Alendronate improves fasting plasma glucose and insulin sensitivity and decreases insulin resistance in prediabetic osteopenic postmenopausal women: a randomized triple-blind clinical trial

Aims Postmenopausal women receive bisphosphonates for osteoporosis treatment. The effect of these medications on developing diabetes mellitus (DM) in prediabetic patients is yet to be investigated. We aimed to determine the effect of alendronate on plasma glucose, insulin indices of postmenopausal women with prediabetes and osteopenia. Methods This triple‐blind randomized controlled clinical trial included 60 postmenopausal women, aged 45–60 years. All patients were vitamin D sufficient. They were randomly enrolled in intervention (70 mg/week alendronate for 12 week) and control (placebo tablet per week for 12 weeks) groups. The morning 8 hour fasting blood samples were collected at the baseline and follow–up visits to measure the fasting plasma glucose (FPG) (mg/dl), insulin and hemoglobin A1c (HbA1c). Plasma glucose and insulin concentration were measured 30, 60, and 120 minutes after glucose tolerance test. Matsuda index, homeostasis model assessment of insulin resistance (HOMA–IR), homeostasis model assessment of beta–cell function (HOMA–B) and the area under the curves (AUC) of glucose and insulin were calculated. Results Mean (SD) FPG (102.43 (1.46) mg/dl vs. 94.23)1.17) mg/dl, P=0.001), 120‐minutes insulin concentration (101.86)15.70) mU/l vs. 72.60 (11.36), P=0.026), HbA1c (5.60 (0.06) % vs. 5.40 (0.05)%, P=0.001), HOMA‐IR (3.57 (0.45) vs. 2.62 (0.24), P=0.021) and Matsuda index (7.7 (0.41) vs. 9.2 (0.4), P=0.001) significantly improved in the alendronate‐treated group. There was statistically significant more reductions in FPG (‐8.2 (8.63) mg/dl vs. ‐2.5 (14.26) mg/dl, P=0.002) and HbA1c (‐0.2 (0.23) % vs. ‐0.09 (0.26) %, P=0.015) were observed in alendronate‐treated group than placebo group during the study course, respectively. Conclusions Administration of 70 mg/week alendronate improves fasting plasma glucose, HbA1c and insulin indices in postmenopausal women

Effect of metformin and folic acid on plasma homocysteine level in type 2 diabetic patients

Hyperhomocysteinemia is associated with an increased risk of cardiovascular disease in diabetic patients. The aim of this study was to evaluate effects of metformin and folic acid on plasma homocysteine level in diabetic patients. In this clinical trial 47 new cases of type 2 diabetes were randomized to two groups. We treated patients in trial group with metformin and 1 mg folic acid, whereas patients in control group treated with metformin and placebo for 16 weeks. There was no significant difference in plasma homocysteine level and glycosylated hemoglobin (HbA1c) between two groups at the start of study. After 16 weeks plasma homocysteine level in the trial group did not change. In contrast plasma homocysteine level increased in the placebo group. There was significant difference in mean plasma homocysteine level between two groups (P-value < 0.01). This difference was highly significant in males (P-value < 0.0001). Correlation between glycosylated hemoglobin and plasma homocysteine level at start and end of study was not significant. This finding indicated that metformin increases plasma homocysteine level in diabetic patients especially males, whereas administration of folic acid with metformin can prevent this process

بررسی تأثیر 8 هفته تمرینات هوازی بر الگوی توزیع فشار کف پایی بیماران مبتلا به دیابت نوروپاتی

مقدمه: نوروپاتی حسی– حرکتی با تحت تأثیر قرار دادن اعصاب حسی و حرکتی منجر به کاهش حس عمقی، درک حرکت و موقعیت مفصل می‌شود. نتیجه آن تغییر الگوی راه رفتن از حالت طبیعی و تغییر مسیر مرکز فشار و اعمال فشار غیر طبیعی در نواحی متاتارسال می‌شود که در طی زمان احتمال بروز زخم پا را به همراه دارد. مطالعه حاضر به منظور بررسی تأثیر تمرینات هوازی بر فشار کف پا در حین راه رفتن در بیماران نوروپاتی مبتلا به دیابت انجام شد. مواد و روش‌ها: جامعه آماری شامل بیماران مبتلا به دیابت، مبتلا به عارضه نوروپاتی بودند که 30 نفر از آن‌ها به عنوان نمونه آماری با روش نمونه‌گیری در دسترس انتخاب و به طور داوطلبانه در دو گروه مساوی تمرین و شاهد قرار گرفتند که در پایان به 12 نفر در هر گروه کاهش یافتند (گروه تمرین 07/9 ± 85/55 سال و Kg/m2 09/10 ± 50/29 = Body mass index یا BMI، گروه شاهد 53/5 ± 66/54 سال و  Kg/m2 26/4 ± 55/31 = BMI). میزان حداکثر فشار کف پا در حین راه رفتن آزمودنی‌ها قبل و بعد از برنامه تمرینی با دستگاه Foot scan (RSscan) در ده ناحیه آناتومیکی اندازه‌گیری شد تا نواحی متأثر از تمرین به طور دقیق مشخص شود. گروه تمرین به مدت 8 هفته، هفته‌ای 3 جلسه و 1 ساعت در هر جلسه به انجام ورزش هوازی (بدون کنترل شدت تمرین) پرداختند. گروه شاهد در این مدت به زندگی معمول خود ادامه دادند. یافته‌ها: داده‌های فشار در پیش و پس آزمون با روش ANOVA با اندازه‌گیری‌های مکرر در نواحی ده‌گانه بررسی شد و نتایج نشان‌گر کاهش معنی‌دار فشار در نواحی متاتارسال و میان پا در گروه تمرین بود (05/0 ≤ P). در حالی که در گروه شاهد هیچ تغییر معنی‌داری مشاهده نشد. نتیجه گیری: این مطالعه نشان داد که بیماران مبتلا به دیابت با انجام فعالیت‌های ورزشی می‌توانند صدمات ناشی از نوروپاتی مانند زخم پا را که به دلیل توزیع غیر طبیعی فشار به خصوص در ناحیه متاتارسال به وجود می‌آید، کاهش دهند. کلید واژه‌ها: فشار کف پایی، تمرینات هوازی، نوروپاتی مبتلا به دیاب

Detection of Ochratoxin A in bread samples in Shahrekord city, Iran, 2011-2012

Background and aims: Ochratoxin A (OTA) is a mycotoxin that possess a risk to human health due to its nephrotoxic, immunotoxic, mutagenic, teratogenic and carcinogenic properties. This study was undertaken in order to determine the presence and levels of ochratoxin A in different types of bread consumed in Shahrekord city. Materials and Methods: Eighty six samples of different types of bread purchased in March 2012 from retail bakeshops in Shahrekord city were surveyed for the presence of ochratoxin A (OTA) using ELISA assay. Results: Ochratoxin A was detected in 45 out of the 86 bread samples (52.3%). Levels of OTA in positive samples ranged between 0.19 and 10.37 ng/g and the average contamination of all positive samples was 3.04 ng/g . The highest frequency of positive samples was related to machinery Taftoon (88.8%) and Lavash bread (81.8%). The most contaminated sample (5.39 ng/g ) was found in the Iranian Lavash bread. Fifteen of the positive samples exceed the maximum level of 5 ng/g set by European regulations for OTA in cereal and bread. Conclusion: The results of this study indicated that contamination levels of ochratoxin A were high in part of the samples (17.4%). Bread and cereals are considered to be the main and predominant ingredient of Iranian food; therefore, their contamination can have long-term negative impact on people's health

Effects of Levothyroxine and thyroid stimulating hormone on bone loss in patients with primary hypothyroidism

Objective: Previous studies on bone mineral density (BMD) abnormalities associated with hypothyroidism are scarce and not conclusive. The effect of thyroid hormone therapy on BMD has shown mixed results. The aim of the present study was to determine the severities of osteoporosis in female patients with hypothyroidism in comparison to healthy women. Methods: This cross-sectional descriptive study was performed on 150 women aged over 50 years. Totally, 100 patients with primary hypothyroidism and 50 healthy subjects were enrolled in this study and divided into three groups. Group A, which consisted the patients who had been recently diagnosed with primary hypothyroidism. The second group of patients diagnosed with primary hypothyroidism for at least 2 years and was treated with levothyroxine (Group B). The third group of healthy individuals was selected as a control group (Group C). Blood samples were taken for the measurements of thyroid stimulating hormone (TSH), and bone densitometry was performed to determine the BMD reported as T-score in order to measure the severity of osteoporosis. T-score of the lumbar vertebra (L2-L4) and femoral neck were measured with dual energy X-ray absorptiometry and were compared between the three groups. Data were analyzed by SPSS using regression analysis and Mann-Whitney, Kruskal-Wallis, or analysis of variances statistical tests. The statistical significance was set at a P < 0.05. Findings: The average age of patients and baseline serum TSH levels in Group B was significantly different from the other two groups (P < 0.001). T-score of the lumbar spine (L2-L4) in Group B was significantly lower than the other groups (P = 0.01). The linear regression between serum TSH levels and BMD categories were not clearly associated. However, after removing the effect of the baseline TSH level in Group B, bone loss was significantly greater than the other two groups (P = 0.01). Conclusion: According to the present study, it seems that the treatment of hypothyroidism with thyroid hormones reduces both serum levels of TSH and bone density. Hence, proper control of this risk factor can be an effective way in prevention of osteoporosis

Isolation of keratinophilic fungi from the soil of islands of Greater Tunb, Abu-Musa and Sirri, Persian Gulf, Iran

Background and Purpose: Keratinophilic fungi are among the important groups of fungi living in the soil. This study aimed to isolate and identify keratinophilic fungi from the soil of three Iranian islands, namely Greater Tunb, Abu Musa, and Sirri, located in the Persian Gulf using morphological and molecular (polymerase chain reaction) methods. Materials and Methods: In this study, a total of 60 soil samples were collected from the three islands of Greater Tunb, Abu Musa, and Sirri. The samples were analyzed for the presence of the keratinophilic fungi using a hair baiting technique. Furthermore, the identification of keratinophilic fungi was accomplished through the employment of molecular and sequencing techniques. Results: A total of 130 fungal isolates, including 11 genera with 24 species, were collected. Accordingly, Chrysosporium tropicum (24;18.5%), C. keratinophilum (17; 13.1%),&nbsp; Chrysosporium&nbsp; species (15; 11.5%), Aspergillus&nbsp; species ( 8;6.1%), Aspergillus flavus (8; 6.1%), Penicillium&nbsp; species (8;6.1%), Alternaria spp ( 6; 4.6%), Phoma&nbsp; species (5;&nbsp; 3.8%), Aphanoascus verrucosus (4;3.1%), Fusarium chlamydosporum (4; 3.1%), Aspergillus trreus (4;3.1%), Acremonium&nbsp; species (4; 3.1%), and other fungi( 23; 17.8 %) isolates were identified . All isolates of keratinophilic fungi were isolated from the soils with the pH range of 7-9. Conclusion: The results of this study contributed towards a better conceptualization of the incidence pattern of keratinophilic fungi in the regions of Iran. Given that no study has investigated this issue, the findings of the present study can be beneficial for the management of public health surveillance, physicians, and epidemiologists.&nbsp;&nbsp

Zinc status in goitrous school children of Semirom, Iran

&lt;ul&gt;&lt;li&gt;&lt;strong&gt;BACKGROUND&lt;/strong&gt;: Iodine deficiency produces the spectrum of iodine deficiency disorders (IDDs) including endemic goiter, hypothyroidism, cretinism and congenital anomalies. Other factors, including goitrogens and micronutrient deficiencies may influence the prevalence and severity of IDDs and response to iodine supplementation. An ssociation between zinc and goiter has previously been reported.&lt;/li&gt;&lt;li&gt;&lt;strong&gt;METHODS&lt;/strong&gt;: A cross sectional study investigating an association between goiter and serum zinc status was performed in 2003 in a mountainous region of Iran. One thousand eight hundred twenty-eight children were selected by multistage cluster sampling. Goiter staging was performed by inspection and palpation. Serum zinc, total thyroxine, thyroid stimulating hormone and urinary iodine concentration were measured in a group of these children.&lt;/li&gt;&lt;li&gt;&lt;strong&gt;RESULTS&lt;/strong&gt;: Thirty six and seven tenth percent of subjects were classified as goitrous. Serum zinc level in goitrous and nongoitrous children was 82.80 &amp;plusmn; 17.85 and 83.38 &amp;plusmn; 16.25 9g/dl, respectively (p = 0.81). The prevalence of zinc deficiency (serum zinc ; 65 9g/dl) in goitrous and nongoitrous children did not differ significantly (9.3 % vs. 10.8%, p = 0.70).&lt;/li&gt;&lt;li&gt;&lt;strong&gt;CONCLUSION&lt;/strong&gt;: Goiter is still a public health problem in Semirom. According to the present study zinc status may not play a role in the etiology of goiter in Semirom school children. However, the role of other goitrogens or micronutrient deficiencies should be investigated in this region.&lt;/li&gt;&lt;li&gt;&lt;strong&gt;KEYWORDS&lt;/strong&gt;: Goiter, Iodine Deficiency, Zinc Deficiency, Child.&lt;/li&gt;&lt;/ul&gt