International Journal of Endocrinology and Metabolism最新文献

{"title":"Glycemic Profiles and Hypoglycemia Awareness Among Pregnant Women with Gestational and Pre-existing Diabetes Referred to a Tertiary Center in Sulaimaniyah-Iraq in 2024.","authors":"Jamal Mahmood Salih","doi":"10.5812/ijem-153529","DOIUrl":"10.5812/ijem-153529","url":null,"abstract":"<p><strong>Background: </strong>Hyperglycemia in pregnancy (HIP) comprises gestational diabetes mellitus (GDM) and pre-existing diabetes; type 1 diabetes (T1DM), type 2 diabetes (T2DM), and undetermined diabetes. Hyperglycemia in pregnancy leads to fetal and maternal complications.</p><p><strong>Objectives: </strong>To observe and compare glycemic profiles (GP) and hypoglycemia awareness (HA) in women with GDM and pre-existing diabetes.</p><p><strong>Methods: </strong>This prospective observational comparative study enrolled women with HIP registered at Sulaimani Maternity Teaching Hospital from January to April 2024. Self-monitoring blood glucose (SMBG) was used to document GP through mean blood glucose (MBG) analysis and the proportions of hyperglycemic, euglycemic, and hypoglycemic records. The Gold score was used to assess HA. Statistical analysis was conducted using SPSS version 27.0, employing chi-square, Mann-Whitney, Fisher's exact test, Kruskal-Wallis test, ANOVA, and independent <i>t</i>-tests. A P-value of ≤ 0.05 was considered significant.</p><p><strong>Results: </strong>One hundred patients were included in the final analysis. Half of the women were over 35 years old, 53% had GDM, and 47% had pre-existing diabetes. The MBG levels at fasting, 1-hour post-breakfast, and post-dinner were significantly highest in T1DM and lowest in GDM, while the levels were similar after lunch. Compared with pre-existing diabetes, women with GDM had a significantly greater proportion of euglycemic records and a lesser proportion of hyperglycemic and hypoglycemic records. Daily insulin requirements were significantly higher in women with pre-existing diabetes than in those with GDM (0.52 ± 0.35 vs 0.24 ± 0.12 units/kg, respectively, P < 0.001). Hypoglycemia episodes (HE) were 5.7 vs 1.83 events/patient/month in pre-existing diabetes vs GDM, respectively (P = 0.002). Using the Gold score to determine HA, 40% of T1DM patients had reduced HA, 40% had borderline HA, while 20% of T1DM and patients with other types of diabetes had normal HA (P < 0.001).</p><p><strong>Conclusions: </strong>Women with GDM had a significantly more stable GP, fewer HE, and lower insulin requirements than those with pre-existing diabetes. Type 1 diabetes patients had the most unstable GP, with significantly higher proportions of hyperglycemic and hypoglycemic records and reduced HA.</p>","PeriodicalId":13969,"journal":{"name":"International Journal of Endocrinology and Metabolism","volume":"22 4","pages":"e153529"},"PeriodicalIF":2.1,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal Cut-off Points of the Standardized Continuous Metabolic Syndrome Severity Score (cMetS-S) for Predicting Cardiovascular Disease (CVD) and CVD Mortality in the Tehran Lipid and Glucose Study (TLGS).","authors":"Maryam Adib, Ladan Mehran, Safdar Masoumi, Iman Vatanpoor, Fereidoun Azizi, Atieh Amouzegar","doi":"10.5812/ijem-154255","DOIUrl":"10.5812/ijem-154255","url":null,"abstract":"<p><strong>Background: </strong>Metabolic Syndrome (MetS) is a prevalent condition associated with an increased risk of cardiovascular disease (CVD) and CVD mortality. Due to the limited clinical applicability of MetS, the standardized continuous metabolic syndrome severity score (cMetS-S) has the potential to provide continuous assessment of metabolic risk.</p><p><strong>Objectives: </strong>This study evaluated the optimal cMetS-S cut-off points in the Tehran Lipid and Glucose Study (TLGS) for predicting CVD and CVD mortality.</p><p><strong>Methods: </strong>The study included 7,776 participants over 30 years old at baseline, followed for 18 years. Sex-specific sensitivity (SS) and specificity (SP) of cMetS-S measures for predicting CVD and CVD mortality were evaluated using a receiver operating characteristic (ROC) curve, along with the area under the curve (AUC), employing a naive estimator and considering event failure status and MetS variables.</p><p><strong>Results: </strong>The cut-off point of cMetS-S for CVD was 0.13 (SS: 65.5%, SP: 59.6%) for the total population, 0.44 (SS: 49.6%, SP: 68.1%) for men, and 0.27 (SS: 64.2%, SP: 69.2%) for women. The cut-off point of cMetS-S for CVD mortality was 0.53 (SS: 51.3%, SP: 71.9%) for the total population, 0.76 (SS: 35.1%, SP: 76.2%) for men, and 0.28 (SS: 78.8%, SP: 66.4%) for women. The AUC (95% CI) of MetS based on the International Diabetes Federation (IDF) and Joint Interim Statement (JIS) definitions were 60.0 (65.3 - 56.8) and 61.1 (59.6 - 56.8) for CVD, and 59.3 (56.0 - 62.5) and 59.4 (56.3 - 62.6) for CVD mortality.</p><p><strong>Conclusions: </strong>The cut-off points of cMetS-S for CVD and CVD mortality differ between men and women. The cMetS-S could be a better predictive tool for CVD and CVD mortality than MetS.</p>","PeriodicalId":13969,"journal":{"name":"International Journal of Endocrinology and Metabolism","volume":"22 4","pages":"e154255"},"PeriodicalIF":2.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of High Protein-High Fat and High Protein-High Carbohydrate Meals on Resting Metabolic Rate and Metabolic Factors in Overweight and Obese Adults: The Study Protocol for a Randomized Crossover Clinical Trial.","authors":"Saber Sahebi, Fatemeh Sadat Hashemi Javaheri, Zahra Valeh, Lida Jarahi, Mohammad Safarian, Mohsen Nematy","doi":"10.5812/ijem-157244","DOIUrl":"10.5812/ijem-157244","url":null,"abstract":"<p><strong>Background: </strong>The macronutrient composition of daily meals plays a crucial role in influencing the body's metabolic responses during the postprandial phase. However, existing research on the effects of macronutrients, particularly fats and carbohydrates, has produced inconsistent findings.</p><p><strong>Objectives: </strong>This study aims to evaluate the postprandial effects of two high-protein meals-one low in fat and high in carbohydrates (HP-LF-HC) and the other high in fat and low in carbohydrates (HP-HF-LC)-on energy metabolism, appetite response, and blood markers in overweight and obese men and women without underlying health conditions.</p><p><strong>Methods: </strong>This study was conducted as an acute randomized crossover clinical trial at the Health Monitoring Center of Mashhad University of Medical Sciences (MUMS) within Imam Reza Hospital, Mashhad, Iran. A total of 30 overweight and obese men and women, meeting the eligibility criteria and free of underlying diseases, were recruited through a public call. Participants were randomly assigned to receive both intervention meals, with a washout period of at least one week between each trial.</p><p><strong>Results: </strong>The primary outcomes focused on the acute effects of the two dietary interventions on energy metabolism, particularly resting metabolic rate (RMR), and appetite response. Secondary outcomes included changes in lipid profiles, insulin, blood glucose levels, thyroid hormones, and epinephrine.</p><p><strong>Conclusions: </strong>This study aims to identify which macronutrient composition most effectively enhances resting energy expenditure. The findings could provide valuable insights for dietitians in developing more efficient dietary plans, helping overweight and obese individuals maintain an ideal weight or achieve weight loss by modifying food composition without altering meal volume.</p>","PeriodicalId":13969,"journal":{"name":"International Journal of Endocrinology and Metabolism","volume":"22 4","pages":"e157244"},"PeriodicalIF":2.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The First Sertoli Cell Tumor of the Adrenal Gland is Potentially Associated with Arterial Hypertension.","authors":"Sara Ivanis, Milan Marinkovic, Milan Jovanovic, Matija Buzejic, Marija Milinkovic, Zlatibor Loncar, Vladan Zivaljevic, Branislav Rovcanin","doi":"10.5812/ijem-156823","DOIUrl":"10.5812/ijem-156823","url":null,"abstract":"<p><strong>Introduction: </strong>Sertoli cell tumors are rare sex cord-stromal tumors, accounting for less than 1% of primary testicular tumors. They typically arise in the testes and ovaries, with other localizations being uncommon. We present the case of a Sertoli cell tumor in the adrenal gland, which, to our knowledge, is the first reported in the literature.</p><p><strong>Case presentation: </strong>A 44-year-old male patient was admitted to the clinic for endocrine surgery for laparoscopic surgery of a right adrenal gland incidentaloma measuring 57 × 47 × 59 mm, discovered during a routine abdominal ultrasonography. The patient had a history of hypertension but no other comorbidities. Biochemical and physical examinations revealed no signs of hypercortisolism. Urinary metanephrine and normetanephrine levels were within normal limits. A right laparoscopic adrenalectomy was performed, and a 5 cm tumor was identified without evidence of locoregional invasion. Pathological examination confirmed a Sertoli cell tumor of the adrenal gland. Immunohistochemical analysis revealed positive staining for vimentin, steroidogenic factor 1 (SF1), and beta-catenin, while chromogranin A, hCG, PSA, and TTF1 were negative. The Ki-67 index was 3%. The patient was subsequently referred to a urologist, where testicular ultrasonography showed no abnormalities. There were no signs of recurrence during a 15-month follow-up period. Additionally, the patient's biannual antihypertensive treatment was discontinued by a cardiologist 1.5 months post-surgery.</p><p><strong>Conclusions: </strong>Sertoli cell tumors are an exceptionally rare entity. To our knowledge, this is the first reported case of a primary Sertoli cell tumor originating in the adrenal gland. Given their potential for malignancy, regular follow-up and additional diagnostic evaluations may be necessary. Laparoscopic adrenalectomy appears to be a suitable definitive treatment for this condition.</p>","PeriodicalId":13969,"journal":{"name":"International Journal of Endocrinology and Metabolism","volume":"22 4","pages":"e156823"},"PeriodicalIF":2.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Obesity, Six Weeks of Aerobic Training, and Cold Water Exposure on the Expression of FNDC5 and UCP1 Genes in Male Wistar Rats.","authors":"Sadegh Tohidi, Seyyed Reza Attarzadeh Hosseini, Mohammad Mosaferi Ziaaldini","doi":"10.5812/ijem-142746","DOIUrl":"10.5812/ijem-142746","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a complex disease that has become increasingly prevalent. While obesity itself is not new, its widespread occurrence is a more recent concern. Stimulating brown adipose tissue (BAT) and promoting the browning of white adipose tissue (bWAT) have shown promise as therapeutic targets to increase energy expenditure and counteract weight gain.</p><p><strong>Objectives: </strong>This study aimed to investigate two main aspects. First, we examined how obesity affects the expression of the fibronectin type-III domain containing 5 (FNDC5) and uncoupling protein 1 (UCP1) genes in male Wistar rats. Second, we assessed the effects of six weeks of aerobic exercise, exposure to cold water, and the combination of both on the expression of the FNDC5 and UCP1 genes in obese male Wistar rats.</p><p><strong>Methods: </strong>In this experiment, 25 male Wistar rats were randomly assigned to five groups (5 rats per group) after inducing obesity. The groups included: A control group (C), an obesity group (O), an obesity group exposed to cold water (OC), an obesity group engaged in aerobic exercise (OE), and an obesity group exposed to both cold water and aerobic exercise (OCE). The aerobic exercise sessions lasted 30 - 60 minutes, with a speed of 15 - 25 meters per minute. The cold water exposure protocol involved shallow water (2 - 4 cm) with a temperature of 14 - 18°C. The OCE group performed both aerobic and cold water exercises in each session. The expression of the FNDC5 gene in the soleus muscle and the FNDC5 and UCP1 genes in subcutaneous fat was evaluated using Real-Time PCR. All statistical analyses were performed using SPSS software version 16, with a significance level set at P ≤ 0.05.</p><p><strong>Results: </strong>Obesity significantly increased the expression of the FNDC5 gene (P = 0.008). After six weeks of aerobic exercise (P = 0.016) or cold water exposure (P = 0.016), there was a significant decrease in FNDC5 gene expression. Surprisingly, the combination of both interventions did not result in a significant effect (P = 0.75). On the other hand, none of the interventions-whether aerobic exercise, cold water exposure, or their combination-had a significant effect on the expression of the UCP1 gene (P > 0.05).</p><p><strong>Conclusions: </strong>The increase in FNDC5 gene expression caused by obesity may serve as a compensatory mechanism to cope with the condition. However, both cold water exposure and aerobic exercise appear to mitigate this increase in FNDC5 gene expression through enhanced thermogenesis.</p>","PeriodicalId":13969,"journal":{"name":"International Journal of Endocrinology and Metabolism","volume":"22 4","pages":"e142746"},"PeriodicalIF":2.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Legacy of the Tehran Obesity Treatment Study: Findings from 10 Years Bariatric Surgery Survey.","authors":"Behnaz Abiri, Minoo Heidari Almasi, Farhad Hosseinpanah, Danial Molavizadeh, Alireza Khalaj, Maryam Mahdavi, Majid Valizadeh, Maryam Barzin","doi":"10.5812/ijem-151608","DOIUrl":"10.5812/ijem-151608","url":null,"abstract":"<p><strong>Context: </strong>This paper aims to review the findings of the Tehran Obesity Treatment Study (TOTS) on obesity and bariatric surgery (BS).</p><p><strong>Evidence acquisition: </strong>The objective of this review is to assess all aspects of BS in individuals with severe obesity, focusing on research conducted within the TOTS framework.</p><p><strong>Results and conclusions: </strong>The TOTS studies have produced significant national-level findings, highlighting critical issues related to the effectiveness and outcomes of bariatric procedures, the importance of comprehensive nutritional management, and the complications associated with these interventions in this population.</p>","PeriodicalId":13969,"journal":{"name":"International Journal of Endocrinology and Metabolism","volume":"22 4","pages":"e151608"},"PeriodicalIF":2.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline Clinical Factors Associated with Cessation of Growth Hormone Therapy in Patients with Severe Growth Hormone Deficiency - Real World Evidence.","authors":"Nageswary Nadarajah, Emmanuel Ssemmondo, Shani Brooks, Remi Akinyombo, Kazeem Adeleke, Harshal Deshmukh, Thozhukat Sathyapalan","doi":"10.5812/ijem-147825","DOIUrl":"10.5812/ijem-147825","url":null,"abstract":"<p><strong>Background: </strong>Growth hormone replacement is indicated in adults with severe growth hormone (GH) deficiency, adult growth hormone deficiency assessment (AGHDA) score of at least 11 and are receiving treatment for other pituitary hormone deficiencies. There are no data looking at the cessation of GH replacement in adult patients with severe GH deficiency and the factors that predict the likelihood of patients continuing or stopping growth hormone replacement.</p><p><strong>Methods: </strong>We audited patients on the GH register between January 2006 and January 2023 in Hull University Teaching Hospitals NHS foundation Trust, a UK tertiary hospital. Baseline characteristics, the cause of GH deficiency, AGHDA score at diagnosis and the reason for stopping GH were collected. Proportions were compared between patients adhering to GH replacement and those who had ceased it. Logistic regression analysis was used to identify factors independently associated with cessation of GH.</p><p><strong>Results: </strong>The study comprised 141 adult patients with a mean age of 52 years, of which 75 (53%) were female. 54 (38%) individuals had discontinued GH replacement therapy. Predominant reasons for discontinuation were lack of therapeutic benefit (46%) and a change in clinical indication (26%). Among patients who discontinued GH therapy, the most frequent cause of GH deficiency was idiopathic (57%), while for those on GH replacement, pituitary surgery was the leading cause of GH deficiency (53%). Logistic regression analysis showed no baseline factor was statistically significantly associated with GH cessation, except female gender which had a borderline significance (P = 0.05).</p><p><strong>Conclusions: </strong>In this real-world investigation of patients with severe GH deficiency, over two in five individuals who discontinued GH therapy cited the absence of perceived benefits. We show a borderline association of female gender with GH cessation and large population-based studies will be needed to investigate this and other causes of GH cessation.</p>","PeriodicalId":13969,"journal":{"name":"International Journal of Endocrinology and Metabolism","volume":"22 3","pages":"e147825"},"PeriodicalIF":2.1,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Hydrogen-Rich Water on Blood Lipid Profiles in Metabolic Disorders Clinical Trials: A Systematic Review and Meta-analysis.","authors":"Hamid Jamialahmadi, Ghazaleh Khalili-Tanha, Mostafa Rezaei-Tavirani, Elham Nazari","doi":"10.5812/ijem-148600","DOIUrl":"10.5812/ijem-148600","url":null,"abstract":"<p><strong>Context: </strong>Metabolic disorders are a growing global concern, especially in developed countries, due to their increasing prevalence. Serum lipid profiles, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), and low-density lipoprotein (LDL), are commonly used clinical biomarkers for monitoring the progression of these metabolic abnormalities. In recent decades, hydrogen-rich water (HRW) has gained attention as a safe and effective treatment, with regulatory effects on lipid peroxidation and inflammatory responses in clinical trials.</p><p><strong>Objectives: </strong>This systematic review and meta-analysis aim to evaluate the effectiveness of HRW therapy on blood lipid profiles in randomized controlled trials (RCTs) for metabolic disorders.</p><p><strong>Methods: </strong>Following the PRISMA guidelines, a search for RCT studies was conducted in the PubMed, Web of Science, Embase, and Google Scholar databases up to January 2024. Eight studies that met all eligibility criteria, including RCTs involving metabolic dysfunctions and evaluations of lipid profiles, were included for further analysis. Data extraction was followed by quality evaluation using the Jadad scoring system. Meta-analysis was conducted using STATA software.</p><p><strong>Results: </strong>The eight selected RCTs included a total of 357 patients with various metabolic disorders. All studies showed either no or low risk of bias. The overall levels of TG [95% CI: -0.27 (-0.47, -0.07)], TC [95% CI: -0.07 (-0.32, -0.18)], and LDL [95% CI: -0.06 (-0.28, 0.15)] demonstrated slight decreases across the studies. However, there was some heterogeneity in HDL levels [95% CI: -0.11 (-0.37, 0.14)] among the studies (I² = 37.32%). Meta-regression analysis further indicated a positive association between the outcomes and the duration of the intervention as a moderating factor.</p><p><strong>Conclusions: </strong>Hydrogen-rich water demonstrated modest lipid-lowering effects in patients with metabolic disorders. However, due to the observed heterogeneity in HDL variations, further long-term trials involving larger populations are needed to clarify these inconsistencies.</p>","PeriodicalId":13969,"journal":{"name":"International Journal of Endocrinology and Metabolism","volume":"22 3","pages":"e148600"},"PeriodicalIF":2.1,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Gluten-Free Diet on HbA1c Level in Children with Type 1 Diabetes Mellitus and Celiac Disease.","authors":"Hedieh Saneifard, Ali Sheikhy, Aida Fallahzadeh, Marjan Shakiba, Maryam Kazemi Aghdam, Asieh Mosallanejad","doi":"10.5812/ijem-144736","DOIUrl":"10.5812/ijem-144736","url":null,"abstract":"<p><strong>Background: </strong>Due to autoimmune mechanisms, celiac disease (CD) may affect patients with type 1 diabetes mellitus (T1DM) more than the general population.</p><p><strong>Objectives: </strong>We evaluated the effect of a gluten-free diet (GFD) on HbA1c levels in patients with both type 1 diabetes and CD.</p><p><strong>Methods: </strong>In this cross-sectional study, biochemical and clinical information was gathered from 174 children with T1DM from January 2013 to January 2019.</p><p><strong>Results: </strong>We assessed 174 children with T1DM (93 girls and 81 boys). Celiac disease was diagnosed in 18 out of 174 cases (10.34%). Height and weight percentiles showed significant differences between children with CD and those without CD (P = 0.015 and P = 0.026, respectively). The average HbA1c in the celiac group was 8.61 ± 2.20 (95% CI: 5.1 - 12.1) prior to GFD therapy. HbA1c was assessed six and twelve months following the initiation of the GFD and was found to be 8.32 ± 1.46 (95% CI: 6 - 9.8) and 8.37 ± 1.67 (95% CI: 6.1 - 10.2), respectively. No significant change in HbA1c was observed before and after therapy (P = 0.501).</p><p><strong>Conclusions: </strong>Diabetic children with CD exhibit lower weight and height compared to those without CD. Gluten-free diet therapy in patients with CD did not affect HbA1c levels.</p>","PeriodicalId":13969,"journal":{"name":"International Journal of Endocrinology and Metabolism","volume":"22 3","pages":"e144736"},"PeriodicalIF":2.1,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication Adherence of Children with Congenital Hypothyroidism in Iran: A National Cross-Sectional Study.","authors":"Shahin Yarahmadi, Bahram Nikkhoo, Shiva Bararpour, Parisa Marabi, Khaled Rahmani","doi":"10.5812/ijem-150329","DOIUrl":"10.5812/ijem-150329","url":null,"abstract":"<p><strong>Background: </strong>Congenital hypothyroidism is the most common preventable and treatable cause of intellectual disability in children. A key component of the surveillance system for congenital hypothyroidism is ensuring a regular treatment program for affected children. Despite nearly 20 years since the successful implementation of the newborn screening program for hypothyroidism in Iran, a comprehensive evaluation of patients' adherence to treatment has not been conducted.</p><p><strong>Objectives: </strong>The aim of this study was to investigate the adherence to treatment among patients with congenital hypothyroidism in Iran.</p><p><strong>Methods: </strong>In this national cross-sectional study conducted in 2024, the adherence to treatment of 400 children with congenital hypothyroidism born between 2019 and 2023 in Iran was examined using the Morisky Medication Adherence Scale. The patients were randomly selected from national registry data. Data were analyzed using chi-squared tests, Fisher's exact test, and logistic regression in Stata software version 16.</p><p><strong>Results: </strong>The mean and standard deviation of medication adherence was 6.35 ± 1.41. Overall, adherence was good (≥ 6) in 284 (71.0%) of the study participants. In the univariate analysis, the most significant factors influencing adherence were place of residence, higher maternal education, lower paternal education, and type of congenital hypothyroidism (CH). In the multivariate analysis, children with permanent CH had good adherence, and parental education was not statistically significant (P > 0.05).</p><p><strong>Conclusions: </strong>The results of this study showed that medication compliance in more than two-thirds of hypothyroid children diagnosed by national newborn screening is good. Given the importance of treatment in these patients, it is recommended that intervention plans be implemented, including educational programs and active follow-up of patients to increase compliance.</p>","PeriodicalId":13969,"journal":{"name":"International Journal of Endocrinology and Metabolism","volume":"22 2","pages":"e150329"},"PeriodicalIF":2.1,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}