The association between acylcarnitine and amino acids profile and metabolic syndrome and its components in Iranian adults: Data from STEPs 2016.

Background: Evidence, albeit with conflicting results, has suggested that cardiometabolic risk factors, including obesity, type 2 diabetes (T2D), dyslipidemia, and hypertension, are highly associated with changes in metabolic signature, especially plasma amino acids and acylcarnitines levels. Here, we aimed to evaluate the association of circulating levels of amino acids and acylcarnitines with metabolic syndrome (MetS) and its components in Iranian adults. Methods: This cross-sectional study was performed on 1192 participants from the large-scale cross-sectional study of Surveillance of Risk Factors of non-communicable diseases (NCDs) in Iran (STEP 2016). The circulating levels of amino acids and acylcarnitines were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in individuals with MetS (n=529) and without MetS (n=663). Results: The higher plasma levels of branched-chain amino acids (Val, Leu), aromatic amino acids (Phe, Tyr), Pro, Ala, Glu, and the ratio of Asp to Asn were significantly associated with MetS, whereas lower circulating levels of Gly, Ser, His, Asn, and citrulline were significantly associated with MetS. As for plasma levels of free carnitine and acylcarnitines, higher levels of short-chain acylcarnitines (C2, C3, C4DC), free carnitine (C0), and long-chain acylcarnitines (C16, C18OH) were significantly associated with MetS. Principal component analysis (PCA) showed that factor 3 (Tyr, Leu, Val, Met, Trp, Phe, Thr) [OR:1.165, 95% CI: 1.121-1.210, P<0.001], factor 7 (C0, C3, C4) [OR:1.257, 95% CI: 1.150-1.374, P<0.001], factor 8 (Gly, Ser) [OR:0.718, 95% CI: 0.651-0.793, P< 0.001], factor 9 (Ala, Pro, C4DC) [OR:1.883, 95% CI: 1.669-2.124, P<0.001], factor 10 (Glu, Asp, C18:2OH) [OR:1.132, 95% CI: 1.032-1.242, P= 0.009], factor 11 (citrulline, ornithine) [OR:0.862, 95% CI: 0.778-0.955, P= 0.004] and 13 (C18OH, C18:1 OH) [OR: 1.242, 95% CI: 1.042-1.480, P= 0.016] were independently correlated with metabolic syndrome. Conclusion: Change in amino acid, and acylcarnitines profiles were seen in patients with MetS. Moreover, the alteration in the circulating levels of amino acids and acylcarnitines is along with an increase in MetS component number. It also seems that amino acid and acylcarnitines profiles can provide valuable information on evaluating and monitoring MetS risk. However, further studies are needed to establish this concept.

Effects of Zinc and Selenium Supplementation on Thyroid Function in Overweight and Obese Hypothyroid Female Patients: A Randomized Double-Blind Controlled Trial.

OBJECTIVE: Zinc (Zn) and selenium (Se) are essential trace elements involved in thyroid hormone metabolism. This study was conducted to investigate the effects of Zn and Se supplementation on thyroid function of overweight or obese female hypothyroid patients in a double-blind, randomized controlled trial. METHODS: Sixty-eight female hypothyroid patients were randomly allocated to one of the 4 supplementation groups receiving Zn + Se (ZS; 30 mg Zn as zinc-gluconate and 200 µg Se as high-selenium yeast), Zn + placebo (ZP), Se + placebo (SP), or placebo + placebo (PP) for 12 weeks. Serum Zn, Se, free and total triiodothyronine (FT3 and FT4), free and total thyroxine (FT4 and TT4), thyroid-stimulating hormone (TSH), and anthropometric parameters were measured. Dietary intake was recorded using 24-hour food recall. Physical activity questionnaire was completed. RESULTS: No significant alterations were found in serum Zn or Se concentrations. Mean serum FT3 increased significantly in the ZS and ZP groups (p < 0.05) but this effect was significant in the ZP group compared to those in SP or PP groups (p < 0.05). Mean serum FT4 increased and TSH decreased significantly (p < 0.05) in the ZS group. TT3 and TT4 decreased significantly in the SP group (p < 0.05). Mean FT3:FT4 ratio was augmented significantly in the ZP group (p < 0.05). No significant treatment effects were found for TT3, FT4, TT4, or TSH between groups. CONCLUSION: This study showed some evidence of an effect of Zn alone or in combination with Se on thyroid function of overweight or obese female hypothyroid patients.

Factors associated with sexual function in Iranian women with type 2 diabetes mellitus: partner relationship as the most important predictor.

BACKGROUND: No comprehensive study has been conducted on risk factors of sexual dysfunction in women with diabetes mellitus. OBJECTIVES: The aim of this study was to consider all possible influencing variables including hormonal, physical and, psychological status, socioeconomic status, and dietary intake to get more accurate and reliable results. PATIENTS AND METHODS: Sexual function was assessed by Iranian validated female sexual function index (FSFI).The variables of the study were demographic and diabetes-related factors, stress-depression, physical activity, blood pressure, anthropometric measurements, lipid profile, cortisol, sex and thyroid hormones, 25-hydroxy vitamin D, and dietary intake. RESULTS: Among all investigated variables, partner relationship showed a strong positive association with FSFI (ß = 1.93 ± 0.41, P < 0.0001). In addition, not considering partner relationship, FSFI showed a significant negative association with age (ß = -0.19 ± 0.20, P = 0.04), stress-depression score (ß = -0.08 ± 0.04, P = 0.04), DD (ß = -0.03 ± 0.01, P = 0.04), and systolic blood pressure (ß = -0.14 ± 0.06, P = 0.03). Significant associations between FSFI and serum sex hormones and other biochemical were found in neither postmenopausal nor non-menopausal women. The means of SFSI in postmenopausal women were greater than non-menopausal (P = 0.02). CONCLUSIONS: It seems that in our population, female sexual function was much more than just a hormonal or physical problem and psychological factors, especially partner relationship and stress-depression, are the most determinants. In addition, age, duration of challenging with disease, and the lack of controlling systolic blood pressure were common factors that decreased sexual function.

Association of high carbohydrate versus high fat diet with glycated hemoglobin in high calorie consuming type 2 diabetics.

BACKGROUND: Since both dietary carbohydrate and fatty acids separately affect carbohydrate metabolism, how dietary macronutrients distribution may have different effects on carbohydrate metabolism pathways and regulation of blood glucose especially in diabetic patients. METHODS: In this cross-sectional study 750 type 2 diabetic patients (261 men and 489 women, aged 35-65 years),who at least two years were followed in Diabetes and Metabolic disease Clinic of Tehran University of Medical Sciences, were recruited according to inclusion and exclusion criteria by simple sampling. Dietary data were collected by a validated food frequency questionnaire. Other variables were anthropometric measurements, Stress, physical activity level, Biochemical analyses including fasting and postprandial plasma glucose, Glycated hemoglobin, total cholesterol, low and high density lipoproteins, triglycerides and 25-hydoxy D3. Linear regression models were used to assess the association of covariates with the mean concentrations of HbA1C in quintiles and multivariate linear regression model was used to distinguish the impacts of dietary macronutrient composition of the diet. RESULTS: Carbohydrate and dietary fiber intakes were inversely (P: < 0.0001 and 0.003 respectively) and dietary amount and proportion of saturated, mono-unsaturated and poly-unsaturated fatty were positively (P: < 0.0001, 0.03, 0.01 and 0.01 respectively) associated with HbA1C concentrations. Multivariate linear regression macronutrient density model that controlled for age, sex, diabetes duration and calorie intake showed that carbohydrate was inversely associated with HbA1C (P < 0.0001, R(2) = 15%). Results were also the same in the other three models adjusted for stress and exercise levels in model 2, waist circumference and sum of meals in model 3 and serum triglyceride and 25-hydroxy vitamin D in model 4(P < .0001, <.0001 and 0.0003 respectively). Calorie intake of 25 Kcal/body weight was identified as a cut of point of the negative effect of dietary carbohydrate and 30 for the positive effect of fat on HbA1c respectively (P = 0.04 and 0.03). Moreover, carbohydrate intake was positively (ß = 0.08, P = 0.01) and protein (ß = -0.04, P < 0.0001), SAFA (ß = -0.04, P < 0.0001) and MUFA (ß = -0.02, 0.07) proportion were negatively associated with increment in calorie intake. CONCLUSION: This study showed that the substitution of fat for carbohydrate is associated with low concentrations of HbA1c in high calorie consuming type 2 diabetic patients.

Intellectual development and thyroid function in children who were breast-fed by thyrotoxic mothers taking methimazole.

OBJECTIVE: Recent studies have shown normal thyroid function in infants whose mothers receive methimazole (MMI) during breast-feeding. This study evaluates the long-term effect of MMI on thyroid function and intellectual development of such children. DESIGN AND METHODS: Eighty-two children aged between 48 and 86 months were studied. Forty-two children had been breast-fed while their thyrotoxic lactating mothers received daily doses of MMI 20-30 mg in the first, 10 mg in the second and 5-10 mg for additional 10 months of therapy. Thyroid function of infants remained normal during the one year of MMI therapy of their mothers. Forty other infants served as controls. Serum T4, T3, and TSH concentrations, urinary iodine, thyroid antibodies, intelligence quotient (IQ), verbal and functional (performance) components (Wechsler and Goodenough tests) were measured in all children of the two groups. RESULTS: Height, weight, serum T4, T3, TSH and antithyroid antibody titers were not different between children in the two groups. The mean IQ was 107 +/- 17 vs 106 +/- 16 (Goodenough test) and 103 +/- 10 vs 103 +/- 16 (Wechsler test) for children of thyrotoxic mothers and control children, respectively. There was no difference in verbal and functional IQ and their components between children of thyrotoxic MMI treated mothers and control children. CONCLUSION: Thyroid function and physical and intellectual development of breast-fed infants whose thyrotoxic lactating mothers were treated with 20-30 mg doses of MMI daily are normal at age 48 to 86 months.