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Zeenny RM, Haddad C, Hajj A, Zeidan RK, Salameh P, Ferrières J. Adherence to the Mediterranean Diet and Cardiovascular Risk Factors among the Lebanese Population: A Nationwide Cross-Sectional Post Hoc Study. Nutrients 2024; 16:2426. [PMID: 39125308 PMCID: PMC11313688 DOI: 10.3390/nu16152426] [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: 06/07/2024] [Revised: 07/16/2024] [Accepted: 07/17/2024] [Indexed: 08/12/2024] Open
Abstract
OBJECTIVE This study aims to identify the association between adherence to healthy eating, using the Lebanese Mediterranean Diet Scale (LMDS), and cardiovascular risk factors in the Lebanese population. MATERIALS AND METHODS A cross-sectional study using a multistage cluster sample was conducted in Lebanon. Sociodemographic characteristics were collected through structured interviews and self-administered questionnaires. The LMDS assessed dietary habits. The associations between diabetes, dyslipidemia, and cardiovascular disease were investigated using stratification analysis. RESULTS The study included 2048 people (mean age: 41.54 ± 17.09 years). Higher adherence to the Mediterranean diet was associated with older age (Beta = 0.175, p < 0.001), being female (Beta = 0.085, p = 0.001), being married (Beta = 0.054, p = 0.047), participating in regular physical activity (Beta = 0.142, p < 0.001), and having cardiovascular disease (Beta = 0.115, p < 0.001) and diabetes (Beta = 0.055, p = 0.043). Adherence was, however, negatively associated with being a smoker (Beta = -0.083, p = 0.002), a previous smoker (Beta = -0.059, p = 0.026), and having higher distress levels (Beta = -0.079, p = 0.002). Stratification analysis by diabetes, dyslipidemia, and cardiovascular disease (CVD) consistently demonstrated these associations. CONCLUSIONS These findings suggest that demographic and health factors influence the Lebanese population's adherence to the Mediterranean diet. Older age, female gender, married status, physical activity, CVD, and diabetes were all found to be associated with adherence to the Mediterranean diet in the Lebanese population. In contrast, smoking and distress were inversely associated with it.
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Affiliation(s)
- Rony M. Zeenny
- Department of Mathématiques Informatique et Télécommunications, Université Toulouse III, Paul Sabatier, INSERM, UMR 1295, F-31000 Toulouse, France
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon; (C.H.); (A.H.); (R.K.Z.); (P.S.)
- Department of Pharmacy, American University of Beirut Medical Center, Beirut 1107, Lebanon
| | - Chadia Haddad
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon; (C.H.); (A.H.); (R.K.Z.); (P.S.)
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos 4504, Lebanon
- School of Health Sciences, Modern University of Business and Science, Beirut 7501, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal El Dib 1525, Lebanon
| | - Aline Hajj
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon; (C.H.); (A.H.); (R.K.Z.); (P.S.)
- Faculté de Pharmacie, Université Laval, Québec, QC G1V 0A6, Canada
- Oncology Division, CHU de Québec-Université Laval Research Center, Québec, QC G1R 3S3, Canada
| | - Rouba K. Zeidan
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon; (C.H.); (A.H.); (R.K.Z.); (P.S.)
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon; (C.H.); (A.H.); (R.K.Z.); (P.S.)
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos 4504, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat 1103, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, 2417 Nicosia, Cyprus
| | - Jean Ferrières
- Department of Cardiology and INSERM UMR 1295, Rangueil University Hospital, F-31059 Toulouse, France;
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Oguoma VM, Coffee NT, Alsharrah S, Abu-Farha M, Al-Refaei FH, Alkandari A, Al-Mulla F, Daniel M. Anthropometric cut-points for discriminating diabetes and the metabolic syndrome among Arabs and Asians: the Kuwait Diabetes Epidemiology Program. Br J Nutr 2022; 127:92-102. [PMID: 33658089 DOI: 10.1017/s0007114521000751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study aimed to determine anthropometric cut-points for screening diabetes and the metabolic syndrome (MetS) in Arab and South Asian ethnic groups in Kuwait and to compare the prevalence of the MetS based on the ethnic-specific waist circumference (WC) cut-point and the International Diabetes Federation (IDF) and American Heart Association/National Heart, Lung, and Blood Institute WC criteria. The national population-based survey data set of diabetes and obesity in Kuwait adults aged 18-60 years was analysed. Age-adjusted logistic regression and receiver operating characteristic (ROC) analyses were conducted to evaluate for 3589 individuals the utility of WC, waist:height ratio (WHtR) and BMI to discriminate both diabetes and ≥3 CVD risk factors. Areas under the ROC curve were similar for WC, WHtR and BMI. In Arab men, WC, WHtR and BMI cut-offs for diabetes were 106 cm, 0·55 and 28 kg/m2 and for ≥3 CVD risk factors, 97 cm, 0·55 and 28 kg/m2, respectively. In Arab women, cut-offs for diabetes were 107 cm, 0·65 and 33 kg/m2 and for ≥3 CVD risk factors, 93 cm, 0·60 and 30 kg/m2, respectively. WC cut-offs were higher for South Asian women than men. IDF-based WC cut-offs corresponded to a higher prevalence of the MetS across sex and ethnic groups, compared with Kuwait-specific cut-offs. Any of the assessed anthropometric indices can be used in screening of diabetes and ≥3 CVD risk factors in Kuwaiti Arab and Asian populations. ROC values were similar. The WC threshold for screening the MetS in Kuwaiti Arabs and South Asians is higher for women.
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Affiliation(s)
- Victor M Oguoma
- Health Research Institute, University of Canberra, Canberra, Australia
- Geohealth Laboratory, Dasman Diabetes Institute, Kuwait City, Kuwait
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Neil T Coffee
- Health Research Institute, University of Canberra, Canberra, Australia
| | - Saad Alsharrah
- Health Research Institute, University of Canberra, Canberra, Australia
- Geohealth Laboratory, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Mohamed Abu-Farha
- Biochemistry and Molecular Biology Department, Dasman Diabetes Institute, Kuwait City, Kuwait
| | | | - Abdullah Alkandari
- Genetics and Bioinformatics Department, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Fahd Al-Mulla
- Genetics and Bioinformatics Department, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Mark Daniel
- Health Research Institute, University of Canberra, Canberra, Australia
- Department of Medicine, St. Vincent's Hospital, The University of Melbourne, Melbourne, Australia
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Work-related musculoskeletal disorders among Egyptian physical therapists. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2021. [DOI: 10.1186/s43161-021-00025-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Physical therapists (PTs) are frequently exposed to work-related musculoskeletal disorders (WMSDs). There is limited evidence on the prevalence of these injuries and their potential risk factors in Egyptian PTs. This study aimed at estimating the prevalence of WMSDs among Egyptian PTs as well as potential risk factors and therapists’ coping strategies. Further, it investigated the association between WMSDs and socioeconomic factors.
Results
Three hundred eighty-five eligible participants completed a survey. The prevalence of WMSDs was 99.5%. The five top affected anatomic regions were lower back (69.1%), neck (65.7%), shoulder (47.7%), wrist/hand (39.1%), and upper back (37.0%). Therapists rated awkward positions and handling of heavy patients as the most common predisposing factors for sustaining injuries. Regarding coping strategies, seeking informal help from peers to treat injuries-related symptoms and changing the posture of therapists and patients while working were mostly used by PTs. Overall, female therapists had higher injury prevalence than males (Cramer’s V < 0.5, p ≤ 0.05); except for upper back (p > 0.05). Education and working in multiple facilities simultaneously (public and private clinics) correlated significantly to sustaining injuries in the upper back (V = 0.14, p = 0.049 and V = 0.178, p = 0.002, respectively) and neck (V = 0.16, p = .019 and V = 0.142, p = 0.020, respectively). WMSDs were not associated with therapists’ experience or specialty (p > 0.05).
Conclusion
WMSDs injuries in PTs are prevalent in Egypt, especially in females, therapists with lower academic education, and those working in multiple facilities simultaneously.
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Abdel Aal A, Youssef G, El Faramawy A, El Remisy D, El Deeb H, El Aroussy W, Ibrahim MM. Registry of the Egyptian specialized hypertension clinics: Sex-related differences in clinical characteristics and hypertension management among low socioeconomic hypertensive patients. J Clin Hypertens (Greenwich) 2021; 23:1120-1128. [PMID: 33774923 PMCID: PMC8678729 DOI: 10.1111/jch.14231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/17/2020] [Accepted: 12/08/2020] [Indexed: 11/29/2022]
Abstract
Hypertension is a major modifiable risk factor for cardiovascular disease (CVD) which is a leading cause of death in developing countries affecting both genders. Gender dissimilarity in clinical characteristics and hypertension (HTN) management among hypertensive patients has been reported in several reports before. The aim was to detect sex differences in clinical characteristics and HTN management among Egyptian hypertensive patients. Data from 4701 hypertensive patients attending 9 university located Specialized Hypertension clinic (SHC) were collected from October 2014 to September 2017. The collected data included demographics, cardiovascular risk profile, hypertension‐related history, anthropometric and blood pressure (BP) measurements, antihypertensive medications used, number of patients attending the follow‐up visits, and HTN control rate. Females represented 58.5% of the recruited patients, they were younger, with higher BMI, lower education level, and employment rate compared with males. Females had lower mean office systolic and diastolic BP than males (144.2 ± 22.6 vs. 146.5 ± 22.0 mmHg and 88.1 ± 13.0 vs. 89.9 ± 12.6 mmHg, respectively) and lower rate of uncontrolled BP (54.8% vs. 61.1% in males P < .001). Antihypertensive drugs were comparable among both sexes except for angiotensin converting enzyme inhibitors which were more prescribed in males. Compliance to antihypertensive medications was better in females (63.6% vs. 60.1% in males, P = .015). To conclude, Egyptian hypertensive females have different clinical characteristics as compared to their counterpart males with better BP control, adherence to antihypertensive medications, lower systolic and diastolic BP, and no major differences in the prescribed antihypertensive distribution.
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Affiliation(s)
- Amr Abdel Aal
- Faculty of Medicine, Department of Cardiology, Helwan University, Cairo, Egypt
| | - Ghada Youssef
- Faculty of Medicine, Department of Cardiology, Cairo University, Cairo, Egypt
| | - Amr El Faramawy
- Faculty of Medicine, Department of Cardiology, Cairo University, Cairo, Egypt
| | - Dalia El Remisy
- Faculty of Medicine, Department of Cardiology, Cairo University, Cairo, Egypt
| | - Heba El Deeb
- Faculty of Medicine, Department of Cardiology, Cairo University, Cairo, Egypt
| | - Wafaa El Aroussy
- Faculty of Medicine, Department of Cardiology, Cairo University, Cairo, Egypt
| | - M Mohsen Ibrahim
- Faculty of Medicine, Department of Cardiology, Cairo University, Cairo, Egypt
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Gharib A, Loza S. Factors affecting the severity of the apnea hypoapnea index: a retrospective study on 838 Egyptian patients diagnosed with obstructive sleep apnea. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2020. [DOI: 10.1186/s43168-020-00034-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Obstructive sleep apnea (OSA) is a common condition in the general population that is highly correlated to obesity, and it is associated with major cardiovascular morbidity and mortality. In Egypt, obesity rates are known to be high; however, OSA remains largely under-diagnosed, and data on its current magnitude is very scarce. Thus, the aims of the study were to identify the percentage of OSA in a large sample of patients referred for polysomnography and to determine the effect of different demographic data on the severity of the disease.
Results
This retrospective study included 1012 patients. Medical data were reviewed by sleep specialists. The correlation between age, body mass index (BMI), and neck circumference (NC) with apnea hypoapnea index (AHI) was explored. Also, gender differences were analyzed. A total of 838 patients (81% males, 19% females) were diagnosed with OSA. Patients with mild, moderate, and severe OSA were 204 (24%), 146 (17%), and 488 (58%), respectively. Females were older than males (58.87 ± 10.25 versus 54.39 ± 22.96, p = 0.001) and BMI was not significantly different between both sexes (34.18 ± 13.53 versus 36.73 ± 23.25, p = 0.07), but NC was higher in men (43.56 ± 5.3 versus 39.34 ± 4.41, p = 0.001). AHI was significantly increased in men compared to women (47.97 ± 31.22 versus 37.95 ± 31.72, p = 0.001) and severe OSA was commonly diagnosed in men than women (p = 0.001). A positive significant correlation was found between BMI, NC with AHI, arousal index, average SpO2, and desaturation index.
Conclusion
OSA is highly prevalent among our patients. Additionally, BMI and NC independently affected the severity of their disease.
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Tladi DM, Mokgatlhe L, Shaibu S, Nell T, Mitchell R, Mokgothu CJ, Gabonthone T, Hubona O. Determination of optimal cut-off values for waist circumferences used for the diagnosis of the metabolic syndrome among Batswana adults (ELS 32). Cardiovasc J Afr 2020; 31:314-318. [PMID: 33404582 PMCID: PMC8762772 DOI: 10.5830/cvja-2020-025] [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: 04/18/2018] [Accepted: 07/07/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND To date, no definitive waist circumference (WC) cut-off values for abdominal obesity (AO) have been established for sub-Saharan Africa, including Botswana. Therefore, the classification of AO among these populations is based on European values. For accurate diagnosis of the metabolic syndrome (MetS), cut-off values reflective of the population investigated must be used. OBJECTIVE The study was an attempt to determine optimal cut-off values for AO among Batswana adults. METHODS The receiver operating characteristic curve was used to determine the optimal cut-off values for predicting at least two other risk factors of the MetS. Data were used from a descriptive cross-sectional study employing a complex multi-stage cluster sampling. Demographic and anthropometric measurements (weight and height, waist and hip circumferences), blood pressure, and blood glucose, triglycerides, high-density lipoprotein cholesterol and total cholesterol levels were collected from 384 men and 416 women in Gaborone and the surrounding villages. RESULTS The ability of waist circumference to predict at least two other risk factors of the MetS gave cut-off values of ≥ 91.0 cm (sensitivity 69.1% and specificity of 90.8%, area under the curve 0.85) for men and ≥ 82.3 cm (sensitivity of 88.6% and specificity of 58.9%, area under the curve of 0.76) for women. CONCLUSIONS There is a difference between the cut-off values for Europeans with those determined for Batswana adults. Inconsistencies in cut-off values used have the potential for undesirable consequences for cardiovascular risk stratification and prioritisation of preventative strategies for AO and the MetS. The need to determine population-, ethnic- and gender-based cut-off values for AO for Batswana adults has never been more paramount.
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Affiliation(s)
- D M Tladi
- Department of Physical Education, Health and Recreation, University of Botswana, Gaborone, Botswana.
| | - L Mokgatlhe
- Department of Statistics, University of Botswana, Gaborone, Botswana
| | - S Shaibu
- School of Nursing, University of Botswana, Gaborone, Botswana
| | - T Nell
- Department of Physiological Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - R Mitchell
- Department of Physical Education, Health and Recreation, University of Botswana, Gaborone, Botswana
| | - C J Mokgothu
- Department of Physical Education, Health and Recreation, University of Botswana, Gaborone, Botswana
| | - T Gabonthone
- Department of Physical Education, Health and Recreation, University of Botswana, Gaborone, Botswana
| | - O Hubona
- Department of Physical Education, Health and Recreation, University of Botswana, Gaborone, Botswana
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Registry of the Egyptian specialized hypertension clinics: patient risk profiles and geographical differences. J Hum Hypertens 2019; 34:520-527. [PMID: 31558807 DOI: 10.1038/s41371-019-0265-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 09/05/2019] [Accepted: 09/12/2019] [Indexed: 11/08/2022]
Abstract
Data regarding the prevalence and characteristics of cardiovascular (CV) risk factors among Egyptian hypertensive patients are limited. Nationwide Specialized Hypertension Clinics (SHCs) were initiated for screening, investigating, and treating hypertensive patients. This study aimed to determine the clinical characteristics and the CV risk profile of hypertensive Egyptians attending SHCs. Data from 4701 hypertensive patients were collected from the SHCs of nine university hospitals representing the different geographical regions of Egypt. Data collection started in October 2014 and ended in September 2017. Data included blood pressure (BP) measurements, clinical data, socio-demographic characteristics, anthropometric measurements, and cardiovascular risk profiles. The patients' mean age was 51.8 ± 11.5 years, 58.7% were older than 50 years, and 58.5% were females. The mean office systolic and diastolic BP values were 145.2 ± 22.4 and 88.7 ± 12.9 mmHg, respectively. Regarding CV risk factors, 58.6% were obese, 23.4% were smokers, and 25.1% had diabetes mellitus. Obesity was more prevalent in females than males (65.7% vs. 53.0%, p < 0.001, respectively), while dyslipidaemia and smoking were significantly more common in male patients. The highest levels of BP and the highest global risk were observed in the inhabitants of the Delta region, despite their younger age. In conclusion, this study revealed a high prevalence of modifiable CV risk factors among a cohort of Egyptian hypertensive patients attending SHCs. The pattern of the risk factors across the different geographic regions may be attributed to rapid urbanization. Governmental and community-based approaches are needed for better control of hypertension and its associated CV risk factors.
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Hegazi R, El-Gamal M, Abdel-Hady N, Hamdy O. Epidemiology of and Risk Factors for Type 2 Diabetes in Egypt. Ann Glob Health 2018; 81:814-20. [PMID: 27108148 DOI: 10.1016/j.aogh.2015.12.011] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Diabetes is a fast-growing health problem in Egypt with a significant impact on morbidity, mortality, and health care resources. Currently, the prevalence of type 2 diabetes (T2D) in Egypt is around 15.6% of all adults aged 20 to 79. OBJECTIVE To describe the epidemiology, principal causes, associated risk factors, cultural aspects, and challenges that may contribute to the rapid rise in T2D in Egypt. METHODS Review of papers in PubMed and relevant gray literature. FINDINGS The International Diabetes Federation (IDF) has identified Egypt as the ninth leading country in the world for the number of patients with T2D. The prevalence of T2D in Egypt was almost tripled over the last 2 decades. This sharp rise could be attributed to either an increased pattern of the traditional risk factors for T2D such as obesity and physical inactivity and change in eating pattern or other risk factors unique to Egypt. These include increased exposure to environmental risk factors like pesticides and increased prevalence of chronic hepatitis C. CONCLUSIONS Prevention, early identification, and effective intervention are integral components of effective T2D care in Egypt. These strategies may reduce the expanding economic burden associated with T2D care.
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Affiliation(s)
- Refaat Hegazi
- Abbott Nutrition Research & Development, Columbus, OH.
| | - Mohamed El-Gamal
- Toxicology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt; Medical Experimental Research Center, Mansoura University, Mansoura, Egypt
| | - Nagy Abdel-Hady
- Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Abstract
Ronald Ma and Barry Popkin discuss the urgent need and challenges to reduce intergenerational transmission of obesity and diabetes.
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Affiliation(s)
- Ronald C W Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.,Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong.,Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Barry M Popkin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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Motawi TK, Shaker OG, Shahin NN, Ahmed NM. Angiotensin-converting enzyme insertion/deletion polymorphism association with obesity and some related disorders in Egyptian females: a case-control observational study. Nutr Metab (Lond) 2016; 13:68. [PMID: 27777603 PMCID: PMC5062892 DOI: 10.1186/s12986-016-0127-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 10/01/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND According to the WHO report in 2015, obesity is the fifth leading cause of death worldwide, and the prevalence of Egyptian female obesity is 37.5 %. Since obesity is highly influenced by genetics, and adipose tissue renin-angiotensin system is over-activated in obesity, the effect of angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism on obesity and related disorders was studied in several populations, because of its effect on ACE activity. Our objective was to study the association of ACE I/D polymorphism with obesity and certain related disorders, namely hypertension, insulin resistance and metabolic syndrome, in Egyptian females. METHODS Eighty female volunteers were recruited, blood pressure and body measurements were recorded and a fasting blood sample was obtained for the quantitation of glucose, lipid profile, insulin, leptin and identification of ACE I/D polymorphs. Subjects were grouped based on hypertension and obesity states. Comparisons of continuous parameters were made with independent sample t-test between two groups. The frequencies of ACE genotypes and alleles, and the association between gene polymorphism and metabolic parameters were assessed using chi-square or Fisher's exact test. RESULTS Genotype frequencies were in Hardy-Weinberg equilibrium for all groups. Genotype distribution did not differ significantly between controls and cases of all the studied disorders. Although DD carriers had apparently higher parameters of blood pressure, lipid profile and insulin resistance, only diastolic blood pressure was almost significant (p = 0.057). I-carriers were significantly less susceptible to hypertension than DD carriers having normal waist/hip ratio (p = 0.007, OR = 17.29, CI = 1.81-164.96) and normal conicity index (p = 0.024, OR = 7.00, CI = 1.36-35.93). In DD genotype carriers, a significant association was found between insulin resistance and high body mass index (p = 0.004, OR = 8.89, CI = 1.94-40.71), waist circumference (p = 0.003, OR = 9.63, CI = 2.14-43.36) and waist/height ratio (p = 0.034, OR = 6.86, CI = 1.25-37.61), although the variations in percentages between DD and I-carriers were not high enough to conclude an effect of ACE I/D on such an association. CONCLUSIONS In this sample of Egyptian females, ACE I/D polymorphism was not significantly associated with obesity nor with any of its related disorders studied. The I allele seemed protective against hypertension in subjects with normal, not high, waist/hip ratio and conicity index compared to DD genotype carriers.
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Affiliation(s)
- Tarek K Motawi
- Department of Biochemistry, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Olfat G Shaker
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nancy N Shahin
- Department of Biochemistry, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Nancy M Ahmed
- Department of Biochemistry, Faculty of Pharmacy, Nahda University, Beni-Suef, Egypt
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Al-Thani MH, Al-Thani AAM, Cheema S, Sheikh J, Mamtani R, Lowenfels AB, Al-Chetachi WF, Almalki BA, Hassan Khalifa SA, Haj Bakri AO, Maisonneuve P. Prevalence and determinants of metabolic syndrome in Qatar: results from a National Health Survey. BMJ Open 2016; 6:e009514. [PMID: 27601485 PMCID: PMC5020868 DOI: 10.1136/bmjopen-2015-009514] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES To determine optimum measurements for abdominal obesity and to assess the prevalence and determinants of metabolic syndrome in Qatar. DESIGN National health survey. SETTING Qatar National STEPwise Survey conducted by the Supreme Council of Health during 2012. PARTICIPANTS 2496 Qatari citizens aged 18-64 representative of the general population. PRIMARY AND SECONDARY OUTCOME MEASURES Measure of obesity (body mass index, waist circumference or waist-to-height ratio) that best identified the presence of at least 2 other factors of metabolic syndrome; cut-off values of waist circumference; frequency of metabolic syndrome. RESULTS Waist circumference ≥102 for men and ≥94 cm for women was the best predictor of the presence of other determinants of metabolic syndrome (raised blood pressure, fasting blood glucose, triglycerides and reduced high-density lipoprotein cholesterol). Using these values, we identified 28% of Qataris with metabolic syndrome, which is considerably lower than the estimate of 37% calculated using the International Diabetes Federation (IDF) criteria. Restricting the analysis to participants without known elevated blood pressure, elevated blood sugar or diabetes 16.5% would be classified as having metabolic syndrome. In a multivariable logistic regression analysis, the prevalence of metabolic syndrome increased steadily with age (OR=3.40 (95% CI 2.02 to 5.74), OR=5.66 (3.65 to 8.78), OR=10.2 (5.98 to 17.6) and OR=18.2 (7.01 to 47.5) for those in the age group '30-39', '40-49', '50-59', '60-64' vs '18-29'; p<0.0001), decreased with increasing educational attainment (OR=0.61 (0.39 to 0.96) for those who attained 'secondary school or more' compared with 'less than primary school'; p=0.03) and exercise (OR=0.60 (0.42 to 0.86) for those exercising ≥3000 vs <600 MET-min/week; p=0.006) but was not associated with smoking or diet. CONCLUSIONS Waist circumference was the best measure of obesity to combine with other variables to construct a country-specific definition of metabolic syndrome in Qatar. Approximately 28% of adult Qatari citizens satisfy the criteria for metabolic syndrome, which increased significantly with age. Education and physical activity were inversely associated with this syndrome.
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Affiliation(s)
| | | | - Sohaila Cheema
- Department of Global and Public Health, Weill Cornell Medical College, Doha, Qatar
| | - Javaid Sheikh
- Office of the Dean, Weill Cornell Medical College, Doha, Qatar
| | - Ravinder Mamtani
- Department of Global and Public Health, Weill Cornell Medical College, Doha, Qatar
| | - Albert B Lowenfels
- Department of Surgery and Department of Family Medicine, New York Medical College, Valhalla, New York, USA
| | | | | | | | | | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
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Al-Daydamony MM, El-Tahlawi M. What Is the Effect of Metabolic Syndrome without Hypertension on Left Ventricular Hypertrophy? Echocardiography 2016; 33:1284-9. [PMID: 27109543 DOI: 10.1111/echo.13247] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
| | - Mohammad El-Tahlawi
- Cardiology Department; Faculty of Medicine; Zagazig University; Zagazig Egypt
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Total Dietary Fiber Content of Selected Traditional Beverages in Egypt: A Brief Profile. BEVERAGES 2015. [DOI: 10.3390/beverages1040311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Assaad-Khalil SH, Mikhail MM, Aati TA, Zaki A, Helmy MA, Megallaa MH, Hassanien R, Rohoma KH. Optimal waist circumference cutoff points for the determination of abdominal obesity and detection of cardiovascular risk factors among adult Egyptian population. Indian J Endocrinol Metab 2015; 19:804-810. [PMID: 26693432 PMCID: PMC4673810 DOI: 10.4103/2230-8210.167556] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To determine the best anthropometric measurement of obesity, and its optimal cutoff, that best predicts the presence of cardiovascular risk factors among adult Egyptian population. METHODS This is a cross-sectional study including a representative randomly chosen sample of the adult Egyptian population from all Alexandria Districts (the second largest governorate in Egypt) based on the multistage random technique. It included 3209 subjects (1567 men, 1642 women) aged 18-80 years from urban and rural areas. The response rate was 80.2%. History, blood pressure, and anthropometric measurements were taken. Laboratory investigations included fasting lipid profile, fasting plasma glucose, and serum uric acid. Different criteria of metabolic syndrome were used and compared. Receiver operator characteristic curve and Youden index were used to determine predictability and cutoffs. RESULTS Waist circumference (WC) is the best to predict at least two other components of the metabolic syndrome as defined by the International Diabetes Federation (IDF). The optimal WC cutoffs were 100.5 and 96.25 cm for Egyptian men and women, respectively. The Joint Interim Statement definition (JIS) of metabolic syndrome was the best to predict cardiovascular disease in both genders and diabetes mellitus in women. The prevalence of metabolic syndrome and abdominal obesity was 42.5%, 61%, respectively (ATPIII definition); 43.8%, 61% (American Heart Association definition); 44.3%, 76.4% (IDF definition); 33.8%, 51.7% (IDF definition with Egyptian cutoffs); and 41.5%, 51.7% (JIS with Egyptian cutoffs). CONCLUSION WC cutoffs in Egyptians differ from those currently recommended. Prevalence of metabolic syndrome and abdominal obesity is high in Egypt, despite being lower on using the Egyptian cutoffs.
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Affiliation(s)
- Samir H. Assaad-Khalil
- Department of Internal Medicine, Unit of Diabetes and Metabolism, University of Alexandria, Faculty of Medicine, Alexandria, Egypt
| | - Magued M. Mikhail
- Department of Clinical Pathology, University of Alexandria, Faculty of Medicine, Alexandria, Egypt
| | - Talaat Abdel Aati
- Department of Internal Medicine, Unit of Diabetes and Metabolism, University of Alexandria, Faculty of Medicine, Alexandria, Egypt
| | - Adel Zaki
- Department of Biostatistics, University of Alexandria, Medical Research Institute, Alexandria, Egypt
| | - Myriam A. Helmy
- Department of Clinical Pathology, University of Alexandria, Faculty of Medicine, Alexandria, Egypt
| | - Magdy H. Megallaa
- Department of Internal Medicine, Unit of Diabetes and Metabolism, University of Alexandria, Faculty of Medicine, Alexandria, Egypt
| | - Rehab Hassanien
- Department of Internal Medicine, Unit of Diabetes and Metabolism, University of Alexandria, Faculty of Medicine, Alexandria, Egypt
| | - Kamel H. Rohoma
- Department of Internal Medicine, Unit of Diabetes and Metabolism, University of Alexandria, Faculty of Medicine, Alexandria, Egypt
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Farah R, Zeidan RK, Chahine MN, Asmar R, Chahine R, Salameh P, Hosseini H. Prevalence of stroke symptoms among stroke-free residents: first national data from Lebanon. Int J Stroke 2015; 10 Suppl A100:83-8. [PMID: 26178607 DOI: 10.1111/ijs.12563] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 04/28/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND Stroke symptoms are common among people without a history of stroke or transient ischemic attack. Reported stroke symptoms may represent stroke episodes that failed to reach the threshold for clinical diagnosis. AIMS This study aimed to assess in the Lebanese population the prevalence of self-reported stroke symptoms in a stroke- and transient ischemic attack-free population, and the association of these symptoms with major risk factors for stroke. METHODS We carried out a cross-sectional study using a multistage cluster sample across Lebanon. We interviewed residents aged 40 years and more. Stroke symptoms were assessed using the Questionnaire for Verifying Stroke-Free Status. RESULTS We included 1515 individuals (mean age was 57·2 ± 12·4 years, 783 women, 51·7%). Among 1460 participants stroke- and transient ischemic attack-free, 175 had experienced at least one stroke symptom (12·1%, 95% CI 9·9%-14·3%). Arterial hypertension (adjOR 4·37, 95% CI 2·68-7·12), history of heart disease (adjOR 3·34, 95% CI 2·00-5·56), current waterpipe smoking (adjOR 3·88, 95% CI 2·33-6·48), current and former cigarette smoking (adjOR 1·84, 95% CI 1·18-2·87 and adjOR 2·01, 95% CI 1·13-3·5, respectively), psychological distress (adjOR 1·04, 95% CI 1·02-1·05), the Mediterranean diet score (adjOR 0·87, 95% CI 0·76-0·99), and regular physical activity (adjOR 0·45, 95% CI 0·26-0·77) were independently associated with stroke symptoms. CONCLUSIONS This is the first study conducted in the Middle East, assessing self-reported stroke symptoms among stroke-free residents. Our study showed that almost one in eight residents without a history of stroke or transient ischemic attack has had stroke symptoms. Major vascular risk factors are associated with these symptoms, thus allowing for prevention strategies.
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Affiliation(s)
- Rita Farah
- Doctoral School of Life and Health Sciences, Paris-Est University, Creteil, France
| | - Rouba Karen Zeidan
- Doctoral School of Biology Health and Biotechnologies, Toulouse III University, Toulouse, France
| | - Mirna N Chahine
- Foundation-Medical Research Institutes, F-MRI®, Beirut, Lebanon
| | - Roland Asmar
- Foundation-Medical Research Institutes, F-MRI®, Beirut, Lebanon
| | - Ramez Chahine
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Pascale Salameh
- School of Pharmacy, Lebanese American University, Byblos, Lebanon.,Laboratory of Clinical and Epidemiology Research, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Hassan Hosseini
- Department of Neurology, Henri Mondor Hospital, Creteil, France.,EA 4391, Excitabilité nerveuse et thérapeutique, Université Paris-Est, Creteil, France
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Sarry El Din AM, Zaki ME, Kandeel WA, Mohamed SK, El Wakeel KH. Cut-Off Values of Anthropometric Indices for the Prediction of Hypertension in a Sample of Egyptian Adults. Open Access Maced J Med Sci 2014. [DOI: 10.3889/oamjms.2014.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Obesity, particularly abdominal adiposity, is closely associated with premature atherosclerosis and many metabolic modifications including insulin resistance dyslipidemia hypertension and diabetes. Cut-off values for abdominal obesity predicting future cardiovascular disease are known to be population specific.Objective: To identify cut-off points of some anthropometric measurements (BMI, WC, WHR and WHtR) that associated with hypertension in a sample of Egyptian adults.Subjects and Methods: This is a cross-sectional analysis. The blood pressure of 5550 Egyptian adults was measured (2670 females – 2880 males).The subjects represented different geographic localities and different social classes. Anthropometric measurements including height, weight, waist circumferences, and hip circumferences were also measured by practitioners.Results: The cut-off values to detect hypertension in females were 30.08 for BMI, 87.75 for WC , 0.81 for WHR and 0.65 for WHtR, and the corresponding sensitivity and specificity were 69.1; 60.7- 80.9; 48.6 -65.3; 53.4 and 61.4; 58.9, respectively. The cut-off values to detect hypertension in males were 27.98 for BMI, 95.75 for WC, 0.92 for WHR, and 0.57 for WHtR and the corresponding sensitivity and specificity were 62.8; 59.9 -71.9; 51.9 -64.6; 55.8 and 59.7; 55.8, respectively.Conclusion: The BMI, Waist circumference, WHR and WHtR values can predict the presence of hypertension risk in adult Egyptians.
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