---

 

ABSTRACT

 Background and Aim: Although osteoporosis is not common in children and adolescents bone mineral density (BMD) studies in early life can be good predictors for this disease in the future. The aim of this study was to provide reference data of Dual X-ray Absorptiometry (DXA) for a population aged 10 to 20 years, in Tehran.

 Materials and Methods: 187 healthy people between 10-20 years of age were entered into this study randomly. Using DXA, BMD of femoral neck and lumbar vertebrae (L1-L4) (anteroposterior) were measured. Stage of puberty was determined and questionnaires about daily calcium intake were filled out. Serum levels of calcium, phosphate, vitamin D, parathyroid hormone and alkaline phosphatase were determined in all participants.

 Results: BMD values showed a positive correlation with age, height, weight and puberty stage. Calcium intake showed a correlation with BMD values of femoral neck, but not of lumbar region. In lumbar region, girls up to age of 18 had higher BMD values. In femoral region, boys had higher BMD values in all age groups. In neither regions, however, these differences were statistically significant. BMD increment at different stages of^�sexual development was statistically different only in stages 3 and 4 of puberty for both sexes in femoral and lumbar regions.

 Conclusion: Normative value curves developed in this study can serve as standards to predict bone mineral density.

Key words: Bone mineral density, Normative values, Calcium intake

---

  ABSTRACT

 Background and Aim: Vitamin D requirements are met by its synthesis in the skin as a result of exposure to UVB (ultra violet B) and also by food. Despite abundant UVB in sunny countries, there is evidence of high prevalence of Vitamin D (vit D) deficiency in these areas.

 Materials and Methods: 5 cities with different longitudes and latitudes were chosen. Patients were selected by random cluster sampling. Blood samples obtained from healthy subjects. After centrifuging the sera collected sent to the EMRC (Endocrinology & Metabolism Research Centre) laboratory for measurment of 25(OH) vitamin D [25(OH)D] and PTH levels. Based on the level of 25(OH), the subjects were classified into 7 groups. Different levels of Vit D deficiency were determined as normal, mild, moderate and severe Vit D deficiency.

 Results: 5329 people were evaluated for 25(OH)D and three threshold levels for women (40, 25 and 12 nmol/L) and two for men (35 and 25 nmol/L) were determined. Mild Vit D deficiency was observed in 27.2% of women and 37.25% of men. Severe or moderate Vit D deficiency was noticed in 47.85% of women and 34.75 % of men.

 Conclusion: The results of this study are compatible with those of other studies in the Middle East. Prevalence of Vit D deficiency in these areas needs justification. Plans for fortification of articles of food with Vit D are recommended.

 Key words: Vit D deficiency, Normal values, PTH

---

Background and Aim: Trace elements have been considered to play critical roles in bone metabolism. The aim of this study was to determine serum zinc profile and its association with bone mineral density (BMD) abnormalities in thalassemic patients. Materials and Methods: Serum zinc levels of 131 transfusion-dependent β-thalassemic patients, between 10-20 years of age, were measured by flame-atomic absorption spectrophotometry (F-AAS). BMD values at lumbar (L1-L4) and femoral neck were determined by dual x-ray absorptiometry (DXA). Daily dietary zinc and calcium intake were evaluated by food frequency questionnaires. Patients’ history of treatment and demographic data were obtained. Results: Low serum zinc was present in 84.8% of the patients and severely low levels detected in 44.7%. In 68.7% and 17.6% of the patients BMD z-scores less than (-2) were observed at lumbar and femoral regions. Female patients with severe zinc deficiency had lower lumbar BMD z-scores (-3.26) in comparison to other females (-2.54). Serum zinc levels of female patients with femoral BMD z-scores less than (-2), were significantly lower than those of other females. Conclusion: Considering low serum zinc level and decreased daily zinc intake, proper nutrition of thalassemic patients showld be regarded important

---

Background and Aim: Adequate vitamin D concentrations during pregnancy are necessary for neonatal calcium homeostasis, bone maturation and mineralization. The purpose of this study was to evaluate serum vitamin D in mothers and their newborns. Materials and Methods: This study comprised 552 pregnant women from Tehran University hospitals. Maternal and cord blood samples were obtained in delivery room just after child birth. The serum samples were assayed for 25-hydroxyvitamin D3, calcium, phosphorus and parathyroid hormone. Results: prevalence of vitamin D deficiency in mothers and cord blood were 66.8% and 93.3% (<35nmol/l) respectively. There was a significant correlation between maternal and cord blood levels of vitamin D. In mothers with vitamin D deficiency, cord blood vitamin D levels were lower than those of normal mothers (p=0.001). Conclusion: Furthermore, considering increased requirements of calcium and vitamin D during pregnancy intake of higher amounts of these nutrients are recommended.

---

Background and Aim: Vitamin D is essential for the health of pregnant women and their newborns. The aim of this study was to determine the relationship between the outcome of pregnancy and maternal calcium and vitamin D intake. Materials and Methods: This cross-sectional study included 449 healthy pregnant women at the time of delivery and also their newborns after delivery. Maternal and neonatal anthropometric data were collected and Calcium and Vitamin D intake was determined. The mean values for vitamin D and calcium intake in mothers were 2.26±1.87 µg/d and 816.284±370.47 mg/d respectively. Results: Our findings showed that, the mean Apgar score and height of the newborns whose mothers had adequate calcium and vitamin D intake were higher than those of infants of mothers with inadequate intake (p=0.04, p=0.03 respectively). Conclusions: Our study showed a significant correlation between adequate maternal calcium and vitamin D intake and appropriate neonatal birth weight, height and one-minute Apgar score. We found that mothers with adequate intake of calcium and vitamin D had greater weight gain. Therefore proper nutritional plans for pregnant women are necessary. Consumption of foods rich in calcium and vitamin D, in particular dairy products, fortification of foods and addition of supplements to diet regimen of the population at risk of developing such nutritional deficiencies should be taken into consideration.

---

Background and Aim: Covid-19 pandemic has caused significant disruptions in the provision of non-communicable disease prevention and management services in many countries and there is a concern that this disorder will lead to long-term complications of these diseases; This study aimed to quantitatively analyze the status of some prevention and management services of non-communicable diseases in the primary health care system of Iran during the Covid-19 pandemic.
Materials and Methods: In this study, the routine data of 8 services related to the prevention and management of non-communicable diseases in the integrated electronic health record system (SIB) within 10 months after the outbreak of Covid-19 were compared to the same period last year.
Results: Non-communicable disease prevention and management services have decreased by an average of 18.89% compared to the same period last year; this decrease was much more severe at the beginning of the epidemic period (up to 75% in some services) and more in the services provided by physicians than in the services provided by non-physicians. Also, observation of the course of selected services during this period showed that after the initial reduction of services, a process of gradual compensation is evident.
Conclusion: like other areas involved in the pandemic, the effect of the Covid-19 epidemic on non-communicable disease prevention and management services in the primary health care system of Iran, has been significant and although partial compensation of some services is promising, more attention and effort is needed to revive the other programs.

---

Background and Aim: Overweight and obesity disrupt people's quality of life and increase the risk of cardiovascular diseases, diabetes, hypertension, gastrointestinal diseases and cancer. It also reduces the immunity of people against epidemic diseases.
Materials and Methods: In this article, extensive search of electronic databases, review of national upstream documents as well as review of documents and reports of the Ministry of Health were conducted to comprehensively review the prevalence of obesity and its associated factors, measures taken to control this risk factor, and challenge of a syndemic of obesity and Covid-19 in Iran.
Results: Based on the results of the national non-communicable diseases risk factors study (STEPS) in Iran, the prevalence of overweight and obesity was estimated to be 59.3% in people aged 18 years and older. Moreover, overweight and obesity were not homogeneously distributed in the country and the mean body mass index (BMI) changed from the lowest in the Southeastern to the highest in the Northwestern provinces. Covid-19 pandemic has made the situation even worse as the social distancing measures along with mental problems have made tremendous changes in people's lifestyles including physical activity and eating behaviors and this resulted in higher prevalence of non-communicable diseases (NCDs) risk factors especially overweight and obesity. Moreover, obesity increased the risk of hospitalization, admission to the intensive care units, the need for mechanical ventilation, and even mortality in patients with Covid-19. Meanwhile, anti-obesity services faced problems during the epidemics and posed a serious challenge to the world.
Conclusion: This study highlighted the need for targeted national policies to simultaneously control the obesity and Covid-19 pandemics.