The prevalence of idiopathic hirsutism and polycystic ovary syndrome in the Tehran Lipid and Glucose Study

<p>Abstract</p> <p>Background</p> <p>There is no clear and contemporaneous method for screening of idiopathic hirsutism (IH) and polycystic ovary syndrome (PCOS) at the community level and current estimates regarding their prevalence are limited. We aimed to ascertain the prevalence of IH and PCOS in a randomly selected sample of reproductive aged female participants of the Tehran Lipid and Glucose Study (TLGS).</p> <p>Methods</p> <p>One thousand and two women, aged 18-45 years, were randomly selected from among reproductive aged women who participated in the TLGS. Those women with either hirsutism or menstrual dysfunction were assessed for biochemical hyperandrogenemia; whereas those participants with hirsutism per se were further assessed for subclinical menstrual dysfunction. PCOS were diagnosed using the National Institute of Health (NIH) criteria. IH was defined as hirsutism without clinical or sub clinical menstrual dysfunction or biochemical hyperandrogenemia (BH).</p> <p>Results</p> <p>The mean ± SD of age of study population was 29.2 ± 8.7 years. Estimated prevalences of idiopathic hirsutism and pure menstrual dysfunction were 13.0% (95% CI: 10.9%-15.1%) and 1.5%(95% CI: 1.1%-1.9%), respectively. The prevalence of PCOS was 8.5% (95% CI: 6.8% - 10.2%); more than one third of these cases would possibly have remained undiagnosed or misdiagnosed, had we not assessed them for subclinical menstrual dysfunction or biochemical hyperandrogenemia.</p> <p>Conclusions</p> <p>These data from a large representative and non selected population of women confirm the concept that IH and PCOS are the two most common gynecological endocrinopathies among reproductive aged women. The estimated prevalence of these conditions is highly influenced by their screening methods at the community level.</p

The effects of inhaled corticosteroid on insulin sensitivity in asthmatic patients

Asthma is an inflammatory disease, which causes airflow limitation and increase insulin resistance. The present study was carried out in order to investigate insulin resistance and the effect of inhaled corticosteroid (ICS) on insulin sensitivity in asthmatic patients. A registered (IRCT201605247411N2) interventional, quasi-experimental trial was performed from 2014 to 2015 in Imam Khomeini hospital Ahvaz, Iran. Patients with mild to moderate asthma participated in this study. Spirometry, fasting blood sugar (FBS), blood sugar 2 hour post prandial (BS2HPP), HbA1C, low density lipoprotein (LDL), high density lipoprotein (HDL), Insulin Level, and C reactive protein (CRP) were measured. Then Homeostatic Model Assessment-Insulin Resistance [HOMA-IR] Index calculated. Data were analyzed using paired t-test and McNemar’s test using SPSS 20.0 Software. The study consisted of 35 non-diabetic patients suffering from asthma (20 men and 15 women) with a mean age of 36.6 ±12.3 years. Inhaled corticosteroid had a significant effect on spirometric parameters, but it had no significant effect on other variables. At baseline, mean HbA1C, insulin level and HOMA-IR were 5.5%, 10.9 mIU/L and 2.7 respectively. None of these values changed significantly after treatment with inhaled corticosteroid for two months. The results indicated that there is no relationship between ICS and increased insulin resistance in asthmatic patients

The Prevalence of Metabolic Syndrome in Patients with Non-Alcoholic Fatty Liver Disease in Ahvaz, Iran

Background: Previous studies have shown that there may be a link between metabolic syndrome (MetS) and non-alcoholic fatty liver disease (NAFLD). Therefore, the present study was designed with the aim of investigating the prevalence of metabolic syndrome in patients with NAFLD.Methods: One hundred and fourteen patients with NAFLD were recruited to the study in Ahvaz, Iran. The Metabolic SyndromeSeverity Score (MSSS) was used in an online calculator from available information. The NAFLD determined based on clinical or laboratory symptoms, and liver ultrasonography. The determination of its severity was made using liver elastography. Univariate and multivariate analyses were used to correlate the collected parameters. Receiver operating characteristic (ROC) curve was used to evaluate the cutoff value of fibrograde and steagrade that predicts fibrosis and steatosis.Results: Totally, 69 patients (60.5%) had MetS. The chance of higher grade of steatosis in patients with MetS was 3.76 times higher than that of patients without MetS (p=0.003). Moreover, the correlation coefficient between MSSS and osteoscore was 0.274 (p=0.023). MSSS had the predictive power to detect steagrade (0:1, 2, 3) with 83.78% sensitivity and 59.38% specificity (p=0.005) and a cutoff point of 0.45.Conclusion: MSSS was shown to have the predictive power to detect steatosis grades. However, further studies are required to determine whether fibrosis has a relationship with severity of MetS

Evaluation of only the chin or lower abdomen for predicting hirsutism

Background: Hirsutism is defined as the growth of terminal hair in a male pattern in women; it affects 5-15% of women. Objective: The aim of this study is evaluation of only the chin or lower abdomen for predicting hirsutism. Materials and Methods: In this cross-sectional diagnostic study, we randomly selected 695 women aged 15-45 years. The examiners scored the subjects on a scale of 0 - 4 for terminal hair growth on nine different body areas according to the Ferriman-Gallwey (FG) scoring system in a form given to the examiners before the examination. An FG score of 8 or more was considered diagnostic of hirsutism. If the sum of the FG scores for the chin or lower abdomen was 2 or more, the test result was assumed to be positive. Statistical analysis was performed using the MacNemar test, and a P value of less than 0.05 was considered to be statistically significant. Results: The age group with the highest prevalence rate was 21-25 years. From the 695 subjects examined, 81 subjects (11.7%) had an FG score of 8 or more with a resultant prevalence rate of 11.7% for hirsutism. In our study population, 39% of the patients had an FG score of 2 or more for the chin or lower abdomen, and 61% of the patients had an FG score of less than 2 for the chin or lower abdomen. Conclusion: Evaluating terminal hair growth on the chin or lower abdomen for predicting hirsutism seems to be an acceptable screening method

The association between concentration of Uric Acid and metabolic syndrome among adolescents

Background: Metabolic syndromes are known as a set of risk factors for the development of cardio-vascular disease and diabetes in the individual. The association between concentration of uric acid and metabolic syndrome in adolescents has yet to be established thoroughly. The aim of this study was to investigate the relationship between uric acid and metabolic syndrome in a sample of adolescents. Methods: This cross-sectional study was conducted from September 23, 2009 to September 22, 2010 in Jundishapur University of Medical Sciences, Ahvaz, Iran. In this study, 240 individuals aged 10-19 years were randomly selected among participants of the Ahvaz MetS study (120 subjects normal and 120 subjects MetS). The serum levels of UA were measured by a colorimetric method. In the normal group, anyone with abdominal obesity, high systolic or diastolic blood pressure, High-density lipoprotein (HDL)&le;40 mg/dl, TG&le;110 mg/dl, fasting blood sugar (FBS)&le;100 mg/dl or diabetes was excluded from the study. History of Anticonvulsive drugs or steroids use was the criteria for exclusion for both groups. Results: Of the 240 subjects aged a mean of 14.95&plusmn;2.64 years, mean of uric acid in metabolic syndrome group was 4.8&plusmn;1.4 mg/dl and in the control group was 4.18&plusmn;1.01 mg/d (P=0.001). Participants were divided into three groups based on uric acid levels: &le;4.9 mg/dl, 4.9-5.7 mg/dl and >5.7 mg/dl. The risk of metabolic syndrome was significantly higher in third group of uric acid than the second and first group (odds ratio [OR], 3.7; 95% confidence interval [CI], 1.70 - 8.04) and (OR, 5.9; 95% CI, 2.42-14.35, P<0.001). In addition, uric acid level was inversely associated with hyperglycemia. The ORs of hypertriglyceridemia for the second and third group of uric acid were 4.36 (95% CI, 2.01- 9.47) 5.75 (95% CI, 2.43-13.61) respectively, compared with lowest group of UA. Conclusion: The results showed that hyperuricemia was significantly linked with increased risk for hypertriglyceridemia, low high-density lipoprotein cholesterol level, high blood pressure and waist circumference. Among Ahvaz adolescents, serum concentrations of uric acid strongly associated with the prevalence of metabolic syndrome and several of its components

The relationship of serum 25-dihydroxy vitamin D3 concentrations with metabolic parameters in non-obese women with polycystic ovarian syndrome

Introduction: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age, which is associated with an increased risk of developing metabolic syndrome (MBS). Recently, many studies have started to dig up the dramatic effect of vitamin D deficiency on PCOS patients suffering from the MBS. However, little is known about the role of this fat-soluble agent in non-obese PCOS women. Aim: To investigate the relationship between serum 25-dihydroxy vitamin D3 [25(OH) D] levels and metabolic parameters in non-obese women with PCOS. Materials and methods: Eighty-eight non-obese women who underwent PCOS were experimentally evaluated. Patients were divided into two categories according to their body mass index (BMI): patients with normal weight and overweight patients. The serum levels of 25(OH) D, FBS, CRP, TC, TG, LDL, HDL, insulin as well as the insulin resistance indexes were assessed in all the study patients. Results: The mean age of the patients was 27 years, 36 (40.9%) had normal weight and 52 (59.1%) were overweight. Vitamin D deficiency was observed in 84.1% of the patients, but its variations between both groups were not significantly different. A significant correlation was found between 25(OH) D levels and the patients’ age, as well as the HDL serum concentration. Furthermore, there was no significant association between 25(OH) D levels and insulin resistance index in both groups with PCOS. Conclusion: Our study found no association between lower 25(OH) D levels and increased risk of metabolic disturbances and insulin resistance in non-obese patients with PCOS

Comparison of Components of Metabolic Syndrome among Metabolically Obese Normal Weight, Metabolically Benign Normal Weight, and Metabolically Abnormal Obese Iranian Children and Adolescents in Ahvaz

Background: Metabolically obese normal-weight (MONW) children and adolescents are characterized by body mass index (BMI) lower than +1SD with metabolic disorders such as hyperglycemia, hypertriglyceridemia, and/or hypertension. This study wants to determineprevalence of MONW, metabolically benign normal weight (MBNW), metabolically abnormality obese (MAO) and comparethe components of metabolic syndrome (MetS) in some Iranian normal-weight children and adolescents in Ahvaz, Iran. Methods: This cross-sectional study was conducted on 1124 boys and 1128 girls, aged 10&ndash;18 y, Ahvaz, Khuzestan.Participants were selected from 6 health centers in Ahvaz by a multistage cluster random sampling method. The Mets was defined according to the modified Adult Treatment Panel III (ATP III). Anthropometric measurements and blood pressure were measured according to standard protocols. Fasting blood samples were collected for biochemical assessment. Results: MetS prevalence in normal weight group was 5.4% and 1.45% in &nbsp;boys and girls, respectively (P = 0.001) showing a significant difference. Triglyceride abnormality percentages (MBNW = 23.9%, MAO = 88.8%, MONW = 91%) and high density lipoprotein (MBNW = 19.2%, MAO = 73.8% and MONW = 67.2%) were higher than other MetS components in these groups. Conclusions: Since BMI in children and adolescents with metabolically obese-normal weight is normal&sbquo; the continuous measurements and treatment of MetS components especially in boys are important from public health view. The components mean of MetS was higher in MONW and MAO individuals compared with MBNW

Improving Depression, and Quality of Life in Patients with Type 2 Diabetes: Using Group Cognitive Behavior Therapy

Objective: Comorbidity with depression is a critical issue in dealing with diabetes type 2. Any intervention for diabetes treatment must consider the psychological dimensions associated with it. The aim of the present study is to assess the effectiveness of group cognitive behavior therapy (CBT) on depression and quality of life of women with diabetes type 2. Method: The sample included 30 diabetic women comorbid with depression who were randomly divided into the experimental and control groups. The subjects received 10 sessions of group cognitive behavioral therapy and filled out Beck s Depression Inventory (BDI) and Quality of Life Scales befor and after the intervention. Results: Using MANCOVA shows that the intervention in the experimental group decreased the depression symptoms (F=72.17, p<0.001) and improved quality of life(F=8.82, p<0.05) in the compared to the control group. The results were statistically significant at p<0/05. Conclusion : The findings suggest that applying cognitive behavior therapy could help in decreasing the psychological symptoms related to diabetes type 2 and subsequently increase the patients’ quality of life.