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Aims/Introduction We aimed to determine the incidence trend of childhood type 1 diabetes mellitus in Isfahan province over a period of 12 years. Materials and Methods In this retrospective study, children aged <20 years at the time of type 1 diabetes mellitus diagnosis, from March 2007 to March 2019, were included. The crude and adjusted incidence rate of type 1 diabetes mellitus is calculated as the number of cases per 100,000 person‐years by the period. The cumulative, age‐ and sex‐specific incidence rates were also calculated. Age‐specific incidence rates were calculated for age and sex groups. Results A total of 1,954 (983 boys and 971 girls) cases of type 1 diabetes mellitus were identified. The mean age at diagnosis in all studied populations was 9.89 (standard deviation 4.76). There were no significant differences between the proportion of boys and girls in different years (P = 0.12) and different age groups (P = 0.19). The average annual percent change of incidence rate for the total population, for girls and boys, was 6.9%, 6.7% and 6.3% respectively. The type 1 diabetes mellitus incidence rate had a significant trend to be increased from 2007 to 2019 (P < 0.001, t = 3.6). Conclusion Our findings showed that currently our region is considered a region with a high incidence rate of type 1 diabetes mellitus. Although we have had fluctuations in the incidence rate over the 12 years, the overall trend is increasing. Increasing incidence trend of type 1 diabetes mellitus in Isfahan.

Some circulating microRNAs, such as miR15b, are predictors of diseases associated with adulthood obesity. This study aimed to evaluate the effect of two selected school-based and high-intensity interval training (HIT) on miR15b expression and lipid profile of obese adolescents. Thirty-eight adolescent males (12 ± 1 years) with obesity (body mass: 74.7 ± 13.2 kg, body mass index (BMI): 26.0 ± 2.3 kg/m , and body fat (BF): 27.2 ± 3.6%) were randomly assigned to the following based on the age-related body mass index: (i) HIT ( = 13), (ii) school-based exercises (SBE, = 13), and (iii) control ( = 12) groups. Mir15b was extracted using the RT-PCR system, and lipid profile was studied using the enzymatic colorimetric method before and after 12 weeks. Three training sessions were held each week during the course. Following the exercise interventions, in both training groups, miR15b (HIT: -63.8 vs. SBE: -56. 7%; = 0.001), cholesterol (HIT: -8.8 vs. SBE: -9.2%; = 0.025), and low-density lipoproteins levels (SBE: -13.1 vs. -20.8%; = 0.48) decreased; however, the peak oxygen uptake of subjects increased (HIT: 4.0 vs. SBE: 4.0%; = 0.003). However, there were no significant differences in triglyceride (HIT: -16.9 vs. SBE: -8.3%; = 0.134), and high-density lipoprotein (HIT: 3.1 vs. SBE: 4.8%; = 0.479) levels between both intervention and control groups ( > 0.05). The results showed that both types of exercises had almost similar effects on reducing miR15b expression and improving the lipid profile. Hence, based on the difficult nature of HIT for children with obesity, further use of school-based exercises is suggested.

The aim of this current study is to investigate the association between familial and environmental factors and prevalence of congenital hypothyroidism (CH) in Isfahan province. In this retrospective cohort study, data of the neonates referred for CH screening in different cities of Isfahan province were evaluated. Data regarding air and soil (lead, cadmium) pollutants were collected. The spatial association between mentioned environmental pollutants and prevalence of CH in different cities of Isfahan province was evaluated by using GIS software, and multilevel linear regression was used for evaluating the levels of environmental pollutants and neonates’ serum TSH . During the study period, 389,945 neonates were screened, from which 934 diagnosed with CH (1 in 417 neonates).The prevalence rate of CH was ranged from < 20 in 10,000 live births to > 45 in 10,000 live births in different cities of Isfahan province. There was no any significant association between level of soil lead and cadmium and air pollutants with prevalence of CH in different cities of Isfahan province ( P  > 0.05).There was a significant positive association between soil cadmium and air pollution evaluated by air quality index (AQI) and level of screening serum TSH in CH patients. Considering the significant association between cadmium and AQI with first serum TSH, it is inferred that the interaction of genetic, autoimmune, familial, and environmental factors with each other could influence on neonatal thyroid function. It seems that the role of some mentioned component is more prominent which should be investigated in future researches.

The impact of phenylketonuria (PKU) on Quality of life (QoL) has been a topic of interest in recent research. This article reviews current researches on the impact of PKU on QoL. The review examines factors that may influence QoL, such as age, metabolic control, and treatment adherence. In this systematic review study, relevant articles were identified using a search strategy built with the keywords phenylketonuria, PKU, or hyperphenylalaninemia (or their synonyms) and QoL in Web of Science, Scopus, and PubMed databases. After identifying the articles, duplicates, reviews, scientific abstracts, articles published in languages other than English, and non relevant studies were excluded. The search strategy identified 951 records from databases, and after excluding duplicates, irrelevant studies, and those published in non English languages, 26 records were left that contained data on 1816 patients with PKU/hyperphenylalaninemia. The studies included both children/adolescents and adults. Overall, the studies found that the QoL of PKU patients was comparable to normative data, but some aspects such as emotional health and school functioning were lower. Metabolic control was found to significantly correlate with QoL. Younger patients and men had better QoL in several studies, while late treated patients and those with lower education had worse outcomes. It is concluded that QOL in patients with PKU is similar to the general population. However, given the chronic nature of the condition, it is important to pay special attention to their QoL. Poor QOL is associated with female gender, lower education, older age, and poor metabolic control.

Purpose. Polycyclic aromatic hydrocarbons (PAHs) are believed to be a possible factor in the development of cancer, ischemic heart disease, obesity, and cardiovascular disease. The objective of this study was to explore the association between certain metabolites of urinary PAH and type 1 diabetes (T1D). Methods. In Isfahan City, a case-control study was carried out involving 147 T1D patients and an equal number of healthy individuals. The study measured the levels of urinary metabolites of PAHs, specifically 1-hydroxynaphthalene, 2-hydroxynaphthalene, and 9-hydroxyphenanthrene, in both the case and control groups. The levels of these metabolites were then compared between the two groups to assess any potential association between the biomarkers and T1D. Results. The mean (SD) age of participants in the case and control groups was 8.4 (3.7) and 8.6 (3.7) years old, respectively, (P>0.05). In terms of gender distribution, 49.7% and 46% of participants in the case and control groups were girls, respectively (P>0.05). Geometric mean (95% CI) concentrations were: 36.3 (31.4-42) μg/g creatinine for 1-hydroxynaphthalene, 29.4 (25.6-33.8) μg/g creatinine for 2-hydroxynaphthalene, and 72.26 (63.3-82.5) μg/g creatinine for NAP metabolites. After controlling for variables such as the child’s age, gender, maternal and paternal education, duration of breastfeeding, exposure to household passive smoking, formula feeding, cow’s milk consumption, body mass index (BMI), and five dietary patterns, it was observed that individuals in the highest quartile of 2-hydroxynaphthalene and NAP metabolites had a significantly greater odd ratio for diabetes compared to those in the lowest quartile (P<0.05). Conclusion. Based on the findings of this study, it is suggested that exposure to PAH might be linked to an increased risk of T1D in children and adolescents. To clarify a potential causal relationship related to these findings, further prospective studies are needed.

In this study, we aimed to investigate the prevalence of nonalcoholic fatty liver disease (NAFLD) in children with renal failure under treatment with dialysis and its association with biochemical measurements. In this cross-sectional study, children aged less than 18 years with chronic kidney disease (CKD) who were under treatment with dialysis at least 3 months ago were enrolled. To evaluate fatty liver in those patients who had no recent liver ultrasonography (last 6 months), liver ultrasonography was performed. The characteristics of patients with renal failure with and without NAFLD based on the ultrasonographic evaluation were compared. The association between NAFLD and the studied variables was evaluated. In this study, 39 children (31 males and 8 females) with renal failure who underwent treatment with dialysis were included. From the studied population, six (19.4%) had NAFLD based on ultrasonographic evaluation. There were no differences between renal failure patients with and without NAFLD regarding the biochemical and anthropometric characteristics ( > 0.0). The prevalence of NAFLD in our studied children with renal failure who underwent treatment with dialysis was like the general population and it was not associated with the biochemical and anthropometric characteristics of the patients. Given the importance of NAFLD in renal failure patients as well as its subtle nature, it is recommended to screen patients with CKD for NAFLD.

This systematic review and meta-analysis aimed to overview the observational studies on the association of exposure to air pollution and type 1 diabetes mellitus (T1DM). Based on PRISMA guidelines, we systematically reviewed the databases of PubMed, Scopus, Embase, and Web of Science databases to determine the association of air pollution exposure and T1DM. Quality assessment of the papers was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for observational studies. The odds ratios (OR) and their 95% confidence intervals (CI) were calculated to assess the strength of the associations between air pollutants (gases and particulate matter air pollutants including PM10, PM2.5, NO2, volatile organic compound, SO4, SO2, O3) and T1DM. Out of 385 initially identified papers, 6 studies were used for this meta-analysis. Fixed effects meta-analysis showed a significant association between per 10 μg/m increase in O3 and PM2.5 exposures with the increased risk of T1DM (3 studies, OR = 1.51, 95% CI: 1.26, 1.80, = 83.5% for O3 and two studies, OR = 1.03, 95% CI: 1.01, 1.05, = 76.3% for PM2.5). There was no evidence of association between increased risk of T1DM and exposure to PM10 (OR = 1.02, 95% CI: 0.99-1.06, = 59.4%), SO4 (OR = 1.16, 95% CI: 0.91-1.49, = 93.8%), SO2 (OR = 0.94, 95% CI: 0.83-1.06, = 85.0%), and NO2 (OR = 0.995,95% CI: 1.05-1.04, = 24.7%). Recent publications indicated that exposure to ozone and PM2.5 may be a risk factor for T1DM. However, due to limited available studies, more prospective cohort studies are needed to clarify the role of air pollutants in T1DM occurrence.

Background: In this study, we aimed to investigate the ability of transvaginal Doppler ultrasonography in predicting in vitro fertilization (IVF) outcome in women undergoing this procedure. Materials and Methods: In this prospective observational study, 65 infertile women underwent IVF procedure in Isfahan, during 2013-2014, were studied. The pulsatility index (PI), resistive index (RI) and peak systolic velocity (PSV) of the uterine arteries and arcuate arteries were measured in all selected women using transvaginal color and pulsed Doppler measurements on the day of human chorionic gonadotrophin injection. The women followed up for the primary endpoint which was a successful pregnancy. The mean of PI, RI, and PSV were compared in groups of women who had successful IVF and not. The receiver operating characteristic (ROC) curve was used to determine the predictive value of studied indices. Results: In this study, from 65 women, 32 (49.2%) and 33 (50.8%) have successful and unsuccessful IVF outcome, respectively. The mean of PI and RI of both uterine and arcuate arteries were significantly lower in pregnant women than non-pregnant ones (P < 0.001). The area under the ROC curve of PI (84.7%) and RI (84.4%) for uterine arteries was higher than other indices. The most accurate indices for predicting the outcome of IVF was RI of uterine arteries with an accuracy of 81.5%. Conclusion: The findings of this study indicated that PI and RI assessments of uterine arteries could be used as a routine non-invasive factor, before hCG stimulation, for predicting the outcome of IVF.

BACKGROUND: Over the last decades, childhood obesity has become a worldwide epidemic health problem. Identifying the barriers to a healthy lifestyle among children and adolescents is necessary for further effective intervention to prevent overweight and obesity. This study aims to assess the barriers to healthy lifestyle habits, including physical activity (PA), eating, and sleep among adolescents from the perspective of their parents. METHODS: In this cross-sectional study, the parents of obese and overweight middle school students were enrolled. Data were collected using a questionnaire about barriers of healthy nutrition and PA. RESULTS: Overall, 172 parents completed the questionnaire. Lack of access to affordable facilities for PA, lack of access to the appropriate place for PA, and lack of sufficient information on how to do or increase PA were the main barriers to PA. The barrier factors for healthy eating were media advertisement of unhealthy foods, lack of motivation to use healthy nutrition, and lack of adequate information about healthy eating. Regarding poor sleep, lack of knowledge about the benefits of sleep, prolonged watching television, and late sleep time of family members were reported as the main barriers. These findings were not statistically different according to the family socioeconomic level. CONCLUSION: Our findings propose that for improving healthy lifestyle in obese children and adolescents, access to facilities, and appropriate places for PA should be provided at the community level. Moreover, training parents and students about healthy lifestyle behaviors is necessary for families of all socioeconomic levels.

Background: Considering that establishment of reference value of nuchal translucency (NT)-related to the crown rump length (CRL) during the first trimester will be helpful for determining an appropriate cutoff level for screening of increased NT thickness-related abnormalities, we determined the NT thickness and investigated its relation with different chromosomal and nonchromosomal abnormalities among a large sample size of pregnant Iranian women. Materials and Methods: In this analytic cross-sectional study, pregnant women who were in their first trimester were enrolled at their antenatal visit. Using an abdominal ultrasonography, the fetal NT thickness of the studied population was measured. Those with increased NT thickness were determined. The reference value of NT thickness (5th, 25th, 50th, 75th, and 95th percentiles) within each 5-mm range of CRL and during the 11th, 12th, and 13th gestational weeks were determined. The presences of the different chromosomal and nonchromosomal abnormalities were compared in women with different percentiles of NT thickness who underwent amniocentesis and those who did not. Results: 1,614 pregnant women were evaluated. The mean NT thickness was 1.30 ± 0.54 mm. Increased NT thickness >2 mm and >95th percentile according to their gestational age (GA) was detected in 89 (5.5%) and 58 (3.6%) pregnant women. The reference 95th percentile value range for NT was 1.8-2.35 and increased NT thickness according to our obtained values was associated significantly with chromosomal abnormalities. Conclusion: The obtained reference range in our studied population was different from that reported for other ethnic groups and it is suggested that using this values are more favorable for screening of chromosomal abnormalities during the first trimester of pregnancy than the recommended single cutoff value.