Publications by authors named "Zhaleh Shadman"

17 Publications

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Obesity in COVID-19 era, implications for mechanisms, comorbidities, and prognosis: a review and meta-analysis.

Int J Obes (Lond) 2021 Feb 26. Epub 2021 Feb 26.

Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Recent studies have shown that obesity is associated with the severity of coronavirus disease (COVID-19). We reviewed clinical studies to clarify the obesity relationship with COVID-19 severity, comorbidities, and discussing possible mechanisms.

Materials And Methods: The electronic databases, including Web of Science, PubMed, Scopus, and Google Scholar, were searched and all studies conducted on COVID-19 and obesity were reviewed. All studies were independently screened by reviewers based on their titles and abstracts.

Results: Forty relevant articles were selected, and their full texts were reviewed. Obesity affects the respiratory and immune systems through various mechanisms. Cytokine and adipokine secretion from adipose tissue leads to a pro-inflammatory state in obese patients, predisposing them to thrombosis, incoordination of innate and adaptive immune responses, inadequate antibody response, and cytokine storm. Obese patients had a longer virus shedding. Obesity is associated with other comorbidities such as hypertension, cardiovascular diseases, diabetes mellitus, and vitamin D deficiency. Hospitalization, intensive care unit admission, mechanical ventilation, and even mortality in obese patients were higher than normal-weight patients. Obesity could alter the direction of severe COVID-19 symptoms to younger individuals. Reduced physical activity, unhealthy eating habits and, more stress and fear experienced during the COVID-19 pandemic may result in more weight gain and obesity.

Conclusions: Obesity should be considered as an independent risk factor for the severity of COVID-19. Paying more attention to preventing weight gain in obese patients with COVID-19 infection in early levels of disease is crucial during this pandemic.
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http://dx.doi.org/10.1038/s41366-021-00776-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7909378PMC
February 2021

Osteoporosis and cognitive impairment interwoven warning signs: community-based study on older adults-Bushehr Elderly Health (BEH) Program.

Arch Osteoporos 2020 09 10;15(1):140. Epub 2020 Sep 10.

Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Cognitive impairment and osteoporosis are frequently seen to coincide in clinical practice. Osteoporosis was higher in elderly populations with cognitive impairment, especially in postmenopausal women. Thus, prophylaxis for osteoporosis, falls, and fractures should be considered as part of the treatment of patients with cognitive impairment.

Introduction: Cognitive impairment and osteoporosis are two important health concerns among older adults that their possible relationship, concurrent occurrence, and linking mechanism have recently been highlighted. The purpose of this study was to assess the sex-independent association of these two conditions.

Materials And Methods: From among 2331 individuals aged ≥ 60 years selected in Bushehr Elderly Health (BEH) Program, Iran; data of 1508 participants were analyzed. Cognitive status was assessed using Category Fluency Test and Mini-cog assessment instrument. Association between osteopenia-osteoporosis and cognitive impairment were assessed using uni- and multivariable logistic regression models.

Results: Osteoporosis was diagnosed in 598 (39.6%) of the participants (58.3% female and 21.9% male, P < 0.001). From among them, 677 (44.9%) had evidence of cognitive impairment (64.5% female and 31.0% male, P < 0.001). Multivariate logistic regressions showed spinal and total hip osteoporosis was associated with 1.83 (CI 95% 1.13-2.96) and 2.24-fold (CI 95% 1.28-3.89) increase in the risk of cognitive impairment among female subjects, respectively. Ordinal logistic regression, on the other hand, revealed cognitive impairment to be associated with 1.42-fold (CI 95% 1.04-1.92) increase in the risk of spinal osteopenia-osteoporosis, 1.5-fold increase in total hip osteoporosis (CI 95% 1.09-2.05), and 1.48-fold increase in general osteoporosis (CI 95% 1.06-2.0).

Conclusion: Different degrees of bone loss and cognitive impairment may be a risk factor for each other among women but not in men. It is suggested that the screening, adopting preventive measures for the other condition and regular follow-ups, if needed, could be of utmost importance.
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http://dx.doi.org/10.1007/s11657-020-00817-1DOI Listing
September 2020

Quality of reporting of randomized controlled trials of herbal medicines conducted in metabolic disorders in Middle East countries: A systematic review.

Complement Ther Med 2018 Jun 11;38:61-66. Epub 2018 Apr 11.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Introduction: Based on WHO recommendation for considering herbal medicine as an inexpensive appropriate method to treat metabolic disorders, conducting randomized controlled trials (RCTs) is increasing worldwide. Since poor quality RCTs can lead to wrong conclusion, we assessed the quality of reporting of herbal medicines' RCTs conducted in Middle East in a systematic review study.

Materials & Methods: All herbal medicines' RCTs in metabolic disorders (diabetes mellitus, metabolic syndrome, hyperlipidemia, obesity and osteoporosis) conducted in Middle East countries and published before January 2017 were included. To obtain all related studies PubMed, Scopus, Web of Science, Cochran library, and Embase web databases were searched. Exclusion criteria were animal studies, non-herbal medicines' RCTs, RCTs conducted in Type 1 diabetes, in children or pregnant women. We used Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist for reporting study selection processes as well as Consolidated Standards of Reporting Trials (CONSORT) statement for assessment of quality of reporting.

Results: Out of 5319 identified studies, 215 RCTs were included. The proportion of published RCTs in the topic increased significantly over the time (P < 0.001). The total mean ± SD score for 37 items of CONSORT checklist was 21.15 ± 4.27. Most of RCTs (60%) were not reported randomization in the title. Some important items were incompletely reported including trial registration (42.3%), sample size estimation (38.1%), randomization method (35.3%), generation of allocation (27.9%), and concealment of allocation (13.5%).

Conclusions: Our findings indicate that the quality of reporting of herbal medicines' RCTs in metabolic disorders has improved over time in Middle East, but remains suboptimal.
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http://dx.doi.org/10.1016/j.ctim.2018.04.004DOI Listing
June 2018

Appendicular Skeletal Muscle Mass Reference Values and the Peak Muscle Mass to Identify Sarcopenia among Iranian Healthy Population.

Int J Prev Med 2018 9;9:25. Epub 2018 Mar 9.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Sacopenia is a common problem in elderly with the adverse outcomes. The objective of this study was to estimate the peak appendicular skeletal muscle mass (ASM) and age of its attainment by sex among the Iranian population.

Methods: A total of 691 men and women aged 18-94 years participated in this cross-sectional, population-based study in Bushehr, Iran. ASM was measured by dual X-ray absorptiometry. Cutoff points for men and women were established considering two standard deviations (SDs) below the mean values of the skeletal muscle index (SMI) for young reference groups. The relationship between ASM and age was described by the second-degree regression models. Two SDs below the mean SMIs of reference groups were as cutoff values of low muscle mass in Iranian population.

Results: The peak ASM values were 21.35 ± 0.12 Kg and 13.68 ± 0.10 Kg, and the age at peak ASM were 26 (24-28) years and 34 (33-35) years for men and women, respectively. Mean and SD of SMI in those ages were 7.01 ± 0.02 Kg/m and 5.44 ± 0.02 Kg/m among men and women, respectively. Calculated cutoff values of low muscle mass among the Iranian population were 7.0 Kg/m and 5.4 Kg/m among men and women, respectively.

Conclusions: Iranian reference values of SMI for both genders were similar to Asia Working Group for Sarcopenia recommendation and lower than the United States and European values. Further studies from different nations and the Middle East countries are needed to obtain reference values for populations, enabling the researchers for comparison and also more valid reports on sarcopenia prevalence.
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http://dx.doi.org/10.4103/ijpvm.IJPVM_295_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5869961PMC
March 2018

Bushehr Elderly Health (BEH) programme: study protocol and design of musculoskeletal system and cognitive function (stage II).

BMJ Open 2017 Aug 4;7(8):e013606. Epub 2017 Aug 4.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Musculoskeletal disorders and cognitive diseases are prevalent, and they are significant determinants of morbidity and mortality in older adults. The aim of this study is to investigate the prevalence of musculoskeletal and cognitive diseases and their risk factors and also to assess their associations during future follow-ups.

Methods And Analysis: Bushehr Elderly Health (BEH) programme is a population-based prospective cohort study being conducted in Bushehr, a southern province of Iran. A total of 3000 older people aged ≥60 years participated in the first stage from which 2772 were eligible to participate in the second stage, which started after 2.5 years. Data including demographic status, lifestyle factors, general healthandmedical history, and mentalandfunctional health are collected through a questionnaire. Anthropometric measures, performance testsandmuscle strength, blood pressure and and body composition measurements are done. A total 25 cc venous blood is taken, and sera are stored at -80°C for possible future analyses.

Ethics And Dissemination: The study protocol was approved by the ethics committee of Endocrinology and Metabolism Research Institute, affiliated to Tehran University of Medical Science as well as the Research Ethics Committee of Bushehr University of Medical Sciences. A written informed consent was signed by all the participants. The study findings will show the prevalence of musculoskeletal disease, cognitive impairment and their risk factors in an elderly population. The participants will be followed during the study to measure the occurrence outcomes.This study will also have the potential to inform the development of beneficial interventions to improve the management of musculoskeletal and cognitive impairment in Iran and other countries in the Middle East.Our findings will be disseminated via scientific publication as well as presentation to stakeholders, including the patients, clinicians, the public and policymakers, via appropriate avenues.
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http://dx.doi.org/10.1136/bmjopen-2016-013606DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577871PMC
August 2017

Association of Major Dietary Patterns with Cardio-metabolic Risk Factors in Type 2 Diabetic Patients.

Iran J Public Health 2016 Nov;45(11):1491-1501

Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Role of dietary modifications on the treatment and management of diabetes and complications was shown by many researchers. This study was designed to examine the association of major dietary patterns with diabetes-related cardio-metabolic risk factors in Iranian diabetes.

Methods: Totally, 525 type 2 diabetic subjects with mean age 55 ± 10 yr were included in this cross-sectional study in 2014 that followed for at least two years by the Diabetes and Metabolic disease Clinic of Tehran University of Medical Sciences, Tehran, Iran. Blood samples were collected after 12 h fasting for glycemic and lipid profiles. Information on the general characteristics, anthropometric, blood pressure measurements and physical activity level was collected. Dietary data were obtained by a validated food frequency questionnaire. Dietary patterns were obtained factor analysis (principal component analysis).

Results: Three major dietary patterns retained through principal component analysis: Western like (high in sweets, fast foods, carbonated drinks, red meat, mayonnaise, nuts, refined grains, potato and visceral meat), Asian like (high in vegetables, low-fat dairy, fish, poultry and egg), and Traditional like (high in high fat dairy, oils, whole grains, vegetables and fruits). Western like dietary pattern was positively associated with fasting serum glucose (=0.05), total cholesterol (=0.005) and low-density lipoprotein cholesterol (=0.008). After extensive adjustment for potential confounders, the association of serum total cholesterol and Western like dietary pattern remained significant (=0.03).

Conclusion: Modifications in dietary pattern, especially in those who have a Western dietary pattern, may be effective in preventing or delaying diabetes-associated cardio metabolic complications.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5182258PMC
November 2016

The Association of Bread and Rice with Metabolic Factors in Type 2 Diabetic Patients.

PLoS One 2016 22;11(12):e0167921. Epub 2016 Dec 22.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran university of Medical Sciences, Tehran, Iran.

Purpose: Carbohydrates are shown to have an important role in blood glucose control, type 2 diabetes and cardiovascular diseases risk. This is even more challenging when considering populations consuming refined grains diets. Bread and rice are staple foods which supply main proportion of Iranian calorie intake. This study was designed to investigate the effect of bread and rice intake on blood glucose control, lipid profile and anthropometric measurements in Iranian type 2 diabetic patients.

Methods: 426 patients with type 2 diabetes were included in this study. Anthropometric measurements were done using standard methods. Dietary information was assessed by a valid and reliable food frequency questionnaire (FFQ). Fasting blood glucose (FBG), glycated hemoglobin (HbA1c), serum triglycride (TG), total cholesterol (TC), low density lipoprotein (LDL) and high density lipoprotein (HDL) cholesterol were examined after 12-hour fasting.

Results: The results represented that people in the highest tertile compared to the lowest tertile of calorie adjusted total bread intake have higher FBG. FBG in the highest tertile of calorie adjusted total bread-rice intake was also significantly higher than the lowest. The association remained significant after adjusting for potential confounders. Rice intake showed no association with cardio-metabolic risk factors.

Conclusion: We founded that higher total bread intake and total bread-rice intake were associated with FBG in type 2 diabetic patients whereas rice intake was not associated with glucose and lipid profile. This result should be confirmed in prospective studies, considering varieties, glycemic index (GI), glycemic load (GL) and cooking method of bread and rice.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0167921PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5179013PMC
July 2017

Nutritional Education Needs in Relation to Ramadan Fasting and Its Complications in Tehran, Iran.

Iran Red Crescent Med J 2016 Aug 8;18(8):e26130. Epub 2016 Jun 8.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran.

Background: Ramadan fasting is associated with some lifestyle changes. A lack of nutritional needs knowledge or the improper performance of fasting, particularly in relation to time, type and amount of food intake, can cause disorders such as indigestion, bloating, constipation, headaches and other clinical problems.

Objectives: To investigate the general knowledge regarding dietary factors associated with Ramadan fasting and its related complications.

Patients And Methods: This prospective, non-interventional, observational study was conducted from April to July, 2012 to coincide with the month before and the month of Ramadan. The initial participants were 600 fasting and 588 non-fasting people (aged 18 - 65 years, BMI 18.5 - 40 kg/m) chosen by random cluster sampling in Tehran, Iran. A questionnaire of Ramadan fasting nutritional knowledge was developed and validated in a pilot study. The Likert scale was used two weeks before Ramadan and during the third and fourth weeks of Ramadan to estimate Ramadan-related complications. Seven-day, 24 - hour food recalls were used to assess food intakes.

Results: The lowest level of general knowledge was identified in the context of foods associated with hunger (22.1%) and hypoglycemia (24.8%) and the highest level of general knowledge was identified in reference to unsuitable foods for Sahar (91.4%). During Ramadan, all attributed complications increased in fasting subjects (P < 0.001). High calorie, carbohydrate, fat and protein intakes in the Ramadan diet were associated with some gastrointestinal and sleep complications (P < 0.05).

Conclusions: Despite the relatively high level of knowledge in the context of the general principles of a diet to prevent Ramadan-related complications, practical training in regard to the amounts of nutrients associated with Ramadan-related complications is both necessary and recommended.
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http://dx.doi.org/10.5812/ircmj.26130DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5066803PMC
August 2016

Lean Body Mass as a Predictive Value of Hypertension in Young Adults, in Ankara, Turkey.

Iran J Public Health 2015 Dec;44(12):1643-54

Dept. of Physical Education and Sports, Gazi University, Ankara, Turkey.

Background: The aim of this study was to assess the predictive capacity of body composition estimated by bioelectrical impedance analysis (BIA) to identify abnormal blood pressure in physical education and sport teaching students in the city of Ankara.

Methods: Data for this cross-sectional study were obtained in the city of Ankara in 2014. A total of 133 students aged 20-35 yr participated in this study. Anthropometric measurements were measured. Body composition was assessed by BIA. Physical activity level (PAL) and usual dietary intake were assessed. Pre-hypertension and hypertension were defined, respectively, as BP ≥120 and/or 80, and ≥140 and /or 90 mmHg.

Results: More overweight students showed abnormal BP especially SBP (P=0.005 and 0.002, respectively). Age adjusted regression showed significant association between arm circumference (β= 0.176, P 0.044), mid arm muscle circumference (MAMC) (β= 0.235, P 0.007), lean body mass (LBM) (β= 0.238, P 0.006), basal metabolism rate (BMR) (β= 0.219, P 0.012) and SBP and, also, MAMC (β= 0.201, P 0.022), LBM (β= 0.203, P 0.021), BMR (β= 0.189, P 0.030) and DBP. Fat intake was associated with DBP (β= 0.14, P =0.040). Multivariate regression models adjusted for age, BMI, WC and fat intake/kg body weight showed positive association of SBP with MAMC, BMR and LBM (P<0.05).

Conclusion: The relationship between blood pressure and body composition in young adults may be associated to LBM and MAMC. LBM or MAMC in this population may be indirect indicators of heart muscle mass and heart pumping power.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4724737PMC
December 2015

Effect of therapeutic dose of vitamin d on serum adiponectin and glycemia in vitamin d-insufficient or deficient type 2 diabetic patients.

Iran Red Crescent Med J 2014 Sep 5;16(9):e21458. Epub 2014 Sep 5.

Research Center of Endocrinology and Metabolism, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran.

Background: Lower vitamin D status has been reported in diabetic patients. Serum 25-hydroxyvitamin D and adiponectin were inversely associated with type 2 diabetes and insulin resistance. Vitamin D may involve in regulation of the adiponectin levels, which is directly related to insulin sensitivity.

Objectives: The aim of this study was to investigate the effect of therapeutic dose of vitamin D on serum adiponectin and insulin resistance in vitamin D-insufficient or deficient type 2 diabetic patients.

Materials And Methods: This double-blind, randomized, clinical trial was conducted on 81 type 2 diabetic patients with vitamin D level of 10-30 ng/mL. Intervention was 50000 IU vitamin D or placebo once a week for 8 weeks. At the beginning and end of the study, blood samples were collected after 12 hours of fasting and serum glucose, insulin, 25-hydroxyvitamin D, and adiponectin were measured. Insulin resistance was calculated by homeostasis model assessment (HOMA-IR).

Results: After 8-week intervention, serum 25-hydroxyvitamin D significantly increased and reached the normal levels in patients receiving vitamin D (P < 0.001) and the levels of fasting serum glucose, insulin, and HOMA-IR were significantly decreased (P = 0.04, 0.02 and 0.007, respectively). No significant changes were observed in these levels in the placebo group. Significant differences were observed in mean changes in the above-mentioned variables between the two groups (P = 0.01, 0.04 and 0.006, respectively). No significant changes were found in serum adiponectin in the vitamin D and placebo groups (P = 0.83).

Conclusions: Therapeutic dose of vitamin D can improve vitamin D status and glycemic indicators. But it seems that an 8-week intervention period was not sufficient to reveal the possible effects of vitamin D on serum adiponectin levels.
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http://dx.doi.org/10.5812/ircmj.21458DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4270651PMC
September 2014

Ramadan major dietary patterns.

Iran Red Crescent Med J 2014 Sep 5;16(9):e16801. Epub 2014 Sep 5.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran.

Background: There has been no data on population based dietary patterns during the Ramadan fasting month.

Objectives: The purpose of this study was to detect Ramadan major dietary patterns among those who fast in Tehran.

Materials And Methods: This cross-sectional study included 600 subjects, aged 18-65 with body mass index (BMI) of 18.5-40, who had decided to fast during Ramadan. Anthropometric measurements, usual physical activity level and educational status were collected two weeks before Ramadan. Information on Ramadan dietary intakes was obtained using a food frequency questionnaire and factor analysis was used to identify major dietary patterns.

Results: We identified four major dietary patterns: 1) Western-like pattern; high in fast foods, salty snacks, nuts, potato, fish, poultry, chocolates, juices; 2) high cholesterol and high sweet junk food pattern; high in pickles, sweets and condiments, butter and cream, canned fish, visceral meats and eggs; 3) Mediterranean-like pattern; high in vegetables, olive oil, dates, dairy, dried fruits, fruits, red meats, tea and coffee and 4) Ramadan-style pattern; large consumption of Halim, soups, porridges, legumes and whole grains, soft drinks, Zoolbia and Bamieh. Age was positively and inversely associated with Mediterranean-like (P = 0.003; r = 0.17) and Ramadan style (P = 0.1; r = -0.13) dietary pattern, respectively. Pre-Ramadan physical activity level was associated with a Mediterranean-like dietary pattern (P < 0.0001; r = 0.20).

Conclusions: This study showed a Ramadan-specific dietary pattern has unique characteristics, which has not yet been identified as a model of dietary pattern. Also, among identified dietary patterns, Mediterranean-like was the healthiest.
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http://dx.doi.org/10.5812/ircmj.16801DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4270674PMC
September 2014

New challenges in dietary pattern analysis: combined dietary patterns and calorie adjusted factor analysis in type 2 diabetic patients.

J Diabetes Metab Disord 2014 10;13:71. Epub 2014 Jul 10.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Science Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Some variability for dietary pattern analysis due to subjective procedures (e.g. arbitrary food categorization and number of factors extraction) was reported. The aim of this study was to present or design a new approach to challenge the conventional dietary pattern analysis through new classification of dietary patterns according to the possibility of the high adherence to more than one dietary pattern and calorie adjusted factor extracting.

Methods: This cross-sectional study conducted on 734 type2 diabetic patients. Factor analysis defined three major dietary patterns (Western like, Asian like and Traditional like) and the associations of each pattern were assessed with glycemic control and lipid profiles among tertiles of each pattern. In order to compare variables in highest tertile of three defined dietary patterns, eight new different groups were classified according to the high adherence to one or more patterns and ANOVA and ANCOVA were used to compare them. Also, calorie adjusted factor extracting were done to find out if the same factor loadings would be extract.

Results: Among three major dietary patterns, only Western like showed a significant association with fasting blood sugar (p = 0.03, 12.49 ± 5.99), serum total cholesterol (p = 0.02, 8.71 ± 3.81) and LDL cholesterol (p = 0.04, 5.04 ± 2.40). While comparison of new classified patterns, showed no significant differences, except a high blood glucose in Western like- Asian like versus traditional like dietary pattern (p = 0.04). Also, calorie adjusted factor extracting showed different factor loadings.

Conclusions: Results showed that the conventional dietary pattern analysis method may have substantial limitations in interpreting the results and may lead to inappropriate conclusions.
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http://dx.doi.org/10.1186/2251-6581-13-71DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100028PMC
July 2014

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

Iran Red Crescent Med J 2014 Mar 5;16(3):e14941. Epub 2014 Mar 5.

Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.

Background: No comprehensive study has been conducted on risk factors of sexual dysfunction in women with diabetes mellitus.

Objectives: The aim of this study was to consider all possible influencing variables including hormonal, physical and, psychological status, socioeconomic status, and dietary intake to get more accurate and reliable results.

Patients And Methods: Sexual function was assessed by Iranian validated female sexual function index (FSFI).The variables of the study were demographic and diabetes-related factors, stress-depression, physical activity, blood pressure, anthropometric measurements, lipid profile, cortisol, sex and thyroid hormones, 25-hydroxy vitamin D, and dietary intake.

Results: Among all investigated variables, partner relationship showed a strong positive association with FSFI (β = 1.93 ± 0.41, P < 0.0001). In addition, not considering partner relationship, FSFI showed a significant negative association with age (β = -0.19 ± 0.20, P = 0.04), stress-depression score (β = -0.08 ± 0.04, P = 0.04), DD (β = -0.03 ± 0.01, P = 0.04), and systolic blood pressure (β = -0.14 ± 0.06, P = 0.03). Significant associations between FSFI and serum sex hormones and other biochemical were found in neither postmenopausal nor non-menopausal women. The means of SFSI in postmenopausal women were greater than non-menopausal (P = 0.02).

Conclusions: It seems that in our population, female sexual function was much more than just a hormonal or physical problem and psychological factors, especially partner relationship and stress-depression, are the most determinants. In addition, age, duration of challenging with disease, and the lack of controlling systolic blood pressure were common factors that decreased sexual function.
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http://dx.doi.org/10.5812/ircmj.14941DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4005440PMC
March 2014

Effect of conjugated linoleic acid and vitamin E on glycemic control, body composition, and inflammatory markers in overweight type2 diabetics.

J Diabetes Metab Disord 2013 Jul 20;12(1):42. Epub 2013 Jul 20.

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

Background: The healthy properties of conjugated linoleic acid (CLA) such as weight loss, reducing cardiovascular risk factors and inflammation have been reported. The trans-10, cis-12 CLA isomer is related to increasing insulin resistance, but the effects of cis-9, trans-11 isomer is not clear. The aim of this study was to investigate the effects of CLA with and without Vitamin E on body weight, body composition, glycemic index, inflammatory and coagulation factors, lipid profile, serum leptin and adiponectin, malondialdehyde (MDA), and blood pressure in type2 diabetes.

Methods: 56 patients with type2 diabetes were included in 8 week double-blind control trial that used metformin. They randomly divided into three groups: CLA + VitE, CLA + VitE placebo, CLA placebo + VitE placebo. All variables, anthropometric measurements, and body composition were evaluated at the beginning and the end of study. Statistical analysis and analysis of dietary data were performed using SPSS and nutritionist IV software, respectively.

Results: There were not any significant differences in variable changes among three groups. However, there was a trend to increase in MDA and decrease in apoB100 among CLA consumers.

Conclusion: The results of this study showed that administration of CLA supplementation for 8 weeks does not affect any indicators of metabolic control in overweight type2 diabetic patients.
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http://dx.doi.org/10.1186/2251-6581-12-42DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7976596PMC
July 2013

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

J Diabetes Metab Disord 2013 14;12:27. Epub 2013 Jun 14.

Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Since both dietary carbohydrate and fatty acids separately affect carbohydrate metabolism, how dietary macronutrients distribution may have different effects on carbohydrate metabolism pathways and regulation of blood glucose especially in diabetic patients.

Methods: In this cross-sectional study 750 type 2 diabetic patients (261 men and 489 women, aged 35-65 years),who at least two years were followed in Diabetes and Metabolic disease Clinic of Tehran University of Medical Sciences, were recruited according to inclusion and exclusion criteria by simple sampling. Dietary data were collected by a validated food frequency questionnaire. Other variables were anthropometric measurements, Stress, physical activity level, Biochemical analyses including fasting and postprandial plasma glucose, Glycated hemoglobin, total cholesterol, low and high density lipoproteins, triglycerides and 25-hydoxy D3. Linear regression models were used to assess the association of covariates with the mean concentrations of HbA1C in quintiles and multivariate linear regression model was used to distinguish the impacts of dietary macronutrient composition of the diet.

Results: Carbohydrate and dietary fiber intakes were inversely (P: < 0.0001 and 0.003 respectively) and dietary amount and proportion of saturated, mono-unsaturated and poly-unsaturated fatty were positively (P: < 0.0001, 0.03, 0.01 and 0.01 respectively) associated with HbA1C concentrations. Multivariate linear regression macronutrient density model that controlled for age, sex, diabetes duration and calorie intake showed that carbohydrate was inversely associated with HbA1C (P < 0.0001, R(2) = 15%). Results were also the same in the other three models adjusted for stress and exercise levels in model 2, waist circumference and sum of meals in model 3 and serum triglyceride and 25-hydroxy vitamin D in model 4(P < .0001, <.0001 and 0.0003 respectively). Calorie intake of 25 Kcal/body weight was identified as a cut of point of the negative effect of dietary carbohydrate and 30 for the positive effect of fat on HbA1c respectively (P = 0.04 and 0.03). Moreover, carbohydrate intake was positively (β = 0.08, P = 0.01) and protein (β = -0.04, P < 0.0001), SAFA (β = -0.04, P < 0.0001) and MUFA (β = -0.02, 0.07) proportion were negatively associated with increment in calorie intake.

Conclusion: This study showed that the substitution of fat for carbohydrate is associated with low concentrations of HbA1c in high calorie consuming type 2 diabetic patients.
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http://dx.doi.org/10.1186/2251-6581-12-27DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3891984PMC
May 2014

Comparison of body dissatisfaction and cosmetic rhinoplasty with levels of veil practicing in Islamic women.

Int J Eat Disord 2009 May;42(4):339-45

Faculty of Nutrition, Department of Human Nutrition, Shaheed Beheshti University of Medical Sciences (SBMU), Tehran, IRI.

Objective: The relationship between Islamic veiling, body dissatisfaction, and desire for cosmetic rhinoplasty (CR) has not been studied. We therefore compared body dissatisfaction (BD), depression, self-esteem, and prevalence and desire to have CR in 1,771 Iranian females.

Method: A battery of questionnaires was administered and participants were categorized into three groups of Islamic veil practicing: voluntarily and ideologically (IVP), non-complete (NCIVP), and Inconsiderate (IIVP).

Results: Despite a similar BMI, the IVP group scored significantly lower on BD, prevalence of dieting and exercising in order to be sexually appealing, and depression, higher on self-esteem, and had a lower desire for a CR than the two other groups. Prevalence of CR was significantly higher in the IIVP group than the other groups.

Discussion: Women who practiced more strict Islamic veiling techniques had increased body satisfaction and self esteem, and decreased depression scores and desire for CR. Consistent with other studies, our findings show that observance of a strict religious practice has a protective effect on psychological health.
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http://dx.doi.org/10.1002/eat.20613DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2804919PMC
May 2009

A pilot study of potassium supplementation in the treatment of hypokalemic patients with rheumatoid arthritis: a randomized, double-blinded, placebo-controlled trial.

J Pain 2008 Aug 12;9(8):722-31. Epub 2008 May 12.

Faculty of Nutrition and Food Sciences, Department of Human Nutrition, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.

Unlabelled: Patients with rheumatoid arthritis (RA) have been described as having significantly low serum potassium concentrations than that in healthy subjects. We assessed the therapeutic efficacy and tolerability of oral potassium supplement dissolved in grape juice in female hypokalemic patients with active RA. Thirty-two hypokalemic patients with active RA were investigated in a parallel, randomized design. In addition to their usual medication, the control group received placebo and the intervention group received 6000 mg chloride potassium dissolved in grape juice on 28 consecutive days. The primary outcome parameter was the change of pain on a visual analog scale (VAS). The American College of Rheumatology (ACR) percent response criteria and Disease Activity Score 28 (DAS28, 28-joint count) and the European League Against Rheumatism (EULAR) moderate response were assessed. Mean age was 48.6 +/- 6 years. In the potassium group, 43.75% (7/16) of the patients met the criteria of 33% lower pain intensity compared with 6.25% (1/16) in the placebo group (P < .02) at day 28. Also, 31.25% (5/16) of the patients in the intervention group achieved moderate responses, according to the EULAR criteria. The corresponding percentage for patients receiving placebo was 6.25% (1/16) (P < .05). Potassium supplements appeared to decrease pain intensity.

Perspective: This article reports a trial evaluating the effect of potassium supplementation in the treatment of pain in hypokalemic patients with rheumatoid arthritis. The elevated serum cortisol and potassium values in the treatment group correlate negatively with patient's assessment of pain intensity, reflecting an anti-pain effect for potassium supplementation.
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http://dx.doi.org/10.1016/j.jpain.2008.03.006DOI Listing
August 2008