Publications by authors named "Majid Mobasseri"

41 Publications

Prevalence of primary osteoporosis and low bone mass in postmenopausal women and related risk factors.

J Educ Health Promot 2021 30;10:204. Epub 2021 Jun 30.

Physical Medicine and Rehabilitation Research Centre, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: Globally, 30% of female over 50 years old have osteoporosis. This disease is one of the major causes of disability and death in the elderly. This research was aimed to determine the prevalence of primary osteoporosis and low bone density based on bone mineral density in postmenopausal women and its sociodemographic, obstetric, and life style risk factors.

Materials And Methods: This cross-sectional descriptive-analytical study was performed by simple random sampling on 850 postmenopausal women aged 50-65 years covered by all health centers, from August 2018 to April 2019, in Tabriz-Iran. Four hundred and forty-five eligible women underwent densitometry using dual-energy X-ray absorptiometry in the lumbar spine and femoral neck. Socio-individual, obstetric-medical, international physical activity questionnaires-short form, and anthropometric questionnaires were completed. Data analyzed using descriptive and analytical statistics including multivariate logistic regression in SPSS 21 software.

Results: The prevalence of primary osteoporosis based on lumbar vertebra T-score, femoral neck T-score, and total was 23.4%, 3.4%, and 24.5%, respectively, and the prevalence of primary osteopenia based on lumbar vertebra T-score, femur neck T-score, and total was 42%, 35.5%, and 43.6%, respectively. The present study showed that the odds of osteoporosis increased by increment of age (odds ratio [OR]: 1.18; 95% confidence interval [CI]: 1.07-1.30), but it decreased by increasing menopausal age (OR: 0.92; 95% CI: 0.85-1.01), body mass index (OR: 0.87; 95% CI: 0.78-0.97), arm circumference (OR: 0.84; 95% CI: 0.74-0.95), and education level ( = 0.028). It was higher in unmarried women (OR: 2.65; 95% CI: 0.99-7.08) and those with nonpersonal housing (OR: 4.02; 95% CI: 1.24-13.07).

Conclusions: Given the high prevalence of primary osteoporosis and low bone mass in postmenopausal women, health education is necessary for preventing modifiable risk factors and reducing the complications of this disease.
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http://dx.doi.org/10.4103/jehp.jehp_945_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8318176PMC
June 2021

Triglyceride glucose (TyG) index and the progression of liver fibrosis: A cross-sectional study.

Clin Nutr ESPEN 2021 08 7;44:483-487. Epub 2021 May 7.

Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address:

Background: Non-alcoholic fatty liver (NAFLD) is a multi-factorial liver disease and its incidence is globally rising. Little is known about the association between triglyceride glucose (TyG) index and liver fibrosis progression in NAFLD patients.

Aim: To examine the association of liver fibrosis with TyG index among patients with NAFLD in a sample of Iranian adults.

Methods: The NAFLD fibrosis score and the fibrosis-4 (FIB-4) index were used for the detection of hepatic fibrosis. Multivariable-adjusted odds ratios (ORs) were applied to assess the association of liver fibrosis with TyG index.

Results: The current study included a total of 230 participants with NAFLD and low probability of fibrosis. The TyG index quartiles were higher in patients with higher body mass index (BMI), higher systolic blood pressure (SBP), and less physical activity than in participants with lower BMI, lower SBP and more physical activity, respectively. Moreover, higher serum levels of total cholesterol, triglyceride, LDL-C, aspartate and aminotransferases, and homeostatic model assessment for insulin resistance (HOMA-IR), and lower serum level of HDL-C were observed in patients with higher quartiles of TyG index (all P < 0.01). The severity of NAFLD significantly increased with increment in the quartiles of TyG index. Increased TyG index was positively associated with worsening of NAFLD fibrosis score and FIB-4 index. Based on NAFLD fibrosis score, the multivariable-adjusted ORs (95% CIs) were 1.98 (1.33-2.22), 2.33 (2.09-2.94), and 3.44 (2.63-4.25) in the 2nd, 3rd, and 4th quantiles of TyG index when compared to the 1st quantile of TyG index. A similar trend was observed in the analysis using FIB-4 index.

Conclusion: According to the results of the current study, excess TyG index contributes to the development of liver fibrosis.
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http://dx.doi.org/10.1016/j.clnesp.2021.04.025DOI Listing
August 2021

Metabolically healthy and unhealthy obesity and the progression of liver fibrosis: A cross-sectional study.

Clin Res Hepatol Gastroenterol 2021 Jul 22;45(6):101754. Epub 2021 Jul 22.

Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address:

Background: The development of liver fibrosis is the most important predictor of adverse outcomes in patients with non-alcoholic fatty liver disease (NAFLD). Little is known regarding the risk factors for the progression of NAFLD to liver fibrosis. The present cross-sectional study aimed to examine the association of liver fibrosis with metabolically healthy and unhealthy obesity among patients with NAFLD.

Methods: The severity of fatty liver was examined using ultrasonography. We used the NAFLD fibrosis score to determine the severity of liver fibrosis. Anthropometric indices, physical activity, and body composition were assessed. Blood samples were collected to determine serum metabolic parameters. Participants without any component of metabolic syndrome and homeostasis model assessment of insulin resistance (HOMA-IR) <2.5 were considered as metabolically healthy. To examine the association of liver fibrosis with metabolically healthy and unhealthy obesity, multivariable-adjusted odds ratios (ORs) were applied.

Results: The current study included a total of 246 patients with NAFLD and low probability of fibrosis. 46.3% of subjects were metabolically healthy and 53.7% were metabolically unhealthy. Among metabolically healthy subjects, multivariable-adjusted ORs (CIs) for worsening of NAFLD fibrosis score comparing body mass indexes (BMIs) 23.0-24.9, 25-29.9, and ≥30 with a BMI=18.5-22.9 kg/m were 1.28 (1.09-1.56), 1.99 (1.49-2.63), and 3.96 (2.89-4.71), respectively. The corresponding ORs (95% CIs) among metabolically unhealthy subjects were 1.39 (1.32-1.64), 2.27 (1.98-2.49), and 4.11 (3.12-4.93), respectively. Moreover, in both healthy and unhealthy individuals, higher percentages of body fat and waist circumference were significantly associated with worsening of NAFLD fibrosis score.

Conclusion: Excess body fat contributes to the progression of liver fibrosis regardless of metabolic health status.
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http://dx.doi.org/10.1016/j.clinre.2021.101754DOI Listing
July 2021

Serum neuregulin 4 (NRG-4) level and non-alcoholic fatty liver disease (NAFLD): A case-control study.

Int J Clin Pract 2021 Jun 22:e14555. Epub 2021 Jun 22.

Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Objective: The current case-control study aimed to examine the association of circulating neuregulin 4 (NRG-4), a brown fat-enriched endocrine factor, with non-alcoholic fatty liver disease (NAFLD).

Methods: A total of 50 patients newly diagnosed with NAFLD with 50 age-matched and sex-matched subjects without NAFLD were recruited in the present study. Circulating NRG-4 levels were assessed with an enzyme-linked immunosorbent assay (ELISA) kit. SPSS version 23 was used for statistical analysis.

Results: Patients with NAFLD had lower levels of circulating NRG-4 than the control group (P < .001). Participants in the highest quartile of circulating NRG-4 had significantly lower body mass index (BMI), waist circumference (WC), triglyceride (TG) and homeostatic model assessment for insulin resistance (HOMA-IR) compared with those in the lowest quartile (all P < .01). The prevalence of NAFLD in the quartile 4 of the serum NRG-4 level was 38.46%, lower than the quartile 1 (62.50%, P = .006), quartile 2 (52.00%, P = .017) and quartile 3 (48.00%, P = .032). In multiple stepwise regression analysis, BMI (β = -0.712, P = .016), WC (β = -0.577, P = .023), TG (β = -0.509, P = .001), high-density lipoprotein cholesterol (HDL-C) (β = 0.489, P = .001) and HOMA-IR (β = -0.609, P = .003) were independently related to serum NRG-4 level. The odds of NAFLD decreased by 41% per 1 SD increase in serum NRG-4 level (OR, 0.59; 95% CI, 0.35-0.78; P = .021), after adjustment for all potential confounders.

Conclusion: The results of the present study demonstrate that circulating NRG-4 levels may play a protective role in NAFLD.
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http://dx.doi.org/10.1111/ijcp.14555DOI Listing
June 2021

Saffron improves life and sleep quality, glycaemic status, lipid profile and liver function in diabetic patients: A double-blind, placebo-controlled, randomised clinical trial.

Int J Clin Pract 2021 Aug 26;75(8):e14334. Epub 2021 May 26.

Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: Type 2 diabetes (T2D) is a metabolic disorder that is related to hyperglycaemia, hyperlipidaemia and liver dysfunction and has detrimental effects on a patient's mental health. Hence, the current study investigated the effects of saffron supplementation on dietary intake, anthropometric measures, mood, sleep quality and metabolic biomarkers in overweight/obese patients with T2D.

Methods: In a double-blind, randomised controlled trial, 70 overweight/obese patients with T2D were randomly allocated to two groups and received 100 mg/day saffron or placebo for 8 weeks. Participants completed the Beck depression inventory-II (BDI-II), Hurlbert index of sexual desire (HISD), Pittsburgh Sleep Quality Index (PSQI) and Diabetes-specific Quality-of-Life Brief Clinical Inventory questionnaires (DQOL-BCI). Dietary intake, anthropometric measures, fasting plasma glucose (FPG), haemoglobin A1C (HbA1C), insulin, lipid profile and liver enzymes were determined at baseline and the end of the study.

Results: At the end of the eighth week, saffron supplementation significantly decreased FPG, triglyceride (TG), insulin, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) (P < .001). Moreover, significant improvements in BDI-II scores and total quality of life were observed in the intervention group (P < .001). The saffron group showed more significant improvements in PSQI scores than the placebo group, such that at the post-intervention analysis, only the saffron group achieved a "good" sleep band. At this relatively high dose, saffron supplementation improved glycaemic status, lipid profile and liver enzyme measures in patients with T2D while also improving sleep and overall quality of life.

Conclusion: Our results indicate that saffron notably reduced hyperglycaemia and hyperlipidaemia and improved liver function in patients with T2D in an 8-week randomised clinical trial. Saffron also significantly improved depression, sleep quality and overall quality of life in diabetic patients. However, further investigation is necessary to confirm whether saffron is an effective complementary therapy for T2D.
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http://dx.doi.org/10.1111/ijcp.14334DOI Listing
August 2021

The effects of citrulline supplementation on meta-inflammation and insulin sensitivity in type 2 diabetes: a randomized, double-blind, placebo-controlled trial.

Diabetol Metab Syndr 2021 May 5;13(1):52. Epub 2021 May 5.

Nutrition Research Center, Department of Biochemistry and Diet Therapy, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: This study aimed to examine the effects of L-citrulline (l-CIT) on low-grade inflammation (meta-inflammation) and insulin sensitivity in type 2 diabetes (T2D) patients since it has exhibited hypoglycemic and anti-inflammatory effects in most animal studies.

Methods: In this double-blind, placebo-controlled randomized clinical trial, 54 patients with T2D referred to specialized clinics of Tabriz University of Medical Sciences were assigned to L-CIT group (receiving orally one 3 g sachet of L-CIT daily before breakfast) or placebo group (receiving orally one 3 g sachet of microcrystalline cellulose daily before breakfast) for eight weeks. Serum levels of fasting blood glucose, hemoglobin A1c (HbA1c), CIT, monocyte chemoattractant protein 1 (MCP-1), interleukin-6 (IL-6), and toll-like receptor 4 (TLR-4) were determined. The quantitative insulin sensitivity check index (QUICKI) and homeostatic model assessment of β-cell function (HOMA-B) index were estimated at the baseline and post-intervention.

Results: No significant difference was observed between the studied parameters at the baseline. L-CIT supplementation significantly reduced not only serum concentrations of fasting blood glucose but also HbA1c, serum IL-6 and TLR-4 levels in the L-CIT group (p < 0.05). Additionally, at the end of the study serum levels of CIT increased significantly in L-CIT group compared to the baseline and placebo group. Fasting blood glucose concentrations and HbA1c significantly decreased after the intervention compared to the placebo. There was no significant difference in serum IL-6, TLR-4, MCP-1 levels, as well as QUICKI and HOMA-B index between the two groups, even after adjusting for baseline variables and confounders.

Conclusions: Our findings revealed that, although L-CIT supplementation significantly reduced fasting blood glucose concentrations, HbA1c and increased serum levels of CIT. It seems it could not significantly improve insulin sensitivity and meta-inflammation biomarkers. Additional studies with longer duration and different doses of L-CIT are required. Trial registration The protocol of this clinical trial is registered at the Iranian Registry of Clinical Trials (registration no: IRCT20100209003320N16 at www.irct.ir ).
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http://dx.doi.org/10.1186/s13098-021-00669-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8097832PMC
May 2021

A comprehensive systematic review of the therapeutic effects and mechanisms of action of quercetin in sepsis.

Phytomedicine 2021 Jun 14;86:153567. Epub 2021 Apr 14.

Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address:

Background: Sepsis is a life-threatening condition caused by a dysregulated host response to infection. Several studies have indicated that flavonoids exhibit a wide variety of biological actions including free radical scavenging and antioxidant activities. Quercetin, one of the most extensively distributed flavonoids in the vegetables and fruits, presents various biological activities including modulation of oxidative stress, anti-infectious, anti-inflammatory, and neuroprotective activities.

Methods: The present systematic review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statements. We searched Web of Sciences, Google Scholar, PubMed, Scopus, and Embase databases up to February 2021 by using the relevant keywords.

Results: Out of 672 records screened, 35 articles met the study criteria. The evidence reviewed here indicates that quercetin supplementation may exert beneficial effects on sepsis by attenuating inflammation and oxidative stress, downregulating the mRNA expression of toll-like receptors (TLRs), modulating the immune response, and alleviating sepsis-related organ dysfunctions.

Conclusion: Due to the promising therapeutic effects of quercetin on sepsis complications and the lack of clinical trials in this regard, future human randomized clinical trials are warranted.
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http://dx.doi.org/10.1016/j.phymed.2021.153567DOI Listing
June 2021

The impact of L-citrulline supplementation on glucose homeostasis, lipid profile, and some inflammatory factors in overweight and obese patients with type 2 diabetes: A double-blind randomized placebo-controlled trial.

Phytother Res 2021 Jun 20;35(6):3157-3166. Epub 2021 Apr 20.

Nutrition Research Center, Department of Biochemistry and Diet Therapy, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.

This study investigated the impact of L-citrulline on glucose homeostasis, lipid profile, and inflammatory factors in overweight and obese patients with type 2 diabetes (T2D). In total, 54 participants with T2D were assigned to L-citrulline (3 g/day L-citrulline) or placebo groups and tested for 8 weeks. Serum levels of insulin, fasting glucose, hemoglobin A1c (HbA1c), lipid profile, tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), and L-citrulline were measured pre- and post-intervention. Totally, 45 patients were enrolled in the research. L-citrulline supplementation decreased serum levels of insulin (p = .025), glucose (p = .032), HbA1c (p = .001), HOMA-IR (p = .037), TNF-α (p = .036), and hs-CRP (p = .027) significantly. At the end of the study, despite the significant decrease in serum levels of triglyceride (p = .027) and the increase in high-density lipoprotein cholesterol levels (p < .001) in the L-citrulline group, no significant differences were found for these parameters between the groups. Moreover, no significant inter- and intra-group changes were observed for dietary intakes, anthropometric indices, total and low-density lipoprotein cholesterol levels (p > .05). In conclusion, L-citrulline supplementation might improve glucose homeostasis, some lipid factors and inflammatory markers in overweight and obese patients with T2D.
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http://dx.doi.org/10.1002/ptr.6997DOI Listing
June 2021

The association of the steatosis severity, NAFLD fibrosis score and FIB-4 index with atherogenic dyslipidaemia in adult patients with NAFLD: A cross-sectional study.

Int J Clin Pract 2021 Jun 21;75(6):e14131. Epub 2021 Mar 21.

Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.

Objectives: Obesity and dyslipidaemia are the major risk factors for non-alcoholic fatty liver disease (NAFLD), and are known to increase cardiovascular disease (CVD), which is the leading cause of death in NAFLD patients. The present cross-sectional study aimed to investigate associations among severity of hepatic steatosis, NAFLD fibrosis score and atherogenic lipid profile.

Methods: A total of 265 patients with NAFLD confirmed by ultrasonographic findings were included. The NAFLD fibrosis score and the fibrosis-4 (FIB-4) index were used to classify the probability of fibrosis as low, intermediate and high probability. Serum lipids including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured, and then TC/HDL-C, LDL-C/HDL-C, TG/HDL-C and non HDL-C/HDL-C ratios were determined. Fasting blood sugar (FBS), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were also assessed. The homeostatic model assessment for insulin resistance (HOMA-IR) was calculated.

Results: The severity of hepatic steatosis was positively correlated with TC/HDL-C (r = 0.29, P = .002), LDL-C/HDL-C (r = 0.32, P < .001), TG/HDL-C (r = 0.36, P < .001) and non-HDL-C/HDL-C (r = 0.24, P = .001) ratios. Similarly, these parameters were positively correlated with NAFLD fibrosis score and FIB-4 index (P < .05). In addition, alanine aminotransferase and aspartate aminotransferase levels were positively correlated with TG/HDL-C ratio (r = 0.31, P = .003; and r = 0.27, P = .001 respectively). With increasing the severity of hepatic steatosis and NAFLD fibrosis score, the mean of all lipid ratios increased significantly (P < .01 and P < .05, respectively). Importantly, after controlling for potential confounders including age, gender, physical activity level, body mass index, waist circumference and HOMA-IR, the severity of steatosis, NAFLD fibrosis score and FIB-4 index remained independent predictors of atherogenic lipid profile.

Conclusions: Severity of hepatic steatosis, NAFLD fibrosis score and FIB-4 index were significantly correlated with atherogenic lipid profile. As NAFLD is high among patients with metabolic risk factors for CVD, their dyslipidaemia should be aggressively managed.
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http://dx.doi.org/10.1111/ijcp.14131DOI Listing
June 2021

Relationship between the levels of serum fibroblast growth factor 19 and metabolic factors in obese and normal weight subjects with and without type 2 diabetes mellitus: a case-control study.

Horm Mol Biol Clin Investig 2021 Feb 1;42(1):11-17. Epub 2021 Feb 1.

Department of Clinical Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran.

Objectives: Fibroblast growth factor 19 (FGF-19) is a metabolic regulating factor with an anti-diabetic effect. This study aimed to evaluate FGF-19 in patients with type 2 diabetes mellitus (T2DM) and its relationship with some metabolic risk factors.

Methods: In this case-control study, 80 diabetic patients and 80 non-diabetic individuals were divided into two subgroups based on body mass index (BMI): obese people (BMI≥30) and participants with normal weight (25>BMI≥18.5). Furthermore, stratified analysis by gender was also performed. The metabolic factors were measured and compared in all groups. The relationship between FGF-19 and the measured items was investigated in each group.

Results: The FGF-19 levels did not show a significant difference between groups. The serum levels of FGF-19 were negatively associated with some metabolic items, such as BMI, low-density lipoprotein (LDL), total cholesterol (TC) (p<0.01), and LDL/high-density lipoprotein (HDL) ratio (p=0.02) only in the healthy group with normal weight. According to the gender-based classification of individuals, FGF-19 showed a significant inverse relationship with BMI, weight (WT), waist circumference (WC), and hip circumference (HC) (p<0.05) in diabetic men; besides, FGF-19 in non-diabetic women had a significant negative association with TC, LDL, and LDL/HDL ratio (p<0.05).

Conclusions: The levels of FGF-19 were negatively correlated to WT, BMI, WC and HC in diabetic males. More studies are needed to warrant these results.
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http://dx.doi.org/10.1515/hmbci-2020-0075DOI Listing
February 2021

Assessment of boron-containing compounds and oleoylethanolamide supplementation on the recovery trend in patients with COVID-19: A structured summary of a study protocol for a randomized controlled trial.

Trials 2020 Oct 27;21(1):890. Epub 2020 Oct 27.

Department of Clinical Nutrition, Nutrition Research Center, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, 5166614711, Iran.

Objectives: In this study, we investigate the effect of boron-containing compounds and oleoylethanolamide supplementation on the recovery trend in patients with COVID-19.

Trial Design: The current study is a single-center, randomized, double-blind, placebo-controlled clinical trial with parallel groups.

Participants: The inclusion criteria include male and female patients≥18 years of age, with a confirmed diagnosis of SARS-CoV-2 infection via polymerase chain reaction (PCR) and/or antibody test and with written informed consent to participate in this trial. The exclusion criteria include regular use of any other supplement, severe and critical COVID-19 pneumonia, pregnancy and breastfeeding. This study is being conducted at Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

Intervention And Comparator: Patients are randomly assigned to four groups. The first group (A) will take one capsule containing 5 mg of boron compounds twice a day for two weeks. The second group (B) will take one capsule containing 200 mg oleoylethanolamide twice a day for two weeks. The third group (C) will take one capsule containing 5 mg boron compounds with 200 mg oleoylethanolamide twice a day for two weeks, and the fourth group (D) does not receive any additional treatment other than routine treatments. Boron-containing compounds and oleoylethanolamide capsules will be synthesized at Nutrition Research Center of Tabriz University of Medical Sciences.

Main Outcomes: The primary end point of this study is to investigate the recovery rate of clinical symptoms, including fever, dry cough, and fatigue, as well as preclinical features, including complete blood count (CBC), the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) profiles within two weeks of randomization.

Randomisation: Patients are randomized into four equal groups in a parallel design (allocation ratio 1:1). A randomized block procedure is used to divide subjects into one of four treatment blocks (A, B, C, and D) by a computer-generated allocation schedule.

Blinding (masking): The participants and investigators (enrolling, assessing, and analyzing) are blinded to the intervention assignments until the end of the study and data analysis.

Numbers To Be Randomised (sample Size): The calculated total sample size is 40 patients, with 10 patients in each group.

Trial Status: The protocol is Version 1.0, May 17, 2020. Recruitment began May 19, 2020, and is anticipated to be completed by October 19, 2020.

Trial Registration: This clinical trial has been registered by the title of "Assessment of boron-containing compounds and oleoylethanolamide supplementation on the recovery trend in Patients with COVID-19: A double-blind randomized placebo-controlled clinical trial" in the Iranian Registry of Clinical Trials (IRCT). The registration number is " IRCT20090609002017N35 ", https://www.irct.ir/trial/48058 . The registration date is 17 May 2020.

Full Protocol: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.
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http://dx.doi.org/10.1186/s13063-020-04820-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7588946PMC
October 2020

Expression of NF-κB, IL-6, and IL-10 genes, body composition, and hepatic fibrosis in obese patients with NAFLD-Combined effects of oleoylethanolamide supplementation and calorie restriction: A triple-blind randomized controlled clinical trial.

J Cell Physiol 2021 01 22;236(1):417-426. Epub 2020 Jun 22.

Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Nonalcoholic fatty liver disease (NAFLD) is one of the most common noncommunicable diseases worldwide. The present study aimed to investigate the effects of oleoylethanolamide (OEA) supplementation combined with calorie restriction on inflammation, body composition, and hepatic fibrosis among obese patients with NAFLD. In this 12-week randomized clinical trial, 76 obese patients newly diagnosed with NAFLD were randomly allocated into either OEA or placebo group. The weight-loss diet was also designed for both groups. Pre- and postintervention messenger RNA expression levels of the transcription factor nuclear factor-κB (NF-κB), interleukin-6 (IL-6) and IL-10, body composition, and NAFLD fibrosis score were assessed. At the end of the study, the OEA group showed lower NF-κB and IL-6 expression levels compared to the placebo (p < .01). However, IL-10 expression level was approximately twofold higher in the OEA group compared to the placebo group (p = .008). A significant reduction was observed in the fat mass of the OEA group compared to the placebo (p = .044) postintervention. In addition, OEA supplementation led to a significant increase in fat-free mass in the OEA group compared to the placebo (p = .032). A remarkable increase was observed in resting metabolic rate (RMR) in the OEA group (p = .009); however, it was not found in the placebo group. There were no significant between-group differences in RMR postintervention. In addition, no significant within-and between-group differences were observed in the NAFLD fibrosis score at the end of the trial. Treatment with OEA along with weight-loss intervention could significantly improve inflammation and body composition in patients with NAFLD.
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http://dx.doi.org/10.1002/jcp.29870DOI Listing
January 2021

Effects of saffron supplementation on glycemia and inflammation in patients with type 2 diabetes mellitus: A randomized double-blind, placebo-controlled clinical trial study.

Diabetes Metab Syndr 2020 Jul - Aug;14(4):527-534. Epub 2020 Apr 29.

Student Research Committee, Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

Background: New evidence indicates that overproduction of pro-inflammatory cytokines is responsible for the development of diabetes difficulties. Some herbals such as saffron, may control inflammation and improve the hyperglycemic states in diabetic patients. Therefore, this investigation aimed to assess the effects of saffron supplementation on fasting glucose and inflammatory markers levels in patients with type2 diabetes mellitus (T2DM).

Methods: In this randomized double-blind, placebo-controlled clinical trial, 60 T2DM patients were randomly assigned into two groups as saffron and placebo (n = 30) receiving 100 mg/day saffron powder or starch capsules (1 capsule) for a duration of 8 weeks. Fasting blood sample was collected at baseline and at the end of the intervention. Fasting blood glucose (FBG) was immediately analyzed by the auto-analyzer. The serum level of Interleukin -6 (IL-6), Tumor necrosis factor-alpha (TNF-α), and Interleukin-10 (IL-10) were measured using ELISA assay by laboratory kits. Also, Real-time quantitative reverse transcription (RT-PCR) assay measured the expression level of TNF-α, IL-6, and IL-10 at the mRNA level.

Results: Saffron supplementation significantly decreased the FBG levels within 8 weeks compared to placebo (130.93 ± 21.21 vs 135.13 ± 23.03 mg/dl, P = 0.012). Moreover, the serum level of TNF-α notably reduced in the saffron group compared to the placebo group (114.40 ± 24.28 vs 140.90 ± 25.49 pg/ml, P < 0.001). Also, saffron supplementation significantly down-regulated the expressions of TNF-α (P = 0.035) and IL-6 mRNA levels (P = 0.014).

Conclusion: In our study, it was indicated that saffron modulates glucose levels as well as inflammation status in T2DM patients through decreasing the expressions levels of some inflammatory mediators. Also, further investigations are necessary to confirm the positive effects of saffron as a complementary therapy for T2DM patients.
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http://dx.doi.org/10.1016/j.dsx.2020.04.031DOI Listing
May 2021

Prevalence and incidence of type 1 diabetes in the world: a systematic review and meta-analysis.

Health Promot Perspect 2020 30;10(2):98-115. Epub 2020 Mar 30.

Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute Affiliated Group, Tabriz University of Medical Sciences, Tabriz, Iran.

Diabetes is referred to a group of diseases characterized by high glucose levels in blood. It is caused by a deficiency in the production or function of insulin or both, which can occur because of different reasons, resulting in protein and lipid metabolic disorders. The aim of this study was to systematically review the prevalence and incidence of type 1 diabetes in the world. A systematic search of resources was conducted to investigate the prevalence and incidence of type 1 diabetes in the world. The databases of Medline (via PubMed and Ovid),ProQuest, Scopus, and Web of Science from January 1980 to September 2019 were searched to locate English articles. The located articles were screened in multiple levels of title, abstract,and full-text and final studies that met the inclusion criteria were retrieved and included in the study. From 1202 located articles, 193 studies were included in this systematic review. The results of meta-analysis showed that the incidence of type 1 diabetes was 15 per 100,000 people and the prevalence was 9.5% (95% CI: 0.07 to 0.12) in the world, which was statistically significant. According to the results, the incidence and prevalence of type 1 diabetes are increasing in the world. As a result, insulin will be difficult to access and afford, especially in underdeveloped and developing countries.
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http://dx.doi.org/10.34172/hpp.2020.18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7146037PMC
March 2020

Corrigendum.

J Cell Physiol 2020 Apr 6;235(4):4023. Epub 2019 Oct 6.

Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.

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http://dx.doi.org/10.1002/jcp.29258DOI Listing
April 2020

A systematic review of the association of neuregulin 4, a brown fat-enriched secreted factor, with obesity and related metabolic disturbances.

Obes Rev 2020 02 28;21(2):e12952. Epub 2019 Nov 28.

Social Determinants of Health Research Center, Department of Biochemistry and Diet Therapy, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.

Neuregulin 4 (Nrg4), a novel brown fat-enriched hormone, plays a key role in the modulation of glucose and lipid metabolism and energy balance. Recent data have demonstrated that the expression of Nrg4 is substantially down-regulated in mouse and human obesity, making its regulatory aspect intriguing. Because of the close relationship between Nrg4, obesity, and associated metabolic diseases, this systematic review aimed to assess the association of Nrg4 with obesity and related metabolic disturbances, emphasizing its possible mechanisms of action in these disorders. We searched PubMed/Medline, ScienceDirect, Scopus, EMBASE, ProQuest, and Google Scholar up until June 2019. The evidence reviewed here indicates that Nrg4 may contribute to the prevention of obesity and related metabolic complications by elevating brown adipose tissue activity, increasing the expression of thermogenic markers, decreasing the expression of lipogenic/adipogenic genes, exacerbating white adipose tissue browning, increasing the number of brite/beige adipocytes, promoting hepatic fat oxidation and ketogenesis, inducing neurite outgrowth, enhancing blood vessels in adipose tissue, increasing the circulatory levels of healthy adipokines, and improving glucose homeostasis. Thus, Nrg4 appears to be a novel therapeutic strategy for the treatment of obesity and associated metabolic complications. However, prospective cohort studies are warranted to confirm these outcomes.
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http://dx.doi.org/10.1111/obr.12952DOI Listing
February 2020

Effects of Choline and Magnesium Concurrent Supplementation on Coagulation and Lipid Profile in Patients with Type 2 Diabetes Mellitus: a Pilot Clinical Trial.

Biol Trace Elem Res 2020 Apr 5;194(2):328-335. Epub 2019 Aug 5.

Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Attar Nishabouri St., PO Box 14711, Tabriz, 5166614711, Iran.

Metabolic failure is associated with dyslipidemia and coagulation which can result in a higher risk of cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM). The aim of this study was to assess the effects of choline and magnesium co-supplementation on lipid profile and coagulation parameters in patients with T2DM. In a randomized, double-blind, placebo-controlled trial, supplements of choline bitartrate (1000 mg), magnesium oxide (500 mg), choline plus magnesium, or placebo were administered for 2 months to 96 diabetic participants of both sexes aged 30-60 years. Anthropometric characteristics, dietary intake, physical activity, serum lipids, and coagulation markers were measured in all subjects. Significant differences were observed in plasminogen activator inhibitor-1 (PAI-1) levels in the magnesium and choline-magnesium groups (p < 0.05). Moreover, tissue plasminogen activator (tPA) levels increased in choline-magnesium groups (p < 0.001). When adjusted for potential confounders, a significant decrease in PAI-1 (p = 0.03) and a marginally significant increase in tPA (p = 0.054) were found in the choline-magnesium group compared with the other groups. Compared with baseline values, there were significant differences in serum magnesium, HDL, and triglycerides (TG) following choline-magnesium co-supplementation (p < 0.05); however, there were no significant differences in serum magnesium, HDL, and TG among the groups (p > 0.05). Overall, concurrent supplementation of magnesium and choline is more effective than either magnesium or choline alone to improve coagulation in subjects with T2DM.
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http://dx.doi.org/10.1007/s12011-019-01802-7DOI Listing
April 2020

The Effects of Choline and Magnesium Co-Supplementation on Metabolic Parameters, Inflammation, and Endothelial Dysfunction in Patients With Type 2 Diabetes Mellitus: A Randomized, Double-Blind, Placebo-Controlled Trial.

J Am Coll Nutr 2019 Nov-Dec;38(8):714-721. Epub 2019 Apr 23.

Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.

To our knowledge, no study has investigated the effects of choline and magnesium co-supplementation on metabolic parameters, inflammation, and endothelial dysfunction in patients with type 2 diabetes mellitus (T2DM). The aim of this study was investigation of the effects of the choline and magnesium co-supplementation on metabolic parameters, inflammation, and endothelial dysfunction in patients with T2DM. A randomized double-blind placebo-controlled parallel clinical trial was carried out among 96 diabetic patients. Ninety-six patients were randomly assigned to either choline, magnesium, choline-magnesium, or placebo for 2 months. Anthropometric measurement; metabolic, inflammatory, and endothelial markers; dietary intake; and physical activity were assessed at baseline and after treatment. There was a significant change in serum magnesium in both magnesium and choline-magnesium groups ( < 0.05). Also, significant changes were observed in interleukin (IL)-6 levels in magnesium and choline-magnesium groups ( < 0.05). Moreover, vascular cell adhesion molecule-1 (VCAM-1) levels decreased in choline and choline-magnesium groups ( < 0.05). When adjusted for potential confounders, inflammation and endothelial factors (IL-6 and VCAM-1) decreased significantly in the choline-magnesium group as compared to other groups ( < 0.05). Compared to baseline values there were no significant differences in all anthropometric measurements and metabolic factors among four groups ( > 0.05). Choline and magnesium co-supplementation was more effective in improving inflammation and endothelial dysfunction than supplementation with choline or magnesium alone.
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http://dx.doi.org/10.1080/07315724.2019.1599745DOI Listing
September 2020

Effect of pomegranate seed oil supplementation on the GLUT-4 gene expression and glycemic control in obese people with type 2 diabetes: A randomized controlled clinical trial.

J Cell Physiol 2019 11 3;234(11):19621-19628. Epub 2019 Apr 3.

Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.

Abnormality in glucose transporter type 4 (GLUT-4) function and insulin secretion are the main causes of type 2 diabetes mellitus (T2DM). Due to adverse effects of antidiabetic drugs, nowadays, nutraceuticals have been of much interest to investigators. The aim of the present study was to determine the effect of pomegranate seed oil (PSO) on the GLUT-4 gene expression and glycemic control in obese people with T2DM. This randomized clinical trial was conducted on 52 obese type 2 diabetic patients for 8 weeks in Tabriz, Iran, in 2018. Patients were divided into the intervention group (n = 26; who consumed daily three capsules containing 1 g PSO) and the placebo group (n = 26; the same amounts paraffin). GLUT-4 gene expression and glycemic indices were evaluated by standard methods. GLUT-4 gene expression was increased significantly in the PSO group. Within-group changes in fasting blood sugar (FBS) and quantitative insulin sensitivity check index were significant in the PSO group. After adjusting the age, gender, and baseline values, FBS was significantly decreased. Insulin concentration, HbA1C, HOMA-IR, and HOMA-β did not manifest significant changes. PSO increased the GLUT-4 gene expression in diabetic patients without any side effects. However, future clinical studies are needed to confirm the obtained results.
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http://dx.doi.org/10.1002/jcp.28561DOI Listing
November 2019

The effects of vitamin D supplementation on lipid profiles and oxidative indices among diabetic nephropathy patients with marginal vitamin D status.

Diabetes Metab Syndr 2019 Jan - Feb;13(1):542-547. Epub 2018 Nov 3.

Nutrition Research Center, Department of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address:

Aims: Diabetic nephropathy is one of the major microvascular complications of type 2 diabetes which insufficient vitamin D might -have a role in it's incidence. This study evaluated the effects of vitamin D supplementation on lipid profiles and oxidative/anti-oxidative indices in marginal vitamin D status patients with diabetic nephropathy.

Methods: For the current paralleled, randomized, double-blinded, placebo-controlled clinical trial, 50 diabetic nephropathy patients with marginal serum vitamin D were selected. Intervention group received 1,25-dihydroxycholecalciferol (50000 IU/week, n = 25), and placebo group (n = 25) received an identical placebo, for 8 weeks. Lipid profiles (LDL, HDL, TG and TC) and oxidative/anti-oxidative markers (TAC, SOD, CAT, GPX and MDA) were measured.

Results: Vitamin D supplementation significantly increased vitamin D status in the intervention group, compared to the control group (P = 0.001). The reductions in the serum levels of TG, LDL and TC were significant (P = 0.04, P = 0.006 and P = 0.02, respectively) in the intervention group. The changes in oxidative/anti-oxidative markers and HDL levels were not significant after intervention.

Conclusion: In conclusion, vitamin D supplementation for 8 weeks among diabetic nephropathy patients has beneficial effects on serum vitamin D status and dyslipidemia.
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http://dx.doi.org/10.1016/j.dsx.2018.11.008DOI Listing
April 2019

Lower glycemic indices and lipid profile among type 2 diabetes mellitus patients who received novel dose of Silybum marianum (L.) Gaertn. (silymarin) extract supplement: A Triple-blinded randomized controlled clinical trial.

Phytomedicine 2018 May 19;44:39-44. Epub 2018 Mar 19.

Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.

Objective: This randomized clinical trial was conducted to evaluate the effects of silymarin supplementation on glycemic indices and serum lipid profile in type 2 diabetes mellitus (T2DM) patients.

Methods: 40 T2DM patients (twenty male and twenty female), 25-50 years of age and on stable medication, were recruited for the present paralleled, randomized, triple-blinded, placebo-controlled clinical trial. The participants were randomly assigned to the silymarin or placebo groups, in which the patients either received 140 mg of silymarin, thrice daily (n = 20) or placebo (n = 20) for 45 days. Anthropometric and dietary intake data were collected at the baseline and end of the trial. Fasting blood samples were collected, and glycemic indices and lipid profile were determined at baseline, as well as the end of the study.

Results: Silymarin supplementation led to significant reduction in fasting blood sugar, serum insulin, homeostatic model assessment for insulin resistance, serum triglyceride and triglyceride to high-density lipoprotein cholesterol ratio as compared to the placebo, by 11.01, 14.35, 25.92, 23.7 and 27.67% respectively. There was significant increase in high-density lipoprotein cholesterol levels and quantitative insulin sensitivity check index in the silymarin group as compared to the placebo group, by 6.88 and 5.64% respectively, (p < 0.05). Total cholesterol and low-density lipoprotein cholesterol concentrations significantly decreased in the silymarin group as compared to the baseline, by 7.93 (p = 0.001) and 7.15% (p = 0.02), respectively.

Conclusion: Silymarin supplementation may improve the glycemic indices and lipid profiles of T2DM patients. More studies are needed to validate the adjunct use of silymarin for metabolic control of T2DM patients.
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http://dx.doi.org/10.1016/j.phymed.2018.03.050DOI Listing
May 2018

Efficacy of radiographic density values of the first and second cervical vertebrae recorded by CBCT technique to identify patients with osteoporosis and osteopenia.

J Dent Res Dent Clin Dent Prospects 2017 20;11(3):189-194. Epub 2017 Sep 20.

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.

Osteoporosis is a systemic skeletal disease characterized by a decrease in bone strength with an increase in the risk of fractures. This study aimed at evaluating the ability to predict osteoporosis and osteopenia based on radiographic density values obtained from CBCT imaging technique. CBCT images of 108 patients were prepared by using NewTom VGI (QR, Verona, Italy). Then the patients were assigned to osteoporosis, osteopenia and healthy group, using the T-score derived from the DEXA technique. Finally, RD of the lateral mass of C1 on the left and right sides and body and dens of the C2 were measured. RD values were compared between the three groups by one-way ANOVA, followed by an appropriate post hoc test. The results of the comparisons of RD values at the first and second cervical vertebrae in the three groups showed that all the values had statistically significant differences (P<0.05). The most precise diagnosis of osteoporosis was related to the RD values of the body of C2 and left lateral mass of C1 that was equal to 99% and their cut-off points were 375 and 386, respectively. Based on the findings of this study, it is possible to predict the osteoporosis status of the patient through the RD related to the body of C2 and the left lateral mass of C1 more accurately than the other areas.
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http://dx.doi.org/10.15171/joddd.2017.034DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5666220PMC
September 2017

Effect of regular exercise training on changes in HbA1c, BMI and VOmax among patients with type 2 diabetes mellitus: an 8-year trial.

BMJ Open Diabetes Res Care 2017 8;5(1):e000414. Epub 2017 Nov 8.

Department of Endocrine Research Center, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

Objective: The effects of regular exercise on the health promotion of patients with type 2 diabetes mellitus (T2DM) have been well documented. The present study investigated the long-term effects of regular exercise training on biological indicators among these patients.

Methods: In this quasi-experimental trial with pretest-post-test design, 65 patients with T2DM aged 33-69 years (experiment (35), control (30)) participated. After 8 years of conducting the program, the data on 30 patients (experiment (15), control (15)) were entered into analysis. The training program included aerobic exercise three sessions per week, 90 min, 50%-80% VOmax. Before and after the intervention, the biological indicators (hemoglobin A1c (HbA1c), body mass index (BMI) and VOmax) were measured. Data were analyzed using multivariate analysis of covariance.

Results: Our long-term exercise training program had a significant effect on HbA1C, BMI and Vomax (P<0.05). Compared with patients in the control group, HbA1c was significantly reduced and BMI and VOmax were significantly improved among the experiment group.

Conclusions: Long-term regular physical activity training was found to be helpful in improving glycemic control, body composition and cardiovascular fitness among patients with T2DM. Long-term continuous physical activity offsets the deteriorations of biological indicators found in the control group. Further research, with a particular focus on practical and real-world programming, is needed to determine the responsive health outcomes of such long-term programs on the patients.
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http://dx.doi.org/10.1136/bmjdrc-2017-000414DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5687538PMC
November 2017

pH sensitive insulin-loaded nanohydrogel increases the effect of oral insulin in diabetic rats.

Artif Cells Nanomed Biotechnol 2017 Sep 18;45(6):1-5. Epub 2016 Aug 18.

g Bone Health Research Center , Tabriz University of Medical Sciences , Tabriz , Iran.

Background: There are different methods for insulin administration in diabetic patient. Nano-hydrogel is one of the most talented drug carrier for its sensitivity to environmental stimulus.

Methods And Results: NIPAAm-MAA-HEM copolymers were synthesized by radical chain reaction. The copolymers were characterized with Scanning electron microscopy (SEM) and Transient electron microscopy (TEM). Copolymers were loaded with regular insulin by modified double emulsion method. Diabetic rats are used for feeding insulin-loaded nanohydrogel. Analysis of the results from the measurement of the amount of blood insulin from the rats blood that received insulin in nanohydrogel loaded form compared with rats that received pure insulin is significantly high, which confirm that insulin has been able to pass from the stomach acid barrier by nanohydrogel and is absorbed from the intestine. Blood sugar levels from tested rats indicate that with increasing amount of insulin, blood sugar levels fall down.

Conclusion: Our study confirms that insulin has been able to pass from the stomach acid barrier by nanohydrogel and be absorbed from the intestine.
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http://dx.doi.org/10.1080/21691401.2016.1216859DOI Listing
September 2017

Perceived barriers to recommended dietary adherence in patients with type 2 diabetes in Iran.

Eat Behav 2016 04 2;21:205-10. Epub 2016 Mar 2.

Department of Endocrine and Metabolism, Imam Reza Medical Research and Training Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

Objective: To identify barriers to recommended dietary adherence in patients with type 2 diabetes.

Design: Observational cross-sectional study.

Sample: One hundred-forty six overweight/obese volunteers with type 2 diabetes, who had previously received dietary advice for at least one year, were recruited from two diabetes clinics in Tabriz, north-west of Iran.

Measurements: A 24-item questionnaire was designed to assess dietary barriers. The validity and reliability of the questionnaire were assessed by Content Validity Index, Content Validity Ratio and Cronbach's alpha, respectively. An exploratory factor analysis with principal component analysis extraction and varimax rotation was utilized in order to extract the underlying factors of dietary nonadherence.

Results: Factor analysis yielded seven barrier factors including: situational barriers/difficulty resisting temptation [percent variance=11.64%], stress-related eating disorder/cost [percent variance=9.11%], difficulty with meal and snack plans [percent variance=8.76%], confusion [percent variance=8.45%], work-related issues [percent variance=7.72%], small portion size [percent variance=6.87%] and lack of palatability/family support [percent variance=6.78%]. These factors explained about 59.4% of the total variance.

Conclusions: Overall, patients with type 2 diabetes perceived some barriers to recommended dietary adherence. In dietary counseling, considering and addressing these barriers will likely be effective in increasing the dietary adherence for patients with type 2 diabetes in Iran.
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http://dx.doi.org/10.1016/j.eatbeh.2016.03.001DOI Listing
April 2016

Effect of Fresh Royal Jelly Ingestion on Glycemic Response in Patients With Type 2 Diabetes.

Iran Red Crescent Med J 2015 Sep 22;17(9):e20074. Epub 2015 Sep 22.

Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, IR Iran.

Background: Type 2 diabetes is the fourth major public health problem worldwide. Royal Jelly (RJ) insulin-like activity and blood glucose modulating properties have been reported in animal and healthy volunteers.

Objectives: This study aimed to investigate the effect of a single dose of fresh RJ as a complementary therapy on glycemic response in patients with type 2 diabetes.

Patients And Methods: In this randomized clinical trial, 40 patients with type 2 diabetes were assigned into the RJ (n = 20) and placebo (n = 20) groups and received either 10 g fresh RJ or placebo after overnight fasting. Serum glucose, insulin and C-peptide concentrations were determined at 0, 60, 120 minutes after the intervention. Independent t-tests and repeated measures ANOVA were used to analyze data.

Results: The mean serum glucose levels were significantly decreased in RJ and placebo groups; however, mean serum level was different but not statistically. (P = 0.77). One hour after RJ ingestion the mean serum insulin concentrations were increased and after 2 hours it was decreased insignificantly (P = 0.54, P = 0.20). The mean C-peptide concentrations were significantly increased after 1 and 2 hours of RJ ingestion; however, in the placebo group we observed a slight but insignificant reduction at the time of 1 and 2 hours in the mean C-peptide serum levels (P = 0.40). Moreover, there was no significant difference in none of the glycemic control parameters between both studied groups (P > 0.05).

Conclusions: It seems that RJ does not appear to have significant immediate effects on glycemic factors in patients with type 2 diabetes. However, further studies with larger sample sizes and different doses of RJ are needed to achieve more precise results.
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http://dx.doi.org/10.5812/ircmj.20074DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4601209PMC
September 2015

A cross-sectional study of barriers to physical activity among overweight and obese patients with type 2 diabetes in Iran.

Health Soc Care Community 2016 09 22;24(5):e92-e100. Epub 2015 Jun 22.

Nutrition Research Center, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.

The objective of this study was to identify common barriers to physical activity practice among overweight/obese patients with type 2 diabetes in Iran and their associations with physical activity level. In this cross-sectional study, 146 overweight/obese volunteers with type 2 diabetes were recruited from diabetes clinics in Tabriz, Iran, between July 2012 and March 2013. A Persian version of the long-format International Physical Activity Questionnaire was used to assess physical activity level. A 12-item structured questionnaire was designed to assess physical activity barriers. The validity and reliability of the latter scale were assessed by related measures. An exploratory factor analysis with the principal component analysis extraction method and varimax rotation was performed to extract the underlying factors. Multivariate regression analysis was used to assess the relationship between barriers and physical activity level. About 73% of patients had moderate physical activity. Factor analysis yielded four factors as barriers to physical activity including: (i) negative attitude towards physical activity, (ii) discouragement, (iii) physical problems and (iv) cost/environmental factors. These factors explained about 51% of the total variance. There was a negative relationship between the factor 'physical problems' and physical activity level (P = 0.024). Overall, there were some barriers to physical activity. Health counsellors should address these barriers to increase the patients' adherence to physical activity recommendations. Physical conditions of the patients must be taken into account.
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http://dx.doi.org/10.1111/hsc.12263DOI Listing
September 2016

Urinary and Milk Iodine Status in Neonates and Their Mothers during Congenital Hypothyroidism Screening Program in Eastern Azerbaijan: A Pilot Study.

Iran J Public Health 2014 Oct;43(10):1380-4

5. Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran, Iran.

Background: Iodine is essential element in thyroid hormones synthesis and normal growth and development of the brain. Milk and iodine concentrations can be appropriate indicator of body iodine status; in this study, we evaluated the concentrations of urine and milk iodine in newborns and their mothers.

Methods: In a cross-sectional study conducted in 2013, urine and milk iodine in 106 neonates and their mothers referred to healthcare center in Shabestar, Eastern Azerbaijan for congenital hypothyroidism screening program were determined. Median urinary iodine < 100 µg/L and milk iodine < 50 µg/L was considered as iodine deficiency.

Results: The median urine iodine concentrations (UIC) in mothers and infants were 142.31 µg/L (.0 - 1260) and 306.76 µg/L (23.56-1020) respectively. Urine iodine concentrations were < 100 µg/L in 33.9% of mothers and 14.2% of neonates. The median milk iodine concentration (MIC) was 58.23 µg/L (20.31- 425) and in 41.9% of mothers was <50 µg/L. A positive significant correlation was found between milk iodine and maternal urinary iodine concentration (r=0.533, P= 0.000). There was significant correlation between neonatal UIC and maternal UIC (r=0.462, P= 0.000), neonatal UIC and MIC (r=0.414, P= 0.000).

Conclusions: Urinary and milk iodine concentrations in mothers and infants were within acceptable range, which indicates adequate iodine intake. However, there were moderate and marginal iodine deficiencies in about half percentage of participants. Insufficient amount of milk iodine in about half of the mothers can result in iodine deficiency in breast-fed infants.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4441891PMC
October 2014

Effect of probiotic fermented milk (kefir) on glycemic control and lipid profile in type 2 diabetic patients: a randomized double-blind placebo-controlled clinical trial.

Iran J Public Health 2015 Feb;44(2):228-37

Dept. of Nutrition, Biochemistry and Diet Therapy, School of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: Diabetes is a global health problem in the world. Probiotic food has anti-diabetic property. The aim of this trial was to determine the effect of probiotic fermented milk (kefir) on glucose and lipid profile control in patients with type 2 diabetes mellitus.

Methods: This randomized double-blind placebo-controlled clinical trial was conducted on 60 diabetic patients aged 35 to 65 years.Patients were randomly and equally (n=30) assigned to consume either probiotic fermented milk (kefir) or conventional fermented milk (dough) for 8 weeks. Probiotic group consumed 600 ml/day probiotic fermented milk containing Lactobacillus casei, Lactobacillus acidophilus and Bifidobacteria and control group consumed 600 ml/day conventional fermented milk.Blood samples tested for fasting blood glucose, HbA1C, triglyceride (TG), total cholesterol, HDL-C and LDL-C at the baseline and end of the study.

Results: The comparison of fasting blood glucose between two groups after intervention was statistically significant (P=0.01). After intervention, reduced HbA1C compared with the baseline value in probiotic fermented milk group was statistically significant (P=0.001), also the HbA1C level significantly decreased in probiotic group in comparison with control group (P=0.02) adjusting for serum levels of glucose, baseline values of HbA1c and energy intake according to ANCOVA model. Serum triglyceride, total cholesterol, LDL-cholesterol and HDL- cholesterol levels were not shown significant differences between and within the groups after intervention.

Conclusion: Probiotic fermented milk can be useful as a complementary or adjuvant therapy in the treatment of diabetes.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4401881PMC
February 2015

Effects of Silybum marianum (L.) Gaertn. (silymarin) extract supplementation on antioxidant status and hs-CRP in patients with type 2 diabetes mellitus: a randomized, triple-blind, placebo-controlled clinical trial.

Phytomedicine 2015 Feb 19;22(2):290-6. Epub 2015 Jan 19.

Department of Epidemiology and Biostatistics, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.

Aim: Diabetes is a serious metabolic disorder and oxidative stress and inflammation contribute to its pathogenesis and complications. Since Silybum marianum (L.) Gaertn. (silymarin) extract is an antioxidant with anti-inflammatory properties, this randomized clinical trial was conducted to evaluate the effects of silymarin supplementation on oxidative stress indices and hs-CRP in type 2 diabetes mellitus patients.

Methods: For the present paralleled, randomized, triple-blinded, placebo-controlled clinical trial, 40 type 2 diabetes patients aged 25-50 yr old and on stable medication were recruited from the Iranian Diabetes Society and endocrinology clinics in East Azarbayjan (Tabriz, Iran) and randomly assigned into two groups. Patients in the silymarin treatment group received 140 mg, thrice daily of dried extracts of Silybum marianum (n = 20) and those in the placebo group (n = 20) received identical placebos for 45 days. Data pertaining to height, weight, waist circumference and BMI, as well as food consumption, were collected at base line and at the conclusion of the study. Fasting blood samples were obtained and antioxidant indices and hs-CRP were assessed at baseline, as well as at the end of the trial.

Results: All 40 patients completed the study and did not report any adverse effects or symptoms with the silymarin supplementation. Silymarin supplementation significantly increased superoxide dismutase (SOD), glutathione peroxidase (GPX) activity and total antioxidant capacity (TAC) compared to patients taking the placebo, by 12.85%, 30.32% and 8.43%, respectively (p < 0.05). There was a significant reduction in hs-CRP levels by 26.83% (p < 0.05) in the silymarin group compared to the placebo group. Malondialdehyde (MDA) concentration significantly decreased by 12.01% (p < 0.05) in the silymarin group compared to the baseline.

Conclusions: Silymarin supplementation improves some antioxidant indices (SOD, GPX and TAC) and decrease hs-CRP levels in T2DM patients.
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http://dx.doi.org/10.1016/j.phymed.2014.12.010DOI Listing
February 2015
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