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There is growing evidence for the involvement of sex hormones in the pathogenesis of keratoconus. This study aimed to evaluate serum androgen and prolactin levels in patients suffering from keratoconus. One hundred and two subjects were enrolled in the keratoconus (76 patients) and control (26 subjects) groups in a cross-sectional survey. Topographic evaluation of the cornea was undertaken for all enrolled participants. Serum testosterone, dehydroepiandrosterone sulphate (DHEAS), prolactin (PRL), luteinising hormone (LH), and follicle-stimulating hormone (FSH) were measured in all subjects. There was no significant difference in demographic characteristics between the study groups. Significantly higher mean serum levels of DHEAS (3.71 ± 2.23 vs. 2.53 ± 1.77 µg/mL; P = 0.009) and T (6.18 ± 3.80 vs. 1.57 ± 1.76 ng/mL; P < 0.001) were observed in men with keratoconus compared to controls. In females, there were also higher mean levels of DHEAS (2.40 ± 1.57 vs. 2.18 ± 0.72 µg/mL; P = 0.355) and T (0.78 ± 0.96 vs. 0.32 ± 0.13 ng/mL; P < 0.001) in patients with keratoconus but only T level reached the statistically significant level of difference. Also, the mean serum PRL level was significantly higher in women with keratoconus compared to control (13.33 ± 17.85 vs. 4.63 ± 3.10 ng/mL; P < 0.001). There was no significant difference between serum FSH and LH levels between study groups. In patients with keratoconus, serum PRL in females and serum androgen levels in both genders are elevated. [ABSTRACT FROM AUTHOR]

Background: The role of phosphate hemostasis in development of thalassemia bone disease has not been extensively studied yet. Due to the lack of sufficient human studies about the changes of serum Fibroblast growth factor-23(FGF23) in patients with beta-thalassemia major as the first step of investigating the role of FGF23 in thalassemia bone disease, the present study aimed to investigate the serum level of FGF23 in patients with thalassemia major. Material and Method: In this case-control study, 25 patients with beta thalassemia major and their age- and sex-matched healthy volunteers were enrolled. Serum phosphorous, calcium, parathyroid hormone (PTH), 25(OH) D, erythropoietin (EPO), serum intact FGF23 (iFGF23) and 1,25 (OH)2 D were checked and analyzed. Result: Patients with beta-thalassemia major had lower 1,25 (OH)2D, (p = 0.025), higher phosphate (p = 0.002), and higher PTH (P <0.001) compared to the control group; however, all of them were in their normal blood range. They also had higher serum FGF23 (p = 0.007) and higher EPO (P<0.001). Serum FGF23 had an independent association with serum Iron (p=0.016), 1, 25(OH)2 Vitamin D (p<0.001), and hemoglobin (p=0.002). Conclusion: Serum FGF23 was associated with serum Iron, 1, 25(OH)2 Vitamin D, and hemoglobin in betathalassemia major patients. Hence, it seems that regular transfusions and chelating agents which can decrease the serum iron and increase hemoglobin level can be associated with lower iFGF23. [ABSTRACT FROM AUTHOR]

Background: Paricalcitol has been proposed for the treatment of secondary hyperparathyroidism in patients with renal failure and vitamin D deficiency (VDD); however, VDD is related to a range of clinical complaints. We aimed to investigate the effects of paricalcitol on body composition in VDD rats. Methods: Thirty adult male rats aged 10 weeks were randomly divided into three groups of 10, comprising control, VDD, and VDD plus paricalcitol32) ng/rat intraperitoneal injection) (VDD+P), at the Animal Lab of the Endocrinology and Metabolism Research Center, Shiraz, Iran, in 2020. Body composition was assessed after three weeks via serum biochemical tests and dual-energy X-ray absorptiometry. Finally, the data were analyzed by using the paired-sample t test, the one-way ANOVA, and the Tukey post hoc test. Results: Global lean mass and fat mass were lower in the VDD and VDD+P groups than in the controls (P<0.001). Global fat percentage was reduced significantly in the VDD+P group (P=0.029). Conclusion: Paricalcitol reduced global fat mass and fat percentage in a rat model with VDD. Evaluation of insulin and adiponectin levels is suggested to clarify the physiology of paricalcitol in VDD states. [ABSTRACT FROM AUTHOR]

To review non-surgical prevention strategies in women with hereditary breast and ovarian cancer syndromes. Women with a gBRCA1 or 2 mutations face a high cumulative breast and ovarian cancer risk. While bilateral mastectomy (PBM) and bilateral salpingo-oophrectomy (PBSO) profoundly reduce the respective cancer risks, they are also associated with considerable side effects. There is therefore an urgent need for alternative and non-surgical risk reduction options. Tamoxifen and aromatase inhibitors have both been evaluated in secondary prevention, but their benefit in primary prevention is currently unknown in BRCA mutation carriers. In addition, their use is compromised by their side effect profile which makes them less appealing for a use in chemoprevention. Denosumab is a well-tolerated osteoprotective drug, which has been demonstrated to have a potential preventive effect particularly in BRCA1-deficient models in vitro. The prospectively randomized double-blind BRCA-P trial is currently investigating the preventative effect of denosumab in healthy BRCA1 germ line mutation carriers. [ABSTRACT FROM AUTHOR]

Background:Wnt signalling/LRP5is involved in adipogenesis by down-regulating adipogenic transcription factors. Therefore polymorphisms in components of this pathway may lead to metabolic disorders. Aim:This study tested the impact ofLRP5polymorphism on lipid profile in Iranian children. Methods:The study population was comprised of 9–18 year old children (125 boys, 137 girls). Total cholesterol (TC), High Density Lipoprotein (HDL), Low-Density Lipoprotein (LDL), Non-HDL cholesterol and Triglyceride (TG) levels were checked. Body composition was measured by the Hologic system DXA. PCR/restriction fragment length polymorphism (RFLP) was done forLRP5(rs556442) genotyping. Multiple association analyses for TG level and genotype frequencies were assessed using logistic regression analysis, with adjustment for age, sex, BMI and puberty. Results:The results revealed thatLRP5(rs556442) had a significant influence on TG levels in unadjusted analysis and when adjusted for interacting factors. Higher TG levels were observed in AA/AG genotype of rs566442 in comparison to GG genotype (OR = 2.028, 95% CI = 0.997–4.127,p =  0.049). Conclusion:It is concluded that allele A has an important impact on increasing TG level inLRP5in the studied population. [ABSTRACT FROM PUBLISHER]

Objectives: To evaluate prevalence of vitamin D deficiency and its associated factors in southern Iranian children.Design: Cross-sectional study. Anthropometric and pubertal characteristics were assessed by a trained physician. Physical activity and sun exposure were evaluated using standard questionnaires. Body composition measurements were performed using dual-energy X-ray absorptiometry. Serum Ca, P alkaline phosphatase and 25-hydroxyvitamin D (25(OH)D) were assessed in all children. Statistical analysis was done using the statistical software package IBM SPSS Statistics 18·0.Subjects: Iranian children (n 477) aged 9-18 years.Setting: Fars Province, Iran, 2011.Results: Of the children, 81·3 % were 25(OH)D deficient. There was no significant difference in 25(OH)D concentration between boys and girls (P=0·3). 25(OH)D concentration was associated with BMI (r=-0·1, P=0·02), pubertal status (r=-0·08, P=0·04) and sun exposure (r=0·10, P=0·04). Fat mass index was associated with 25(OH)D concentration (r=-0·13, P=0·03), but not lean mass index (P=0·86). In multiple regression analysis with adjustment for confounding factors, age and puberty were found to be independently associated with 25(OH)D concentration (P=0·008 and P=0·006); there was a significant correlation between exercise and 25(OH)D concentration after adjustment for either BMI (P=0·01) or fat mass index (P=0·02).Conclusions: 25(OH)D deficiency is highly prevalent among children in the south of Iran. It is related to insufficient sun exposure, low physical activity, advancing age and pubertal stage. Measures should be taken to improve the health of southern Iranian children in this critical age group by preventing 25(OH)D deficiency. [ABSTRACT FROM AUTHOR]

The genetic epidemiology of variation in bone mineral density (BMD) and osteoporosis is not well studied in Iranian populations and needs more research. We report a candidate gene association study of BMD variation in a healthy cross-sectional study of 501 males and females sampled from the Iranian Multi-Centre Osteoporosis Study, Shiraz, Iran. We selected to study the association with 21 single nucleotide polymorphisms (SNPs) located in the 7 candidate genes LRP5, RANK, RANKL, OPG, P2RX7, VDR, and ESR1. BMD was measured at the three sites L2-L4, neck of femur, and total hip. Association between BMD and each SNP was assessed using multiple linear regression assuming an allele dose (additive effect) on BMD (adjusted for age and sex). Statistically significant (at the unadjusted 5% level) associations were seen with seven SNPs in five of the candidate genes. Two SNPs showed statistically significant association with more than one BMD site. Significant association was seen between BMD at all the three sites with the VDR SNP rs731246 (L2-L4 p = 0.038; neck of femur p = 0.001; and total hip p < 0.001). The T allele was consistently associated with lower BMD than the C allele. Significant association was also seen for the P2RX7 SNP rs3751143, where the G allele was consistently associated with lower BMD than the T allele (L2-L4 p = 0.069; neck of femur p = 0.024; and total hip p = 0.045). [ABSTRACT FROM AUTHOR]

Aim of the study: Thyroid dysfunction and autoimmunity are common problems in women of child-bearing age. It could be associated with pregnancy morbidities in the mother and fetus. Due to lack of sufficient data about the prevalence of thyroid autoimmunity in pregnant women in Iran, and controversies about its complications on pregnancy outcomes, this study was conducted. Materials and methods: This is a prospective study on 600 singleton pregnant women in 15-28 weeks of pregnancy; they were residents of Fars province. We evaluated the prevalence of preeclampsia, intra-uterine growth retardation (IUGR), preterm delivery and low Apgar score and their association with TSH, thyroid peroxidase (TPO), and thyroglobulin (Tg) antibodies. Results: Prevalence of anti-TPO and anti-Tg positivity is 12.8% and 8.5% among Iranian pregnant women. Mothers with either positive TPO or Tg antibody have a higher risk of preeclampsia ( p = 0.019), preterm delivery ( p < 0.001), IUGR ( p < 0.001), and low first minute Apgar score ( p < 0.001). This association was independent of thyroid dysfunction for preterm delivery (RR = 5, p < 0.001), and low Apgar score neonates (RR = 8.8, p < 0.001), but this association for preeclampsia was due to thyroid dysfunction (RR = 3.7, p = 0.003). About IUGR in either TPO or Tg positive mothers, this association results from the additive effect of thyroid dysfunction and thyroid autoimmunity (RR = 8.3, p < 0.001). Cesarean section delivery was significantly higher in abnormal TSH/positive anti-Tg mothers ( p = 0.045). Conclusion: Thyroid autoimmunity independent of thyroid dysfunction could have significant adverse outcomes in the mother and fetus. Further investigation should be done to reveal the significance of screening and treating the thyroid autoimmunity during pregnancy. [ABSTRACT FROM AUTHOR]

BACKGROUND: The prevalence of childhood obesity has risen greatly worldwide. However, assessment of obesity among children and adolescents is further complicated by the changes occurring in the body composition during the growth. The aim of this study is to create gender-specific percentile curves for total body fat percentage (TBFP), total body fat mass (TBFM), fat mass index (FMI), and fat free mass index (FFMI) in healthy Iranian children and adolescents. METHODS: In this cross-sectional study, 472 healthy Iranian children and adolescents (234 girls and 238 boys) aged 9-18 years old participated. TBFP and TBFM were measured by Dual-Energy X-ray Absorptiometry (DEXA). Weight, height, and waist circumference (WC), pubertal stage and level of physical activity were also recorded. RESULTS: Mean TBFM, TBFP and FMI in girls were significantly more than boys (P < 0.001). The median TBFM in boys increased from 4.8 Kg to 7.5 Kg and in girls from 6.0 Kg to 15.6 Kg. The percentile curves of TBFP in boys were down sloping compared with that in girls (19% increase in girls and 21% decrease in boys from 9-18 years of age). We showed TBFP and FMI had a more complicated relationship with BMI depending on gender and level of BMI, but FFMI consistently increased with BMI in both genders. Also, we found that waist circumference -as a marker of metabolic syndrome-had the greatest correlation with FMI (P < 0.001) between DEXA measured parameters. CONCSLUSION: This study presents normative data for body composition in healthy Iranian children and adolescents and would be useful in adiposity assessment. Our study showed that Iranian children and adolescents had lower total body fat in all age groups and percentiles in comparison with those reported from western children. [ABSTRACT FROM AUTHOR]

Background And Objectives: Thyroid dysfunction is a common health problem affecting millions of patients worldwide. Autoimmune thyroid disorders are among the most common autoimmune disorders. In this population-based study, we assessed the prevalence of abnormal thyroid function, antithyroid antibodies and the probable relationship between them in Shiraz, southern Iran. Methods: Serum thyrotropin (TSH) was determined in 981 subjects (66.8% female and 33.2% male; mean age: 39.1 ± 14.3 years), who were selected with stratified random sampling. Because of the preponderance of females over males, we performed the statistical analyses using sex-weighted data (50% for each sex). Also, antithyroid peroxidase antibodies (TPOAb), and antithyroglobulin antibodies (TgAb) were measured in two random subgroups of 376 and 537 patients respectively). Thyromegaly detected on physical examination. Results: In this cross-sectional study, 8.1% of participants had elevated serum TSH level and 3.4% had low serum TSH level. A statistically significant relationship was found between gender and thyromegaly and TSH values. Positive TPOAb and positive TgAb were detected in 17% and 5.1% of participants respectively. In addition, a significant relationship was observed between elevated TSH levels and positive results for both antibodies. Detectable levels of thyroid antibodies correlated with female sex, while no correlation was observed between detectable levels of thyroid antibodies and thyromegaly. Conclusion: Thyroid disorders, especially elevated TSH level, are common. It seems that autoimmune mechanisms are strongly involved in the etiology of hypothyroidism in this area. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the prevalence, metabolic risk factors, and thyroid dysfunction among a healthy urban population. Methods: in a cross-sectional study, the patients were evaluated for nonalcoholic fatty liver disease (NAFLD) using ultrasonography. The participants' characteristics such as age, sex, weight, height, body mass index (BMI), waist circumference, hip circumference, waist-to-hip ratio, systolic and diastolic blood pressure, and history of diabetes, ischemic heart disease (IHD), hypertension, and hypelipidemia were recorded using a data gathering form. The patients were compared to those without NAFLD in terms of metabolic factors and thyroid abnormalities. Results: From 832 participants, 127 (15.3%) individuals had NAFLD. Metabolic syndrome was detected in 39 participants (30.70%) with NAFLD and in 85 participants (12.05%) without NAFLD (P<0.001) (OR: 3.22; 95% CI: 2.07-5.01). In multivariate logistic regression analysis BMI, waist-to-hip ratio, and higher serum ALT levels were independent predictors for NAFLD (P<0.001). There was no statistically significant difference in serum TSH, free T4, and free T3 levels between the participants with NAFLD and the participants without NAFLD (P>0.05). Neither hypothyroidism nor markers of thyroid autoimmunity were associated with NAFLD in our study population (P>0.05). Serum TSH was categorized according to the 25th, 50th, and 75th percentile to <1.29 mIU/L, 1.29-1.91 mIU/L, 1.91-2.77 mIU/L, and >2.77 mIU/L. Compared with non-NAFLD participants, the diagnosis of NAFLD was significantly higher in the low TSH group (P=0.004). Conclusion: Central obesity as reflected by waist-to-hip ratio is one of the major risk factors for NAFLD. However, thyroid dysfunction was not correlated with NAFLD and the observed alterations in thyroid hormones are due to sick euthyroid syndrome. [ABSTRACT FROM AUTHOR]

Background: Adiponectin plays important roles in the endocrine and cardiovascular systems, in fat and carbohydrate metabolism, and inflammation. In this study the relationship between adiponectin levels with the presence and severity of coronary artery disease (CAD) is evaluated. Methods: This was a cross-sectional study that enrolled 213 persons who referred for coronary angiography. One cardiologist reported the results of each coronary angiography by using two scoring systems [number of vessel disease (usual method) and Gensini scoring system]. Then, the relationship between adiponectin levels with the presence and severity of CAD as well as predictive factors for CAD were evaluated. Results: There was a significant negative association between mean serum adiponectin levels and presence of CAD (P = 0.04) after adjustment for all conventional risk factors for CAD. Also there was a significant negative correlation between serum adiponectin levels and severity of CAD based on the usual method for reporting coronary angiograms (P = 0.01). After adjustment for all conventional risk factors for CAD the serum adiponectin level tended to be inversely associated with the Gensini score (P= 0.09). Logistic regression analysis showed that a higher serum adiponectin level was negatively and independently associated with CAD (odds ratio: 0.94; 95% confidence interval: 0.88-1.00; P<0.05). The variables predictive of serum adiponectin levels were determined as follows: HDL-cholesterol (P = 0.001); age (P = 0.002); insulin resistance (P = 0.005) and triglycerides (P = 0.036). Conclusions: This cross-sectional study showed a significant negative association between serum adiponectin levels to the presence and severity of CAD. [ABSTRACT FROM AUTHOR]