Primary adrenal insufficiency and myocarditis in COVID-19 disease: a case report.

BACKGROUND: COVID-19 has different manifestations from respiratory to GI problems, and some of them are more common, but some are rare. Reporting rare cases can significantly advance our understanding of the disease. CASE PRESENTATION: In this case, we report an 18-year-old teenage boy with chest pain and resistant hypotension following COVID-19 infection, finally diagnosed as primary adrenal insufficiency and COVID-19 myocarditis. CONCLUSION: Adrenal insufficiency can be life-threatening due to its adverse effects on hemodynamic and electrolyte equilibrium. In addition, COVID-19 induced myocarditis can make the situation more complicated.

Changes in the size of the thyroid in patients with benign non-toxic multinodular goiter after radioactive iodine therapy.

Background: Multinodular goiter (MNG) is regarded as one of the most common causes of hyperthyroidism, particularly in areas of mild-to-moderate iodine deficiency. The present study aims to explore the effects of the radioactive iodine (RAI) therapy on benign non-toxic MNG and evaluate its side effects. Methods: Patients with benign non-toxic MNG entered the study. Ultrasonography was applied to calculate the percentage of the decrease in the size of the thyroid before and six months minimum after the treatment. Chi-square, Mann-Whiteny-U and T-test were done using SPSS v.18.0 (p<0.05). Results: The volumes of the thyroid lobes and nodules decreased significantly due to RAI therapy (p<0.001). The total volume of the thyroid, volume of the right nodule, and volume of the left nodule decreased by 77.8%, 40.7%, and 34.6% respectively. Conclusion: According to the results of the current study, RAI therapy is an effective treatment method although it has short-term side effects. This treatment option is recommended for patients with benign non-toxic MNG, notably those who cannot be a candidate for surgery. This treatment affects the size of the thyroid and its nodules significantly and decreases almost all of the complications.

Comparison of adjunctive therapy with metformin and acarbose in patients with Type-1 diabetes mellitus.

OBJECTIVE: All the aforementioned data have stimulated interest in studying other potential therapies for T1DM including noninsulin pharmacological therapies. The present study attempts to investigate the effect of adjunctive therapy with metformin and acarbose in patients with Type-1 diabetes mellitus. METHOD: In a single-center, placebo-controlled study (IRCT201102165844N1) we compared the results of two clinical trials conducted in two different time periods on 40 patients with Type-1 diabetes mellitus. In the first section, metformin was given to the subjects. After six months, metformin was replaced with acarbose in the therapeutic regimen. In both studies, subjects were checked for their BMI, FBS, HbA1C, TGs, Cholesterol, LDL, HDL, 2hpp, unit of NPH and regular insulin variations. RESULTS: Placebo-controlled evaluation of selected factors has showna significant decrease in FBS and TG levels in the metformin group during follow up but acarbose group has shown substantial influence on two hour post prandial (2hpp) and regular insulin intake decline. Moreover, Comparison differences after intervention between two test groups has shown that metformin has had superior impact on FBS and HbA1C decline in patients. Nonetheless, acarbose treatment had noteworthy influence on 2hpp, TGs, Cholesterol, LDL, and regular insulin intake control. CONCLUSION: The results of this experiment demonstrate that the addition of acarbose or metformin to patients with Type-1 diabetes mellitus who are controlled with insulin is commonly well tolerated and help to improve metabolic control in patients.

Association of meat and dairy consumption with normal weight metabolic obesity in men: the Qazvin Metabolic Diseases Study.

BACKGROUND: Insulin resistance (IR) is not limited to obese individuals. Normal weight individuals may also be insulin resistant. The aim of this study was to determine the association of lifestyle and diet patterns with IR in normal weight Iranian men. METHODS: This cross-sectional study was conducted in 232 men with a body mass index lower than 25 kg/m(2) (aged 20-72 years old) between September 2010 and April 2011 in Qazvin, Iran. Metabolically obese normal weight (MONW) was defined as IR using the homeostatic model assessment (HOMA). The optimal cut point to diagnose IR was the 80th percentile of HOMA-IR values in normal subjects. The HOMA-IR cut point was 2.48. Dietary pattern was assessed by a semi-quantitative food frequency questionnaire. Data were analyzed using backward logistic regression and ANCOVA. RESULTS: Fat and meat consumption and energy intake in subjects with MONW were more than subjects without MONW. Each serving of meat consumption was associated with three times increased risk of MONW (OR: 3.06), while each serving of dairy consumption was associated with 56 % lower risk of MONW with borderline significance (OR: 0.64). Adjusted mean of HOMA-IR in the first tertile of dairy consumption was significantly higher than other tertiles. Adjusted HOMA-IR value in the third tertile of meat consumption was significantly higher than the second tertile. CONCLUSION: Higher meat consumption was associated with MONW in men. Higher meat consumption and lower dairy consumption were associated with higher means of HOMA-IR.

Effect of vitamin D administration in vitamin D-deficient pregnant women on maternal and neonatal serum calcium and vitamin D concentrations: a randomised clinical trial.

There are several studies in which a correlation between maternal vitamin D deficiency and serum mineral disorders in the mother and the newborn has been reported. The present randomised clinical trial was designed to investigate the effect of vitamin D administration on maternal and fetal Ca and vitamin D status. The trial was carried out on 160 pregnant women. Vitamin D-deficient (25-hydroxyvitamin D (25(OH)D) < 30 ng/ml) pregnant women were recruited at 26-28 weeks of pregnancy. In the control group, a multivitamin supplement containing 400 IU vitamin D3/d was given. Patients in the treatment group were treated with 50 000 IU vitamin D3 weekly for a total duration of 8 weeks. At delivery, maternal and fetal Ca and 25(OH)D levels in both groups were compared. In total, 81 % of pregnant women were vitamin D deficient. At the time of delivery, Ca and vitamin D levels were higher in the treatment group compared with the control group (92 (SD 3) v. 85 (SD 4) mg/l, respectively, P= 0·001 for serum Ca; 47·8 (SD 11·1) v. 15·9 (SD 6·6) ng/ml, respectively, P< 0·001 for vitamin D). At the time of delivery, 32·7 % of women in the control group had hypocalcaemia, while no hypocalcaemic case was detected in the vitamin D-treated group. Mean neonatal serum 25(OH)D was higher in the treatment group compared with the control group (27·7 (SD 5·2) v.10·9 (SD 4·4) ng/ml, respectively, P< 0·01). The neonatal Ca level in the treatment group was significantly higher than that of the control group (99 (SD 3) v. 91 (SD 3) mg/l, respectively, P< 0·001). The administration of vitamin D to pregnant women with vitamin D deficiency improves both maternal and neonatal Ca levels.

A Case Report of Cushing's Disease Presenting With Psychosis and Muscle Weakness Postpartum.

Cushing's syndrome is a condition leading to overproducing of cortisol by the adrenal glands. If the pituitary gland overproduces cortisol, it is called Cushing's disease. Cushing's syndrome and even Cushing's disease during and after pregnancy are rare events. There is not enough literature and guidance for managing and treating these patients. The diagnosis of Cushing's syndrome in pregnancy is often delayed because the symptoms overlap. We presented a thin 31-year-old woman, admitted 2 months after a normal-term delivery, with an atypical presentation of Cushing's disease, unusual clinical features, and a challenging clinical course. She had no clinical discriminatory features of Cushing's syndrome. Given that the patient only presented with psychosis and proximal myopathy and had an uncomplicated pregnancy, our case was considered unusual. The patients also had hyperpigmentation and severe muscle weakness which are among the less common presentations of Cushing's syndrome. Our findings suggest that an early diagnosis of Cushing's disease is important in pregnancy period for its prevalent fetal and maternal complications, and it should be treated early to optimize fetal and maternal outcomes as there is an increasing trend toward live births in treated participants.

Complications in patients with transfusion dependent thalassemia: A descriptive cross-sectional study.

Background and Aims: One of the most common hemoglobinopathies globally related to blood transfusion and iron overload in the body is thalassemia syndrome. Increasing ferritin levels can cause severe damage to the patient's body organs. This study aims to evaluate the complications of iron overload on vital body organs in patients with transfusion-dependent beta-thalassemia. Methods: This descriptive cross-sectional study was performed in Iran University of Medical Sciences Hospitals on patients with a beta-thalassemia major with frequent blood transfusions. To evaluate the effect of iron overload on vital body organs, hematologic and blood analysis, echocardiography with measurement of pulmonary artery pressure (PAP) and ejection fraction (EF) tests, bone densitometry, and audiometric tests were performed for all patients. Results: Of the 1010 patients participating in this study, 497 (49%) were males, 513 were (51%) females aged 5-74 years, and the majority of participants (85%) were over 20 years old. This study demonstrated that increasing ferritin levels had no notable correlation with sex, cholesterol, low-density lipoprotein, parathyroid hormone, T4, and aspartate aminotransferase. However, elevating ferritin levels had significant correlations with increasing triglyceride, phosphorus, thyroid stimulating hormone, alkaline phosphatase, alanine transaminase, and PAP levels, age, hearing disorders, splenectomy, osteoporosis, and decreasing high-density lipoprotein, body mass index, calcium, and EF levels. Conclusion: Improvement in beta-thalassemia patients' survival and quality of life can be due to multidisciplinary care in a comprehensive unit through regular follow-up and early complication detection.

The efficacy of licorice root extract in decreasing transaminase activities in non-alcoholic fatty liver disease: a randomized controlled clinical trial.

This study was performed to investigate the effects of licorice on non-alcoholic fatty liver disease (NAFLD). In this double blind randomized clinical trial, 66 patients were divided into case and control groups. All patients had elevated liver enzymes and had increased liver echogenicity (lipid accumulation) on sonography. The case group was treated with one capsule containing 2 g aqueous licorice root extract per day for 2 months while the control group was treated in the same manner with a placebo. Weight, body mass index (BMI) and liver transaminase levels were measured for each patient before and after the study. In the case group, the mean alanine aminotransferase (ALT) level decreased from 64.09 to 51.27 IU/mL and the aspartate aminotransferase (AST) level decreased from 58.18 to 49.45 IU/mL, which were statistically significant (p < 0.001 and p < 0.001). But in the control group, a drop in the ALT and AST levels was not statistically significant. The BMI difference before and after the study was not statistically significant in both groups. Despite the significant drop in liver enzymes following administration of licorice root extract, it is recommended that further studies that include histological examination are necessary.

Effect of metformin and pioglitazone treatment on cardiovascular risk profile in polycystic ovary syndrome.

AIM: to compare the effectiveness of metformin and pioglitazone in ameliorating insulin resistance and cardiovascular risk factors in women with polycystic ovary syndrome (PCOS). METHODS: this study was a randomized clinical trial to compare treatment with metformin and pioglitozone. Fifty two women with PCOS aged 20-45 years were randomly allocated to one of the two treatment groups. All patients underwent clinical and biochemical evaluation and analyses involving these measures which consisted of repeated measures MANOVA using the pre- and post-intervention fasting blood sugar (FBS), lipid profiles, body mass index (BMI), serum insulin in two groups. RESULTS: weight and BMI were significantly decreased in metformin group but not in case of pioglitazone. FBS, serum triglycerides, total cholesterol were all reduced significantly by both metfomin and pioglitazone. Insulin resistance measured by homeostasis model assessment (HOMA) method was significantly decreased in both treatment groups (P<0.05). There were no significant differences between treatments in most of variables except BMI. CONCLUSION: these results suggest pioglitazone is as effective as metformin in improving insulin sensitivity and some cardiovascular risk biomarkers but it has no significant effect on reducing BMI and body weight.

Evaluate the prevalence of depression in type 2 diabetics with microvascular complications.

INTRODUCTION: Diabetes is one of the most common diseases in the world that is accompanied with many microvascular complications. Any chronic disease such as diabetes can cause types of mood disorders such as depression in patients. The aim of this study was to evaluate the prevalence of depression in type 2 diabetics with microvascular complications. EXECUTION METHOD: In this cross-sectional study, type 2 diabetics with microvascular complications that referred to Hazrat Rasoul Akram Hospital during 2016-2017 were studied. After verification of retinopathy and nephropathy in patients, 100 patients were enrolled in the study and correlated between variables such as age, sex, body mass index, medication, education, retinopathy, nephropathy, marital status, hemoglobin A1c (HbA1c), triglyceride, low-density lipoprotein (LDL) and high-density lipoprotein (HDL), blood pressure, and fasting blood sugar was investigated in patients given the possibility of depression. RESULTS: The results of this study showed that 72% of patients were with depression and by evaluating the mentioned variables with depression disorder it was found that there was a significant relationship between fasting blood sugar, HbA1C, retinopathy, medication, and LDL with depression. CONCLUSION: Given the high prevalence of depression (72%) in diabetics in this study, it seems that psychiatric consultation is needed to diagnose depression in diabetics.

Application of modified electrospun nanofiber membranes with α-Fe2O3 nanoparticles in arsenate removal from aqueous media.

In the present study, electrospun nanofiber membranes (ENMs) of polyacrylonitrile (PAN) were modified by dispersing α-Fe2O3 nanoparticles, synthesized using a thermal solvent process, in a PAN solution. The morphology and physiochemical properties of the prepared ENMs and the α-Fe2O3 were characterized using FESEM, EDX, BET, XRD, FTIR, porosity, and contact angle measurement. XPS was used to investigate the interaction of ENM with arsenate (As(V)) during the adsorption. Moreover, the effect of pH, the equilibrium isotherm, and the kinetics were investigated in batch experiments. The Langmuir isotherm best correlated the experimental results, indicating monolayer adsorption on ENMs, and the kinetics was best fitted, R2 > 0.99, by the pseudo-second-order model. In addition, the effects of certain conditions on the filtration performance were examined, such as feed concentration and transmembrane pressure (TMP). By passing sodium hydroxide (0.1 M) for 20 min, the membrane was regenerated. The increase in TMP, along with the presence of co-ions including chloride, nitrate, and sulfate, had negative impacts on the removal of As(V). The results show that the modified ENMs with α-Fe2O3 nanoparticles are applicable for As(V) ion removal and possibly for eliminating other heavy metals from aqueous media.

Ultrasonographic versus fluoroscopic access for percutaneous nephrolithotomy: a randomized clinical trial.

PURPOSE: Achieving access to the pyelocaliceal system in percutaneous nephrolithotomy (PCNL) is routinely performed using fluoroscopic guidance. We compared ultrasonography-guided access for PCNL with conventional fluoroscopy-guided access. PATIENTS AND METHODS: In a clinical trial, 100 patients with no abnormality of the upper urinary tract were selected from among candidates for PCNL and randomly assigned to two 50-patient groups: ultrasonography-guided access (group 1) versus fluoroscopy-guided access (group 2). In group 1, location of the target calix was identified in the transverse and sagittal planes by real-time ultrasonography when patients were in the prone position. Puncture of the target calix was attempted with a Chiba needle attached to the side of the ultrasound probe. If access to the collecting system was achieved, the site of puncture was controlled using fluoroscopy. In group 2, access was achieved using fluoroscopy guidance. Tract dilatation and stone extraction were the same in both groups. The mean age of patients was 40.7 +/- 12 years and 41.6 +/- 13.7 years in groups 1 and 2, respectively (P = 0.4). The male to female ratio in groups 1 and 2 was 34/16 and 31/19, respectively (P = 0.5). RESULTS: On average, duration of access was 11 +/- 3.5 minutes and 5.5 +/- 1.7 minutes in groups 1 and 2, respectively (P = 0.0001). Duration of radiation exposure, on average, was 0.69 +/- 0.26 minutes and 0.95 +/- 0.44 minutes in groups 1 and 2, respectively (P = 0.0001). CONCLUSION: Access for PCNL using ultrasonography guidance is an acceptable alternative to fluoroscopy and decreases radiation hazards.

Attempted suicide among Iranian population.

Predictors of suicide attempts in Iran, to distinguish any similarities and differences of these predictors between suicide attempts in Iran and other developed and developing countries and to investigate the relation between general psychiatric symptoms and repetition of suicidal attempts were assessed. The validated Farsi version of the General Health Questionnaire-28 (GHQ-28) was used to assess multiple dimensions of quality of life of suicide attempters as depression, anxiety, social dysfunction, and somatic symptoms. Pivotal differences emerged in the clinical profiles of suicide attempters living in a developing country versus developed countries. In developing countries, those who attempt suicides are more likely to have no psychiatric disorder and are less likely to have used alcohol as part of the suicide attempt, but are more likely to have been assaulted physically or verbally. The results on the GHQ-28 indicate that the process through which individuals move from suicidal thought to action may decrease multiple dimensions of quality of life.

Awareness of osteoporosis among female head of household: an Iranian experience.

More than 81% of the studied women had a poor knowledge of different aspects of osteoporosis and its complications, suggesting that more educational programs targeting women in particular are needed to help improve the osteoporosis practice in the societies and reduce the burden of the disease. PURPOSE: The family structure has changed considerably in the past decade. But, women from Iran and many countries in the region and even families with similar cultural background living in other parts of the world are still responsible for childcare as well as the lifestyle adapted by the family. The present study was conducted to assess the awareness of the female head of household of osteoporosis and its complications. METHODS: As part of a population-based study in two Iranian cities, Arak and Sannandaj, to study osteoporosis and its risk factors, a questionnaire on the knowledge of female head of households of osteoporosis and its complications was completed. The subsample filled out the knowledge survey along with the questionnaire on their demographic data, socioeconomic status (SES), reproductive factors, bone-related lifestyle habits, family and personal medical history, medication use, and compliance with osteoporosis medication (if used) as well as a FFQ filled out for all the 2100 participants. They also underwent a bone mineral density (BMD) test, and their serum levels of vitamin D were calculated. These data were then used to assess the factors affecting their awareness level. RESULTS: The knowledge of 81.3% (473) of the studied women was found to be poor on different aspects of osteoporosis and its complications. Multivariate analysis revealed that each level increase in vit D intake tertile increases the chance of higher awareness level in K-Total by 1.5 times. Each level increase in physical activity tertile was associated with a 30.6% lower chance of having a good knowledge. CONCLUSION: Considering the poor awareness level of the studied women and their poor practice of bone healthy behavior, one could conclude that more programs are needed or the content/delivery style of the existing ones should be optimized.

Association of sleep quality components and wake time with metabolic syndrome: The Qazvin Metabolic Diseases Study (QMDS), Iran.

PURPOSE: The aim of this study was to determine the association of sleep quality and sleep quantity with metabolic syndrome in Qazvin, Iran. METHODS: this cross sectional study was conducted in 1079 residents of Qazvin selected by multistage cluster random sampling method in 2011. Metabolic syndrome was defined according to the criteria proposed by the national cholesterol education program third Adult treatment panel. Sleep was assessed using the Pittsburgh sleep quality index (PSQI). A logistic regression analysis was used to examine the association of sleep status and metabolic syndrome. RESULTS: Mean age was 40.08±10.33years. Of 1079, 578 (52.2%) were female, and 30.6% had metabolic syndrome. The total global PSQI score in the subjects with metabolic syndrome was significantly higher than subjects without metabolic syndrome (6.30±3.20 vs. 5.83±2.76, P=0.013). In logistic regression analysis, sleep disturbances was associated with 1.388 fold increased risk of metabolic syndrome after adjustment for age, gender, and body mass index. CONCLUSION: Sleep disturbances component was a predictor of metabolic syndrome in the present study. More longitudinal studies are necessary to understand the association of sleep quality and its components with metabolic syndrome.

Association of hematological indices with prediabetes: A cross-sectional study.

BACKGROUND: Prediabetes is a condition that occurs when blood glucose levels are higher than normal, but not high enough to be classified as diabetes. Prediabetic people have an increased risk of developing type 2 diabetes and cardiovascular disease. Moreover Hyperglycemia has multiple effects on the hematological parameters. OBJECTIVE: To examine the association between hematological indices and anthropometric measurement, with prediabetes. METHODS: This cross-sectional study was conducted on 125 diabetics and 259 prediabetics in the 20-70 age range. They were selected by a convenience sampling method at the Taban Diabetes Center in 2015. An oral glucose tolerance test was performed for each participant who had never been diagnosed with diabetes. Participants were characterized as having prediabetes or diabetes according to American Diabetes Association criteria. The hematologic parameters were measured by using Sysmex-KX 21N analyzers. Data were analyzed by IBM-SPSS version 22 using independent-samples t-test, Mann-Whitney U test, and Pearson's correlation coefficient at p<0.05. RESULTS: There was significant difference in mean corpuscular hemoglobin concentration (MCVH) (33.81±0.92 g/dL vs. 34.06±1.05 g/dL) between prediabetes patients and diabetes. There was not a statistically significant difference in the prediabetics' hematological parameters, compared with the diabetics. In the prediabetic group, only the mean corpuscular hemoglobin concentration was found to be negatively correlated with diastolic blood pressure (p=0.013) and FBS (p=0.026). CONCLUSION: Hematological indices are important markers for the assessment of variations in size, number, and maturity of different blood cells. Hematological indices could be utile indicators of vascular complication and glycemic control in type 2 DM patients. Thus, they are important for the evaluation and early management of patients with per diabetes.

Association of Sleep Quality and Waking Time with Prediabetes: The Qazvin Metabolic Diseases Study, Iran.

Aims. It is known that sleep has a major role in the regulation of endocrine functions and glucose metabolism. However, it is not clear whether the sleep pattern is affected at or prior to the onset of diabetes, among those with prediabetes. The purpose of this study was to determine the association of sleep patterns and prediabetes in Qazvin, Iran. Methods. A representative sample of residents of Qazvin was selected by multistage cluster random sampling method in 2011. Plasma glucose level and sleep quality were measured cross-sectionally as well as demographic characteristics. A logistic regression analysis was used to examine the association of sleep status and prediabetes. Results. Mean age was 39.3 ± 10.1 years. Of 958, 474 (49.47%) were female. Poor sleep quality was associated with 2.197-fold increased risk of prediabetes after adjustment for age, gender, body mass index, and metabolic syndrome. Conclusion. This study provides evidences that subjects with poor sleep quality are more likely to develop prediabetes than people with good sleep quality.

The threshold value of homeostasis model assessment for insulin resistance in Qazvin Metabolic Diseases Study (QMDS): assessment of metabolic syndrome.

BACKGROUND: The homeostasis model assessment of insulin resistance (HOMA-IR) is a useful model for application at large epidemiologic studies. The aim of this study was to determine the HOMA cut off values to identify insulin resistance (IR) and metabolic syndrome (MS) in Qazvin, central Iran. METHODS: Overall, 480 men and 502 women aged 20-72 yr attended in this cross sectional study from September 2010 to April 2011. The diagnostic criteria proposed by national cholesterol education program third adult treatment panel (ATPIII), International Diabetes Federation (IDF) and new Joint Interim Societies (JIS); were applied to define MS. Lower limit of the top quintile of HOMA values in normal subjects was considered as the threshold of IR. The receiver operating characteristic (ROC) curves of HOMA for MS diagnosis were depicted. The optimal cut point to determine MS was assessed by maximum Youden index and the shortest distance from the point (0, 1) on the ROC curve. RESULTS: The threshold of HOMA for IR was 2.48. Fifty one percent of the subjects were insulin resistant. The cut point for diagnosis of JIS, IDF, ATP III and Persian IDF defined MS was 2.92, 2.91, 2.49 and 3.21, respectively. Sensitivity and specificity of ATP III defined MS to diagnose IR was 33.95% and 84.78%, of IDF defined MS was 39.13%, 81.29% and of JIS defined MS was 43.77% and 78.11% and of Persian IDF defined MS was 27.32% and 88.76%, in that order. CONCLUSIONS: The high prevalence of IR in the present study warns about the future burden of type 2 diabetes. Only the ATP III criteria introduced more specific cut point for putative manifestations of IR.

Association of serum 25-hydroxyvitamin d levels and vitamin D dietary intake with metabolic syndrome: a case control study.

BACKGROUND: Association between the vitamin D deficiency and metabolic syndrome (MetS) has previously been noted and reported to be controversial. The aim of this study was to determine the association of serum 25 (OH) D Level and Vitamin D dietary intake with MetS among Iranian population. METHODS: This analytical study was conducted on 122 patients with MetS based on the ATPIII criteria and 128 subjects without MetS as control from September 2010 to April 2011. Serum levels of calcium, phosphorus and 25(OH) D were compared between the two groups. A food frequency questionnaire (FFQ) was used to calculate dietary intake. Data were analyzed using Chi- square test, t-test, Mann-Whitney U test and logistic regression analysis. RESULTS: Serum concentrations of 25 (OH) D, calcium and phosphorus and calcium intake were significantly lower in subjects with MetS compared to the subjects without MetS. 98.4% of subjects with MetS and 88.3% without MetS had Vit. D deficiency and this difference was statistically significant (P=0.005). In regression analysis, lower concentration of serum 25 (OH) D, calcium and phosphorus and lower calcium and diary intake were predictors of MetS. CONCLUSIONS: Serum 25 (OH) D Level, calcium and phosphorus and calcium intake are associated with metabolic syndrome. However, the mechanism of this association requires further studies.

Serum Phospholipase A2-IIA, hs-CRP, and Lipids in Women With Subclinical Hypothyroidism.

BACKGROUND: Subclinical hypothyroidism (SCH) is a metabolic disorder characterized by elevated TSH level but normal T4 level. Some previous studies suggest that SCH is associated with inflammation. OBJECTIVES: The present study aimed to compare lipid serum levels in SCH patients and normal participants, also explore possible association between SCH and the two inflammatory markers hs-CRP and PLA2-IIA. PATIENTS AND METHODS: This study was performed on 77 women aged 20-45 (39 with SCH and 38 in the control group). TSH and T4 levels were measured by electrochemiluminescenceassay. Lipid profiles were analyzed using enzymatic-colorimetric methods. Hs-CRP and PLA2-IIA were determined using the ELISA method. IBM SPSS 19.0 was used for statistical analysis. RESULTS: Serum levels of TG, cholesterol, and LDL were higher in the SCH group than the control group. However, there was no significant difference between the two groups for HDL level. Likewise, no difference was observed for the serum level of hs-CRP. PLA2-IIA mean value was higher in the SCH group. CONCLUSIONS: SCH is associated with increased level of PLA2-IIA, which is independent of BMI. The stronger association of SCH with PLA2-IIA than with hs-CRP indicates that PLA2-IIA is an inducer of inflammation while hs-CRP is not.