High prevalence of goiter in schoolchildren in Isfahan; zinc deficiency does not play a role

Wstęp: Dane dotyczące znaczenia niedoboru cynku w etiologii wola endemicznego są niejednoznaczne. Celem niniejszego badania było ustalenie związku między stężeniem cynku w surowicy a występowaniem wola u dzieci w wieku szkolnym w Isfahanie. Materiał i metody: Badanie przeprowadzono w 2005 roku. Włączono do niego 2331 dzieci, u których oceniono palpacyjnie wielkość tarczycy. U części dzieci oznaczono stężenie jodu w moczu (UIC, urinary iodine concentration) i stężenie cynku w surowicy. Wyniki: Obecność wola stwierdzono u 32,9% dzieci. Średnie UIC wynosiło 195,5 μg/l. Stężenie cynku w osoczu oznaczono u 94 dzieci z wolem i 326 dzieci, u których nie stwierdzono wola. Średnie stężenie cynku w osoczu ± odchylenie standardowe wynosiło 100,81 ± 22,33 μg/dl u dzieci z wolem i 96,00 ± 25,79 μg/dl u dzieci bez wola (p = 0,08). Częstość niedoboru cynku (stężenie cynku w surowicy ≤ 65 μg/dl) nie różniła się istotnie w grupie dzieci z wolem i bez wola (6,4% v. 8,0%, p = 0,61). Wnioski: Częstość występowania wola u dzieci w wieku szkolnym w Isfahanie jest nadal duża. Wydaje się, że niedobór cynku nie ma wpływu na znaczną liczebność przypadków wola w tym regionie. Wskazane są dalsze badania mające na celu identyfikację czynników zwiększających częstość występowania wola w Isfahanie. (Endokrynol Pol 2010; 61 (3): 287-290)Introduction: There are controversial data about the role of zinc deficiency in the aetiology of endemic goiter. The aim of the present study was to determine the association between zinc status and goiter in schoolchildren of Isfahan. Material and methods: This study was performed in 2005. Two thousand three hundred and thirty-one schoolchildren were enrolled, and thyroid size was determined by inspection and palpation. Urinary iodine concentration (UIC) and serum zinc level were measured in a group of those children. Results: The prevalence of goiter was 32.9%. The median UIC was 195.5 μg/L. Serum zinc was measured in 94 goitrous and 326 nongoitrous children. The mean ± standard deviation of serum zinc in goitrous and non-goitrous children was 100.81 ± 22.33 and 96.00 ± 25.79 μg/dL, respectively (P = 0.08). The prevalence of zinc deficiency (serum zinc ≤ 65 μg/dL) in goitrous and non-goitrous children did not differ significantly (6.4 % v. 8.0%, P = 0.61). Conclusions: The prevalence of goiter is still high in Isfahan schoolchildren. It seems that zinc status is not involved in the high prevalence of goiter in this region. The role of other possible goitrogens should be investigated in Isfahan. (Pol J Endocrinol 2010; 61 (3): 287–290

Association between Serum Ferritin and Goitre in Iranian School Children

Despite long-standing supplementation of iodine in Iran, the prevalence of goitre among general people remains high in some regions. The study investigated the role of iron status in the aetiology of goitre in school children in Isfahan, Iran. Two thousand three hundred and thirty-one school children were selected by multi-stage random sampling. Thyroid size was estimated by inspection and palpation. Urinary iodine concentration (UIC) and serum ferritin (SF) were measured. Overall, 32.9% of the children had goitre. The median UIC was 195.5 μg/L. The mean±SD of SF in the goitrous and non-goitrous children was 47.65±42.51 and 44.55±37.07 μg/L respectively (p=0.52). The prevalence of iron deficiency in goitrous and non-goitrous children was 9.6% and 3.1% respectively (p=0.007). Goitre is still prevalent in school children of Isfahan. However, their median UIC was well in the accepted range. Iron deficiency is associated with goitre in a small group of goitrous children. The role of goitrogens should also be investigated in this region

Vitamin D status of 6- to 7-year-old children living in Isfahan, Iran

Wstęp: Witamina D ma podstawowe znaczenie dla utrzymania dobrego zdrowia. O niedoborach witaminy D donoszą autorzy z wielu krajów, również tych o dużym stopniu nasłonecznienia. Niniejsze badanie przeprowadzono w celu dokonania oceny stężenia witaminy D u zdrowych dzieci w wieku 6-7 lat, zamieszkałych w Isfahanie, Iran. Materiał i metody: Do badania włączono 513 zdrowych dzieci. Zmierzono u nich stężenie PTH i 25-hydroksywitaminy D (25-OHD) w surowicy. Określono spożycie witaminy D w diecie, czas ekspozycji na słońce w ciągu doby i odsetek powierzchni ciała wystawionej na działanie słońca. Przyjęto, że stężenia 25-OHD wynoszące < 20 ng/ml i 10 ng/ml odpowiadają odpowiednio łagodnemu i ciężkiemu niedoborowi witaminy D. Do ustalenia lokalnych punktów odcięcia dla niedoborów witaminy D użyto krzywych ROC. Wyniki: U 3% dzieci stężenie witaminy 25-OHD wynosiło < 20 ng/ml, a u 26% wynosiło < 33 ng/ml (lokalny punkt odcięcia dla niedoboru witaminy D). Czas ekspozycji na słońce i dzienne spożycie witaminy D w diecie miały istotny wpływ na stężenie witaminy D w surowicy. Wnioski: W omawianym badaniu wykazano częste występowanie niedoboru witaminy D u dzieci zamieszkałych w Isfahanie. Wydłużenie czasu ekspozycji na słońce i zwiększenie dziennego spożycia witaminy D w diecie może zapobiec niedoborom witaminy D u tych dzieci. (Endokrynol Pol 2010; 61 (4): 377-382)Introduction: Vitamin D is essential for the maintenance of good health, and vitamin D deficiency has been reported from many countries, including those with a lot of sunshine. This study was conducted to evaluate the vitamin D status in healthy 6- to 7-year-old children in Isfahan, Iran. Material and methods: Five hundred and thirteen healthy children were enrolled. Serum PTH and 25-hydroxyvitamin D (25-OHD) were measured. Dietary vitamin D intake, duration of daily sunlight exposure, and percentage of exposed body surface area were determined. 25-OHD levels < 20 ng/mL and < 10 ng/mL were defined as mild and severe vitamin D deficiency, respectively. The ROC curve was utilized to obtain a local cut-off point of vitamin D deficiency. Results: 25-OHD was < 20 ng/mL in 3% and < 33 ng/mL (local cut-off point of vitamin D deficiency) in 26% of subjects. Duration of sunlight exposure and daily intake of vitamin D had significant effects on serum level of vitamin D. Conclusions: A high prevalence of vitamin D deficiency in Isfahan children was observed in this study. Improvements in duration of sunlight exposure and daily intake of vitamin D can prevent vitamin D deficiency in these children. (Pol J Endocrinol 2010; 61 (4): 377-382

Association between Serum Ferritin and Goitre in Iranian School Children

Despite long-standing supplementation of iodine in Iran, the prevalence of goitre among general people remains high in some regions. The study investigated the role of iron status in the aetiology of goitre in school children in Isfahan, Iran. Two thousand three hundred and thirty-one school children were selected by multi-stage random sampling. Thyroid size was estimated by inspection and palpation. Urinary iodine concentration (UIC) and serum ferritin (SF) were measured. Overall, 32.9% of the children had goitre. The median UIC was 195.5 \u3bcg/L. The mean\ub1SD of SF in the goitrous and non-goitrous children was 47.65\ub142.51 and 44.55\ub137.07 \u3bcg/L respectively (p=0.52). The prevalence of iron deficiency in goitrous and non-goitrous children was 9.6% and 3.1% respectively (p=0.007). Goitre is still prevalent in school children of Isfahan. However, their median UIC was well in the accepted range. Iron deficiency is associated with goitre in a small group of goitrous children. The role of goitrogens should also be investigated in this region

Urine and milk iodine concentrations in healthy and congenitally hypothyroid neonates and their mothers

Wstęp: Częste występowanie wrodzonej niedoczynności tarczycy (CH, congenital hypothyroidism) w Iranie skłoniło autorów do oceny roli jodu w etiologii CH, opierając się na porównaniu jego stężenia w moczu zdrowych noworodków i noworodków z wrodzoną niedoczynnością tarczycy oraz w mleku i moczu ich matek. Materiał i metody: W tym przekrojowym badaniu zmierzono stężenie jodu w moczu (UIC, urinary iodine concentration) noworodków z CH oraz UIC i stężenie jodu w mleku (MIC, milk iodine concentration) ich matek, a następnie porównano je z wynikami otrzymanymi w grupie kontrolnej. Wartości UIC zmierzone u noworodków i karmiących matek podzielono na 3 kategorie: niskie UIC < 150 mg/l, średnie - 150-230 mg/l i wysokie > 230 mg/l. Analogiczne kategorie przyjęto dla MIC: niskie 180 mg/l. Wyniki: Mediana UIC u noworodków z CH (n = 68) i u zdrowych noworodków (n = 179) wynosiła odpowiednio 300,5 i 290,5 mg/dl, (P > 0,05). Mediana UIC w grupach badanej i kontrolnej wynosiła odpowiednio 150 i 130 mg/l (P > 0,05). Mediana MIC w grupie badanej była większa niż w grupie kontrolnej (210 mg/l v. 170 mg/l, P < 0,05). Stwierdzono dodatnią korelację między UIC u noworodków i MIC u ich matek. Nie wykazano wyraźnej zależności między UIC i stężeniem TSH w surowicy u noworodków oraz UIC I MIC u matek. Wnioski: Spożycie sodu w badanej populacji było prawidłowe. Nadmierna podaż sodu może być czynnikiem ryzyka CH, jednak w badaniu wykazano brak korelacji między MIC I UIC u matek i podobne wartości mediany UIC u noworodków w obu grupach, dlatego do sformułowania jednoznacznych wniosków potrzebne są dalsze badania. (Endokrynol Pol 2010; 61 (4): 371-376)Introduction: In view of the high prevalence of Congenital Hypothyroidism (CH) in Iran, in this study we evaluated the role of iodine in the aetiology of CH by comparing urine and milk iodine concentrations in healthy and congenitally hypothyroid neonates and their mothers. Material and methods: In a cross-sectional study, urinary iodine concentrations (UIC) in newborns with CH, as well as UIC and the milk iodine concentrations (MIC) of their mothers, were measured and compared with a control group. The lower, mid, and upper range of UIC for neonates and lactating mothers was considered to be 230 mg/L, and lower, mid, and upper range of MIC was considered to be 180 mg/L, respectively. Results: The median UICs in subjects with CH (n = 68) and healthy subjects (n = 179) were 300.5 and 290.5 mg/L, respectively (P > 0.05). The median UICs in the case and control groups were 150 and 130 mg/L, respectively (P > 0.05). The median MIC in the case group was higher than in the control group (210 mg/L v. 170 mg/L, P < 0.05).There was a positive correlation between newborn UIC and MIC. There was no significant correlation between newborn UIC and serum TSH, maternal UIC and maternal MIC, or newborn UIC and serum TSH. Conclusions: There is no inadequacy in iodine intake in the studied population. Iodine excess could be a possible risk factor for CH, but there were findings, such as lack of correlation between maternal MIC and UIC, and the median neonatal UIC, which was similar in the two groups, so, drawing conclusions should be done with some caution and requires further studies. (Pol J Endocrinol 2010; 61 (4): 371-376

Dietary patterns, nutrition, and risk of breast cancer: a case-control study in the west of Iran

OBJECTIVES Unhealthy dietary patterns are the most important changeable risk factors for breast cancer. The aim of this study was to assess the relationship between dietary patterns and the risk of breast cancer among under-50 year women in the west of Iran. METHODS All women under 50 years old with pathologically confirmed breast cancer between 2013 and 2015 who were referred to oncology clinics in the west of Iran, and 408 under-50 women referred to other outpatient clinics who were without breast or other cancers at the time of the study and 2 years later were selected as the control group. The data were collected using the middle-aged periodical care form of the Iranian Ministry of Health and analyzed using univariate and multivariate logistic regression in Stata. RESULTS The most powerful risk factor for breast cancer was fried foods; the odds ratio of consuming fried foods more than once a month for breast cancer was 4.5 (95% confidence interval, 2.1 to 9.4). A dose-response model indicated that increasing vegetable and fruit consumption up to 90 servings per month decreased the odds of breast cancer, but consuming more than 90 servings per month increased the risk. CONCLUSIONS Inadequate consumption of vegetables and consumption of soft drinks, industrially produced juices, fried foods, and sweets were identified as risk factors for breast cancer. In response to these findings, it is necessary to raise awareness and to provide education about healthy diets and the need to change unhealthy dietary patterns

Effects of Methadone on Liver Enzymes in Patients Undergoing Methadone Maintenance Treatment

Background: Methadone is currently the most frequently used substance in the treatment of short-term and particularly long-term opiate dependence. Patients' beliefs about the adverse effects of methadone on function of organs, especially liver, have widely affected the use of this substance. This study aimed to determine the effects of methadone on liver enzyme levels in patients on methadone maintenance treatment. Methods: In a retrospective study, a total of 94 patients undergoing methadone maintenance therapy were recruited from Shahid Beheshti Hospital (Kerman, Iran). Liver enzyme levels in all patients were tested every six months from the onset of treatment until 24 months. The relations between test results and age, gender, and methadone dose were then evaluated. Data was analyzed using logistic regression with random data plan. Findings: At the 24th month, alanine aminotransferase (ALT) levels in 4 patients (4.3%) and aspartate aminotransferase (AST) levels in 3 patients (3.2%) were above normal. Among 46 patients (50%) who had normal alkaline phosphatase (ALP) levels after 24 months, 26 subjects were younger than 40 and 20 subjects were over 40 years of age. The mean age of subjects with abnormal ALP levels and the mean methadone dose were 39.9 years and 19.55 cc, respectively.Conclusion: The results of this study indicated the significant effect of methadone on ALP levels. These effects can account for cholestatic pattern liver injury (obstruction). Further prospective studies including greater samples of patients with heart and liver complications and encompassing other drugs are required to confirm our findings.Keywords: Methadone, Substance abuse, Liver, Alanine aminotransferase, Aspartate aminotransferase, Alkaline phosphatas

Thyroid Peroxidase Gene Mutation in Patients with Congenital Hypothyroidism in Isfahan, Iran

Background. Thyroid peroxidase gene (TPO) mutations are one of the most common causes of thyroid dyshormonogenesis in patients with congenital hypothyroidism (CH). In this study, the prevalence of TPO gene mutations in patients with thyroid dyshormonogenesis in Isfahan was investigated. Methods. In this cross-sectional study, genomic DNA of 41 patients with permanent CH due to thyroid dyshormonogenesis was extracted using the salting out method. The 17 exonic regions of the TPO gene were amplified. SSCP technique was performed for scanning of the exonic regions of the TPO gene, except exon 8. DNA sequencing was performed for those with different migration patterns in SSCP by chain termination method. Exon 8 was sequenced directly in all patients. In 4 patients, all fragments were also sequenced. Results. One missense mutation c.2669G>A (NM_000547.5) at exon 15 (14th coding exon) in one patient in homozygous form and seven different single nucleotide polymorphisms (SNPs) in exons 1, 7, 8, 11, and 15 of TPO gene. Conclusion. The TPO gene mutations among CH patients with dyshormonogenesis in Isfahan were less frequent in comparison with other similar studies. It may be due to the presence of other unknown gene mutations which could not be detected by SSCP and sequencing methods

Socioeconomic inequalities in prevalence, awareness, treatment and control of hypertension: evidence from the PERSIAN cohort study

Background Elevated blood pressure is associated with cardiovascular disease, stroke and chronic kidney disease. In this study, we examined the socioeconomic inequality and its related factors in prevalence, Awareness, Treatment and Control (ATC) of hypertension (HTN) in Iran. Method The study used data from the recruitment phase of The Prospective Epidemiological Research Studies in IrAN (PERSIAN). A sample of 162,842 adults aged > = 35 years was analyzed. HTN was defined according to the Joint National Committee)JNC-7(. socioeconomic inequality was measured using concentration index (Cn) and curve. Results The mean age of participants was 49.38(SD = +/- 9.14) years and 44.74% of the them were men. The prevalence of HTN in the total population was 22.3%(95% CI: 20.6%; 24.1%), and 18.8%(95% CI: 16.8%; 20.9%) and 25.2%(95% CI: 24.2%; 27.7%) in men and women, respectively. The percentage of awareness treatment and control among individuals with HTN were 77.5%(95% CI: 73.3%; 81.8%), 82.2%(95% CI: 70.2%; 81.6%) and 75.9%(95% CI: 70.2%; 81.6%), respectively. The Cn for prevalence of HTN was -0.084. Two factors, age (58.46%) and wealth (32.40%), contributed most to the socioeconomic inequality in the prevalence of HTN. Conclusion The prevalence of HTN was higher among low-SES individuals, who also showed higher levels of awareness. However, treatment and control of HTN were more concentrated among those who had higher levels of SES, indicating that people at a higher risk of adverse event related to HTN (the low SES individuals) are not benefiting from the advantage of treatment and control of HTN. Such a gap between diagnosis (prevalence) and control (treatment and control) of HTN needs to be addressed by public health policymakers

Ellagic acid improved arrhythmias induced by CaCL2 in the rat stress model

Objective: In ventricular arrhythmias, due to their free radical scavenging action, antioxidant agents are usually used in the treatment of cardiovascular disease. Since stress is considered as risk factor for increased mortality by causing malignant arrhythmias, the study was designed to evaluate the cardioprotective effects of ellagic acid (EA) on CaCl2-induced arrhythmias in rat stress model. Materials and Methods: Male Sprague-Dawley rats (200-250 g) were divided into four groups: Group I: Control rats (2 ml of saline by gavage), Group II: Rats treated with EA (15 mg/kg, gavage), Group III: stress group, Group IV: received EA plus stress. Stress was applied in a restrainer box (6 hour/day, 21 days). After induction of anesthesia, lead II electrocardiogram was recorded for calculating heart rate and QRS complex. The arrhythmia was produced by injection of CaCl2 solution (140 mg/kg, iv) and incidences of Ventricular fibrillation, Ventricular premature beats and Ventricular tachycardia were recorded. Results were analyzed by using one-way ANOVA and Fisher`s exact test. pResults: The results showed a positive inotropic effect and negative chronotropic effect for the EA group in comparison with the control group. Incidence rates (%) of premature beats, ventricular fibrillation and ventricular tachycardia in stress group and all the arrhythmia parameters decreased in groups which received EA. Conclusions:  By decreasing the incidence rates of premature beats, fibrillation and ventricular tachycardia in groups which received EA, ellagic acid probably acted as an anti-arrhythmic agent which showed to have aprotective functionin heart