Is There a Relation between Hypothyroidism and Polycystic Ovary Syndrome and its Metabolic Components?

BACKGROUND: Polycystic Ovary Syndrome (PCOS) is one of the most prevalent endocrine illnesses among women of reproductive age. PCOS is linked to several issues, including hypothyroidism and metabolic disorders. Hypothyroidism seems to be associated with insulin resistance and other metabolic factors. OBJECTIVE: The present study aimed to evaluate the incidence of hypothyroidism in PCOS patients and compare it with healthy controls. Moreover, the impact of hypothyroidism on metabolic parameters, particularly insulin resistance, in PCOS patients was also examined. METHODS: This study was conducted on 41 women with PCOS and 41 healthy women as controls from March to November, 2018. Participants' demographic information was recorded. Thyroid function tests were compared between the case and control groups. Metabolic parameters were examined between hypothyroid and euthyroid PCOS individuals. RESULTS: Patients with PCOS displayed a greater incidence of hypothyroidism and a higher level of anti-thyroid peroxidase antibodies compared to the control group. High-density lipoprotein (HDL) cholesterol was substantially higher in hypothyroid PCOS patients than in non-hypothyroid individuals, although no significant changes were observed in other metabolic markers. Hypothyroid PCOS patients and those without hypothyroidism did not differ in insulin resistance. Autoimmunity was not found to be linked to a higher risk of metabolic problems. CONCLUSION: As evidenced by the results of this study, PCOS patients had a higher prevalence of subclinical hypothyroidism than healthy subjects. Metabolic indicators, except for HDL, were not different between PCOS patients with and without hypothyroidism.

Effect of crocin on diabetic patients: A placebo-controlled, triple-blinded clinical trial.

OBJECTIVE: The purpose of this study was to evaluate the effect of Saffron and its active ingredient, crocin, as a natural antioxidant in the treatment of type II diabetes. METHODS: A total of 150 uncontrolled type 2 (non-insulin-dependent) diabetic patients were selected based on inclusion criteria, randomly divided into three groups (crocin, saffron and placebo) for three months' clinical trial. Fasting blood glucose (FBS), insulin level, glycosylated hemoglobin (HbA1c), lipid profile, kidney and liver function tests were performed before and three months after the study. The patients were followed every two weeks for possible clinical side effects. RESULTS: Our results showed that after three months of treatment with crocin and saffron, FBS reduction was significant in all groups (P-value < 0.05). In addition, reduction of HbA1c was significant in the crocin and saffron groups compared to placebo group. Comparison between groups showed that treatment with crocin and saffron led to a significant reduction in HbA1c than placebo, and FBS level significantly reduced only in crocin compared to saffron and placebo groups. In addition, changes in lipid profile were not significant in any of the three groups. Also, there was no significant difference in liver and liver parameters in all three groups. Inter-group comparison of insulin levels showed significant difference only between the saffron and placebo groups. CONCLUSION: Crocin can be effective in controlling the level of FBS and HbA1c in patients with type 2 diabetes.

The Prognostic Role of Metabolic and Endocrine Parameters for the Clinical Severity of COVID-19.

OBJECTIVE: An outbreak of coronavirus disease-19 (COVID-19) began in December 2019 and spread globally, overwhelming the entire world. COVID-19 is a public health emergency of international concern. Due to its high morbidity and mortality rate, recognition of its risk and prognostic factors is important. We aimed to understand the relationship between metabolic and endocrine parameters and the prognosis of COVID-19. METHODS AND MATERIALS: This was a cross-sectional clinical study. A total of 70 patients with severe COVID-19 were enrolled. Laboratory results at the first admission time (including complete blood count, C-reactive protein, lactate dehydrogenase, blood glucose, calcium, phosphate, albumin, creatinine, magnesium, lipid profiles, liver enzymes, thyroid hormones, cortisol, and vitamin D) and outcome data were recorded. We divided patients into (1) intensive care unit- (ICU-) admitted and non-ICU-admitted and (2) survivors and nonsurvivors for estimation of severity and prognosis. We determined the risk factors associated with critical illness and poor prognosis. RESULTS: Patients with higher white blood cell (WBC) count and phosphate levels had significantly higher ICU admission rates. According to univariate analysis, serum levels of T3, phosphate, and WBC as well as the duration of hospitalization were associated with mortality. Multivariate analysis revealed that only WBC and duration of hospitalization were independent predictors for mortality rate in COVID-19 patients. CONCLUSION: Our findings suggest that longer duration of hospitalization and higher WBC count are associated with poor outcomes in patients with COVID-19.

Assessment of insulin resistance in patients with primary hyperparathyroidism before and after Parathyroidectomy.

BACKGROUND: Primary hyperparathyroidism (PHPT) can lead to renal and skeletal disorders, as well as insulin resistance and impaired glucose metabolism. The current study aimed to assess the effects of parathyroidectomy on insulin resistance in patients with PHPT. MATERIALS AND METHODS: The present study was conducted on 65 patients with PHPT and indications for parathyroidectomy who were referred to the endocrinology clinics of Mashhad University of Medical Sciences. Thereafter, the demographic characteristics of the patients were recorded. Blood tests, including haemoglobin A1c (HbA1c), fasting blood glucose (FBG) and insulin levels, were assessed one week before and three months after the surgery. The insulin resistance score (HOMA-IR) was calculated and compared using the relevant formula. RESULTS: A total of 65 participants with a mean age of 45.44 ± 9.59 years were included in the current study. In one-month postoperative tests, mean scores of FBG (p < .05), insulin level (p < .05) and HbA1c (p < .05) were significantly reduced. Moreover, the HOMA-IR index decreased in 51 patients after the surgery. CONCLUSION: According to our findings, parathyroidectomy can be effective in the reduction of insulin resistance and corresponding complications in patients with PHPT in the present short-term study. However, it has yet to be confirmed as a treatment method for insulin resistance in these patients. Future long-term studies are required to be done to investigate the effect of parathyroidectomy on insulin resistance.

Necessity of Fine-Needle Aspiration in Probably Benign Sonographic Appearance of Thyroid Nodules.

INTRODUCTION: The management of thyroid nodules has been proposed based on US features and information obtained from Fine-Needle Aspiration Cytology (FNAC). In this study, we checked the diagnostic value of ultrasound in comparison with FNAC in probably benign nodules of thyroid. MATERIALS AND METHODS: Patients with thyroid nodules referred to the Radiology department from 2015 to 2020, were classified into five types based on the American College of Radiology/thyroid imaging reporting and data system (TI-RADS) standards. The patients with TI-RADS III-V were examined by FNA biopsy. Subsequently, the collected data of 535 patients having thyroid nodules with TI-RADS III were statistically analyzed. RESULTS: The mean age of the patients was estimated at 46.57. The analysis of TI-RADS III cases examined by the FNA biopsy revealed that 99.1% of the cases were diagnosed with benign lesions. The mean size of benign and malignant nodules was 27mm and 41mm, respectively. There was no significant correlation between the size of the nodules or patients age, and thyroid malignancy (P-values > 0.05). CONCLUSION: There was a very low chance of malignancy (0.9%) in thyroid nodules with thyroid imaging classification of TI-RADS III. Furthermore, no meaningful correlation was observed between the size of the nodules and their malignancy. Therefore, the use of FNAC, based on the current guidelines, on thyroids for nodules larger than 2.5 cm might need to be revised.

The effect of platelet-rich plasma-fibrin glue dressing in combination with oral vitamin E and C for treatment of non-healing diabetic foot ulcers: a randomized, double-blind, parallel-group, clinical trial.

OBJECTIVE: The current study assesses the effects of platelet-rich plasma-fibrin glue (PRP-FG) dressing along with oral vitamin E and C on wound healing and biochemical markers in patients with non-healing diabetic foot ulcers (non-healing DFU). METHODS: This randomized controlled trial was performed on 25 patients with non-healing DFU. Patients were treated with PRP-FG dressing plus oral vitamin E and C (intervention group) or PRP-FG dressing plus placebo (control group) for 8 weeks. RESULTS: Eight weeks after treatment, six wounds in the intervention group and two wounds in the control group were completely closed, and also wound size significantly reduced in both intervention and control groups (p < 0.05). This reduction in wound size was significantly greater in the intervention group compared to the control group (p = 0.019). Also, a significant decrease in prooxidant-antioxidant balance (PAB) , ESR, and hs-CRP was observed in the intervention group compared to the control group (p < 0.05). CONCLUSION: Our results showed that PRP-FG dressing along with oral vitamin E and C could be used to increase wound healing in patients with non-healing DFU by enhancing the wound healing process and reducing oxidative stress. TRIAL REGISTRATION: This trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT04315909).

Pattern visual evoked potential in hypothyroid patients.

PURPOSE: To investigate the functional integrity of visual pathway in hypothyroid patients by pattern visual evoked potential (PVEP). METHODS: We enrolled 36 female patients with history of hypothyroidism (18 overt and 18 subclinical) aged 20 to 60 years and 36 healthy women of similar age (control group). All subjects had a complete ophthalmic examination. For VEP testing, subjects were exposed to checks subtending a visual angle of 15 and 60 min of arc. RESULTS: For the 15 min of arc check size, the mean P100 latency was significantly delayed (113 milliseconds (ms)) and amplitude significantly reduced (9.2 microvolts (µv)) in the hypothyroidism group compared with controls (109.6 ms and 11.6 µv, respectively). For this 15' check size, the group differences were related to significantly increased latency and reduced amplitude of responses in the group with overt hypothyroidism compared with controls. There was no difference between the groups (hypothyroid vs control) with 60 min of arc check size. There was a significant correlation between severity of the disease and PVEP component. CONCLUSIONS: In conclusion, low levels of circulating hypothyroid hormone are associated with delay in the pattern VEP to small check sizes. This CNS involvement worsens in patients with greater severity and duration of hypothyroidism.

Effect of Capparis spinosa Extract on Metabolic Parameters in Patients with Type-2 Diabetes: A Randomized Controlled Trial.

BACKGROUND: Experimental studies have reported beneficial effects of Capparis spinosa L., a perennial shrub from the Capparidaceae family, on the glycemic status and serum lipids in diabetic animals. OBJECTIVE: The aim of the present randomized triple-blind placebo-controlled clinical trial was to investigate the safety and efficacy of C. spinosa oxymel on blood glucose, lipid profile, and other diagnostic indexes of metabolic syndrome in patients with poorly controlled type 2 diabetes. METHOD: The C. spinosa oxymel was prepared by adding hydroalcoholic extract of C. spinosa fruit to simple oxymel (a mixture of grape vinegar and lactulose). Thirty diabetic patients with metabolic syndrome whose glycemic status was not controlled despite receiving full doses of oral hypoglycemic agents did not want to start insulin therapy and were randomly allocated to three groups to receive placebo, simple oxymel, or C. spinosa oxymel (10 mL/thrice daily for 3 months). All patients continued conventional therapy with hypolipidemic, antihyperlipidemic, and antihypertensive drugs during the study. RESULTS: C. spinosa oxymel significantly decreased the body weight and body mass index at the end of the study compared to the baseline. While the patients in the placebo and simple oxymel groups displayed further increase in the level of FBG or PPBG, administration of C. spinosa oxymel inhibited the progression of hyperglycemia. Nevertheless, there was not a significant difference between placebo and intervention groups regarding HbA1c at the end of the study. C. spinosa oxymel had no significant effect on the serum cholesterol but inhibited the progression of hypertriglyceridemia during the study. There were no significant changes in creatinine, microalbuminuria, AST, ALT, and ALP values following C. spinosa treatment, suggesting that it had no unwanted effects on kidney and liver function. CONCLUSION: The results suggest that although C. spinosa oxymel cannot enhance the effects of hypoglycemic and hypolipidemic drugs, it can prevent further increase of blood glucose and triglycerides in patients with poorly controlled diabetes.

Correlation Between White Blood Cell Count and Insulin Resistance in Type 2 Diabetes.

BACKGROUND: The role of chronic inflammation in insulin resistance states and the pathogenesis of metabolic syndrome, cardiovascular disease and diabetes have been reported earlier. White Blood Cell (WBC) count is an easy marker for estimation of systemic inflammation. OBJECTIVE: This study is to clarify whether WBC count is associated with insulin resistance in type 2 diabetic patients. METHODS: This cross sectional study was conducted in 283 patients with type 2 diabetes and in 283 healthy non diabetic subjects as control group. Data including: age, gender, blood pressure, height and weight, history of smoking were collected for each patient. Fasting blood sugar, HbA1C, insulin, lipid profiles, creatinine, Urine albumin to creatinine ratio, high sensitive C- reactive protein (HCRP) and WBC was measured for all patients. WBC count was measured in control group. Two groups were compared in WBC count. Insulin resistance was calculated with HOMA-IR formula. Association of WBC count with insulin resistance and metabolic parameters was assessed in diabetic patients. RESULTS: WBC count was significantly associated with body mass index, hypertension, and triglyceride level. There was not significant association between WBC count and glycemic index and insulin resistance. CONCLUSION: An elevated WBC count (even in the normal range) is closely related to various components of metabolic syndrome but not related to insulin resistance in type 2 diabetes.

The Relationship Between Vitamin D Deficiency and Insulin Resistance in Pregnant Women with Gestational Diabetes.

BACKGROUND: Diabetes Mellitus is one of the most common medical disorders in pregnancy. The possibility of vitamin D deficiency as a pathogenesis for impaired glucose tolerance tests show a probable role of vitamin D in insulin secretion and reduction of insulin resistance. This study was assigned to evaluate relation between serum vitamin D level and insulin resistance in Gestational Diabetes Mellitus (GDM). METHODS: This cross sectional study was done throughout one year between 2015-2016 in GDM patients (age, 20-40 years). After history taking and physical examination, the laboratory tests including : Fasting Blood Sugar (FBS), Glucose Tolerance Test (GTT), calcium, phosphorous, parathormone, 25(OH) vitamin D, insulin, HbA1C, TG, LDL, HDL were performed for all patients. Insulin resistance was calculated according to HOMA-IR formula. Vitamin D level was compared between patients with and without insulin resistance. RESULTS: This research was performed in 93 GDM patients with average age (30.3 ± 5.6). Thirty eight patients with insulin resistance and 55 patients without insulin resistance were detected. The prevalence of vitamin D deficiency was 91.4% in all patients. There was no significant difference in vitamin D levels between insulin resistant and non insulin resistant group (P-value=0.51). In all variable parameters, only FBS and triglyceride level in insulin resistant group were more than non insulin resistant group (P-value<0.05). CONCLUSION: Obtained results showed not significant relationship between vitamin D deficiency and insulin resistance in GDM patients.

A study of difference in serum 25-hydroxyvitamin D concentrations in patients with angiographically-defined coronary disease and healthy subjects.

BACKGROUND: Cardiovascular disease (CVD) is one of the most important causes of death in developing countries. The current study evaluates the serum 25-hydroxyvitamin D (25OHD), phosphate and calcium levels in patients with angiographically-defined coronary artery disease (CAD) and healthy subjects in a sample population in northeastern Iran. METHODS: There were 566 subjects aged between 20-80 years out of whom283 subjects with CAD were divided into two study groups based on their angiogram results; those with > 50% stenosis of one or more coronary arteries and those with ≤ 50% stenosis. Serum 25OHD levels and anthropometric parameters were measured for all subjects. RESULTS: There were approximately 53% (n = 303) males and 47% (n = 269) females in the population sample. We found that crude serum 25OHD concentrations were significantly higher in both the Angio- (21.6 ±â€¯11.8 ng/ml) and Angio+ (21.3 ±â€¯10.2 ng/ml) groups compared to the control subjects (16.4 ±â€¯9.5 ng/ml) (P < 0.001). CONCLUSION: The findings show that 25OHD state could be a risk factor for CAD, although this would need to be explored further, taking the potential confounding effects of diet into account in future studies.

The relationship between serum levels of fibroblast growth factor 21 and diabetic retinopathy.

Fibroblast growth factor 21 (FGF21) is a major metabolic regulator that has been shown to be elevated in a number of metabolic disturbances including type 2 diabetes mellitus (T2DM) and the metabolic syndrome, but few studies about the relationship between serum FGF21 and the complications of diabetes have been done. Since the association between FGF21 and diabetic retinopathy is not clear, this study was conducted to investigate this relationship. In this cross-sectional study, 61 subjects (14 healthy controls, 22 diabetic patients without retinopathy, and 25 patients with diabetic retinopathy) were evaluated. All patients in the study were examined for the presence of diabetic retinopathy. Various clinical and biochemical parameters including FGF21 were evaluated and analyzed and compared between the study groups. Serum levels of FGF21 showed a significant difference between the three groups (P=0.003) but the difference between diabetic patients with and without retinopathy was not significant (P=0.122). Regression model was used to evaluate the role of FGF21 in predicting diabetic retinopathy. In the multivariate logistic regression model after adjustment of systolic blood pressure and fasting blood glucose, the level of FGF21 was not associated with diabetic retinopathy. In the multivariate model, only fasting blood glucose was associated with diabetic retinopathy (P=0.009). According to the results of this study, serum levels of FGF21 in diabetic patients was higher than the control group but these raised levels could not predict the presence of diabetic retinopathy.

Is There any Correlation Between Diabetic Retinopathy and Risk of Cardiovascular Disease?

BACKGROUND: There are growing evidence that indicate a relation between diabetic microangiopathy and cardiovascular disease with different mechanism. OBJECTIVE: To investigate the association of diabetic retinopathy (DR) with the risk of cardiovascular disease (CVD) in type 2 diabetic patients. METHODS: 180 type 2 diabetic patients who were free of CVD at baseline were enrolled. Patients were classified according to fundoscopy to no diabetic retinopathy (NDR), non proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). CVD risk at 10 years was estimated using the UK Prospective Diabetes Study risk engine and patients were classified as high risk (20%), moderate risk (10-20%) and low risk (10%). RESULTS: Prevalence of DR was 30.5%. Risk of CVD was significantly higher in PDR vs NDR (18.7±10.0% vs. 11.3±8.4%, p= 0.01) .The prevalence of NPDR (32% vs. 17.8%, p=0.002) and PDR (20% vs. 4.1%, p=0.04) was more in high risk group for CVD in comparison with low risk group for CVD. After adjustment for traditional risk factor for CVD, the risk for CVD remained markedly increased in the presence of DR. CONCLUSION: DR is associated with estimated risk of CVD in type 2 diabetic patients.

Soluble (Pro) Renin Receptor is a Predictor of Gestational Diabetes Mellitus.

BACKGROUND: Gestational diabetes mellitus (GDM) is a common endocrine complication in pregnancy. While it has been established that age, family history of diabetes, insulin resistance and several biomarkers are associated with GDM but significant gaps remain in understanding risk factors for GDM. Soluble pro-renin receptor (s [Pro] RR) as a biomarker reflects the activation of renin-angiotensin system in tissues which may be related to insulin resistance Objective: The aim of this study was to determine the role of (s [pro] RR) in predicting GDM. METHODS: one hundred-eighty singleton pregnant women in first trimester were enrolled. We excluded women with previous history of GDM, hypertension and consumption of drugs affected reninangiotensin system. A fasting blood glucose and s (pro) RR level were obtained during first trimester and OGTT was performed at 24-28 weeks of gestation. We used ROC curves to identify s (pro) RR cutoff points for detecting GDM and the difference in s (pro)RR level was assessed in GDM and non- GDM women. RESULTS: Among 180 women, 24 (13.33%) had GDM. There was no significant difference between age and body mass index in subjects with GDM compared to non- GDM. The concentration of s (pro) RR was significantly higher in GDM subjects rather than non- GDM [29.27(24.60-35.92) vs. 22.89(19.46- 24.27), P<0.001]. Multiple logistic regression analysis revealed a significant association of s(pro) RR with GDM (odd ratio: 1.32, 95% CI: 1.17-1.48, P=0.04). A cut-off point 24.52 ng/ml of s(pro) RR had 75% sensitivity and 80% specificity for predicting GDM. CONCLUSION: Increased level of s (pro) RR in first trimester may be a marker for predicting GDM.

Effect of Oral Methadone on ECG Characteristics and Endocrine Hormonal Changes and Their Inter-relationship.

INTRODUCTION: Methadone is the most common opioid in use for opioid substitution therapy. The relation of methadone and electrocardiographic findings is nearly well known while the relationship between its electrocardiographic indexes and hormonal changes is not well recognized. OBJECTIVE: To evaluate the hormonal changes in patients who are taking methadone maintenance treatment (MMT) and its effects on electrocardiographic indexes, in comparison with healthy control groups. PATIENTS AND METHODS: 40 patients receiving MMT therapy for at least last six months and 40 healthy subjects were enrolled in the study. Serum estradiol, testosterone, luteinizing hormone, follicle stimulating hormone and thyroid function tests were measured. Mean QT Interval, P-R Interval (PRi) and QRS duration were also documented in maximum. RESULTS: There were no significant differences in hormonal parameters between MMT and control groups. No significant relation was found between hormonal parameters, dose and duration of methadone usage in patients group. QTc was significantly higher in methadone users than control groups. QTc had a significant negative correlation with Testosterone level (r=-0.581, P=0.007) in males. Significant difference was found between PRi in patients and control groups (P=0.007). CONCLUSION: Electrocardiographic changes are an important complication of methadone that seems to be related to low testosterone level in men.

Association between serum 25-hydroxyvitamin D concentrations and prevalence of metabolic syndrome.

PURPOSE: There is now good evidence that 25-hydroxyvitamin D (25OHD) status may have an important impact on the development and progression of cardiovascular disease. Because of the potential involvement of vitamin D deficiency in blood pressure control and immune responses, we aimed to investigate whether there was a relationship between 25OHD status and the prevalence of metabolic syndrome in an Iranian population. MATERIAL/METHODS: The study was carried out on a sample of 846 subjects [357(42.19%) males and 489(57.80%) females], derived from MASHAD STUDY. Serum 25OHD levels were measured using a competitive electroluminescence protein binding assay. Anthropometric indices were measured using standard protocols. RESULTS: Serum 25OHD was 12.7 (6.8-18.4) ng/ml in the metabolic syndrome (MetS) group and 14.1 (8.8-19.0) ng/ml in the group without metabolic syndrome (P=0.43). The frequency of vitamin D deficiency was 80.7% and 79.0% in subjects with or without metabolic syndrome in Iranian population. CONCLUSIONS: We found no significant difference in serum 25OHD concentrations between individuals with or without MetS and no significant linear relationship between serum 25OHD and several CVD risk factors.

Evaluation of insulin resistance in idiopathic hirsutism compared with polycystic ovary syndrome patients and healthy individuals.

INTRODUCTION: Hirsutism is defined as the excessive male-pattern growth of hair in women. Hirsutism is often idiopathic or the consequence of polycystic ovary syndrome (PCOS). Insulin resistance is common in PCOS (especially in obese patients) but the association between insulin resistance and idiopathic hirsutism (IH) is not clear. The aim of this study was to investigate the rate of insulin resistance in IH, compared with healthy individuals and patients with PCOS. METHODS: The study included three groups, patients with idiopathic hirsutism, PCOS and healthy women. Each group included 30 non-obese women. Fasting blood sugar (FBS), insulin level and insulin resistance (estimated by the homeostasis model assessment [HOMA-IRIR]) were compared in the three groups. RESULTS: There was a significant difference between the age of the women with IH compared with two other groups. There were no significant difference in levels of serum insulin (P = 0.49, HOMA-IR (P = 0.47) and prevalence of insulin resistance (P = 0.07) in the three groups. The age-adjusted prevalence of insulin resistance was similar in the three groups. CONCLUSION: Insulin resistance was no more frequent in IH patients than in healthy control groups.

Oral Glucosamine Effect on Blood Glucose and Insulin Levels in Patients With Non-Diabetic Osteoarthritis: A Double-Blind, Placebo-Controlled Clinical Trial.

OBJECTIVES: This study aims to determine the effects of oral glucosamine on glucose metabolism and insulin resistance in non-diabetic patients with osteoarthritis in Northeastern Iran. PATIENTS AND METHODS: This placebo-controlled, randomized clinical trial included 40 non-diabetic patients with osteoarthritis (15 males, 25 females, mean age 63.8±7.64 years; range 49 to 80 years). Patients were randomly divided into two equal groups and treated with oral glucosamine sulfate 1500 mg a day or placebo for 90 days. Fasting blood sugar, glucose tolerance test with 75 grams glucose and serum insulin levels, and homeostatic model assessment-insulin resistance were evaluated initially and at the end of intervention. RESULTS: There were no significant differences between the groups in terms of blood sugar, glucose tolerance test, and insulin levels at the beginning and end of the study. In the oral glucosamine group, there were no significant changes in fasting blood sugar (94.1±7.14 mg/dL versus 93.5±9.45 mg/dL, p=0.15), glucose tolerance test (99.3±8.99 mg/dL versus 103.3±10.1 mg/dL, p=0.07), and homeostatic model assessment-insulin resistance (1.57±0.21 versus 1.48±0.21, p=0.13) after treatment. Also, placebo did not significantly affect serum glucose levels and insulin resistance. CONCLUSION: Oral glucosamine with routine dosage was safe in our non-diabetic patients with osteoarthritis and had no significant effect on glucose metabolism and insulin resistance.

Low-Glycemic-Index Foods Can Decrease Systolic and Diastolic Blood Pressure in the Short Term.

Background. We aimed to compare the effects of low- and high-GI foods on 24-hour ambulatory blood pressure. Methods. This longitudinal study was performed on 30 women, aged 18 to 40 years, during 24 hours. In the first leg of study all recruited subjects were assigned to LGI period for 24 hours and, after a 2-week washout period, all subjects were assigned to HGI period. BP was measured every hour during the 24-hour monitoring. Results. After the intervention, there were significant decreases in SBP and DBP in the LGI period (102.26 ± 14.18 mmHg versus 112.86 ± 9.33 mmHg for SBP and 66.96 ± 10.39 mmHg versus 74.46 ± 7.61 mmHg for DBP) (P = 0.00 and P = 0.002, resp.). However, in the HGI period, there was no significant change in SBP or DBP (110.66 ± 9.85 versus 111.80 ± 9.57 for SBP and 71.16 ± 9.16 versus 74.26 ± 10.09 for DBP) (P = 0.6 and P = 0.06, resp.). Conclusion. The results suggest that LGI foods may be beneficial in reducing 24-hour BP.

Methimazole discontinuation before radioiodine therapy in patients with Graves' disease.

INTRODUCTION: Although radioiodine therapy (RIT) has been used for the treatment of hyperthyroidism for many decades, there is no consensus on the optimal time of methimazole (MMI) discontinuation before RIT. The aim of this clinical trial is to study the effect of three different time points of MMI discontinuation on response to RIT. METHOD AND PATIENTS: Overall, 151 patients (18-65 years old), with Graves' disease who were taking MMI and referred to I-131 therapy, were consecutively assigned to one of three groups, and MMI was discontinued for 24-48, 48.1-72, and 72.1-168 h in group, 1, 2, and 3, respectively. Radioiodine uptake was measured in all patients and the radioiodine dose was calculated according to the Quimby formula to deliver 7.4 MBq of I-131 per gram of thyroid weight. Response to RIT was assessed at 1, 3, 6, and 12 months after RIT. RESULTS: A total of 102 women and 49 men were included in the study. The mean administered dose of I-131 was 362.9±188.7 MBq (9.8±5.1 mCi) and the mean time to response for radioiodine was 4.1±3.6 months. There was no significant difference between the three groups in age, thyroid weight, anti-TPO level, radioactive iodine uptake level, and radioiodine dose (P>0.1). Response to RIT at 1, 3, 6, and 12 months after administration was also not different between the three groups (P>0.57). CONCLUSION: No difference was found in the response to treatment between patients with MMI discontinuation for 24-48, 48.1-72, and 72.1-96 h before RIT. Shorter discontinuation of MMI before RIT may be preferable in most patients. Video Abstract: http://links.lww.com/NMC/A39.