Psychometric evaluation of a self-reported physical activity questionnarie used in the pilot phase of the AZAR Cohort Study

Mediterranean diet quality index is associated with better cardiorespiratory fitness and reduced systolic blood pressure in adults: A cross-sectional study

BACKGROUND

Literature suggests higher cardiorespiratory fitness (CRF) is inversely related to chronic diseases such as metabolic syndrome and cardiovascular disease and hypertension. The aim of this study was to assess the association of Mediterranean dietary quality index (Med-DQI) with CRF and hypertension in a sample of Iranian adults.

METHODS

This was a cross-sectional study on 270 healthy men and women, aged 18-45 years. Dietary intake and physical activity level were assessed through a validated food frequency questionnaire (FFQ); and the International Physical Activity Questionnaires (IPAQ), respectively. Cardiorespiratory fitness was assessed by using a graded exercise treadmill test. The association between Med-DQI and CRF was investigated using multiple regression models.

RESULTS

Participants in the top tertiles of Med-DQI, had higher VO2 max (mL/kg/min) (p = 0.02) and lower SBP (p = 0.01). When we controlled for age, sex, weight, smoking, physical activity and energy intake, the significant results were remained. Results of unadjusted linear regression shows that CRF was positively associated with cholesterol (p < 0.001) and fish (p < 0.001). Also, CRF was positively associated with vegetables and fruits (p < 0.001) and olive oil (p = 0.05). After adjustments for confounders, the significant associations of olive oil and cholesterol with CRF were disappeared while vegetables and fruits and total score of Med-DQI remained significant. There were no significant relations between saturated fatty acids meat, and cereals with Med-DQI.

CONCLUSIONS

Our results demonstrated that Med-DQI was associated with better CRF in Iranian adults and SBP. Further studies with interventional approaches are needed to better clarify the causal inference of these associations.

Visceral adiposity index and atherogenic index of plasma as useful predictors of risk of cardiovascular diseases: evidence from a cohort study in Iran

Background

Visceral adiposity index (VAI) and atherogenic index of plasma (AIP) are relatively new indicators for predicting non-communicable diseases (NCDs). Therefore, the present study was done to assess the association of AIP and VAI with risk of cardiovascular diseases (CVDs).

Methods

This cross-sectional study was conducted on 7,362 individuals aged between 35 and 65 years old participated in Ravansar non-communicable diseases (RaNCD) cohort study. AIP was calculated based on levels of triglyceride and high -density lipoprotein cholesterol (HDL-C). VAI was calculated using values of body mass index (BMI), waist circumference (WC), triglyceride, and HDL-C. Logistic regression models were used to assess the association of AIP and VAI with risk of CVDs.

Results

Mean values of anthropometric indices, lipid profile, AIP, and VAI were significantly higher in patients with CVDs than individuals without CVDs (P < 0.001). Mean values of anthropometric indices, lipid profile, and NCDs including hypertension, dyslipidemia, diabetes, metabolic syndrome (MetS), and CVDs in the third tertile of AIP and VAI were significantly increased compared to the first tertile (P < 0.001). After adjusting confounding factors, risk of CVDs in the third tertile of AIP was (OR = 1.32, 95 % CI: 1.03, 1.69) significantly increased compared to the first tertile. Risk of CVDs in the third tertile of VAI was (OR = 1.48, 95 % CI: 1.12, 1.97) significantly increased compared to the first tertile.

Conclusions

According to the findings, AIP and VAI were positively associated with risk of CVDs. Therefore, AIP and VAI can be useful in identifying high-risk subgroups of CVDs in general population.

Controlled direct effect of psychiatric disorders on cardiovascular disease: evidence from a large Kurdish cohort

Background

Psychiatric disorders are significantly associated with the incidence and prevalence of cardiovascular diseases, mortality, hospital readmissionn. Oral and dental hygiene may play a role in such association. This study aimed to evaluate the controlled direct effect of psychiatric disorders on cardiovascular diseases by controlling the mediating effect of oral and dental hygiene.

Methods

The data used for this study came from the baseline phase of Ravansar Non-communicable Disease (RaNCD) cohort study. RaNCD cohort study is including a representative sample of 10,065 adults (35–65 years old) living in Ravansar, a city in the west of Iran. The marginal structural model with stabilized inverse probability weights accounted for potential confounders was used to estimate the controlled direct effect of psychiatric disorders on cardiovascular diseases. Three different models using three mediators including oral and dental hygiene behaviors, oral ulcer and lesions, and decayed, missing, and filled tooth, were used.

Results

Psychiatric disorders increase the odds of cardiovascular diseases by 83% (OR = 1.83, CI 1.27, 2.61) and about two times (OR = 2.14, 95% CI 1.74, 2.63) when controlled for oral and dental hygiene behaviors, and oral ulcer and lesions as mediators, respectively. When decayed, missing, and filled tooth, as a mediator, was set at ≤ 8, there was no statistically significant controlled direct effect of psychiatric disorders on cardiovascular diseases (OR = 0.90, 95% CI 0.62, 1.30).

Conclusion

Our results suggested that psychiatric disorder was directly related to cardiovascular diseases even if it was possible to have good oral and dental hygiene. The results suggested that interventions targeting people with psychiatric disorders could reduce prevalence of the cardiovascular diseases.

Sociodemographic Pattern of Physical Activity in the Northwest of Iran: Results of the Pilot Phase of the Azar Cohort Study

Background:

Sedentary lifestyle plays a key role in the emergence of many noncommunicable diseases. Given the importance of physical activity (PA) in population-based studies, the present study was conducted to investigate the pattern of PA and its correlates in the pilot phase of Azar cohort study.

Methods:

In the pilot phase of Azar cohort study, 1236 individuals aged 35–70 years in Khameneh, a city in East Azarbaijan, Iran, were invited to participate in the study. A total of 952 individuals completed the overall and the PA questionnaire, a response rate of 82%. The PA level was evaluated using the classified PA questionnaire based on the equivalent metabolic activities. The general linear model was used to determine the factors affecting PA.

Results:

The overall mean score of PA was 36.54 (standard deviation = 5.3). In multivariate analysis, after adjustment for sociodemographic variables, total PA score was associated with gender (adjusted β = 0.014, confidence interval [CI] 95% = [0.01–0.82]), occupation (adjusted βs ranged over 0.015–0.059, (CI 95% = 0.01–0.079), level of education (adjusted βs ranged over 0.010–0.018, CI 95% = 0.001–0.026). In other word, sex (mean ranged over 35.49–36.81), educational level (mean ranged over 35.01–36.73) and occupation status (mean ranged over 34.62–39.62) were predictors of PA (all P < 0.05). This variable could also predict 20% of the variance of the PA.

Conclusions:

The current study identifies that gender, occupation and level of education could be factors that influence on PA level in the study population.

Hypertension prevalence, awareness, treatment and its correlates among people 35 years and older: Result from pilot phase of the Azar cohort study

BACKGROUND AND OBJECTIVE

There is remarkable alteration in hypertension prevalence and awareness, and their correlates among various geographic locations and ethnic groups. The aim of this study was to report hypertension prevalence, awareness, and its correlates as well as hypertension treatment, and control among Azari people aged 35 years and older.

MATERIALS AND METHODS

The pilot phase of the Azar Cohort Study; a state level of a nationwide PERSIAN cohort study was conducted in Khameneh city between October 2014 and January 2015. All people 35 years of age and above were invited to take part in this study. A comprehensive range of different biomarkers, lifestyle, socioeconomic factors, and health-related factors was collected. Blood pressure was measured by a trained nurse/midwife. Descriptive statistical methods were used to present general characteristics of the study population as frequency tables. Separate multiple logistic regression models were built to assess the predictors of hypertension prevalence.

RESULTS

A total of 1038 people were included in this study. The overall prevalence of hypertension was 22.9%. Awareness of hypertension was 60.5% and in those with known hypertension, 84% were using the antihypertensive medications, of those 68.5% had controlled hypertension. After adjustment; age (odds ratios [OR]_adj= 1.12 95% confidence interval [CI]: 1.09-1.15), gender (OR_adj= 1.65 95% CI: 1.08-2.51), obesity OR_adj= 2.51 (1.40-4.88), waist-to-hip ratio (WHR) (OR_adj= 1.70 (1.05-2.75), and comorbidities (OR_adj= 2.51 (1.72-3.66) were independent predictors of hypertension.

CONCLUSION

Age, sex, body mass index, WHR, and comorbidities were known as predictors of hypertension in this study, health promotion strategies including lifestyle modification to reduce overweight/obesity and secondary prevention programs for early detection of hypertension in high-risk groups according to age, gender, and disease profile are recommended.

Validity and Reliability of the Questionnaire for Assessing Women's Reproductive History in Azar Cohort Study

This study was done to evaluate the validity and reliability of women’s reproductive history questionnaire which will be used in Azar Cohort study; a cohort that is conducted by Tabriz University of Medical Science in Shabestar county for identifying risk factors of no communicable diseases. Content and face validity were evaluated by ten experts in the field and quantified as content validity index (CVI) and content validity ratio (CVR). To assess the reliability, using test-retest approach, kappa statistic was calculated for categorical variables and intra-class correlation coefficient (ICC) was used for the quantitative items. The calculated CVI and CVR were 0.91and 0.94, respectively. Reliability for all items was high. The ICC was 0.99 and kappa statistic was equal to 1. The final version of questionnaire was redesigned in 26 items with 7 subscales.