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Talaei A.,Arak University of Medical Sciences | Amini M.,Isfahan University of Medical Sciences | Siavash M.,Isfahan University of Medical Sciences | Zare M.,Isfahan Endocrine and Metabolism Research Center
Hormones | Year: 2010

OBJECTIVE: Dehydroepiandrosterone (DHEA) and Dehydroepiandrosterone-sulfate (DHEA-S) are the most abundant steroid hormones in the body. recently, DHEA-S has gained interest as an antidepressant substance, with positive effects on autoimmune disease such as lupus and ulcerative colitis, as well as obesity, cancer, cardiovascular disease and diabetes. Its effect on insulin resistance is also assumed to be positive, but has not as yet been confirmed. The present cross-over clinical trial was conducted to evaluate the efficacy of DHEA and placebo on insulin resistance. DESIGN: Participants were selected among relatives of diabetic patients who were referred to the Isfahan Endocrine research Center because of Impaired Glucose Tolerance (IGT) test. Thirty IGT patients were treated randomly with DHEA (50 mg/day) or placebo by cross-over clinical trial for six months and insulin resistance between the beginning and the end of each three months treatment period was assessed. rESULTS: At the end of the first three months, the mean changes from baseline of the various parameters in the drug group were: DHEA-S, 2.5μmol/l (p=0.008); Homeostatic Model Assessment of Insulin resistance (HOMA-Ir), 0.6 (p=0.6); insulin, 7.1 pmol/l (p=0.3) and FPG, 0.5mmol/l (p=0.1). The changes in the placebo group were: DHEA-S, 0.08 μmol/l (p=0.6); HOMA-Ir, 0.9 (p=0.03); FPG, 0.8 mmol/l (p=0.1); insulin, 25.1 pmol/l (p=0.05). In the second three months, the mean changes in the drug group were: DHEA-S, 4.5 μmol/l (p=0.003); Fasting Plasma Glucose (FPG), 0.1 mmol/l (p = 0.4); insulin, 4.3 pmol/l (p=0.2); HOMA-Ir, 0.3 (p=0.1) and the changes in placebo group were: DHEA-S, 0.7 μmol/l (p=0.5); FPG, 0.3 mmol/l (p=0.3); insulin, 10.7 pmol/l (p=0.1); HOMA-Ir, 0.6 (p=0.03). CONCLUSION: DHEA did not reduce insulin resistance, although there was a tendency to improvement. The data indicate a possible but not clearly favorable effect of DHEA on insulin resistance.


PubMed | Isfahan University of Medical Sciences, Isfahan Endocrine and Metabolism Research Center, Food Security Research Center and Research Institute for Primordial Prevention of Non Communicable Disease
Type: | Journal: Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences | Year: 2016

Different populations have shown various patterns of association between impaired fasting glucose (IFG) and body composition parameters and risk factors of cardiovascular disease (CVD). The current study aimed at investigating the differences between persons with prediabetes and healthy people in terms of CVD risk factors including body composition parameters, blood pressure, and lipid profile in a sample of the Iranian population.In a case-control setting, a sample containing 386 (193 prediabetic subjects and 193 normal subjects) of the first-degree relatives of diabetic patients aged 35-55 years were investigated. Samples were assessed using glucose tolerance categories. Prediabetes was defined according to the American Diabetes Association (ADA) criteria. Body composition parameters, blood pressure, glucose parameters, and lipid profile were measured and compared between the two groups.Prediabetic patients had higher body mass index (BMI), waist circumference (WC), and body fat (BF) in comparison to the control group (Both the risk factors of CVD and body composition parameters were different between the prediabetic and normal groups; total cholesterol (TC), triglyceride (TG), and FBS were predictors of the risk of prediabetes.


Ahmadi N.,Resident of Internal Medicine | Mortazavi M.,Isfahan University of Medical Sciences | Iraj B.,Isfahan Endocrine and Metabolism Research Center | Askari G.,Isfahan Endocrine and Metabolism Research Center
Journal of Research in Medical Sciences | Year: 2013

Background: Nowadays Vitamin D deficiency is a notable medical condition world-wide and also in Iran. Since, vitamin D can have renoprotective effect by inhibiting the renin-angiotensin system; it appears that low vitamin D level can worsen the renal injury in diabetic patients. This study demonstrates the effect of vitamin D3 therapy on reducing proteinuria in diabetic patients with concomitant diabetic nephropathy and vitamin D deficiency after controlling hypertension and use of angiotensin converting enzyme inhibitors (ACEIs) or angiotensin II type receptor blockers (ARBs). Materials and Methods: In this randomized double blinded parallel groups clinical trial, 51 diabetic patients with proven nephropathy and vitamin D deficiency/insufficiency and stable hypertension, dyslipidemia, and hyperglycemic treatment were enrolled. The patients were divided randomly into two groups (treatment and placebo group). Patients received oral vitamin D3 (pearl 50000 IU) or placebo one pearl every week for 12 weeks. Patients were assessed at baseline and 12 weeks after intervention from the point of 25(OH) D level, and urine albumin/creatinine ration (UACR). Results: Mean serum 25(OH) D concentrations were 14.06 ng/ml and 16.05 ng/ml before treatment. Furthermore, after intervention, its levels were risen to71.23 and 17.63 in drug and placebo groups, respectively. Whereas, UACR as the main variable did not change significantly after intervention in both groups (P = 0.919). Conclusion: According to our finding, there was not a decrease in proteinuria in diabetic patients who received vitamin D for a period of 3 months.


Taheri N.,Isfahan Endocrine and Metabolism Research Center | Aminorroaya A.,Isfahan Endocrine and Metabolism Research Center | Ismail-Beigi F.,Case Western Reserve University | Amini M.,Isfahan Endocrine and Metabolism Research Center
Endocrine Practice | Year: 2012

Objective: To determine the effect of a single 8-mg orally administered dose of dexamethasone or placebo on glucose and insulin homeostasis, during an oral glucose tolerance test (OGTT) performed before and 24 hours after the administered dose. Methods: In a randomized, double-blind, placebo-controlled study, we conducted experiments in subjects with normal glucose tolerance (NGT) or prediabetes, all of whom had at least one first-degree relative with type 2 diabetes mellitus. Measures of glucose and insulin homeostasis derived from an OGTT before and 24 hours after administration of dexamethasone or placebo were compared in 21 placebo-treated versus 23 dexamethasone-treated subjects with NGT as well as in 23 placebo-treated versus 20 dexamethasone-treated subjects with prediabetes. Results: Before administration of dexamethasone or placebo, area under the curve (AUC) for glucose and homeostasis model assessment of insulin resistance were higher, and the Matsuda and disposition indices were lower, in the prediabetic versus the NGT group. In both NGT and prediabetic groups treated with dexamethasone, glucose and insulin values at fasting and during OGTT were increased in comparison with placebo-treated groups at 24 hours (P = .001). Dexamethasone treatment in both study groups increased homeostasis model assessment of insulin resistance and AUC glucose and decreased the Matsuda index (P = .001). No significant changes were observed in AUC insulin/AUC glucose or homeostasis model assessment of beta-cell function after dexamethasone treatment in either the NGT or the prediabetic group. The disposition index decreased and was lowest in the prediabetic group after dexamethasone treatment. Conclusion: In a study population in which all subjects had at least one first-degree relative with type 2 diabetes mellitus, those with prediabetes were more insulin resistant and had a lower disposition index than did subjects with NGT. Subjects with prediabetes also had a pronounced decrease in disposition index when challenged with a single 8-mg orally administered dose of dexamethasone. Copyright © 2012 AACE.


Faghihimani E.,Isfahan Endocrine and Metabolism Research Center | Aminorroaya A.,Isfahan Endocrine and Metabolism Research Center | Rezvanian H.,Isfahan Endocrine and Metabolism Research Center | Adibi P.,Isfahan University of Medical Sciences | And 2 more authors.
Endocrine Practice | Year: 2012

Objective: To evaluate the effect of salsalate as an antiinflammatory agent on insulin resistance and glycemic control in persons with prediabetes. Methods: In this double-blind, placebo-controlled clinical trial, 66 persons who had prediabetes on the basis of the American Diabetes Association criteria were enrolled. They were randomly assigned to receive salsalate (3 g daily) or placebo for 12 weeks. Fasting plasma glucose (FPG) and insulin, glucose 2 hours after oral administration of 75 g of glucose, hemoglobin A1c, lipid profile, homeostasis model assessment of insulin resistance (HOMA-IR), and homeostasis model assessment of beta-cell function were determined before and after treatment. Results: Salsalate treatment reduced the FPG level from 5.86 ± 0.07 mmol/L to 5.20 ± 0.11 mmol/L and HOMA-IR from 4.2 ± 0.9 to 3.8 ± 0.3 (P = .01 for both changes). Homeostasis model assessment of beta-cell function increased in the salsalate-treatment group from 139.8 ± 11.0 to 189.4 ± 24.6 (P = .01). At the end of the study, FPG, HOMA-IR, and insulin levels were significantly different between salsalate and placebo groups (5.20 ± 0.11 mmol/L versus 5.53 ± 0.10 mmol/L, 3.8 ± 0.3 versus 4.4 ± 0.9, and 16.1 ± 1.9 μIU/mL versus 18.2 ± 2 μIU/mL, respectively; P<.05 for all). There were no persistent complications after salsalate therapy. Conclusion: Treatment with salsalate can reduce insulin resistance and the FPG level in subjects with prediabetes. Determination of the long-term safety and efficacy of the use of salsalate necessitates further investigation. Copyright © 2012 AACE.


Janghorbani M.,Isfahan Endocrine and Metabolism Research Center | Janghorbani M.,Isfahan University of Medical Sciences | Amini M.,Isfahan Endocrine and Metabolism Research Center
Annals of Nutrition and Metabolism | Year: 2016

Background/Aim: It is not clear whether levels of continuous metabolic syndrome (cMetS) are associated with type 2 diabetes (T2D). The aim of this study was to determine the ability of the cMetS score to predict progression to T2D in non-diabetic first-degree relatives (FDRs) of patients with T2D in Isfahan, Iran. Methods: A total of 1,869 non-diabetic FDRs 30-70 years old in 2003-2005 were followed through 2014 for the occurrence of T2D. At baseline and through follow-ups, participants underwent a standard 75 g 2-h oral glucose tolerance test. MetS was defined by the National Cholesterol Education Program-Adult Treatment Panel III. The cMetS score was calculated using age-and gender-standardized Z-score for MetS components. Receiver operating characteristic (ROC) curve was used to assess the association between cMetS and components of MetS with T2D. Results: During 13,571 person-years of follow-up, 72 men and 210 women developed diabetes. Those in the top quartile of cMetS were 8.0 times more likely to develop diabetes than those in the bottom quartile (OR 7.96; 95% CI 4.88-12.99). On ROC curve analysis, a higher area under the ROC were found for FPG (74.3%; 95% CI 70.8-77.8), than for cMetS (69.4%; 95% CI 66.0-72.8). Conclusions: The cMetS score is a robust predictor of T2D and may be more effective and efficient than the current binary definition of MetS in predicting progression to T2D in our study population. © 2015 S. Karger AG, Basel.


Amini M.,Isfahan Endocrine and Metabolism Research Center | Horri N.,Isfahan Endocrine and Metabolism Research Center | Zare M.,Isfahan Endocrine and Metabolism Research Center | Haghighi S.,Isfahan Endocrine and Metabolism Research Center | And 3 more authors.
Annals of Nutrition and Metabolism | Year: 2010

Background/Aims: To compare the cardiovascular disease (CVD) risk factors between subjects with impaired fasting glucose (IFG) and those with impaired glucose tolerance (IGT) in the first-degree relatives (FDR) of type 2 diabetic patients. Methods: A cross-sectional study, conducted between 2004 and 2006 in 1,893 (1,412 females and 481 males) FDR of type 2 diabetic outpatients of the Isfahan Endocrine and Metabolism Research Center. In all participants, blood pressure, weight, height, waist circumference, serum lipids and HbA1c were measured and a standard 75-g 2-hour oral glucose tolerance test was performed. The diagnosis of IGT, IFG and diabetes was made according to American Diabetes Association criteria. Results: Isolated IGT and isolated IFG, and both IFG and IGT were observed in 8.8%, 17.4% and 11.2% of subjects, respectively. In comparison to subjects with normal glucose levels and tolerance (control group): the mean waist circumference was significantly higher in both IFG and IGT groups; BMI, HDL-c and LDL-c in the IFG group; and triglycerides in the IGT group. The means of all studied CVD risk factors were significantly higher in the IGT+IFG group than the control group, except for blood pressure, HDL-c and HbA1c. No significant differences were found regarding CVD risk factors between IFG and IGT groups. Conclusions: The prevalence of IFG and IGT is high in FDR of type 2 diabetic patients. CVD risk factors are similar in these 2 groups and higher than in the control group. More attention should be paid to screening and treatment of this high-risk population. © 2010 S. Karger AG, Basel.


Ghahiri A.,Isfahan University of Medical Sciences | Najafian A.,Isfahan University of Medical Sciences | Ghasemi M.,Isfahan University of Medical Sciences | Najafian A.,Isfahan Endocrine and Metabolism Research Center
Iranian Journal of Reproductive Medicine | Year: 2012

Background: About 75% of the symptomatic patients who involved with endometriosis have pelvic pain and dysmenorrhea. Pentoxifyllin is one of the drugs that according to its mechanism could be effective for pain relief of endometriosis which has been used for endometriosis treatment recently.Objective: We conducted a comparative study for detecting the effect of pentoxifylin (as an immonomodelator) in preventing recurrence endometriotic pain with pentoxifylin plus a combined contraceptive pill with low dose estrogen (LD) and also the LD pill alone. Materials and Methods: This was a comparative clinical trial on 83 patients with the chief complaint (CC) of pain (dysmenorrheal /or pelvic pain) and with the end diagnosis of endometriosis, in an operative laparoscopy. Patients, dividing to 3 groups, were treated with pentoxifylin, pentoxifylin+LD and LD alone for 10 months. The severity of pain (dismenorhea and/or pelvic pain) was detected by visual analogue scale (VAS) before and after the treatment. The severity of endometriosis in the patients was: I in class I and II in class II and III in class III. The groups were matched for the pain. The number of the patients in group 1, 2 and 3 were 28, 28 and 27 respectively. Results: The pain was reduced in the groups of pentoxifylin+LD (p<0.001) and LD alone (p=0.00). The pain relief was not significant in the group of pentoxifylin alone (p=0.136). After treatment, the severity of pain was not significantly different between the LD group and the LD+penthoxyfillin group, but there was difference between these two groups and the group of penthoxyfillin alone. Conclusion: This study showed that penthoxyfillin actually could not have any effect on the pain relief of endometriosis. It also made it clear that penthoxyfillin could not increase the efficacy of LD when used with this medication.


PubMed | Isfahan University of Medical Sciences and Isfahan Endocrine and Metabolism Research Center
Type: | Journal: Advanced biomedical research | Year: 2016

Subclinical hyperthyroidism (SHy) is a widespread condition in which cardiovascular manifestations are frequently occur, but there is still a debate about the vascular responsiveness in it. Measuring flow-mediated dilation (FMD) and intimae-media thickness (IMT) are used to evaluate endothelial function in these patients.Twenty-five patients with a diagnosis of exogenous SHy and 25 full matched healthy subjects were enrolled. At first FMD of brachial artery and IMT of common carotid artery were obtained from all the participants. In the second phase, in the second phase of study, the dosage of levothyroxine was reduced at least 25% of prior dosage, and this was continued until thyroid stimulating hormone became normal range. Measuring FMD and IMT was repeated after this intervention in the case group.The mean age of case and control groups were 38.48 12.05 and 36.72 11.15 years, respectively. The mean of FMD in healthy people was dramatically higher than the subclinical hyperthyroid patients (This study demonstrated that FMD decreased in exogenous subclinical hyperthyroid patients which could be partially restored by treatment. These findings suggest that treatment of subclinical hyperthyroid state could improve endothelial dysfunction and at the end decreased the cardiovascular complications.


PubMed | Isfahan Endocrine and Metabolism Research Center
Type: Journal Article | Journal: Annals of nutrition & metabolism | Year: 2015

It is not clear whether levels of continuous metabolic syndrome (cMetS) are associated with type 2 diabetes (T2D). The aim of this study was to determine the ability of the cMetS score to predict progression to T2D in non-diabetic first-degree relatives (FDRs) of patients with T2D in Isfahan, Iran.A total of 1,869 non-diabetic FDRs 30-70 years old in 2003-2005 were followed through 2014 for the occurrence of T2D. At baseline and through follow-ups, participants underwent a standard 75 g 2-h oral glucose tolerance test. MetS was defined by the National Cholesterol Education Program-Adult Treatment Panel III. The cMetS score was calculated using age- and gender-standardized Z-score for MetS components. Receiver operating characteristic (ROC) curve was used to assess the association between cMetS and components of MetS with T2D.During 13,571 person-years of follow-up, 72 men and 210 women developed diabetes. Those in the top quartile of cMetS were 8.0 times more likely to develop diabetes than those in the bottom quartile (OR 7.96; 95% CI 4.88-12.99). On ROC curve analysis, a higher area under the ROC were found for FPG (74.3%; 95% CI 70.8-77.8), than for cMetS (69.4%; 95% CI 66.0-72.8).The cMetS score is a robust predictor of T2D and may be more effective and efficient than the current binary definition of MetS in predicting progression to T2D in our study population.

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