), which is an important regulator of angiogenesis. Our investigation aims to evaluate plasma VEGF changes after pan-retinal photocoagulation (PRP) in diabetic patients. Twenty-nine type two diabetic patients (17 male, 12 female: mean age 53.13±12.22 years) with PDR secondary to diabetes were studied. Blood samples were obtained before and at 2 months after the last PRP session. Serum VEGF levels were measured by ELISA. After PRP, the mean serum VEGF decreased, but this reduction was not remarkable (88.68±71.09 vs. 77.01±60.33 ng/ml) (P=0.18). There was a statistically significant difference in serum VEGF changes between patients who had regressed PDR with patients who had progressed PDR (-25.98±47.37 vs. 56.44±31.7 ng/ml) (P=0.003). Our results showed a significant reduction in levels of serum VEGF in the patients who had successful laser treatment. Our findings suggest that serum VEGF levels could be used for monitoring diabetic retinopathy outcome.

The safety and efficacy of biphasic insulin aspart 30 (BIAsp 30) in Iranians with type 2 diabetes: an open-label, non-randomised, multi-centre observational study--the Iran subgroup of the IMPROVE™ study.

INTRODUCTION: To evaluate the clinical profile of BIAsp 30 (30% soluble insulin aspart, 70% protamine-crystallized insulin aspart) (NovoMix®)30) in type 2 diabetes patients in routine clinical practice in Iran. MATERIAL AND METHODS: IMPROVE™ was a 26-week, multinational, open-label, non-randomized study in patients with type 2 diabetes. The safety and efficacy of BIAsp 30 were assessed at baseline and at 13 and 26 weeks. The titration of BIAsp30 was at the physician's discretion. RESULTS: In Iran, 478 patients (47% male) previously treated with oral antidiabetic drugs (OADs) (N = 159, 33.3%) and/or insulin other than BIAsp30 (N = 317, 66.3%) or a few who were treatment-naïve (N = 2, 0.4%) participated in the study. After 26 weeks of treatment with BIAsp 30, the rate of reported major hypoglycaemic episodes was reduced by 88.1% from baseline (baseline v. Week 26: 0.303 v. 0.037 episodes/pt-year; p < 0.001). No significant differences in minor hypoglycaemic episodes between baseline and Week 26 were found. Glycaemic control was significantly improved from baseline to Week 26 with a mean HbA(1c) reduction of 1.2 +/- 1.9%. Patients' quality of life as measured by the DiabMedSat questionnaire significantly improved from baseline (58.1) to the end of the study (75.4, p < 0.001). CONCLUSIONS: BIAsp 30 therapy appeared safe and effective and improved quality of life in Iranian patients with type 2 diabetes after 26 weeks of treatment.

Maternal serum adiponectin concentration in gestational diabetes.

AIM: Adiponectin is an insulin sensitizing protein. Because gestational diabetes mellitus is associated with insulin resistance, we compared serum adiponectin levels in women with gestational diabetes mellitus and healthy pregnant women. STUDY DESIGN: Twenty-nine women with gestational diabetes and 26 women with impaired glucose tolerance were compared with 27 normal pregnant women in control group. Controls were matched for gestational age, age and body mass index (BMI) before pregnancy with two other groups. At 28 weeks of gestation serum concentration of adiponectin, insulin and insulin resistance (calculated by the homeostasis model assessment) were measured in three groups. MAIN FINDINGS: The serum adiponectin level in gestational diabetes (6379.31 + or - 1934.90 ng/ml), was significantly lower than the impaired glucose tolerance test (7384.61 + or - 1626.70 ng/ml) and control groups (7962.96 + or - 2667.20 ng/ml),(p = 0.02). Serum level of insulin and HOMA index in gestational diabetes were higher than the normal group (p > 0.05). In patients with gestational diabetes, there was a significant correlation between serum adiponectin level and BMI before pregnancy (r = -0.531, p = 0.013). Also, the correlation between maternal serum adiponectin levels and neonatal birth weight was not significant (r = -0.07, p value = 0.73). CONCLUSION: Our data show that serum adiponectin level was significantly lower in gestational diabetes in comparison with healthy pregnant women.

Prevalence and predictors of vitamin D insufficiency in adult population of yazd - The sun province in center of Iran.

BACKGROUND: Vitamin D insufficiency (VDI) is one of impaired calcium absorption causes. It is associated with increased risk of several diseases. The aim of this study was to survey the prevalence and predictors of VDI in Yazd. METHOD AND MATERIAL: This cross sectional study was conducted on 700 participant aged between 20 and 70 years old on second phase of the Iranian Multi-Center Osteoporosis Study (IMOS) in Yazd province. All analyzes were performed with the SPSS 20 and Stata 14.1 software. Chi-squared test, Pearson correlation and binary logistic regression were used. A significance level was considered for all tests P ≤ 0.05. RESULTS: The prevalence of VDI was 55.1% (51.37-58.87%) in total participant of this study. Predictors of VDI including: age 31-45 years old (OR = 1.68, CI = 1.04-2.70), female (OR = 3.49, CI = 1.80-6.78), live in the apartment houses (OR = 2.15, CI = 1.06-4.35), inability of climbing of steps (OR = 2.59, CI = 1.17-5.69), serum Calcium (OR = 0.53, CI = 0.34-0.81) and serum PTH (OR = 1.04, CI = 1.02-1.06). CONCLUSIONS: The prevalence of VDI in Yazd is high. It is recommended to people that to be exposed to sunlight per day. And people should consumption vitamin D supplements under their physician.

Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients.

BACKGROUND: This study was performed to assess the prevalence of dry eye syndrome and diabetic retinopathy (DR) in type 2 diabetic patients and their contributing factors. METHODS: 199 type 2 diabetic patients referred to Yazd Diabetes Research Center were consecutively selected. All Subjects were assessed by questionnaire about other diseases and drugs. Dry eye syndrome was assessed with Tear break up time tests and Schirmer. All the subjects underwent indirect ophthalmoscopy and retinal color photography. DR was graded according to early Treatment Diabetic Retinopathy (ETDRS) criteria. RESULTS: Of 199 subjects, 108 patients (54.3%) suffer from dry eye syndrome. Although dry eye syndrome was more common in older and female patients, this association was not significant. But there was significantly association between dry eye syndrome and duration of diabetes (P = 0.01). Dry eye syndrome was more frequent in diabetic patients with DR (P = 0.02). DR was found in 140 patients (70.35%), which included 34 patients (17.1%) with mild non proliferative DR (NPDR), 34 patients (17.1%) with moderate NPDR, 22 patients (11.1%) with severe NPDR and 25 patients (25.1%) with proliferative DR (PDR). There were significant relation between age, sex and duration of diabetes and DR. CONCLUSION: In this study the prevalence of dry eye syndrome was 54.3%. Diabetes and dry eyes appear to have a common association. Further studies need to be undertaken to establish an etiologic relationship. However, examination for dry eye should be an integral part of the assessment of diabetic eye disease.

Effect of opium addiction on diabetes.

BACKGROUND: Type 2 diabetes is a common disorder that is recognized as a major health problem in Iran. Diabetes is a major cause of morbidity, mortality, and economic burden to the society. Some people believe that smoking opium can reduce serum glucose and lipids in diabetes mellitus. This study was designed to compare blood glucose and lipids in opium addicts with non-addicts among patients with type 2 diabetes. METHODS: In this case, control study subjects were chosen from type 2 diabetic patients. Twenty-three males with type 2 diabetes and addicted to opium were selected as the case group, and 46 patients with no addiction to opioid drugs were chosen as control group. Blood Sugar (BS), glycated hemoglobin (HbA1C), lipids and microalbumin in urine were measured in two groups. RESULTS: Our results showed that the mean FBS and 2-hour post prandial were significantly different between two groups. (P = .04). No significant difference was observed in HbA1C, triglyceride, total cholesterol, LDL, and HDL between the two groups (P > .05). CONCLUSIONS: Our finding showed that while opium might decrease blood glucose temporarily, it had no clear and long-lasting effects on blood glucose, as it had no significant effect on HbA1c.

Effect of vitamin C on blood glucose, serum lipids & serum insulin in type 2 diabetes patients.

BACKGROUND & OBJECTIVE: Diabetes mellitus is one of the most common metabolic disorders that causes micro- and macro-vascular complications. Because of additive effects of hyperglycaemia and hyperlipidaemia for cardiovascular diseases, lipid abnormalities should be evaluated in diabetes. As vitamin C is known for its beneficial effects on serum lipids and glycated haemoglobin (HbA1c), we evaluated the effect of different doses of vitamin C on blood glucose, serum lipids and serum insulin in individuals with type 2 diabetes mellitus. METHODS: A total of 84 patients with type 2 diabetes referred to Yazd Diabetes Research Center, Iran, were included in the study. They received randomly either 500 mg or 1000 mg daily of vitamin C for six weeks. Fasting blood sugar (FBS), triglyceride (TG), total cholesterol (TC), low and high density lipoprotein (LDL, HDL), glycated haemoglobin HbA(Ic) and serum insulin were measured before and after vitamin C consumption and the results were analyzed. RESULTS: A significant decrease in FBS, TG, LDL, HbA1c and serum insulin was seen in the group supplemented with 1000 mg vitamin C. The dose of 500 mg vitamin C, however, did not produce any significant change in any of the parameters studied. INTERPRETATION & CONCLUSION: Our results indicate that daily consumption of 1000 mg supplementary vitamin C may be beneficial in decreasing blood glucose and lipids in patients with type 2 diabetes and thus reducing the risk of complications.

The effects of vitamin D supplementation on adiponectin level and insulin resistance in first-degree relatives of subjects with type 2 diabetes: a randomized double-blinded controlled trial.

BACKGROUND: Despite the certain role of both vitamin D and adiponectin in the regulation of insulin sensitivity, the interaction between these two agents has remained uncertain. OBJECTIVE: The present study aimed to determine whether vitamin D is able to change plasma adiponectin and affect glucose homeostasis and insulin sensitivity in first-degree relatives of subjects with type 2 diabetes. METHODS: This randomized clinical trial was conducted at Clinic of Shahid Sadoughi Hospital in Yazd, Iran, from January 25, 2012 to December 25, 2014. In this randomized, double-blinded controlled trial, 64 first-degree relatives of type 2 diabetic patients were assigned randomly to receive either vitamin D supplement (50000 IU vitamin D tablet weekly) plus lifestyle change as the intervention group (n = 32) or placebo plus lifestyle change as the control group (n = 32) for twelve weeks (three months). RESULTS: Fifty-three patients (28 in the intervention group and 25 in the control group) completed the study. Serum levels of vitamin D increased while insulin level and consequently insulin resistance (calculated by HOMA formula) significantly decreased in the case group (p-value <0.001 for all variables). Although the values of these three biomarkers showed a slight increase in control group, the changes were not statistically significant. The levels of the changes in other markers including adiponectin, Fasting Blood Sugar (FBS), triglyceride, and total cholesterol remained insignificant in both study groups after completing interventions compared with before interventions. CONCLUSION: This study showed that decreased insulin resistance is expected by administrating vitamin D supplement in first-degree relatives of the patients with diabetes mellitus. TRIAL REGISTRATION: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT ID: 201105176430N1. FUNDING: The authors received no financial support for the research or publication of this article.

High prevalence of type 2 diabetes and pre-diabetes in adult Zoroastrians in Yazd, Iran: a cross-sectional study.

BACKGROUND: The prevalence of type 2 diabetes mellitus (T2DM) varies among ethnic groups. We aimed to estimate the prevalence of diagnosed and undiagnosed diabetes mellitus, impaired fasting glucose (IFG), and impaired glucose tolerance (IGT) for the first time in an ethnic population, specifically Zoroastrian citizens in Yazd, Iran whose ages were 30 or older. METHODS: In a cross-sectional study, participants aged≥30 years were selected using systematic random sampling. An inventory, including socio-demographic data, was completed. Weight, height, body mass index (BMI), and blood pressure (BP) were measured using standard methods. Also, blood levels of glucose, triglycerides (TG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), urea, creatinine (Cr), and uric acid were measured. The latest criteria established by the American Diabetes Association (ADA) were used to diagnose DM. RESULTS: The mean age of the participants (n=403) was 56.9±12.8 years. The total prevalence of diabetes, including previously diagnosed and undiagnosed diabetes, IFG, and IGT was 26.1%, 18.6%, 7.5%, 34.7% and 25.8%, respectively. Participants with diabetes had higher fasting blood sugar (FBS) (P<0.001), oral glucose tolerance test (OGTT) (P<0.001), urea (P=0.019), BMI (P=0.001), systolic blood pressures (P<0.001), TG (P=0.007) and lower HDL (P=0.034) than patients with IFG, IGT, and normoglycemic subjects. CONCLUSIONS: The current study showed a high prevalence of T2DM in the Zoroastrian population of Yazd, Iran. One-third of the total cases with diabetes were undiagnosed.

Association between Glutathione S-Transferase GSTM1-T1 and P1 Polymorphisms with Metabolic Syndrome in Zoroastrians in Yazd, Iran.

BACKGROUND: The aim of this study was to assess the possible association between genetic polymorphisms of the glutathione S-transferase (GST) gene family and the risk of the development of metabolic syndrome (MS) in Zoroastrian females in Yazd, Iran. METHODS: In this case-control study, GSTM1, T1, and P1 polymorphisms were genotyped in 51 randomly selected MS patients and 50 randomly selected healthy controls on February 2014 among Zoroastrian females whose ages ranged from 40 to 70 yr. DNA was extracted from peripheral blood. Data were analyzed with SPSS version 17. RESULTS: We observed a significant association of GSTP1-I/V (Isoleucine/Valine) allele and GSTP1-V/V (Valine / Valine) allele with MS (P = 0.047 and P = 0.044, respectively). The combined analysis of the two genotypes, the present genotype of GSTT1, I/V and V/V alleles of GSTP1 genotype demonstrated a decrease in the risk of acquiring MS (OR = 0.246, P = 0.031). The null genotype of GSTM1, I/V, and V/V alleles of the GSTP1 genotype showed a lower risk in double combinations (OR = 0.15, P = 0.028 and OR = 0.13, P = 0.013, respectively). The combinations of the GSTM1 null genotypes and GSTT1 present genotypes and the GSTP1 I/V and V/V alleles together were associated with decreased risk of having MS in triple combinations (OR = 0.071, P = 0.039 and OR = 0.065, P = 0.022, respectively). CONCLUSION: GSTP1-I/V and V/V alleles, alone or in association with GSTM1 null and GSTT1 present genotypes, are related with decreased susceptibility to the development of MS in Zoroastrian females.

Prevalence of vitiligo among type 2 diabetic patients in an Iranian population.

BACKGROUND: Vitiligo is one of many diseases that can be found with diabetes mellitus. Diabetic patients have a high incidence of vitiligo compared to the general population. This study assesses prevalence of vitiligo in type 2 diabetic patients in Iran. METHODS: One thousand one hundred type 2 diabetic patients and 1100 healthy adults were recruited in this cross-sectional study. Patients were evaluated for vitiligo by a dermatologist both clinically and by Wood's lamp. Data were analyzed using SPSS. P value ≤0.05 was considered statistically significant. RESULTS: There was a significant difference between groups with respect to presence of vitiligo; 4.9% of diabetic patients had vitiligo versus 1.8% of control group (P = 0.001). In the female group with diabetes, 5.8% had vitiligo, and in male diabetic patients, 3.9% had vitiligo (P = 0.057). In the control group, 1.8% of females and 1.8% of males had vitiligo that was equal. CONCLUSION: Vitiligo and diabetes may have a causal relationship. Vitiligo may coexist with type 2 diabetes. Therefore it is reasonable to investigate each patient periodically.

Risk of postoperative hypocalcemia in patients underwent total thyroidectomy, subtotal thyroidectomy and lobectomy surgeries.

The main objective of this study was to identify the incidence of post-thyroidectomy hypocalcemia in patients underwent lobectomy, subtotal thyroidectomy or total thyroidectomy. This randomized trial study was performed from May 2010 to July 2011 among 108 consecutive patients undergoing thyroidectomy. Patients were allocated into 3 groups based on the 3 common type of thyroidectomy. Pre and postoperative serum calcium levels were determined by using standard protocol for all patients. All patients' preoperative serum calcium levels were normal. Post-thyroidectomy hypoglycemia occurred in 0%, 8.3% and 8.3% of patients who underwent total hypocalcemia, subtotal thyroidectomy and lobectomy, respectively, which represents 5.6% of all patients who shown hypocalcemia (P=0.58). Serum calcium levels were fall in 93% patients, however within several days were returned to normal ranges. We did not find a significant relation between the hypocalcemia and thyroidectomy types. We recommended determination other alternative factors as a more effective prediction for postoperative hypocalcemia.

Investigating GSTT1 and GSTM1 null genotype as the risk factor of diabetes type 2 retinopathy.

BACKGROUND: Diabetes is one of the multifactorial disorders with genetics and environmental factors playing important role in its cause. In diabetes, the defects in cellular metabolism results in increasing free radicals. These radicals react with other vital cellular molecules which are responsible in diabetes side effects. Human glutathione S-transferases (GST) are a family of enzymes that catalyses conjugation of electrophilic substances with glutathione. In this research the deletion of two of the most important genes of this family; GSTT1 and GSTM1 genes was investigated as the risk factor for diabetes mellitus type II and one of its most important complications; retinopathy. MATERIAL AND METHODS: In this study deletion of GSTT1 and GSTM1 genes in 57 diabetics' patients with retinopathy and 58 diabetic peoples without retinopathy was examined. DNA was extracted from peripheral blood and then multiplex PCR was performed following agarose gel electrophoresis to detect GSTT1 and GSTM1 null genotypes. Data were analyzed with SPSS v16 software. RESULTS: The results indicated that there was significant relationship between GSTM1 null genotype with retinopathy side effect of diabetes type 2. While there was no significant relationship between GSTT1 null genotypes with retinopathy in diabetes type 2. CONCLUSION: Significant correlation between GSTM1 null genotype and retinopathy in this and other studies could indicate this fact that impair cellular metabolism result in increase free radicals and oxidative pressure. Therefore, GST null genotypes may result in decrease antioxidant capacity which causes side effects of diabetes. Considering the performance of different classes of GST null genotypes additional studies are required to confirm this study.

Influence of physiological factors on thyroid size determined by ultrasound.

According to its superficial anatomical location, the thyroid gland is easily accessible by sonography. Sonography allows an exact documentation of the size and thyroid volume. The relationship between thyroid volume and anthropometric characteristics is a matter of controversy. The aim of this study was to investigate thyroid volume and its determinants in healthy adult. A cross-sectional study was performed from June2003 until April 2005 in 314 healthy adults aged over 18 years old in Yazd, Iran. Data were collected on age, sex, and weight and thyroid size by sonography. Mean of thyroid volume in male and female was 9.08 ± 2.49 and 7.93 ± 3.2 milliliter which the differences was significant (P<0.003).Differences between thyroid volume and weight was significant (P=0.001). Mean of female weight and proportion of thyroid volume to their weight was 61.83 ± 12.09kg and 0.130 ± 0.33. Mean of male weight and proportion of thyroid volume to their weight was 71.41 ± 9.05kg and 0.126 ± 0.028 (P<0.003). Results of study is similar to other studies .Mean of thyroid volume in Yazd citizens is not differ from other Iranian but is different from other countries. This difference could be related to food intake habit, geographical region and daily oral iodine consumption.

Incidence and trend of a metabolic syndrome phenotype among Tehranian adolescents: findings from the Tehran Lipid and Glucose Study, 1998-2001 to 2003-2006.

OBJECTIVE: To assess the incidence and trend of the metabolic syndrome phenotype in adolescents from the Tehran Lipid and Glucose Study during 3.6 years of follow-up. RESEARCH DESIGN AND METHODS: A total of 932 adolescents, aged 10-19 years, who had complete data and returned for reassessment 3.6 years later were investigated. RESULTS: Prevalence of metabolic syndrome at baseline and after 3.6 years was 7.4 and 6.7%, respectively, based on the Adult Treatment Panel (ATP) III definitions; 3.5 and 8.0%, respectively, based on the International Diabetes Federation (IDF) definitions; 4.1 and 9.4%, respectively, based on the American Heart Association (AHA) definitions; and 13.6 and 13.4%, respectively, based on the National Health and Nutrition Examination Survey (NHANES) definitions. Incidence rates were 5.2% (95% CI 3-6) based on ATP III, 6.8% (5-8) based on IDF, 8.3% (6-10) based on AHA, and 8.8% (6-10) based on NHANES definitions. CONCLUSIONS: Incidence of metabolic syndrome is high in Tehranian adolescents.

Iron status in women with and without gestational diabetes mellitus.

OBJECTIVE: Gestational diabetes mellitus (GDM) affects approximately 7% of all pregnancies. Pregnancy, mostly because of the mitochondria-rich placenta, is a condition that favors oxidative stress. A transitional metal, especially iron, which is particularly abundant in the placenta, is important in the production of free radicals. Also, studies have shown that free radicals have a role in GDM. As there are little data about iron status in GDM, this study was performed to compare iron status in GDM and control group. RESEARCH DESIGN AND METHODS: In this case-control study, 34 women with diagnosed GDM were compared with 34 non-GDM women in the control group at 24-28 weeks of pregnancy in terms of iron status, including ferritin, serum iron, total iron-binding capacity (TIBC), hemoglobin (Hb), mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH). RESULTS: In this study, concentration of serum ferritin, iron, transferrin saturation and hemoglobin, MCV, and MCH was significantly higher in the GDM group and TIBC was significantly lower in this group (P<.05). No significant association was observed with the other variables including familial history of diabetes and GDM. CONCLUSION: Our findings indicate an association between increased iron status and GDM. The role of iron excess from iron supplementation in the pathogenesis of GDM needs to be examined.

Effects of sour tea (Hibiscus sabdariffa) on lipid profile and lipoproteins in patients with type II diabetes.

OBJECTIVES: There is increasing evidence that intake of sour tea (Hibiscus sabdariffa) has hypoglycemic and hypolipidemic effects and may benefit patients suffering from metabolic disorders such as diabetes. The objective of the present study was to investigate the hypolipidemic effects of sour tea in patients with diabetes and compare them with those of black tea. DESIGN: In this sequential randomized controlled clinical trial, 60 patients with diabetes were recruited and randomly assigned into two groups: sour tea (ST) and black tea (BT). They were instructed to consume sour tea or black tea two times a day for 1 month. OUTCOME MEASURES: Fasting blood samples were taken at the beginning and at the end of the study for evaluation of lipids, lipoproteins, and apoproteins. RESULTS: Fifty-three (53) patients concluded the study. In the ST group, mean of high-density lipoprotein-cholesterol (HDLc) increased significantly (p = 0.002) at the end of the study, whereas changes in apolipoprotein-A1, and lipoprotein (a) were not significant. Also, a significant decrease in the mean of total cholesterol, low density lipoprotein-cholesterol, triglycerides, and Apo-B100 were seen in this group. In the BT group, only HDLc showed significant change (p = 0.002) at the end of the study and changes in the other measures were not statistically significant. CONCLUSIONS: The results of the present study showed that ST has a significant effect on blood lipid profile in patients with diabetes.

Relationship between Anti-Thyroid Peroxidase Antibody and Thyroid Function Test.

BACKGROUND: Anti-thyroid peroxidase antibody (anti-TPO antibody) is a member of thyroid autoantibodies which are important in inducing and also diagnosing autoimmune thyroid diseases. Thyroid autoimmunity can cause several forms of thyroiditis and abnormal thyroid functions, ranging from hypothyroidism to hyperthyroidism. OBJECTIVE: To evaluate the relationship between serum levels of anti-TPO antibody and thyroid function test parameters (T3, T4, and TSH) in patients with thyroid disease. METHODS: In 2425 subjects suspected of having thyroid disease referred to Yazd central medical laboratory by physicians during a 2 year period, the concentrations of serum anti-TPO antibody (ELISA) and T3, T4, and TSH (RIA) were measured. RESULTS: 53.53% of the patients were 20 to 39 years old. 2135 patients (88.04%) were female and 290 (11.96%) were male. The levels of T3, T4, and TSH in individuals with normal and raised anti-TPO antibody titers was significantly different (p<0.0001). A correlation between TSH and T4 levels and abnormal anti-TPO antibody was detected (p=0.002). CONCLUSION: Our results confirm the correlation between thyroid function test and anti-TPO antibody values, indicating the clinical significance of this antibody and suggesting a through clinical examination and follow up of individuals with high anti-TPO antibody titer.