Association of serum calcium with level of blood pressure in type 2 diabetic patients

Introduction: Hypertension and diabetes are two common diseases and they affect the same major target organs. Objectives: In this study, we sought to investigate the probable association of serum calcium with levels of systolic and blood pressure in a group of type 2 diabetic (T2D) patients. Patients and Methods: A total of 60 patients with T2D were enrolled to the study. To determine serum creatinine, calcium and hemoglobin A1c (HbA1c), venous blood samples were obtained in the fasting state. Results: Among 60 participants, 56.7 were female. Mean of ages was 57±8.3 years. Mean of systolic and diastolic blood pressure were 133±13 mmHg and 84±7.4 mmHg, respectively. Mean of serum calcium was 9.0±0.4 mg/dl. In this study, there was no significant difference of serum calcium and HbA1c between males and females. A significant inverse correlation of serum calcium with level of diastolic blood pressure (r=-0.261, p=0.046) was seen (adjusted for duration of diabetes). Moreover, a negative correlation of systolic blood pressure with level of serum calcium was existed, however, this correlation was not significant (r=-0.232, p=0.080) adjusted for duration of diabetes. Conclusions: We found a significant inverse correlation of serum calcium with level of diastolic blood pressure. We propose to more attention to serum calcium during the treatment of hypertension in diabetic patients. © 2013, Society of Diabetic Nephropathy Prevention. All rights reserved

Association of body mass index and serum vitamin D level in healthy Iranian adolescents

Introduction: In studies of obese adolescents in various countries, vitamin D deficiency has been correlated with greater weight and elevated BMI. However, there is insufficient data on the relation between vitamin D status and body fat indexes in adolescence. The aim of this study was to investigate the association of serum (25OHD) concentrations with body mass index of healthy Iranian subjects to understand whether specific data on the relation between vitamin D status and body mass index is common in all populations. Material and methods: Data was collected from 259 ambulant medical staff adults, students and other subjects who met the inclusion criteria of the study. Body mass index and fasting 25-Hydroxy vitamin D level were measured. Vitamin D deficiency was defined as having a 25(OH)D concentration < 25 nmol/L. Results: Participants were aged 20-64 years, mean age 34 ± 9 years, and about 57.5% of the participants were women. The mean (± SD) body mass index (kg/m 2) was 24.2 ± 3.8 kg/m2 (median = 23.7 kg/m 2), the mean (± SD) vitamin D level of the participants was 29 ± 16 nmol/L (median = 26 nmol/L), and 48% of the participants had vitamin D deficiency. In this study, there was no significant association between vitamin D level and BMI (r = 0.064; p = 0.307) (age adjusted). Moreover, there was no association between vitamin D level and sex of the participants. In addition, no association between BMI and sex of the adolescents was seen (p; NS), but a significant association between age and vitamin D level was found (r = 0.002). Conclusion: Our data suggests that various mechanisms could potentially contribute to the robust association of vitamin D with adiposity; in normal or near normal BMI, vitamin D status may not be correlated with age

Effect of Salvia officinalis on diabetic patients.

INTRODUCTION Herbs are rich sources of natural antioxidants, and are used in traditional medicine for the control and treatment of many diseases. The reducing effect of a large number of these plants on blood glucose has been approved in animal models and clinical studies. OBJECTIVES This study was therefore, performed to investigate the hypoglycemic effect of Salvia officinalis on blood glucose, Glycosylated hemoglobin (HbA1c), lipid profile, liver and kidney function tests. PATIENTS AND METHODS A double-blind clinical trial was carried out on 80 type II diabetic patients who had not reached the ideal control of the disease. Patients were randomly divided into two equal groups of case and control. The case group received Salvia officinalis and the control group received placebo tablets three times a day for three months. The fasting blood sugar (FBS) and 2 hours postprandial (2hpp) glucose were checked at the beginning and every 2 weeks, for three months Glycosylated hemoglobin (HbA1c), lipid profile, liver and kidney function tests were also measured at the beginning and at the end of trial and compared in two mentioned groups. RESULTS The 2hpp blood sugar and cholesterol levels were significantly decreased in Salvia officinalis treated patients compared to control group (p<0.05). There were no significant changes in glycosylated hemoglobin and FBS between the two groups. CONCLUSION RESULTS showed that Salvia officinalis might be beneficial in diabetic patients to reduce 2hpp and cholesterol. However higher doses might be needed to decrease fasting blood glucose and glycosylated hemoglobin

Effect of supplementary Vitamin D on improvement of glycemic parameters in patients with Type 2 Diabetic

Background: Type 2 diabetes mellitus (T2DM) and Vitamin D deficiency, are too common disorders in the world. Various investigations argues the association between two diseases, however, findings are contradictory and controversial. The aim of the present study was to examine the effect of complementary vitamin D supplementation on improvement of various glycemic parameters in T2DM. Methods: In a double blind randomized clinical trial, 60 persons of T2DM patients were selected and divided into 2 groups with 30 patients. Group 1 were treated with oral Vitamin D (50,000 unit /week for 12 week), and group 2 were treated with placebo drug. Findings: The age of studied population were between 34 to 76 years and the mean age was 55 ± 10.7 years. Age, sex, BMI and serum levels of HbA1c and 25(OH) vitamin D were not significantly different between two groups before the study. After 12 weeks treatment intervention, no significant difference was found in serum HbA1c and lipids between two groups. Conclusion: In this study weekly vitamin D supplementation for 12 weeks had not significant decremental effect on HbA1c and lipid profiles, however, further studies needs to evaluate clinical usefulness of our findings

Association of Serum Uric Acid With Level of Blood Pressure in Type 2 Diabetic Patients

This study was conducted to investigate the association between serum uric acid level and blood pressure in type 2 diabetes mellitus. Sixty patients with type 2 diabetes mellitus were enrolled to the study. None of the patients had a history of gout, were treated with allopurinol, or were treated with antihypertensive drugs previously. The mean duration of DM was 9.2 +/- 4.9 years. The mean serum creatinine level was 0.98 +/- 0.22 mg/dL, and the mean serum UA level was 4.4 +/- 1.2 mg / dL. The mean protein level in 24-hour urine sample was 388 +/- 22 mg/ d. The mean systolic and diastolic blood pressure values were 133.0 +/- 13.0 mm Hg and 84.0 +/- 7.4 mm Hg, respectively. There was no significant difference in levels of serum uric acid, hemoglobin A1c, serum creatinine, proteinuria, or systolic and diastolic pressure between the men and the women. A significant positive correlation was seen between serum UA and systolic (r = 0.312, P = .02) and diastolic blood pressure (r = 0.297, P = .03). Results of this study suggest that serum uric acid had a strong association with levels of systolic and diastolic blood pressure in type 2 diabetic patients. More attention to the serum uric acid level and treatment of hyperuricemia could halt the progress of diabetic nephropathy

Effects of spironolactone on proteinuria of patients with type 2 diabetes

Background: Diabetic nephropathy is the most common cause of kidney failure. We investigated the beneficial effects of spironolactone, alone and in combination with hydrochlorothiazide, on diabetic nephropathy. Methods: This randomized clinical trial was conducted on 60 type 2 diabetic patients with nephropathy. The patients were allocated to three groups of 20 to receive spironolactone (50 mg/d) plus placebo, spironolactone (50 mg/d) plus hydrochlorothiazide (25 mg/d), or placebo plus hydrochlorothiazide (25 mg/d). The duration of the study was three months. Measurements of 24-hour urine protein and other markers were performed at start and end of the study. Findings: Of 60 patients, 43 were male. The mean age of patients was 56.8 ± 8.3 years. The three groups were homogeneous regarding general factors. At the end of the study, a significant difference in proteinuria was observed between the groups. In the groups that received spironolactone, the mean 24-hour urine protein was reduced (200 mg/24h). However, there was no significant change in the last group. The mean serum potassium in the first group showed a significant increase (0.26 meq/l). However, there were no significant increases in the second and third groups. Conclusion: This investigation showed that spironolactone plus hydrochlorothiazide had a significant effect on reducing proteinuria without causing hyperkalemia and renal failure in patients with glomerular filtration rate > 50 cc/min. Therefore, spironolactone can serve as a renoprotective drug in diabetic nephropathy

Association of serum uric acid with proteinuria in type 2 diabetic patients

Background: Various findings suggest that uric acid is an inflammatory factor and may have a role in endothelial dysfunction and act as a mediator of diabetic nephropathy. The objective of this study was to evaluate the relationships between serum uric acid level and level of proteinuria in type 2 diabetic (T2D) patients. Materials and Methods: A cross-sectional analytical study was conducted in 60 patients with T2D without a history of gout. None was treated with allopurinol. Venous blood samples were obtained in fasting state for determinations of serum creatinine, uric acid, and hemoglobin A(1c) (HbA(1c)) (reference range 3.8-5.5%); 24-h urine proteinuria was also measured. Results: Mean age of the patients was 57 +/- 8.3 years. Mean +/- standard error (SE) of serum creatinine was 0.98 +/- 0.028 mg/dL, mean +/- SE of serum uric acid was 4.5 +/- 0.15 mg/dL, and mean +/- SE of proteinuria was 388 +/- 28.7 mg/day (median = 303.5 mg/day). There was no significant difference in serum uric acid, HbA(1c), and creatinine level between males and females (P > 0.05). There was a significant positive association between body mass index (BMI) and serum uric acid levels (r = 0.428, P = 0.001). After adjustment for weight, a significant positive association of serum uric acid with level of proteinuria was seen (r = 0.47, P < 0.001). Conclusion: Serum uric acid had a significant positive association with diabetic nephropathy. It might be hypothesized that serum uric acid plays a role in diabetic nephropathy in T2D

Impact of oral vitamin D (Cholecalciferol) replacement therapy on blood pressure in type 2 diabetes patients; a randomized, double-blind, placebo controlled clinical trial

Background: Vitamin D is an important mediator of calcium metabolism. It has also been implicated as a potential contributor to the pathophysiology of various extra-skeletal conditions, consisting hypertension, renal disease, and insulin resistance. Objectives: The primary objective of this study was to determine whether oral vitamin D (cholecalciferol) supplementation can lead to improvement of blood pressure in type 2 diabetes patients. Patients and Methods: This study was a double blind clinical trial conducted on 60 type 2 diabetes mellitus patients. Exclusion criteria were taking calcium, vitamin D supplements or any drugs effecting calcium and vitamin D metabolism in the past 6 months. Patients were administered weekly vitamin D supplementation (50000 units) for 12 weeks. Serum 25-Hydroxy vitamin D 25(OH)D level was measured with ELISA method. Results: Five patients (8.3%) had vitamin D deficiency, 27 (45%) had insufficient levels of vitamin D and in 28 (45%) patients vitamin D level was within normal limits. The means of systolic blood pressure (BP) and diastolic BP in patients before intervention were 121 and 80.5 mmHg; after intervention they were 110 and 76.3 mmHg, respectively. After intervention, systolic and diastolic blood pressure levels were significantly less than control group (p< 0.01). Conclusions: In this study we found that weekly vitamin D supplementation (cholecalciferol; 50,000 units for 12 weeks) had beneficial effect on the level of blood pressure in type 2 diabetic patients. Thus, oral vitamin D may help in improvement of hypertension in these patients. © 2014, Society of Diabetic Nephropathy Prevention. All rights reserved

Effect of Metformin on Serum Ferritin Level in Women with Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) is one of the most common diseases among women associated with various inflammatory reactants such as C-reactive protein (CRP) and ferritin. This study aimed to investigate the effect of metformin on probable reduction of serum ferritin in patients with PCOS.Methods: This study was conducted on 45 patients with PCOS who had not other systemic diseases and did not take any medications. Weight, waist and hip circumstances (WHR), body mass index (BMI), metabolic indexes,CRP, ferritin and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) double acute accent were measured before the study. Metformin (500 mg/tid) tablets were prescribed for three months and then same above parameters were re-measured.Results: Of 45 patients, 19 (42.2) were overweight and 14 (31.1) were obese. After drug therapy, there was a significant reduction in waist circumstance and serum ferritin. This reduction was significant only in the lean and overweight groups but not in the obese group. There was not significant association between serum ferritin and CRP, HOMA-IR, BMI and WHR. There was not significant correlation between CRP and HOMA-IR and also BMI.Conclusion: The effect of metformin on reduction of serum ferritin was not significant just in obese group and was not associated with metabolic and anthropometric indexes. © Iranian Red Crescent Medical Journal