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Background: Considering the high prevalence of both vitamin D deficiency (VDD) and sleep impairment in children and adolescents, this study was conducted to determine the association between VDD and sleep duration in the Iranian pediatric population., Methods: This multicentric national study was conducted in 2019 on 2564 frozen sera obtained from 7 to 18- year students who were studied in the fifth survey of a national school-based surveillance program conducted in 30 provinces of Iran. Sleep duration was assessed using a questionnaire based on the World Health Organization-Global School-based Student Health Survey protocol. Short sleep duration was defined as sleep duration less than 8 h/day VDD Vitamin D < 20 ng/dL, and vitamin D insufficiency as 20-30 ng/dL.An adjusted logistic regression model was applied to evaluate the associations of vitamin D status with sleep duration., Results: The Mean (SD) of students' age was 12.1(3.0) years; overall 10.6%of participants had VDD and 23% of participants had short sleep duration. in the adjusted logistic model, s tudents with a low level of vitamin D (insufficient and deficient) had a higher odds of short sleep duration in comparison to those with normal vitamin D level (OR: 1.29, 95%CI: 1.02-1.62)., Conclusion: The current study showed that low Vitamin D levels (insufficient and deficient)were significantly associated with short sleep duration in school-aged children. Further studies are recommended to determine the efficacy of vitamin D replacement in improving sleep duration and quality., Competing Interests: Conflict of interestAll contributing authors declare that they have no conflicts of interest., (© The Author(s), under exclusive licence to Tehran University of Medical Sciences 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: The prognostic factors of long-term outcomes in hospitalized patients with diabetes mellitus and COVID-19 are lacking., Methods: In this retrospective cohort study, we evaluated patients aged ≥ 18-years-old with the COVID-19 diagnosis who were hospitalized between Feb 20 and Oct 29, 2020, in the Sina Hospital, Tehran, Iran. 1323 patients with COVID-19 entered in the final analysis, of whom 393 (29.7%) patients had diabetes. We followed up patients for incurring in-hospital death, severe COVID-19, in-hospital complications, and 7-month all-cause mortality. By doing univariate analysis, variables with unadjusted P-value < 0.1 in univariate analyses were regarded as the confounders to include in the logistic regression models. We made adjustments for possible clinical (model 1) and both clinical and laboratory (model 2) confounders., Results: After multivariable regression, it was revealed that preadmission use of sulfonylureas was associated with a borderline increased risk of severity in both models [model 1, OR (95% CI):1.83 (0.91-3.71), P-value: 0.092; model 2, 2.05 (0.87-4.79), P-value: 0.099] and major adverse events (MAE: each of the severe COVID-19, multi-organ damage, or in-hospital mortality) in model 1 [OR (95% CI): 1.86 (0.90-3.87), P-value: 0.094]. Preadmission use of ACEIs/ARBs was associated with borderline increased risk of MAE in the only model 1 [OR (95% CI):1.83 (0.96-3.48), P-value: 0.066]., Conclusions: Preadmission use of sulfonylureas and ACEIs/ARBs were associated with borderline increased risk of in-hospital adverse outcomes., Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-021-00901-4., Competing Interests: Conflict of interestAll authors declare that they have no competing interests., (© Springer Nature Switzerland AG 2021.)

Purpose: This study aims to investigate risk indicators of in-hospital mortality and severity of coronavirus disease-2019 (COVID-19) in patients with diabetes mellitus (DM)., Methods: In this retrospective study, we studied patients with COVID-19 referred to Sina Hospital, Tehran, Iran, from February 20 to May 14, 2020. Patients with either a positive real-time reverse-transcriptase polymerase-chain-reaction test of swab specimens or high clinical suspicion according to the World Health Organization interim guidance were included. We accurately divided all patients into two groups based on diabetes affection and followed-up patients with DM based on incurring death, severe COVID-19, and in-hospital complications., Results: We enrolled 574 patients with COVID-19 in the final analysis, of whom 176 (30.7%) patients had DM. In this study, 104 (18.1%) patients deceased, and 380 (66.2%) patients incurred severe COVID-19. We found that COVID-19 patients with DM had a significantly higher mortality rate ( P value<0.001), severe disease ( P value<0.001), and in-hospital complications (all P values<0.05). Besides that, in patients with DM, admission temperature (odds ratio (OR): 1.69, P value: 0.024), oxygen saturation (OR: 0.92, P value: 0.004), and urea (OR: 1.01, P value: 0.048) were independent risk indicators of in-hospital mortality. In addition, subgroup analysis of diabetic patients based on admission glucose level showed significant differences between these groups regarding acute cardiac injury ( P value: 0.044) and acute liver injury (P value: 0.002)., Conclusions: Patients with DM admitted with lower oxygen saturation, elevated temperature, and higher urea are more susceptible to progress to more severe COVID-19 and poor prognosis. This indicates a necessity for more precise care during hospitalization for these patients., Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-020-00701-2., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© Springer Nature Switzerland AG 2021.)

Background: Smoking behavior as a harmful trend among adolescents and young adults has increased over last two decades. Many children and adolescents are at the risk of "second-hand" smoking at home due to their exposure to parents' or siblings' smoking. These second hand smokers are called "passive smokers" and are at risk of several health complications like cardiometabolic risk factors., Objectives: The present study aims to evaluate the association between passive smoking and increase of cardiometabolic risk factors in a sample of Iranian's children and adolescents, aged 7-18 years., Methods: This multicenter cross-sectional study was carried out over 14,400 students (aged 7-18 years). Blood sampling were randomly collected from a sub-sample of 4200 selected pupils. According to their degree of exposure to smoke for both cigarette and hookah, water pipes that are used to smoke specially made tobacco that comes in different flavors, all participants were divided to the two separate groups of positive and negative exposure. Metabolic syndrome (MetS) is defined as a constellation of at least three out of five cardiometabolic risk factors, including abdominal obesity, elevated blood pressure, elevated fasting plasma glucose concentration, high serum levels of triglycerides (TG), and depressed high-density cholesterol (HDL-C) levels., Results: The mean and standard deviation (SD) age of participants was 12.3 ± 2.24 years. 49.4% were girls and 71.4% of them were urban residents. The mean SD for BMI of participants was 18.5 (4.7) Kg/m2. The mean TG levels were considerably higher among passive smoker children and adolescents. MetS and being overweight were found to have a major association with passive smoking (OR 1.63 CI 95% 1.17-2.29 P Value 0.004 and OR 1.21 95% CI 1.06-1.37 P Value 0.004, respectively)., Conclusion: This study confirms that passive smoking or second-hand smoking is linked with the increased prevalence of cardiometabolic risk factors and places children and adolescents at a higher risk of being overweight. Preventive strategies could be incorporated against passive smoking to recognize it as a health priority among children and adolescents., Competing Interests: Conflict of interestAll authors declare that there is not any kind of conflict of interests., (© Springer Nature Switzerland AG 2019.)

Background: As one of the most common chronic diseases, diabetes and its control are affected by the patients' psychological and spiritual attributes. The present study investigates the relationship between glycemic control in patients with type II diabetes and personality traits, defense mechanisms and spirituality., Method: The present cross-sectional study was conducted on 400 Iranian patients with type II diabetes, 64% were men. Participants completed the NEO Personality Inventory, the Defense Style Questionnaire (DSQ) and the Spiritual Assessment Inventory (SAI) and then underwent a blood sampling for the assessment of HbA1C levels., Results: Of the five personality traits, extraversion ( r =  -0.13 and P <  0.01) and conscientiousness ( r =  -0.13 and P <  0.01) had significant negative relationships with HbA1C HbA1C levels, while neuroticism had a significant positive relationship with HbA1C levels ( r =  0.12 and P <  0.05). Of the defense styles assessed, the neurotic style was found to have a significant negative relationship with HbA1C levels ( r =  -0.1 and P <  0.05). Also, of the spirituality elements, impression management had significant relationship with glycemic control ( r =  0.17 and P <  0.001)., Conclusion: According to data, Extraversion and conscientiousness can help control blood sugar while anxiety and negative emotions have detrimental effects on glycemic control. As a result considering psychological counselling beside medical interventions can help to better treatment.

Background: The objective of this study was to assess side effects and satisfaction about OsteoCalVitFort (500 mg calcium and 400 I.U. of vitamin D3) usage., Methods: A total 186 people were participated with range age from 18 to 65 years old. Each participant received 1 pack that contains 60 OsteoCalVitFort tablet and used two tablet OsteoCalVitFort daily (1 tablet after breakfast and 1 after dinner). By a phone call, side effects and satisfaction about OsteoCalVitFort were assessed., Results: The rate of constipating (8.0 %) and bloating (12.5 %) were decreased significantly after OsteoCalVitFort supplement intake (1.2 %, and 0.6 %, respectively). Similar results were observed in metallic taste in mouth, tiredness, weakness, loss of appetite, bone/muscle pain and mental/mood change after Calcium Vitamin D3 supplementation intake. Totally, 94 % of patients were satisfied about OsteoCalVitFort usage., Conclusion: The results of the research indicate despite the high quality of OsteoCalVitFort supplement, there are no side effects which have been seen in other supplements.

Background: The objective of this study was to assess side effects and satisfaction about OsteoCalVitFort (500 mg calcium and 400 I.U. of vitamin D3) usage., Methods: A total 186 people were participated with range age from 18 to 65 years old. Each participant received 1 pack that contains 60 OsteoCalVitFort tablet and used two tablet OsteoCalVitFort daily (1 tablet after breakfast and 1 after dinner). By a phone call, side effects and satisfaction about OsteoCalVitFort were assessed., Results: The rate of constipating (8.0 %) and bloating (12.5 %) were decreased significantly after OsteoCalVitFort supplement intake (1.2 %, and 0.6 %, respectively). Similar results were observed in metallic taste in mouth, tiredness, weakness, loss of appetite, bone/muscle pain and mental/mood change after Calcium Vitamin D3 supplementation intake. Totally, 94 % of patients were satisfied about OsteoCalVitFort usage., Conclusion: The results of the research indicate despite the high quality of OsteoCalVitFort supplement, there are no side effects which have been seen in other supplements.

Background: Blue- green algae is one of the most nutrient dense foods which is rich in substances that have useful effects on human health. The purpose of this study was to evaluate the effectiveness of a water- soluble extract of the cyanophyta Aphanizomenon Flos-aquae (Stemtech (TM) ) as a functional supplement on CD markers, lipid profile, glucose levels as well as its side effects in Iranian patients with type 2 diabetes., Methods: During this randomized, double-blind, placebo-controlled trial 49 type 2 diabetic patients, aged between 20 and 60 years with a HbA1C ≥ 7.5 %, were allocated. Patients were divided into two groups of placebo and treated with an equal ratio 1:1. The subjects in StemtechTM group received one capsule of StemFlo (508 mg) before breakfast and two capsules of StemEnhance (500 mg) after each meal for a period of 12 weeks, and placebo group was instructed to take placebo with the same pattern. During the intervention period, subjects were asked to keep usual diet and prohibited to take any functional foods or dietary supplements. Metabolic panel has been measured as the primary outcome of study at the beginning and end of the intervention period via blood sampling., Results: Stemtech (TM) supplementation for 12 weeks decreased fasting blood glucose (FBG) and Glycatedhemoglobin (HbA1c). Mean serum chemistry parameters (Triglyceride, Total Cholesterol, LDL, HDL, CRP, AST, ALT, BUN and Creatinine) as well as CD 34(+), IL-6, TNF-α in treated and control groups before and after the study showed no considerable dissimilarities., Conclusion: StemtechTM intervention brought in positive consequence on blood glucose levels in Iranian patients with type 2 diabetes, consequently suggests the Stemtech (TM) as a functional food for the management of diabetes.

Background: The present study is designed to assess the incidence rate of osteoporotic fracture and its risk factors, particularly those used to predict the 10-year risk of osteoporotic fracture in FRAX based on the data gathered through a follow up cohort initiated in 2000., Methods: The present retrospective cohort was conducted on men and women from 40 to 90 years of age enrolled in the IROSTEOPs study. A phone survey was conducted during 2013 and beginning of 2014 to assess the fractures (traumatic/osteoporotic) occurring at the time of inclusion until the date of the telephone survey, its type and mechanism, and the patient's age at the time of accident. Survival analysis using Kaplan-Meier product-limit method was performed with the time of fracture as the study outcome., Results: Final study population consisted of 1233 individuals, translated in to 9133 person years. The incidence rate of osteoporotic fracture was reported to be 359.1 cases in every 10,000 person years. The 10-year Kaplan-Meier estimate of any kind of major osteoporotic fractures for all the subcohort population was 10.75%. Osteoporosis (HR = 0.75), Discordance between femoral neck and spine (HR = 1.45), Diabetes (HR = 1.81), IBD (HR = 1.84), immobility more than 90 days (HR = 2.19), and personal history of fracture (HR = 7.75) had a considerable effect on the 10-year risk of major osteoporotic fractures., Conclusions: Adding new clinical risk factors to FRAX® may help improve fracture prediction in the Iranian population.

Osteoporosis is a health concern characterized by reduced bone mineral density (BMD) and increased risk of fragility fractures. Many studies have investigated the association between genetic variants and osteoporosis. Polymorphism and allelic variations in the vitamin D receptor gene (VDR) have been found to be associated with bone mineral density. However, many studies have not been able to find this association. Literature review was conducted in several databases, including MEDLINE/Pubmed, Scopus, EMBASE, Ebsco, Science Citation Index Expanded, Ovid, Google Scholar, Iran Medex, Magiran and Scientific Information Database (SID) for papers published between 2000 and 2013 describing the association between Fok1 and Bsm1 polymorphisms of the VDR gene and osteoporosis risk. The majority of the revealed papers were conducted on postmenopausal women. Also, more than 50% studies reported significant relation between Fok1, Bsm1 and osteoporosis. Larger and more rigorous analytical studies with consideration of gene-gene and gene-environment interactions are needed to further dissect the mechanisms by which VDR polymorphisms influence osteoporosis.