International Journal of Endocrinology and Metabolism最新文献

Context: Coronavirus disease 2019 (COVID-19) has been one of the deadliest pandemics in recent decade. The virus has specifically targeted the comorbid population in terms of mortality. The present systematic review and meta-analysis aimed to determine the overall mortality and diabetes-associated mortality in COVID-19 patients.

Methods: To obtain the related data, six databases, including Pubmed, Embase, MEDLINE, Web of Science, Google Scholar, and DOAJ, were searched. The full-texts of articles presenting the data of COVID-19 mortality and diabetes-associated mortality were screened and retrieved. Statistical analysis was performed using the Stata (version 13). The odds ratio (OR) of mortality in diabetic patients was calculated with 95% confidence interval (CI). Random-effects model was used to synthesize data for the relevant outcomes. Heterogeneity was evaluated using I2 statistic. Forest plots visually showed the effect estimates of the included studies. We used funnel plots to evaluate potential publication bias. A two tailed P < 0.05 was considered as statistically significant.

Results: A total of 35 studies with 25,934 patients were finally included for meta-analysis. The pooled prevalence of diabetes mellitus in patients with COVID-19 was 16.8% (n = 4381). The overall mortality seen in all the studies was 12.81% (n = 3159), and diabetes-associated mortality was 22.14% (n = 970). The pooled analysis of included studies showed that diabetes mellitus had a significantly higher mortality rate (22.14% vs. 12.81%, P < 0.05) with higher odds of death (pooled OR 1.83, 95% CI: 1.61 - 2.05). The funnel plot was symmetric, thereby indicating a low risk of publication bias.

Conclusions: In conclusion, the presence of diabetes was associated with a significantly increased risk of mortality in patients admitted to the hospital with COVID-19. Thus, this subpopulation must be continuously monitored for glycemic levels, coagulation abnormalities, and inflammatory surge.

Background: Maternal characteristics have been known to be associated with parenting practices, which could eventually influence their child's weight and health-related quality of life (HRQoL).

Objectives: This study aimed to assess the direct and indirect associations of maternal emotional states (depression, anxiety, and stress) with body mass index (BMI) and HRQoL in their children.

Methods: This study was conducted within the framework of the Tehran lipid and glucose study (TLGS). Participants were the children (n = 231) enrolled in TLGS during 2014 - 2016, who had complete data on maternal emotional states. The body weight and height of children were measured using the standard protocol, and BMI Z-score was determined using Anthroplus. Also, HRQoL in children and emotional states in mothers were assessed using the Iranian version of the pediatric quality of life inventory (PedsQLTM4.0) and the depression, anxiety, and stress scale (DASS-21), respectively. Structural equations modeling (SEM) was used to assess the direct and indirect relations of maternal emotional states with children's BMI Z-score and HRQoL.

Results: Mean age, BMI Z-score, and HRQoL total score in children were 13.8 ± 3.1 years, 0.74 ± 1.5, and 84.7 ± 11.3, respectively. In the mothers, median DASS-21 scores (interquartile ranges) in the three scales of depression, anxiety, and stress were 4 (0 - 10), 6 (2 - 12), and 14 (8 - 20), respectively. Maternal level of education was significantly associated with the DASS-21 score (β = -0.23, 95% CI: -0.37,-0.07). Maternal DASS-21 score was significantly associated with BMI Z-score only in girls (β = 0.25, 95% CI: 0.06, 0.53). Significant determinants of HRQoL in boys were the child's age (β = -0.21, 95% CI: -0.40, -0.01) and maternal education (β = -0.24, 95%CI: -0.44, -0.02) and emotional state (β = -0.24, 95% CI: -0.44, -0.03). The child's age (β = -0.33, 95% CI: -0.53, -0.10) and maternal emotional state (β = -0.31, 95% CI: -0.54, -0.08) were significantly associated with HRQoL in girls.

Conclusions: The maternal emotional state is an important determinant of HRQoL in children, regardless of their weight status. Further research is recommended to examine the current hypothesized model in rural and suburban populations, taking into consideration more influential factors.

Background: Following menopause, the risk of many diseases is increased, and this situation may be due to changes in anthropometric indices (AI), while the association between adiposity and age at natural menopause (ANM) is not clear yet.

Objectives: This longitudinal study was conducted to investigate the ability of AI in predicting ANM.

Methods: For this purpose, a total of 3,876 women aged > 20 years old from participants of the Tehran lipid and glucose study (TLGS) met our eligibility criteria. The association between ANM and various AIs was assessed using the Accelerated Failure Time (AFT) model, and time ratio (TR) with 95% confidence intervals was reported in this longitudinal study.

Results: The median [interquartile range (IQR) 25 - 75] of the survival time was 12.5 (7.9 - 15.8) years. At the end of the follow-up, 1,479 (38.2%) of the participants reached menopause. The median time to natural menopause was decreased by about 2% with one standard deviation (SD) increase of both a body shape index (ABSI) (time ratio (TR): 0.98, 95% CI: 0.97, 0.99) and lipid accumulation product (LAP) (TR: 0.98, 95% CI: 0.98, 0.99) z-scores; and this time was increased by about 1% (TR: 1.01, 95% CI: 1.00, 1.02) with one SD increase in body mass index (BMI) z-score.

Conclusions: The ABSI, LAP, and BMI were the most useful AIs for identification of the time to menopause onset, and ABSI and LAP were inversely associated with the ANM. Also, the BMI was directly associated with the ANM.

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Context: There has been an increasing emphasis on the role of education in diabetes prevention and management, and shedding light on evidence gaps is mandatory for national action plans establishment.

Data sources: This scoping review was part of the Iranian Diabetes Road Map project that used a systematic method based on the Arksey and O'Malley approach.

Results: After the screening, 173 articles were included, most of which were published in 2018 and focused on self-management. Most included articles were considered patient-related self-management/care/efficacy, while only a limited number of articles studied healthcare provider education and educational establishment. Additionally, a significant number of included studies were addressed virtual education, an issue as the strength of Iranian studies in diabetes education.

Conclusions: Education is an important part of diabetes, and specific needs for Iranian patients should be addressed in future studies. Paying attention to new topics and conducting high-quality interventional studies will help fill evidence gaps in this field in Iran.

Background: The actions of adipocytokines may be a connective factor between obesity and polycystic ovary syndrome (PCOS). It is suggested that irisin, as recently described cytokine secreted by skeletal muscles and glucose-dependent insulinotropic polypeptide (GIP) as an incretin hormone that induces cytokine expression, may play key roles in favoring obesity in these women.

Objectives: We aimed to evaluate the association between body mass index (BMI) and serum concentrations of irisin/GIP in women with and without PCOS in the linear and non-linear models.

Methods: This cross-sectional study was conducted among 159 PCOS and 82 healthy eumenorrheic non-hirsute women aged 20 - 50 years. The fractional-polynomial model was used to develop a model of continuous risk factors, which evaluates non-linear associations between irisin/GIP and BMI among women with and without PCOS.

Results: Women with PCOS were significantly younger (28.2 ± 5.8 vs. 33.0 ± 7.8 years, P < 0.001) and had a greater BMI (26.6 ± 5.2 vs. 25.2 ± 4.8 kg/m², P = 0.04) than the healthy counterparts. There were no significant linear and non-linear associations between serum concentration of irisin/GIP and BMI in both groups. The analysis of pair-wise age and BMI matching of women with PCOS and controls confirmed these findings.

Conclusions: This study showed that irisin and GIP have no association with BMI in women with or without PCOS. This finding could help to better understand the underlying pathophysiological status of PCOS, insulin resistance, and obesity-related disorders. Further large cohort studies are needed to confirm these findings.

Introduction: Rapid-onset obesity concurrently with hypoventilation, hypothalamic, autonomic dysregulation (ROHHAD) is an uncommon disease that presents with multiorgan disorders during early childhood, with fewer than 100 cases reported around the world. We aim to present a case of ROHHAD syndrome admitting with rare neurologic symptoms. We also present our treatment regimen.

Case presentation: An 8-year-old boy was admitted to our department with ataxia and gait disturbance that led us to the final diagnosis after a thorough investigation. He had multiple admissions and was treated for other diagnoses. His first symptoms started from age 5 with obstructive apnea. He underwent an adenectomy surgery at that time, but the symptoms continued. A year after the surgery, he was admitted again due to his somnolence but was diagnosed only with hypothyroidism and anemia. At the age of 7 years and 8 months, he was admitted to our department with ataxia and abnormal gait from the past year with instability and numerous falls. He also had shown hyperphagia that had been resulted in 10 kilograms of weight gain in six months. He was experiencing gradual behavioral symptoms, including episodes of self and hetero aggression and impulsivity. His other symptoms included fatigue, somnolence, gastrointestinal dysmotility, hyperhidrosis, central hypothyroidism, polyuria, precocious puberty, and rapid obesity. His laboratory investigation revealed hyperprolactinemia.

Conclusions: Our case indicates that ROHHAD is a complex disease with divergent signs and symptoms that needs to be kept in mind for diagnosis and should be treated with a high level of collaboration of various medical specialties. Since late diagnosis of this syndrome leads to a magnificent increase in morbidity and mortality rates, it is vital to pay extreme attention to this syndrome. The diagnosis should be considered even more in children over two years old with rapid-onset obesity, which is accompanied by other symptoms. Here, our patient's complaint was ataxia that revealed the underlying cause after investigation.

Background: Familial non-medullary thyroid cancer (NMTC) are supposed to be more aggressive and require more frequent treatment compared to non-familial thyroid cancer.

Objectives: This matched case-control study aimed to compare the response to treatment between the matched case-control groups of familial and sporadic NMTC.

Methods: This is a retrospective study in patients with familial NMTC (at least one other first-degree relative involved) who were treated with surgery, followed by radio-iodine therapy (RIT) without consideration of its familial origin. Response to treatment was compared between familial NMTC and age, sex, and TNM stage-matched non-familial NMTC (control group). Response to treatment was assessed one and two years after RIT, and time to excellent response was identified.

Results: Out of 2,944 NMTC patients, 81 (2.75%) patients had familial NMTC. We compared 66 patients with familial NMTC and 66 sporadic NMTC patients. There was no significant difference in first thyroglobulin, initial and accumulative iodine dose, and additional treatments (additional surgery and radiotherapy) between patients and controls. Although no significant difference was noted in one and two years' responses to treatment between the case and control groups, familial NMTC patients required more time to achieve excellent response (26.7 ± 24.9 versus 15.9 ± 9.0 months, P = 0.01). No significant difference was noted between familial NMTC patients with two or more than two involved relatives.

Conclusions: Our study showed that if patients with familial NMTCs were treated in the same way as non-familial patients, the time to excellent response would be significantly longer, even when they have only one other involved relative.