Socioeconomic Inequalities in Gastroesophageal Reflux Disorder: Results from an Iranian Cohort Study

Association between latent profile of dietary intake and cardiovascular diseases (CVDs): Results from Fasa Adults Cohort Study (FACS)

Cardiovascular diseases (CVDs) have been among the most significant non-communicable diseases. Dietary risks account for the most cause of CVDs mortalities. Evaluating overall dietary patterns (through the Latent profile of dietary intake) can provide a more accurate prediction regarding the prevalence of CVDs. The present cross-sectional study aimed to investigate the relationship between the latent profile of dietary intake and CVDs prevalence. The population of the Fasa Adults Cohort Study was employed to gather the data (n = 8319). A modified FFQ was employed to assess eating behaviors. Minerals, as well as the energy intake and total fiber, were measured using Nutritionist IV software (version 7.0). To estimate the prevalence of CVDs, accurate records of patients' histories were made. Individuals were clustered according to their dietary intake using latent profile analysis. The mean age was 48.75 ± 9.59 years, and 53.28% (4430) were women. 63.9% of participants with low Socioeconomic Status (SES) were in the low-intake profile (P < 0.001), and high SES increases the odds of being in the high-intake profile (ORhigh/low = 2.87, 95% CI 2.55-3.24). The low-intake group had the lowest amount of physical activity (Met) (P < 0.001). The result of multivariate logistic regression revealed that categorized in the low-intake group significantly increased the development of CVDs (OR = 1.32, 95% CI 1.07-1.63, P = 0.010). The mean micronutrients and total fiber, in individuals with a low intake profile, were significantly lower than other groups (P < 0.001). Overall, we estimated that a low intake of all food groups increases the odds of developing CVDs significantly.

Predictive value of triglycerides to high-density lipoprotein cholesterol and triglyceride glycemic index for diabetes incidence in pre-diabetes patients: a prospective cohort study

BACKGROUND

The triglyceride glucose (TyG) and triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-c) are the indices that can predict the progression of pre-diabetes to type 2 diabetes mellitus (T2DM). This study aimed to examine the relationship between TyG and TG/HDL-c indices with the incidence of T2DM in pre-diabetes patients.

METHODS

A total of 758 pre-diabetic patients aged 35-70 years who were enrolled in a prospective Fasa Persian Adult Cohort were followed up for 60 months. TyG and TG/HDL-C indices were obtained at baseline data and divided into quartiles. The 5-year cumulative incidence of T2DM was analyzed by Cox proportional hazards regression analysis while controlling for baseline covariates.

RESULTS

During 5 years of follow-up, there were 95 incident cases of T2DM, with an overall incidence rate of 12.53%. After adjusting for age, sex, smoking, marital status, socioeconomic status, body mass index, waist circumference, hip circumference, hypertension, total cholesterol, and dyslipidemia, the multivariate-adjusted hazard ratios (HRs) demonstrated that patients with the highest TyG and TG/HDL-C indices quartile were at higher risk of T2DM (HR = 4.42, 95%CI 1.75-11.21) and (HR = 2.15, 95%CI 1.04-4.47), respectively, compared to participants in the lowest quartile. As the quantiles of these indices increase, the HR value shows a significant increment (P < 0.05).

CONCLUSION

The results of our study showed that the TyG and TG/HDL-C indices can be important independent predictors for the progression of pre-diabetes to T2DM. Therefore, controlling the components of these indicators in pre-diabetes patients can prevent developing T2DM or delay its occurrence.

Causal links between socioeconomic status, leisure sedentary behaviours and gastro-oesophageal reflux disease: a multivariable two-sample Mendelian randomisation study

INTRODUCTION

We implemented a two-sample multivariable Mendelian randomisation (MR) analyses to estimate the causal effect of socioeconomic status and leisure sedentary behaviours on gastro-oesophageal reflux disease (GERD).

METHODS

Independent single-nucleotide polymorphisms associated with socioeconomic status and leisure sedentary behaviours at the genome-wide significance level from the Medical Research Council Integrative Epidemiology Unit (MRC-IEU) UK Biobank were selected as instrumental variables. Summary-level data for GERD were obtained from a recent publicly available genome-wide association involving 78 707 GERD cases and 288 734 controls of European descent. Univariable and multivariable two-sample MR analyses, using inverse variance weighted method for primary analyses, were performed to jointly evaluate the effect of socioeconomic status and leisure sedentary behaviours on GERD risk.

RESULTS

Three socioeconomic status, including educational attainment (OR 0.46; 95% CI 0.30 to 0.69; p<0.001), average total household income before tax (OR 0.65; 95% CI 0.47 to 0.90; p=0.009) and Townsend Deprivation Index at recruitment (OR 1.60; 95% CI 1.06 to 2.41; p=0.026), were independently and predominately responsible for the genetic causal effect on GERD. In addition, one leisure sedentary behaviour, such as time spent watching television, was independently and predominately responsible for genetic causal effect on GERD (OR 3.74; 95% CI 2.89 to 4.84; p<0.001). No causal effects of social activities and driving on GERD were observed.

CONCLUSIONS

Genetically predicted Townsend Deprivation Index at recruitment and leisure watching television were causally associated with increased risk of GERD, and age at completion of full-time education and average total household income before tax were causally associated with decreased risk of GERD.

Socioeconomic Inequalities in Chronic Disease in Kharameh Cohort Study: A Population-Based Cross- Sectional Study in Southern Iran

BACKGROUND

The trend of chronic diseases is increasing globally. Socioeconomic status (SES) is a major factor underlying many chronic diseases. This study was conducted to investigate the socioeconomic inequalities in distribution of chronic diseases in Iran, as a middle-income country.

METHODS

This cross-sectional study was conducted using the baseline data of the Kharameh cohort study, that were collected between 2014 and 2016. The number of participants in this study was 10663 people in the age range of 35 to 70 years. Principal component analysis was used for calculating the SES of the people under study. In addition, we used concentration index and concentration curve to measure socioeconomic inequality in chronic disease.

RESULTS

The mean age of 10,663 participants in our study was 52.15±8.22 years and the male to female ratio was 1.26. Recurrent headache (25.8%( and hypertension (23.5%) were the most prevalent diseases. The concentration index showed that the distribution of movement disorder, recurrent headaches and gastroesophageal reflux diseases is significantly concentrated among people with low SES, and obesity among people with high SES. The results of the analysis by gender were similar to the results seen in all participants.

CONCLUSION

The findings of this study show that socioeconomic inequality is the cause of the concentration of non-communicable diseases among people with low socio-economic status. Therefore, health policy makers should pay special attention to identifying vulnerable subgroups and formulate strategic plans to reduce inequalities.

Epidemiological investigation, extraesophageal symptoms and risk factors of gastroesophageal reflux disease in Kashgar, Xinjiang, China

OBJECTIVE

To explore the incidence, distribution characteristics and related symptoms of gastroesophageal reflux disease (GERD) as well as its related risk factors in Kashgar, Xinjiang.

METHODS

From March 2020 to October 2020, a questionnaire survey was conducted among 5,080 permanent residents aged 18-80 years in Kashgar using cluster sampling and stratified sampling methods. The content included basic information, accompanying symptoms and diseases, living, customs and eating habits, and Gastroesophageal Reflux Disease Questionnaire score, etc. Results: The prevalence of GERD in Kashgar was 23.4% (1187/5080), and the proportions of patients with reflux symptoms lasting 1 day, 2-3 days and 4-7 days within a week were 12.5%, 6.4% and 4.4%, respectively. The proportion of patients showing symptoms in the GERD group was significantly higher than that in the non-GERD group (P<0.05). The proportion of people who are overweight or obese, take alcohol drink, eat, constipate, or take various chronic disease drugs in the GERD group is higher than that in the non-GERD group. The proportion of people in the GERD group who often eat sweet foods, pickled products, roasted products, spicy foods and meat, or drink coffee, acidic beverages, and cold drinks was higher than that in the non-GERD (P<0.05). The proportion of people in the GERD group who regularly consume fish, milk, eggs, vegetables, and fruits was significantly lower than that in non-GERD group (P<0.05). Logistic regression analysis found that Uyghur nationality (for the Han nationality), age (for the 30-39 years group), drinking, overeat, constipation, and frequent medication were risk factors (P<0.05, OR>1). Multivariate logistic regression analysis found that sweets, baked products, cold drinks, and spicy foods were independent risk factors (P<0.05, OR>1). Eggs and vegetables were protective factors (P<0.05, OR<1).

CONCLUSION

The high incidence of GRED in Kashgar, Xinjiang may be related to the local living environment, and life and eating habits.

Alcohol consumption in Iran: A systematic review and meta-analysis of the literature

ISSUES

Alcohol production, marketing and consumption are illegal in Iran. This systematic review examines the lifetime and last 12-month prevalence of alcohol consumption among the general and young population in Iran.

APPROACH

We searched Web of Science, PubMed, Embase, Scopus and Iranian scientific databases (i.e. Scientific Information Database and Magiran) for relevant publications in English and Persian from inception to 12 May 2019. Following a random-effects meta-analysis, we estimated the pooled prevalence of alcohol consumption among the general population and young people (<30 years old). Meta-regression was used to identify potential sources of heterogeneity.

KEY FINDINGS

Of the 2400 identified records, 62 met the inclusion criteria. The overall pooled prevalence of lifetime alcohol consumption among the general population and young people was 13.0% [95% confidence intervals (CI) 10.0, 16.0]. The overall pooled prevalence of last 12-month alcohol consumption was 12.0% (95% CI 7.0, 18.0) for the general population and 15.0% (95% CI 9.0, 22.0) for young people. The prevalence of alcohol consumption varied from 0.03% to 68.0% in different regions, 0.3% to 66.6% among males and 0.2% to 21.0% among females.

IMPLICATIONS

Our findings highlight the need for public health surveillance of alcohol use in Iran.

CONCLUSION

These estimates show that, on average, one in eight people in the general population have ever consumed alcohol in Iran, indicating that alcohol consumption is not an uncommon practice in the country.