Effect of lifestyle modification for two years on obesity and metabolic syndrome components in elementary students: A community- based trial.

Background: Lifestyle modifications, especially improving nutritional patterns and increasing physical activity are the most important factors in preventing obesity and metabolic syndrome in children and adolescents. For this purpose, the following interventional study was designed to investigate the effects of educational programs for students, as well as the changes in diet and physical activity on obesity and components of the metabolic syndrome. Methods: This study is part of an interventional research project (elementary school) conducted on all students of Sama schools in Zanjan and Abhar in three levels;elementary, middle and high school, including 1000 individuals in Zanjan (intervention group) and 1000 individuals (control group) in Abhar in 2011. Interventions were based on educating students, teachers and parents, changes in food services and physical activity. We primarily measured anthropometric indices, fasting blood sugar, lipid profiles and blood pressure and completed standard nutrition and physical activity questionnaires. Also, blood insulin levels were randomly measured in a number of students. Data analysis was done by SPSS software Version 16.0. Results: Overall, 589 individuals (252 males, 337 females) entered the case group and 803 individuals (344 males, 459 females) entered the control group. After two years of intervention, the mean waist circumference (63.8±10.9) and diastolic BP (63.8±10.4) were significantly lower, however, the mean systolic BP (10.1.0±12.5), food score (25.0±5.0) and drinking score (12.1±2.3) were higher in the intervention group (p<0.001). Comparing the components of metabolic syndrome between the second year and at the time of recruitment within the intervention group, showed that although the number of overweight/obese individuals, individuals with hypertriglyceridemia and high LDL increased, while those with abdominal obesity, high BP, hyperglycemia, and insulin resistance decreased (p<0.001). On the other hand, in the control group, the number of individuals with high BP increased significantly. Conclusion: The prevalence of abdominal obesity and hypertension, which are the two major components of metabolic syndrome, are much higher in our study than the other regions of the country. However, interventions for modification of diet and increasing physical activity, are effective in lowering of their prevalence.

Cardiovascular Risk Factors and Events in Iranian Immigrants Versus Other Immigrants from the Middle East.

We report the incidence of cardiovascular events, mortality and risk factors (diabetes and hypertension) in immigrants from Iran and in non-Iranian immigrants from the Middle East. Using population-based healthcare administrative data, all immigrants from the Middle East and the non-immigrant population of Ontario, Canada as of July 2012 were identified. Baseline differences in diabetes and hypertension prevalence were compared. Outcomes were ascertained through March 2016 and included the incidence of acute coronary events, ischemic heart disease mortality, all-cause mortality, and incident diabetes and hypertension. The study population included 55,539 Iranian immigrants, 106,926 non-Iranian Middle Eastern immigrants, and 6,967,132 non-immigrants. Non-immigrants had the highest crude baseline prevalence of diabetes and hypertension. Compared to non-immigrants, Iranian and non-Iranian Middle Eastern immigrants had significantly lower incidence rate of acute coronary events, ischemic heart disease mortality and all-cause mortality. Both Iranian and non-Iranian Middle Eastern immigrants had better cardiovascular health status than non-immigrants.

Vitamin D status and its associations with components of metabolic syndrome in healthy children.

AIM: High prevalence of vitamin D insufficiency/deficiency has been reported in populations of different countries. The aim of this cross-sectional study was to determine the prevalence and association of vitamin D status with components of metabolic syndrome. METHODS: Lipid profile indices, anthropometric indices [body mass index and waist circumference (WC)], insulin resistance index (HOMA-IR), systolic blood pressure (SBP), diastolic blood pressure (DBP), C-reactive protein, intact parathyroid hormone (iPTH), and serum 25-hydroxyvitamin D [25(OH)D] concentration were evaluated in 297 healthy schoolchildren aged 7-11 years. Multivariate linear regression was used to determine independent predictors associated with low serum 25(OH)D concentrations. RESULTS: The mean serum 25(OH)D concentration was 14.12±8.20 ng/mL (35.3±20.5 nmol/L); 96% of children had low serum 25(OH)D levels, 31.0% were deficient, and 65.0% had insufficient levels of 25(OH)D. Vitamin D deficiency was higher in girls (χ²=13.66; p=0.00); 25(OH)D level was negatively associated with WC, HOMA-IR, SBP, DBP, and iPTH. In the multivariate model, WC, DBP, and HOMA-IR were significant independent predictor of low 25(OH)D concentrations. CONCLUSION: The prevalence of low vitamin D level in the studied healthy children was high and it is correlated with some components of metabolic syndrome. Outdoor activity for optimum sun exposure and additional studies are needed to evaluate the underlying metabolic syndrome components and hypovitaminosis D complications.

Tip-enhanced Raman spectroscopy of graphene-like and graphitic platelets on ultraflat gold nanoplates.

In this study, tip-enhanced Raman spectroscopy (TERS) is used to characterize graphene-like and graphitic platelets composed of a few layers of graphene. Specifically, gap-mode TERS geometry provides a larger enhancement of the local electromagnetic field at the junction formed by a gold sharp tip and a gold substrate. Graphene-like platelets are deposited onto ultra-flat thin gold nanoplates using a surfactant-assisted method. Au-coated atomic force microscopy (AFM) tips are used to probe specific substrate regions coated by the platelets. TERS spectra are collected on distinctive points on the graphene-like layers and surrounding substrate using radially or linearly polarized light, with an excitation wavelength of 632.8 nm. The position, width and intensity of G, D, and 2D Raman-active modes of graphene are discussed as a function of the incident light polarization and for distinct positions on the graphene layer. We report here on the nature of the collected TERS spectra focusing in particular on the edges of the graphene platelets.

Insulin resistance in hypothyroid patients under Levothyroxine therapy: a comparison between those with and without thyroid autoimmunity.

BACKGROUND: A chronic inflammation resulting from an imbalance between pro-inflammatory and anti-inflammatory cytokines in Hashimoto's thyroiditis (HT) might be responsible for IR in hypothyroidism. This study was performed to investigate a probable association between autoimmune background of hypothyroidism and IR. METHODS: In this clinical study, 63 subjects with Hashimoto's thyroiditis and 49 subjects with post-ablation hypothyroidism were enrolled. All the participants were euthyroid for more than one year through Levothyroxine therapy. Serum concentrations of Thyroid-stimulating Hormone (TSH), Free Thyroxin (FT4, FT3), Anti-Thyroid Peroxidase Antibodies (Anti-TPO Abs), Total Cholesterol (TC), HDL-Cholesterol (HDL-C), Triglyceride (TG), Fasting Blood Glucose (FBG), and insulin levels were measured and Oral Glucose Tolerance Test (OGTT) was performed for all of the subjects. Participants with anti TPO levels more than 1000 IU /ml were classified as having highly positive antibodies. RESULTS: No significant differences regarding to plasma insulin, glucose and lipid concentration, were detected between subjects with and without Hashimoto's thyroiditis. However, subjects with highly positive Anti TPO Abs had higher prevalence of elevated fasting insulin level than those with lower titers of Anti TPO Abs and subjects without autoimmune background (94.1% vs. 62.8% and 71.4% respectively, P = 0.05). Subjects with highly positive titers of Abs also had a lower serum HDL-c levels than the rest of the subjects (40.6 ± 2.1 vs. 47.2 ± 1.7 and 47.4 ± 1.4, P = 0.04). CONCLUSIONS: There is no obvious association between thyroid autoimmunity and metabolic indexes of hypothyroid patients. Only patients with Ani TPO antibody levels more than 1000 IU/ml may experience higher insulin level and less HDL-c with the same BMI.

The effect of ginger consumption on glycemic status, lipid profile and some inflammatory markers in patients with type 2 diabetes mellitus.

OBJECTIVE: To assess the effect of ginger consumption on glycemic status, lipid profile and some inflammatory markers in patients with type 2 diabetes mellitus. METHODS: In a double-blinded, placebo-controlled clinical trial, 70 type 2 diabetic patients were enrolled. They allocated randomly into ginger group and control group. They consumed 1600 mg ginger versus 1600 mg wheat flour placebo daily for 12 weeks. Serum sugar, lipids, CRP, PGE2 and TNFα were measured before and after intervention. RESULTS: Ginger reduced fasting plasma glucose, HbA1C, insulin, HOMA, triglyceride, total cholesterol, CRP and PGE2 significantly compared with placebo group (p < 0.05). There were no significant differences in HDL, LDL and TNFα between two groups (p > 0.05). CONCLUSION: Ginger improved insulin sensitivity and some fractions of lipid profile, and reduced CRP and PGE2 in type 2 diabetic patients. Therefore ginger can be considered as an effective treatment for prevention of diabetes complications.

Acylated ghrelin and leptin concentrations in patients with type 2 diabetes mellitus, people with prediabetes and first degree relatives of patients with diabetes, a comparative study.

BACKGROUND: Ghrelin is known as a new endocrine component supposed to have an influence in control of feeding behavior and energy balance. Recent studies have shown that ghrelin concentration in the subjects with diabetes mellitus type 2 (DM 2) is lower than normal. To clarify the relationship between ghrelin and insulin resistance and also DM 2, a cross-sectional study was designed. METHODS: In a cross-sectional study, 87 subjects were enrolled in three groups, 29 with DM2, 29 pre-diabetes state and 29 normoglycemic subjects of first-degree relatives of diabetic group. After clinical examination, blood samples were taken to measure fasting blood glucose, HbA1c, lipids, insulin, leptin and acylated ghrelin concentrations. RESULTS: Mean serum concentrations of acylated ghrelin in all groups (47.4 ± 27.9 pg/ml) were lower than normal values (150.3 ± 56.4 pg/ml) (P: 0.006) without significant difference within groups comparison(P: 0.1). A significant correlation was found between ghrelin concentration with body mass index (BMI) (r: -0.23, p <0.02) and abdominal circumference (AC) (r: -0.28, P < 0.008). Also inverse relationship between ghrelin level and insulin resistance (HOMA-IR) (r: -.032, p: 0.002) was seen in all subjects. Leptin level has a significant correlation with abdominal circumference (AC) and BMI (P < 0.0001) but not with ghrelin. CONCLUSION: This study showed that obesity has a strong association with the reduced level of ghrelin concentration. It seems that the process of ghrelin reduction is initiated in earlier stages of insulin resistance prior to the onset of overt DM.

Defining a cutoff point for vitamin D deficiency based on insulin resistance in children.

BACKGROUND: Vitamin D deficiency is a common worldwide problem. Low levels of serum 25-hydroxy vitamin D [25(OH)D], as a marker of vitamin D deficiency, have been linked to a wide field of health problems, including metabolic diseases such as insulin resistance, type 1 and type 2 DM. There is no universal definition for cutoff value of vitamin D deficiency and it seems that it varies in different populations. OBJECTIVE: Most previous studies have used a start rise of PTH as a criteria to detect threshold of serum 25(OH)D, However, the aim of this study was to determine a cutoff point of serum 25(OH)D for vitamin D deficiency based on HOMA-IR. MATERIALS AND METHODS: Two hundred and ninety seven healthy children (aged 7-11 years) were enrolled. Serum 25(OH)D and PTH were measured and HOMA-IR was calculated. The ROC curve was utilized to obtain a cutoff of vitamin D deficiency based on HOMA-IR. RESULTS: 25(OH)D concentrations were inversely correlated with HOMA-IR levels (Spearman's r=-0.14, p=0.016). Serum 25(OH)D cutoff point was 11.6ng/mL (29nmol/L) in relation with HOMA-IR >2.1. By using this cutoff value, the prevalence of vitamin D deficiency was 43.4% in this study population of healthy children. CONCLUSION: We found that serum 25(OH)D levels are inversely associated with insulin resistance. These results suggest that in MetS patients it may benefit to determine cutoff value of 25(OH)D levels based on HOMA-IR.

Determinants of developing diabetes mellitus and vascular complications in patients with impaired fasting glucose.

AIMS: To detect the risk factors of diabetes mellitus (DM) and cardiovascular complications in subjects with impaired fasting glucose (IFG). MATERIALS AND METHODS: One hundred and twenty three subjects with proved IFG in Zanjan Healthy Heart Study (2002-2003) were recalled and participated in this study (2009-2010). Demographic and laboratoryinformation of the participants were collected.Ischemic heart disease (IHD) was assessed by the exercise tolerance test (ETT). All the subjects with abnormal ETT or documented past history of IHD confirmed by angiographic evaluation. Ophthalmic complications including cataract, glaucoma, and diabetic retinopathy were estimated by an ophthalmologist. RESULTS: Incidence of DM was 19.5%. All the diabetic and pre-diabetic patients had at least one of the other components of metabolic syndrome. Obesity (P: 0.04, OR: 1.8, 95%CI: 1.2-9) and low physical activity (P < 0.001, OR: 9.6, 95%CI: 3.4-32) were the only independent prognostic risk factors for progression to DM in patients with IFG. Total incidence of IHD was 14.6% and had a strong correlation with sex (P: 0.01, OR: 1.8, 95%CI: 1.2-1.5), age (P < 0.001, OR: 23, 95%CI: 2.1-67) and cigarette smoking (P < 0.001, OR: 36.5, 95%CI: 3.9-337). Non-proliferative diabetic retinopathy was shown in 2 (1.6%) subjects who were all women. CONCLUSION: Obesity and low physical activity are the main factors of developing DM and its macrovascular complications in subjects with IFG.

The efficacy of Ezetimibe added to ongoing Fibrate-Statin therapy on postprandial lipid profile in the patients with type 2 Diabetes mellitus.

BACKGROUND: Postprandial hypertriglyceridemia in diabetes mellitus can be followed by endothelial dysfunction, impaired vascular compliance and increased cardiovascular complications. So focus on better control of postprandial hypertriglyceridemia is as important as controlling fasting triglyceride level in type 2 DM. OBJECTIVE: We evaluated the effect of ezetimibe adding to fibrate or statin on postprandial hypertriglyceridemia. METHODS: In a randomized controlled clinical trial, 47 subjects with type 2 diabetes and hypertiglyceridemia were enrolled and divided in three treatment groups including Gemfibrozil 1200mg/d + placebo(group A), Ezetimibe10mg/d + Gemfibrozile 1200mg/d(group B) or Ezetimibe10mg/d + Atorvastatin10mg/d (group C) for a 6- week period. Oral fat loading test were performed in the initiation and also at the end of the study and lipid profile and APOB were measured. RESULTS: Fasting and postprandial serum triglyceride (TG) decreased significantly with all the three treatment groups with no difference between them in the percent of TG reduction. Although serum total cholesterol decreased significantly in all the three groups of treatment its reduction was more prominent in group C(-38.1% ± 11.2%in group C vs. -16.5% ± 19.6% and -7.2% ± 10.7% in groups B & A respectively, p < 0.0001 ). Fasting serum HDL increased significantly only by Gemfibrozil (23.4% ± 28.4% vs. 6.4% ± 18.9% and 1.8% ± 17.7%, p < 0.05 ). Fasting serum APOB was reduced only in ezetimibe containing groups (B &C). CONCLUSION: Adding ezetimibe to gemfibrozil has no additional effect on reducing postprandial TG but ezetimibe can potentiate the effect of low-dose atorvastatin on lowering TG and LDL-c.

Independent Predictors of Erectile Dysfunction in Type 2 Diabetes Mellitus: Is It True What They Say about Risk Factors?

Introduction. The aim of this study was to evaluate the independent predictors of ED in adult men with type 2 diabetes mellitus (T2DM). Methods. We have recruited 200 T2DM patients referred to our center between March 1, 2009 and March 1, 2010. All the patients were scored with the International Index of Erectile Function (IIEF)-5 questionnaires. Contribution of age, body mass index (BMI), smoking, blood pressure, lipid profile, fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), free testosterone concentration, and duration of diabetes to risk of ED were evaluated. Results. Of 200 men with T2DM, 59.5% had ED (95%CI: 52%-67%). A negative significant correlation was found between potency score and HbA1c (r: 0.20,P: 0.01), FPG (r: 0.17, P: 0.03) and SBP (r: 0.18, P: 0.02) but not between other risk factors such as lipid profile, BMI, and serum testosterone level. By using multivariate logistic regression analysis, we found out that the only two independent predictors of ED in these group of patients are age (OR: 2.8, P: 0.01), and taking calcium channel blockers (CCB) (OR: 4.1, P: 0.01). Conclusions. Aging and taking CCB were the only two major predictors for ED but surprisingly other metabolic or sexual covariates in this study did not have predictive value for ED risk in T2DM patients.

Association between Hypoadiponectinemia and Low Serum Concentrations of Calcium and Vitamin D in Women with Polycystic Ovary Syndrome.

Objective. To investigate the possible association of calcium and vitamin D deficiency with hypoadiponectinemia in women with PCOS. Subjects and Methods. In this case-control study, 103 PCOS cases and 103 controls included. The concentrations of calcium, 25-OH-vitamin D (25OHD), adiponectin, insulin, glucose, total cholesterol, HDL-cholesterol, triglyceride (TG), and androgens were measured in fasting blood samples. Results. Adiponectin (8.4 ± 2.7 ng/mL versus 13.6 ± 5 ng/mL in control group, P : 0.00), calcium (2 ± 0.1 mmol/L versus 2.55 ± 0.17 mmol/L in controls, P : 0.00), and 25-OH-Vit D (30 ± 2.99 nmol/L versus 43.7 ± 5.2 nmol/L in control group, P : 0.00) levels were decreased in women with PCOS. Subjects with PCOS had higher concentrations of TG (1.4 ± 0.77 mmol/L versus 1.18 ± 0.75 mmol/L in control group, P : 0.019) and dehydroepiandrosterone sulfate (DHEA-S) (10.7 ± 11 mmol/L versus 9.7 ± 10.4, P : 0.02 in control group). There were significant correlations between adiponectin concentrations with calcium (r : 0.78, P : 0.00) and 25OHD levels (r : 0.82, P : 0.00). The association of hypoadiponectinemia and PCOS was not significant considering 25OHD as a confounding factor. Conclusion. The present findings indicate that the association of hypoadiponectinemia with PCOS is dependent on vitamin D. A possible beneficiary effect of vitamin D on the metabolic parameters in PCOS may be suggested.

Transparent and conducting graphene-RNA-based nanocomposites.

Ribonucleic acid (RNA) is proposed as a nonionic surfactant for the efficient exfoliation of graphite in thin flakes of few-layer graphene and the subsequent preparation of transparent and conducting thin films. Parameters such as the type of RNA used and the size of starting graphite flakes are demonstrated to be essential for obtaining RNA-graphene thin films of good quality. A model explaining the exfoliation of graphene by RNA in water is suggested. A number of post- and predeposition treatments (including thermal annealing, functionalization of the films, and the preoxidation of graphite) are critical to improve the performance of graphene-RNA nanocomposites as transparent conductors. The study establishes an ideal link between RNA and graphene, the fundamental building blocks for nanobiology and carbon-based nanotechnology.

The relationship between retinol-binding protein 4 levels, insulin resistance, androgen hormones and polycystic ovary syndrome.

BACKGROUND: Retinol-binding protein 4 (RPB4), a 21-kDa peptide, is a recently identified adipokine that may contribute to the pathogenesis of polycystic ovary syndrome (PCOS). The aim of this study was to explore the association between serum RBP4 levels, androgen hormones and insulin resistance (IR) in women with PCOS. METHODS: In this case-control study, 75 PCOS patients and 53 age- and body mass index (BMI)-matched control subjects referred to the Zanjan Metabolic Disease Research Center were enrolled. Serum RBP4 was measured using an enzyme-linked immunosorbent assay. BMI, waist circumference (WC), fasting levels of glucose, lipid profiles and insulin were also measured. A homeostatic model assessment of insulin resistance (HOMA-IR) value was used to determine the level of insulin resistance. RESULTS: PCOS cases had significantly higher serum RBP4 and insulin levels than control subjects (44130 ± 12760 vs. 32980 ± 9560 µg/L, p < 0.001, and 11790 ± 11480 vs. 7890 ± 4300 µU/L, p < 0.05, respectively), in univariable analysis. RBP4 showed a positive correlation with serum testosterone (r = 0.62, p < 0.0001), dehydroepiandrosterone sulfate (r = 0.45, p < 0.0001) and the waist circumference (r = 0.37, p < 0.001) of PCOS patients but not with other measured clinical and biochemical variables. However, no correlation was observed between serum RBP4 levels and HOMA-IR in all studied subjects. A final logistic regression analysis demonstrated that testosterone and dehydroepiandrosterone sulfate are independently associated with PCOS. CONCLUSION: These findings indicate that RBP4 is not independently associated with PCOS. The elevation of RBP4 levels in PCOS women might be influenced by androgen hormones. Further prospective studies are needed to clarify molecular mechanisms.

Serum magnesium concentrations in polycystic ovary syndrome and its association with insulin resistance.

OBJECTIVE: It has been revealed that low serum magnesium (Mg) is often associated with insulin resistance (IR), cardiovascular problems, diabetes mellitus, and hypertension. Patients with polycystic ovary syndrome (PCOS) are known to have a high incidence of insulin resistance. This study was designed to determine whether women with PCOS exhibit serum magnesium deficiency and its potential association with IR. SUBJECTS AND METHODS: In this cross-sectional study, 103 cases with PCOS and 103 normal women who were matched for their age and body mass index (BMI) were included. Blood samples were collected after an overnight fast and concentrations of calcium, magnesium, testosterone, dehydroepianderosterone sulfate, insulin, fasting plasma glucose (FPG), triglyceride, total cholesterol, and HDL-cholesterol were measured. RESULTS: The risk of PCOS for subjects with Mg deficiency was 19 times greater than those who had normal serum Mg concentrations (p ≤ 0.0001). No correlation was found between Mg and insulin sensitivity or secretion, FPG, dyslipidemias, and also androgen concentrations. After adjustment for calcium concentration the role of magnesium to predict PCOS attenuated and became non-significant (ß:-1.9, p: 0.7). CONCLUSION: The present study provides the first evidence showing that magnesium deficiency is not associated with IR in PCOS. According the evidences of this study, serum calcium concentration is more potent predictor of PCOS than serum Mg and only calcium, not Mg, is related to insulin resistance in PCOS.

Serum ferritin concentration in gestational diabetes mellitus and risk of subsequent development of early postpartum diabetes mellitus.

PURPOSE: To compare the serum ferritin concentrations of normal pregnant women with those having gestational diabetes mellitus (GDM) and to determine the possible role of ferritin in predicting pregnancy outcome and early development of postpartum glucose intolerance and diabetes mellitus. METHOD: This case-control study consisted of 128 pregnant women (64 women with GDM and 64 age-matched healthy pregnant women) seen at a university hospital in Zanjan, Iran. Anthropometric measurements were determined, and serum ferritin, C-reactive protein, insulin, glycosylated hemoglobin (HbA(1c)), and hemoglobin levels were measured. Pregnancy outcomes were recorded in all subjects. In the women with GDM, a diagnostic oral glucose tolerance test was performed eight weeks after delivery. RESULTS: Women with GDM had a higher concentration of serum ferritin (112 ± 28.4 pmol/L in GDM versus 65 ± 16.9 pmol/L in controls, P < 0.001). A positive correlation was found between serum ferritin level and mid-pregnancy fasting plasma glucose and HbA(lc) levels. Although women in the highest quartile of serum ferritin had a greater than two-fold increased risk of GDM, no significant correlation was found between ferritin levels and early postpartum oral glucose tolerance test results. CONCLUSIONS: Elevated serum ferritin concentrations in mid-pregnancy are associated with an increased risk of GDM independent of C-reactive protein and body mass index. Ferritin levels in GDM cannot be used as an indicator to predict subsequent glucose concentration in early postpartum oral glucose tolerance test.

Decreased adiponectin levels in polycystic ovary syndrome, independent of body mass index.

BACKGROUND: Insulin resistance has been shown to have an association with polycystic ovary syndrome (PCOS). This study was designed to evaluate the potential role of adiponectin, which is linked with insulin resistance, in the etiology of PCOS and its relationship to obesity. METHODS: This case-control study consisted of 103 newly diagnosed PCOS cases and 73 female controls seen at a referral university hospital in Zanjan, Iran. Serum adiponectin, insulin, plasma fasting glucose, and lipid levels were measured. The homeostasis model assessment index was used to determine the level of insulin resistance. Women were classified as follows: Group I (normal nonlean women); group II (normal lean women); group III (nonlean women with PCOS); and group IV (lean women with PCOS) RESULTS: Adiponectin levels were decreased in women with PCOS (8.4 +/- 2.7 ng/mL vs. 13.6 +/- 5 ng/mL in the control group, P < 0.001). There was no significant difference between the adiponectin concentrations of women in group III and that in group IV (8.1 +/- 2.8 ng/mL vs. 9.2 +/- 2.6 ng/mL, respectively, P = 0.1). Adiponectin levels were significantly lower in group I compared with group II. A weak but significant negative correlation was found between adiponectin and insulin levels in all the subjects. Multiple regression analyses showed that the presence of PCOS was the only significant determinant of serum adiponectin levels. CONCLUSIONS: Adiponectin levels were reduced in all the women with PCOS. There seemed to be an interaction between adiponectin and PCOS pathogenesis that was independent of body mass index.

High prevalence of vitamin D deficiency among pregnant women and their newborns in an Iranian population.

BACKGROUND AND OBJECTIVE: Vitamin D deficiency during pregnancy has important health implications for the mother and infant. This study was designed to determine the prevalence of hypovitaminosis D in pregnancy and to examine the probable correlation between serum concentrations of 25-hydroxyvitamin D [25(OH)D] in maternal blood and in neonates' cord blood. As yet, few studies have examined this phenomenon in the Iranian population; thus, this research adds to a small body of literature. METHODS: Sixty-seven full-term pregnant mothers were enrolled serially from a referring general hospital in Zanjan, a province located west of Tehran. All participating mothers delivered their babies via typical vaginal delivery. Samples of maternal and cord blood were collected on the day of delivery. Serum concentrations of calcium, phosphorus, 25(OH)D and alkaline phosphatase were measured in the samples. 25(OH)D concentrations <25 nmol/L were considered to be indicative of hypovitaminosis D. RESULTS: Mean maternal serum 25(OH)D was 19.4 +/- 3.9 nmol/L, and cord blood 25(OH)D was 16.7 +/- 2.9 nmol/L. Hypovitaminosis D was detected in 86% of the women and in 75% of the newborns during winter and 46% of the mothers and 35% of the newborns during summer. A positive correlation was found between maternal and cord blood 25(OH)D (r = 0.55, p < 0.001). CONCLUSIONS: We observed a high prevalence of physiologically significant hypovitaminosis D among pregnant women and their newborns, the magnitude of which warrants public health intervention.

Hemochromatosis gene (HFE) mutations in patients with type 2 diabetes and their control group in an Iranian population.

OBJECTIVE: To assess the frequency of 2 different forms of hemochromatosis HFE gene mutations (C282Y and H63D mutations) in a normal population in comparison with type 2 diabetic patients. METHODS: This case control study was undertaken in Zanjan Diabetic Care Center, Zanjan, western Tehran, in 2005. Two hundred and two individuals were included in this study: 101 type 2 diabetes mellitus (T2DM) patients, and 101 age, and gender-matched controls. The patients were examined for mutations in the HFE gene. Nucleotide 845 (C282Y) and 187 (H63D) alleles were amplified by polymerase chain reaction PCR with lymphocyte deoxy-ribonucleic acid. The PCR products were analyzed by restriction enzyme digestion. Chi-square, student's t test, and Fisher's exact tests were used for comparison, and odds' ratio was calculated. RESULTS: Two hundred and two individuals were studied. The frequency of wild/C282Y alleles was 98/2% in T2DM patients, and 99/1% in controls p=0.6. The frequency of wild/H63D alleles was 68.3/31.7% in diabetics p=0.08, and 73.4/26.3% in control subjects p=0.08. The distribution of genotypes was not statistically different. CONCLUSION: Based on our data, HFE mutations were not found in excess in patients with T2DM, and there was no evidence that a population-based search for an excess of these alleles in type 2 diabetes was indicated.

Elevated serum ferritin concentrations in prediabetic subjects.

BACKGROUND: Few data are available on the association of variables of the insulin resistance syndrome and serum ferritin, an indicator of body iron stores. We examined the relationship between serum ferritin levels and impaired fasting glucose, a pre-diabetes stage associated with insulin resistance, in this study. SUBJECTS & METHODS: One hundred and eighty seven people, including 91 subjects with impaired fasting glucose (IFG) and 96 healthy people who were well matched for age and sex, were enrolled. Body mass index (BMI) and blood pressure of the participants were measured and serum cholesterol, triglyceride, white blood cells (WBC) count, C-reactive protein (CRP) and ferritin were evaluated. All the data were analysed by t-test, chi2 test and analysis of variance. RESULTS: The IFG group had higher serum ferritin concentrations (85.5+/-6.6 microg/L vs. 49.4+/-3.7 microg/L, p=0.001). A positive correlation was found between fasting plasma glucose and serum ferritin (r=0.29, p=0.001). Using multiple regression analysis, we found an association between serum ferritin and blood pressure (0.15, p=0.01), FPG (0.29, p=0.001), triglyceride (0.08, p=0.01) and cholesterol (0.07, p=0.03). The odds ratio for the association of IFG in male subjects with a high serum ferritin level was 8.3 (95% CI: 1.2-11.9, p=0.01) and for females was 3.06 (95% CI: 0.58-15, p=0.1). CONCLUSION: Based on the data from our study, aelevation in serum ferritin can be seen in pre-diabetes stage, before the occurrence of an overt diabetes mellitus.