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Abstract: Thyroid function disorders (hypothyroidism and hyperthyroidism) are relatively common, and more frequently seen in females than in males. They have significant cardiovascular effects and often simulate cardiac diseases, specially hyperthyroidism that can induce and aggravate CAD, CHF and AF. Cardiac diseases and hyperthyroidism have some similar symptoms and signs, so clinical diagnosis of latter in the presence of the former is difficult. We evaluated 382 patients admitted to CCU of Modarres and Taleghani hospitals. After signing informed consent, TRH test was performed on all of them, clinical data including symptoms, signs, cardiac diagnosis and diagnostic methods, were evaluated too. Of these 382 patients, 186 (%48.7) were in Modarres and 196 (%51.3) in Taleghani hospital. Mean age of patients was 60.5±11.3 year. 164 (%42.9) were female and 218 (%57.7) male. History of thyroid disease was found in %10.7. %47.1 of patients had cardiac diagnosis of unstable angina, %17.8 AMI and %15.2 CHF. These ratios were similare in two hospitals. 27 (%6.3) of these 382 patients had thyroid function disorders including 9 (%2.4) hyperthyroidism and 15 (%3.9) hypothyroidism, of these 7 (%29.2) were female and 17 (%70.8) male, and only 3 (%13) had history of thyroid disease. 8 of 9 patients with hyperthyroidism were in Taleghani (%4.1 hyperthyroidism) and 1 in Modarres (%0.5 hyperthyroidism) (P<0.02) and all patient were male. 10 of 15 patients with hypothyroidism were in Taleghani (%5.1 hypothyroidism) and 5 (%2.7 hypothroidism) in Modarres hospital (P<0.35). 7 (%46.6) were female and 8 (%53.4) male. The prevalence of hypothyroidism in patients ≤50 year old (%9.6) was higher than that in patients 51-71 year old (%3.75) (P<0.07) but conversely the prevalence of hyperthyroidism in patients 51-71 year old (%4.2) was higher than in patient ≤ 50 year old (%0). 48 (%12.8) of all admitted patients had noncardiac disease and %10.4 of them had thyroid function disorders, %6.2 hypothyroidism and %4.2 hyperthyroidism. This research revealed that thyroid function disorders are relatively common in CCU-admitted patients and also more common in patients ≤ 50 year old. Hypothyroidism was more common than hyperthyroidism and hyperthyroidism more frequent in males than in females.

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Abstract: Iodine deficiency disorders (IDD) constitute a worldwide health problem. Many parts of the Islamic Republic of Iran had been known as areas of endemic goiter. IDD was accepted as a priority health problem in the country, and a National IDD Council was formed in 1989, under the supervision of the Ministry of Health and Medical Education. One of the main strategies of National council for IDD control was to provide at least 150 μg of iodine per day to the entire population through making iodized salt available. This study was performed to evaluate the National IDD Council program in 1996, in rural and urban areas of Fars province. 1350 schoolchildren, aged 8 to 10 years, including 50% girls and 50% boys, were selected through random sampling. Grading of goiter was performed according to WHO classification. Serum T3 and T4 were measured by RIA and uninary iodine by digestion method. The mean serum T4 and T3 were: 10.0±1.4 μg/dl, and 141±18 ng/dl, respectively. There were no differences between males and females and schoolchildren of rural or urban areas. Five persons had serum T4 more than 12.5 μg/dl. The mean urinary iodine was 30 μg/dl in entire population, 89% had urinary iodine more than 10 μg/dl. Only 4% had urinary iodine less than 5 μg/dl. Total prevalence of goiter was 68% (69% in girls and 66% in boys). Based on the available data, seven years after generalized use of iodized salt and 2 years after the use of iodized salt by more than 50% of pupulation, urinary iodine in schoolchildren of Fars province is in acceptable range. However, goiter is still hyperendemic in Fars province.

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Abstract: Iodine deficiency disorders are usually found in the countries with malnutrition problems. One of the most important problems of malnutrition is iron deficiency, which can affect thyroid metabolism and it may decrease the effect of iodine supplementation. This is a cross-sectional study to determine serum ferritin concentration and its association with the prevalence of goiter, urinary iodine and thyroid function. Schoolboys and girls aged 8-10 years were equally and randomly selected from 26 provinces of the country. In total, 36178 schoolchildren were assessed for goiter. Blood and urinary samples were taken randomly from 10% of the subjects for the measurement of T4, T3, TSH, T3RU, ferritin and urinary iodine. The prevalence of goiter was more than 50% in 6, 40-50% in 7 and less than 40% in 13 provinces. Changes in ferritin concentration in these 3 groups of provinces were not statistically significant. The median urinary iodine excretion was more than 50 in 4, 30-40 in 2, 20-29 in 11 and 13-20 μg/dl in 9 provinces. The mean serum ferritin value was higher in the provinces where the median urinary iodine value of schoolchildren was desirable (13-20 μg/dl) than the provinces where the median urinary iodine value of schoolchildren was more than 20 μg/dl (P<0.001). There was a significant difference in the prevalence of goiter in schoolchildren with serum ferritin above 10 μg/dl and those with serum ferritin below 10 μg/dl (20% vs. 80%, P<0.0001). Serum ferritin was significantly correlated with T3RU, T3 and FT3I (P<0.05). The data shows that goiter is more prevalent in schoolchildren with low serum ferritin, but there is an unimportant change in thyroid function. Low serum ferritin may impair the efficacy of iodized salt supplementation in reducing goiter size. Therefore, we suggest that iodized salts with Dextran-coat should be considered in the national IDD program.

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Introduction: The province of Charmahal & Bakhtiari was one of the first regions with endemic goiter in Iran. Following initiation of the program of control of iodine deficiency in 1989, production, distribution and consumption of iodized salt were begun. Goal This survey was conducted within the framework of the 2001 national monitoring survey to find the prevalence of goiter and urinary iodine level in order and to evaluate the iodine status of school aged children in Charmahal & Bakhtiari. Methods 1200 schoolchildren, aged 7-10 years, were selected randomly from all regions of Charmahal & Bakhtiari, and the grade of goiter, in 600 boys and 600 girls, was determined according to WHO classification. Urinary iodine content was estimated using the digestion method in one tenth of the schoolchildren. Results:Total goiter rate was 18.4%, 15.4% in girls and 21.4% in boys. Median urinary iodine was 17 µg/dl. Urinary iodine was above 10 g/dl in 80.9% and less than 5 µg/dl in 2.5%, no one had urinary iodine below 2 µg/dl. Conclusion: It is concluded that the rate of goiter in Charmahal & Bakhtiari has decreased significantly since 1996 and urinary iodine levels in schoolchildren are indicative of adequate iodine intake. The charmahal & Bakhtiari province therefore can hence be considered a “iodine deficiency free” zone.

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Introduction: Pareneteral vitamin D3 administration, a common practice in Iran, is usually used based mainly on clinical symptoms or serum mineral disturbances. Since studies about the effects and side effects of parenteral vit D3 preparations are limited, this study was designed to evaluate the effect of different intramuscular vitamin D3 dosage on serum 25(OH)D levels. Material and methods: In this study, 54 health voluneers were selected, and randomly assigned to 4 groups, based on their serum vitamin D3. Mean body mass index, age and sex frequency were not significantly different between groups. Mean serum 25(OH)D levels before injections were 27.24±21.30, 25.21±17.09, 24.70±16.8 and 25.10±14.48 ng/mL in groups I to IV respectively. Vitamin D3 was injected in dosages of 300/000, 600/000, 900/000 units and placebo in groups I-IV respectively. 25(OH)D levels were determined before, and at 2 weeks, 2 months and 4 months after injection. Results: Serum 25(OH)D levels before injection were significatly higher compared to levels assessed 2 and 4 months after injection. At the end of study, in groups I to III, mean serum 25(OH)D levels in group I to IV were 48.20±28.32 ng/mL, 65.46±33.52 ng/mL, 72.90±37.68 ng/mL, and 14.38±11.14 ng/mL respectively. Frequency of vitamin D hypervitaminosis in groups I, II and III was 9%, 38% and 40% respectively. Conclusion: Usage of parenteral vit D3, especially dosages higher than 300/000 IU, is associated with a high risk of vitamin D hypervitaminosis.

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Introduction: Two years after legislation of salt iodization of 40 parts per million (ppm) in 1994, goiter was still endemic and urinary iodine concentration (UIC) remained elevated in many provinces of Iran. Goiter prevalence and UIC were compared two and seven years after sustained consumption of uniformly iodized salt by Iranian households. Material and Methods: From December 2000 to June 2001, schoolchildren (7-10 yr) of all provinces were randomly selected by cluster sampling their goiter rate, UIC, and household salt iodine levels were compared to similar data collected in 1996. Factory salt iodine produced in 2001 was also compared to that of 1996. Ultrasonographically determined thyroid volumes of 7-10 yr old children were compared in 2001 to thoese of 1999. Results: Total, grade 1, and grade 2 goiters were 13.9 vs. 53.8%, 11.0% vs. 44.8%, and 2.9% vs. 9.0%, in 2001 (n=33600) vs. 1996 (n=36178), respectively (p<0.0001). Median (range) UIC in 2001 (n=3329) was 165 (18-410) µg/L and in 1996 (n=2917) was 205 (10-2300) µg/L (P<0.0001). Means for iodine salt content were 32.7±10.1 and 33.0±10.2 (P=0.79) in households and 33.2±13.4 and 33.8±13.2 (P=0.67) in factories, in 2001 and 1996, respectively. Only 7-yr-old children in 2001 (the only group with probably no history of iodine deficiency) showed significantly smaller thyroid volumes compared to those in 1999. Conclusion: After seven years of optimized iodized-salt supplementation in Iran, adequate UIC values and marked reduction in goiter rate have been achieved.

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Abstract

Introduction: Data available reports that the novel biomarkers of cardiovascular diseases have more sensitivity and accuracy in anticipating cardiovascular disease. Hence, considering the significant role of physical activity in decreasing and preventing these diseases, determining the type of physical activity, its duration and intensity, and appropriate pattern significantly promotes the individual's health. In this study, effects of two training methods, the aerobic and anaerobic, on some pre-inflammatory cytokines in adult male rats were compared. Materials and Methods: In this experiment, 54 male wistar rats (3 months), were kept in a controlled condition, randomly divided into three groups, the control, aerobic and anaerobic groups. The training program was conducted for a period of 12 weeks - 3 sessions per week, specified durations and intensity. To assess the influence of one session of an aerobic and anaerobic, training program,  following the program, the first blood sample was taken. After the 24th and 36th sessions, the second and the third blood samples were obtained. Blood samplings were done after 14 hours of fasting and 24 hours after the final training session. Data were analyzed with Kolmogrov-Smirnov, One Way ANOVA, Repeated Measurement and the LSD post hoc tests, at the level of α ≤ 0. 05. Results: Aerobic training causes a significant decrease in quantities of sICAM-1(p<0. 001), inflammatory mediators of IL-1β (p<0. 01), and TNF-α (p<0. 05), whereas anaerobic training leads to a significant increase in quantities of sICAM-1(p<0. 01), IL-1β (p<0. 05) and TNF-α (p<0. 05). Conclusion: The results of this study show that the regular aerobic training (55-85% Vo2max) causes a significant decrease in novel biomarkers of cardiovascular diseases, whereas intensive anaerobic training (100 and over 100%Vo2max) causes a significant increase in these, and exposes the body to the risk of inflammatory impairment. Therefore, it is possible that decrease in the novel anticipating factors of cardiovascular diseases after regular aerobic training could be due to reduction of the atherogenesis process, whereas anaerobic training could have the opposite effect.

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Abstract

Introduction: In cross-sectional studies, low serum levels of 25-hydroxyvitamin D are associated with a higher prevalence of cardiovascular risk factors. This study aimed to determine whether vitamin D deficiency is related to cardiovascular disease. Material and Methods: This nested case-control study was performed within the framework of a population-based Cohort study (Tehran Lipid and Glucose Study, TLGS) among male and female participants, aged 30 years or older (mean [SD] age, 56.7 [10.6] years), free of diagnosed cardiovascular disease at initial blood collection. Using risk set sampling, controls (n=251) were selected in a 1:1 ratio and matched for age, sex and date of blood collection. We measured serum 25-hydroxyvitamin D levels in serum specimens,  kept at -80°C until assay. Results: Median serum 25(OH)D was significantly lower in the CVD group than in controls (p<0.001). For 25(OH)D values of less than 10 ng/ml, compared with values more than 20 ng/ml (reference), the multivariable-adjusted OR (with 95% confidence intervals) for incident cardiovascular events was 3.21 (1.75-5.88). Conclusion: Low levels of 25(OH)D are independently associated with higher risk of cardiovascular events in a graded manner, even after adjustment for factors known to be associated with coronary artery disease.

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Introduction: Previous studies showed that inflammation is an important factor in the pathogenesis of atherosclerosis. IL-1β, IL-6, and HS-CRP are biomarkers with a predictive value in cardiovascular disease. Considering that the effects of resistance training at moderate and high intensity on inflammatory markers have not been studied, the purpose of this study was to investigate the effects of resistance exercise intensities on levels of IL-1β, IL-6, HS-CRP and fibrinogen. Materials and Methods: Thirty healthy young male volunteer students were randomly divided into 3 groups of 10 participants each. Groups I and II performed moderate (45-55% 1RM) and high intensity (80-90% 1RM) resistance exercise for 6 consecutive weeks (3 days/week) respectively. Group III, was the control group. Seven exercise stations were employed per session. The rest intervals between the sets of the protocols and stations were 1-2min and 3min respectively. Serum levels of IL-1, IL-6, HS-CRP and plasma level of fibrinogen were assessed before and after resistance training periods. Statistical analysis of data was accomplished using analysis of variance with repeated-measures design. Results: There were no significant differences in serum levels of IL-1 and IL-6 before and after the training period. HS-CRP was decreased in groups I and II, but this was not significant (p>0.05). Post test, however, HS-CRP in the two exercising groups was significantly lowered (p=0.008), compared to the control group. Plasma levels of fibrinogen decreased significantly in the high intensity resistance exercise group. Conclusion: In conclusion, short term resistance training can have beneficial effects on serum levels of some proinflammatory markers in healthy young males. In addition high intensity resistance training decreases plasma level of fibrinogen.

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Introduction: In the rapidly increasing elderly population of Iran, no prospective health studies have yet been undertaken. This study was conducted to identify the risk factors of survival time of elderly Tehranians, aged above 60 years. Materials and Methods: Individuals aged above 60 years old (n=929), recruited in the primary phase (1998-2001) of the ongoing Tehran Lipid and Glucose Study (TLGS), were followed up for 10 years and their vital statistics were documented (1998-2008). Age and sex mortality rates for age groups (60-69, 70-79, 80+) were calculated and the hazard rates were estimated using Cox proportional hazard model. Results: Of 929 males, 154 (17%) and out of 869 women 85(10%) died during the follow-up years. Cox model showed that diabetes, on an average, reduced 2.5 years and 4.4 years, while smoking reduced 6.6 and 5 years of females' and males' survival time, respectively. BMI>33Kg/m2 and dyslipoproteinemia reduced 4.5 years and 4 years of women's life spans, respectively. Native Tehranian males on an average, live 3 years less than other male residents in addition, hypertension and history of MI, stroke or sudden death of father, brother or son reduced 3.3 years and 4.1 years of men's life time respectivly. Conclusion: Elderly women with BMI>33 Kg/m2 and/or smokers and/or with dyslipoproteinemia are more in need of health care, while among their male countery parts elderly diabetic men and/or smokers and/or those who have history of MI, stroke or sudden death of a father, brother or son also need more attention.

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Introduction: Thyroid carcinoma including into four types papillary, follicular, medullary, and anaplastic is the most common endocrine malignancy. Medullary thyroid carcinoma (MTC) is one of the most aggressive forms of thyroid cancer and it accounts for up to 10% of all types of this disease. The mode of inheritance of MTC is autosomal dominant and is closely related to mutations of gain of function (missense mutations) in the RET proto-oncogene, well known in MTC development. MTC occurs as hereditary (25%) and sporadic (75%) forms. Hereditary MTC also has two syndromic (multiple endocrine neoplasia type 2A, B MEN2A, MEN2B) and non-syndromic (Familial MTC, FMTC) types. Increasing advances in molecular biology, genomics, and proteomics have led to personalized therapeutic interventions. Over the last two decades, the genetic basis of tumorgenesis has provided useful screening tools for affected families. Advances in genetic screening of the RET have enabled early detection of hereditary MTCs and prophylactic thyroidectomy for relatives who may not show any symptom of the disease. In this review we emphasize the main RET mutations in the syndromic and non syndromic forms of MTC, and have tried focus on the importance of RET genetic screening for early diagnosis and management of MTC patients.