Trend of atherosclerosis risk factors in children of Isfahan

The prevalence of major atherosclerosis risk factors in Iran was evaluated in 1993 and again in 1999 in 4500 randomly selected children aged 2 to 18 years. Serum lipid levels were significantly higher than standard values in both sexes and in all age groups in the 1993 and 1999 studies. The increase in serum lipid levels was most marked in teenagers. High-density lipoprotein cholesterol was significantly lower than standard values in both studies. There were no significant differences in blood pressure percentiles or the prevalence of hypertension compared to standard values in 1993 and 1999. No case of diabetes mellitus was found. Although the prevalence of obesity was low in these studies (0.2% in 1993, and 0.35% in 1999), a two-fold rise in overweight subjects was noted (4% in 1993, 8% in 1999; p < 0.05), especially in school-aged and adolescent girls. In view of these results and the increasing incidence of coronary artery disease among young people, special attention should be paid to primary prevention

Comparison the effect of low glycemic index diet with healthy nutritional recommendations based diet on obese adolescent girls

زمینه و هدف: هر چند مطالعات بسیاری به ارزیابی تأثیر نمایه گلیسمی بر چربی خون در بزرگسالان پرداخته اند، اما اطلاعات در این زمینه برای کودکان و نوجوانان محدود است. هدف این تحقیق مقایسه اثرات رژیم غذایی با نمایه گلیسمی پایین (LGI) با رژیم غذایی مبتنی بر توصیه های تغذیه سالم (HNR) بر سطح فراسنج های لیپیدی و آپولیپوپروتئین ها در نوجوانان دختر مبتلا به اضافه وزن و چاقی بود. روش بررسی: در این مطالعه کارآزمایی بالینی تصادفی شده پنجاه دختر سالم چاق یا دارای اضافه وزن و با وضعیت بلوغ یکسان بطور تصادفی در یکی از دو گروه رژیم غذایی LGI و رژیم غذایی مبتنی بر HNR قرار گرفتند. افراد هر دو گروه، رژیم غذایی با ترکیب مشابهی از درشت مغذی ها (56-53 کربوهیدرات، 18-16 پروتئین و 30-27 چربی) دریافت و مصرف نمودند. ارزیابی های بیوشیمیایی شامل تری گلیسیرید (TG)، کلسترول تام (TC)، لیپوپروتئین با دانسیته پایین (LDL)، لیپوپروتئین با دانسیته بالا (HDL)، آپولیپوپروتئین های A (Apo A) و B (Apo B) و لیپوپروتئین (a) (Lpa) یک بار در ابتدا و یک بار در انتهای مطالعه انجام شد. مقایسه مقادیر قبل و بعد در هر گروه با آزمون t زوجی و مقایسه تغییرات مشاهده شده در دو گروه با آزمون t مستقل در نرم افزار SPSS انجام شد. یافته ها: نمایه گلیسمی در گروه رژیم غذایی LGI کمتر از 50 بود (67/1 ± 67/42). میانگین نمایه توده بدنی در گروه LGI برابر 55/0 ± 97/27 متر بر مجذور قد و در گروه HNR برابر 01/1 ± 82/28 متر بر مجذور قد بود. میانگین سن در افراد گروه HNR از افراد گروه LGI به طور معنی داری بالاتر بود (27/0 ± 98/13 در مقابل 21/0 ± 18/13، 031/0=P). مقادیر متغیرهای بیوشیمیایی در ابتدا و انتهای مطالعه در بین دو گروه با یکدیگر تفاوتی نداشت. درصد تغییرات شاخص های چربی خون در بین گروه LGI و HNR نشان دهنده عدم وجود تفاوت معنی دار در تغییرات TG (به ترتیب 20/17± 90/27 و 53/10 ± 15/6؛ 274/0=P)، TC (به ترتیب 49/4 ± 58/5 و 63/3 ± 65/0-، 283/0=P)، HDL (به ترتیب 05/4 ± 20/1 و 07/3 ± 77/1-، 556/0=P)، LDL (به ترتیب 52/4 ± 35/4 و 32/3 ± 24/2-، 225/0=P)، Apo A (به ترتیب 73/5 ± 18/0- و 19/5 ± 37/9-؛ 242/0=P)، Apo B (به ترتیب 22/7±24/10 و 40/7±73/6؛ 738/0=P) و Lpa (به ترتیب 13/40 ±71/57 و 24/47 ± 18/97، 676/0=P) در بین دو گروه بود. نتیجه گیری: رژیم غذایی با نمایه گلیسمی پایین در مقایسه با رژیم غذایی مبتنی بر توصیه های تغذیه سالم تاثیر مفیدی در چربی خون ندارد

Mutations of Dual Oxidase 2 (DUOX2) Gene among patients with Permanent and Transient Congenital Hypothyroidism

Objective: The prevalence of congenital hypothyroidism (CH) is high in Isfahan, Iran. In addition, it has different etiologies compared with other countries. The rate of parental consanguinity is also high in the city. Moreover, DUOX2 gene is effective in transient CH and permanent CH due to dyshormonogenesis. Therefore, the aim of this research was to investigate the mutations of DUOX2 gene in patients with transient CH and permanent CH due to dyshormonogenesis. Methodology: In this descriptive, prospective study, patients diagnosed with transient and permanent CH due to dyshormonogenesis during CH screening program were selected. Venous blood samples were obtained to determine the 3 mutations (Q36H, R376W, and D506N) of DUOX2 gene using polymerase chain reaction (PCR) method by specific primers and complementary methods such as restriction fragment length polymorphism (RFLP) and singlestrand conformation polymorphism (SSCP). Results: In this study, 25 patients with transient CH and 33 subjects with permanent CH due to dyshormonogenesis were studied. In addition, 30 children were studied as the control group. We did not find any mutations of the 3 mentioned mutations of DUOX2 gene. Conclusion: Considering the findings of the current study, further studies with other methods are required to evaluate other gene mutations such as pendrin, sodium-iodide symporter (NIS) and thyroglobuli

Anthropometric indices associated with dyslipidemia in obese children and adolescents: a retrospective study in isfahan

<p class="abstract"><strong>&nbsp;&nbsp; </strong><strong>BACKGROUND:</strong> Central obesity is an important risk factor for cardiovascular diseases (CVD). Preventive interventions from childhood are necessary due to the increasing prevalence of childhood obesity. Body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and waist to height ratio (WSR) are anthropometric indices for measurement of obesity. This study aimed to assess the association between these anthropometric indices and dyslipidemia in obese children and adolescents.</p> <p class="abstract"><strong>&nbsp;&nbsp; METHODS:</strong><strong> </strong>This retrospective study was done on the records of 2064 obese children and adolescents aged 6-18 years at the obesity clinic, in Isfahan Cardiovascular Research center. Age, gender, weight, height, WC, hip circumference (HC), triglyceride (TG), total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), Fasting blood sugar (FBS), diastolic blood pressure (DBP) and systolic blood pressure (SBP) were taken from patients&rsquo; record. Receiver operating characteristics (ROC) curve and Pearson correlation were used to analyze the data.</p> <p class="abstract"><strong>&nbsp;&nbsp; RESULTS:</strong> 2064 girls and boys aged 6-18 years were divided into 3 age groups of 6-9.9 years, 10-13.9 years and 14-18 years. Prevalence of high LDL-C, TC, TG, FBS, SBP, DBP and low HDL-C was higher among the boys compared to the girls. There was a significant association between TC, LDL-C, TG and FBS with BMI, WC, WHR and WSR. However, no significant correlation was seen between HDL-C and the four anthropometric indices.<strong>&nbsp;</strong></p> <p class="abstract"><strong>&nbsp;&nbsp; </strong><strong>CONCLUSION:</strong> Our study showed a significant correlation between BMI, WC and WSR with high levels of TC, TG and LDL-C in children and adolescents. Correlation between WHR and dyslipidemia in this study was significant but its predictive value was weaker than other three indices.</p> <p class="abstract">&nbsp;</p><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td width="35" height="12"><br /></td></tr> <tr><td><br /></td> <td>&nbsp;</td></tr></tbody></table> &nbsp; <strong>Keywords:</strong> Body Mass Index, Waist Circumference, Waist to Hip Ratio, Waist to Height Ratio, Dyslipidemia, Children, Adolescents

High prevalence of goiter in schoolchildren in Isfahan; zinc deficiency does not play a role

Wstęp: Dane dotyczące znaczenia niedoboru cynku w etiologii wola endemicznego są niejednoznaczne. Celem niniejszego badania było ustalenie związku między stężeniem cynku w surowicy a występowaniem wola u dzieci w wieku szkolnym w Isfahanie. Materiał i metody: Badanie przeprowadzono w 2005 roku. Włączono do niego 2331 dzieci, u których oceniono palpacyjnie wielkość tarczycy. U części dzieci oznaczono stężenie jodu w moczu (UIC, urinary iodine concentration) i stężenie cynku w surowicy. Wyniki: Obecność wola stwierdzono u 32,9% dzieci. Średnie UIC wynosiło 195,5 &#956;g/l. Stężenie cynku w osoczu oznaczono u 94 dzieci z wolem i 326 dzieci, u których nie stwierdzono wola. Średnie stężenie cynku w osoczu &#177; odchylenie standardowe wynosiło 100,81 &#177; 22,33 &#956;g/dl u dzieci z wolem i 96,00 &#177; 25,79 &#956;g/dl u dzieci bez wola (p = 0,08). Częstość niedoboru cynku (stężenie cynku w surowicy &#8804; 65 &#956;g/dl) nie różniła się istotnie w grupie dzieci z wolem i bez wola (6,4% v. 8,0%, p = 0,61). Wnioski: Częstość występowania wola u dzieci w wieku szkolnym w Isfahanie jest nadal duża. Wydaje się, że niedobór cynku nie ma wpływu na znaczną liczebność przypadków wola w tym regionie. Wskazane są dalsze badania mające na celu identyfikację czynników zwiększających częstość występowania wola w Isfahanie. (Endokrynol Pol 2010; 61 (3): 287-290)Introduction: There are controversial data about the role of zinc deficiency in the aetiology of endemic goiter. The aim of the present study was to determine the association between zinc status and goiter in schoolchildren of Isfahan. Material and methods: This study was performed in 2005. Two thousand three hundred and thirty-one schoolchildren were enrolled, and thyroid size was determined by inspection and palpation. Urinary iodine concentration (UIC) and serum zinc level were measured in a group of those children. Results: The prevalence of goiter was 32.9%. The median UIC was 195.5 &#956;g/L. Serum zinc was measured in 94 goitrous and 326 nongoitrous children. The mean &#177; standard deviation of serum zinc in goitrous and non-goitrous children was 100.81 &#177; 22.33 and 96.00 &#177; 25.79 &#956;g/dL, respectively (P = 0.08). The prevalence of zinc deficiency (serum zinc &#8804; 65 &#956;g/dL) in goitrous and non-goitrous children did not differ significantly (6.4 % v. 8.0%, P = 0.61). Conclusions: The prevalence of goiter is still high in Isfahan schoolchildren. It seems that zinc status is not involved in the high prevalence of goiter in this region. The role of other possible goitrogens should be investigated in Isfahan. (Pol J Endocrinol 2010; 61 (3): 287&#8211;290

Association between Serum Ferritin and Goitre in Iranian School Children

Despite long-standing supplementation of iodine in Iran, the prevalence of goitre among general people remains high in some regions. The study investigated the role of iron status in the aetiology of goitre in school children in Isfahan, Iran. Two thousand three hundred and thirty-one school children were selected by multi-stage random sampling. Thyroid size was estimated by inspection and palpation. Urinary iodine concentration (UIC) and serum ferritin (SF) were measured. Overall, 32.9% of the children had goitre. The median UIC was 195.5 μg/L. The mean±SD of SF in the goitrous and non-goitrous children was 47.65±42.51 and 44.55±37.07 μg/L respectively (p=0.52). The prevalence of iron deficiency in goitrous and non-goitrous children was 9.6% and 3.1% respectively (p=0.007). Goitre is still prevalent in school children of Isfahan. However, their median UIC was well in the accepted range. Iron deficiency is associated with goitre in a small group of goitrous children. The role of goitrogens should also be investigated in this region

Sonographic assessment of congenitally hypothyroid children in Iran

Introduction: Considering the high prevalence of congenital hypothyroidism (CH) in Isfahan, it seems that it is necessary to investigate the aetiology of the disorder and its related factors. The aim of this study was to determine the aetiology of CH among children in Isfahan province. Material and methods: In this cross-sectional study, the aetiology of CH and the volume of the thyroid was assessed using neck ultrasonography. The results of thyroid function screening tests were additionally recorded. The correlation between ultrasonographic findings and the level of TSH and as well as T4 was determined. Results: During this study 385 CH patients aged 0-3 years were studied. According to ultrasonographic findings, in 19.9% of patients the aetiology of CH was dysgenesis (agenesis, ectopy, and hemiagenesis) and 80.1% had normal thyroid. Mean thyroid gland volume in all studied patients was 0.78 &#177; 0.44 mL. The prevalence of ultrasonographic findings was as follows: normal 80.1%, agenesis 12.7%, hemiagenesis 5.8%, and ectopy 1.4%. There was a significant correlation between thyroid volume and TSH and T4 and as well as between TSH and ultrasonographic findings (p < 0.05). Conclusions: In spite of the limitations of ultrasonography in the field of determining the aetiology of CH, it is an appropriate imaging tool for determining the volume of the thyroid gland in children. Considering that the rate of goitrous gland was low, it seems that iodine deficiency could not be responsible for the high rate of CH in this region. (Pol J Endocrinol 2010; 61 (6): 665-670)Wstęp: Z uwagi na częste występowanie w Isfahanie wrodzonej niedoczynności tarczycy (CH, congenital hypothyroidism) należy wyjaśnić przyczyny powstania tego zaburzenia i sprzyjające jego rozwojowi czynniki. Celem badania było ustalenie etiologii CH u dzieci zamieszkałych w prowincji Isfahan. Materiał i metody: W tym przekrojowym badaniu przeprowadzono badanie ultrasonograficzne szyi w celu oceny wielkości tarczycy i ustalenia etiologii niedoczynności tego narządu. W ramach programu badań przesiewowych wykonano testy oceniające czynność tarczycy. Zbadano korelacje między wynikami badań ultrasonograficznych a stężeniami TSH i T4. Wyniki: Do badania włączono 385 dzieci z CH w wieku 0-3 lat. Badania obrazowe wykazały, że u 19,9% chorych przyczyną CH były zaburzenia rozwoju tarczycy (agenezja, ektopia i hemiagenezja). Średnia objętość gruczołu tarczowego w badanej grupie wynosiła 0,78 &#177; 0,44 ml. Uzyskano następujące wyniki badań ultrasonograficznych: obraz prawidłowy u 80,1% dzieci, agenezja - 12,7%, hemiagenezja - 5,8%, ektopia - 1,4%. Stwierdzono istotną korelację między wielkością tarczycy a stężeniem TSH i T4 oraz między stężeniem TSH a wynikami badań ultrasonograficznych (p < 0,05). Wnioski: Mimo ograniczeń ultrasonografii, jako metody określania etiologii CH, ten rodzaj badań obrazowych jest przydatny do oceny wielkości tarczycy u dzieci. Biorąc pod uwagę rzadkie występowanie wola u dzieci z CH, można przypuszczać, że niedobór jodu nie jest przyczyną wysokiej zachorowalności na tę chorobę w prowincji Isfahan. (Endokrynol Pol 2010; 61 (6): 665-670

Pamidronate therapy for hypercalcemia and congenital mesoblastic nephroma: a case report

Hypercalcemia can causes life threatening complications. We report an infant with severe hypercalcemia due to congenital mesoblastic nephroma. Hypercalcemia was corrected before nephrectomy by pamidronate. According to our knowledge this is a rare case with severe neoplasm induced hypercalcemia among neonates who treated by bisphosphonates. The aim of this report is to define new approach to neoplasm induced neonatal hypercalcemia

Age of menarche and final height in patients with permanent congenital hypothyroidism

Purpose We compared the age at menarche and standard deviation score (SDS) of final height (FH) in permanent congenital hypothyroidism (CH) patients with those of healthy female adolescents and assessed their associations with CH screening-related variables or demographic factors. Methods In this cross-sectional study, we included 207 female CH patients and 598 healthy age-matched female adolescents. Ages at puberty onset and menarche, height at puberty and menarche, and the FH and its SDS were evaluated in the 2 groups and compared. Associations between screening variables and anthropometric data with age at menarche and SDS of FH were also assessed in CH patients. Results In the included population, 113 patients with CH and 453 healthy girls attained their FH. The mean ages at puberty onset and menarche in CH patients were higher than those in the healthy population (P0.05). There was no significant association between FH SDS in CH patients and age of treatment (P=0.30). Age at menarche was significantly higher in CH patients with delayed age at treatment initiation (P=0.04). The difference between FH and target height was not significantly different among CH patients (P=0.83). Conclusions While CH patients had a significantly higher age at menarche compared to the healthy population, appropriate treatment changed this age to be similar to that in the healthy group. However, CH patients who experienced delayed treatment had a higher age at menarche. Age at treatment initiation was the only screening-related variable related to age at onset of menarche and puberty