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Background: Studies have suggested that oxidative stress is a common pathway of different leading mechanisms to diabetes complications. Oxidative stress play a crucial role in atherogenesis and cause oxidation of low density lipoprotein. Evidence has been shown that oxidized LDL in diabetic patients is higher than nondiabetic individuals. Regarding to known role of oxidative stress in developing of micro and macrovascular complications of diabetes and recent evidences about importance of IL-6 in initiating of inflammatory processes in atherosclerotic plaques formation and reports that shown the effects of Ox-LDL upon IL-6 release, in this study evaluation of serum levels of IL-6 and correlation of these two agents in diabetic patients in comparison with healthy persons was performed. Methods: This stratified cross-sectional study was conducted in diabetic clinic of Imam khomeini Hospital, Tehran University of Medical Sciences during 2009-2010, recruiting 40 type2 diabetic (T2DM) patients as cases and 40 healthy subjects as controls. FBS, lipid profile, HbA1c, oxidized- LDL and IL-6 levels were measured for both patients and controls after 12 hours fasting state. Results: The mean of Ox-LDL/LDL ratio in T2DM group (0.65±0.14) were significantly higher than control group (0.5±0.15) (p<0.001). The mean level of IL-6 in T2DM group were 2.6±1.8 pg/ml that was higher than control group (1.9± 0.8pg/ml) (p=0.05). BMI, systolic and diastolic blood pressures revealed significant correlation with IL- 6 level in diabetic group. There was no correlation between diabetes duration and IL-6 level. Conclusion: We concluded that diabetes, as an independent factor, is responsible for increased IL-6 in T2DM. [ABSTRACT FROM AUTHOR]

Background: This study was designed to present initial results on clinical presentation, therapeutic modalities, and outcome information of patients with pituitary tumors registered in Iran Pituitary Tumor Registry (IPTR). Methods: We collected data from a web-based electronic medical records of patients with various pituitary tumors referred to four tertiary care centers in the country. Retrospective analysis was performed on demographic, clinical, and therapeutic information of 298 patients including 51 clinically nonfunctioning adenoma (CNFA), 85 acromegaly, 135 prolactinoma, and 27 Cushing's disease (CD). Results: From October 2014 to July 2016, 298 people with the diagnosis of pituitary tumor were registered. Prolactinoma was the most prevalent tumor (45.3%), followed by Acromegaly (28.6%), CNFPA (17.1%), and CD (9%). Female dominance was seen among patients with prolactinoma and CD, while the majority of patients with CNFPA were male and acromegaly was equally distributed between men and women. Hypogonadal symptoms were almost always seen in all types of pituitary groups. Surgery alone was the most common therapeutic modality used in cases of acromegaly, CNFPA, and CD. However, medical therapy alone was frequently applied for cases of prolactinoma. Finally, biochemical cure was achieved in most cases of prolactinoma and CD, but only in 36.5% of acromegalics. Moreover, 80% of patients suffering from CNFPA showed no residual tumor in their imaging. Conclusion: In conclusion, this comprehensive tumor registry enables early identification, selection of best therapeutic approaches, and evaluation of long-term treatment outcomes. Furthermore, this registry can be used to improve surveillance protocols. [ABSTRACT FROM AUTHOR]

Background: Hashimoto's thyroiditis (HT) is the most prevalent autoimmune disease, and there is no definitive treatment available for this disease. To find the appropriate therapeutic approach, it is necessary to determine the mechanism of this disease. To achieve this purpose, the frequency of CD4 + T cells was evaluated in patients with HT and compared with healthy individuals., Methods: Twenty-six female patients with HT, aged 20 - 45 years, enrolled in this study. Based on the level of thyroglobulin antibody (anti-TG) and anti-thyroid peroxidase antibody (anti-TPO) in serum of patients with HT, they were divided into two groups. The serum level of anti-TPO was above 100 IU/mL in the group 1 (n = 13), whereas the serum levels of both anti-TPO and anti-TG were above 100 IU/mL in the group 2 (n = 13). Eleven healthy women were considered control group, or group 3. Using flow cytometry, the frequency of T helper (Th)1, Th2, Th17, T regulatory type 1 (Tr1), and LT CD4 + IL-4 + IL-17 + cells and mean fluorescent intensity (MFI) of their related cytokines were evaluated., Results: The frequency of Th2 cells in the groups 1 (anti-TPO > 100) and 2 (anti-TPO > 100 and anti-TG > 100) were more than control group. Only the difference between groups 3 (healthy control) and 2 was significant (P = 0.022). The frequency of LT CD4 + IL-4 + IL-17 + cells in the group 1 was significantly more than group 3 (P = 0.027); However, the difference between group 2 and 3 was not significant (P = 0.126). The expression of interferon-gamma (IFN-γ) in the group 2 (P = 0.001) and group 1 (P = 0.001) was significantly higher than group 3. The frequency of Th17, Th1, and Tr1 cells and MFI of IL-17 and IL-10 were not significantly different between the study groups., Conclusions: In the present study, no significant differences were observed in the frequency of Th17 and Tr1 cells and in MFI of IL-17 and IL-10 in comparison to healthy individuals. Therefore, trying to make a change in the population of these cells probably does not have a significant therapeutic effect. Since Th2 cells and the expression of IFN-γ increased in women with HT, reducing the frequency of Th2 cells or the expression of IFN-γ may be effective in controlling the disease progression. It may be helpful for these patients to prevent the progression of the disease., Competing Interests: Conflict of Interests: The authors have no conflict of interest to declare., (Copyright © 2021, International Journal of Endocrinology and Metabolism.)

Realizing the cause of Cushing's syndrome (CS) is one of the most challenging processes in clinical endocrinology. The long high dose dexamethasone suppression test (standard test) is costly and need an extended inpatient stay. In this study we want to show the clinical utility of the overnight 8 mg dexamethasone suppression test (DST) for differential diagnosis of CS in a referral center. Retrospectively from 2002-2005 we selected the patients of endocrinology ward in Imam Hospital who were admitted with the diagnosis of Cushing syndrome and had 8 mg DST (modified test) along with classic DST. In modified test a decrease in an 8 AM serum cortisol level of 50% or more is thought to indicate suppression and we compared the results of modified test with standard test. This test had been done on 42 patients: 10 male (23%) and 32 female (76%). The mean age of patients was 31.39 (15-63), 32 with proven pituitary Cushing's disease, 7 with primary adrenal tumors and 3 with ectopic ACTH syndrome. The standard test according to 50% suppression of UFC had 90.62% sensitivity, and according to 90% suppression had 43.75% sensitivity. The sensitivity of this test was 71.85% for serum cortisol suppression. The modified test (8 mg overnight DST) had 78% sensitivity. All of these tests had 100% specificity for the diagnosis of Cushing's disease. The positive predictive vale (PPV) of all of these tests was 100%. The negative predictive value (NPV) of modified test for the diagnosis of Cushing's disease was 58.82%. In standard test the NPV of serum cortisol was 52.6%, UFC 50% had 76.9% NPV and UFC 90% had 35.7% NPV. The results of serum cortisol suppression in modified test is better than standard test. Although 50% suppression of UFC in standard test had greater sensitivity than modified test, collecting of urine is difficult, time consuming and needing hospitalization, so we advice modified test that is much simpler and more convenient instead of standard test in the first step of evaluating the cause of Cushing's syndrome in referral centers.

Objective: To determine the distribution of solitary parathyroid adenoma over the parathyroid glands in a group of patients with primary hyperparathyroidism Design: A case-series., Place and Duration of Study: Departments of Surgery and Pathology at Shariati Hospital, Tehran, Iran, between the years 1981 and 2003., Patients and Methods: A retrospective review of surgery reports of 118 patients with primary hyperparathyroidism was performed. All of the patients had solitary parathyroid adenoma and the anatomical location of each adenoma was clearly defined during operation. Serum calcium, phosphorus and parathormone levels along with clinical characteristics were also included., Results: The distribution of adenomas over the superior and inferior parathyroid glands showed a significant higher incidence of adenoma in the lower parathyroids (p < 0.001). The right to left distribution of adenomas was not significant (p=0.4)., Conclusion: Surgical exploration for primary hyperparathyroidism should be initiated from the lower parathyroid glands provided that pre-operative localization scans are not helpful.

Hepatitis C virus (HCV) infection has been associated with a plethora of immune and autoimmune perturbations. A variety of conditions ranging from endocrinopathies to different skin diseases has been described in HCV infection. The aim of this study was to investigate the prevalence and clinical significance of HCV infection in patients with graves' disease (GD). A total of 55 patients with GD (30 women, 25 men, mean age: 35.24 +/- 12.27 years) and 50 control subjects (28 women, 22 men, mean age: 33.34 +/- 11.99 years) were examined. Third generation ELISA test was used for detection of antibodies to HCV in human sera, and anti-HCV seropositivity was confirmed by recombinant immunoblot assay (RIBA).All normal controls were anti-HCV negative whereas anti-HCV antibody was present in 1 patient with GD and confirmed by Western blotting. These results indicate that there was no significant difference of anti-HCV antibodies between patients and controls.In this study no relationship was found between GD and HCV infection, which imply that hepatitis C virus has not a direct causal role in the pathogenesis of GD, however, this does not rule out a "hit and run" virus induced disease.