Publications by authors named "Mahin Hashemipour"

121 Publications

Intelligence Quotient, Anxiety, and Depression in Congenital Hypothyroid Children at School Age.

Int J Prev Med 2020 11;11:197. Epub 2020 Dec 11.

Endocrine and Metabolism Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Many studies who evaluated the outcome of the congenital hypothyroidism (CH) screening reported some intellectual and behavioral deficit despite early diagnose and treatment. The aim of the present study was to compare the intellectual and behavioral adjustment of CH children with controls.

Methods: This study was conducted among a group of 135 children aged 8--12 years in Isfahan, including transient and permanent congenital hypothyroidism (TCH and PCH) and a matched group of their classmate. Demographic characteristics collected using a designed data collecting form completed by parents. Intellectual quotient (IQ) was evaluated using Wechsler Intelligence Scale for Children aged 6--16 years (WISC-III). Depression and anxiety were evaluated using The Children's Depression Inventory (CDI) and the Multidimensional Anxiety Scale for Children (MASC), respectively. The SPSS software version 20.0 was used for data analysis. Nonparametric tests (Mann--Whitney) were used to investigate the association between variables. A significant level of less than 0.05 was considered in all analyzes.

Results: There was no significant difference in the IQ scores between PCH and TCH groups ( = NS). However, neither of them had intellectual disability (defined as IQ <70). IQ scores were significantly lower in PCH comparing to controls ( < 0.001). Total IQ and verbal IQ were significantly differenct between TCH and control group ( = 0.007 and = 0.001). No significant difference was found in anxiety and depression scores between CH children and controls.

Conclusions: There is no significant difference in anxiety and depression scores between congenital hypothyroidism children and controls, although IQ scores in children with congenital hypothyroidism is lower than controls.
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http://dx.doi.org/10.4103/ijpvm.IJPVM_574_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8000161PMC
December 2020

Whole grain intake favorably affects blood glucose and serum triacylglycerols in overweight and obese children: A randomized controlled crossover clinical trial.

Nutrition 2021 Feb 12;87-88:111200. Epub 2021 Feb 12.

Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Objectives: The aim of this study was to determine the effects of whole grain consumption on the metabolic profiles of overweight or obese children.

Methods: This was a randomized crossover clinical trial with 44 overweight or obese girls. After a 2-wk run-in period, girls were randomly assigned to either intervention or control groups. Participants in the intervention group were asked to obtain 50% of their grain servings from whole grain foods each day for 6 wk. Those in the control group were asked not to consume any of these foods. A 4-wk washout period was applied following which participants were crossed over to the alternate arm. Fasting blood samples were taken before and after each phase of study.

Results: Mean (± SD) age and body mass index was 11.2 ± 1.49 y and 23.5 ± 2.5 kg/m, respectively. Mean whole grain intake in intervention and control groups throughout the study was 26.5 and 3.7 g/d, respectively (P = 0.01). Whole grain consumption resulted in lower concentrations of plasma glucose (changes from baseline in intervention group: -0.10 versus 0.21 mmol/L in control group, P = 0.01), serum triacylglycerols (changes from baseline in intervention group: -0.18 versus 0.08 mmol/L in control group, P = 0.01) and higher concentrations of serum high-density lipoprotein cholesterol (changes from baseline in intervention group: 0.16 versus -0.14 mmol/L in control group, P = 0.05) after 6 wk of intervention. No effects of whole grain intake on serum concentrations of total- and low-density lipoprotein cholesterol or on blood pressure were found.

Conclusion: This study provided evidence supporting the beneficial effects of whole grain foods on serum concentrations of glucose, triacylglycerols and high-density lipoprotein cholesterol in overweight children.
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http://dx.doi.org/10.1016/j.nut.2021.111200DOI Listing
February 2021

The effects of whole grain intake on anthropometric measures in overweight and obese children: a crossover randomised clinical trial.

Br J Nutr 2021 Jan 21:1-7. Epub 2021 Jan 21.

Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Whole-grain foods have been reported to affect body weight and satiety. However, we are aware of no study in this regard among children. The present study aimed to determine the effects of whole grain consumption on anthropometric measures in overweight or obese children. In this randomised crossover clinical trial, forty-four overweight or obese girls participated. After a 2-week run-in period, subjects were randomly assigned to either intervention (n 44) or non-intervention (n 44) groups. Subjects in the intervention group were given a list of whole-grain foods and were asked to obtain half of their grain servings from these foods each day for 6 weeks. Individuals in the non-intervention group were asked not to consume any of these foods. A 4-week washout period was applied. Then, participants were crossed over to the alternate arm. The measurements were done before and after each phase. Mean age, weight and BMI of participants were 11·2 (sd 1·49) years, 51·2 (sd 10·2) kg and 23·5 (sd 2·5) kg/m2, respectively. Despite the slight reduction in weight and BMI, there were no significant differences in changes in these anthropometric measures. We found a significant effect of whole grain intake on waist circumference (-2·7 v. 0·3 cm, P = 0·04). No significant changes in hip circumference were observed. Changes in the prevalence of overweight, obesity and abdominal obesity were not significantly different. This study indicated a beneficial effect of whole-grain foods on waist circumference in overweight children; however, these foods did not influence weight and BMI.
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http://dx.doi.org/10.1017/S000711452100026XDOI Listing
January 2021

Association of Maternal Dietary Components During Pregnancy and/or Lactation with Insulin-Dependent Diabetes Mellitus.

Int J Endocrinol Metab 2020 Jul 22;18(3):e93076. Epub 2020 Jul 22.

Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.

Context: Considering the increasing trend in the incidence of type 1 diabetes mellitus (T1DM), the identification of its environmental determinants, especially those related to the prenatal and lactation period, might ultimately result in primary prevention of the disease. We aimed to review the evidence of the association between mothers' dietary components during pregnancy and/or lactation with T1DM.

Evidence Acquisition: An electronic and comprehensive literature search was performed until August 2019 in the international databases, including Web of Science (ISI), PubMed, and Scopus, using the following keywords: type 1 diabetes mellitus, autoimmunity, mother, maternal, diet and lactation in different combinations. Papers related to the objectives of the study were selected.

Results: Based on our review, the maternal consumption of meat, especially processed meat, was associated with increased risk of T1DM, whereas the maternal use of vegetables, potato, low-fat margarine, and berries showed protective effects against the development of T1DM in offspring. There was no significant association between the use of multivitamins and mineral supplements with T1DM, according to the available data. The results of the reviewed studies regarding the association between the maternal use of vitamin D, fatty acids, and coffee during pregnancy with T1DM were not consistent and conclusive.

Conclusions: Findings of this review indicate that the maternal consumption of some foods is associated with increased or decreased risk of T1DM. However, for some foods or dietary components, including coffee, vitamin D, and fatty acids, the results are not conclusive. We conclude that although maternal diet could influence the development of insulin autoantibodies (IA) and T1DM in offspring, there is no sufficient evidence for most nutrients, and available data are controversial, which should be dealt with in future cohort or interventional studies.
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http://dx.doi.org/10.5812/ijem.93076DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695223PMC
July 2020

Comparison of Family Life Quality in Type 1 Diabetic and Healthy Children from the Perception of their Mothers.

Int J Prev Med 2020 10;11:154. Epub 2020 Sep 10.

Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Given the fact that the quality of care of diabetic children and their mothers' psychological health and family life quality have mutual effects on each other; in this study, we aimed to compare family life quality of type 1 diabetic (T1DM) patients with healthy children from the perception of their mothers. However, our findings would be helpful for further interventional studies in order to improve both diabetes management and psychological health of their parents.

Methods: In this case control study, mothers of children with T1DM, who referred to endocrine and metabolism clinics of Isfahan city, were enrolled. Demographic and familial characteristics of studied population were recorded. Family life quality was evaluated using Retting and Leichtentritt questionnaire and compared between two groups. The questionnaire consists of 32 items, which were representative of six resources including love, status, services, information, goods, and money.

Results: In this study, 50 children with T1DM and 50 healthy children and their mothers were evaluated. Mean total score of family life quality and its resource classes were significantly higher in mothers of T1DM patients than mothers of healthy children ( < 0.05) except for love ( = 0.05).

Conclusions: The findings of this study indicated that the total family life quality score was significantly lower in families of diabetic patients than healthy children families from the perception of their mothers. Our results indicated that most of the family-life-related dimensions including attitude and service, services, information, goods, and money affected by the disease conditions and its related comorbidities.
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http://dx.doi.org/10.4103/ijpvm.IJPVM_200_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7643571PMC
September 2020

The association between familial and environmental factors and prevalence of congenital hypothyroidism in center of Iran.

Environ Sci Pollut Res Int 2021 Feb 15;28(7):8434-8441. Epub 2020 Oct 15.

Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Imam Hossein Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

The aim of this current study is to investigate the association between familial and environmental factors and prevalence of congenital hypothyroidism (CH) in Isfahan province. In this retrospective cohort study, data of the neonates referred for CH screening in different cities of Isfahan province were evaluated. Data regarding air and soil (lead, cadmium) pollutants were collected. The spatial association between mentioned environmental pollutants and prevalence of CH in different cities of Isfahan province was evaluated by using GIS software, and multilevel linear regression was used for evaluating the levels of environmental pollutants and neonates' serum TSH. During the study period, 389,945 neonates were screened, from which 934 diagnosed with CH (1 in 417 neonates).The prevalence rate of CH was ranged from < 20 in 10,000 live births to > 45 in 10,000 live births in different cities of Isfahan province. There was no any significant association between level of soil lead and cadmium and air pollutants with prevalence of CH in different cities of Isfahan province (P > 0.05).There was a significant positive association between soil cadmium and air pollution evaluated by air quality index (AQI) and level of screening serum TSH in CH patients. Considering the significant association between cadmium and AQI with first serum TSH, it is inferred that the interaction of genetic, autoimmune, familial, and environmental factors with each other could influence on neonatal thyroid function. It seems that the role of some mentioned component is more prominent which should be investigated in future researches.
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http://dx.doi.org/10.1007/s11356-020-10959-xDOI Listing
February 2021

The association between prenatal exposure to organochlorine compounds and neonatal thyroid hormone levels: a systematic review.

J Pediatr Endocrinol Metab 2020 Jan;33(1):21-33

Isfahan Endocrine and Metabolism Research Center, Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.

In this systematic review, the association between prenatal exposure to organochlorine pesticides (OCPs) and neonatal thyroid hormone levels was studied. A systematic search of scientific literature was performed from the PubMed, SCOPUS and ISI web of science electronic bibliographic databases. The search strategy for the review was [(organochlorine OR "organochlorine pesticides" OR "organochlorine pollutants" OR "organochlorine pollutant") AND ("thyroid hormone" OR triiodothyronine OR Thyroxine OR "fetal thyroid function" OR "thyroid function" OR "Thyroid Stimulating Hormone" AND "prenatal" AND "maternal exposure")] in English sources. In this review, 305 papers (PubMed: 30; Scopus: 29; ISI: 246) were identified through an electronic database search. Twenty-seven articles were assessed for eligibility, from which 16 qualified articles were selected for the final evaluation. The most common OCP metabolites which were evaluated in order were hexachlorobenzene (HCB) (13 studies), pp-dichlorodiphenyldichloroethylene (pp-DDE) (13 studies), hexachlorocyclohexane (HCH) (10 studies) and dichlorodiphenyltrichlorethane (DDT) (eight studies). A review of the documents related to the association of prenatal exposure of OCPs with fetal or neonatal thyroid function tests provides us with heterogeneous data in this field. Factors such as differences in the studied populations and their area, ethnic and genetic background, time and rate of exposure, possible interaction of other thyroid-disrupting environmental factors and dietary intake of micronutrients such as iodine and/or selenium are considered the main limitations for making an accurate conclusion. For some OCPs including DDT, DDE, HCH and HCB, there are supporting evidences, and it is suggested that their exposure could potentially alter the fetal thyroid function and consequently impair the neurodevelopment process of the infants.
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http://dx.doi.org/10.1515/jpem-2019-0336DOI Listing
January 2020

Investigating the incidence rate and geographical distribution of congenital hypothyroidism among neonates in Isfahan province using geographic information system (GIS) between 2002 and 2015.

J Pediatr Endocrinol Metab 2020 Jan;33(1):35-45

Department of Epidemiology, Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran.

Background Congenital hypothyroidism (CH) is one of the main causes of mental retardation in neonates. The disease is associated with genetic, climatic and environmental factors. Accordingly, the present study was conducted to determine the incidence rate and correlation of geographic factors with CH in Isfahan province in order to explain the role of climatic factors in the incidence of disease in this province. Methods This cross-sectional study was conducted to determine the incidence rate and geographical distribution of CH in neonates born in the Isfahan province from the beginning of 2002 to the end of 2015. To estimate the geographic distribution, the ArcGIS software (version 10.3) was used and to investigate the relationship between geographical factors and CH, the Poisson regression test and dispersion diagrams were used. Data analysis was done using the SPSS16 software. Results According to the results of the screening of 1,006,404 neonates born in Isfahan, the mean incidence rate of CH in all infants was 2.3, and that in male and female infants was 2.39 and 2.2 per 1000 live births, respectively. There was a statistically significant correlation between the city of residence (p = 0.01), climatic conditions (p = 0.044), annual precipitation (p = 0.027), sunlight (p = 0.01) and CH. However, there was no significant relationship between the mean altitude above sea level (p = 0.6), land use (p = 0.4) and relative humidity (p = 0.24). Conclusions Based on the findings of this study, the incidence rate of CH in Isfahan province was higher than the average of the country. Moreover, among the geographical factors, climatic conditions, annual precipitation and sunlight were associated with CH.
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http://dx.doi.org/10.1515/jpem-2019-0181DOI Listing
January 2020

A rare enzymatic defect, true isolated 17,20-lyase deficiency leading to endocrine disorders and infertility: case report.

Gynecol Endocrinol 2020 Apr 6;36(4):297-302. Epub 2019 Nov 6.

Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran.

The cytochrome P450 17A1 catalyzes the formation of 17-hydroxysteroids and 17-ketosteroid. Most defects in CYP17A1 impair both enzymatic activities and cause a combined 17α-hydroxylase/17,20-lyase deficiency, which impairs hormone production (cortisol and sex steroids), sexual development, and puberty. Isolated 17,20-lyase deficiency is usually defined by evidently normal activity of 17α-hydroxylase with a dramatic decline of 17,20-lyase activity or complete inactivity. The changes in enzyme activity lead to a lack in the production of sex steroids with normal levels of glucocorticoid and mineralocorticoid hormones. A 24-years-old married woman, as a product of a consanguineous marriage, presented with infertility and a background marked by primary amenorrhea. Laboratory data showed low normal serum cortisol levels and low levels of 17-hydroxyprogesterone. Also, her adrenal androgens were low but estradiol was normal. The chromosomal investigation uncovered a male karyotype of 46, XY. These clinical and laboratory evidence confirm the determination of an isolated 17,20-lyase deficiency in a genotypic male.
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http://dx.doi.org/10.1080/09513590.2019.1683819DOI Listing
April 2020

Genetic Study of Hepatocyte Nuclear Factor 1 Alpha Variants in Development of Early-Onset Diabetes Type 2 and Maturity-Onset Diabetes of the Young 3 in Iran.

Adv Biomed Res 2019 23;8:55. Epub 2019 Sep 23.

Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Maturity-onset diabetes of the young (MODY) is a clinically and genetically heterogeneous group of diabetes characterized by noninsulin-dependent, autosomal-dominant disorder with strong familial history, early age of onset, and pancreatic beta-cell dysfunction. Mutations in at least 14 different genes are responsible for various MODY subtypes. Heterozygous mutations in the hepatocyte nuclear factor 1 alpha () gene are responsible for the MODY3 subtype, which is a common subtype of MODY in different studied populations. To date, more than 450 different variants of this gene have been reported as disease causing for MODY3. This study was carried out to evaluate mutations in Iranian diabetic families fulfilling MODY criteria.

Materials And Methods: Polymerase chain reaction and Sanger sequencing were performed. All the ten exons of the gene were sequenced in ten families, followed by cosegregation analysis and evaluation. Computational protein modeling was accomplished for the identified mutation.

Results: MODY3 was confirmed in two large families by detecting a mutation (p.G253E) in coding regions of . Compound heterozygous state for two common variants in (p.I27 L and p.S487N) was detected in affected members of 5 families, and in one family, a rare benign variant in the coding sequence for Kozak sequence was detected. Two new nonpathogenic variants were found in noncoding regions of .

Conclusion: It seems that mutations are a common cause of MODY in Iranian diabetic patients. Identified common variants in heterozygous state can cause diabetes Type II in earlier ages. The role of rare variant rs3455720 is unknown, and more investigation is needed to uncover the function of this variant.
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http://dx.doi.org/10.4103/abr.abr_54_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6777141PMC
September 2019

Congenital hypothyroidism in different cities of the Isfahan province: A descriptive retrospective study.

J Educ Health Promot 2019 29;8:137. Epub 2019 Jul 29.

Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Considering the high prevalence rate of congenital hypothyroidism CH in Iran, an epidemiological study in each region would be helpful in understanding the etiology of the disorder and providing preventative strategies in this field. This study aims to determine the prevalence of CH in different cities of the Isfahan province.

Materials And Methods: This descriptive and retrospective study was conducted among 918 primarily diagnosed CH neonates, who have been identified through the neonatal screening program from 2009 to 2015. At the age of ≥3 years, treatment was discontinued for 4 weeks, and T4 and thyroid-stimulating hormone were measured. Permanent (PCH) or transient (TCH) was determined from the results of the thyroid function tests.

Results: From 389,101 screened neonates, 918 were diagnosed with primary CH. The overall prevalence rate of CH was 2.36 in 1000 live birth (ranged 1.58-7.22 in 1000 live birth in different cities). The highest prevalence rate of CH was reported in Ardestan, Khansar, Golpaygan, and Nain cities with prevalence rate of 4.86-7.22 in 1000 live birth and lowest prevalence occurring in Fereydan, Shahreza, Isfahan, and Mobarakeh cities with prevalence rate of 1.58-1.89 in 1000 live birth. In 392 cases which reached to 3 years of age, the rate of TCH was 47.45%. In Chadegan, Natanz, Fereydunshahr, Shahinshahr, Najafabad, Dehaghan, Borkhar, and Mobarakeh, the prevalence of PCH was <50%.

Conclusion: The current findings indicate that the incidence rate of both PCH and TCH are high in Isfahan province with significant variability in different cities which could be due to the role of different genetic, prenatal, and different environmental factors. These epidemiological data could be used as baseline date to design more etiological studies.
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http://dx.doi.org/10.4103/jehp.jehp_219_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691614PMC
July 2019

Wolcott-Rallison syndrome in Iran: a common cause of neonatal diabetes.

J Pediatr Endocrinol Metab 2019 Jun;32(6):607-613

Genetics of Complex Traits, University of Exeter Medical School, Medical Research - Level 3, Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, UK.

Background Wolcott-Rallison syndrome is a rare autosomal recessive disorder characterized by neonatal/early-onset non-autoimmune insulin-dependent diabetes, multiple epiphyseal dysphasia and growth retardation. It is caused by mutations in the gene encoding eukaryotic translation initiation factor 2α kinase 3 (EIF2AK3). We aimed to study the clinical characteristics and frequency of the disease in the Iranian population. Methods We recruited 42 patients who referred to the endocrine and metabolism clinic at Mashhad Imam Reza Hospital with neonatal diabetes. Molecular screening of KCNJ11, INS, ABCC8 and EIF2AK3 was performed at the Exeter Molecular Genetics Laboratory, UK. We calculated the frequency of the disease in 124 patients referred from Iran to the Exeter Molecular Genetics Laboratory for genetic screening and compared it to other countries worldwide. Results We identified seven patients as having Wolcott-Rallison syndrome. Genetic testing confirmed the clinical diagnosis and indicated five novel mutations. Only two patients developed clinical features of the syndrome by 6 months of age. Of all 124 cases of Iranian neonatal diabetes referred to the Exeter Molecular Genetics Laboratory for genetic screening, 28 patients (22.58%) had a recessive mutation in EIF2AK3. Conclusions The results of this study raises awareness of the condition and provides further accurate data on the genetic and clinical presentation of Wolcott-Rallison syndrome in the Iranian population. Our study highlights the importance of genetic testing in patients from consanguineous families with diabetes diagnosed within the first 6 months of life.
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http://dx.doi.org/10.1515/jpem-2018-0434DOI Listing
June 2019

The impact of poor glycemic control on lipid profile variables in children with type 1 diabetes mellitus.

J Educ Health Promot 2019 29;8. Epub 2019 Jan 29.

Pediatric Pulmonology, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Type 1 diabetes mellitus (T1DM) and its related comorbidities are considered an important health issue. This study aimed to evaluate the impact of glycemic control on lipid profile variables in children with T1DM.

Materials And Methods: This study included 274 children (≤19 years of age) with T1DM who had referred to the outpatient clinics of endocrinology in Emam-Hossein Hospital of Isfahan, Iran. Based on American Diabetes Association criteria, patients were divided into two groups including optimal glycemic control (OGC) and poor glycemic control (PGC). Mean lipid level and frequencies of lipid profile abnormalities between the two studied groups were compared.

Results: Mean age of the studied population was 13 ± 5.9 years and 133 (48.5%) were boys. A total of 162 (59.1%) and 112 (40.9%) patients had PGC and OGC, respectively. Hypercholesterolemia was the most common dyslipidemia in both groups (33 [29.1%] of OGC and 63 [39.1%] of PGC patients). The frequency of high low-density lipoprotein (LDL) was significantly higher in patients with PGC than those with OCG ( = 0.007). The frequencies of hypercholesterolemia, hypertriglyceridemia, and low levels of high-density lipoprotein were also higher in PGC group, but did not reach the significant threshold.

Conclusion: It is suggested that glycemic control is in association with lipid profile abnormality in patients with T1DM. High LDL was significantly more frequent in patients with PGC than those with OGC. It is recommended to investigate the role of glycemic control on other cardiometabolic risk factors of T1DM patients. Our findings could be used for planning preventative strategies for reducing T1DM-related cardiovascular disease.
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http://dx.doi.org/10.4103/jehp.jehp_194_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378828PMC
January 2019

SOFT Syndrome: The First Case in Iran.

Adv Biomed Res 2018 21;7:128. Epub 2018 Sep 21.

Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Primordial dwarfism (PD) is a group of rare genetically heterogeneous disorders consisted of disorders with intrauterine growth retardation continued through the life. SOFT syndrome with characteristics of short stature, onychodysplasia, facial dysmorphism, and hypotrichosis has been presented as a subtype of PD. Only 20 cases of SOFT syndrome have been reported in world to date, but none of them were not in Iran. Our case was 6.5-year-old girl with a complaint of growth retardation including height of 97 cm (Z = -4.6 standard deviation [SD]) and weight of 14 kg (Z = -4 SD) referred to growth clinic. She had a prominent forehead, triangular face, short limbs, malformed nails, and crowded teeth and her psychomotor function was normal. Laboratory and karyotype tests were normal while she was homozygous for c.G491A mutation of POC1A gene thus SOFT syndrome diagnosis was confirmed for her and recombinant growth hormone therapy was discontinued.
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http://dx.doi.org/10.4103/abr.abr_13_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159314PMC
September 2018

High protein diets do not affect anthropometric indexes and cardiometabolic risk factors among children with excess weight: A randomized controlled trial.

J Cardiovasc Thorac Res 2018 27;10(2):95-103. Epub 2018 Jun 27.

Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.

Limited information exists regarding the effects of high protein (HP) diets on cardiovascular disease (CVD) risk factors among overweight and obese children. Our aim was to determine the effects of an HP diet on anthropometric indexes and CVD risk factors among overweight and obese children. In a parallel randomized controlled trial, we recruited 50 overweight and obese children, aged 6-11 years, for a 10 week HP or control diet (protein, carbohydrate, fat: 25%, 45%, 30% in the HP diet vs. 15%, 55%, 30% in the control diet, respectively). Fasting blood glucose (FBG) serum insulin levels, lipid profiles, systolic and diastolic blood pressure (SBP and DBP), and anthropometric measurements were assessed using standard guidelines. 86% of children completed the trial. Percent changes (PC) for anthropometric and biochemical variables were not significantly different between the two groups. The PC of serum triglyceride (TG) level was significantly decreased in the HP group compared to in the control group (PC: -10.16±4.30% vs.12.11±7.80%; P = 0.01) in the crude model, but not in the adjusted model. For other variables, we did not find any significant differences between the HP group and the controls. In the present study, we did not find any significant effect of adherence to an HP diet in improving anthropometric measurements or other CVD risk factors among obese and overweight children.
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http://dx.doi.org/10.15171/jcvtr.2018.15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6088760PMC
June 2018

Twin Brothers with Carnitine Membrane Transporter Deficiency: A Case Study.

Adv Biomed Res 2018 2;7:106. Epub 2018 Jul 2.

Department of Pediatric Endocrinology, Isfahan University of Medical Sciences, Isfahan, Iran.

Carnitine membrane transporter deficiency or primary carnitine deficiency (PCD) is an autosomal recessive disorder of fatty acid oxidation, in which the transport of carnitine into cells is impaired. Carnitine plays an important role in transporting fatty acids into the mitochondria and carnitine deficiency block oxidation of long-chain fatty acids in the mitochondria that leads to heart and hepatic disease, myopathy, nonketotic hypoglycemia, and neurological complications. PCD has a wide range of symptoms and can reveal itself as symptomatic cardiomyopathy or even asymptomatic. In this study, we reported twin brothers with PCD. One of them had symptoms of disease and cardiomyopathy and was under treatment with carnitine. Another twin was asymptomatic and was diagnosed during follow-up period of his brother.
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http://dx.doi.org/10.4103/2277-9175.235779DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6050976PMC
July 2018

Effect of fermented camel milk on glucose metabolism, insulin resistance, and inflammatory biomarkers of adolescents with metabolic syndrome: A double-blind, randomized, crossover trial.

J Res Med Sci 2018 26;23:32. Epub 2018 Apr 26.

Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: This study, for the first time, aimed to assess the effects of fermented camel milk (FCM) on glycemic and inflammatory parameters related to metabolic syndrome (MetS), an aggregation of cardiometabolic risk factors, in adolescents.

Materials And Methods: In a double-blind, randomized crossover trial, overweight/obese adolescents (fulfilling MetS criteria, aged 11-18 years) were randomly assigned to receive FCM 250 cc per day for an 8-week period, a 4-week washout, and then diluted cow's yogurt (DCY) 250 cc/day for another 8-week period, or the reverse sequence. Fasting blood sugar (FBS), fasting insulin, insulin resistance by three equations, incretin hormone glucose-dependent insulinotropic peptide (GIP), and glucagon-like peptide-1 (GLP1) as well as inflammatory markers such as interleukin 6 (IL6) and tumor necrosis factor-alpha (TNF-α) were measured before and after each of the four periods. A 3-day food record and physical activity questionnaire were completed before each period. Statistical analyses were done using Minitab and SPSS software considering the significance level of 0.05.

Results: Twenty-four participants with a mean (standard deviation) age of 13.77 (1.87) years (range: 10.45-16.25 years) (58% girls) completed the study. It resulted in nonsignificant mean reduction in IL6 (-18.28 pg/mL [95% confidence interval [CI]: -47.48; 10.90]; = 0.20) and nonsignificant increase in glucose metabolizing hormones such as GIP (683.10 pg/mL [95% CI: -457.84; 1824.0]; = 0.22) and GLP1 (6.98 pg/mL [95% CI: -66.61; 80.57]; = 0.84) by FCM consumption in comparison to DCY. Nonsignificant decrease was observed in TNF-α in the first periods of the study. The changes of FBS, fasting insulin, and insulin resistance indices were not statistically significant as well.

Conclusion: According to preliminary positive influences of FCM on inflammatory markers, and findings related to glucose metabolism, we suggest conducting further studies on its clinical impacts.
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http://dx.doi.org/10.4103/jrms.JRMS_1191_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5961288PMC
April 2018

Relationship of lipid regulatory gene polymorphisms and dyslipidemia in a pediatric population: the CASPIAN III study.

Hormones (Athens) 2018 Mar 17;17(1):97-105. Epub 2018 Apr 17.

Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezar-Jarib Ave, Isfahan, Iran.

Objective: In this study, we aimed to assess the association between four variants in three genes whose association has been reported in adults but not in children. We evaluated the relationship of the GCKR (rs780094), GCKR (rs1260333), FADS (rs174547), and MLXIPL (rs3812316) polymorphisms with serum lipid levels in Iranian children.

Design: This cross-sectional study was conducted in a subpopulation of the CASPIAN III study. During this study, 550 frozen whole blood samples were selected randomly. Using the recorded information of selected cases, those with and without abnormal lipid levels were determined. Allelic and genotypic frequencies of GCKR (rs780094), GCKR (rs1260333), MLXIPL (rs3812316), and FADS (rs174547) polymorphisms were determined and compared in dyslipidemic and normal children. The association between the studied polymorphisms and lipid profiles was determined using logistic regression analysis.

Results: Prevalence of hypercholesterolemia, hypertriglyceridemia, high low-density lipoprotein cholesterol (LDL-C), and low high-density lipoprotein cholesterol (HDL-C) were 24.9, 34.5, 19.0, and 40.7%, respectively. Significant correlations were found between GCKR (rs780094) and GCKR (rs1260333) polymorphisms and cholesterol and triglyceride levels, between FADS (rs174547) polymorphism and level of triglyceride, and also between MLXIPL (rs3812316) and levels of HDL-C.

Conclusions: The results of this population-based study provide evidence for a relationship between lipid regulatory gene polymorphisms including GCKR (rs780094), GCKR (rs1260333), FADS (rs174547), and MLXIPL (rs3812316) with dyslipidemia in an Iranian population. These results could provide baseline information on as well as further insight into the genetic makeup of lipid profiles in Iranian children, which could be used for preventative strategies.
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http://dx.doi.org/10.1007/s42000-018-0020-xDOI Listing
March 2018

Positive Effect of Fermented Camel Milk on Liver Enzymes of Adolescents with Metabolic Syndrome: a Double Blind, Randomized, Cross-over Trial.

Mater Sociomed 2018 Mar;30(1):20-25

Students' Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Metabolic syndrome (MetS) has several health consequences. Liver enzymes elevation is among them.

Aim: This study aimed to assess the effects of fermented Camel milk (FCM), as a functional food and dairy, on some features of MetS in adolescents including liver enzymes status, serum lipids and anthropometric measures.

Methods: Overweight/obese adolescents with MetS were randomly assigned to FCM 250 cc per day for 8 weeks, a 4-week washout, and then to diluted Cow's yogurt (DCY) 250 cc per day for 8 weeks, or the reverse sequence. Anthropometric measures, liver enzymes and serum lipids were measured just before and after each one of the four periods. A three-day food record and physical activity questionnaire were completed before each period. Statistical analyses were done using Minitab and SPSS soft-wares considering the significance level of 0.05.

Results: Twenty-four participants with a mean age (SD) of 13.77 (1.87) years (range: 10.45-16.25) (58% girls) completed the study. It resulted significant mean reduction of aspartate aminotransferase (AST) (-3.75 U/L [95% CI: -7.06; -0.43]; p=0.042) and alanine aminotransferase (ALT) (-2.54 U/L [95% CI: -3.33; -2.24], and p=0.006) and AST/ALT ratio (-0.16 U/L [95% CI: -0.28; -0.05]; p= 0.029) by FCM consumption in comparison to DCY. Non-significant favorable effects on anthropometric measures and serum lipids were seen as well.

Conclusion: According to the observed favorable effects of fermented camel milk on liver enzymes, its consumption may be considered as a functional food supplement in related circumstances.
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http://dx.doi.org/10.5455/msm.2018.30.20-25DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5857053PMC
March 2018

Thrombotic Thrombocytopenic Purpura in a Child with Diabetic Ketoacidosis.

Adv Biomed Res 2018 21;7:33. Epub 2018 Feb 21.

Metabolism Research Center, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Thrombotic thrombocytopenic purpura (TTP) secondary to diabetic ketoacidosis has been rarely reported and is considered as a rare complication. If left untreated, this condition could be life threatening with considerable morbidity and mortality. Herein, we report a 6-year-old girl with reduced consciousness and respiratory distress with a history of polydipsia and polyuria in the 2 weeks before hospitalization. The patient was initially diagnosed as diabetic ketoacidosis based on clinical and laboratory findings and treated accordingly. After treatment and during hospitalization although she had gained relative consciousness, she experienced seizure and reduced consciousness again. Considering laboratory and clinical findings and the patient's underlying conditions (thrombocytopenia, renal failure, and high lactate dehydrogenase), TTP was suspected although ADAMTS13 test could not be done. Treatment with plasmapheresis was initiated, and after 48 h, the patient was conscious, and laboratory indices became normal within a few days. The patient was discharged after full recovery. TTP should be considered as a rare complication of diabetic ketoacidosis in patients with thrombocytopenia, renal failure, and reduced consciousness and should be immediately treated.
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http://dx.doi.org/10.4103/2277-9175.225928DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5840966PMC
February 2018

Lipid regulatory genes polymorphism in children with and without obesity and cardiometabolic risk factors: The CASPIAN-III study.

J Res Med Sci 2018 20;23:11. Epub 2018 Feb 20.

Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Genetically, predisposed children are considered as at-risk individuals for cardiovascular disease. In this study, we aimed to compare the frequency of four-lipid regulatory polymorphism in obese and normal-weight children with and without cardiometabolic risk factors.

Materials And Methods: In this nested case-control study, 600 samples of four groups of participants consisted of those with normal weight with and without cardiometabolic risk factors and obese with and without cardiometabolic risk factors. Allelic and genotypic frequencies of GCKR (rs780094), GCKR (rs1260333), MLXIPL (rs3812316), and FADS (rs174547) polymorphisms were compared in the four studied groups.

Results: Data of 528 samples were complete and included in this study. The mean (standard deviation) age of participants was 15.01 (2.21) years. Frequency of tt allele (minor allele) of GCKR (rs1260333) polymorphism was significantly lower in normal weight metabolically healthy participants than metabolically unhealthy normal weight (MUHNW) and obese children with and without cardiometabolic risk factor ( = 0.01). Frequency of ga allele of GCKR (rs780094) polymorphism was significantly higher in normal weight children with cardiometabolic risk factor than in their obese counterparts with cardiometabolic risk factor ( = 0.04). Frequency of cg and gg alleles (minor type) of MLXIPL (rs3812316) polymorphism in normal weight metabolically healthy participants was significantly higher than MUHNW ( = 0.04) and metabolically healthy obese children ( = 0.04).

Conclusion: The findings of our study indicated that the minor allele of GCKR (rs1260333) single nucleotide polymorphisms (SNPs) could have pathogenic effect for obesity and cardiometabolic risk factors. Ga allele of GCKR (rs780094) SNPs had a protective effect on obesity. Minor alleles of MLXIPL (rs3812316) could have a protective effect for obesity and cardiometabolic risk factors.
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http://dx.doi.org/10.4103/jrms.JRMS_911_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842446PMC
February 2018

Is there any association between phthalate exposure and precocious puberty in girls?

Environ Sci Pollut Res Int 2018 May 1;25(14):13589-13596. Epub 2018 Mar 1.

Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Hezar-Jarib Avenue, Isfahan, 81745-185, Iran.

Considerable increase in the prevalence of precocious puberty (PP) during the last decade has raised a lot of concerns. Some environmental endocrine disruptor chemicals (EDCs), such as phthalate esters, have intrinsic estrogen activity or increase endogenous sex hormone levels leading to PP. This study was conducted to investigate the association between exposure to phthalate esters and PP in a sample of girls. Plasma levels of seven phthalate ester metabolites were measured in 87 girls with PP and 63 age- and sex-matched controls by dispersive liquid-liquid microextraction and GC/MS analysis. History of exposure to main sources of phthalates was obtained by a checklist. Diethyl hexyl phthalate (DEHP) metabolite levels were significantly higher in those with PP than that in controls (p < 0.05), but this difference was not significant for other phthalate metabolites. 30.1% girls with PP and 12.2% of controls had played for more than 2 h/day with plastic toys in their childhood. 65.1% girls with PP and 32.8% of controls have regularly used some cosmetic products. Consumption of bottled water and beverages by those with PP was about twofold higher than that in the control group. A positive correlation was found between bottled ware consumption and plasma concentrations of four phthalate metabolites. The frequency of seafood consumption was not significantly different between the groups studied. Our findings confirm positive association between phthalate exposure and incidence of PP in girls. Control and reduction of children exposure to phthalate esters should be considered as a health priority.
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http://dx.doi.org/10.1007/s11356-018-1567-4DOI Listing
May 2018

A Case of Tyrosinemia Type III with Status Epilepticus and Mental Retardation.

Adv Biomed Res 2018 22;7. Epub 2018 Jan 22.

Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Tyrosinemia type III is an autosomal recessive disorder caused by the deficiency of 4- hydroxyphenylpyruvate dioxygenase (4-HPPD). It is characterized by elevated levels of blood tyrosine and massive excretion of its derivatives into the urine. Clinical findings of tyrosinemia type III include neurological symptoms and mental retardation. Only a few patients presenting with this disease have been described, and the clinical phenotype remains variable and unclear. We present a case, who was admitted to the hospital at the age of 4 months for recurrent seizures. Two months later, she was admitted again with status epilepticus. Laboratory data showed increased level of tyrosine in the blood. She was treated with a diet low in tyrosine and phenylalanine and anamix formula that leading to catch-up growth and improvement of her symptoms. Plasma tyrosine level dropped to normal values. In any child who presents with the neurologic symptom, some rare diagnosis like tyrosinemia type III should be considered.
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http://dx.doi.org/10.4103/2277-9175.223740DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812087PMC
January 2018

Homocystinuria with Stroke and Positive Familial History.

Adv Biomed Res 2017 25;6:132. Epub 2017 Oct 25.

Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Homocystinuria is the second most common treatable aminoacidopathy. Clinically, affected patients present with eye, skeleton, central nervous system, and most importantly, vascular system abnormalities. This autosomal recessive disorder leads to accumulation of homocysteine and its metabolites in the blood and urine. In this report, we present a case with clinical and biochemical findings of homocystinuria with stroke and a positive familial history of the disease in her brother. A 4-year-old girl was admitted to pediatric emergency ward because of acute onset of right hemiparesis and subsequent generalized tonic-clonic seizures. Cranial magnetic resonance imaging revealed acute infarct areas in the left cerebral hemisphere. Metabolic screening revealed elevated concentrations of serum homocysteine and methionine and a normal serum concentration of vitamin B12. These findings, along with a positive familial history led to the diagnosis of homocystinuria. In any child who presents with stroke, some rare condition such as homocystinuria should be considered in diagnosis.
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http://dx.doi.org/10.4103/2277-9175.217215DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5674651PMC
October 2017

Is there any association between urinary metabolites of polycyclic aromatic hydrocarbons and thyroid hormone levels in children and adolescents?

Environ Sci Pollut Res Int 2018 Jan 5;25(2):1962-1968. Epub 2017 Nov 5.

Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.

Considering the possible effects of polycyclic aromatic hydrocarbons (PAHs) on thyroid function, the current study aims to investigate the association of PAH urinary metabolites with the level of thyroid hormones in a sample of Iranian children and adolescents. This cross-sectional study was conducted from September 2015 to July 2016 in Isfahan, Iran. Participants were 150 students, aged 6-18 years, who were selected by multistage cluster random sampling from schools of Isfahan province. Blood and urine samples of participants were obtained for measurement of thyroid hormone levels (measured by immunoradiometric assay) and PAH urinary metabolites, including 1-hydroxynaphthalene, 2-hydroxynaphthalene, 9-hydroxyphenanthrene, and 1-hydroxypyrene. The association of serum thyroid-stimulating hormone (TSH) and PAH urinary metabolites was determined by correlation and regression analyses. Multivariate regression analysis revealed significant association between serum TSH and PAH urinary metabolites; this association remained significant after adjustment for gender and age. The corresponding figures were r = 0.85 for 1-naphthol, r = 0.86 for 2-naphthol, r = 0.87 for 1-hydroxypyrene, and r = 0.42 for 9-phenantrol, respectively, all p values < 0.001. The mean levels of 1-hydroxypyrene and 9-phenanthrol were higher in boys than those in girls (p < 0.05). The findings of this study indicated significant positive association between urinary PAH biomarkers and the TSH level in children and adolescents. It can be suggested that long-term exposure to PAHs might result in thyroid function impairment. The clinical implication of the current findings should be confirmed by future longitudinal studies.
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http://dx.doi.org/10.1007/s11356-017-0577-yDOI Listing
January 2018

Screening of congenital hypothyroidism in preterm, low birth weight and very low birth weight neonates: A systematic review.

Pediatr Neonatol 2018 Feb 22;59(1):3-14. Epub 2017 Jul 22.

Students Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Evidence from different screening programs indicated that the rate of congenital hypothyroidism (CH) was higher in pre-term and low-birth-weight (LBW) newborns than normal ones. Incomplete development of hypothalamic-pituitary axis in this group of neonates results in the delayed rise of TSH and missing cases with CH. Hence, there is a great need for a practicable systematic screening method for proper diagnosis of CH in this group of neonates. In this review, we systematically reviewed papers with the following key words ([Congenital Hypothyroidism AND Screening AND Thyroxine AND Thyroid Stimulating Hormone AND Low Birth Weight AND Premature]) in international electronic databases including PubMed, Scopus, and Google Scholar. After quality assessment of selected documents, data of finally included papers were extracted. In this review, 1452 papers (PubMed: 617; Scopus: 714; Google scholar: 121) were identified through electronic database search. One hundred and ninety four articles were assessed for eligibility, from which 36 qualified articles were selected for final evaluation. From the reviewed articles, 38.9%, 11.11% and 8.3% recommended rescreening in this group of neonates, lowering the screening cutoff of TSH and using cutoffs according to the gestational age, respectively. Some of them (13.9%) recommended using both TSH and T4 for screening of preterm infants. After reviewing available data, we recommend repeating the screening test in pre-term, LBW and very-low- birth-weight (VLBW) infants at age of two, six and ten weeks by measuring TSH and FT4 levels simultaneously and considering TSH = 10 mU/L as the cutoff level for positive and suspicious cases.
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http://dx.doi.org/10.1016/j.pedneo.2017.04.006DOI Listing
February 2018

Relationship of lipoprotein lipase gene variants and fasting triglyceride levels in a pediatric population: The CASPIAN-III study.

Adv Clin Exp Med 2017 Jan-Feb;26(1):77-82

Physiology Department, Applied Physiology Research Center, Isfahan University of Medical Sciences, Iran.

Background: Lipoprotein lipase (LPL) is one of the major enzymes responsible for the hydrolysis of triglyceride (TG)-rich lipoprotein. The effects of LPL polymorphisms on serum TG are inconsistent among different populations.

Objectives: This study aims to assess the TG serum concentration and distributions of three LPL single nucleotide polymorphisms (SNPs), namely D9N, HINDIII and S447X, in a nationally representative sample of Iranian adolescents.

Material And Methods: We studied the associations between SNP genotypes and TG levels in a nationally representative sample of Iranian adolescents. Genotyping was performed in 750 randomly selected participants. We compared the genotypes according to different TG levels.

Results: This study comprised 746 participants, with mean ± SD age of 14.6 ± 2.5 years. The distribution of genotypes of D9N and S447X were not significantly different according to TG levels. Regarding the HINDIII polymorphism, the distribution of GG, GT, and TT genotypes were significantly different in participants with low, borderline-high, and elevated TG (p = 0.02, 0.03, and 0.01, respectively). The mean TG was not significantly different according to the genotype distribution.

Conclusions: In this study, most of the LPL gene variants were not significantly different in adolescents with normal and elevated TG, and the mean TG was not different in participants with various genotypes. As the first evidence from the pediatric population of the region of the Middle East and North Africa (MENA), these results might be used in international comparisons. Our findings might suggest that the high prevalence of hypertriglyceridemia in Iranian adolescents is more likely to be a result of lifestyle rather than genetic factors.
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http://dx.doi.org/10.17219/acem/61003DOI Listing
June 2017

Effect of long-term Vitamin C intake on vascular endothelial function in diabetic children and adolescents: A pilot study.

J Res Med Sci 2016 7;21:119. Epub 2016 Nov 7.

Department of Research Faculty, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: This study attempted to determine the effects of long-term use of Vitamin C on vascular endothelial function.

Materials And Methods: During a pilot clinical trial study conducted at Imam Hussein Hospital (Isfahan) in 2014-2015, a total of forty diabetic patients were selected and then assigned randomly into two twenty-subject groups receiving Vitamin C and placebo tablets. The patients were treated with Vitamin C or placebo for 6 months. All patients were examined through echocardiography in terms of cardiac function before and after treatment. To evaluate the endothelial function (flow-mediated dilatation [FMD], intima-media thickness), they underwent arterial Doppler. Moreover, the chemical indices of vascular function were tested through intercellular adhesion molecule and vascular cell adhesion molecule (VCAM). Finally, the results were compared between the two groups.

Results: Based on the results, the mean left ventricular mass significantly reduced after the intervention in the group treated with Vitamin C (from 76.35 ± 25.6-68.62 ± 22.66; = 0.015) while there was no significant difference observed in the control group (from 67.58 ± 25.38-71.63 ± 26.84; = 0.19) but no statistically difference between the two groups-based repeated measures ANOVA test ( = 0.6). In addition, the mean of VCAM changes was significantly difference between the two groups ( < 0.001).

Conclusion: Long-term use of Vitamin C in diabetic patients can improve certain echocardiographic parameters such as ejection fraction, fractional shortening, and FMD, which in turn enhances vascular endothelial function.
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http://dx.doi.org/10.4103/1735-1995.193510DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5331767PMC
November 2016

Effects of Probiotics on Nonalcoholic Fatty Liver Disease in Obese Children and Adolescents.

J Pediatr Gastroenterol Nutr 2017 03;64(3):413-417

Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Noncommunicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.

Objectives: This study aims to evaluate the effects of some probiotics on sonographic and biochemical nonalcoholic fatty liver disease (NAFLD).

Methods: This randomized triple-blind trial was conducted among 64 obese children with sonographic NAFLD. They were randomly allocated to receive probiotic capsule (containing Lactobacillus acidophilus ATCC B3208, 3 × 10 colony forming units [CFU]; Bifidobacterium lactis DSMZ 32269, 6 × 10 CFU; Bifidobacterium bifidum ATCC SD6576, 2 × 10 CFU; Lactobacillus rhamnosus DSMZ 21690, 2 × 10 CFU) or placebo for 12 weeks.

Results: After intervention, in the probiotic group the mean levels of alanine aminotransferase decreased from 32.8 (19.6) to 23.1 (9.9) U/L (P = 0.02) and mean aspartate aminotransferase decreased from 32.2 (15.7) to 24.3 (7.7) U/L (P = 0.02). Likewise the mean cholesterol, low-density lipoprotein-C, and triglycerides as well as waist circumference decreased in the intervention group, without significant change in weight, body mass index, and body mass index z score. After the trial, normal liver sonography was reported in 17 (53.1%) and 5 (16.5%) of patients in the intervention and placebo groups, respectively.

Conclusions: The present findings suggest that a course of the abovementioned probiotic compound can be effective in improving pediatric NAFLD.
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http://dx.doi.org/10.1097/MPG.0000000000001422DOI Listing
March 2017

The effect of (Lemon) peels on cardiometabolic risk factors and markers of endothelial function in adolescents with excess weight: A triple-masked randomized controlled trial.

Med J Islam Repub Iran 2016;30:429. Epub 2016 Oct 18.

MD, Professor of Pediatrics, Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.

Childhood obesity is becoming a global problem and its incidence is increasing. The role of dietary intervention with fruits containing vitamin C and flavonoid to control obesity consequences in childhood has not been yet defined. Lemon () peels contain flavonoid, pectin and vitamin C. We aimed to compare the effects of lemon peels and placebo on cardiometabolic risk factors and markers of endothelial function among adolescents with overweight and obesity. In this triple-masked, randomized controlled trial, 60 overweight/obese adolescents were enrolled in a 4-week trial. Eligible participants were randomly assigned into two groups of equal number receiving daily oral capsules containing lemon powder or placebo. Fasting blood sugar, lipid profile, ICAM-1 and VCAM-1, as well as systolic and diastolic blood pressure were compared between the two groups before and after administration of medication and placebo. Of the total 60 enrolled patients, 30 and 29 patients in the lemon and control groups completed the study, respectively. The results of within-group analysis demonstrated a slight reduction in body mass index, LDL-C and systolic blood pressure in the lemon group, but no between group differences existed in the studied variables. This study revealed that consumption of lemon peel extract has some beneficial effects for childhood obesity; however, no considerable effect was documented on anthropometric measures and biochemical factors. Future studies with longer follow up are highly recommended.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5307599PMC
October 2016