Association between Metabolic Syndrome and Premicroalbuminuria among Iranian Women with Polycystic Ovary Syndrome: A Case Control Study

Abstract Objective: The aim of this study was to assess the association between premicroalbuminuria and metabolic syndrome in women with Polycystic Ovary Syndrome (PCOS). Methods: In this case – control study, we analyzed the medical records of 78 women from an endocrinology outpatient center of Buali university hospital Qazvin city in Iran during 2008 to 2010. Anthropometric characteristics, Albumin/Creatinine Ratio (ACR), Lipid profile, Liver enzyme concentration, and occurrence of metabolic syndrome were compared between the two groups. Premicroalbuminuria was defined as ACR>7mg/g. Results: Mean age of patients with PCOS was 27.2± 2.5 years and mean age of 63 controls was 26.9±2.4 years. Premicroalbuminuria was found in 53.8% of PCOS and 33.3% of control group (p value=0.015). Again, patients with PCOS divided in two groups: ACR>7mg/g and ACR7mg/g. Fifty percent of patients with PCOS and ACR>7mg/g fulfilled criteria of metabolic syndrome; whereas no case of metabolic syndrome was found in PCOS patients with ACR<7mg/g. Conclusions: Premicroalbuminuria is more prevalent in patients with PCOS compared to normal individuals. Metabolic syndrome is more frequently seen in patients with PCOS and premicroalbuminuria against patients with ACR<7mg/g. Keywords: polycystic ovary syndrome, metabolic syndrome, premicroalbuminuri

Predictors of hypoglycemia fear in patients with type 2 diabetes under treatment of oral anti hyperglycemic agents

Introduction: Hypoglycemia is a medical emergency that disrupt routine life. Hypoglycemia experience likely causes fear of its recurrence. Even mild or moderate episodes may worry patients for frequent events. Limited studies have assessed predictors offear of hypoglycemia in patients with diabetes. The aim of the present study was to determine the predicting factors of hypoglycemia in type 2 diabetic patients treated with oral anti-hyperglycemic agents. Materials and Methods: This cross-sectional study was conducted on 357 patients with type 2 diabetes treated with oral anti-diabetic drugs. Data was collected through interviews by using a three-part questionnaire (socio-demographic & clinical characteristics, HFS-II). The data was analyzed with descriptive and deductive statistic methods (Generalized Linear Models) at 5<0.05 using SPSSv.16 software. Results: Mean age of patients was 54.11±11.54 years and the majority were female (56.6%). The mean HFS score was 16.8±16.33. In regression analysis, frequency of hospitalization (p<0.001), employment (p<0.048), number of medications (p<0.029), hyperlipidemia (p<0.026), hypoglycemia (p<0.001) and hypoglycemia intensity (p<0.001) were related to fear of hypoglycemia. Conclusion: According to the results of the present study, hypoglycemia and its intensity are considered as the strongest predictors of fear of hypoglycemia. Therefore, prevention of hypoglycemia occurrence and reduction of its related fear can be performed by modifying the other predictors identified in this study. Keywords: Fear of hypoglycemia, Diabetes Mellitus, Oral anti-hyperglycemic agent

Occupational Difference in Association of Poor Sleep Quality and Metabolic Syndrome: Differences between Workers and Employees

Background. Regarding insufficient data about interaction of job in association of sleep quality with metabolic syndrome (MS), this study has been designed to evaluate this association in workers and employees. Methods. This cross-sectional study was conducted on 448 municipal staff (employee group: N = 295; worker group: N = 153) referring for periodic examinations. The relationship between sleep quality and MS and their relevant components was investigated in both groups. Results. In the worker group, poor sleep quality was independently associated with the risk of MS by 3.04 times (P < 0:01). Among the components of metabolic syndrome, hypertriglyceridemia was associated with a greater number of sleep disorder components. There was no association between metabolic syndrome and sleep quality in the employee group. Conclusion. Poor sleep quality exerts different effects on metabolic complications in employees and workers

Orlando’s nursing process application on anxiety levels of patients undergoing endoscopy examination

Background and aims: Anxiety is a common reaction when people encounter new problems where they do not know what expect. The nurses are responsible for assessing the patient and helping them with the procedure of endoscopy. This study investigates differences in anxiety level of patients who receive nursing process of Orlando's theory prior to endoscopy examination compared to a control group. Methods: A Quasi -experimental research design was used in this study. Samples were 60 adult patients who were randomly assigned to two groups (30 patients each). Patients in the study group receive nursing process of Orlando's theory by the researcher plus the routine hospital intervention, while the control group only received the routine hospital intervention. The Spielberger State-Trait Anxiety Inventory (STAI scale) is administering to both groups before and after endoscopy examination. STAI, a self-reporting psychometric test, is used to assess state anxiety levels. STAI has demonstrated reliability and validity in previous studies. Results: Statistically significant difference was evident between the 2 groups regarding the mean of anxiety level of patients after the intervention. Before the intervention, the mean of anxiety level in the control and study groups were 47±9 and 58 ±11 and after the intervention were: 41±7, 35±7, respectively. Conclusion: Intervention groups have the lower mean of anxiety level after the intervention. Female patients in this study experienced low level anxiety compared to male patients after Orlando nursing process. The data suggest that endoscopy unit personnel and the referring physician should consider the patient’s perception of the procedure. Detailed information on the procedure and training in relaxation techniques should be given. Positive re-appraisal and information on sensations to be anticipated, rather than procedural details, will be more successful in alleviating stress and anxiety

Association of sleep quality components and wake time with metabolic syndrome: The Qazvin Metabolic Diseases Study (QMDS), Iran

A B S T R A C T Purpose: The aim of this study was to determine the association of sleep quality and sleep quantity with metabolic syndrome in Qazvin, Iran. Methods: this cross sectional study was conducted in 1079 residents of Qazvin selected by multistage cluster random sampling method in 2011. Metabolic syndrome was defined according to the criteria proposed by the national cholesterol education program third Adult treatment panel. Sleep was assessed using the Pittsburgh sleep quality index (PSQI). A logistic regression analysis was used to examine the association of sleep status and metabolic syndrome. Results: Mean age was 40.08 � 10.33 years. Of 1079, 578 (52.2%) were female, and 30.6% had metabolic syndrome. The total global PSQI score in the subjects with metabolic syndrome was significantly higher than subjects without metabolic syndrome (6.30 � 3.20 vs. 5.83 � 2.76, P = 0.013). In logistic regression analysis, sleep disturbances was associated with 1.388 fold increased risk of metabolic syndrome after adjustment for age, gender, and body mass index. Conclusion: Sleep disturbances component was a predictor of metabolic syndrome in the present study. More longitudinal studies are necessary to understand the association of sleep quality and its components with metabolic syndrome

Association between Uric Acid and Metabolic Syndrome in Qazvin Metabolic Diseases Study (QMDS), Iran

Background: The prevalence of Metabolic Syndrome (MS) has been increasing worldwide. Although Uric Acid (UA) Levels are often increased in subjects with MS, it is still unclear whether uric acid plays a causal role for MS or is a marker. The purpose of this study was to examine the association between UA and the MS in Qazvin, Iran. Methods: 529 men and 578 women aged 20 – 78 years attended in cross sectional study from September 2010 to April 2011 in Qazvin, Iran. The criteria proposed by new joint Interim societies (JIS) were applied for diagnosis of MS. Hyperuricemia was defined as UA ≥ 7 mg/dL in men and UA ≥ 6 mg/dL in women. Logistic regression analysis was performed to evaluate the relationship between UA quartiles and MS. Results: The prevalence of MS was found to be 39.3%. Prevalence of hyperuricemia was 8.4% in males and 4.1% in females (P=0.004). Mean UA level was higher in males than in females (P<0.001). UA levels increased significantly with an increasing number of MS components in both genders. Prevalence of MS increased across UA quartiles in females; however the increasing trend began from second quartile in males. Using the lowest quartile of UA level as a reference, there were no significant association between UA quartile groups and MS. Conclusion: This study showed that UA levels are not an appropriate predictor of MS in Iranian population. More longitudinal studies are necessary to confirm the role of UA in MS occurrence. Keywords: prevalence, hyperuricemia, logistic regression, association, uric aci

Association between health-related quality of life and impaired glucose metabolism in Iran: The Qazvin Metabolic Diseases Study

Aim To evaluate the association between health-related quality of life and glucose metabolism status in a study population in Qazvin, Iran. Methods This cross-sectional study was conducted in 1044 people (aged 20–78 years old) between September 2010 and April 2011 in Qazvin, Iran. An oral glucose tolerance test was performed for each participant who had never been diagnosed with diabetes. Participants were characterized as having normal glucose metabolism, pre-diabetes or diabetes according to American Diabetes Association criteria. The short-form 36 questionnaire was used to measure quality of life. Data were analysed using a chi-squared test, ANOVA and ANCOVA. Results A total of 530 (51.7%) of the participants were women, and 24.1 and 11.6% of the participants were categorized as having prediabetes and diabetes mellitus, respectively. Except for the role emotional domain, there was a gradual decrease in the mean scores of every domain of the short-form 36 scale across the three study groups. The mean scores in the physical domains were significantly different among the participants with normal glucose metabolism and those with diabetes. After adding age as covariate, there were no significant differences between the categories in any of the domains. Conclusion There is no association between quality of life domains and glucose metabolism status in Iranian subjects. More longitudinal studies are necessary to investigate the natural history of pre-diabetes, diabetes and quality of life. Diabet. Med. 31; 754–758 (2014

Association of sleep quality with insulin resistance in obese or overweight subjects

Introduction: Obesity or overweight are two factors associated with insulin resistance (IR). There are limited studies with regard to the role of some non-traditional factors such as sleep quality in level of IR in obese individuals. The current study aimed at investigating the association of sleep quality with IR in overweight or obese people. Material and Methods: In this cross-sectional study, 612 obese or overweight participants of the Qazvin metabolic disease study (QMDS) were evaluated. Sleep quality was measured using the Pittsburgh sleep quality index (PSQI) and compared between two groups of participants with and without IR. Results: Our findings showed that the total score of sleep quality in the IR group was significantly lower than that in the non-insulin resistant group (8.78±2.78 vs. 8.13±2.70, p=0.008). After adjustment, each unit increase of the sleep latency and subjective sleep quality scores was associated with a 1.23 and 1.33 times increased risk of IR, respectively (p<0.05).Conclusion: In the obese or overweight people, sleep quality is associated with IR

The relationship between fear of hypoglycemia and quality of life in patients with type 2 diabetes

Introduction: Fear of hypoglycemia is one of the biggest obstacles to achieving proper blood glucose control in diabetic patients, adversely affecting the proper treatment of diabetes and quality of life in these patients. The aim of this study was to investigate the relationship between fear of hypoglycemia and quality of life in patients with type 2 diabetes. Materials and Methods: The present study was a descriptive analytic-correlational study, conducted in 2018 on 360 patients with 2 diabetes referreing to the Velayat teaching hospital in Ghazvin. Data collection tools included a personal-social checklist, the Hypoglycemia Fear Survey (HFS) and information on Diabetes Quality of Life (DQOL). Data collected were analyzed using one-way ANOVA, Pearson correlation test statistics by SPSS.24 software. Results: Mean scores of quality of life and fear of hypoglycemia were 44.3±8.6 and 22.07±8.7 respectively. The highest quality of life score for patients in the pill treatment group was 46.4±7.8, and the highest scores of hypoglycemia were in the insulin treatment group with a mean of 26.1±10.5. In this study, there was a significant, inverse relationship between fear of hypoglycemia and quality of life (r=-0.46, p<0.001). Conclusion: Results show a significant, inverse relationship between fear of hypoglycemia and quality of life in diabetic patients, such that the occurrence of this fear is higher in patients treated with insulin. Based on results, it is recommended that these patients should be educated on the action of insulin and its mode of injection, and on how to prioritize and manage their activities