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Irisin, a novel adipomyokine, has been proposed to be a therapeutic agent against obesity‐related metabolic disease. Royal Jelly (RJ) and tocotrienol‐rich fraction (TRF) are suggested to promote obesity and its related problems through potential mutual mechanistic pathways. This investigation intended to evaluate the glycemic and inflammation‐promoting effects of RJ, TRF, and their combinations to evaluate their synergic effects through irisin action in obese rats induced by a high‐fat diet (HFD) that underwent a calorie restriction diet (CRD). Fifty HFD‐fed obese rats received the following interventions: RJ, TRF, or RJ + TRF in combination with a CRD for eight consecutive weeks. After the investigation, body weight, fasting blood sugar (FBS), irisin, insulin, C‐reactive protein (CRP), interleukin‐6 (IL‐6), interleukin‐1 beta (IL‐1β), leptin, adiponectin, and insulin resistance (IR) were assessed. After 8 weeks of treatment, significant weight reduction was noticed in rats that received RJ and RJ + TRF related to the CRD rats (p <.001), although this reduction was not considerable in TRF‐treated rats. RJ and RJ + TRF supplementation markedly elevated irisin concentrations in CRD rats (p <.05), but TRF did not. Glycemic indices, inflammatory indices including IL‐1β and CRP levels, and leptin concentrations were significantly decreased after RJ, TRF, and their combinations were added to CRD (p <.05). According to the mediational analysis results, irisin mediated the promoting effects of RJ on glycemic hemostasis. Based on the results of this investigation, RJ and TRF are novel nutrients that have the potential to improve obesity‐related disorders. This research suggests that RJ exerts its beneficial glycemic regulatory effects through irisin. [ABSTRACT FROM AUTHOR]

Introduction: Headache is one of the essential symptoms of pituitary adenoma associated with the tumor and the patient’s characteristics. The pattern of adenoma-related headaches varies widely and can significantly impact the patient’s quality of life. Objectives: We aimed to investigate the severity and pattern of headaches in patients with pituitary adenoma in Iran. Patients and Methods: In this cross-sectional study, we investigated 109 patients with an initial complement of headaches. The diagnosis of pituitary adenoma was confirmed. Patients’ demographic characteristics [e.g., gender, body mass index (BMI), and age] and tumor characteristics (e.g., subtype of tumor and size of tumor) were collected by interview, clinical examination, and imaging. We measured the severity of the headache using Headache Impact Test-6 (HIT-6) questionnaire version 1.1. Results: In our study, the most common subtype of pituitary adenoma was prolactinoma, followed by nonfunctional growth hormone (GH)-releasing and adrenocorticotropic hormone (ACTH)-releasing adenomas. Functional adenoma was significantly more common in women; however, the incidence of non-functional adenoma was more in men (61%), indicating the correlation between gender and subtype of adenoma (P = 0.008). Most tumors were functional microadenomas (69%), while macroadenomas were primarily non-functional (50%). The HIT-6 scores demonstrated that functional microadenomas had higher HIT-6 scores and patients with prolactinoma experienced more severe headaches than other subtypes (P = 0.003). Conclusion: Our study revealed significant effects of the type of adenoma on the severity of headaches, as patients with functional microadenomas had more muscular headaches. Additionally, the hormonereleasing function of tumors plays a vital part in the advent and severity of adenoma-related headaches. [ABSTRACT FROM AUTHOR]

Background and Objectives: Iron overload is a major problem in patients with beta-thalassemia major, and it has many structural and metabolic consequences. The aim of this study was evaluation of endocrine disturbances in patients with beta-thalassemia major who were older than 10 years of age. Patients and Methods: In this cross-sectional study, investigators collected demographic data and medical histories, as well as menstrual history in females, from the medical records of 56 patients with beta-thalassemia major. Patients were examined to determine their pubertal status and the standard deviation score for height for evaluation of short stature. For evaluation of glucose tolerance, a fasting blood glucose and oral glucose tolerance test were performed. Evidence for diabetes mellitus was based on American Diabetes Association and World Health Organization criteria. Serum levels of calcium, phosphorous, thyroid-stimulating hormone, free thyroxin, luteinizing hormone and follicular-stimulating hormone, and estradiol in girls and testosterone in boys were measured. Results: The mean and standard deviation for age in the 56 patients (36 males and 20 females) was 15.62±4.44 years. Diabetes mellitus was present in 5 patients (8.9%), impaired fasting glucose was found in 16 patients (28.6%) and an impaired glucose tolerance test was found in 4 patients (7.1%). Short stature (standard deviation score Conclusion: Despite therapy with deferoxamine to treat iron overload, the risk of secondary endocrine dysfunction remained high. Hypogonadism was one of the most frequent endocrine complications. Impaired glucose tolerance, short stature, hypocalcemia, subclinical and overt hypothyroidism are also frequent.

Background: Gestational diabetes mellitus (GDM) is defined as glucose intolerance due to insulin resistance during pregnancy. This metabolic disorder includes 8.3% of pregnancies worldwide. Thyroid gland autoantibodies can induce insulin resistance probably because of inflammatory cytokines production. However, a distinct mechanism of this phenomenon has not well understood. Objectives: Regarding the high prevalence of GDM which concerns the mother and fetus health, this study aimed to compare the therapeutic methods frequency in GDM patients with or without anti-thyroperoxidase (TPO) autoantibodies. Methods: One hundred and two GDM patients aged between 20- 30 years, with (n=52) or without (n=50) anti-TPO antibodies were enrolled in this experimental study. Overt hypothyroidism or hyperthyroidism, creatinine>1.4 mg/dl, Congestive Heart Failure, liver diseases, and diabetes history were considered as exclusion criteria. Insulin administration was performed in patients with fasting blood glucose (FBS)>105 mg/dl. Other patients regarding the blood glucose level were treated by metformin or diet. All patients were followed up for one week. Results: Patients were divided into anti-TPO (+) and anti-TPO (-) groups with the average age of 25.52±3.35 and 26.28±3.53, respectively. Significant differences were observed in FBS, 1hour BS and 2 hour BS levels between groups (p=0.003, p=0.041 and p=0.007 for FBS, 1 hour BS and 2 hour BS, respectively). Based on therapeutic methods, significant differences were observed in insulin (p=0.026) and diet (p=0.03) therapy. Conclusion: Our data showed that the presence of anti-TPO antibody is correlated with GDM severity, indicating the importance of thyroid gland function on feto-maternal health status. [ABSTRACT FROM AUTHOR]

Introduction: Acromegaly patients have high bone turnover and negative calcium balance. Different studies have also reported that acromegaly causes disrupted calcium homeostasis and bone remodeling. Objective: The aim of this study was to compare bone mineral density between acromegaly patients and healthy individuals. Materials and Methods: Twenty-nine acromegaly patients referred to Imam Reza Hospital of Tabriz University of Medical Sciences were enrolled in this case-control study. Eighty-eight sex-, age-, and body mass index-matched individuals without any endocrine diseases were also considered as the control group. Lumbar (L2-L4) and hip bones' densities were determined using a dual-energy x-ray absorptiometry (DEXA) scan. Results: Lumbar T-score was significantly lower in acromegaly patients compared to healthy controls (-0.76±0.21 versus -0.13±0.18, p=0.042, respectively). However, the incidence of osteopenia and osteoporosis were not different in the studied population (p=0.072). Conclusion: Regarding our data, T-scores can be considered as a marker for response to therapy monitoring in acromegaly patients. [ABSTRACT FROM AUTHOR]

Introduction: Hypercalcemia of immobilization is rare, but hypercalciuria is more common than hypercalcemia. Hypercalcemia an uncommon presentation of sarcoidosis occurs in 5 to 10% of patients, but 30 to 50% has hypercalciuria. The cause of hypercalcemia in sarcoidosis is similar to other granulomatous diseases, and increased activity of 1 alpha hydroxylase. Case report: A 32-year-old man with a history of car accident and severe trauma to lumbar spine. High serum calcium was reported (14.6 mg/dL) in his laboratory data. Chest computed tomography (CT) scan revealed numerous nodules in parenchyma of both lungs. Chronic non-caseating granulomatous inflammation (more probably sarcoidosis) was reported. Prednisolone was started at a dose of 35 mg/day and 10 days aftertreatment serum calcium level decreased to normal range. Conclusion: Hypercalcemia has been described in patients with granulomatous disorders, most commonly sarcoidosis. Treatment of the hypercalcemia or hypercalciuria in granulomatous disorders is aimed at treatment of the underlying disorder. Moderate-dose glucocorticoid therapy is typically used to treat sarcoidosis. The serum calcium concentration begins to fall in two days, but the full hypocalcemic response may take 7 to 10 days depending upon the prednisone dose. [ABSTRACT FROM AUTHOR]

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