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Zahedi AS, Zarkesh M, Sedaghati-khayat B, Hedayati M, Azizi F, Daneshpour MS. Insulin resistance-related circulating predictive markers in the metabolic syndrome: a systematic review in the Iranian population. J Diabetes Metab Disord 2024; 23:199-213. [PMID: 38932859 PMCID: PMC11196549 DOI: 10.1007/s40200-023-01347-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/08/2023] [Indexed: 06/28/2024]
Abstract
Background Specific biomarkers for metabolic syndrome (MetS) may improve diagnostic specificity for clinical information. One of the main pathophysiological mechanisms of MetS is insulin resistance (IR). This systematic review aimed to summarize IR-related biomarkers that predict MetS and have been investigated in Iranian populations. Methods An electronic literature search was done using the PubMed and Scopus databases up to June 2022. The risk of bias was assessed for the selected articles using the instrument suggested by the Joanna Briggs Institute (JBI). This systematic review protocol was registered with PROSPERO (registration number CRD42022372415). Results Among the reviewed articles, 46 studies investigated the association between IR biomarkers and MetS in the Iranian population. The selected studies were published between 2009 and 2022, with the majority being conducted on adults and seven on children and adolescents. The adult treatment panel III (ATP III) was the most commonly used criteria to define MetS. At least four studies were conducted for each IR biomarker, with LDL-C being the most frequently evaluated biomarker. Some studies have assessed the diagnostic potency of markers using the area under the curve (AUC) with sensitivity, specificity, and an optimal cut-off value. Among the reported values, lipid ratios and the difference between non-HDL-C and LDL-C levels showed the highest AUCs (≥ 0.80) for predicting MetS. Conclusions Considering the findings of the reviewed studies, fasting insulin, HOMA-IR, leptin, HbA1c, and visfatin levels were positively associated with MetS, whereas adiponectin and ghrelin levels were negatively correlated with this syndrome. Among the investigated IR biomarkers, the association between adiponectin levels and components of MetS was well established. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01347-6.
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Affiliation(s)
- Asiyeh Sadat Zahedi
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Zarkesh
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahar Sedaghati-khayat
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Hedayati
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam S Daneshpour
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Nouri-Keshtkar M, Shojaei Shahrokhabadi M, Ghaheri A, Hosseini R, Ketabi H, Farjam M, Chen DG, Rezaeian M, Homayounfar R, Tahamtani Y, Totonchi M. Role of gender in explaining metabolic syndrome risk factors in an Iranian rural population using structural equation modelling. Sci Rep 2023; 13:16007. [PMID: 37749166 PMCID: PMC10520016 DOI: 10.1038/s41598-023-40485-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/10/2023] [Indexed: 09/27/2023] Open
Abstract
Many factors can lead to an increase in the prevalence of metabolic syndrome (MetS) in different populations. Using an advanced structural equation model (SEM), this study is aimed to determine the most important risk factors of MetS, as a continuous latent variable, using a large number of males and females. We also aimed to evaluate the interrelations among the associated factors involved in the development of MetS. This study used data derived from the Fasa PERSIAN cohort study, a branch of the PERSIAN cohort study, for participants aged 35 to 70 years with 10,138 males and females. SEM was used to evaluate the direct and indirect effects, as well as gender effects of influencing factors. Results from the SEM showed that in females most changes in MetS are described by waist circumference (WC), followed by hypertension (HP) and triglyceride (TG), while in males most changes in MetS are described by WC, followed by TG then fasting blood glucose (FBG). Results from the SEM confirmed the gender effects of social status on MetS, mediated by sleep and controlled by age, BMI, ethnicity and physical activity. This study also shows that the integration of TG and WC within genders could be useful as a screening criterion for MetS in our study population.
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Affiliation(s)
- Marjan Nouri-Keshtkar
- Department of Developmental Biology, University of Science and Culture, Tehran, Iran
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | | | - Azadeh Ghaheri
- Department of Basic and Population Based Studies in NCD, Reproductive Epidemiology Research Center, Royan Institute, ACECR, Tehran, Iran
| | - Roya Hosseini
- Department of Basic and Population Based Studies in NCD, Reproductive Epidemiology Research Center, Royan Institute, ACECR, Tehran, Iran
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Hassan Ketabi
- Mobile Telecommunication Company of Iran, Tehran, Iran
| | - Mojtaba Farjam
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Ding-Geng Chen
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
- Department of statistics, University of Pretoria, Pretoria, South Africa
| | - Mehdi Rezaeian
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Reza Homayounfar
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Yaser Tahamtani
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
- Department of Basic and Population Based Studies in NCD, Reproductive Epidemiology Research Center, Royan Institute, ACECR, Tehran, Iran.
| | - Mehdi Totonchi
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
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Pluimakers VG, van Santen SS, Fiocco M, Bakker MCE, van der Lelij AJ, van den Heuvel-Eibrink MM, Neggers SJCMM. Can biomarkers be used to improve diagnosis and prediction of metabolic syndrome in childhood cancer survivors? A systematic review. Obes Rev 2021; 22:e13312. [PMID: 34258851 PMCID: PMC8596408 DOI: 10.1111/obr.13312] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/11/2021] [Accepted: 06/09/2021] [Indexed: 12/26/2022]
Abstract
Childhood cancer survivors (CCS) are at increased risk to develop metabolic syndrome (MetS), diabetes, and cardiovascular disease. Common criteria underestimate adiposity and possibly underdiagnose MetS, particularly after abdominal radiotherapy. A systematic literature review and meta-analysis on the diagnostic and predictive value of nine newer MetS related biomarkers (adiponectin, leptin, uric acid, hsCRP, TNF-alpha, IL-1, IL-6, apolipoprotein B (apoB), and lipoprotein(a) [lp(a)]) in survivors and adult non-cancer survivors was performed by searching PubMed and Embase. Evidence was summarized with GRADE after risk of bias evaluation (QUADAS-2/QUIPS). Eligible studies on promising biomarkers were pooled. We identified 175 general population and five CCS studies. In the general population, valuable predictive biomarkers are uric acid, adiponectin, hsCRP and apoB (high level of evidence), and leptin (moderate level of evidence). Valuable diagnostic biomarkers are hsCRP, adiponectin, uric acid, and leptin (low, low, moderate, and high level of evidence, respectively). Meta-analysis showed OR for hyperuricemia of 2.94 (age-/sex-adjusted), OR per unit uric acid increase of 1.086 (unadjusted), and AUC for hsCRP of 0.71 (unadjusted). Uric acid, adiponectin, hsCRP, leptin, and apoB can be alternative biomarkers in the screening setting for MetS in survivors, to enhance early identification of those at high risk of subsequent complications.
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Affiliation(s)
| | - Selveta S van Santen
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.,Department of Medicine, Endocrinology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Marta Fiocco
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.,Medical Statistics, Department of Biomedical Data Science, Leiden UMC, Leiden, Netherlands.,Mathematical Institute, Leiden University, Leiden, Netherlands
| | - Marie-Christine E Bakker
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.,Department of Medicine, University Medical Center Utrecht, Netherlands
| | - Aart J van der Lelij
- Department of Medicine, Endocrinology, Erasmus Medical Center, Rotterdam, Netherlands
| | | | - Sebastian J C M M Neggers
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.,Department of Medicine, Endocrinology, Erasmus Medical Center, Rotterdam, Netherlands
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Kalan Farmanfarma K, Kaykhaei MA, Adineh HA, Mohammadi M, Dabiri S, Ansari-Moghaddam A. Prevalence of metabolic syndrome in Iran: A meta-analysis of 69 studies. Diabetes Metab Syndr 2019; 13:792-799. [PMID: 30641809 DOI: 10.1016/j.dsx.2018.11.055] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 11/29/2018] [Indexed: 01/08/2023]
Abstract
AIMS Metabolic syndrome increases the risk of chronic diseases including cardiovascular diseases and diabetes. The present study investigated the prevalence of metabolic syndrome in Iran. MATERIALS AND METHODS Published articles in English and Persian during 2000-2016 identified using keywords of prevalence, metabolic syndrome, and Iran in the following databases: Web of Science, PubMed, Scopus, Google scholar, SID and Magiran. Random effect model used to calculate the pooled estimates. Heterogeneity of studies assessed using Q statistic, and geographical distribution of metabolic syndrome demonstrated via GIS map. Data were analyzed by STATA-11. RESULTS The overall prevalence of metabolic syndrome was 30.4% (95%CI: 28.3-32.6) with no significant heterogeneity by diagnostic criteria. The lowest frequency was reported in Sistan and Baluchestan Province [18.3% (95% CI: 12.9-25.8)] compared to the highest in Bushehr [57.8% (95% CI: 41.8-80.0)]. It was significantly more prevalent in women [(34.8% (95%CI: 31.2-38.8)] compared to men [25.7% (95%CI: 23.4-28.3)] (P = 0.001)]. A significant increasing trend (P = 0.001) was observed in different age groups, as metabolic syndrome increased from 12.1% (95% CI: 9.37-15.6) in 20-29 years-old age group to 51.7% (95%CI: 47.4-56.4) in the over 60 years-old age group. CONCLUSIONS Approximately one-third of Iranian adults have metabolic syndrome which varied by regions, age and gender. Then, appropriate intervention based on behavioral patterns of inhabitants and local conditions may help to reduce the burden of disease.
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Affiliation(s)
- Khadijeh Kalan Farmanfarma
- Department of Epidemiology, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mahmoud Ali Kaykhaei
- Department of Endocrinology and Metabolism, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hosein Ali Adineh
- Department of Epidemiology, Iranshahr University of Medical Sciences, Iran
| | - Mehdi Mohammadi
- Health Promotion Research Center, Zahedan University of Medical Science, Zahedan, Iran
| | - Soroosh Dabiri
- Department of Laboratory Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
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Chen VCH, Chen CH, Chiu YH, Lin TY, Li FC, Lu ML. Leptin/Adiponectin ratio as a potential biomarker for metabolic syndrome in patients with schizophrenia. Psychoneuroendocrinology 2018; 92:34-40. [PMID: 29625373 DOI: 10.1016/j.psyneuen.2018.03.021] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 03/28/2018] [Accepted: 03/28/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Leptin and adiponectin are adipokines which have opposing roles in the development of insulin resistance and metabolic syndrome (MetS). Leptin/adiponectin ratio (L/A ratio) has been proposed as a good biomarker for MetS in general population. This study aimed to compare the strength of association between MetS and leptin, adiponectin and L/A ratio, as well as to assess their performance to diagnose MetS in patients with schizophrenia. METHODS Patients diagnosed with DSM-IV schizophrenia and under clozapine or olanzapine monotherapy for at least six months were recruited. We used the modified ATP III criteria for Asians to evaluate subjects for a diagnosis of MetS. RESULTS We recruited 262 study subjects with schizophrenia, and classified them into those with MetS (n = 87) and those without MetS (n = 175). Leptin level was positively correlated with BMI, waist circumference, and insulin level. Adiponectin level was negatively correlated with most metabolic parameters, except glucose level. L/A ratio was positively correlated with most metabolic parameters, except levels of glucose and HDL-C. Significant gender differences existed in leptin levels, adiponectin levels, and L/A ratio. Without and with adjustment of age and gender, binary logistic regression analysis showed that leptin level, adiponectin level, and L/A ratio were significantly associated with MetS. The area under curve (AUC) of L/A ratio and leptin level for MetS was 0.744 (95% CI = 0.685-0.802) and 0.666 (95% CI = 0.601-0.731). The AUC of adiponectin level for the absence of MetS was 0.717 (95% CI = 0.655-0.780). The discriminative strength of L/A ratio for MetS was better in men than in women. CONCLUSIONS The present study results suggest that L/A ratio may be a preferential marker of metabolic syndrome in patients with schizophrenia compared to leptin or adiponectin alone.
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Affiliation(s)
- Vincent Chin-Hung Chen
- Department of Psychiatry & Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi Branch, Taiwan; School of Medicine, Chang Gung University, Taiwan
| | - Chun-Hsin Chen
- Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hang Chiu
- Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tsang-Yaw Lin
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan
| | - Feng-Chiao Li
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan
| | - Mong-Liang Lu
- Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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Sahin-Efe A, Upadhyay J, Ko BJ, Dincer F, Park KH, Migdal A, Vokonas P, Mantzoros C. Irisin and leptin concentrations in relation to obesity, and developing type 2 diabetes: A cross sectional and a prospective case-control study nested in the Normative Aging Study. Metabolism 2018; 79:24-32. [PMID: 29108900 DOI: 10.1016/j.metabol.2017.10.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 09/12/2017] [Accepted: 10/21/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the associations between irisin and leptin levels in obesity and insulin resistance in a cross sectional study. To assess the potential role of irisin and leptin as a predictive marker of T2DM using a nested case-control study. METHODS Both studies were designed within the longitudinal VA NAS cohort. The cross sectional study involved 111 non obese and 105 obese subjects who were subdivided into two groups based on their fasting glucose tolerance. In the nested 1:3 case-control study, 47 subjects with T2DM and 140 non-diabetic controls were selected. Serum samples collected 3-5 years before the diagnosis of T2DM were analyzed. Irisin and leptin concentrations were measured using a validated ELISA and radioimmunoassay respectively. RESULTS In the cross-sectional study, irisin did not differ between groups based on their fasting glucose tolerance. When subjects were grouped based on obesity status, both irisin and leptin concentrations were significantly higher in obese compared to the non-obese group (p=0.03 and <0.001, respectively). Irisin concentrations positively correlated with leptin concentrations (r= 0.392, P < 0.001). In the nested case control study, leptin concentrations were a significant predictor of developing diabetes (p=0.005) in unadjusted models, but not after correcting for BMI, whereas irisin concentrations did not play a role of comparable significance. CONCLUSIONS Leptin concentrations are higher in the obese group irrespective of their glucose tolerance. Obese individuals with impaired fasting glucose have higher concentrations of circulating irisin compared to non-obese subjects with normal glucose tolerance. Irisin concentrations do not predict risk of developing diabetes prospectively.
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Affiliation(s)
- Ayse Sahin-Efe
- Division of Endocrinology, Beth-Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA; Division of Endocrinology, Boston University Medical Center, Boston, MA, USA; Section of Endocrinology, Department of Medicine, VA Boston Healthcare System, Boston, MA, USA
| | - Jagriti Upadhyay
- Division of Endocrinology, Beth-Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA; Division of Endocrinology, Boston University Medical Center, Boston, MA, USA; Section of Endocrinology, Department of Medicine, VA Boston Healthcare System, Boston, MA, USA.
| | - Byung-Joon Ko
- Division of Endocrinology, Beth-Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Fadime Dincer
- Division of Endocrinology, Beth-Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Kyung Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University, Gyeonggi-do, Republic of Korea
| | - Alexandra Migdal
- Division of Endocrinology, Beth-Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Pantel Vokonas
- Normative Aging Study, VA Boston Healthcare System and Boston University Schools of Public Health and Medicine, Boston, MA, USA
| | - Christos Mantzoros
- Division of Endocrinology, Beth-Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA; Division of Endocrinology, Boston University Medical Center, Boston, MA, USA; Section of Endocrinology, Department of Medicine, VA Boston Healthcare System, Boston, MA, USA
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Ramos-Romero S, Molinar-Toribio E, Pérez-Jiménez J, Taltavull N, Dasilva G, Romeu M, Medina I, Torres JL. The combined action of omega-3 polyunsaturated fatty acids and grape proanthocyanidins on a rat model of diet-induced metabolic alterations. Food Funct 2016; 7:3516-23. [PMID: 27418399 DOI: 10.1039/c6fo00679e] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
It has been suggested that food components such as ω-3 polyunsaturated fatty acids (ω-3 PUFAs) and (poly)phenols counteract diet-induced metabolic alterations by common or complementary mechanisms. To examine the effects of a combination of ω-3 PUFAs and (poly)phenols on such alterations, adult Wistar-Kyoto rats were fed an obesogenic high-fat high-sucrose diet supplemented, or not, for 24 weeks with: eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA) 1 : 1 (16.6 g kg(-1) feed); proanthocyanidin-rich grape seed extract (GSE, 0.8 g kg(-1) feed); or EPA/DHA 1 : 1 + GSE. Body weight, feed intake, and plasma glucose were evaluated every 6 weeks, while adipose tissue weight, insulin, glucagon, ghrelin, leptin, adiponectin, cholesterol, and triglycerides were evaluated at the end of the experiment. ω-3 PUFAs reduced plasma leptin and cholesterol levels, but did not modify diet-induced perigonadal fat or plasma insulin levels; while GSE increased plasma triglyceride levels. The combined action of ω-3 PUFAs and the proanthocyanidins reduced plasma insulin and leptin, as well as partially prevented perigonadal fat accumulation. While separate supplementation with ω-3 PUFAs or grape proanthocyanidins may not counteract all the key metabolic changes induced by a high-energy-dense diet, the combination of both supplements reverts altered insulin, leptin and triglyceride levels to normal.
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Affiliation(s)
- Sara Ramos-Romero
- Institute of Advanced Chemistry of Catalonia (IQAC-CSIC), Barcelona, Spain.
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Zhao M, Cooney MT, Klipstein-Grobusch K, Vaartjes I, De Bacquer D, De Sutter J, Reiner Ž, Prescott E, Faggiano P, Vanuzzo D, AlFaleh H, Menown IBA, Gait D, Posogova N, Sheu WHH, Zhao D, Zuo H, Grobbee DE, Graham IM. Simplifying the audit of risk factor recording and control: A report from an international study in 11 countries. Eur J Prev Cardiol 2016; 23:1202-10. [DOI: 10.1177/2047487316647827] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 04/13/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Min Zhao
- Julius Global Health, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands
| | | | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ilonca Vaartjes
- Julius Global Health, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands
- Global Geo and Health Data Centre, Utrecht University, The Netherlands
| | | | - Johan De Sutter
- AZ Maria Middelares Hospital Ghent and Ghent University, Belgium
| | - Željko Reiner
- University Hospital Centre Zagreb, School of Medicine, Zagreb University, Croatia
| | - Eva Prescott
- Bispebjerg University Hospital, Copenhagen, Denmark
| | - Pompilio Faggiano
- Cardiology Department, Spedali Civili and University of Brescia, Italy
| | - Diego Vanuzzo
- Cardiovascular Prevention Centre, Health Unit 4 ‘Friuli Centrale’, Udine, Italy
| | | | | | - Dan Gait
- University of Medicine and Pharmacy ‘Victor Babes’, Cardiology Department, Timisoara, Romania
| | - Nana Posogova
- National Research Centre for Preventive Medicine, Moscow, Russia
| | - Wayne H-H Sheu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taiwan
| | | | - Huijuan Zuo
- Beijing Institute of Heart, Lung & Blood Vessel Diseases, Beijing Anzhen Hospital affiliated to the Capital University of Medical Sciences, Beijing, China
| | - Diederick E Grobbee
- Julius Global Health, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands
- Global Geo and Health Data Centre, Utrecht University, The Netherlands
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9
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Amirkalali B, Fakhrzadeh H, Sharifi F, Kelishadi R, Zamani F, Asayesh H, Safiri S, Samavat T, Qorbani M. Prevalence of Metabolic Syndrome and Its Components in the Iranian Adult Population: A Systematic Review and Meta-Analysis. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e24723. [PMID: 26756015 PMCID: PMC4706734 DOI: 10.5812/ircmj.24723] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 04/30/2015] [Accepted: 06/15/2015] [Indexed: 11/07/2022]
Abstract
CONTEXT Metabolic syndrome (MetS) increases the risk of most non-communicable diseases; gathering information about its prevalence can be very effective in formulating preventive strategies for metabolic diseases. There are many different studies about the prevalence of MetS in Iran, but the results and the study populations of these studies are very different; therefore, it is very important to have an overall estimation of its prevalence in Iran. OBJECTIVES This study systematically reviewed the findings of all available studies on MetS in the adult Iranian population and estimated the overall prevalence of MetS in this population. DATA SOURCES International databases (Scopus, ISI Web of Science, and PubMed) were searched for papers published from January, 2000 to December, 2013 using medical subject headings (MeSH), Emtree, and related keywords (metabolic syndrome, dysmetabolic syndrome, cardiovascular syndrome, and insulin resistance syndrome) combined with the words "prevalence" and "Iran." The Farsi equivalent of these terms and all probable combinations were used to search Persian national databases (IranMedex, Magiran, SID, and Irandoc). STUDY SELECTION All population-based studies and national surveys that reported the prevalence of MetS in healthy Iranian adults were included. DATA EXTRACTION After quality assessment, data were extracted according to a standard protocol. Because of between-study heterogeneity, data were analyzed by the random effect method. RESULTS We recruited the data of 27 local studies and one national study. The overall estimation of MetS prevalence was 36.9% (95% CI: 32.7 - 41.2%) based on the Adult Treatment Panel III (ATP III) criteria, 34.6% (95% CI: 31.7 - 37.6%) according to the International Diabetes Federation (IDF), and 41.5% (95% CI: 29.8 - 53.2%) based on the Joint Interim Societies (JIS) criteria. The prevalence of MetS determined by JIS was significantly higher than those determined by ATP III and IDF. The prevalence of MetS was 15.4% lower in men than in women (27.7% versus 43.1%) based on the ATP III criteria, and it was 11.3% lower in men based on the IDF criteria; however according to the JIS criteria, it was 8.4% more prevalent in men. CONCLUSIONS There is a high prevalence of MetS in the Iranian adult population, with large variations based on different measurement criteria. Therefore, prevention and control of MetS should be considered a priority.
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Affiliation(s)
- Bahareh Amirkalali
- Gastrointestinal and Liver disease research Center (GILDRC), Iran University of Medical Sciences, Tehran, IR Iran
| | - Hossein Fakhrzadeh
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Roya Kelishadi
- Child Growths and Development Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Farhad Zamani
- Gastrointestinal and Liver disease research Center (GILDRC), Iran University of Medical Sciences, Tehran, IR Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, IR Iran
| | - Saeid Safiri
- Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, IR Iran
| | - Tahereh Samavat
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Mostafa Qorbani
- Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, IR Iran
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran
- Department of Epidemiology, Iran University of Medical Sciences, Tehran, IR Iran
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10
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Yu ZR, Ning Y, Yu H, Tang NJ. A HPLC-Q-TOF-MS-based urinary metabolomic approach to identification of potential biomarkers of metabolic syndrome. ACTA ACUST UNITED AC 2014; 34:276-283. [DOI: 10.1007/s11596-014-1271-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 03/01/2014] [Indexed: 01/03/2023]
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Predictive ability of C-reactive protein for early mortality after ischemic stroke: comparison with NIHSS score. Acta Neurol Belg 2014; 114:41-5. [PMID: 23975559 DOI: 10.1007/s13760-013-0238-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 07/23/2013] [Indexed: 01/22/2023]
Abstract
We aimed to compare the association of high-sensitivity C-reactive protein (CRP) and National Institutes of Health Stroke Scale (NIHSS) score with mortality risk and to determine the optimal threshold of CRP for prediction of mortality in ischemic-stroke patients. A series of 162 patients with first-ever ischemic-stroke admitted within 24 h after onset of symptoms was enrolled. CRP and NIHSS score were estimated on admission and their predictive abilities for mortality at 7 days were determined by logistic-regression analyses. Receiver-Operating Characteristic (ROC) curves were depicted to identify the optimal cut-off of CRP, using the maximum Youden-index and the shortest-distance methods. Deceased patients had higher levels of CRP and NIHSS on admission (8.87 ± 7.11 vs. 2.20 ± 4.71 mg/l for CRP, and 17.31 ± 6.36 vs. 8.70 ± 4.85 U for NIHSS, respectively, P < 0.01). CRP and NIHSS were correlated with each other (r (2) = 0.39, P < 0.001) and were also independently associated with increased risk of mortality [odds ratios (95 % confidence interval) of 1.16 (1.05-1.28) and 1.20 (1.07-1.35) for CRP and NIHSS, respectively, P < 0.01]. The areas under the ROC curves of CRP and NIHSS for mortality were 0.82 and 0.84, respectively. The CRP value of 2.2 mg/l was identified as the optimal cut-off value for prediction of mortality within 7 days (sensitivity: 0.81, specificity: 0.80). Thus, CRP as an independent predictor of mortality following ischemic-stroke is comparable with NIHSS and the value of 2.2 mg/l yields the optimum sensitivity and specificity for mortality prediction.
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Feng H, Zheng L, Feng Z, Zhao Y, Zhang N. The role of leptin in obesity and the potential for leptin replacement therapy. Endocrine 2013; 44:33-9. [PMID: 23274948 DOI: 10.1007/s12020-012-9865-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 12/15/2012] [Indexed: 12/13/2022]
Abstract
Leptin (from the Greek word "lepto'' meaning "thin") is a 167-amino acid peptide hormone encoded by the obesity (ob) gene and secreted by white adipocytes. Blood leptin concentrations are increased in obese individuals. Leptin is a satiety hormone that provides negative feedback to the hypothalamus, controlling appetite and energy expenditure. Leptin binds to presynaptic GABAergic neurons to produce its effect, raising the distinct possibility that GABAergic axon terminals are the ultimate subcellular site of action for its effects. Released into the circulation, leptin crosses the blood-brain barrier and binds to leptin receptors, influencing the activity of various hypothalamic neurons, as well as encoding orexigenic and anorexigenic neuropeptides. Moreover, leptin affects a wide range of metabolic functions in the peripheral tissue. In this review, we discuss some physiologic functions of leptin, including effects on obesity and some effects of leptin replacement therapy.
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Affiliation(s)
- Helin Feng
- Department of Orthopedics, The Fourth Affiliated Hospital of Hebei Medical University, 12 Health Road, Shijiazhuang, 050011, China.
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Abstract
South Asia is home to one of the largest population of people with metabolic syndrome (MetS). The prevalence of MetS in South Asians varies according to region, extent of urbanization, lifestyle patterns, and socioeconomic/cultural factors. Recent data show that about one-third of the urban population in large cities in India has the MetS. All classical risk factors comprising the MetS are prevalent in Asian Indians residing in India. The higher risk in this ethnic population necessitated a lowering of the cut-off values of the risk factors to identify and intervene for the MetS to prevent diabetes and cardiovascular disease. Some pharmacological and nonpharmacological interventions are underway in MetS to assess the efficacy in preventing the diabetes and cardiovascular disease in this ethnic population.
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Affiliation(s)
- Kaushik Pandit
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
| | - Soumik Goswami
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
| | - Sujoy Ghosh
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
| | - Pradip Mukhopadhyay
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
| | - Subhankar Chowdhury
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
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