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Background: Obesity is a global issue, with over 1.9 billion adults overweight. Disruption of circadian rhythms (CR) leads to obesity and metabolic disorders. Dietary nutrition significantly impacts sleep disorders and disruption in CR, influencing hormones and inflammation, which can contribute to insomnia. The dietary insulin index (DII) and dietary insulin load (DIL) are important factors in determining sleep quality. The current study aims to investigate the association between DII and DIL with CR and sleep quality among with overweight and obesity women. Methods: A case-control study involved 280 overweight/obese women aged 25–40 from Tehran University Medical Science. They were assessed for dietary intake, physical activity, and sleep using validated questionnaires. The study also assessed body composition, bioelectrical impedance analysis, biochemical components, anthropometric components, and blood pressure. Socio-demographic and lifestyle characteristics, such as age, educational level, physical activity, and smoking habits, were also assessed through questionnaires. Result: In the crude and adjustment models, high adherence of DII compared with lower adherence increased the odds of poor sleep quality index among participants. This significant association remained even after adjustment for confounding variables (P < 0.05), such that the odds of poor sleep quality index was 1.92 times higher. Conclusion: This study showed high adherence to DII and DIL may cause CR disruption. Furthermore, higher adherence to DII lead to poor sleep quality in women. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) is one of the most significant public health issues worldwide, which increases the risk of various diseases. Epidemiological evidence suggests that newer anthropometric measures, such as a body shape index (ABSI) and body roundness index (BRI) can be used to predict MetS. However, anthropometric measures to predict the risk for MetS should be clarified in each population. Therefore, this study aimed to examine the association between ABSI, BRI, and MetS risk factors among overweight and obese Iranian adults. Methods: This cross-sectional study included 347 overweight and obese individuals [body mass index (BMI) > 25 kg/m2] aged 20–50 years in Tabriz, Iran. Anthropometric measures were assessed, including BMI, waist circumference (WC), and waist-to-hip ratio (WHR). Additionally, ABSI and BRI were calculated based on the collected data. Blood pressure was measured using standard protocols. Body composition also was measured using body impedance analysis (BIA). Enzymatic-colorimetric methods were used to assess serum glucose and lipids, and enzyme-linked immunosorbent assay (ELISA) kits were used to measure insulin levels. Results: Participants with higher ABSI exhibited significantly higher systolic blood pressure (SBP) (P = 0.001), diastolic blood pressure (DBP) (P = 0.010), and triglyceride (TG) levels (P < 0.001), along with significantly lower high-density lipoprotein cholesterol (HDL-C) levels (P < 0.001). In the crude model, individuals in the highest ABSI tertile (tertile 3) had a higher likelihood of having higher SBP (OR: 1.032; 95% CI: 1.014–1.051) and DBP (OR: 1.33; 95% CI: 1.009–1.058), as well as a significant association with lower HDL-C levels (OR: 0.945; 95% CI: 0.918–0.973). Additionally, both ABSI tertile 2 (OR: 1.005; 95% CI: 1.001–1.008) and tertile 3 (OR: 0.993; 95% CI: 1.003–1.011) were linked to a higher likelihood of having higher TG levels. No significant associations were found between BRI tertiles and MetS risk factors. Conclusion: According to our results, ABSI and BRI are poor predictors of MetS risk variables, in overweight and obese individuals. High ABSI is only slightly linked with high SBP, DBP, and TG and low HDL-C. However, longitudinal and long-term investigations are encouraged to verify the efficacy of these two measures. [ABSTRACT FROM AUTHOR]

Background: Reducing the frequency of self-monitoring of blood sugar, due to needle phobia, pain, stress, and costs associated with the procedure, can improve patient compliance and quality of life, provided that adequate blood sugar control is maintained. This study aimed to evaluate the effect of low-frequency blood glucose self-monitoring (LFBGSM) on glycosylated hemoglobin (HbA1C) levels among older adults living with type 2 diabetes mellitus (T2DM), treated with or without insulin. Materials and Methods: This randomized controlled trial with a parallel design was conducted on 121 older adults with T2DM in Sabzevar, Iran, between 2018 and 2020. Initially, subjects were stratified based on the type of treatment (with or without insulin) and then randomly assigned to intervention (LFBGSM) and control (no blood glucose self-monitoring [no-BGSM]) groups. HbA1C levels were measured at the beginning of the study and 3 months later for all study groups. Results: The mean age of participants treated with and without insulin was 64.3 ± 9.60 and 64.7 ± 5.01 years, respectively. The ANCOVA test revealed a significant difference in the mean HbA1C levels among the four groups 3 months postintervention (P < 0.001). The HbA1C scores significantly decreased in the LFBGSM groups and increased in the no-BGSM groups at 3 months postintervention (insulin/LFBGSM, insulin/no-BGSM, noninsulin/LFBGSM, and noninsulin/no-BGSM: 7.74 ± 0.76, 8.34 ± 1.53, 7.70 ± 0.75, and 8.14 ± 1.11, respectively) compared to baseline (8.25 ± 0.67, 8.03 ± 0.64, 8.08 ± 0.69, and 7.83 ± 0.74, respectively). The least significant difference post hoc tests showed significant differences between specific groups, emphasizing subtle responses to interventions (P values ranging from 0.001 to 0.929). Conclusion: Findings suggest a significant reduction in HbA1C scores within the LFBGSM groups, while a discernible increase is observed in the no-BGSM groups over the 3 months. These findings underscore the efficacy of the interventions and emphasize the crucial role of personalized approaches in optimizing glycemic control for individuals with diabetes. [ABSTRACT FROM AUTHOR]

Objective: Limited studies have been conducted on insulin index/load, with inconsistent results regarding the glycemic index/load in relation to cardiometabolic risk factors among people with diabetes. The present study aimed to reveal the association of dietary glycemic index and load and dietary insulin index and load with cardiometabolic risk factors among people with diabetes. Method: This cross-sectional study was performed on 88 adults with diabetes who enrolled in the Cohort Study of Employees of Shiraz University of Medical Sciences. The scores of dietary glycemic index (DGI), dietary glycemic load (DGL), dietary insulin index (DII), and dietary insulin load (DIL) were measured using a 116-item food frequency questionnaire (FFQ). Multivariate linear regressions were used to associate each dietary score with fasting blood glucose (FBG), triglyceride, total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and systolic and diastolic blood pressure. Results: DGI was significantly associated with serum FBG (β; 0.24, 95% CI; 0.02, 0.46) and triglyceride (β; 0.53, 95% CI; 0.002, 1.06) levels but not TC, HDL, LDL, or blood pressure after adjusting for age, sex, education, marital status, smoking, body mass index, energy intake, physical activity, having other diseases, and family history of diabetes. Neither DGL, DII, nor DIL was significantly associated with each of the cardiometabolic risk factors after controlling for the confounders. Conclusion: A diet with a higher glycemic index accompanied by a higher serum FBG and triglyceride level. Further studies are needed to determine the association of DGL, DII, and DIL with cardiometabolic risk factors. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have revealed the role of dietary fatty acids in human health. However, few studies have evaluated dietary fatty acid patterns and their association with metabolic parameters. The current study aimed to explore the association between dietary fatty acid patterns and risk factors for metabolic syndrome (MetS) among overweight and obese adults. Methods: This cross-sectional study involved 340 participants who were overweight or obese. The study included assessments of body composition and anthropometric measurements. Dietary fatty acid consumption was evaluated using a validated Food Frequency Questionnaire (FFQ) containing 168 items. Additionally, biochemical parameters, including serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), fasting serum glucose (FSG), and insulin levels, were measured using enzymatic methods. Fatty acid patterns were determined by principal component analysis (PCA), and the association between these dietary FA patterns and risk factors related to MetS components was assessed using logistic regression. Results: Factor analysis conducted in this study explored three dietary fatty acid patterns: saturated fatty acids (SFA), polyunsaturated fatty acids (PUFA), and long-chain combined fatty acids (LC-CFA). Those at the highest tertile of the SFA pattern had lower diastolic blood pressure (DBP) (P = 0.03). Low-density lipoprotein cholesterol (LDL) was lower in the second and third tertiles (P ≤ 0.05). Also, higher fasting blood glucose (FBS) was observed in the second and third tertiles (P < 0.05), and the homeostatic model assessment of insulin resistance (HOMA-IR) was higher in the third tertile (P = 0.049). In the PUFA pattern, FBS was lower in the third tertile (P = 0.03). In the LC-CFA pattern, lower TC was achieved in higher tertiles (P = 0.04). Conclusion: Our findings demonstrated that consuming high and moderate SFA patterns is associated with higher FBS and HOMA-IR. Also, increased consumption of SCFAs is related to lower DPB and LDL. Individuals who consumed more PUFA, especially linoleic acid, had lower FBS. These outcomes might be beneficial in managing MetS and leading to a new field of research. [ABSTRACT FROM AUTHOR]

Aim: The potential of different foods to induce postprandial hyperinsulinemia may be involved in the development of metabolic syndrome (MetS). We aimed to evaluate the association between dietary insulin indices and MetS in a large population of adults in Iran. Methods: A total of 6356 adults aged 35–70 years were included in the present cross‐sectional study. A validated block‐format 125‐item semiquantitative food frequency questionnaire (FFQ) was used to obtain usual food intakes, and MetS was defined according to the International Diabetes Federation (IDF) and American Heart Association (AHA)/National Heart, Lung, and Blood Institute (NHLBI) criteria. Results: MetS was prevalent in 13.8% of participants. Mean age of the study participants was 46.58 ± 8.82 years, and mean body mass index (BMI) was 25.02 ± 4.60 kg/m2. Mean dietary insulin index (DII) and dietary insulin load (DIL) were 63.15 ± 7.57 and 168.253 ± 52.09, respectively. In the crude model, men in the highest DIL quartile were more likely to have hyperglycemia than those in the lowest quartile (OR: 1.75, 95% CI: 1.12–2.73, p trend = 0.04). This association remained significant and was even stronger after adjusting for potential confounders in model I (OR: 3.64, 95% CI: 1.57–8.47, p trend = 0.005) and further adjustment for BMI in model II (OR: 3.61, 95% CI: 1.55–8.44, p trend = 0.006). Conclusions: In healthy men, adherence to a high‐DIL diet may be associated with a greater likelihood of having hyperglycemia. No statistically significant association was observed between insulin indices and the odds of having MetS. [ABSTRACT FROM AUTHOR]

Introduction: Clinical and experimental studies have shown that type 2 diabetes is associated with depression-related disorders. Inflammation has been identified as a common mechanism in both type 2 diabetes and depression. Several studies have suggested that swimming exercise might be able to reduce depression-related symptoms Aim: The present research aims to investigate the effect of swimming training on inflammatory cytokines in the serum of rats with depression-type 2 diabetes. Method: The experimental research design is a randomized controlled trial. The statistical population is male C57BL6 mice kept in Pasteur Institute of Iran in 2021. 40 mice were randomly selected and randomly divided into two groups (20 samples in each group). One group became diabetic with a high-fat diet and Streptozotocin. Diabetic samples underwent swimming training for 4 weeks. Then, depression-like behaviors were assessed with Sucrose preference, Noveltysuppressed feeding, Social interaction, and Tail suspension test. We also measured the levels of glucose, insulin and inflammatory cytokines such as IL-1β and TNF-α in the serum of the animals. The data were analyzed by Graphpad Primes. Results: The results indicated that type 2 diabetes significantly increased anhedonia- and depression-like behaviours in mice. Moreover, swimming exercise reduced anhedonia- and depression-like behaviour in type 2 diabetic mice. Swimming exercise also decreased glucose and inflammatory cytokines in the serum of mice with type 2 diabetes. Conclusion: Collectively, this study demonstrates that swimming exercise decreased depressionlike behaviour by reducing inflammation in type 2 diabetic mice.Further clinical studies are needed to validate these findings in patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background: Specific biomarkers for metabolic syndrome (MetS) may improve diagnostic specificity for clinical information. One of the main pathophysiological mechanisms of MetS is insulin resistance (IR). This systematic review aimed to summarize IR-related biomarkers that predict MetS and have been investigated in Iranian populations. Methods: An electronic literature search was done using the PubMed and Scopus databases up to June 2022. The risk of bias was assessed for the selected articles using the instrument suggested by the Joanna Briggs Institute (JBI). This systematic review protocol was registered with PROSPERO (registration number CRD42022372415). Results: Among the reviewed articles, 46 studies investigated the association between IR biomarkers and MetS in the Iranian population. The selected studies were published between 2009 and 2022, with the majority being conducted on adults and seven on children and adolescents. The adult treatment panel III (ATP III) was the most commonly used criteria to define MetS. At least four studies were conducted for each IR biomarker, with LDL-C being the most frequently evaluated biomarker. Some studies have assessed the diagnostic potency of markers using the area under the curve (AUC) with sensitivity, specificity, and an optimal cut-off value. Among the reported values, lipid ratios and the difference between non-HDL-C and LDL-C levels showed the highest AUCs (≥ 0.80) for predicting MetS. Conclusions: Considering the findings of the reviewed studies, fasting insulin, HOMA-IR, leptin, HbA1c, and visfatin levels were positively associated with MetS, whereas adiponectin and ghrelin levels were negatively correlated with this syndrome. Among the investigated IR biomarkers, the association between adiponectin levels and components of MetS was well established. [ABSTRACT FROM AUTHOR]

Background & Objective: As the prevalence of type 2 diabetes is growing worldwide, the need to use insulin and the resulting costs are progressively increasing. Exercise can be an effective way to reduce the insulin dose and its cost. This study investigates the effects of 12 weeks combined exercises on cost, dosage of insulin, and glycemic indices in type 2 diabetic patients. Materials & Methods: Sixty-eight patients, aged 40 to 60 years, with type 2 diabetes and acceptable conditions to perform targeted exercises, were recruited in a randomized clinical trial. All of them had been on treatment with a combination of short-acting and long-acting insulins. Participants were randomly divided into control and case groups with matched gender and age (17 women and 17 men). In addition to the standard exercise recommendations given to both groups, the case group also received the supervised aerobic and resistance exercises three sessions a week for 12 weeks reaching the defined maximum heart rate percentage. The dose of short- and long-acting insulins used during the study was recorded and the resulting cost change along with FBS, 2hpp and HbA1clevel alterations were calculated. Results: The cost and dosage of long-acting and short-acting insulins in the trained group were significantly reduced by 50% and 39.67%, respectively, compared to the control group (p=0.00). The values of HbA1c (21.5%), 2hpp-BS (24.68%), and FBS (13.89%) also decreased in the trained group (p=0.00), while all the mentioned values increased in the control group. Conclusion: The effect of 12 weeks combined exercises was remarkable on reducing the dose of injectable insulins, better glycemic control of patients, and reducing the cost of treatment. Providing the necessary arrangements for supervised exercise in diabetic patients can be economical and beneficial. [ABSTRACT FROM AUTHOR]

This study was designed to assess the relationship between dietary insulin index (DII) and dietary insulin load (DIL) and rheumatoid arthritis (RA) risk in a case–control study. This study enrolled ninety-five newly diagnosed RA patients and 200 age- and sex-matched healthy controls. Dietary intakes were assessed using a validated 168-item semi-quantitative FFQ. DII and DIL were calculated using food insulin index values from previously published data. In the unadjusted model, individuals in the highest DIL tertile had the significantly higher odds of RA than those in the lowest tertile of the DIL scores (OR = 1·32, 95 % CI (1·15, 1·78), P for trend = 0·009). After adjusting for confounders, the risk of RA was 2·73 times higher for participants in the highest tertile of DIL than for those in the lowest tertile (OR = 2·73, 95 % CI (1·22, 3·95), P for trend < 0·001). In addition, patients in the highest DII tertile had higher risk of RA than those in the first tertile (OR = 2·22, 95 % CI (1·48, 3·95), P for trend = 0·008). This association persisted after adjusting for potential confounders (OR = 3·75, 95 % CI (3·18, 6·78), P for trend = 0·002). Our findings suggest that diets high in DII and DIL may increase the risk of developing RA, independent of other potential confounders. These findings can be verified by more research, particularly with a prospective design. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to assess the association of Healthy Eating Index (HEI) with levels of fasting blood sugar (FBS) and lipid profile in normoglycemic and elevated FBS patients. Design/methodology/approach: This case-control study was conducted on 144 participants, namely, 72 normoglycemic subjects (FBS < 100 mg/dl) and 72 high-glycemic patients (FBS ≥ 100 mg/dl) aged 20–60 years of age, who were selected from the nutrition and diet clinics in Tehran city. The dietary intake was collected by using a validated food frequency questionnaire to determine the HEI score. Findings: The mean±SD age and body mass index of participants were 47.1 ± 12.7 years and 29.6 ± 6.0 kg/m2, respectively. The median (interquartile range) of HEI scores in the normoglycemic group and the high-glycemia group were 19.34 (15.24–24.31) and 16.53 (13.35–24.07), respectively. In the overall population, the findings of the multi-variable linear regression model indicated a positive association between the HEI score and high-density lipoprotein-cholesterol (HDL-C) (ß = 0.34; 95%CI: 0.05–0.64, P = 0.01). However, there is no significant association between HEI and HDL-C in normoglycemic (ß = 0.19; 95%CI: −0.31, 0.69, P = 0.45) and hyperglycemic subjects (ß = 0.28; 95%CI: −0.10–0.66, P = 0.15). Furthermore, the association of HEI with levels of FBS, triglycerides (TGs) and low-density lipoprotein-cholesterol (LDL-C) was not significant in any of the analyzed groups, including the total population, normoglycemic individuals and hyperglycemic subjects. Originality/value: This study was the first study to assess the role of HEI and its components with levels of FBS and lipid profile in normoglycemic and hyperglycemic individuals in Iran. The findings suggested that higher adherence to HEI may be associated with an increase in the HDL-C level. However, HEI could not predict FBS, TGs and LDL-C levels in the adult population. [ABSTRACT FROM AUTHOR]

Background. Type 2 diabetes, as the most common metabolic disease, is a chronic and progressive disorder that causes permanent complications and increases cardiovascular diseases, brain vessels, peripheral vessels, and mortality in affected people. This study, therefore, aimed to investigate the effect of eight weeks of interval training and caffeine supplementation on glycemic indices in men with type 2 diabetes. Methods. The current research was a semi-experimental study. As a pilot research, 50 people were selected trough an available and targeted manner, among men with type 2 diabetes (with a history of more than one year) referring to Salamat and Sheikh Al-Rais Specialist clinics, Tabriz, Iran In the period of 2020-2021. 32 people met the inclusion criteria and entered into the study. Participants in the study were simple randomly divided into four homogenous groups of 8 including; Placebo, caffeine, exercise and exercise + caffeine were divided. Drug interventions and intermittent exercises were performed for 8 weeks. Blood samples were collected during two stages (pre-test and post-test) to measure serum levels of glucose, insulin, HbA1c and HOMA-IR index. The data were analyzed using repeated analysis of variance, Bonferroni post hoc and independent t tests at a significance level of 0.05. Results. The results showed that the levels of the glucose, insulin, HbA1c, and HOMA-IR in the three intervention groups significantly decreased compared to those in the placebo group (P=0.001). Furthermore, the results of post hoc test showed that the combined group of interval training + caffeine, compared to the caffeine group, had double effects on the changes in studied indices (P=0.001). Conclusion. A combination of interval training and caffeine supplementation may have been adopted as an effective method to improve and treat symptoms associated with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Context Cardiovascular disease is the leading cause of death worldwide. Low-calorie, low-fat therapeutic diets (TDs) developed by the US National Cholesterol Education Program, ie, the Step I and II diets and the therapeutic lifestyle changes diet, are approximately similar and are the initial therapeutic interventional approaches for lifestyle modification. Objective This systematic review with meta-analysis was undertaken to evaluate the effects of TDs diet on blood lipids, apolipoprotein A-1, apolipoprotein B, blood pressure, fasting blood glucose, and insulin. Data Sources A comprehensive search of the PubMed/MEDLINE, Web of Science, Scopus, and Google Scholar databases until October 2022 was performed to identify clinical trials investigating the effects of TDs on the aforementioned parameters. Data Extraction One investigator screened the records and extracted data, and another reviewed the extracted data. Data Analysis A total of 910 records were retrieved. After records were screened for eligibility, 34 clinical trials met the inclusion criteria. The pooled analysis from the random-effects model revealed a significant reduction in total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, apolipoprotein A-1, and apolipoprotein B in the TD intervention group vs the control group. The overall effects of TDs on fasting blood glucose, insulin, and blood pressure were not significant, but the results of subgroup analysis revealed a significant reduction in fasting blood glucose with the Step II diet and an intervention duration of more than 24 weeks. For blood pressure, the Step I diet and an intervention duration of more than 24 weeks resulted in significant reduction. There was no evidence of publication bias, but strong heterogeneity was observed. Conclusion Therapeutic diets have promising effects on lipid profile parameters, glycemic indexes, and blood pressure, which can promote cardiovascular health. Systematic Review Registration PROSPERO registration no. CRD42021259355. [ABSTRACT FROM AUTHOR]

Background: Anabolic-androgenic steroids (AAS) have positive anabolic effects on muscle mass. Some bodybuilders use high doses of AAS to build more muscle mass and strength. This study was conducted to measure the extent of AAS use among Iranian male bodybuilders and associated risk factors. Methods: A cross-sectional study was carried out among 588 male bodybuilders from July to August 2020 in Isfahan. Isfahan city was divided into 15 clusters according to Isfahan municipal districts. In each cluster, three clubs were randomly selected. A self-administered questionnaire including demographic information and AAS usage data was completed by a consecutive sample of bodybuilders. Results: One hundred and seventy-one (29.1%) participants were current users and 32 (7.7%) planned to use AAS in the future. AAS users had higher incomes, longer gym memberships, and more weekly sessions. They significantly used more supplements and other substances including growth hormone, caffeine, insulin, and glucocorticoid. The most prevalent AAS was testosterone enanthate. Income, length, and frequency of workouts could predict AAS use. Conclusion: Increasing AAS consumption seems to become a public health concern that suggests the need to develop some new policies and programs which would educate and inform bodybuilders and coaches about the adverse effects of AAS use. [ABSTRACT FROM AUTHOR]

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a common liver disease characterized by an increase in fat in liver cells. The outbreak of NAFLD is estimated to be 32.4% worldwide, with higher rates in Asia and Iran. Nutritional factors such as excessive calorie intake, high fructose intake, copper deficiency, and increased iron intake play an important role in NAFLD. Since there is no specific treatment for NAFLD, intermittent fasting (IF) diet has been suggested as an alternative treatment for obesity and related complications. Previous studies showed the potential positive effects of IF on metabolic health and the reduction of oxidative stress in NAFLD. This randomized controlled trial (RCT) will be aimed to examine the effect of the IF diet in comparison with a low-calorie diet (LCD) on lipid profile, glycemic status, and liver fibrosis in patients with NAFLD. Methods and analysis: This is a parallel randomized clinical trial conducted on 52 overweight and obese patients with NAFLD. Participants will be randomly assigned to receive either 16:8 IF (fasting from 8 P.M. to 12 P.M. the next day) or a low-calorie (55% carbohydrate- 30% fat, 15% protein) diet for 12 weeks. Anthropometric measurements, liver assessments, and metabolic evaluations will be assessed before and after the intervention. Primary outcomes include liver steatosis and fibrosis, while secondary outcomes include liver function enzymes, insulin resistance, lipid profile, and anthropometric measurements. Discussion: Since obesity and insulin resistance are the most important risk factors of NAFLD, and there is no treatment for it, it seems that lifestyle changes such as low caloric diet like IF and exercise can improve lipid metabolism and liver enzymes. Trial registration: Iranian registry of clinical trials (IRCT20170202032367N5). [ABSTRACT FROM AUTHOR]

Background & Objective: Peganum harmala has emerged as a promising antidiabetic medicine. There is no study regarding the impact of P. harmala concentration on the insulin secretion, C-peptide secretion, and glucose uptake. We investigated the effect of different concentrations of methanolic extracts of P. harmala seed and leaf on insulin and C-peptide secretion, and glucose uptake. Materials & Methods: After the cell passaging, pancreatic carcinoma cell line (PANC-1) and HT1080 were treated with different concentrations of seed and leaf extract of P. harmala, harmine, and ghrelin agonists. The MTT was employed to assess the cell survival at the selective doses, and using a spectrophotometer, the absorbance was determined at 570 nm. After 72-h treatment, the insulin and C-peptide secretion were measured by ELISA. To measure the intracellular glucose concentrations after treating muscle carcinoma cell lines, glucose oxidase method was utilized. Results: P. harmala seed and leaf extracts increased the secretion of insulin and Cpeptide in a dose-dependent manner compared to ghrelin and harmine. These extracts increased the intracellular glucose concentration at high doses (150 and 1500 µg/ml for the seed and leaf extract, respectively) of HT1080 cell line. However, their high concentration was toxic and reduced the cell survival. The methanolic extracts of seed showed a higher insulin (17.5-fold) and C-peptide (7.8-fold) secretion compared to the leaf methanolic extracts. Conclusion: Due to the presence of β-carbolines, the P. harmala seed extract has toxicity and affects insulin secretion and C-peptide uptake secretion at lower concentrations than those of leaf extract. [ABSTRACT FROM AUTHOR]

Background Metabolic-associated fatty liver disease (MAFLD) is the concurrent presence of fatty liver disease (FLD) with overweight or obesity and/or type 2 diabetes mellitus. We aimed to determine the frequency and characteristics of MAFLD in patients with FLD. Materials and Methods This cross-sectional study was conducted on 143 patients with FLD referred to the gastrointestinal clinic of Shahid Rahimi Hospital in Khorramabad, Iran in 2021-2022. After obtaining a detailed medical history and in case of clinical suspicion of FLD, the levels of functional liver enzymes, fasting blood sugar (FBS), and lipid profile were measured. Furthermore, an ultrasound study of the liver was performed. The degree of insulin resistance was determined by the Homeostasis Model Assessment (HOMA) index. The data were gathered in a checklist and analyzed using SPSS software version 22. Results The mean FBS was 93.15±16.21 mg/dL, and the mean serum insulin levels were 7.88±15.81 mmol/L. The mean triglyceride level was 82.13±172.13 mg/dL, and the mean high-density lipoprotein was 37.27±7.15 mg/dL. In this study, 105 patients (73.4%) had high HOMA indexes. Serum alkaline phosphatase, alanine transaminase, and cholesterol levels were significantly higher in patients with high HOMA index than in those with normal index (P values=0.004, 0.047, and 0.039, respectively). Conclusion There appears to be a strong relationship between insulin resistance and impaired liver function in patients with FLD, indicating the necessity for managing insulin resistance in these patients. [ABSTRACT FROM AUTHOR]

Background: Bariatric surgery delivers substantial weight loss for obese patients with comorbidities like diabetes mellitus. We aimed to investigate the impacts of bariatric surgery on diabetic markers after 5 years of follow-up. Methods: This is a retrospective study on patients with diabetes and a history of bariatric surgery between 2016-2017. The diabetic markers before and 5 years following surgery, including a lipid profile, glucose level, and the required antidiabetic medications, were evaluated. Results: 34 consecutive patients were included, 30 (88.2%) women, with a mean age of 52.71 ± 8.53 years. The majority (65%) of surgeries were Roux-en-Y gastric bypass (RYGB), and the remaining were one anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG). The serum levels of diabetic markers reduced during follow-up (P = 0.001), except for high-density lipoprotein levels and serum total cholesterol, which increased (P = 0.011, P = 0.838). Low-density lipoprotein levels reduced, but it was insignificant (P = 0.194). Surgery types had affected the changes of diabetic markers (P > 0.05). Demand for oral medication was reduced significantly, but insulin injection reduction was not significant (P = 0.006 and P = 0.099, respectively). Conclusion: Our study showed favorable bariatric surgery results on patients with diabetes in long-term follow-up. However, dyslipidemia is still a concern. [ABSTRACT FROM AUTHOR]

Introduction: Insomnia and sleep disorders are related to a decrease in physical and mental health and quality of life. The purpose of this study was to investigate the effect of sleep deprivation on blood sugar, cortisol and insulin levels in athletes compared to non-athletes. Methods: In this semi-experimental study, 14 healthy men participated in two groups of athletes (7 people) and non-athletes (7 people). One night of sleeplessness (8 hours) was applied to the subjects of both groups. According to the objectives of the research, blood samples were taken from all the subjects in two stages. The data were analyzed using the dependent t test for intragroup comparison and independent t test for inter-group comparison at a significance level of 5%. In conducting the research, the principles of the Declaration of Helsinki, the general guidelines for ethics in research with human subjects and the regulations governing it were observed and the code of ethics was issued by the ethics committee of Lorestan University. Results: Insomnia did not lead to a significant difference between the blood sugar and insulin levels of athletes and non-athletes when faced with a (p ≤ 0.05). Also, insomnia did not cause a significant difference in the amount of cortisol between two groups of athletes and nonathletes (p ≤ 0.05). Conclusions: It seems that changes in blood sugar, cortisol and insulin are related to the duration of insomnia and are not affected in short-term and intermittent insomnia. [ABSTRACT FROM AUTHOR]

Background: The predisposition of humans to metabolic syndrome is affected by many factors, including diet and lifestyle. Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) are a set of carbohydrates that are fermented by gut microbiota. In animal studies, supplementation with FODMAP-rich diets as prebiotics can alter body composition and gut microbiota. This study evaluates any relationship between FODMAP and metabolic syndrome risk factors among adults with metabolic syndrome in Iran. Methods: This cross-sectional study is based on sociodemographic information from 347 overweight and obese participants selected from outpatient clinics through public declaration. Participants body composition and anthropometric measures were also determined. A validated Food Frequency Questionnaire (FFQ) with 168 questions was used to collect dietary data. Biochemical parameters, including serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), fasting serum glucose (FSG), and insulin levels, were determined by enzymatic methods. In addition, the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and Quantitative Insulin Sensitivity Check Index (QUICKI) were calculated. Results: In moderate FODMAP and low FODMAP groups, lower waist-to-hip ratio (WHR) and higher fat-free mass (FFM) were achieved in higher tertiles. In high FODMAP groups, higher systolic blood pressure (SBP) was shown in the higher tertile (P < 0.05). Higher insulin, HOMA-IR, and lower QUICKI in the second tertile of the high FODMAP group were also observed. Conclusion: Findings of this study highlight the potential role of FODMAP in managing metabolic syndrome and open a new field of research. [ABSTRACT FROM AUTHOR]

Background: The hypothesis of the effect of the insulinogenic effects of diet on the development of cardiometabolic disorders has been suggested, but limited data are available for adults with obesity. This study aimed to determine the association of dietary insulin index (DII) and dietary insulin load (DIL) with cardiometabolic risk factors among Iranian adults with obesity. Methods: The study was conducted with a total of 347 adults aged 20–50 years in Tabriz, Iran. Usual dietary intake was assessed through a validated 147-item food frequency questionnaire (FFQ). DIL was computed using published food insulin index (FII) data. DII was calculated by dividing DIL by the total energy intake of each participant. Multinational logistic regression analysis was performed to evaluate the association between DII and DIL and cardiometabolic risk factors. Results: Mean age of participants was 40.78 ± 9.23 y, and mean body mass index (BMI) was 32.62 ± 4.80 kg/m2. Mean of DII and DIL was 73.15 ± 37.60 and 196,242 ± 100,181. Participants with higher DII had higher BMI, weight, waist circumference (WC), and blood concentrations of triglyceride (TG) and Homeostasis model assessment insulin resistance index (HOMA-IR) (P < 0.05). After taking potential confounders into account, DIL was positively associated with MetS (OR: 2.58; 95% CI: 1.03–6.46), and high blood pressure (OR: 1.61; 95% CI: 1.13–6.56). Moreover, after adjustment for potential confounders, moderate DII was associated with increased odds of MetS (OR: 1.54, 95% CI: 1.36–4.21), high TG (OR, 1.25; 95% CI, 1.17–5.02), and high blood pressure (OR: 1.88; 95% CI: 1.06–7.86). Conclusion: This population-based study revealed that adults with higher DII and DIL associated with cardiometabolic risk factors and consequently, replacement of high with low DII and DIL may have reduce the risk of cardiometabolic disorders. Further studies with longitudinal design are required to confirm these findings. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) is a common chronic disease with several complications. Given that, studies on the association of plant-based diet indices (PDIs) with risk of MetS among adults with obesity, are limited, we aimed to examine the association between PDIs (including overall PDI, healthy PDI (hPDI), unhealthy PDI (uPDI)) and MetS in Iranian adults with obesity. Methods: In Tabriz, Iran, a total of 347 adults between the ages of 20 and 50 participated in this cross-sectional research study. We created an overall PDI, hPDI, and uPDI from validated semi-quantitative food-frequency questionnaire (FFQ) data. To investigate the association between hPDI, overall PDI, uPDI, and MetS and its components, a binary logistic regression analysis was performed. Results: The average age was 40.78 ± 9.23 years, and the average body mass index was 32.62 ± 4.80 kg/m2. There was no significant association between overall PDI (OR: 0.87; 95% CI: 0.54–1.47), hPDI (OR: 0.82; 95% CI: 0.48–1.40), and uPDI (OR: 0.83; 95% CI: 0.87–2.46) with MetS, even after adjustment for confounders. Moreover, our findings showed that participants with the highest adherence to uPDI had a higher chance of hyperglycemia (OR: 2.50; 95% CI: 1.13–5.52). Also, this association was significant in the first (OR: 2.51; 95% CI: 1.04–6.04) and second (OR: 2.58; 95% CI: 1.05–6.33) models, after controlling for covariates. However, in both adjusted and crude models, we did not find a significant association between hPDI and PDI scores and MetS components such as high triglyceride, high waist circumference, low High-density lipoprotein cholesterol, raised blood pressure, and hyperglycemia. Moreover, those in the top tertile of uPDI had higher fasting blood sugar and insulin levels when compared with those in the first tertile, and subjects in the last tertile of hPDI compared with participants in the first tertile had lower weight, waist-to-hip ratio, and fat-free mass. Conclusion: We found a direct significant association between uPDI and odds of hyperglycemia in the whole population of study. Future large-scale, prospective studies on PDIs and the MetS are necessary to confirm these findings. [ABSTRACT FROM AUTHOR]

Background: Paliurus spina-christi Mill. (PSC) fruit is frequently used in the treatment of diabetes mellitus in Mediterranean regions. Here, we investigated the effects of various PSC fruit extracts (PSC-FEs) on glucose consumption and some key mediators of insulin signaling pathways in high glucose and high insulin-induced insulin-resistant HepG2 cells. Methods: The effects of methanolic, chloroform and total extracts on cell proliferation were assessed by the MTT assay. The potential of non-toxic extracts on glucose utilization in insulin-resistant HepG2 cells was checked using a glucose oxidase assay. AKT and AMP-activated protein kinase (AMPK) pathway activation and mRNA expression levels of insulin receptor (INSR), glucose transporter 1 (GLUT1), and glucose transporters 4 (GLUT4) were determined by western blotting and real-time PCR, respectively. Results: We found that high concentrations of methanolic and both low and high concentrations of total extracts were able to enhance glucose uptake in an insulin-resistant cell line model. Moreover, AKT and AMPK phosphorylation were significantly increased by the high strength of methanolic extract, while total extract raised AMPK activation at low and high concentrations. Also, GLUT 1, GLUT 4, and INSR were elevated by both methanolic and total extracts. Conclusions: Ultimately, our results shed new light on methanolic and total PSC-FEs as sources of potential anti-diabetic medications, restoring glucose consumption and uptake in insulin-resistant HepG2 cells. These could be at least in part due to re-activating AKT and AMPK signaling pathways and also increased expression of INSR, GLUT1, and GLUT4. Overall, active constituents present in methanolic and total extracts of PCS are appropriate anti-diabetic agents and explain the use of these PSC fruits in traditional medicine for the treatment of diabetes. [ABSTRACT FROM AUTHOR]

The deficiency of vitamin D amongst Iranian people is high and also is related on hyperglycemia. This study aims to evaluate the association of vitamin D levels with the required dose of insulin prescribed based on an insulin therapy protocol in critical condition patients admitted to intensive care unit (ICU), in an investigation based in Iran. This cross-sectional study was performed on patients who required insulin due to hyperglycemia. The relationship between serum vitamin D level and the required dose of insulin prescribed based on insulin therapy protocol in this group of patients was investigated. A total of 172 patients with a mean age of 46.93 ± 31.9 years were included in this study. Across the included participants, 78.8% of patients had vitamin D deficiency, 11.9% had insufficient vitamin D and 9.3% had normal vitamin D levels. There was a significant difference in mean blood sugar between the vitamin D deficiency group and the normal group. Vitamin D levels were also significantly higher in men than women. Furthermore, the HbA1C hemoglobin level in patients with Vitamin D deficiency was significantly higher compared to the group with normal levels of vitamin D. Our findings suggest that decreased vitamin D is associated with increased blood sugar and insulin requirements in patients admitted to ICU. Women are at a higher risk for vitamin D deficiency. We hope that these findings may help inform relevant treatment strategies. [ABSTRACT FROM AUTHOR]

Background & Objective: Genetic modifications in the adiponectin receptor 2 (AdipoR2) gene can affect phenotypes associated with insulin resistance and diabetes. The purpose of this study was to evaluate the possible role of genetic modifications in the AdipoR2 gene, to determine the frequency of genotypes and polymorphism alleles of this gene at rs11061971 (+219 A>T), and to investigate its correlation with type 2 diabetes (T2D) and its related metabolic profile. Materials & Methods: In this case-control study, the single-nucleotide polymorphism (SNP) of AdipoR2 in 116 T2D patients and 102 controls was evaluated using RFLP PCR and FOK 1 enzyme. Fasting blood sugar, cholesterol, triglyceride, insulin, HDL-C, LDL-C and HbA1c were also measured and their correlation with the studied genetic modifications was assessed. The collected data were analyzed using Chi-square test and Hardy-Weinberg equation. Results: There was a significant association in AT and TT genotypes in rs11061971 (+219 A>T) with T2D. However, no significant difference was observed in the frequency of alleles between the case and control groups. In addition, in LDL-C and total cholesterol in the control group, there was a significant difference between AA and TT genotypes as well as with AA and AT genotypes. However, no correlation was found between the other studied serum parameters and the genotype of individuals in the rs1106197171 polymorphism. Conclusion: It can be concluded that rs11061971 (+219 A>T) polymorphism is associated with T2D incidence. The findings suggest that AT and TT genotypes in this gene compared to AA genotype increase the risk of diabetes. [ABSTRACT FROM AUTHOR]

Background: Diabetes management in hemodialysis patients with end-stage renal disease needs precision to avoid complications. The study aimed to investigate the effect of ginger supplementation on prooxidant-antioxidant balance, glycemic management, and renal function in diabetic hemodialysis patients. Trial design and methods: Forty-four patients were randomly allocated to either the ginger or the placebo group in this randomized, double blind, placebo-controlled study. Patients in the ginger group received 2000 mg/d ginger for eight weeks, whereas those in the placebo group received equivalent placebos. After a 12- to 14-h fast, serum levels of fasting blood glucose (FBG), insulin, urea, creatinine, and prooxidant-antioxidant balance (PAB) were measured at baseline and at the end of the study. The homeostatic model evaluation of insulin resistance was used to determine insulin resistance (HOMA-IR). Results: Serum levels of FBG (p = 0.001), HOMA-IR (p = 0.001), and urea (p = 0.017) were considerably lower in the ginger group compared to baseline, and the difference was significant when compared to the placebo group (p < 0.05). Moreover, ginger supplementation decreased serum levels of creatinine (p = 0.034) and PAB (p = 0.013) within the group, but the effect was insignificant between groups (p > 0.05). On the other hand, insulin levels did not vary significantly across and among the groups (p > 0.05). Conclusion: In summary, this study indicated that in diabetic hemodialysis patients, ginger could result to lower blood glucose levels, enhanced insulin sensitivity, and lower serum urea levels. Further studies with a more extended intervention period and various doses and forms of ginger are needed. Trial registration: IRCT20191109045382N2. (06/07/2020), Retrospectively registered, https://www.irct.ir/trial/48467 [ABSTRACT FROM AUTHOR]

Background and aim: Previous studies have shown that Rheum ribes (R. ribes) could be effective in controlling the blood glucose levels. This study was conducted to determine the effects of R. ribes supplementation on glycemic indices and apolipoproteins in patients with type 2 diabetes mellitus (T2DM). Methods: In the present randomized double-blind controlled trial, 60 type 2 diabetic patients aged 30–60 years with a body mass index (BMI) of 20–30 kg/m2 and hemoglobin A1c (HbA1c) of 6–8% were enrolled. Patients were randomly assigned to receive 450 mg of aqueous R. ribes extract (AG), 450 mg of ethanolic R. ribes extract (EG), or placebo (PG) three times daily for 6 weeks. At the baseline and at the end of the study, blood glucose levels, homeostatic model assessment of insulin resistance (HOMA-IR) and the homeostatic model assessment of β-cell dysfunction (HOMA-B), as well as apolipoprotein A-I (ApoA1) and apolipoprotein B (ApoB) were measured. Results: There was a significant decrease in the serum levels of insulin in AG and EG groups (P = 0.003 and P = 0.001, respectively), HOMA-IR (P = 0.01 and P = 0.001, respectively), HOMA-B (P = 0.002 and P = 0.001, respectively), ApoB (P = 0.006 and P = 0.03, respectively), ApoB/ApoA1 ratio (P = 0.016 and P = 0.04, respectively). However, a significant increase in ApoA1 (P = 0.08 and P = 0.05, respectively) with no significant changes in blood glucose, at the end of study compared to beginning values, were observed. None of the variables showed a significant change in PG. At the end of the study; while there were significant differences in insulin (P = 0.04), HOMA-IR (P = 0.03), HOMA-B (P = 0.01), ApoB (P = 0.02), and ApoB/ApoA1 ratio (P = 0.03) among the groups but ApoA1 had no significant change. Conclusion: Consumption of R. ribes intake could have beneficial effects on insulin resistance and apolipoproteins in type 2 diabetic patients. (Registered at en.irct.ir, identification number: IRCT201410142709N31). [ABSTRACT FROM AUTHOR]

Background: Several previous studies revealed the role of dietary energy density (DED) in developing obesity and related disorders. However, the possible role of DED in triggering cardiometabolic risk factors of individuals with obesity has not been studied yet. This study aimed to evaluate the association between DED and anthropometric parameters, blood pressure, and components of metabolic syndrome (MetS) (such as glycemic markers, lipid profile, and blood pressure) among individuals with obesity. Methods: In this cross-sectional study, we included 335 adults with obesity (BMI ≥ 30 kg/m2) aged 20–50 years in Tabriz and Tehran, Iran. Dietary intake was assessed by a validated semi-quantitative Food Frequency Questionnaire (FFQ), including 168 food items; then, DED was calculated. MetS was defined based on the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). Enzymatic methods were used to assess serum lipids, glucose, and insulin concentrations. Blood pressure was measured by sphygmomanometer and body composition by bioelectrical impedance analysis (BIA). Results: Participants in the higher tertiles of DED had more intake of carbohydrate, dietary fat, saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), polyunsaturated fatty acid (PUFA), and meat, fish, poultry (MFP). Increasing the DED in both methods had no association with systolic blood pressure (SBP), fasting blood sugar (FBS), low-density lipoprotein cholesterol (LDL-C), insulin, triglyceride (TG), and homeostatic model assessment of insulin resistance (HOMA-IR) even after adjustment for confounders. However, diastolic blood pressure (DBP) decreased in second tertile of DED I (β = 0.921, P = 0.004). The quantitative insulin-sensitivity check index (QUICKI) in second tertile of both DED methods had significant positive association with DED. In the second tertile of DED II, while total cholesterol (TC) significantly decreased (P crude = 0.036, P adjusted = 0.024), high-density lipoprotein cholesterol (HDL-C) increased (β = 1.096, p = 0.03). There was no significant changes in biochemical parameters in third tertile of DED I and II even after adjustment for covariates. Also, higher tertiles of DED was associated with reduced prevalence of MetS. Conclusion: High DED was associated with lower levels of blood pressure and TC but elevated levels of HDL and QUICKI independent of such confounders as age, BMI, sex, and physical activity. Further longitudinal studies are warranted to better elucidate casual associations. [ABSTRACT FROM AUTHOR]

Purpose: Type 1 diabetes mellitus (T1DM) is a chronic metabolic disorder, and its prevalence and incidence are increasing globally. Insulin therapy is the basis of T1DM management that can prevent numerous complications. Identifying and resolving the factors involved in patients' non-adherence can reduce complications, mortality, and economic burden. Methods: In this cross-sectional study, a sample of patients with T1DM were included from Alborz and Tehran cities of Iran in 2020. Patients filled the questionnaires consisting of sociodemographic and diabetes characteristics, weight and height measurements, 8-item Morisky Medication Adherence Scale (MMAS), and barriers to insulin therapy. Patients with < six scores of MMAS were considered to have low adherence, while ≥ 6 scores showed moderate/high adherence. Data were analyzed using SPSS, and a P-value of less than 0.05 was considered statistically significant. Results: 189 patients with T1DM with a mean (± SD) age of 17.95 (± 10.98) years were enrolled in the study, and 73.5% of patients had moderate/high adherence to insulin therapy. Younger age and owning insurance were significantly associated with being classified in the higher adherence group. The barriers that were significantly associated with non-adherence were forgetting to buy, physician inaccessibility, cost, exhaustion from the long-term injection, forgetfulness, injection site reaction, and rebellion against parents in the < 20 years age group. The main barriers in ≥ 20 years age group were forgetting to buy and insufficient injection instruction. Conclusion: The identified barriers to insulin injection would be helpful for policymakers and clinicians to increase insulin adherence among patients with T1DM. [ABSTRACT FROM AUTHOR]

Background/objectives: The roles of potential inflammation of diet and lifestyle in the risk of insulin-related disorders are unclear. In the current study, we aimed to assess the relationship between dietary inflammation scores (DIS), lifestyle inflammation scores (LIS), and dietary and lifestyle inflammation score (DLIS) and the risk of insulin resistance (IR) and hyperinsulinemia in Tehranian adults.Subjects/methods: A total of 1,244 participants, aged ≥20 years, who were free of insulin-related disorders at baseline (2006-08), were followed for 3.2 years (2009-11) to ascertain the incidence of hyperinsulinemia and IR. A food frequency questionnaire was used to determine the score of DIS, LIS, and DLIS at baseline. Logistic regression models were used to determine the odds ratio (ORs) of insulin-related disorders across tertiles of DIS, LIS, and DLIS.Results: Mean ± SD age of participants (42.7% men) was 43.0 ± 13.0 years. During the 3.2 years follow-up, the incidence of IR and hyperinsulinemia was 30.0% and 20.0%, respectively. In the multivariable model, there was a direct association between the higher score of DLIS (OR = 2.10; 95% CI: 1.17-3.74) and DIS (OR = 1.84; 95% CI: 1.09-3.11) with the risk of IR incident (P for trend <0.05). Also, the higher score of LIS was related to increased risk of IR (OR = 2.28; 95% CI: 1.19-4.37) and hyperinsulinemia (OR = 1.69; 95% CI: 1.02-2.85) (P for trend <0.05). However, no significant association was observed between the higher score of DLIS and DIS with risk of hyperinsulinemia CONCLUSION: The higher inflammatory potential of diet and lifestyle, determined by DLIS, DIS, and LIS scores, were associated with a higher risk of IR. Also, individuals with a higher score of LIS are more prone to hyperinsulinemia risk. [ABSTRACT FROM AUTHOR]

Kidney stones or Nephrolithiasis are the most common health condition associated with the urinary system. Dietary factors stand as important factors in the occurrence and development of kidney stones. This study aimed to examine the potential link between dietary insulin index (DII) and dietary insulin load (DIL) with prevalence of kidney stones. This cross-sectional study was conducted among adults aged 30 to 75 years in the Shahedieh district of Yazd, Iran, over the period of 2015-2016. DII and DIL were calculated using a validated semi-quantitative food-frequency questionnaire and mathematical formula. Diagnosis of kidney stones is made on the basis of information obtained from self-reported questionnaire (Yes/ No). To explore the association between DII and DIL with the odds of kidney stones, logistic regression was employed in crude and adjusted models. A total of 4,829 participants were included in this study. Individuals in the last quartile of DIL had 214% higher odds of kidney stones in the crude model (OR: 2.14, 95% CI: 1.62-2.83; P-trend < 0.001); this association was remained significant after adjustments for confounding variables (OR: 1.44, 95% CI: 1.04-1.97; P-trend: 0.019). There was a direct significant relationship between DII and odds of kidney stones among third and forth quartiles of DII (OR: 1.52, 95% CI: 1.16-1.98, P-trend = 0.002); but this association disappeared for adjusted models. Higher DII and DIL were associated with an increased odd of renal stones. Large longitudinal study is required to clarify these associations., Competing Interests: Declarations Competing interests The authors declare no competing interests. Ethics approval and consent to participate The study adhered to the ethical standard outlined in the Declaration of Helsinki for conducting medical research with human beings. The study received ethical approval from the ethics committee of Shahid Sadoughi University of Medical Science (IR.SSU.SPH.REC.1397.161). All participants also provided written informed consent prior to the collection of data., (© 2024. The Author(s).)

To evaluate the effect of magnesium supplementation on insulin resistance and cardiovascular markers in people with prediabetes. A 12 week double-blind placebo-controlled randomized clinical trial was conducted at Isfahan Endocrine and Metabolism Research Center, Iran, on people with prediabetes (n = 86) to compare the effects of magnesium oxide 250 mg/day versus a placebo on anthropometric indices, blood pressure, fasting glucose, insulin, HOMA-IR index, C-reactive protein, uric acid and lipid profile. Both groups had similar distributions of anthropometric and biochemical variables at baseline. Those who received magnesium supplementation had significantly higher levels of HDL-cholesterol compared to the placebo group at the end of the study (49.7 ± 10.9 vs 43.6 ± 7.2 mg/dL, P = 0.003). The mean changes of HOMA-IR index, total cholesterol, LDL-cholesterol, triglyceride, uric acid and C-reactive protein levels as well as anthropometric indices and blood pressure in supplemented and placebo groups did not differ significantly. Magnesium supplementation increased HDL-cholesterol levels in people with prediabetes. However, other cardiometabolic markers were not improved by magnesium supplementation at the above dosage and duration. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes is one of the most common metabolic disorders during pregnancy. Some studies have reported the effect of vitamin D deficiency on the incidence of this disorder. Therefore, the purpose of the present study was to determine the effect of vitamin D supplementation on fasting blood glucose (FBG) levels, fasting blood insulin (FBI) levels and insulin resistance index (HOMA-IR) (primary outcomes) and symptoms of depression, musculoskeletal pain, frequency of gestational diabetes and the frequency of abortion (secondary outcomes). Methods: In this triple-blind randomized controlled trial, 88 pregnant women at 8–10 weeks of pregnancy who had the vitamin D of less than 30 ng/ml were randomly assigned to the vitamin D group (n = 44) and control group (n = 44) using block randomization. The vitamin D group received 4,000 units of vitamin D tablets daily and the control group received placebo tablets for 18 weeks. Independent t-test, Mann-Whitney U and ANCOVA tests were used to analyze the data. Results: After the intervention, there was no statistically significant difference between the two groups in terms of FBG (P = 0.850), FBI (P = 0.353), HOMA-IR (P = 0.632), mean score of depressive symptoms (P = 0.505), frequency of gestational diabetes (P = 0.187) and frequency of abortion (P = 1.000) and there was only a difference in terms of serum vitamin D level (P = 0.016) and musculoskeletal pain including knee pain (P = 0.025), ankle pain (P < 0.001) and leg pain (P < 0.001). Conclusion: Vitamin D could improve the musculoskeletal pain in pregnant women but couldn't decrease FBG, FBI, HOMA-IR, depression symptoms score, incidence of GDM and abortion. Trial registration: Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N59. Date of registration: 4/11/2020. URL: https://en.irct.ir/user/trial/50973/view; Date of first registration: 21/11/2020. [ABSTRACT FROM AUTHOR]

The progression of cardiometabolic diseases is determined by both genetic and environmental factors. Gene–diet interactions may therefore be important in modulating the risks of developing metabolic diseases. The objectives were to investigate the effect of the interaction between brain-derived neurotrophic factor (BDNF) Val66Met polymorphisms and dietary insulin index (DII) and dietary insulin load (DIL) on cardiometabolic markers among diabetic patients. In this cross-sectional study, blood samples were collected from 667 patients. DIL and DII were defined using a validated FFQ. Genotyping the BDNF Val66Met polymorphism was conducted by the PCR-Restriction fragment length polymorphism (RFLP) method. Interactions between dietary indices and gene variants were evaluated using a generalised linear model. PGF2a concentrations were significantly higher among Val homozygotes than Met-allele carrier. This study revealed that, compared with individuals with the Val/Val genotype, those with the Met/Val or Met/Met genotype had lower BMI (Pinteraction = 0·04), TAG (Pinteraction = 0·04), leptin (Pinteraction = 0·01), LDL (Pinteraction = 0·04) and total cholesterol (Pinteraction = 0·01) when they consumed diets higher on the DIL index. Moreover, the highest quartile of the DIL, compared with the lowest, showed increase in waist circumference (Pinteraction = 0·02) and LDL/HDL (Pinteraction = 0·04) for Val/Val homozygotes compared with Met-allele carriers. BDNF Val66Met variants may interact with DIL and DII, thus be involved in the development of cardiometabolic risk factors. If diabetic patients with Met alleles regulate dietary intakes, they have a protective opportunity to regulate their cardiometabolic markers. [ABSTRACT FROM AUTHOR]

The associations between components of metabolic syndrome (MetS), insulin resistance (IR), and several malignancies have been reported. However, the possible link between IR and dermal malignancies, including non-melanoma skin cancers (NMSCs), has not been investigated to date. In this study, we aimed to examine the possible association between components of MetS, IR, adhesion molecules, and NMSC for the first time. This was a case-control study comprising 73 confirmed cases of NMSC and 72 unrelated healthy controls. Anthropometric and biochemical assessments including fasting blood lipid profile, glucose and insulin assays were performed. To evaluate IR, HOMA-IR formula was used. Though fasting serum glucose showed no significant between-group difference, serum concentrations of insulin (p = 0.048) as well as HOMA-IR (p = 0.037) were both significantly higher in NMSC group than in controls. Logistic regression analysis revealed significant associations between waist circumference (OR: 1.04, 95% CI: 1.007-1.080, p = 0.018), percent of visceral fat (OR: 1.10, 95% CI: 1.024-1.190, p = 0.01), HOMA-IR (OR: 1.169, 95% CI: 1.004-1.360, p = 0.044), circulating VCAM-1 concentrations (OR: 1.005, 95% CI: 1.003-1.007, p < 0.001) and NMSC risk. Interestingly, the occurrence of MetS was significantly higher in subjects with NMSC than in healthy controls (p = 0.038). MetS and its components were associated with increased NMSC risk. [ABSTRACT FROM AUTHOR]

Background: Hypoglycemia is a fairly common complication in diabetic patients, particularly in those on insulin therapy. Hypoglycemia symptoms are classified into two types: autonomic and neuroglycopenic symptoms. If a person develops neuroglycopenic symptoms before the appearance of autonomic symptoms or is asymptomatic until blood sugar levels are very low, the patient will develop hypoglycemic unawareness (HU).Case Presentation: A 25-year-old Iranian woman with HU presented with a severe hypoglycemic episode. This episode was characterized by loss of consciousness and focal neural deficits, which were unusual symptoms in the patient, who was a medical intern with type 1 diabetes and currently being treated with regular and NPH insulin.Conclusions: Hypoglycemia is a common complication in diabetic patients receiving oral or insulin therapy. A patient who is unaware of their condition may experience severe and potentially fatal episodes. These incidents can negatively affect their daily lives as well as their careers and jobs. Hypoglycemia-associated autonomic failure is a possible cause for patients with multiple episodes of severe hypoglycemia. IThe use of a continuous glucose monitoring device with an alarm, if available, can be an excellent option for these patients. [ABSTRACT FROM AUTHOR]

Background: The inflammatory and metabolic responses to mushroom in type 2 diabetes mellitus (T2DM) are unknown. The study aimed to evaluate the effect of Hot Air-dried White Button Mushroom (HAD-WBM) powder on glycemic status, lipid profile, inflammatory markers, and total antioxidant capacity (TAC) in T2DM patients. Materials and Methods: This randomized controlled trial was conducted at Golestan Hospital, Ahvaz, Iran. Eligible patients were adults aged 20-50 with Type 2 diabetes. Patients were assigned to each group using a randomized block design with block randomization (n = 22, in each group). Randomization was performed by an assistant and group allocation was blinded for the investigator and participants. The intervention and control groups received 16 g/day HAD-WBM or cornstarch powder for 8 weeks. The primary outcomes of interest were fructosamine, fasting blood sugar (FBS), insulin, homeostatic model assessment for insulin resistance, and secondary outcomes were triglyceride, low-density lipoprotein (LDL), high-density lipoprotein, very-LDL, cholesterol, high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and TAC. Results: After 8 weeks, a significant decrease was observed in fructosamine (-0.228 ± 0.36 vs. 0.03 ± 0.38; P = 0.02) and LDL (-13.05 ± 20.67 vs. 0.81 ± 21.79; P = 0.04) in the HAD-WBM group compared to the control group. No significant changes were observed in fasting insulin and FBS between the two groups. However, a significant within-group reduction (-28.00 ± 42.46; P = 0.006) was observed for FBS in the HAD-WBM group. In the HAD-WBM group, insulin resistance reduced significantly at the end of the study (From 4.92 to 3.81; P = 0.016), but it was not significantly different between the two groups. There was no significant difference in TAC, hs-CRP, and IL-6 between the two groups. Conclusion: Considering the results of this study about the beneficial effects of HAD-WBM on the improvement of glycemic indices and LDL in T2DM patients, it is recommended that HAD-WBM could be used to control T2DM. [ABSTRACT FROM AUTHOR]

Vitamin D deficiency in cigarette smokers (CS) might associate with several complications, including metabolic deficits, depression and anxiety. This study evaluated the effects of vitamin D on mental health symptoms, nicotine misuse, and biomarkers of metabolic diseases in individuals with a tobacco use disorder. A randomized, double-blind, placebo-controlled trial was conducted with 60 CS subjects receiving either 50,000 IU vitamin D supplements (n = 30) or placebo (n = 30) every 2 weeks for 24-weeks. Nicotine misuse, mental health scale, and metabolic parameters were measured before and after the intervention in the CS subjects. Compared with the placebo-group, after the 24-weeks intervention, serum 25 (OH) vitamin D levels increased in the intervention group (β 2.96; 95% CI, 0.91, 5.01; P = 0.006). In addition, vitamin D supplementation significantly improved Beck Depression Inventory (BDI) (β −2.06; 95% CI, −3.84, −0.28; P = 0.02). In addition, vitamin D administration significantly decreased fasting plasma glucose (FPG) (β −4.56; 95% CI, −8.94, −0.19; P = 0.04), insulin (β −0.50; 95% CI, −0.88, −0.13; P = 0.009), and homeostasis model of assessment-estimated insulin resistance (HOMA-IR) levels (β −0.21; 95% CI, −0.33, −0.08; P = 0.001). Furthermore, vitamin D resulted in a significant elevation in total antioxidant capacity (TAC) (β 81.20; 95% CI, 18.30, 144.11; P = 0.01), and plasma glutathione (GSH) levels (β 73.05; 95% CI, 18.56, 127.54; P = 0.01), compared with the placebo-group. Administration of vitamin D for 24-weeks to CS subjects had beneficial effects on symptoms of depression and several metabolic biomarkers. While this preliminary study suggests that vitamin D might have beneficial effects, its clinical efficacy in individuals with a tobacco use disorder should be further validated in future clinical trials. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the ABO blood group characteristics in women with Gestational Diabetes Mellitus (GDM). Methods: This cross-sectional research was conducted on pregnant women with GDM in Yas Hospital, Tehran, Iran, from April 2018 to March 2019. Results: Totally, 449 pregnant women enrolled in the study. The average age of the participants was 32.26±5.08 years with a range between 18 and 45 years. 46% of the participants were treated with insulin. In this study, 35% were typed as group O, 34.3% as group A, 24.3% as group B, and 6.5% as group AB. The Rh+ blood antigen was present in 92% of the pregnant women. Blood group A (35.7%) was the highest in pregnant women with insulin therapy and the frequency of blood group O was the highest in pregnant women with diet (39.5%) and metformin therapy (35.7%). Conclusion: In pregnant women with insulin therapy, the most prevalent blood group was A. This was different from those that are frequent in the Iranian normal population and pregnant women with GDM who underwent diet therapy. It seems that blood group A, as a probable associated factor for GDM, can be beneficial in high-risk pregnancy detection for GDM in the Iranian population. [ABSTRACT FROM AUTHOR]

Introduction: The anti-inflammatory effects of exercise training and zataria multiflora have been proven. In the present study, researcher investigated the effect of eight weeks combined exercise training and Zataria multiflora (Z. multiflora) supplement on the levels of IL-1β and insulin resistance in overweight and obese men. Materials and Methods: The 40 overweight and obese men with average age of 27.73 ± 2.15 years old and average body mass index (BMI) 28.41 ± 1.75 kg/m² were randomly divided into four groups including the placebo, Z. multiflora, combined training, and training + Z. multiflora. Combined exercise training program conducted for eight weeks and three sessions per week. Z. multiflora supplement was also consumed at 500 mg daily. Blood sampling was performed before and 48 hours after the eight weeks intervention. The levels of IL-1β and insulin were measured by ELISA method. Data were analyzed by analysis of covariance and Bonferroni post hoc test. Results: The levels of IL-1β in training and training + Z. multiflora groups significantly decreased compared to placebo and Z. multiflora groups (P < 0.001). In addition, significant decrease of insulin resistance in training group compared to placebo (P < 0.001) and Z. multiflora (P = 0.003) groups, and also in training + Z. multiflora group compared to placebo and Z. multiflora groups were observed (P < 0.001). Conclusion: Combined training alone or in combination with Z. multiflora supplementation can exert anti-inflammatory effects. Moreover, Z. multiflora supplementation cause the relative increase in exercise training effect for decrease in IL-1β and insulin resistance. [ABSTRACT FROM AUTHOR]

Objectives: According to the world health organization (WHO), by the year 2030 diabetes will become the world's seventh leading cause of death. This study aimed to design and conduct a descriptive pharmacoepidemiological investigation of anti-diabetic drugs utilization during a ten-year period using the anatomical therapeutic classification/defined daily dose (ATC / DDD) system in Iran. Methods: Based on pharmaceutical wholesalers' sale reports, sale data, including value and volume, were retrieved from the Iranian Annual Pharma Statistics for 2009–2018. The ATC/DDD system was used to standardize the raw sales data. Anti-diabetic drug utilization was reported as DDD per 1000 person in the population per day. Expenditure was calculated as USD per DDD. Results were then analyzed descriptively. Results: During the ten-year study period, total anti-diabetic drug consumption increased by 235.53%. Insulin utilization grew by 148.65%, whereas non-insulin agents' use showed a 132.68% increase. Anti-diabetic drugs' expenditure increased by almost 9-fold, but changes were accompanied with many fluctuations. Although the absolute expenditure of almost all classes of anti-diabetic drugs were increasing, this growth was greater in biguanides, which only includes metformin in Iran. Approximately one-third of anti-diabetic drugs expenditures were related to fast-acting insulins. Imported drugs share in cost was significant, but not in consumption. The overall share of insulin consumption was less than 19%, but their share of total value reached 60% of the anti-diabetic market. Conclusions: The growing trend in both insulin and non-insulin anti-diabetic drugs utilization is a substantial issue for health authorities' policy making for sustainable access to medicine. [ABSTRACT FROM AUTHOR]

Background: Many studies in dairy cows are towards calcium homeostasis and there is a lack of knowledge about the effect of vitamin D in preventing insulin resistance and improving energy balance in the transition period of dairy cows. Methods: The trial was conducted in a commercial dairy farm with about 1500 lactating cows in Tehran province, Iran. Twenty‐four Holstein cows had been randomly selected and divided into control and treatment groups. In the treatment group, 12 cows, received a single dose of 8,000,000 IU vitamin D3 intramuscularly and in the control group, 12 cows were injected placebo (distilled water) 2–8 days before the expected calving time. Blood samples were collected between 8 and 10 AM 2 h after feeding on 21 and 7 days before calving and 1,3,7,15 and 30 days after calving. 25(OH)vitamin D, insulin‐like growth factor 1 (IGF‐1), insulin, nonesterified fatty acid (NEFA), β‐hydroxybutyric acid (BHBA), albumin, total protein, glucose, urea, triglyceride, cholesterol and aspartate amino transferase (AST) were measured by commercially available kits. The insulin resistance index was calculated. Results: Vitamin D3 injection significantly affected the amounts of 25(OH) vitamin D, urea, insulin and insulin resistance index (p ≤ 0.05). On the other hand, the amounts of glucose, NEFA, BHBA concentration and AST activity were higher in control group (p ≤ 0.05). Time had a significant effect on the amounts of most measured variables except IGF‐1 and insulin. There were no group and time interactions for measured variables. Conclusion: It seems that injection of vitamin D3 in close up period influenced lipolysis potentially modifying energy metabolism and resulted in reducing insulin resistance. [ABSTRACT FROM AUTHOR]

Background & Aims: There is a close relationship between obesity and type 2 diabetes, so that the risk of developing type 2 diabetes in obese people is higher than people with normal weight (2, 3). Both type 2 diabetes and obesity are associated with changes in the body's metabolism, which is a determining factor in the development of insulin resistance (4, 5). Studies show that adipose tissue is a central metabolic organ in regulating energy homeostasis throughout the body and plays an important role in the development of insulin resistance and type 2 diabetes (6). It also secretes various hormones, cytokines, and metabolites that control systemic energy balance by regulating appetite signals from the central nervous system and metabolic activity in peripheral tissues (8). One of the peptide hormones expressed by various body tissues, including adipose tissue in animal and human samples, is adropin, which is involved in energy homeostasis, metabolic adaptation, and modulation of insulin sensitivity and obesity (9). Increased adropin levels have been reported following aerobic exercise (17). also, Abbasian et al. (2016) observed increase in serum adropin levels in overweight and obese men after 8 weeks of intense intermittent exercise (18). However, in the study of Alizadeh et al. (2015) following a session of aerobic exercise, no significant change in glucose and adropin factors was observed in overweight women (19). The effects of exercise training on changes of factors involved in energy metabolism in obese diabetic subjects have been less studied, therefore, the present study intends to investigate the question of whether six weeks of aerobic training affect the on adipose tissue energy homeostasis index in obese diabetic rats? Methods: This is an experimental study. This research was conducted on Wistar rats at Islamic Azad University, Marvdasht Branch. 32 obese male wistar rats (weight 320±20 gr) after induction of diabetes randomly were divided into 4 groups including obese control, shem (obese), obese diabetic, obese aerobic training - obese diabetic. Rats were exposed to a high-fat controlled diet in the form of pellets for 4 weeks to gain weight (20). In this study, the rats were type 2 diabetic using peritoneal injection nicotinamide-STZ (21). Aerobic training program was performed on treadmill 4 days a week with intensity of 70% VO2max for six weeks (22). Blood samples were used to measure fasting glucose by enzymatic colorimetric method with glucose oxidase technology by Pars Azmoun Tehran kit company. Insulin was measured by ELISA method using a laboratory kit (Demeditec insulin ELIZA DE2935, Germany). Insulin resistance index was measured after Calculated fasting glucose and fasting insulin concentrations using the homeostasis model (HOMA-IR) and according to the formula. Also, the amount of adropine in adipose tissue of rats was measured using a special kit (Phoenix Pharmaceuticals, Inc. USA) by ELISA method. Adropin level were measured using ELISA kit. Data were analyzed by One-way ANOVA and Tukey post hoc test at the P<0.05. Results: Mean and standard deviation of variables in adipose tissue of different research groups are presented in Table 2. The results showed that the adropin level in adipose tissue in the obese diabetic group was significantly lower than the obese control group (P=0.001). Also, insulin resistance was significantly higher in the obese diabetic group than the obese control groups (P=0.004). Aerobic training was associated with significant increase of adropin in adipose tissue and decrease of insulin resistance in obese diabetic rats (P=0.001). Conclusion: The findings of this study were consistent with the results of Previous research (17, 23, 24). Insulin resistance, fasting glucose and insulin have a negative correlation with adropin levels (29). In the present study, a negative relationship was observed between adropin levels of adipose tissue and insulin and insulin resistance index, which may be one of the effective factors in increasing adropin levels of adipose tissue after aerobic training in the obese-diabetic exercise group. The molecular mechanism by which fat causes insulin resistance is unclear. Inflammation due to lipid accumulation, inhibitory effect of fatty acid oxidation on glucose oxidation, and secretion of adipocytokines are all associated with the development of local and systemic insulin resistance (36). Improvements in insulin resistance following exercise may be due in part to the potential effect of adropine on vasodilation. This improvement can facilitate access to glucose and enhance glucose metabolism (9). There were some limitations in the present study, such as the lack of measurement of other indicators of associated with energy homeostasis and metabolic adaptation in adipose tissue. According to the results, it seems that Aerobic training may be able to help reduce the effects of obesity in diabetes by improving adropin levels in adipose tissue and insulin resistance. [ABSTRACT FROM AUTHOR]

Background: There is no study regarding developing a valid index to predict insulin-related disorders in the Iranian population based on their dietary habits and lifestyle. In the current study, we aimed to develop and validate insulinemic potential indices of diet and lifestyle in Iranian adults. Methods: In this cross-sectional study, we analysed data of 1063 men and women aged ≥ 25 years among participants of the examination three of Tehran lipid and glucose study (TLGS) (2006–2008). Dietary intakes were assessed using a valid semi-quantitative food frequency questionnaire. Dietary and lifestyle indices were developed using stepwise linear regression analysis based on dietary intakes, body mass index, and physical activity data. Fasting serum insulin concentration and homeostatic model assessment for insulin resistance (HOMA-IR) were used as biomarkers of hyperinsulinemia (HI) and insulin resistance (IR). Validation analyses were performed in examination four of TLGS. Results: We developed four indices related to insulin homeostasis, including the dietary index for HI (DIH), the dietary index for IR (DIR), the lifestyle index for HI (LIH), and the lifestyle index for IR (LIR). Based on multivariable-adjusted models, the relative values of the biomarker in subjects in the highest quartile of indices were 45% for LIH (95% CI 1.36–1.55, Ptrend < 0.001), 28% for DIR (95% CI 1.13–1.42, Ptrend = 0.019), and 51% for LIR (95% CI 1.41–1.61, Ptrend < 0.001), higher than those in the reference quartile, respectively. Conclusion: We designed and validated indices to determine the insulin potential of diet and lifestyle for the Iranian population, according to Iran's demographic and dietary intake characteristics. [ABSTRACT FROM AUTHOR]

Introduction: The goal of this study was to elucidate harmful complications of intraoperative hyperglycemia following children cardiac surgery and benefits of insulin administration for accurate blood sugar controlling. Methods: this study is a Randomized clinical trial. We conducted this study in the operating room of shahid madani hospital. Fifty patients who were children under 12 years old undergone cardiac surgery using cardiopulmonary bypass (CPB). Intraoperative insulin infusion was administered intravenously targeting blood sugar levels of 110-140 mg/dL. Blood sugar and arterial blood gas (ABG) were measured every 30 min during operation. Results: Inotropes were used less in the study than the placebo group during surgery. The means of hospitalization and extubation time were more in the placebo group than the study group (P = 0.03) and (P = 0.005), respectively. However, the mean time of hospitalization in the ICU ward did not differ significantly between the two groups. Conclusion: Hyperglycemia has a relation with long time of intubation and hospitalization in ICU. These findings suggest the positive effect of accurate blood sugar control on reducing complication and hospitalization time in children undergoing cardiac surgery. [ABSTRACT FROM AUTHOR]

Objective: We investigated the association of dietary Mg intake with insulin resistance and markers of endothelial function among Iranian women.Design: A cross-sectional study.Setting: Usual dietary intakes were assessed using a validated FFQ. Dietary Mg intake was calculated by summing up the amount of Mg in all foods. A fasting blood sample was taken to measure serum concentrations of glycemic indices (fasting plasma glucose and insulin) and endothelial function markers (E-selectin, soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1). Insulin resistance and sensitivity were estimated using the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR), Homeostasis Model Assessment β-cell function (HOMA-β) and quantitative insulin sensitivity check index (QUICKI).Participants: Iranian female nurses (n 345) selected by a multistage cluster random sampling method.Results: The Mg intake across energy-adjusted quartiles was 205 (se 7), 221·4 (se 8), 254·3 (se 7) and 355·2 (se 9) mg/d, respectively. After adjustments for potential confounders, QUICKI level was significantly different across quartiles of Mg intake (Q1: 0·34 (se 0·02), Q2: 0·36 (se 0·01), Q3: 0·40 (se 0·01), and Q4: 0·39 (se 0·02), P = 0·02); however, this association disappeared after considering markers of endothelial function, indicating that this relation might be mediated through endothelial dysfunction. After controlling for all potential confounders, Mg intake was inversely, but not significantly, associated with serum concentrations of sICAM (Q1: 239 (se 17), Q2: 214 (se 12), Q3: 196 (se 12), and Q4: 195 (se 17), P = 0·29). There was no other significant association between dietary Mg intake and other indicators of glucose homoeostasis or endothelial markers.Conclusions: Higher dietary Mg intake was associated with better insulin sensitivity in Iranian females. This linkage was mediated through reduced endothelial dysfunction. [ABSTRACT FROM AUTHOR]

Background: Hyperinsulinaemia is considered as a major risk factor for the development of a myriad of chronic diseases. We examined the association between the dietary insulinaemic potential and the odds of non‐alcoholic fatty liver disease (NAFLD) among Iranian adults. Methods: After being subjected to a liver ultrasound, 166 patients with NAFLD and 200 controls were included in the study. The dietary intakes and the physical activity levels of the participants were evaluated using a validated semi‐quantitative food frequency questionnaire and the International Physical Activity Questionnaire (short IPAQ), respectively. The insulinaemic potential of the diet was assessed by computing the scores of the Empirical Dietary Index for Hyperinsulinemia (EDIH) and the Empirical Dietary Index for Insulin Resistance (EDIR). Results: Compared with the control subjects, patients with NAFLD were significantly older; had higher values for body mass index, fasting blood sugar, triglycerides, low‐density lipoprotein cholesterol, total cholesterol and alanine transaminase; and were more likely to smoke. Moreover, NAFLD patients had significant lower levels of high‐density lipoprotein cholesterol and were less likely to perform physical activity. The risk of NAFLD was higher in the individuals in the highest tertile of the EDIH (odds ratio [OR] = 2.79; 95% confidence interval [CI] = 1.32–5.90; p value for trend < 0.05) and EDIR (OR = 2.42; 95% CI = 1.22‐4.79; p value for trend < 0.05) compared to those in the lowest tertile of these scores. Conclusions: Our study indicates that a higher dietary insulinaemic potential is associated with an increased risk of NAFLD. [ABSTRACT FROM AUTHOR]

Objective: Uncoupling protein 2 (UCP2) plays a crucial role in energy homeostasis via insulin secretion regulation, free fatty acid concentrations, and lipid metabolism. This study aimed to investigate the association of 45-bp ins/del polymorphism of UCP2 with susceptibility to NAFLD (Non-Alcoholic Fatty Liver Disease) and T2DM (Type 2 Diabetes Mellitus). DNA was extracted from the white blood cells of the subjects, and the gene polymorphism was determined using polymerase chain reaction (PCR). In this study, 72 patients with NAFLD, 71 healthy individuals as control, 80 patients with T2DM, and 77 healthy controls were enrolled in the study. Results: A higher prevalence of insertion/insertion genotype was observed in T2DM patients compared to the controls (p- value˂ 0.05). There was no difference in genotype distribution between NAFLD patients and controls (p-value > 0.05). NAFLD patients with D/D, D/I genotype had higher triglyceride, ALT, and AST levels; however, their HDL levels were lower than healthy controls. Patients with T2DM with D/D or D/I genotype also had significantly higher fasting serum glucose (FSG). While we found an association between the 45 bp I/D polymorphism in 3ʹUTR of UCP2 and T2DM, no correlation between this polymorphism and NAFLD was identified. [ABSTRACT FROM AUTHOR]