Iranian Journal of Diabetes and Obesity

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OBJECTIVE: Oxidative stress is a serious complication in diabetic patients. Black tea and also sour tea contained some flavonoids with antioxidant properties and may be helpful in prevention of lipid oxidation. The aim of this study was to compare the effects of sour tea and black tea on in-vitro copper induced serum lipids oxidizability in diabetic patients. MATERIALS AND METHODS: In this sequential double-blind randomized controlled clinical trial, 60 diabetic patients were divided into case and control group randomly. Patients in case group used sour tea, and control subjects used black tea as the same program for 4 weeks. Fasting blood samples were taken at the beginning and end of the study for evaluation of serum lipid oxidizability. Lipid oxidation was followed by the formation of conjugated dienes, in diluted serum, after added Cu2+. RESULTS: There were no significant differences in serum lipid oxidation parameters between the case and control groups. CONCLUSION: Our finding revealed that sour tea or black tea consumption does not affect the quantitative parameters of serum lipid oxidation.

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Objective: The aim of this study was to compare the quality of diet measured by Healthy Eating Index (HEI) between individuals with and without metabolic syndrome. Materials and Methods: This case-control study was performed in Tehran and consisted of 103 overweight and obese individuals (52 cases and 51 controls) within age range of 20 to 55 years. Case and control were matched for age and sex. The NCEP ATPIII criteria were used for identifying metabolic syndrome. Appropriate instruments were used for anthropometric measurement of weight, height and waist circumference. The participants were asked to record their food consumption of three days (two week days and one weekend day) and technical report was used to calculate HEI-2005. Independent t-test was used to compare Healthy Eating Index. Results: There was no significant difference between case and control groups for mean of HEI (p-value=0.1). Mean score of whole fruit consumption in control group was significantly higher than case group (p-value=0.04). Mean score of oil consumption (p-value=0.03) and saturated fat consumption (p-value=0.05) in case group were significantly higher than control group. Conclusion: The comparison of HEI between overweight/obese individuals with and without metabolic syndrome in this study shows that the quality of diet in both groups needs to be improved.

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Objective: Oxidative stress is involved in the pathophysiology of diabetes and cardiovascular complications of metabolic syndrome. The main objective of this study was to evaluate total antioxidant status by diphenylpicrylhydrazyl (DPPH)-scavenging activity in patients developed metabolic syndrome (MetS). Materials and Methods: Forty-four patients with MetS diagnosed on the basis of adult treatment panel (ATPIII) criteria along with 46 age- and gender-matched healthy controls were studied. A blood sample was taken after a 12-hour fasting period, and blood glucose, lipid profile, and DPPH were determined. Results: A significant decrease (p=0.03) in DPPH-scavenging activity levels in the study group was observed compared to the control group. Among the components of metabolic syndrome, hyperglycaemia, hypertriglyceridaemia and hypertension were negatively correlated with DPPH-scavenging activity levels. Conclusions: The findings of the present study suggest the oxidative stress in patients with MetS which further increases the cardiovascular risk and diabetes mellitus in these patients. We posited that studying of the oxidative status is crucial in order to prevent type 2 diabetes development and cardiovascular disease and its complications because it is installed long before the disease actually appears.

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Objective: Type 2 diabetes mellitus (DM-2) is a chronic and progressive metabolic disorder known as a serious threatening condition in the individual and society. Type 2 diabetes mellitus is known as the major cause of cardiovascular diseases (CVD). Contradictory evidences about the effect of omega-3 fatty acids on CVD risk factors, particularly hypertension. The aim of this study was to determine the effect of omega-3fatty acids supplementation on blood pressure in DM-2 patients. Materials and Methods: This is a double-blind, placebo-controlled clinical trial on patients referred to Yazd Diabetes Research Center. Seventy DM-2 patients were randomly assigned to receive either 2 g/day omega-3 soft gels (OG) or 2 g/day placebo (PG) for 6 weeks. At the beginning and end of the study, blood pressure was measured and compaired Results: Fifty nine percepts of patients in OG and 41% in PG had hypertension. Initially, there was no significant difference in the mean of age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP) and duration of diabetes between two groups. At the end of the study, the mean of SBP, DBP and differences between groups were not significant. Conclusion: Consumption of 2 g/day omega-3 supplement for6 weeks has no significant effect on systolic and diastolic blood pressure in DM-2 patients.

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Objective: Obesity is a worldwide and major public health problem including Iran and other countries. Available data indicates that the prevalence of obesity has significantly increased among the Iranian population over the past 30 years. The aim of the present study was to evaluate the prevalence of obesity in Yazd (central province of Iran) population. Materials and Methods: This was a cross-sectional population-based study and performed by census method on Yazd population aged 30 years old or above. Height, body weight and Body Mass Index (BMI) were measured. Statistical analyses were performed with Chi-Square test. Results: Totally, 8448 subjects aged>30 years from both sexes were evaluated. Data showed that the rate of BMI above 25kg/m2 for women and men was 43.9% and 32.2% respectively. In both genders, the rate of obesity and overweight raised by increasing of age up to 50 years old. Overall, the prevalence of obesity was higher in women compared with men in all ages. The prevalence of obesity and overweight were 9.5% and 29%, respectively. Conclusion: This study indicated a high prevalence of obesity and overweight in the central area of Iran, especially in urban people.

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Abstract Objective: The aim of this study was to compare the body fat parameters in individuals with and without metabolic syndrome using an objective method. Materials and methods: This case-control study was performed in Tehran and consisted of 105 individuals with age range of 20 to 55 years. All participants were overweight and obese. NCEP ATP III criteria were used for identifying subjects with metabolic syndrome. Waist circumference, weight and height were measured by an expert person and with non-elastic tape measure, balanced beam scale and standing stadiometer, respectively. Fat mass was measured using BIA (model: Tanita BC 418). Results: Mean age of total participants, case group, and control group were 35±14, 35.85±6.9 and 34.98±8.1 years, respectively. Mean BMI in case group was higher than control group (P<0.01). There was no significant difference between case and control groups for total body fat, right hand fat, as well as right and left leg fats. But there was significant difference between the two groups for trunk and left right hand fats, before controlling of confounding factors. After controlling confounding factors this observed difference was disappeared. One unit increase in BMI raised the development odds of metabolic syndrome by 1.14% (95%CI: 1.02-1.27). Conclusion: We found that BMI is a more accurate predictor of MetS rather than body fat mass. However, other predisposing factors especially at molecular levels are needed to clarify underlying mechanisms of this syndrome.

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Objective: Patients with metabolic syndrome are prone to cardiovascular disease and diabetes. Regarding the importance of nutritional factors in management of metabolic syndrome, this study was designed to evaluate the effects of dark chocolate consumption on serum lipid profile in patients with metabolic syndrome. Materials and Methods: In this randomized clinical trial, 114 patients with metabolic syndrome, aged 30 to 60 years, without heart, renal and hepatic diseases were recruited. The eligible patients were randomly allocated to receive either dark chocolate (76% purity), 20 or 40 grams daily for two months. Total cholesterol, high-density lipoprotein (HDL), triglycerides (TG) and fasting blood glucose (FBG) were measured with enzymatic methods before and after intervention. A low-density lipoprotein (LDL) level was calculated by the Friedewald formula. Data were analyzed using SPSS version 16.0 and ANOVA test P<0.05 was considered significant. Dietary intake was measured with NUT4 software at the beginning and the end of the study. Results: There were no significant changes in dietary intakes of patients during the intervention in three groups. No significant differences were seen in mean concentration of lipid profile before and after intervention in groups (P>0.05). Conclusion: Consumption of 20-40g/day dark chocolate with 76% purity for 2 months doesn't change the lipid profile of patients with metabolic syndrome.

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Objective: Sexual dysfunction is considered as an important health problems. Chronic diseases such as diabetes can have negative effect on sexual function. This study aims to determine the level of sexual dysfunction in male patients with diabetes mellitus type 2 in Yazd Diabetics Research Center. Materials and Methods: This descriptive study involved 69 male patients with type 2 diabetes mellitus in Yazd Diabetes Research Center- 2014. The Questionnaire consisted of two parts: demographic characteristics of patients and the IIEF questionnaire (the International Index of sexual function). Data analysis was performed by using SPSS software version 21, and by using descriptive statistics, mean, standard deviation and statistical tests of Fisher' exact and T-test. Results: The mean of age, height and weight of participants were 51.44 year, 171.14 cm, 77.55 kg, respectively. Through 15 items surveyed, lowest mean is related to the question attempted to intercourse (1.20±0.40) and the highest average related to the question marriage satisfaction (3.50±0.50). Conclusion: According to the results, most of the participants were in trouble in making erection and frequency of intercourse. Informing the patient as the first and most effective ways of prevention and treatment is essential.

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Objective: Diabetes is a common endocrine disorder caused by deficiency of insulin secretion or insulin resistant. nowadays, in addition to trying to find a safe way to control diabetes, find the low side effect way is important. This study was designed to find the effect of Urtica dioica extract on glycemic control and insulin resistance in patients with type 2 diabetes. Materials and Methods: A parallel randomized clinical trial was conducted with participating 60 patients with type 2 diabetes who met inclusion criteria were recruited. Patients were randomly assigned to receive 100mg/kg/day extract of Urtica dioica group (UG) and the other group which received placebo (PG) over an 8 weeks period. Fasting blood sugar (FBS) concentration and insulin resistance indices (insulin concentration, insulin resistance (IR), insulin sensitivity (S%) and β-cell function (β%)) were measured at baseline and end of the study. Data were analyzed using SPSS 16.0 and P<0.05 was considered significant. Results: The mean difference of FBS in UG and PG were 20.16±52.6 mg/dl and -0.7±45.29 mg/dl (P-value=0.14) and the mean concentration of insulin in UG and PG were 2.5mU/L and 0.2mU/L (P-value=0.003), respectively, that showed a significant increase in insulin concentration in UG compared to PG and the mean IR in UG and PG were 0.3 and 0.1 (P-value=0.01) that showed a significant decrease in IR in UG compared to PG. The mean difference of β% in UG and PG were -24.16±35.07% and 1.22±18.14% (P-value=0.003), and the mean difference of S% in UG and PG were -54.72±69.3% and 1.1±74.01% (P-value=0.009), respectively that showed increase in insulin concentration, β% and S% and decrease in IR in UG compared to PG. Conclusions: In the present study we demonstrated that consumption of 100mg/kg/day extract of U.dioica for 8 weeks did not have significant effect on FBS and it has significant effect on insulin resistance indices.

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Objectives: Inflammation is a common complication in patients treated with hemodialysis and increasing in inflammatory factors such as C-reactive Protein (CRP) is associated with increased cardiovascular disease and mortality in these patients. The purpose of this study was to investigate the effect of oral L- carnitine supplementation on serum CRP concentration and fasting blood sugar (FBS) in patients undergoing hemodialysis. Materials and Methods: This study was a randomized clinical trial on 50 patients (30 males and 20 females) undergoing hemodialysis in the age range of 21-84 years from hemodialysis units of Yazd hospitals. Participants randomly divided into two groups, the Carnitine group (CaG) consumed daily oral syrup of L- carnitine containing 1000 mg of Carnitine for three months and the control group (CoG) did not use Carnitine. Serum levels of CRP and FBS were measured at baseline and at the end of the intervention. Statistical analysis was performed using the SPSS version 16.0. Results: the mean difference in CRP concentration in CaG and CoG were, 1.95 ±9.4 and 0.6±10.8 (μg/l), respectively (P-value=0.7) and the mean of FBS at the baseline and after 12 weeks in the CaG were 118.7±51.4 mg/dl and 110.1±48.2 mg/dl, respectively (P-value=0.3) and in the CoG were 142.8±88.7 mg/dl and 131.8±68.9 mg/dl (P-value=0.26). Conclusion: The oral administration of daily 1000 mg of L-carnitine for three months doesn’t effect on serum CRP and FBS concentrations in patients undergoing hemodialysis.

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Objective: Although smoking increase the risk of cardiovascular diseases, its quitting leads to weight gain due to increased appetite. The aim of this study was to determine the effect of face to face dietary counseling on metabolic syndrome (MetS) indices in cigarette quitter.

Materials and Methods: This 9-week parallel randomized clinical trial was conducted by participation of 50 patients with metabolic syndrome who have recently quit smoking. Participants were assigned randomly into two groups. Intervention group (IG) received weekly nutritional education and consultation, while control group (CG) did not receive any intervention. Before and after the trial, both groups were evaluated nutritionally using 24-hour dietary recall questionnaire, and metabolic syndrome parameters were measured. Paired T-test and ANCOVA were used for statistical analysis.

Results: After intervention, weight, body mass index (BMI), triglycerides and systolic blood pressure were significantly different between CG and IG, while indices of low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C) and diastolic blood pressure were not significantly different between two groups. Amount of energy, lipid, protein, and carbohydrate intake were significantly lower in IG compare to CG. After adjustment of age, duration of smoking and the initial concentration of biochemical and anthropometric factors, significant differences were found between IG and CG in the changes of LDL-C (P-value 0.001), BMI (P-value 0.001), weight (P-value 0.001), waist circumference (P-value 0.002), and triglyceride (P-value 0.001).While the difference in changes of HDL-C, FBS, systolic and diastolic blood pressure, were not significant between two groups.

Conclusion: Given the findings of this study, nutritional counseling could improve some indices of MetS in cigarette quitters.

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Objective: The current study was conducted to compare the effect of 150,000 and 300,000 IU of vitamin D on the healing status of diabetic foot ulcer among the patients with diabetes.
Materials and Methods: This randomized clinical trial was carried out on 47 patients with diabetic foot ulcer and vitamin deficiency during four weeks follow-up. The patients were randomly assigned into two groups; group G150 was administered 150000 IU of vitamin D and group G300 was administered 300000 IU of vitamin D. Serum 25-hydroxyvitamin D, ulcer area, fasting blood sugar (FBS), c-reactive protein (CRP), white blood cells (WBC) and erythrocyte sedimentation rate (ESR) were measured in both groups before and after intervention.
Results: Serum vitamin D level in both groups was significantly increased compared to the baseline (P<0.01). The mean of serum vitamin D changes were 12.6±5.0 and 18.4±6.4 ng/ml (P=0.001) in G150 and in G300, respectively. The ulcer area was significantly reduced in both groups compared to the baseline (P<0.01).WBC, ESR, FBS and CRP were significantly declined compared to the baseline in both groups. However, the mean changes of serum FBS and CRP levels were found to be significantly different between groups.
Discussion: The findings showed administration of 150,000 and 300,000 IU of vitamin D improved the ulcer and vitamin D status and reduced ESR, CRP, WBC and FBS in the patients with diabetic foot ulcer. In addition, the 300,000 IU of vitamin D was significantly more effective than 150,000 IU.

 

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Objective: Hypertension is a common component of metabolic syndrome (MetS). Some studies showed that L-arginine reduced the blood pressure (BP) .Therefore this study was designed to evaluate the effect of L-arginine supplementation on BP in MetS.
Materials and Methods: In this randomized, double-blind, placebo-controlled trials, 60 patients with MetS were randomly divided into two groups: the L-arginine-supplemented group (AG), who received 5 gr of L-arginine daily and placebo group (PG). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP) were measured before and after the intervention and compared.
Results: At the end of the study in the AG significant reductions were observed in the SBP, DBP and MAP (P-value:0.001).The comparison of changes in variables between the AG and PG indicated that in the AG, patients had a significantly greater decrease in the SBP (-11.25±10.93 vs. -2.67±6.15 mmHg: P-value:0.001), DBP(-5.71±7.16 vs. -1.25±7.02 mmHg: p-value: 0.02) and MAP (-7.55±5.61 vs.-1.72±5.16 mmHg, P-value: 0.001). The PP decreased in both groups but a significant decrease compared with baseline in the AG was observed (-5.53±13.83 vs. -1.42±9.21 mmHg: P-value: 0.19).
Conclusion: The findings of the present study showed that 5 gr/d L- arginine supplementation for 12 weeks in MetS resulted in significant decrease in the SBP, DBP and MAP but had no significant effect on the PP.