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BMC Endocrine Disorders (1)
Journal of Diabetes and Metabolic Disorders (1)
Larijani, Bagher (2)
Abbasvandi, Fereshteh (1)
Abbasvandi, Nasreen (1)
Amini, Mohammad Reza (1)
Amini, Mohammad-Reza (1)
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Shoa, Nahid Zerafati (1)
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Year of Publication
Waist circumference and insulin resistance in elderly men: an analysis of Kahrizak elderly study
Shoa, Nahid Zerafati
Journal of Diabetes and Metabolic Disorders
Diagnosis of the metabolic syndrome (MS) is crucial for health care practitioners to identify at risk people for early treatment. Visceral obesity may make unnecessary other laborious measures of insulin resistance. The aim of this study was to see whether waist circumference (WC) can predict insulin resistance as well as MS in a group of Iranian elderly.
Out of 94 nondiabetic elderly, thirty three subjects were recognized with MS. MS diagnosis was based on NCEP ATP III (National Cholesterol Education Program Adult Treatment Panel III) and IDF (International Diabetes Federation) definitions. HOMA (Homeostasis Model Assessment) index was used to measure insulin sensitivity. Insulin resistance (IR) was defined as top quartile of HOMA.
In both sexes, WC and HOMA index were significantly positively correlated. The optimal waist circumference (OWC) cutoff point was 94.5 cm for men and 90.5 cm for women. The high sensitivity (0.80) and specificity (0.84) of WC in males indicates the proportion of IR which is correctly identified and recognizes all non-IR males as such. In regression model only the TG level was associated with WC. But the WC is strongly associated with HOMA-IR.
While OWC is very likely a good measure to exclude non-IR subjects in our study, determination of optimal WC to identify elderly IR subjects warrants further study in a larger sample of the general population.
Waist circumference; Insulin resistance; Metabolic syndrome; Elderly
Treatment of hyperfunctioning thyroid nodules by percutaneous ethanol injection
BMC Endocrine Disorders
Autonomous thyroid nodules can be treated by a variety of methods. We assessed the efficacy of percutaneous ethanol injection in treating autonomous thyroid nodules.
35 patients diagnosed by technetium-99 scanning with hyperfunctioning nodules and suppressed sensitive TSH (sTSH) were given sterile ethanol injections under ultrasound guidance. 29 patients had clinical and biochemical hyperthyroidism. The other 6 had sub-clinical hyperthyroidism with suppressed sTSH levels (<0.24 μIU/ml) and normal thyroid hormone levels. Ethanol injections were performed once every 1–4 weeks. Ethanol injections were stopped when serum T3, T4 and sTSH levels had returned to normal, or else injections could no longer be performed because significant side effects. Patients were followed up at 3, 6 and, in 15 patients, 24 months after the last injection.
Average pre-treatment nodule volume [18.2 ± 12.7 ml] decreased to 5.7 ± 4.6 ml at 6 months follow-up [P < 0.001]. All patients had normal thyroid hormone levels at 3 and 6 months follow-up [P < 0.001 relative to baseline]. sTSH levels increased from 0.09 ± 0.02 μIU/ml to 0.65 ± 0.8 μIU/ml at the end of therapy [P < 0.05]. Only 3 patients had persistent sTSH suppression at 6 months post-therapy. T4 and sTSH did not change significantly between 6 months and 2 years [P > 0.05]. Ethanol injections were well tolerated by the patients, with only 2 cases of transient dysphonia.
Our findings indicate that ethanol injection is an alternative to surgery or radioactive iodine in the treatment of autonomous thyroid nodules.
Hot Thyroid Nodules; Treatment; Ethanol; Thyrotoxicosis; Ultrasonography
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