Search

Purpose: There is limited research on the effects of maternal hyperandrogenism (MHA) on cardiometabolic risk factors in male offspring. We aimed to compare the risk of metabolic syndrome (MetS) in sons of women with preconceptional hyperandrogenism (HA) to those of non-HA women in later life. Methods: Using data obtained from the Tehran Lipid and Glucose Cohort Study, with an average of 20 years follow-up, 1913 sons were divided into two groups based on their MHA status, sons with MHA (n = 523) and sons without MHA (controls n = 1390). The study groups were monitored from the baseline until either the incidence of events, censoring, or the end of the study period, depending on which occurred first. Age-scaled unadjusted and adjusted Cox regression models were utilized to evaluate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between MHA and MetS in their sons. Results: There was no significant association between MHA and HR of MetS in sons with MHA compared to controls, even after adjustment (unadjusted HR (95% CI) 0.94 (0.80–1.11), P= 0.5) and (adjusted HR (95% CI) 0.98 (0.81–1.18),P= 0.8). Sons with MHA showed a HR of 1.35 for developing high fasting blood sugar compared to controls (unadjusted HR (95% CI) 1.35 (1.01–1.81), P= 0.04), however, after adjustment this association did not remain significant (adjusted HR (95% CI) 1.25 (0.90–1.74), P= 0.1). Conclusion: The results suggest that preconceptional MHA doesn’t increase the risk of developing MetS in sons in later life. According to this suggestion, preconceptional MHA may not have long-term metabolic consequences in male offspring.

Purpose: Prenatal androgen exposure could be a source of early programming, leading to the development of cardiometabolic diseases in later life. In this study, we aimed to examine cardiometabolic disturbances in males exposed to maternal androgen excess during their prenatal life. Methods: In this prospective population-based study, 409 male offspring with maternal hyperandrogenism (MHA), and 954 male offspring without MHA, as controls, were included. Both groups of male offspring were followed from the baseline to the date of the incidence of events, censoring, or end of the study period, whichever came first. Age-scaled unadjusted and adjusted Cox regression models were applied to assess the hazard ratios (HR) and 95% confidence intervals (CIs) for the association between MHA with pre-diabetes mellitus (Pre-DM), type 2 diabetes mellitus (T2DM), pre-hypertension (Pre-HTN), hypertension (HTN), dyslipidemia, overweight, and obesity in the offspring of both groups. Statistical analysis was performed using the STATA software package; the significance level was set at P< 0.05. Results: A higher risk of Pre-DM (adjusted HR: 1.46 (1.20, 1.78)) was observed in male offspring with MHA after adjustment for potential confounders, including body mass index, education, and physical activity. However, no significant differences were observed in the risk of T2DM, Pre-HTN, HTN, dyslipidemia, overweight, and obesity in males with MHA compared to controls in both the unadjusted and adjusted models. Conclusion: Maternal androgen excess increases the risk of Pre-DM in male offspring in later life. More longitudinal studies with long enough follow-up are needed to clarify the effects of MHA on the cardiometabolic risk factors of male offspring in later life.

Purpose: Controversies exist in the effect of body weight loss and fluctuation on cardiovascular disease (CVD) and mortality. This study aims to assess the effect of weight variability on CVD and all-cause and cardiovascular mortality in the Tehran Lipid and Glucose Study (TLGS) cohort. Method: Participants aged  ≥ 40 year at the baseline period with at least 3 BMI measurements were included in this study. After excluding individuals with cancer, CVD, end-stage renal disease, systemic use of glucocorticoids, pregnancy, and missing covariates at the baseline, a total of 3461 participants were enrolled and followed for 18 years. BMI variability was defined using root mean squared error (RMSE) and average successive variability (ASV). In the RMSE method, BMI variability was calculated using the best-fitting model for BMI trend of each subject. Multivariate Cox proportional hazard models were applied to assess BMI variability’s effect on CVD and mortality. Results: Among the 3461 participants in this study, the group with the highest weight variability had an increased risk of death for all-cause (HR 1.65; 95% CI 1.21–2.25), non-cardiovascular (HR 1.77; 95% CI 1.24–2.53), and non-cancer (HR 1.77; 95% CI 1.25–2.50) mortality. However, BMI variability showed to be protective against CVD (HR 0.76; 95% CI 0.6–0.97). These findings were significant in males, non-smokers, participants with age  ≤ 60 year, BMI < 30, negative BMI slope, and both diabetic and non-diabetic subjects. Conclusion: High BMI variability is associated with increased risk of all-cause, non-CVD, and non-cancer mortality, although protective for the CVD event. Appropriate strategies for body weight maintenance after weight loss could be adopted to avoid weight variability, particularly in non-obese subjects.

Purpose: To compare the effects of different thyroid screening scenarios, using the universal and targeted high-risk case-finding approaches with different diagnostic tests on the prevalence of subclinical hypothyroidism (SCH), thyroid autoimmunity, and pregnancy outcomes after adjustments for the intervention. Methods: During a secondary analysis of data collected in Tehran Thyroid and Pregnancy Study, a total of 2277 women from the total population, including 1303 high-risk individuals for thyroid dysfunction. The Cochran–Mantel–Haenszel method, adjusted for the intervention, was also used to evaluate the relationships between different screening scenarios [i.e., universal approach using thyroid-stimulating hormone (TSH) and/or thyroid peroxidase antibody (TPOAb) tests and targeted high-risk case-finding approach using TSH and/or TPOAb tests] and pregnancy outcomes (i.e., preterm delivery and NICU admission). The universal approach using both TSH and TPOAb measurements was considered as the reference scenario. We analyzed outcomes of different screening methods in individuals treated with LT4, compared to those individuals who were not treated. Results: Compared to the universal screening approach with both TSH and TPOAb measurements, the targeted high-risk case-finding approach overlooked approximately 42%, 62%, and 74% of women with elevated TSH (> 4 µlU/mL) when using both TSH and TPOAb tests, TSH alone, and TPO alone, respectively. After adjusting for the missed cases, 2.86% of women with preterm delivery and 2.76% of women with NICU admission were missed when they were screened using the targeted high-risk case-finding approach by measuring both TSH and TPOAb. The percentage of missed cases increased when applying the targeted approach with the TSH test alone, without measuring TPOAb. Overall, 4.16% and 4.02% of women with preterm delivery and NICU admission were overlooked in this scenario, respectively. After adjustments for the intervention, the probability of NICU admission in neonates of mothers, who were screened using the targeted high-risk case-finding approach with TPOAb measurement, was 2.31 folds higher than those screened by the reference scenario. Conclusion: This study suggests that although the targeted high-risk case-finding approach including both TSH and TPOAb tests, may overlook some women with SCH, it is a reasonable option since it is not associated with a higher risk of adverse pregnancy outcomes.

Background: Following the conventional 12–18 month antithyroid drug (ATD) treatment in Graves’ disease (GD), 50% of patients experience relapse of hyperthyroidism. Objective: The aim of this systematic scoping review was critical appraisal of duration of ATD therapy in the last 80 years. Methods: Articles were identified through the search of PubMed from January 1, 1941 to April 30, 2021. All study types were included. Articles were eligible if they reported data on the length of ATD treatment, particularly thyroid hormones and TSH receptor antibodies (TRAb) concentrations and specifically those with data on the remission and/or relapse rates. Results: We described major progress regarding the duration of ATD therapy and related outcomes at every 20 years. Articles of 1941–1960 were mainly concerned with determination of favorable treatment, minimal effective dose, side effects and rate of remission after < 12-month ATD therapy. Studies with larger number of patients and longer follow-ups appeared in 1961–1980; higher remission rate after 18–24 months versus 6 months of ATD therapy was reported. Articles of 1981–2000 focused on identification of factors associated with high relapse rates after discontinuation of ATD. In 2001–2021, ATD became the first choice of treatment in many countries. However, 12–18 months of ATD therapy was arbitrarily chosen as the appropriate option. According to recent studies, persistent normalization of TRAb occurs after 5 years of methimazole therapy and ATD treatment of > 60 months could offer a 4-year remission rate of 85%. Conclusion: Long-term ATD treatment for more than 60 months is safe and effective, has the highest remission rate and cures most patients with GD; hence, it should be considered as the most appropriate duration for ATD therapy in these patients.

ABSTRACTObjectiveTo investigate the association between different lipid measures and long-term hospitalization-required incident fracture among Iranian men and women.MethodsA total of 3309 individuals aged ≥50 years (men = 1598) were included in the study. Multivariate Cox proportional hazard analyses were performed to assess the risk of incident fracture across quintiles, considering first quintile as reference, as well as for 1-standard deviation (SD) increase in each lipid measure, i.e. total cholesterol (TC), triglycerides (TG), low- and high-density lipoprotein cholesterol (LDL-C and HDL-C, respectively), non-HDL-C, and related indices (TG/HDL-C and TC/HDL-C). Covariates included age, body mass index, current smoking, type 2 diabetes mellitus, hypertension, lipid lowering-drugs, and steroid medications (for women).ResultsDuring a median follow-up of 18 years, incident fracture was observed in 201 cases (men = 87). In both gender, no linear association was found between different lipid measures and incident fracture. Among men, only the fourth quartile of TG was associated with lower risk of fracture in the age-adjusted analysis with the hazard ratio (HR) and 95% confidence interval (CI) of [0.45 (0.21–0.95)]. Among women, the age-adjusted HRs and 95% CIs for the second, third, fourth, and fifth quintiles of non-HDL-C were [0.46 (0.25–0.87)], [0.73 (0.42–1.25)], [0.90 (0.54–1.51)], and [0.52 (0.29–0.95)], respectively; the corresponding values in the multivariate model were [0.48 (0.26–0.90)], [0.76 (0.4–1.32)], [0.94 (0.56–1.58)], and [0.52 (0.28–0.95)], respectively. The second quintile of LDL-C was also associated with lower risk for incident fracture in the multivariate analysis [0.53 (0.29–0.98)].ConclusionsAmong Iranian women, a nonlinear association between non-HDL-C and LDL-C and incident fracture was found as the second and fifth quintile of the former and the second quintile of the latter were associated with about 50% lower risk of fracture. Generally, our findings did not support harmful impact of these lipid measures on incident fracture.

Purpose: A link between maternal thyroid dysfunction during pregnancy and the risk of cognitive and behavioral problems in the offspring has previously been established; however, the potential effects of maternal thyroid autoimmunity on neurodevelopment in the absence of maternal hypothyroidism are less clear. The present review aims to highlight the gaps in knowledge in this regard and provide a thorough assessment of relevant literature. Method: Related keywords searched in MEDLINE, Web of Science, and Scopus till January 2021. Results: There is some evidence that neuropsychological and intellectual developments of offspring are adversely affected by maternal thyroid autoimmunity, although the results of available studies are not concordant. The tools and measurements that have been applied in different studies to assess neurodevelopment or IQ vary widely and the children born to mothers with thyroid autoimmunity have been assessed at different chronological stages of life. Such variations may explain some of the differences across studies. In addition, the definition of thyroid autoimmunity has been based on TPOAb cut points provided by manufacturers in most cases, but it is preferable to define these values based on age, trimester, and method-specific reference ranges. Conclusion: Well-designed studies are needed to assess verbal and non-verbal neurocognition of offspring born to mothers with autoimmune thyroid disease before or during pregnancy.

Purpose: Aging is associated with significant changes in fat distribution and menopause may alter this process. This study aimed to investigate the longitudinal effect of menopause on changes in adiposity indices (AI). Methods: A total number of 3876 non-menopausal women, aged > 20 years, who participated in the Tehran Lipid and Glucose study, were selected for the present study. They were followed from 1998 to 2018 at a 3-year interval and their adiposity indices were measured. Throughout the study, participants were categorized into two groups according to their menopausal status as group 1): women who reached menopause and group 2): women who did not reach menopause. The generalized estimation equation (GEE) models were used to compare the trend of changes in AIs between these two groups. Results: At the end of the study, a total number of 1479 (38.2%) participants reached menopause. The odds of general obesity decreased by 5% (OR: 0.95, 95% CI: 0.90–0.99), and the odds of central obesity increased by 6% in group1 compared to group2 (OR: 1.06, 95% CI: 1.01–1.12). Conclusions: Menopause alters the impact of aging on central fat distribution. Increasing awareness of the related risk in menopausal women and their healthcare professional may prevent adverse related outcomes.

Background: This study aimed to compare the time to achieve euthyroidism and sustained control of hyperthyroidism after treatment with radioactive iodine (RAI) or long-term methimazole (LT-MMI) in patients with post-RAI relapsed hyperthyroidism. Methods: Sixty four patients with recurrence of hyperthyroidism after RAI treatment were randomly assigned to either RAI or LT-MMI treatment. Both groups were followed every 1–3 months in the first year and then every 6 months for a total of 60 months. Results: In RAI and LT-MMI groups, mean age was 49.0 ± 12.1 and 50.1 ± 14.6 years and time of relapse of hyperthyroidism after previous RAI treatment was 23.2 ± 18.8 and 20.8 ± 17.1 months, respectively. At the end of study, in the LT-MMI group, 31 (97%) and 1 (3%) were euthyroid and hypothyroid, respectively; in the RAI group, 8 (25%) patients were euthyroid, whereas 18 (56%), 3 (9.5%) and 3 (9.5%) had overt hypothyroidism, subclinical hypothyroidism and hyperthyroidism, respectively. Mean time to euthyroidism was 9.4 ± 5.0 months in the RAI group and 3.5 ± 2.8 months in the LT-MMI group (p< 0.001). Patients in the RAI group spent 77.7 ± 14.0 percent and those in the LT-MMI group spent 95.2 ± 5.9 percent of 60 months in the euthyroid state (p< 0.001). Conclusion: In patients with post-RAI relapse of hyperthyroidism, LT-MMI treatment was superior to radioiodine because of faster achievement of euthyroidism and more sustained control of hyperthyroidism during 60 months of follow-up.

Objective: The significance of subclinical hypothyroidism (SCH) is largely due to its potential risk for developing overt hypothyroidism (OH). Investigations are still exploring predictive factors contributing to the progression of SCH to OH, particularly in patients with mildly elevated serum thyrotropin (TSH). We aimed to clarify the natural history of SCH and the predictive factors of its progression, based on the grade of SCH severity. Methods: This study was conducted within the framework of the Tehran Thyroid Study (TTS), in which 5783 individuals aged ≥ 20 years were followed. After applying exclusion criteria, data of 270 SCH subjects remained for the analysis. Thyroid function tests were assessed at baseline and every 3 years. Results: Of 270 participants with SCH, 239 (88.5%) had TSH level between 5.06 and 10 mU/L, and 31 (11.4%) had TSH ≥ 10 mU/L. During a median follow-up of 10 years, 40% had TSH within the reference range, 44% maintained elevated TSH, and 16% had added low T4 to the elevated TSH. The annual incidence rate of progression to OH was 22.3 (16.5–101.9) per 1000 person-years [18 (12.6–25.6) for those with TSH 5.07–9.9 mU/L and 57.8 (22.8–101.9) for patients with TSH ≥ 10 mU/L per 1000 person-years (P= 0.001)]. After adjusting age, sex, body mass index (BMI), thyroid peroxidase antibody (TPOAb), and serum TSH, only TPOAb positivity (HR: 2.31; 95% CI 1.10–4.83, P= 0.026) and baseline TSH level ≥ 10 mU/L (HR: 5.14; 95% CI 2.14–12.3, P< 0.001) remained as predictors for development of OH. In patients with TSH 5.07–9.9 mU/L, TPOAb positivity was associated with an increased risk of OH (HR: 2.41; 95% CI 1.10–5.30, P= 0.027). However, in patients with TSH ≥ 10 mU/L, TPOAb positivity was not a predictor (P= 0.49). Conclusion: TPOAb and not TSH are associated with the development of OH in individuals with serum TSH below 10 mU/L, and follow-up at regular intervals is recommended in TPOAb-positive individuals with TSH between 5 and 10 mU/L.

Background: Although Iran has been considered iodine replete since 2000, the first national survey of iodine intake among Iranian pregnant women in 2014 indicated that despite the adequate intake of iodine by the general population, this vulnerable group has moderate iodine deficiency. Therefore, in this national cross-sectional interventional study, we aimed to assess the iodine intake and thyroid function of Iranian pregnant women 2 years after implementing national iodine supplementation for this vulnerable group. Materials and methods: In this cross-sectional study, we conducted a national interventional survey of pregnant women. A total of 1200 pregnant women (400 women from each trimester) from 12 provinces of Iran were recruited from the antenatal care clinics from October 2018 to March 2019. The median urinary iodine concentration (MUIC), as an indicator of iodine status in three spot urine samples, was measured, along with the serum total T4 (TT4), thyrotropin (TSH), thyroglobulin (Tg), thyroid peroxidase antibody (TPO-Ab), and iodine content of household salt. Results: The mean age of the cohort was 28 ± 6.2 years, with the mean gestational age of 22.7 ± 13.0 weeks. The overall MUIC (IQR) of pregnant women was 188 µg/L (124.2–263 µg/L). Also, the MUICs in the three trimesters of pregnancy were 174 µg/L (110–254), 175 µg/L (116–251), and 165 µg/L (114–235), respectively. The MUICs ≥ 150, 100–149, and < 100 µg/L were found in 63, 19.8, and 16.2% of the subjects, respectively. The mean TT4 level was 12 ± 4.5 µg/dL, and the median (IQR) level of TSH was 2.37 mIU/L (1.66–3.18 mIU/L). According to our local reference range, 118 (10.5%) pregnant women had subclinical hypothyroidism, 6 (0.53%) women had isolated hypothyroxinemia, and 65 (5.7%) women were TPO-Ab positive. Also, the median (IQR) level of Tg was 10.08 µg/dL (5.7–20.4 µg/dL), and the median iodine content of household salt was 29.6 µg/g; the iodine content was ≥ 30 µg/g in 85% of household salt. The results showed that more than 95% of households were under iodized salt coverage. Conclusion: The results of this study indicated that iodine supplementation with at least 150 µg of iodine per day improved the iodine intake of pregnant women. Except for subclinical hypothyroidism, the prevalence of clinical hypothyroidism, clinical/subclinical thyrotoxicosis, TPO-Ab positivity, and isolated hypothyroxinemia decreased significantly, which emphasizes the importance of iodine supplementation during pregnancy.

•The investigation of RKKY interaction in doped graphene nanotube in the presence of electron phonon coupling.•The study of the effects electron doping on RKKY interaction.

•The study of dynamical spin conductivity of honeycomb lattice in the presence of spin-orbit coupling.•The investigation of magnetic ordering on spin conductivities of the structure.•The study of static spin conductivity due to next nearest neighbor coupling.

Continued low-dose MMI treatment for longer than 12–18 months may be considered in patients not in remission. However, ATDs are not free from adverse effects. We undertook a systematic review to clarify safety of long-term ATD treatment. Medline and the Cochrane Library for trials published between 1950 and Nov 2018 were systematically searched. We included original studies containing data for long-term (> 18 months) ATD treatment. Two reviewers independently extracted data from included trials and any disagreement was adjudicated by consensus. Of 615 related articles found, 12 fulfilled the criteria. Six articles had data for adults, five for non-adults and one article had data for both groups. The sample sizes ranged between 20 and 249 individuals, and the mean duration of ATD treatment ranged between 2.1 and 14.2 years. Considering all data from 1660 patients treated with ATD for a mean duration of 5.8 years (around 10,000 patient-years), major complications occurred only in 14 patients: 7 severe agranulocytosis, 5 severe liver damage, one ANCA-associated glomerulonephritis and one vasculitis with small cutaneous ulcerations. Minor complications rates were between 2 and 36%, while more complications were in higher doses and in the children. The most reported AE was cutaneous reaction; the other adverse events were elevated liver enzymes, leukocytopenia, arthritis, arthralgia, myalgia, thrombocytopenia, fever, nausea and oral aphthous. Long-term ATD treatment is safe, especially in low dose and in adults, indicating that it should be considered as an earnest alternative treatment for GD.

•The study of magneticm structure factor of ordered graphene.•The investigation of nex nearest neighbor exchange on the behavior of structures factors.•The study of structure factor of magnetic system.

•The study of RKKY interaction between two moments in nanoribbon.•The investigation of electron phonon coupling effects in nanoribbon on RKKY interaction.•The study of electron density on RKKY interaction in nanoribbon.

•The thermodynamic properties of localized electrons on honeycomb lattice using Bosonic transformation are studied.•The temperature dependence of specific heat and magnetization of Heisenberg model on honeycomb lattice is obtained.•The specific heat of Heisenberg model on honeycomb lattice increases with Dzyaloshinskii-Moriya interaction strength.

•We study thermodynamic properties of a frustrated quantum magnet compound.•The effects of the anisotropic parameters are investigated.•A hard core bosonic transformation is used as a quantum many particle method.

Iodine deficiency and related disorders were very common in Iran prior to 1996, when universal salt iodization (USI) was implemented and in 2000 Iran was declared iodine deficiency disorders (IDD) free. The aim of this study was to evaluate the adequacy of iodine intake by Iranian households in all 30 provinces of Iran, a quarter of a century after the intervention. A total of 18,000 school-aged children (8–10 years with mean 8.7 ± 1 year) were included in this study. Urine samples were collected from all children for measurement of urinary iodine excretion and 1800, 210 and 3000 salt samples were randomly collected from the family kitchen, production site of 73 salt factories and distribution circles of 30 provinces, respectively. The median urinary iodine concentration (UIC) of participants was 161 μg/L. The proportion of children with UIC of, 20–49, 50–99 and ≥ 100 μg/L were 10.3, 15.9 and 73.7%, respectively. The mean (± SD) and median salt iodine values were 28.2 (± 12.6) and 31.7 ppm, at the production site, and 31.5 (± 13.6) and 29.6 ppm at the distribution circles, respectively. About 80% of factory salts had more than 20 ppm iodine. 98% of households consumed iodized salt, 80% had appropriate salt storage, and 83% of the household salts contained ≥ 20 ppm. Based on the results of this study, Iranian populations are consuming adequate iodine. The well-maintained and monitored USI program has improved the dietary iodine intakes of the population, and the country has achieved all criteria of a well-controlled IDD program.

The purpose of this study was to evaluate the effect of combinations of blood pressure and glucose tolerance status on cardiovascular and all-cause mortality. A total of 7619 participants aged ⩾30 years old were stratified to nine categories as follows: (1) normotension (NTN) and normal glucose tolerance (NGT) (reference group), (2) NTN and pre-diabetes mellitus (pre-DM), (3) NTN and DM, (4) pre-hypertension (pre-HTN) and NGT, (5) pre-HTN and pre-DM, (6) pre-HTN and DM, (7) HTN and NGT, (8) HTN and pre-DM and (9) HTN and DM. Cox proportional hazards were applied to calculate the multivariate hazard ratios (HRs) of different groups for outcomes. For all-cause mortality outcomes, prevalent cardiovascular disease (CVD) was also adjusted. In a median follow-up of 11.3 years, 696 CVD and 412 all-cause mortality events occurred. Among the population free from CVD at baseline (n=7249), presence of HTN was associated with increased risk of CVD, regardless of glucose tolerance status with HRs of 1.97 (95% confidence interval (CI), 1.49–2.61), 2.25 (1.68–3.02) and 3.16 (2.28–4.37) for phenotypes of HTN and NGT, HTN and pre-DM and HTN and DM for CVD, respectively; corresponding HRs for all-cause mortality were 1.65 (95% CI, 1.15–2.37), 1.69 (1.15–2.49) and 2.73 (1.80–4.14), respectively. Phenotypes of NTN and pre-DM (1.48; 1.03–2.14) and NTN and DM (2.04; 1.06–3.92) were also associated with CVD and all-cause mortality, respectively. HTN was significantly associated with CVD/mortality events, regardless of glucose tolerance status. Blood pressure <120/80 mm Hg among pre-diabetic/diabetic population, not on antihypertensive medications, was generally associated with worse outcomes.

This study aimed to investigate the interactive effect of polycystic ovary syndrome (PCOS) status and obesity status on the serum levels of adipokines. In this comparative case–control cross-sectional study, 58 women with PCOS and 104 eumenorrheic non-hirsute women as the control group were recruited. They were further divided into two subgroups of overweight/obese and normal weight. The interactive effect of the PCOS status and obesity status on the circulating levels of adipokines was assessed using general linear model with the adjustment of age. A statistically significant negative interaction was reported between obesity status and PCOS status in the determination of serum adiponectin and resistin concentrations (effect size = −0.14, interaction P= 0.001, effect size = −0.15, P= 0.016). It indicated that adiponectin and resistin were significantly decreased in overweight/obese patients with PCOS compared with other subgroups. Statistically significant positive interactive effects were found between PCOS status obesity status and leptin (effect size = 0.321, interaction P= 0.036), indicating that the overweight/obese women with PCOS had the higher levels of leptin compared with the control group. Also, no interaction was reported between PCOS status and obesity status with regard to the serum levels of other adipokines. While no sufficient evidence is available with regard to the causal association between adipokines and PCOS, they may contribute to the development of PCOS and regarded as the novel biomarkers of PCOS.

There is still debate on whether the relationship between blood pressure (BP) and risk of cardiovascular diseases (CVD) in patients with type 2 diabetes (T2D) is linear or not. Since these cardio-metabolic disturbances share interrelated complex pathogenic mechanisms, we aimed to assess the relationship of baseline systolic (SBP)/diastolic pressures with CVD and coronary heart disease (CHD) events in a cohort of Iranians with T2D during a median follow-up of 8.8 years. Of all 1009 eligible participants with T2D with a mean (s.d.) age of 54.4 (11.6) years and free of CVD at baseline, we primarily focused on 260 participants undergoing anti-hypertensive treatment. Multivariate Cox proportional hazard models were used to evaluate hazard ratios (HR) of BP categories for CVD and CHD events. Also, multivariable regression modelling was applied to obtain their risk curve. We detected a J-shaped phenomenon between the continuous baseline BP and risk of CVD events. Considering 130⩽SBP<140 mm Hg as reference, a SBP ⩾140 mm Hg was associated with increased CVD (HR [95% confidence interval (CI)]: 2.43 [1.23–4.82]) and CHD (HR [95% CI]: 2.05 [1.02–4.13]) risk. However, a SBP⩽120 mm Hg in those with drug-treated hypertension also showed higher risk for CVD (HR [95% CI]: 2.80 [1.24–6.34]) and CHD events (HR [95% CI]: 2.39 [1.03–5.57]). Our findings revealed that the risk for macrovascular morbidity events was inversely associated with BP reduction below the level of 120/80 mm Hg for those with diabetes. People with diabetes might benefit from a BP management to a moderate range of 120/80–140/90 mm Hg for CVD risk reduction.

To evaluate the relationship between inflammatory and pro inflammatory markers, with obesity and visceral adiposity in male subjects with or without metabolic syndrome (MS). A total of 37 patients with MS and 37 age matched controls were included (mean age 46.35 ± 1.6 years). MS was defined by the criteria of the international diabetes federation 2005. Anthropometric and biochemical profiles, including high-sensitivity C-reactive protein (Hs-CRP), visfatin and interleukin 6 (IL-6), were measured. Data were compared between groups by using ttest. Pearson’s correlation was used to evaluate the relationship between variables. Pvalues less than 0.05 were considered as statistically significant. In patients with MS, CRP and IL-6 were significantly correlated with body mass index, waist circumference and waist to hip ratio. Visfatin levels were significantly lower in patients with MS compared to controls (log visfatin: 1.74 ± 0.27 vs. 1.86 ± 0.13 ng/ml, MS vs. control group respectively). We cannot find any significant correlation between visfatin, CRP and IL-6. Also there were no correlation between visfatin levels and any anthropometric parameters in patients with MS or control groups. Serum visfatin was lower in patients with MS. Therefore it seems that visfatin could not be considered as a pro inflammatory adipocytokine in MS. The positive associations of obesity and visceral adiposity with elevated CRP and IL-6 levels suggest the importance of reducing visceral adiposity to prevent the risk of coronary disease.

Wrist circumference is an easy to measure anthropometric index of body frame and bone size. The aim of this study was to examine the association of wrist circumference with incidence of cardiovascular disease (CVD) among adult men. For this study 2531 male participants aged ≥30 years, without any history of CVD were selected and followed from 1999 to 2011. Cox proportional hazard models and logistic regression were used to examine the relation of wrist circumference with incident CVD. A total of 339 cases of CVD were reported throughout a median follow-up of 9.4 years. In the multi-variable Cox model, 1 unit increase of wrist circumference was inversely associated with incident CVD with a HR (95 % CI) of 0.84 (0.72–0.98, Pvalue = 0.02). The receiver operating characteristics curve in a logistic regression model for wrist circumference in prediction of CVD showed a cutoff of 17.75 cm, beyond which was associated with a lower risk for CVD. In a population with a high prevalence of CVD risk factors, it was shown that a higher wrist circumference was associated with lower risk for incident CVD. Further studies are needed to explore the underlying mechanisms of this inverse relation.

I. R. Iran has been considered iodine replete since 2000, but iodine nutrition of vulnerable subjects is not clear. The main goal of this study was assessment of iodine nutrition and thyroid function in pregnant Iranian women. A total of 1072 pregnant women from ten provinces in the different parts of the country were recruited from November to March 2014. Median urinary iodine concentration (UIC) as the measure of iodine status and serum free T4 (FT4), thyrotropin (TSH), thyroglobulin (Tg), anti-thyroglobulin and anti-thyroid peroxidase antibodies (TgAb and TPOAb) were measured. Mean ± SD age of the cohort was 27.0 ± 7.2 years and gestational age was 20.7 ± 10.0 weeks. The median UIC for pregnant women was 87.3 μg/L, being 92.1, 86.0 and 76.8 μg/L, in three trimesters of pregnancy, respectively. Median UIC of <100, 100–149, 150–249, 250–499 and ≥500 μg/L was found in 58.4, 19.8, 16.2, 5.13 and 0.46 % of subjects, respectively. Median (IQR) values in the first, second, and third trimesters were 1.7 (0.9–2.8), 2.1 (1.5–2.9), and 2.1 (1.4–2.8) mIU/L for TSH, and 16.4 (12.21–21.13), 14.34 (12.16–19.69), and 14/07 (12.02–18.64) pmol/L for FT4, respectively. The frequency of elevated serum TSH was 9.0 % (6.6 % subclinical, 2.4 % overt hypothyroidism). The frequency of low serum TSH was 0.6 %. The frequency of positive TPOAb was 7.6 %. Results of this study have clarified that despite iodine sufficiency of school children in Iran, pregnant women have moderate iodine deficiency and need iodine supplementation.

One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes.

There is much controversy regarding the use of oral contraceptive pills (OCPs) on cardiometabolic parameters, which is why this longitudinal population-based study was conducted to assess the impact of OCP use and its duration on cardiometabolic factors. Of 5532 reproductive-aged participants of the Tehran lipid and glucose study, 3160 women who met our inclusion criteria were subdivided according to the duration of OCPs consumption into four sub-groups: (1) Non-users; (2) <11 month users; (3) 12–35 month users, and (4) ≥36 month users, and their cardiometabolic parameters were compared. No statistical significant differences were observed between the cardiometabolic parameters of these sub-groups, after further adjustment for confounding factors including age, parity, and education, except for mean low-density lipoprotein-cholesterol which was significantly higher in women who used OCPs for >36 months in comparison to non-OCP users. The odds ratio of hypercholesterolemia was significantly higher in women who used OCPs for >36 months in comparison to non-OCP users; being 1.5 times higher than non-users (95 % CI 1.01–2.2). Results showed that if used for less than 3 years, OCPs have no cardiometabolic effects.

Background/Objectives:: We aimed to investigate the associations of colors of fruit and vegetable (FV) subgroups, with 3-year changes of cardiometabolic risk factors. Subjects/Methods:: This longitudinal study was conducted in the framework of Tehran Lipid and Glucose Study, between 2006–2008 and 2009–2011, on 1272 adults. Total intake of FV and their subgroups have been assessed by a validated semi-quantitative food frequency questionnaire at baseline (2006–2008) and again at the second examination (2009–2011). Demographics, anthropometrics and biochemical measures were evaluated at baseline and 3 years later. The associations of anthropometric and lipid profile changes with FV subgroups were estimated. Results:: The mean age of men and women at baseline was 39.8±12.7 and 37.3±12.1 years, respectively. Mean total intake of FV, red/purple, yellow, green, orange and white FV was 706±337, 185±95, 141±91, 152±77, 141±87 and 22±18 g/day, respectively. In men, 3-year changes of weight (β=−0.13, P=0.01) and waist circumference (β=−0.14, P=0.01) were related to intake of red/purple FV; the yellow group was inversely associated with 3-year changes of total cholesterol (β=−0.09, P=0.03) and High-density lipoprotein cholesterol (β=−0.11, P=0.03). Consumption of green and white FV was inversely related to abdominal fat gain, and atherogenic lipid parameters in men (P&lt;0.05). In women, higher intake of red/purple FV was associated to lower weight and abdominal fat gain, fasting serum glucose and total cholesterol (P&lt;0.05); yellow FV was also related to 3-year weight gain (β=−0.11, P=0.01). Conclusions:: Various colors of FV subgroups had different effects on cardiometabolic risk factors; higher intake of red/purple FV may be related to lower weight and abdominal fat gain, and yellow, green and white FV may be related to lipid parameters.

The objective of this study was to investigate whether a diet rich in legumes are associated with oxidative stress among type 2 diabetic patients. In a randomized, controlled, crossover clinical trial, 31 type 2 diabetic patients were randomly assigned to receive 2 diets, each for a period of 8 weeks: (1) The legume-free therapeutic lifestyle change (TLC) diet and (2) the legume-based TLC diet. Both diets were similar except that 2 servings of red meat were replaced by different types of legumes 3 days per week in the legume-based TLC diet. Oxidative stress biomarkers were measured at baseline and after 8 weeks. Compared to the legume-free TLC diet, the legume-based TLC diet significantly decreased malondialdehyde (−0.22 versus −0.68 μmol/l; P=0.002), oxidized-LDL (−0.9 versus −2.3 mU/l; P=0.05) and increased nitric oxide (0.40 versus 0.96 mM/l; P=0.03) and catalase activity (1.2 versus 2.1 Iu/ml; P=0.05).

Hirsutism is the most common indicator of hyperandrogenism. Both, the sensitivity of the patients to the serum androgen levels and the responsiveness of women to the perceived excess hair growth vary among different populations. This report elaborates the relationship between the woman’s discerned abnormal hair growths with the clinical diagnosis of hirsutism. The survey was conducted among 1160 women aged 18–45 and randomly selected from Tehran Lipid and Glucose Study for further detailed assessment of Hirsutism; using the m-FG scoring method. Data gathering was performed by interviews and physical examinations. The receiver operating characteristic curve was drawn and the new cutoff value, sensitivity, specificity and concordance percentage were calculated. The results demonstrated that among 12 androgen-dependent body areas, the chin skin had the highest area under curve of 0.81 (CI; 0.78–0.84). According to the patient’s evaluation, a threshold point of 4 had the optimum concordance percentage of 0.77 with the modified Ferriman–Gallwey scoring system. Patient’s self-identification of excess terminal hair based on the chin area has great sensitivity and reliability in predicting the clinical hirsutism.

Menopausal status exposes women to increased risk of cardiovascular disease. This study was performed to compare the effect of menopausal types, including surgical and natural, on metabolic syndrome and other metabolic disorders 3 years before and after menopause. Of 437 postmenopausal women, who participated in the Tehran Lipid and Glucose Study, 13 women with surgical menopause and 39 age-matched controls with natural menopause were selected. During the follow-up period, changes in metabolic and biochemical profiles were compared between surgical and natural menopause women. Odds of incidence of metabolic syndrome in surgical menopause women, compared to natural menopause women, was 9.7 (95 % CI 1.8–51.8). Metabolic disturbances after menopause are highly influenced by type of menopause and are more prevalent in those undergoing surgical menopause.

In our previous study, we introduced a rat model of polycystic ovary syndrome (PCOS) induced by prenatal exposure to a single dose of testosterone on embryonic day 20. In the current study, we aimed to investigate whether prenatal exposure to a single dose of testosterone could also induce metabolic disturbances, especially insulin resistance in adulthood (100–110 days of age) and also to make it as an appropriate rat model of PCOS (exhibiting both reproductive and metabolic disturbances with minimum morphological disorders in reproductive system) for further studies in PCOS. Pregnant rats in the experimental group were subcutaneously injected with 5 mg free testosterone on the gestational day 20, while controls received only the solvent. Female offspring of both groups, prenatally androgenized (PNA) rats (PCOS models of rats) and controls were examined. Body weight measures showed significant increase in the PNA rats compared to controls on days 30, 45, 60 of age and in adulthood (P< 0.05). PNA rats showed insulin resistance compared to controls. Impaired glucose tolerance was not observed in the PNA rats compared to controls. There were no significant differences in lipid profile between the PNA and control rats (P> 0.05). Our study suggests that metabolic disturbances in PCOS and their severity during adult life probably depend on the particular time and levels of prenatal androgen exposure.

To evaluate the association of idiopathic hirsutism, insulin resistance and metabolic disorders. Participants of this study included 137 women with idiopathic hirsutism and 698 women as controls selected from two large population-based cross-sectional studies including 1,772 reproductive-aged women. Anthropometric and biochemical characteristics of the participants were measured and compared; for instance, insulin resistance was estimated through the homeostatic model assessment and the metabolic syndrome was detected using the Joint Interim Statement. Mean age, body mass index and other anthropometric measures including waist and hip circumferences were statistically higher in women with idiopathic hirsutism. No differences were observed in blood pressure, glucose and lipid profiles, homeostatic model assessment or the prevalence of insulin resistance, obesity and metabolic syndrome in women with idiopathic hirsutism and controls after adjustment of age and body mass index. In the subgroup of women with metabolic syndrome, fasting glucose levels of those with idiopathic hirsutism were significantly higher than controls, after adjustment of age and body mass index as 114 ± 25.85 vs. 103.52 ± 41.90 mg/dL, P= 0.003. Furthermore, the age and body mass index-adjusted prevalence of impaired fasting glucose in women with idiopathic hirsutism were higher than controls as 16.8 vs. 4.6 %, OR = 2.26, 95 % CI 1.59–5.38. A threshold of 74.5 cm for waist circumference had the optimal combined sensitivity and specificity for prediction of insulin resistance in women with idiopathic hirsutism, though this value was 90.5 cm for controls. Our data suggest that although the overall metabolic characteristics were similar in women with idiopathic hirsutism and controls, glycemic disturbances were more often seen in those suffered from metabolic syndrome and idiopathic hirsutism simultaneously.

Background:Current reference values for thyroid function tests are based on data from different ethnicities and geographical areas. The aim of the present study was to determine reference intervals for thyrotropin (TSH) and free T4(FT4), based on the criteria of the National Academy of Clinical Biochemistry (NACB) in an Iranian population. Material and methods:This study was conducted within the framework of Tehran Thyroid Study (TTS), an ongoing prospective cohort of 5704 randomly selected individuals, age ≥20 yr. A total of 2199 individuals (43.3% male, 56.7% female), based on NACB criteria were included in this study. Reference limit analysis was performed for the negative thyroid peroxidase antibody (TPOAb) group. Results:After applying all exclusion criteria except TPOAb positivity (10.5%), data of 2459 participants remained for analysis. Of these, 953 (43.3%) were males and 1246 (56.7%) were females; the mean±SD age was 43.53±14.16 yr. The mean±SD and median+IQR for TSH were 1.77 mU/l ±1.24 and 1.46 (0.93–2.23) mU/l, respectively. The 2.5thand 97.5thpercentiles TSH were 0.32 mU/l and 5.06 mU/l respectively. The mean±SD and median (IQR) for FT4for all negative TPOAb subjects were 1.19±0.16 and 1.18 (1.08–1.31) ng/dl respectively. Conclusion:Reference ranges for thyroid function tests need to be derived from national databases. This study determined age and sex specific TSH and FT4reference ranges in a Tehranian population, which could eventually enable clinicians to classify patients more appropriately.

AbstractThis study aimed the removal of heavy metals by Algerian bentonite. An Algerian natural clay, a bentonite of Mostaganem (N.W. Algeria), has been first acid-activated (HCl) and characterized by powder X-ray diffraction, FT-IR spectroscopy, electron microscopy (SEM), and specific surface area. The acid-activated clay (AAC) was employed as adsorbent for the removal of Zn2+, Pb2+, Cu2+, and Ni2+ions from aqueous solutions using adsorption method. The sorption process was examined in terms of its equilibrium and kinetics. The study was carried out by varying shaking time, pH, concentration of metal ions and amount of adsorbent. The optimum parameters of our study obtained were pH values range (4–6), mass of AAC (1 g), shaking time (1 h), and initial concentration of metal ions (10 mg L−1). The results have shown that Algerian bentonite clay had significant potential for removing Zn2+, Pb2+, Cu2+, and Ni2+ions from polluted water.

Background:Despite the high prevalence of thyroid dysfunction, the epidemiology and natural course of these disorders have not been identified yet. Aim:The present survey was conducted to determine the incidence of thyroid dysfunction and natural course of subclinical thyroid disorders in an urban community of Tehran, I.R. Iran. Subjects and methods:Serum TSH and thyroperoxidase antibody (TPOAb) were measured at baseline and after 6.7 yr from a sample of 1999 randomly selected subjects aged ≥20 yr, participants of the Tehran Lipid and Glucose Study (TLGS). Median TSH value and 2.5, 5, 95, and 97.5 TSH percentiles were determined at baseline using data obtained from 808 negative TPOAb subjects with no history of any thyroid disease or surgery, goiter, nodule, taking thyroid hormone preparations or anti-thyroid drugs. In those with abnormal TSH level, total T4and T3uptake were measured and free T4index was calculated. Results:Normal TSH reference range was 0.4–5.8 µU/ml according to the 2.5 and 97.5 TSH percentiles. The incidence rates of thyroid function abnormalities in 1000 subjects per year were as follows: clinical hypothyroidism: 0.28 in women and 0.21 in men; subclinical hypothyroidism: 11.59 in women and 4.69 in men; clinical hyperthyroidism: 1.4 in women and 0.21 in men; and subclinical hyperthyroidism: 5.72 in women and 3.62 in men. A significant increase was found in the frequency of positive TPOAb in women from 15.9 to 17.7% (p=0.006). Of 8 women with subclinical hypothyroidism at baseline, 5 remained unchanged, 1 became normal, and 1 developed clinical hypothyroidism at follow-up. Two women with subclinical hyperthyroidism normalized at follow-up. Of 2 men with subclinical hypothyroidism at baseline, 1 remained unchanged, whereas the other progressed to clinical hypothyroidism. Conclusion:After a 6.7 yr follow-up significant increase in the incidence of subclinical thyroid disorders was observed in both men and women, as compared to overt thyroid dysfunction. Increase in the prevalence of TPOAb positivity was observed only in women.

Aim:To quantify the burden of cardiovascular diseases (CVD), and all-cause mortality attributable to diabetes. Subjects and methods:Data on an 8.6-yr follow-up of 6331 participants (2741 men), free of CVD at baseline, were analyzed to determine the burden of CVD and all-cause mortality attributable to self-reported and screen-detected diabetes mellitus (SRDM and SDDM, respectively). Risks of events of interest were separately assessed for women and men using Cox-proportional-hazard model. Results:The mean age at baseline was 47 yr with 997 (15.7%) of participants having diabetes (men 14.8%, women 16.5%). SRDM and SDDM prevailed in 9.7% (men 9.2, women 10.2%) and 6.0% of participants (men 5.7, women 6.3%), respectively. During follow up (52,404 person-yr), we observed 447 incident cases of CVD [387 had coronary heart disease (CHD)] and 209 deaths. Among men, participants with SDDM had increased relative hazard for all-cause mortality translated to a population attributable risk fraction (PAF) of 10.1%. Among women, SDDM was associated with CVD and CHD but not with all-cause mortality; so that 9.3% and 8.8% of CVD and CHD events were respectively attributable to the SDDM. If SRDM had been eliminated from the population, the incidences of CVD, CHD, and death would have decreased by 10.5, 9.5, and 17.3% in men; and 22.0, 24.2, and 17.8% in women, respectively. Conclusion:SDDM and SRDM have high PAF for all-cause mortality and CVD. Besides diabetes treatment and prevention, screening to detect undiagnosed diabetes should warrant high priority among the public health strategies to lower the incidence of CVD and mortality.

Background: Iran has long been recognized as a country of iodine sufficiency; however, recent studies show that the proportion of subjects with insufficient urinary iodine is gradually increasing in Tehran capital city. Aim: The aim of this study was to evaluate differences between individuals with sufficient and deficient urinary iodine in Tehran. Material and methods: In this cross-sectional study, 639 Tehranian adult subjects, aged ≥19 yr (242 males, 397 females), were enroled through randomized cluster sampling. A 24-h urine sample was collected for measurement of urinary iodine, sodium and creatinine concentrations using the digestion method, flame photometry and autoanalizer assay, respectively. Salt intake was estimated and iodine content of household salt was measured by titration. Results: Medians (interquartile range) of 24-h urinary iodine concentrations in subjects with sufficient and deficient urinary iodine were 163.0 (126.0–235.0) and 44.0 (26.0–67.0) µg/l, p<0.001, respectively. Salt with iodine content of >20 parts per million was consumed by 77.4 and 38.3% of subjects with sufficient and deficient urinary iodine, respectively (p<0.001). Median daily salt intake in subjects with sufficient urinary iodine was significantly higher than in those with deficient urinary iodine (8.1 vs7.3 g, p<0.001). No significant differences in the mentioned variables were observed between males and females. Fifty and 30% of subjects with insufficient and sufficient urinary iodine had <7 yr education, respectively (p<0.001). Conclusions: Iodine content of salt, the amount of salt intake and education levels differ greatly between subjects with sufficient and deficient urinary iodine in Tehran.

Background: Iodine deficiency constitutes a public health problem in many countries worldwide. Fetal neurodevelopment is affected by maternal iodine intake. The aim of present study was to assess urinary iodine excretion (UIE) in the 3 trimesters of pregnancy and evaluate its association with newborn thyroid function in Tehran, an area of iodine sufficiency. Methods: Based on median urinary iodine in 3 trimesters, 138 pregnant women were divided into 2 groups with UIE<150 (group I) and UIE>150 µg/l (group II). Cord blood samples of their newborns were evaluated for serum concentrations of TSH, T3, T4, free T4(FT4), and thyroglobolin. Quartiles of UIE were also determined. Correlations between mothers’ UIE and newborns’ thyroid function in both groups were investigated. Results: Fifty-two pregnant women (38%) had median UIE<150 µg/l and 86 had (62%) UIE>150 µg/l. Median UIE in groups I and II in the 1st, 2nd, and 3rdtrimesters were 125 and 212 µg/l, 97 and 213 µg/l, 93 and 227 µg/l, respectively. No significant difference was seen in thyroid function of newborns in the 2 groups. Mean concentrations of T4, T3, FT4, and TSH of newborn did not show significant difference in median UIE of mothers in various quartiles. Conclusion: This study shows that newborns, irrespective of mothers’ UIE, in an area with a sustained iodine supplementation program, may not be at risk of alterations in thyroid functions.

Background: Despite the high prevalence of diabetes, limited information is available about the impact of impaired glucose regulation on the cardiovascular disease (CVD) risk among Middle East populations. Aims: To determine the risk of CVD in an urban Iranian population according to glucose tolerance status. Material and methods: The study population consisted of 1752 men and 2273 women, aged ≥40 yr, free of CVD at baseline. Incident CVD was ascertained over a median of 7.6 yr of follow-up. Results: A total of 340 CVD events occurred (197 in men and 143 in women). At baseline, there was no difference between newly diagnosed and known diabetes regarding the Prospective Cardiovascular Münster (PROCAM) risk score and prevalence of metabolic syndrome in both genders. Applying the 1997 American Diabetes Association (ADA) criteria, compared with those with normal glucose tolerance, after controlling traditional risk factors, hazard ratios (HR) and 95% confidence intervals (95% CI) for CVD in women with known and newly diagnosed diabetes were 3.30 (2.09–5.21) and 1.93 (1.16–3.21) and the corresponding values for men were 1.90 (1.11–3.25) and 1.69 (1.12–2.54), respectively. Impaired fasting glucose or impaired glucose tolerance was associated with 56% increased risk of CVD in women (HR 1.56, 95% CI 1.00 to 2.45), in the age-adjusted analysis, considering the 2003 ADA criteria. Conclusions: All diabetic subjects, whether newly diagnosed or known cases, should receive intensive primary prevention for CVD regardless of risk factors, in particular females with abnormal glucose regulation.

Purple kernel streaking (PKS) in white food corn (Zea maysL.) is characterized by the accumulation of purple‐pigmented streaks (anthocyanins) in an otherwise colorless pericarp. This paper is the first published report documenting PKS, the prevalence of the trait in commercial white food corn germplasm, and the genetics underlying it. Entries from the Early White Food Corn Performance Trials were grown in Ontario over a three‐year period and rated for incidence of PKS and days to flower. All commercial hybrids entered were genetically predisposed to PKS with severity varying across years and entries, and not consistently related to hybrid maturity. Quantitative trait locus (QTL) mapping was used to identify the genomic regions influencing PKS expression in an F2:3population derived from the cross of two white food corn inbred lines, SD79 and SD80. PKS exhibited significant genotype × year interaction. QTLs were identified for each year explaining 64 and 46% of the phenotypic variation, with only one single‐effect and one two‐way interaction common across the two years. Linkage of the main single‐effect QTL with the y1gene, coupled with the G×E effects, may explain the prevalence of PKS in commercial white food corn hybrids.

Background: Changes in concentration of thyroid hormones can affect Na+-K+-ATPase number and activity and phospholipid composition of the cell membranes leading to changes in the surface to volume ratio and strength of membrane. Aim: In this study, the osmotic fragility of the red blood cells from non-treated hypo- and hyperthyroid patients was compared to that of control subjects. Material/subjects and methods: After 3 washings with normal saline, red blood cells were placed in varying concentrations of sodium chloride (NaCl) (0–0.9%) and fragility was assessed with colorimetric method; to do this, after the incubation period, tubes were centrifuged and the optical density of the tubes was measured. Hemolysis percentage in tubes was calculated based on 100% hemolysis in the tubes containing no NaCl (0%). Results: Osmotic fragility of the cells from hyperthyroid patients in 0.45% NaCl was significantly lower than control subjects (74.6%±30.2 vs 93.8%±9.1, p<0.01 ). The osmotic fragility of red blood cells in 0.5% concentration of sodium chloride in hyperthyroid patients was significantly lower compared to that of controls (27.8%±26.0 vs 63.5%±27.5, p<0.001). No significant difference was observed between the osmotic fragility of the hypothyroid patients compared with control subjects. Conclusions: Alteration in osmotic fragility is seen in patients with hyperthyroidism; however, anemia reported in hypo- or hyperthyroid patients is not due to high osmotic fragility of red blood cells and other causes need to be investigated.

Objective: Two yr after legislation of salt iodization of 40 parts per million (ppm) in 1994, goiter was still endemic and urinary iodine concentration (UIC) remained elevated in many provinces of Iran. Goiter prevalence and UIC were compared 2 and 7 yr after sustained consumption of uniformly iodized salt by Iranian households. Methods: Schoolchildren (7–10 yr) of all provinces were randomly selected by cluster sampling from December 2000 to June 2001. Goiter rate, UIC, and household salt iodine values were compared to those in 1996. Factory salt iodine was also compared in 2001 vs1996. Ultrasonographically determined thyroid volumes of 7–10 yr old children were compared in 2001 vs1999. Results: In 2001 (no.=33600) vs1996 (no.=36178), total, grade 1, and grade 2 goiter rates were 13.9 vs53.8%, 11.0 vs44.8%, and 2.9 vs9.0%, respectively (p<0.0001). Weighted total goiter rate was 9.8% in 2001. Median (range) UIC in 2001 (no.=3329) was 165 (18–499) μg/l and in 1996 (no.=2917) was 205 (10–2300) μg/l (p<0.0001). In 2001 vs1996, mean±SD for iodine salt content was 32.7±10.1 vs33.0±10.2 ppm (p=0.68) in households and was 33.2±13.4 and 33.8±13.2 ppm (p=0.57) in factories, respectively. Among 7–10 yr old children in 2001 (no.=400) vs1999 (no.=396), only 7-yr-old children in 2001 (the only group with probably no history of iodine deficiency) showed significant smaller thyroid volumes by ultrasonography compared to those in 1999. Conclusions: After 7 yr of optimized iodized-salt supplementation in Iran, adequate UIC values and marked reduction in goiter rate have been achieved.

Objective: To assess transient congenital hypothyroidism (TCH) etiologies in two Iranian cities. Materials and methods: Cord dried blood spot samples were collected from neonates in Tehran and Damavand. Serum TSH and T4were measured in those with cord TSH ≥20 mlU/l. Normal serum values at 2–3 weeks of age confirmed transient hyperthyrotropinemia (THT), while persistently abnormal levels revealed congenital hypothyroidism (CH). Normal serum TSH and T44–6 weeks after levothyroxine replacement therapy discontinuation at 2–3 yr of age differentiatedTCH from persistent CH. Results: Among 50,409 screened newborns, 9 (1:5601 births) were diagnosed as TCH and compared to 88 full-term neonates (≥37 weeks’ gestation) with THT and 45 normal (cord TSH<20 mIU/l) neonates. At a median age of 11 days, median (range) serum TSH values in TCH, THT, and normal neonates were 36.8 (13–130), 3.6 (0.1–13.3), and 2.9 (0.7–8.0) mIU/l (p<0.0001) and serum T4values were 97 (36–168), 142 (74–232), and 160 (79–228 nmol/l), respectively (p=0.002). Urinary iodine concentration (UIC) >220 μg/l was observed in 5 (55.6%) of TCH neonates. The occurrence of TCH was not associated with gender, parental consanguinity, mode of delivery, pre- or post-natal consumption of goitrogens and/or thyroid affecting medications, TSH receptor autoantibodies, or neonatal UIC. Conclusions: Elevated UIC was the most frequent finding in newborns with TCH but the distribution of excessive UIC was not significantly different among TCH, THT, and normal neonates. Since no other etiologies were found in TCH neonates without elevated UIC values, evaluation of other environmental and/or genetic factors is warranted.

Goiter rate, serum TSH, antithyroperoxidase (TPOAb), antithyroglobulin (TgAb) antibodies, and urinary iodine concentration (UIC) were evaluated 10–11 yr prior (1983–1984) and 5–6 yr after (1999–2000) national salt iodization in Iran. Pre- and post-iodization groups consisted of 465 and 1426 adults aged ⁥20 yr, respectively, selected by random cluster sampling in Tehran province. Total, grade 1 and grade 2 goiter rates were 65.2, 53.1, and 12.1 % in 1983–1984 vs25.2, 15.5, and 9.7% in 1999–2000 (p<0.0001). Median serum TSH was 1.5 mIU/l in 1983–1984 vs0.8 mIU/l in 1999–2000 (p<0.0001). Median TSH also decreased in 20–29, 30–39, 40–49, 50–59, and ⁥60yr-adults in 1983–1984 vs1999–2000 (p<0.0001). In 1983–1984, positive TPOAb and positive TgAb were detected in 3.2 and 4%, respectively, using agglutination test. Corresponding values were 12.5 and 16.8% using immunoenzymometric assay in 1999–2000. Overt and subclinical hypothyroidism was present in 0 and 32.8/1000 in 1983–1984 vs3.5 and 21.7/1000 in 1999–2000, respectively. Overt and subclinical hyperthyroidism was detected in 4.4 and 4.4/1000 in 1983–1984 vs0.7 and 5.6/1000 in 1999–2000, respectively. Subclinical hypothyroidism in males was significantly more frequent in 1983–1984 vs1999–2000 (odds ratio 5.02, 95% confidence interval 1.72–14.68; p=0.004). Salt iodization resulted in adequate UIC, decrease in serum TSH and subclinical hypothyroidism in males, and an increase in thyroid autoantibodies without significant change in thyroid abnormalities. Benefits of iodine supplementation far outweigh its hazards in Tehranian adults.

AbstractIn this study the association between β3-adrenoceptor gene polymorphism and serum concentration of leptin with body mass index (BMI) is investigated. Using subjects in the Tehran Lipid and Glucose Study, genotyping of the Trp64Arg polymorphism of the β3-adrenoreceptor gene was performed using a restriction fragment length polymorphism–polymerase chain reaction (RFLP-PCR) technique was used and the association with obesity was investigated. At total of 197 men and 204 women were divided into four groups (BMI<20, 20≤BMI<25, 25≤BMI<30, BMI≤30) and 97, 98, 104 and 102 subjects, respectively, were placed randomly in the four groups. Leptin level was determined by an enzyme immunoassay (EIA) method and FBS, HDL-C, triglyceride and total cholesterol levels were determined by an enzyme colorimetric method. Body mass index (BMI) was also measured. The A (Arg) allele frequency was 0.08 among the population and its presence was significantly associated with increase of leptin level (AA/TA, 30.5±24.8 ng/mL; TT, 22.6±20.9 ng/mL; P=0.014) but there was no significant association with increased BMI (AA/TA, 27±5.6 kg/m2; TT, 25.4±5.5 kg/m2; P=0.072). These data show that the presence of the Arg64 allele at the β3-adenoceptor gene locus is related to increase in leptin level in this population, but is not related to body mass index.

Introduction and aims: Calcium and vitamin D play major roles in calcium homeostasis and skeletal development, especially during pregnancy. This study was conducted to determine changes in calcium, 25 hydroxy [25(OH)] vitamin D3 and other biochemical factors (PTH, osteocalcin, alkaline phosphatase, magnesium, phosphorus) related to calcium homeostasis and bone turnover during pregnancy and compare the values to those of non-pregnant women. Materials and Methods: In a cohort study, 48 pregnant women, in their first trimester of pregnancy (12±2.7 weeks), from 5 prenatal care centers, and 47 non-pregnant women randomly selected from the Tehran Lipid and Glucose Study (TLGS) population were enrolled. These pregnant women were followed in their second (26±1.9 weeks) and third trimesters (37±3.2 weeks) of pregnancy. Samples were drawn from June 2002 to March 2003. Including criteria were healthy women with no background of disease. Women using photo protection and calcium and vitamin D supplementation were excluded. A questionnaire was used to obtain demographic information for both groups. Venous blood samples were taken after 12–14 h of overnight fasting to measure serum calcium, phosphorus, magnesium, alkaline phosphatase, PTH, 25 (OH) vitamin D3 and serum osteocalcin levels. The repeated measures analysis of variance and t-test were used for statistical analysis. Data were matched for age and weight in both the case (in the first trimester) and control groups. Results: Significant differences were found in the mean serum levels of osteocalcin and alkaline phosphatase between the three trimesters of pregnancy (p<0.001). Osteocalcin was significantly higher in the first trimester as compared to second and third trimesters of pregnancy. Alkaline phosphatase was significantly lower in the first trimester as compared to the second and third trimesters of pregnancy and their controls. There was also a significant difference in osteocalcin in the second and third trimesters and alkaline phosphatase in the first and third trimesters of pregnancy in comparison to the control group. The mean values of osteocalcin were 12.7±8.5, 8.1 ±6.9,5.6±5.0 and 13.9±7.9 ng/ml, respectively, and mean values for alkaline phosphatase were 115±38, 125±37, 174±61 and 134±35.0 Iu/l, respectively. In the first trimester, alkaline phosphatase was lower and osteocalcin was higher than in the second and third trimesters. In the first trimester of pregnancy, 20 and 40% of women had 25(OH) vitamin D3 <10 and <20 ng/ml, respectively, and 19% of women had serum calcium levels <8.6 mg/dl. Conclusion: 60% of women in the first trimester, 48% in the second and 47% in the third trimester had either severe or moderate vitamin D deficiency. It is recommended that the importance of calcium supplements with vitamin D in pregnant women be stressed for these individuals.

Background: One decade after universal salt iodization in Iran, goiter prevalence, urinary iodine concentration (UIC) and thyroperoxidase antibody (TPOAb) values were assessed among schoolchildren in Gorgan, Iran. Methods: From 2003–2004, 500 girls and 900 boys aged 7–11 yr were evaluated for goiter by palpation. UIC was measured in 183 randomly-selected goitrous children. Serum TSH, T4, and TPOAb were measured in 53 goitrous and 30 non-goitrous children with adequate UIC. Results: Goiter was detected in 370 (26.4%) children. Goiter was present in 31 % of girls and 17% of boys age 9 (p<0.012); 37% of girls and 20% of boys age 10 (p<0.003); and 52% of girls and 19% of boys age 11 (p<0.0001). Median (range) UIC for all goitrous children sampled was 190 (20–600) μg/I; 220 (30–590) in boys and 170 (20–600) in girls (p=0.001). Eight point seven percent of goitrous children and 22% of goitrous girls aged 10–11 had UIC<100 μg/I, while 47% of the goitrous children had UIC≥200 μg/ I. TPOAb was present in 52.8% of goitrous children and 10% of non-goitrous children (p=0.0001 ). TPOAb was present in 53.9% of 10–11 and 22.7% of 7–9 yr old goitrous and non-goitrous children (p=0.003) with adequate UIC. Median (range) TSH was 2.9 (0.3–10.9) mIU/I in TPO-positive and 1.8 (0.5–4.1) in TPO-negative children (p=0.001). Conclusions: Gorgan, Iran, is an iodine-sufficient area and almost half of schoolchildren have more than adequate UIC. TPOAb is associated with endemic goiter. Despite sufficient UIC overall, some school-aged girls remain at risk of iodine deficiency.