مجله‌ي بین المللی غدد درون‌ريز و متابوليسمInt J Endocrinol MetabMedical Scienceshttp://www.ijem.org1726-913Xen

Post-Modern Medicine: Reconciling Traditional and Modern Medical PracticeKaynamaMR^a, Saberi M^b, Tazmini G^cKaynamaMR^a Saberi M<sup>b</sup> Tazmini G<sup>c</sup><sup>a</sup>Division of Endocrinology, Department of Medicine, Arad Hospital, Tehran, I.R.Iran <sup>b</sup>American College of Physicans, Delaware, US, <sup>c</sup>Kent University, UKEditorial....Post-Modern MedicineMR Kaynama7/1/2008 12:00:00 AM7/2/2008 12:00:00 AMgf_mkey@yahoo.com25862http://www.ijem.org/Default.aspx

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Medroxyprogesterone Acetate and Progesterone, Used Short Term, Do not Adversely Affect Forearm Reactive Hyperemia in Postmenopausal Women on Estradiol TherapyCho MM^a, Hodis HN^b, Mack WJ^b, Roy S^c, Paulson RJ^c, Li Y^c, Stanczyk FZ^cCho MM^a Hodis HN<sup>b</sup> Mack WJ<sup>b</sup> Roy S<sup>c</sup> Paulson RJ<sup>c</sup> Li Y<sup>c</sup> Stanczyk FZ<sup>c</sup><sup>a</sup>Department of Obstetrics, Gynecology, and Women’s Health, UMDNJ-New Jersey Medical School, Newark, NJ; <sup>b</sup>Departments of Medicine and Preventive Medicine, Atherosclerosis ResearchOriginal ArticleThis study aimed at investigating whet-her oral medroxyprogesterone acetate (MPA) or micronized progesterone (P) combined with micronized estradiol (E2) adversely affect endothelial function in postmenopausal women. Materials and Methods: Randomized, double-blind, crossover trial of MPA or micronized P with oral E2 treatment in menopausal women. Result: Flow-mediated, endothelium-dependent vasodilation of the brachial artery was not sig-nificantly affected by short-term administration of E2 alone or E2 combined with cyclic MPA, or E2 combined with cyclic P. Conclusion: Short-term oral E2 treatment of postmenopausal women alone or with cyclic oral MPA or oral P did not affect flow-mediated en-dothelium-dependent vasodilation. Medroxyprogesterone acetate, pro-gesterone, estradiol, forearm reactive hyperemia.Effects of MPA and P on reactive hyperemiaMichael M. Cho12/30/2007 12:00:00 AM7/2/2008 12:00:00 AMchomm@umdnj.edu26369http://www.ijem.org/Default.aspx

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The Effects of Thiazolidinedione Therapy on NT-proBNP Levels in Patients with Type 2 DiabetesTildesley HD^a,b, Aydin CM^a, Billington E^a, Ignaszewski AP^a,b, Strelzow JA^a, Wise SJ^b, Yu E^a,c, Bondy GP^a,bTildesley HD<sup>ab</sup> Aydin CM<sup>a</sup> Billington E<sup>a</sup> Ignaszewski AP<sup>ab</sup> Strelzow JA<sup>a</sup> Wise SJ<sup>b</sup> Yu E<sup>ac</sup> Bondy GP<sup>ab</sup><sup>a</sup> St. Pauls Hospital; <sup>b </sup>University of British Columbia; and; <sup>c</sup>Center for Health Evaluation and Outcome Sciences, Vancouver BC, Canada Original ArticleWe sought to determine whether thiazolidinedione (TZD) therapy affects levels of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with type 2 diabetes. Materials and Methods: This study population consisted of 76 patients with type 2 diabetes and no history of heart failure. Subjects had NT-proBNP levels determined prior to initiating TZD therapy, and after 3 months of treatment. We compared within-person changes in NT-proBNP over the 3 month duration. We determined if the magnitude of change in NT-proBNP over the treatment period was correlated with baseline parameters or nature/dose of TZD medication. Results: The subjects were 42% female and 58% male, and the mean age and duration was 59.8&amp;#177;11.8 years old and 11.4&amp;#177;8.3 years respectively. The baseline mean A1C and BMI was 8.7&amp;#177;1.1% and 30.9&amp;#177;8.7 kg/m2 respectively. We found that NT-proBNP levels did not vary significantly between baseline (mean&amp;#177;SD: 143.8&amp;#177;203.9 pg/mL) and 3 month follow-up (150.6&amp;#177;186.2 pg/mL). Conversely, A1C levels declined significantly (p&amp;lt;0.0001) and BMI increased significantly (p&amp;lt; 0.05). Conclusion: Adding TZD therapy to patients with type 2 diabetes and no history of heart failure does not have a significant effect on NT-proBNP levels. Thiazolidinedione, NT-proBNP, Type 2 diabetes, Congestive heart failureTZD therapy and NT-proBNP levelsHugh D. Tildesley3/6/2008 12:00:00 AM6/1/2008 12:00:00 AMhught@istar.ca27077http://www.ijem.org/Default.aspx

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Relation Between Secretory Status of Growth Hormone, Serum Concentration of Insulin-like Growth Factor I, and Insulin-like Growth Factor Binding Protein 3 with Bone Mineral Density in Postmenopausal WomenAliasgharzadeh A, Bahrami A, Najafipoor F, Astanei A, Niafar M, Aghamohammadzadeh N, Mobasseri MAliasgharzadeh A Bahrami A Najafipoor F Astanei A Niafar M Aghamohammadzadeh N Mobasseri MEndocrine and Metabolism Research Center, Emamreza Teaching Hospital Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, I.R. Iran Original ArticleAlthough the decline in sex steroid levels, particularly estradiol, may be largely responsible for age-related bone loss and osteoporotic fractures in older women, the insulin-like growth factor (IGF) system may also play a key role. This study aimed at evaluating the relation between the secretory status of growth hormones (GH), insulin-like growth factor I (IGF-I) and In-sulin-like growth factor binding protein 3 (IGFBP3) and bone mineral density (BMD) in postmenopausal women. Materials & Methods: In a descriptive cross-sectional study, 150 postmenopausal healthy women were selected from among 1328 patients, referred to Tabriz Sina Hospital for bone densi-tometry, and divided into three groups according to their bone mineral density (BMD) (normal, os-teopenic and osteoporotic). The GH response to provocation by clonidine was assessed in all pa-tients. Results: One hundred and fifty patients with a mean age of 65.6±6.6 years, were enrolled in this study. The impaired GH response to provocation by clonidine was significantly more common in the group with osteoporosis compared to their healthy and osteopenic counterparts (72% vs. 56% and 44%, respectively; p=0.018). Mean levels of serum IGF-I and IGFBP3 were not signifi-cantly different in healthy, osteopenic and os-teoporotic patients (55.4±20.7 μg/L, 57.5±21.7 μg/L, and 56.7±19.2 μg/L; p=0.880 and 2648.3±786.4 ng/ml, 2374.0±707.2 ng/ml, and 2613.5±1023.6 ng/ml; p=0.217, respectively). There was no strong cor-relation between the level of serum IGF-I or IGFBP3 and T-Score (r=-0.026, p=0.753 for IGF-1 and r=0.046, p=0.575 for IGFBP3). Conclusion: The results of this study showed that the defective release of GH is more prevalent in postmenopausal women suffering from osteoporosis; such a defect was not observed regarding serums of IGF1 and IGFBP3. Prescription of supplementary doses of synthetic GH might be beneficial in this population. Growth hormone, Insulin-like growth factor I, Insulin-like growth factor binding protein 3, Postmenopausal, Bone mineral densityRelation between secretory status of Growth HormoneAkbar Aliasgharzadeh2/13/2008 12:00:00 AM7/1/2008 12:00:00 AMasgharzadeha@tbzmed.ac.ir27888http://www.ijem.org/Default.aspx

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Comparison of Umbilical Cord and Maternal Serum Levels of IGF-1, Leptin and Cortisol in Appropriate for Gestational Age and Small for Gestational Age NeonatesKaramizadeh Z, Saki S, Kashef S, Saki FKaramizadeh Z Saki S Kashef S Saki FDepartment of Pediatrics, Shiraz University of Medical Sciences, Shiraz, I.R. IranOriginal ArticleIGF-1), leptin, and cortisol concentrations in maternal and umbilical cord vein and to investi-gate the relationship between these values and fetal growth in appropriate for gestational age (AGA) and small for gestational age (SGA) neo-nates. Materials and Methods: In a case-control study, maternal and umbilical cord venous samples were collected from 25 SGA neonates and 25 AGA neonates in the obstetric ward at Hafez Hospital, Shiraz, Iran, between 2004 and 2005. Serum levels of IGF-1, leptin, and cortisol were measured by specific radioimmunoassay using commercial kits. Results: Mean maternal age was 25.38±5.22 years (range 17-38 yr) and mean gestational age was 37.92±1.79 weeks (range 34-41 weeks). Mean con-centration of leptin and IGF-1 in cord blood was lower in SGA as compared with AGA neonates (p<0.012 and p<0.001, respectively). Maternal se-rum concentration of IGF-1 and cortisol were lower in SGA neonates (p<0.032 and p<0.011, re-spectively), however there was no significant difference in the concentration of maternal leptin levels between the two groups. A correla-tion was observed between the head circumfer-ence of neonate and maternal cortisol levels in the SGA group (p<0.01). Conclusion: Low IGF-1 and leptin concentra-tions in cord blood and low maternal serum con-centration of IGF-1 and cortisol are associated with growth retardation in SGA as compared to AGA neonates. Also maternal cortisol level plays an important role in intrauterine brain de-velopment of SGA neonates. Leptin, Cortisol, IGF-1, Intrauterine growth retardationUmbilical cord and maternal IGF-1, leptin, cortisolZohreh Karamizadeh9/7/2007 12:00:00 AM5/29/2008 12:00:00 AMkaramizadehz@sums.ac.ir28994http://www.ijem.org/Default.aspx

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Evaluation of the Effectiveness of Local Insulin Injection in Type 2 Diabetic Patients with Carpal Tunnel SyndromeAshraf A, Yazdani AH, Mirshams SAshraf A Yazdani AH Mirshams SDepartment of Physical Medicine and Rehabilitation, Shiraz University of Medical Sci-ence, Shiraz I.R. IranOriginal ArticleCarpal tunnel syndrome (CTS) is the most com-mon type of peripheral nerve entrapment and is a significant cause of morbidity; this syndrome has a higher incidence in diabetic patients. It has been suggested that insulin has an effect on nerve regeneration similar to that of nerve growth factor (NGF). Hence we aim to evaluate the effectiveness of local insulin injection on the median nerve in patients with type 2 diabetes mellitus who have mild-to-moderate carpal tun-nel syndrome. Materials and Methods: We carried out a single-blind randomized controlled trial (RCT) study in 50 patients, using a simple sampling and a ran-dom allocation of these 50 patients, of whom 20 had bilateral mild-moderate CTS, into two groups; 35 women and 15 men, aged between 43 to 60 years old, resulting in 70 hands, were cate-gorized into two groups. At baseline, we injected NPH insulin (10 U) directly into the carpal tun-nel in group 1 and performed physiotherapy for the other group (group 2). Two weeks later, NPH insulin (10 U) was again injected into the carpal tunnel, while physiotherapy was continued for group 2. Electrodiagnostic studies were carried out for these both groups before and 4 weeks af-ter the last injection and physiotherapy, and pa-tients were followed up for 6 weeks. Results: In both groups, decrement of distal mo-tor latency (DML) of the median nerves was sta-tistically significant, as was the increment of the sensory nerve conduction velocity. Also the dec-rement of pain, paresthesia, numbness, weak-ness/clumsiness and nocturnal awaking was sta-tistically significant in both groups; however there was no significant difference between two the groups. Conclusion: Local insulin injection is an effec-tive and safe treatment for carpal tunnel syn-drome in type 2 diabetic patients as physiother-apy. Carpal tunnel syndrome, Type 2 diabe-tes mellitus, Electrodiagnosis, Insulin, Physiother-apy Local Insulin Injection in Carpal Tunnel Syndrome Amir H Yazdani2/16/2008 12:00:00 AM6/29/2008 12:00:00 AMah_yazdani@hotmail.com295103http://www.ijem.org/Default.aspx

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Evaluation of Endocrine Disorders in Patients with Thalassemia MajorNajafipour FNajafipour FDepartment of Endocrinology and Metabolism, Emam Reza Hospital, Tabriz University of Medical sciences, Tabriz, I.R. IranOriginal ArticleThalassemia major is a genetic disorder and blood transfusion is critical for survival in these patients. Over the course of the past three dec-ades, hyper transfusion therapy in these patients has shown significant increase in life expectancy and quality of life. Unfortunately this type of therapy also increased the frequency of compli-cations due to iron overload. The aim of this study was to evaluate the prevalence of endo-crine disturbances in patients, aged over 10 years, with thalassemia major. Materials and Methods: Fifty six patients, aged over 10 years, with thalassemia major were en-rolled. Physicians collected demographic data and history of therapies as well as menstrual his-tories in females. Patients were examined to de-termine their pubertal status and SDS of height for evaluation of short stature. For evaluation of glucose tolerance, fasting blood glucose and oral glucose tolerance tests were performed. Serum levels were measured for calcium, phosphorous, thyroid stimulating hormone, free thyroxin, lu-teinizing hormone, follicular stimulating hor-mone, and estradiol and testosterone in girls and boys respectively. Results: Fifty-six patients with thalassemia ma-jor, aged between 10-27 years, were evaluated. In this study prevalences of diabetes mellitus, im-paired fasting glucose and impaired glucose tol-erance test were 8.9%, 28.6% and 7.1% respec-tively. Short stature (SDS ≤-2) was seen in 70% of boys and in 73% of girls. Hypocalcaemia and primary overt hypothyroidism were present in 41% and 16% respectively; 14.3% of our patients had no endocrine abnormalities. Conclusion: Despite recent therapy with Desferal in the management of beta-thalassemia major, the risk of secondary endocrine dysfunction remains high. Hypogonadism is one of the most frequent endocrine complications. Endocrine evaluation in patients with thalassemia major must be carried out regularly especially in those patients over the age of 10 years, in Tabriz. Thalassemia major, Hypocalcaemia, Hypogonadism, Hypothyroidism, Diabetes mellitus, Impaired glucose tolerance test, Impaired fasting glucose, Endocrine disorders, Growth retardEndocrine Disorders in ThalassemiaFarzad Najafipour11/22/2007 12:00:00 AM4/23/2008 12:00:00 AMNajafipourf@tbzmed.ac.ir2104113http://www.ijem.org/Default.aspx

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The Effect of Age on Ovarian Reserve Markers in Tehranian Women with Normal FertilityMoini A^{a ,b}, Shafizadeh N^a, Vahid Dastjerdi M^a, Majidi SH^a, Eslami B^aMoini A<sup>a b</sup> Shafizadeh N<sup>a</sup> Vahid Dastjerdi M<sup>a</sup> Majidi SH<sup>a</sup> Eslami B<sup>a</sup><sup>a</sup> Department of Gynecology and Obstetrics, Roointan-Arash Womens Health Research and Educational Hospital, Tehran University of Medical Sciences; <sup>b</sup> Department of Endocrinology anOriginal ArticleThe main goal of this study was to evaluate the effect of age and body mass index (BMI) on ovar-ian reserve markers in fertile Iranian women. Materials &amp;amp; methods: One hundred fifteen fer-tile women were included in this cross-sectional study conducted from May 2005 until December 2006 in the Arash Hospital, Tehran. A transvagi-nal ultrasound examination and blood test were carried out between the third and fifth day of their menstrual cycle (follicular phase). The ovarian volume was measured and total antral follicles (AFC) were counted. Hormonal markers such as FSH, LH and estradiol were measured. Results: Age had positive correlation with FSH (r = 0.819, P &amp;lt;0.01) and FSH/LH (r = 0.452, P &amp;lt;0.01). Meanwhile age had negative correlation with to-tal ovarian volume (r=-0.835) and AFC (r=-0.924) P value &amp;lt; 0.01. Age had no effect on LH and es-tradiol levels (P &amp;gt; 0.05). Comparison of ovarian reserve markers between the four age subgroups (25-30, 31-35, 36-40 and 41-45 years) showed the FSH level, total ovarian volume and AFC had significant differences between these groups, while LH and estradiol did not different be-tween subgroups. Meanwhile BMI had moderate positive correlation with FSH (r = 0.35, P &amp;lt;0.01) and LH (r=0.30, P &amp;lt;0.01) and moderate negative correlation with estradiol (r=-0.20, P&amp;lt;0.05), total ovarian volume (r=-0.31) and AFC (r=-0.41) by P &amp;lt;0.01. In multivariate analysis after adjustment of age, BMI as an independent factor had no ef-fect on ovarian reserve markers. Conclusions: AFC had the best correlation with age, followed by ovarian volume, FSH level and FSH/LH, making it a better predictor of ovarian response than BMI. Age, Ovarian reserve marker, FSH/LH ratio, fertile women, AFC, Ovarian volumeOvarian reserve markers in fertile womenAshraf Moini5/12/2008 12:00:00 AM7/2/2008 12:00:00 AMhosp_arash@tums.ac.ir2114119http://www.ijem.org/Default.aspx

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