Endocrinology and Metabolism Research Center
Endocrinology & Metabolism Research Centre,
Tehran University of Medical Sciences:
At the Forefront of Osteoporosis Research and Treatment in Iran
The Endocrinology and Metabolism Research Centre (EMRC), in conjunction with the Ministry of Health’s Secretariat for Health (MOH-SH), has and is continuing to carry out a significant amount of research in the field of osteoporosis, disorders of vitamin D metabolism, and dietary fortification/enrichment with the latter, the following items being examples thereof:
National Osteoporosis Prevention Plan
This project was initiated 2 years ago with the help of MOH-SH General Office of Endocrinology and Metabolism (GOEM) and academic input from the universities of Tehran, Shiraz, Mashad, Bushehr and Tabriz. The objectives of this study were to determine the status quo; to obtain a normal range for bone density in the Iranian population; to measure the risk of and precipitating factors for osteoporosis, especially vitamin D; as well as the relationship between bone density and important lifestyle indicators, such as physical activity. In parallel, the project aimed to raise public awareness of the disorder itself, the risk factors associated with it and methods of prevention, and to improve the level of knowledge of healthcare professionals on osteoporosis and its risk factors, the principles of prevention, screening, diagnosis and management of patients.
Design of a Vitamin D Fortification Programme
Initial results from the above study in the three cities of Tehran, Shiraz and Mashad point to a high prevalence of severe vitamin D deficiency (<25 nmol/l) in the districts of Tehran (56%), Shiraz (39.8%) and Mashad (27.5%). At the same time, 28.7%, 53.3% and 47.5% of the study populations in Tehran, Mashad and Tabriz, respectively, suffered from moderate vitamin D deficiency (25 nmol/l £ vitamin D £ 50 nmol/l). Based on the data, more than 80% of the population in these areas suffers to some degree from vitamin D deficiency. Given the central role played by vitamin D in the pathogenesis of osteomalacia, osteoporosis and immunodeficiency, and recent evidence confirming its role in the pathogenesis of diabetes mellitus, exacerbation of hypertension, atherosclerosis, and infertility, EMRC and the Department of Nutrition at MOH-SH have carried out an extensive study of the fortification of foodstuff, including milk and yoghurt, with vitamin D. The preliminaries are also in place for the trial fortification of milk with vitamin D, and are being vigorously followed up by the MOH-SH nutrition unit.
Establishment of the University of Tehran’s Bone Densitometry Centre
From the earliest stages of INOP-1, and with a considerable amount of follow-up, the EMRC has acquired a bone densitometer, which not only serve a research purpose at the Centre but also deliver diagnostic services to other departments within the hospital.
Purchase of New Densitometry Equipment, and Research and Comparative Studies
Currently, instruments using ultrasound to measure bone density for diagnostic and, in particular, screening purposes are becoming increasingly prominent. In view of the importance of research in this domain, therefore, EMRC has been in contact with scientific and industrial bodies and been able as a result to acquire two ultrasonic bone densitometers, one for the ankle region and the other for fingers. This technique is currently undergoing appraisal with the help of volunteers from the INOP study population.
Contact with International Osteoporosis Associations
There is greater focus now on contact with experts in the field of osteoporosis at home and abroad in order to exchange and benefit from their views and experiences, and to present the results of our activities at home. Contacts with the Secretary of the International Osteoporosis Foundation (IOF) for the Middle-East region, participation in the International Densitometry Workshop in Lebanon, and presentation of our research output at domestic and international gatherings have all gone to further this goal.
Compilation of a Strategic Plan for Osteoporosis
Given the importance of the disorder and significant economic burden it imposes on the public, EMRC has taken steps to compile a Strategic Plan for Osteoporosis (SPO). At present, preliminary studies in the field have been completed, and priorities for the different sectors involved (education, research, prevention, treatment…) have been identified.The SPO is to be prosecuted with the help of GOEM at the MOH-SH.
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