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AkbariRad M, Darroudi S, Farsi F, Mohajer N, Ghalibaf AM, Firoozi A, Esmaeili H, Izadi HS, Ghayour-Mobarhan M, Moohebati M. Investigation of the relationship between atherogenic index, anthropometric characteristics, and 10-year risk of metabolic syndrome: a population-based study. Ir J Med Sci 2024:10.1007/s11845-024-03791-6. [PMID: 39180637 DOI: 10.1007/s11845-024-03791-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 07/01/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND People with metabolic syndrome (MetS) are at a higher risk of coronary artery disease, diabetes mellitus, stroke, osteoarthritis, and some types of cancers. Finding markers which are available and inexpensive are most useful for the prediction of MetS. The present study aimed to determine the relationship between atherogenic index and anthropometric indicators and the 10-year risk of MetS. METHODS During the 10-year follow-up on Mashhad stroke and heart atherosclerotic disorder (MASHAD study), 4684 subjects who did not MetS at baseline were recruited in this study. The anthropometric indices and atherogenic index including atherogenic index of plasma (AIP), Castelli's risk index I and II (CRI-I, CRI-I), and atherogenic coefficient (AC) were measured. SPSS-23 was used for all statistical analyses. RESULT Among subjects who did not have MetS at baseline 1599 cases (34.1%) developed MetS. The anthropometric and lipid indices were significantly elevated in patients with MetS compared to the healthy ones (p < 0.001). It was revealed that an increase of one unit in AIP and AC can raise the risk of MetS 22.7% (OR: 1.227 (95% CI, 1.166-1.291)) and 37.7% (OR: 1.377 (95% CI, 1.291-1.468)), respectively. Moreover, increasing one unit of WHtR decreases the risk of MetS by 8.5% (OR: 0.915 (95% CI, 0.886-0.946)). CONCLUSION The results of this longitudinal study showed that increasing AC and AIP could enhance the risk of MetS. The present study also indicated that AC and AIP are useful predictors in the clinical setting for identifying individuals with MetS in the Iranian adult population.
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Affiliation(s)
- Mina AkbariRad
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Susan Darroudi
- Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farima Farsi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Najme Mohajer
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - AmirAli Moodi Ghalibaf
- Student Research Committee, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Abdollah Firoozi
- Faculty of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaeili
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hanie Salmani Izadi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mohsen Moohebati
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Cardiovascular Diseases, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Ghotbi S, Joukar F, Orang Goorabzarmakhi M, Shahdkar M, Maroufizadeh S, Mojtahedi K, Asgharnezhad M, Naghipour M, Mansour-Ghanaei F. Evaluation of elevated serum liver enzymes and metabolic syndrome in the PERSIAN Guilan cohort study population. Heliyon 2024; 10:e32449. [PMID: 38961895 PMCID: PMC11219353 DOI: 10.1016/j.heliyon.2024.e32449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 06/01/2024] [Accepted: 06/04/2024] [Indexed: 07/05/2024] Open
Abstract
Objective The purpose of this study is to evaluate the association between elevated serum liver enzymes and Metabolic Syndrome (MetS) in Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan Cohort Study (PGCS) population. Methods This cross-sectional study involved 10,519 individuals between the ages of 35 and 70 enrolled in the PGCS. The gathered data encompassed demographic information, anthropometric measurements, blood pressure, and biochemical indicators. MetS was defined by the National Cholesterol Education Program-Adult Treatment Panel III criteria (NCEP-ATP III). The associations between elevated liver enzymes and MetS were examined using logistic regression analysis. Odds ratio (OR) and 95 % confidence interval (CI) were calculated. Results The prevalence of MetS was 41.8 %, and the prevalence of elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP) were 19.4, 4.6, 11.6, and 5.1 %, respectively. In the unadjusted model, elevated ALT, AST, and GGT were associated with increased odds of MetS (OR = 1.55, 95 % CI: 1.41-1.71; OR = 1.29, 95 % CI: 1.07-1.55, and OR = 1.90, 95 % CI: 1.69-2.14, respectively). These associations remained significant for ALT and GGT after adjustment for some demographic and clinical characteristics (aOR = 1.31, 95 % CI: 1.17-1.46 and aOR = 1.30, 95 % CI: 1.14-1.49, respectively). In addition, the odds of MetS increased with the number of elevated liver enzymes, up to almost 1.32-fold among subjects with three/four elevated liver enzymes. Conclusion The higher incidence of elevated liver enzymes was associated with an increased likelihood of MetS. Including liver markers in diagnosing and predicting MetS holds promise and is considered a possible approach.
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Affiliation(s)
- Saideh Ghotbi
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Milad Shahdkar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Saman Maroufizadeh
- Department of Biostatistics, School of Health, Guilan University of Medical Sciences, Rasht, Iran
| | - Kourosh Mojtahedi
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mehrnaz Asgharnezhad
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammadreza Naghipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Moradpour F, Karimi Z, Fatemi Z, Moradi Y, Khosravi MR, Shokri A, Karimzadeh M. Prevalence of metabolic syndrome and its association with oral health: First results from the Kurdish cohort study. Health Sci Rep 2023; 6:e1602. [PMID: 37841941 PMCID: PMC10568541 DOI: 10.1002/hsr2.1602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/05/2023] [Accepted: 09/18/2023] [Indexed: 10/17/2023] Open
Abstract
Aims Investigate the association between oral and dental health (ODH) and metabolic syndrome (MetS) in adults aged 35-70 years. Methods The study utilized data from the enrollment phase of Dehgolan prospective cohort study in the west of Iran. A cross-sectional assessment was conducted on a total of 3996 participants, involving a comprehensive oral examination and the assessment of their oral hygiene behavior (ODH). MetS was defined according to the updated National Cholesterol Education Program Adult Treatment Panel III. Logistic regression used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for sociodemographic characteristics. Results MetS was more prevalent among those who not daily brushing and flossing. Participants with missing teeth (MT) show higher prevalent of MetS. Being female, lower age, illiteracy, family history of diabetes, low physical activity, and salt at table were independently associated with increase odds of MetS (p < 0.05). Odds of MetS were significantly decreased with use flossing (OR = 0.75; CI = 0.60-0.93), decayed (OR = 0.83; CI = 0.72-0.97), filled (OR = 0.84; CI = 0.71-0.99), and increased with MT (OR = 1.45; CI = 1.16-1.81) as long as adjusted for ODH factors. When other potential confounder such as sociodemographic, personal and nutritional habits were adjusted, daily flossing was the only factor that still statistically decreased (OR = 0.79; CI = 0.62-0.99) the odds of MetS. Conclusion Daily flossing was the only factor that independently associated with MetS. Relationship of other ODH factors with Mets were confounded by sociodemographic characteristics of the participants.
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Affiliation(s)
- Farhad Moradpour
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Zahra Karimi
- Vice Chancellor for Research and TechnologyKurdistan University of Medical SciencesSanandajIran
| | - Zeinab Fatemi
- Vice Chancellor for Health AffairsKurdistan University of Medical SciencesSanandajIran
| | - Yousef Moradi
- Department of Epidemiology and Biostatistics, Faculty of MedicineKurdistan University of Medical SciencesSanandajIran
| | | | - Azad Shokri
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Mohammad Karimzadeh
- Department of Epidemiology and Biostatistics, Faculty of MedicineKurdistan University of Medical SciencesSanandajIran
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Saeedi F, Baqeri E, Bidokhti A, Moodi M, Sharifi F, Riahi SM. Clinical utility of lipid ratios as potential predictors of metabolic syndrome among the elderly population: Birjand Longitudinal Aging Study (BLAS). BMC Geriatr 2023; 23:403. [PMID: 37400781 DOI: 10.1186/s12877-023-04040-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 05/15/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Elderly adults are at higher risk of developing metabolic syndrome (MetS). The present study aims to investigate the relationship between lipid ratios and MetS in the elderly population. METHODS This study was conducted on elderly population of Birjand during 2018-2019. The data of this study was driven from Birjand Longitudinal Aging Study (BLAS). The participants were selected based on multistage stratified cluster sampling. Patients were categorized into quartiles according to the lipid ratios (TG/HDL-C, LDL-C/HDL-C, non-HDL/HDL-C), and the relationship between lipid ratio quartiles and MetS was determined by Logistic Regression using Odds Ratio. Finally, the optimal cut-off for each lipid ratio in MetS diagnosis was calculated according to the Area Under the Curve (AUC). RESULTS This study included 1356 individuals, of whom 655 were men and 701 were women. In our study, the crude prevalence of MetS was 792 (58%), including 543 (77.5%) women and 249 (38%) men. Increasing trends were observed in quartiles of all lipid ratios for TC, LDL-C, TG, and DBP. TG/HDL was also the best lipid ratio to diagnose the MetS, based on NCEP ATP III criteria. One unit increased in level of TG/HDL resulted in 3.94 (OR: 3.94; 95%CI: 2.48-6.6) and 11.56 (OR: 11.56; 95%CI: 6.93-19.29) increasing risk of having MetS in quartile 3 and 4 compared to quartile 1, respectively. In men and women, the cutoff for TG/HDL was 3.5 and 3.0, respectively. CONCLUSIONS Our results showed that the TG/HDL-C is superior to the LDL-C/HDL-C and the non-HDL /HDL-C to predict MetS among the elderly adults.
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Affiliation(s)
- Farhad Saeedi
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Elnaz Baqeri
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Ali Bidokhti
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Mitra Moodi
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Riahi
- Cardiovascular Diseases Research Center, Department of Epidemiology and Biostatistics, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran.
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Zhao Y, Zhang H, Liu X, Desloge A, Wang Q, Zhao S, Song L, Tzoulaki I. The prevalence of cardiometabolic multimorbidity and its associations with health outcomes among women in China. Front Cardiovasc Med 2023; 10:922932. [PMID: 36844741 PMCID: PMC9947472 DOI: 10.3389/fcvm.2023.922932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 01/20/2023] [Indexed: 02/11/2023] Open
Abstract
Objective In China, a limited number of studies focus on women and examine the effect of cardiometabolic multimorbidity (defined as the presence of two or more cardiometabolic diseases) on health outcomes. This research aims to investigate the epidemiology of cardiometabolic multimorbidity and the association of cardiometabolic multimorbidity with long-term mortality. Methods This study used data from the China Health and Retirement Longitudinal Study between 2011 and 2018, which includes 4,832 women aged 45 years and older in China. Poisson-distributed Generalized Linear Models (GLM) were applied to examine the association of cardiometabolic multimorbidity with all-cause mortality. Results Overall, the prevalence of cardiometabolic multimorbidity was 33.1% among the total sample of 4,832 Chinese women, and increased with age, ranging from 28.5% (22.1%) for those aged 45-54 years to 65.3% (38.2%) for those aged ≥75 years in urban (rural) areas. Compared with the group of none and single disease, cardiometabolic multimorbidity was positively associated with all-cause death (RR = 1.509, 95% CI = 1.130, 2.017), after adjusting socio-demographic and lifestyle behavioral covariates. Stratified analyses revealed that the association between cardiometabolic multimorbidity and all-cause death was only statistically significant (RR = 1.473, 95% CI = 1.040, 2.087) in rural residents, but not significant in urban residents. Conclusion Cardiometabolic multimorbidity is common among women in China and has been associated with excess mortality. Targeted strategies and people-centered integrated primary care models must be considered to more effectively manage the cardiometabolic multimorbidity shift from focusing on single-disease.
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Affiliation(s)
- Yang Zhao
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia,The George Institute for Global Health, Beijing, China
| | - Huan Zhang
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Xiaoyun Liu
- China Centre for Health Development Studies, Peking University, Beijing, China
| | - Allissa Desloge
- School of Public Health, University of Illinois Chicago, Chicago, IL, United States
| | - Qian Wang
- Yeda Hospital of Yantai, Yantai, Shandong, China
| | - Siqi Zhao
- Yantaishan Hospital of Yantai, Yantai, Shandong, China,Yantai Sino-French Friendship Hospital, Yantai, Shandong, China
| | - Lili Song
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia,The George Institute for Global Health, Beijing, China,*Correspondence: Lili Song,
| | - Ioanna Tzoulaki
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom,Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
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Liu Y, Chen X, Deng X, Yang F, Zheng J, Zhou T, Xu L, Xie X, Ju Z, Wang B, Zhang C, Zhou Y. Association of NAD + levels with metabolic disease in a community-based study. Front Endocrinol (Lausanne) 2023; 14:1164788. [PMID: 37152934 PMCID: PMC10158491 DOI: 10.3389/fendo.2023.1164788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/04/2023] [Indexed: 05/09/2023] Open
Abstract
Background Nicotinamide adenine dinucleotide (NAD+) is a coenzyme and plays a crucial role in several metabolic processes. This study explored the association of nicotinamide adenine dinucleotide (NAD+) levels with metabolic disease (MD) in adults. Methods In this cross-sectional study, all data were collected from the Jidong community. MD was defined as the presence of one or more of the following disease components: hypertension, dyslipidemia, diabetes, hyperuricemia, obesity, and non-alcoholic fatty liver disease (NAFLD). The MD components were categorized into three groups: those with one component, those with two components, and those with three to six components. The whole blood NAD+ level was measured using a cycling assay and LC-MS/MS analysis. The participants were divided into four groups based on their NAD+ level quartiles. Multivariable logistic regression was used to evaluate the association of the whole blood NAD+ levels with MD. Results Of the 1,394 eligible participants, the average age was 43.2 years, and 74.3% had MD. In the top quartile of NAD+, the prevalence of MD and each of its components (hypertension, hyperlipidemia, diabetes, hyperuricemia, obesity, and NAFLD) were 87.9% 35.2%, 62.3%, 8.7%, 36.9%, 21.0%, and 60.5%, respectively. As compared with the lowest NAD+ quartile (≤29.4 μmol/L), the adjusted odds ratios and 95% confidence interval of the highest quartile were 3.01 (1.87-4.87) for MD, 2.48 (1.44-4.29) for 1 MD component, 2.74 (1.45-5.17) for 2 MD components, and 4.30 (2.32-7.98) for 3-6 MD components. The risk of MD began to increase at NAD+ levels of 31.0 μmol/L, as revealed by the gradient associations of NAD+ levels with MD. There was no significant interaction between age, sex, drinking, smoking, and NAD+ for MD (p for interaction ≥0.10). Conclusions Increased NAD+ was significantly associated with MD, as well as its individual components. Our findings provide new evidence for the relationship between blood NAD+ levels and MD.
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Affiliation(s)
- Yuhe Liu
- Institute of Biochemistry and Molecular Biology, Hengyang Medical College, University of South China, Hengyang, Hunan, China
| | - Xueyu Chen
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xuan Deng
- Clinical Research Institute, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fan Yang
- The First Affiliated Hospital of Jinan University, Institute of Aging and Regenerative Medicine, Jinan University, Guangzhou, China
| | - Jinping Zheng
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi, China
| | - Tianyun Zhou
- Clinical Medicine, School of Basic Medicine, Shanghai Medical College Fudan University, Shanghai, China
| | - Ling Xu
- Clinical Research Institute, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaomei Xie
- Department of Clinical Laboratory, Tangshan Gem Flower Hospital, Tangshan, China
| | - Zhenyu Ju
- The First Affiliated Hospital of Jinan University, Institute of Aging and Regenerative Medicine, Jinan University, Guangzhou, China
| | - Baoguo Wang
- Sanbo Brain Hospital, Capital Medical University, Beijing, China
- *Correspondence: Yong Zhou, ; Caiping Zhang, ; Baoguo Wang,
| | - Caiping Zhang
- Institute of Biochemistry and Molecular Biology, Hengyang Medical College, University of South China, Hengyang, Hunan, China
- *Correspondence: Yong Zhou, ; Caiping Zhang, ; Baoguo Wang,
| | - Yong Zhou
- Clinical Research Institute, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Yong Zhou, ; Caiping Zhang, ; Baoguo Wang,
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Armanmehr A, Jafari Khamirani H, Zoghi S, Dianatpour M. Analysis of DYRK1B, PPARG, and CEBPB Expression Patterns in Adipose-Derived Stem Cells from Patients Carrying DYRK1B R102C and Healthy Individuals During Adipogenesis. Metab Syndr Relat Disord 2022; 20:576-583. [PMID: 36318489 DOI: 10.1089/met.2021.0140] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background: Metabolic syndrome (MetS) is a group of signs and symptoms that are associated with a higher risk of type 2 diabetes mellitus and cardiovascular diseases. The major risk factor for developing MetS is abdominal obesity, which is caused by an increase in adipocyte size or quantity. Increased adipocyte quantity is a result of differentiation of stem cells into adipose tissue. Numerous studies have investigated the expression of key transcription factors, including PPARG and CEBPB during adipocyte differentiation in murine cells such as 3T3-L1 cell lines. To better understand the expression changes during the process of fat accumulation in adipose-derived stem cells (ASCs), we compared the expression of DYRK1B, PPARG, and ẟB in ASCs between the patient (harboring DYRK1B R102C) and control (healthy individuals) groups. Methods: Gene expression was evaluated on the eighth day before induction and days 1, 5, and 15 postinduction. The pluripotent capacity of ASCs and the potential for differentiation into adipocytes were confirmed by flow cytometry analysis of surface markers (CD34, CD44, CD105, and CD90), and Oil Red O staining, respectively. The Expression of DYRK1B, PPARG, and CEBPB were assessed by real-time-polymerase chain reaction in patients and normal individuals. The effects of AZ191, a potent small molecule inhibitor on DYRK1B and CEBPB expression in patients' samples were studied. Result: The expression of DYRK1B kinase and transcription factors (CEBPB and PPARG) are higher in ASCs harboring DYRK1B R102C compared with noncarriers on days 5 and 15 during adipocyte differentiation. These proteins may be helpful to elucidate the mechanisms underlying obesity and obesity-related disorders like MetS. Furthermore, the new compound AZ191 exhibited inhibitory activity toward DYRK1B and CEBPB. We suggest that AZ191 may be helpful in defining the potential roles of DYRK1B and CEBPB in adipogenesis.
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Affiliation(s)
- Azam Armanmehr
- Department of Medical Genetics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Jafari Khamirani
- Department of Medical Genetics, Shiraz University of Medical Sciences, Shiraz, Iran.,Comprehensive Medical Genetic Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sina Zoghi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Dianatpour
- Department of Medical Genetics, Shiraz University of Medical Sciences, Shiraz, Iran.,Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Azimi-Nezhad M, Aminisani N, Ghasemi A, Farimani AR, Khorashadizadeh F, Mirhafez SR, Hyde M, Shamshirgaran SM. Metabolic Syndrome and Body Composition Among People Aged 50 Years and Over: Results from The Neyshabur Longitudinal Study on Ageing (NeLSA). Indian J Clin Biochem 2022; 37:432-440. [PMID: 36262782 PMCID: PMC9573828 DOI: 10.1007/s12291-021-01014-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/12/2021] [Indexed: 10/19/2022]
Abstract
There are few studies regarding body composition and metabolic syndrome (MetS) association in older adults. To evaluate the association between MetS and body composition indices in a large-scale population of subjects with an age of 50 and up. This study was based on the data from Neyshabur Longitudinal Study on Ageing (NeLSA) in a total of 7462 people of Neyshabur city in IRAN. The best cut-off scores and AUC value of body composition variables for having association with likelihood of MetS were determined by using a receiver operating curve analysis. Each unit increase in the Waist/Hip ratio, the odds of having MetS increase 3-6 times (OR: 4.937, 95%CI: 3.930, 6.203 in men; OR: 3.322, 95%CI: 2.259, 4.884 in women). In addition, in the case of BMI (OR: 1.256, 95% Cl: 1.226, 1.286 in men; OR: 1.104, 95% Cl: 1.086, 1.121 in women) and BFM (OR: 1.119, 95% Cl: 1.105, 1.133 in men; OR: 1.050, 95% Cl: 1.041, 1.060 in women), the chance of having MetS increases with increasing these variables. Totally, BMI and BFM showed the best AUC values. The optimal cut-off values for BMI in men was 26.45 and in women was 27.35 and for BFM in men was 23.35 and in women was 26.85. These results suggest that adiposity measures such as BMI and BFM are associated with likelihood of having MetS in subjects with an age of 50 and up, and that avoiding high adiposity is important to prevent MetS incidence.
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Affiliation(s)
- Mohsen Azimi-Nezhad
- Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Nayyereh Aminisani
- Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Ahmad Ghasemi
- Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Azam Rezaei Farimani
- Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Fatemeh Khorashadizadeh
- Department of Epidemiology and Biostatistics, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Seyed Reza Mirhafez
- Non-communicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Martin Hyde
- Centre for Innovative Ageing, College of Human and Health Sciences, Swansea University, Swansea, Wales UK
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9
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Gharipour M, Nezafati P, Sadeghian L, Eftekhari A, Rothenberg I, Jahanfar S. Precision medicine and metabolic syndrome. ARYA ATHEROSCLEROSIS 2022; 18:1-10. [PMID: 36817343 PMCID: PMC9937665 DOI: 10.22122/arya.2022.26215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 10/09/2021] [Indexed: 02/24/2023]
Abstract
Metabolic syndrome (MetS) is one of the most important health issues around the world and a major risk factor for both type 2 diabetes mellitus (T2DM) and cardiovascular diseases. The etiology of MetS is determined by the interaction between genetic and environmental factors. Effective prevention and treatment of MetS notably decreases the risk of its complications such as diabetes, obesity, hypertension, and dyslipidemia. According to recent genome-wide association studies, multiple genes are involved in the incidence and development of MetS. The presence of particular genes which are responsible for obesity and lipid metabolism, affecting insulin sensitivity and blood pressure, as well as genes associated with inflammation, can increase the risk of MetS. These molecular markers, together with clinical data and findings from proteomic, metabolomic, pharmacokinetic, and other methods, would clarify the etiology and pathophysiology of MetS and facilitate the development of personalized approaches to the management of MetS. The application of personalized medicinebased on susceptibility identified genomes would help physicians recommend healthier lifestyles and prescribe medications to improve various aspects of health in patients with MetS. In recent years, personalized medicine by genetic testing has helped physicians determine genetic predisposition to MetS, prevent the disease by behavioral, lifestyle-related, or therapeutic interventions, and detect, diagnose, treat, and manage the disease. Clinically, personalized medicine is providing effective strategies for the prevention and treatment of MetS by reducing the time, cost, and failure rate of pharmaceutical clinical trials. It is also eliminating trial-and-error inefficiencies that inflate health care costs and undermine patient care.
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Affiliation(s)
- Mojgan Gharipour
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Mojgan Gharipour; Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan
University of Medical Sciences, Isfahan, Iran;
| | - Pouya Nezafati
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ladan Sadeghian
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ava Eftekhari
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medicine Sciences, Isfahan, Iran
| | - Irwin Rothenberg
- Laboratory Quality Advisor/Technical Writer at COLA Resources Inc., Washington, Columbia, USA
| | - Shayesteh Jahanfar
- Health Sciences Building, Central Michigan University, Mount Pleasant, MI, USA
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10
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de Siqueira Valadares LT, de Souza LSB, Salgado Júnior VA, de Freitas Bonomo L, de Macedo LR, Silva M. Prevalence of metabolic syndrome in Brazilian adults in the last 10 years: a systematic review and meta-analysis. BMC Public Health 2022; 22:327. [PMID: 35172790 PMCID: PMC8848905 DOI: 10.1186/s12889-022-12753-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 02/07/2022] [Indexed: 11/30/2022] Open
Abstract
Background A cluster of interconnected cardiometabolic risk factors characterizes metabolic Syndrome (MS). The prevalence of MS is increasing worldwide, but there is not a meta-analysis of this prevalence in the Brazilian population. We aimed to determine the prevalence of metabolic syndrome among adult general population in Brazil through a meta‑analysis study. Methods Original research studies were searched at PubMed, Scopus, Web of Science, and SciELO databases, from 2011 to 2021. We used the Joanna Briggs Institute tool to assess the quality of included studies. The random effect model was used to estimate the pooled prevalence of MS. Subgroup and meta-regression analysis were conducted for explored heterogeneity and used the Funnel Plot and Egger’s test to assess publication bias. The study was performed based on the criteria of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Results The search in electronic databases identified 1598 records. From this total, 26 studies were eligible to be included in the final analysis. The overall pooled prevalence among the general population of Brazil was 33% with high heterogeneity observed. By gender, the prevalences were 26% in males and 38% in females. By criteria that was used to define MS, the prevalence were 31% in NCEP ATP III, 25% in JIS, 37% in IDF/NHLBI/AHA/WHF/IAS/IASO and 33% in IDF criteria. The prevalence in different habitat was 34% in urban, 15% in rural, 28% in quilombola and 37% in indigenous. In different regions was 37% in the South, 30% in Southeast, 38% in North, 31% in Northeast and 39% in Midwest. The pooled prevalence of MS with age was < 45 years: 43% and ≥ 45 years: 42% and the prevalence based on year of study implementation was 31% in 2015–2019, 35% in 2010–2014 and 28% in 2005–2009. There were no statistically significant differences between subgroups. Most of the studies showed high quality assessment criteria’s except adequate sample size criteria and many studies participants were not sampled in an appropriate way. Conclusions Our review indicates a high prevalence of MS in the healthy Brazilian adult population, when compared to others countries and with a world estimate. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12753-5.
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Affiliation(s)
| | | | - Valdir Alves Salgado Júnior
- Universidade Federal de Juiz de Fora, Campus Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | | | | | - Maísa Silva
- Department of Basic Life Sciences, Universidade Federal de Juiz de Fora, Governador Valadares Campus, Avenida Moacir Paleta, nº 1167, no bairro São Pedro.CEP 35020-360, Governador Valadares, MG, Brazil.
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11
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Effects of nano-curcumin supplementation on oxidative stress, systemic inflammation, adiponectin, and NF-κB in patients with metabolic syndrome: A randomized, double-blind clinical trial. J Herb Med 2022. [DOI: 10.1016/j.hermed.2021.100531] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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12
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Azimi-Nezhad M, Aminisani N, Ghasemi A, Farimani AR, Khorashadizadeh F, Mirhafez SR, Hyde M, Shamshirgaran SM. Sex-specific prevalence of metabolic syndrome in older adults: results from the Neyshabur longitudinal study on aging, Iran. J Diabetes Metab Disord 2022; 21:263-273. [PMID: 35673447 PMCID: PMC9167326 DOI: 10.1007/s40200-022-00969-6] [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: 07/25/2021] [Accepted: 12/31/2021] [Indexed: 01/19/2023]
Abstract
Purpose The prevalence of metabolic syndrome (MetS) and associated diseases grows as the population ages. This study aimed to investigate sex differences in the prevalence of MetS and its components among people aged 50 years and older in Iran. Methods Data were drawn from the Neyshabur Longitudinal Study on Ageing (NeLSA), which is an ageing component of the Prospective Epidemiological Research Studies in IraAn (PERSIAN). The NCEP ATP III and IDF criteria were used to identify the prevalence of MetS among 3383 men and 3873 women aged 50 years and older. Sociodemographic information, lifestyle and clinical factors were collected via an interview-based questionnaire. Weight and height, waist circumferences and blood pressure were measured. Laboratory measures such as fasting blood sugar, triglycerides and high-density cholesterol were also assessed. Results The overall prevalence of the MetS according to the NCEP ATP III and IDF definitions were 45% and 47%, respectively. The prevalence of the MetS in men and women was 37% and 63% according to the NCEP ATP III definition, 33% and 67% by the IDF definition, respectively. The prevalence of MetS components was significantly higher in women than in men. Conclusion In the current study, the prevalence of MetS and its components was significantly higher among women than men. We also observed good concordance between IDF and NCEP ATP III criteria.
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Affiliation(s)
- Mohsen Azimi-Nezhad
- Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, 9329774448 Neyshabur, Iran
| | - Nayyereh Aminisani
- Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, 9329774448 Neyshabur, Iran
| | - Ahmad Ghasemi
- Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, 9329774448 Neyshabur, Iran
| | - Azam Rezaei Farimani
- Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, 9329774448 Neyshabur, Iran ,Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Fatemeh Khorashadizadeh
- Department of Epidemiology and Biostatistics, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Seyed Reza Mirhafez
- Non-Communicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Martin Hyde
- Centre for Innovative Ageing, College of Human and Health Sciences, Swansea University, Swansea, Wales UK
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13
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Ghosn B, Falahi E, Keshteli AH, Yazdannik AR, Azadbakht L, Esmaillzadeh A. Lack of association between nuts and legumes consumption and metabolic syndrome in young Iranian nurses. Clin Nutr ESPEN 2021; 46:173-178. [PMID: 34857192 DOI: 10.1016/j.clnesp.2021.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/03/2021] [Accepted: 10/17/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Most studies have investigated the association between dietary pattern and risk of metabolic syndrome. Limited studies have examined the association between nuts and legumes as a food group and metabolic syndrome. This study explored the association between nuts and legumes and components of metabolic syndrome in Iranian nurses. METHODS This cross-sectional study included a representative sample of 420 female nurses of Isfahan who were randomly selected. Nuts and legumes consumption was assessed using a validated dish-based semi quantitative food frequency questionnaire (FFQ). Metabolic syndrome was defined by the National Cholesterol Education Program's Adult Treatment Panel III (ATP III). Linear and logistic regression tests were used to study the association between nuts and legumes consumption and metabolic syndrome and its components. RESULTS Mean age of study participants was 35 years. The prevalence of the metabolic syndrome among study participants was 3.6%. Consumption of nuts and legumes was not associated with waist circumference either before (β = -0.01, P = 0.24) or after adjusting for potential confounders (β = -0.18, P = 0.41). The same findings were also observed for diastolic blood pressure (DBP) (β = 0.001, P = 0.42), serum triglyceride (TG) (β = 0.07, P = 0.32), high-density lipoprotein cholesterol (HDL-C) (β = 0.008, P = 0.65) and fasting blood sugar (FBS) (β = -0.001, P = 0.94). We failed to find a significant association between consumption of nuts and legumes and systolic blood pressure (SBP) after adjusting for confounders (β = 0.002, P = 0.38). Individuals in the highest category of nuts and legume consumption did not had elevated odds for metabolic syndrome after adjusting for potential confounders (OR = 0.89, 95% CI = 0.08-9.80, P = 0.93). CONCLUSIONS Nuts and legumes consumption was not associated with metabolic syndrome or its components. Prospective studies are needed to investigate further this association.
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Affiliation(s)
- Batoul Ghosn
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Falahi
- Department of Nutrition, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ammar Hassanzadeh Keshteli
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Ahmad Reza Yazdannik
- School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran; Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular- Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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14
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Xie Q, Xu H, Wan Q. Correlation between parity and metabolic syndrome in Chinese women aged 40 years and older: the Reaction study. BMC Endocr Disord 2021; 21:236. [PMID: 34819073 PMCID: PMC8614030 DOI: 10.1186/s12902-021-00902-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/15/2021] [Indexed: 01/09/2023] Open
Abstract
AIMS The purpose of the present study was to investigate the correlation between the number of live-birth pregnancies and metabolic syndrome (MetS) in Chinese women according to menstruation history. METHODS Registry data for all pregnancies in a cohort of 6157 Chinese women aged 40 years or older were obtained and the number of live-birth pregnancies were enumerated. We defined MetS using five criteria: impaired insulin metabolism and glucose tolerance, obesity in the abdominal area, dyslipidemia, and hypertension. Multivariate logistic regression analysis was conducted to assess potential risk factors for MetS. Postmenopausal women with three or more of live-birth pregnancies had the highest prevalence of MetS (P < 0.05). RESULTS Among the 6157 females aged 40 years or older in Luzhou city, 2143 (34.8%) participants had incident MetS. The number of live-birth pregnancies was significantly correlated with age and fasting blood glucose (FBG) level (P < 0.05). The prevalence of MetS increased with the number of live-birth pregnancies (P < 0.01), and the frequency in postmenopausal women was significantly higher than that in premenopausal women (P < 0.001). In the binary logistic regression model, menopausal status [OR = 0.343 (0.153-0.769), P < 0.001] were significantly associated with an increased risk of MetS. CONCLUSIONS The number of live-birth pregnancies is correlated with an increased risk of MetS in Chinese women aged 40 years and over, especially in postmenopausal women. Greater attention should be paid to postmenopausal women who have had multiple live-birth pregnancies with a view to intervening early to prevent related diseases.
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Affiliation(s)
- Qian Xie
- Department of Gerontology, the people's Hospital of LeShan, LeShan, 614000, China.
| | - Haoran Xu
- The first clinical institute, ZunYi Medical University, ZunYi, 5630066, China
| | - Qin Wan
- Department of Endocrinology, the Affiliated Hospital of Southwest Medical University, Luzhou, 641400, China
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15
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Shemirani F, Fotouhi A, Djafarian K, Azadbakht L, Rezaei N, Mahmoudi M. Effects of modified-Paleo and moderate-carbohydrate diets on body composition, serum levels of hepatokines and adipocytokines, and flow cytometric analysis of endothelial microparticles in adults with metabolic syndrome: a study protocol for a randomized clinical trial. Trials 2021; 22:673. [PMID: 34593030 PMCID: PMC8483422 DOI: 10.1186/s13063-021-05612-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/08/2021] [Indexed: 11/12/2022] Open
Abstract
Background Metabolic syndrome is a combination of metabolic risk factors causing a pathological condition that increases the risk of non-communicable diseases, such as diabetes and cardiovascular diseases. A variety of dietary approaches have been examined to halt this rapid trend; however, the effects of modified-Paleo diet and medium-carbohydrate diet on inflammation, adipokines, hepatokines, and the profile of endothelial microparticles in individuals with metabolic syndrome have not been investigated in detail. The present study is designed to examine the effect of modified-Paleo and moderate-carbohydrate diet with two delivery modes: “fixed diet plan” vs “calorie counting” on weight, body composition, serum levels of some hepatokines and adipocytokines, and flow cytometric analysis of endothelial microparticles in adults with metabolic syndrome. Methods Eighty metabolic syndrome patients will be recruited in this study. They will be randomly allocated to one of the following 4 groups: (1) receiving a modified-Paleo diet with calorie counting, (2) receiving a modified-Paleo diet with a fixed diet plan, (3) receiving a medium-carbohydrate diet with calorie counting, and (4) receiving a medium-carbohydrate diet with a fixed diet plan for 10 weeks. Weight, height, waist circumference, and body composition will be assessed at the study baseline and at the end of the trial. Serum insulin, asprosin, chemerin, FGF-21, CTRP-1, PYY, ghrelin, plasma EMPs (CD31+/CD42b− and CD144+/CD42b−), lipid profile, glycemic indices, hs-CRP, leptin, vitamin C, creatinine and satiety, hunger, fullness, and desire to eat (via visual analog scales) will be measured at the study baseline and at the end of the trial. Insulin resistance and insulin sensitivity will be determined using the HOMA-IR and QUICKI equations. Discussion To the best of our knowledge, this is the first randomized controlled trial that will determine the effect of modified-Paleo and moderate-carbohydrate diet on weight, body composition, serum levels of some hepatokines and adipocytokines, and the profile of EMPs in adults with metabolic syndrome. Moreover, the effects of different diet delivery modes, including “fixed diet plan” and “calorie counting” will also be analyzed. The results of this trial can provide clinical witnesses on the effectiveness of carbohydrate-restricted diets in ameliorating metabolic status and prevent the development of chronic diseases. Trial registration Iranian Registry of Clinical Trials IRCT2016121925267N4. Registered on 26 July 2017 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05612-y.
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Affiliation(s)
- Farnoosh Shemirani
- Department of Cellular and Molecular Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, 14155-6447, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Mahmoudi
- Department of Cellular and Molecular Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, 14155-6447, Iran.
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16
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ÇIRPAN R, DEĞİRMENCİOĞLU AZ, KOCAÖZ S. Effect of the metabolic syndrome on the quality of life and sleep in women. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.911214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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17
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Loukzadeh Z, Hazery A, Zare Z, Mehrparvar AH. Relationship between metabolic syndrome and pulmonary function in workers with respiratory dust exposure in Iran. Diabetes Metab Syndr 2021; 15:102161. [PMID: 34186347 DOI: 10.1016/j.dsx.2021.05.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 11/29/2022]
Abstract
AIMS we designed a study to investigate the relationship between metabolic syndrome (MetS) and lung function in workers with dust exposure based on five years of longitudinal study data. METHODS In this historical cohort study that conducted in iron ore mine, non-smoker male workers who exposed to dust, were enrolled. MetS was determined according to the National Cholesterol Education Program Adult Treatment Panel III. New spirometry parameters and spirometry from 5 years ago, were compared. RESULTS In this study 192 workers were identified without MetS and 77 with MetS. The mean of all lung parameters was lower in subjects with MetS, but it was not statistically significant. The median decline in FEV1 and FVC in 5 years was greater in subjects with MetS but were only significant for a decline in FEV1 (P-Value = 0.04). Linear regression analysis showed a significant relationship between a decline in FEV1 and waist circumference (P-Value = 0.001) when adjusted for age, BMI, physical activity level. CONCLUSION In this study, a significant association between mean decline in FEV1 in 5 years and MetS in dust-exposed workers was demonstrated. Decline in FEV1 in 5 years was significantly associated with a Waist circumference as one of the components of MetS.
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Affiliation(s)
- Ziba Loukzadeh
- Industrial Diseases Research Center, Center of Excellence for Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Atefeh Hazery
- Industrial Diseases Research Center, Center of Excellence for Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Zohreh Zare
- Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Amir Houshang Mehrparvar
- Industrial Diseases Research Center, Center of Excellence for Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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18
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Khazdouz M, Hasani M, Mehranfar S, Ejtahed HS, Djalalinia S, Mahdavi Gorabi A, Esmaeili-Abdar M, Karbalahi Saleh S, Arzaghi SM, Zahedi H, Kasaeian A, Qorbani M. Validity of continuous metabolic syndrome score for predicting metabolic syndrome; a systematic review and meta-analysis. J Diabetes Metab Disord 2021; 20:497-510. [PMID: 34222074 PMCID: PMC8212237 DOI: 10.1007/s40200-021-00771-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/11/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Nowadays, use of continuous metabolic syndrome (cMetS) score has been suggested to improve recognition of metabolic syndrome (MetS). The aim of this study was to evaluate the validity of cMetS scores for predicting MetS. METHODS We searched the electronic databases included MEDLINE/PubMed, Embase, ISI Web of Science, and Scopus from 1 January 1980 to 30 September 2020. Observational studies on participants with different cMetS scores were included in this meta-analysis. The sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR) and diagnostic odds ratio (DOR) with 95% CI were calculated. RESULTS Ten studies involving a total of 25,073 participants were included. All studies had cross-sectional design. The pooled sensitivity and specificity of cMetS scores for predicting MetS were 0.90 (95% CI: 0.83 to 0.95) and 0.86 (95% CI: 0.83 to 0.89), respectively. Moreover, cMetS scores had the pooled LR+ of 6.5 (95% CI: 5.0 to 8.6), and a pooled (LR-) of 0.11 (95% CI: 0.063 to 0.21). The pooled DOR of cMetS scores to predict MetS were 57 (95% CI: 26 to 127). CONCLUSIONS The high sensitivity and specificity of cMetS scores indicates that it has a high accuracy to predict the risk of MetS. Furthermore, the cMetS scores has a good ability to rule out healthy people. STUDY REGISTRATION This study was registered as PROSPERO CRD42020157273.
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Affiliation(s)
- Maryam Khazdouz
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Motahareh Hasani
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Sanaz Mehranfar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | | | - Mohammad Esmaeili-Abdar
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Shahrokh Karbalahi Saleh
- Department of Cardiology, School of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Arzaghi
- Elderly Health Research Center, Endocrinology and Metabolism Population Science Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hoda Zahedi
- Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Kasaeian
- Hematology, Oncology and Stem Cell Transplantation Research Center, Research Institute for Oncology, Hematology and Cell Therapy, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Inflammation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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19
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Zhao Y, Zhang P, Lee JT, Oldenburg B, van Heusden A, Haregu TN, Wang H. The Prevalence of Metabolic Disease Multimorbidity and Its Associations With Spending and Health Outcomes in Middle-Aged and Elderly Chinese Adults. Front Public Health 2021; 9:658706. [PMID: 34012951 PMCID: PMC8126686 DOI: 10.3389/fpubh.2021.658706] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/31/2021] [Indexed: 12/28/2022] Open
Abstract
Objective: Metabolic diseases have been a clinical challenge worldwide and a major public health issue. Very few studies from China investigated the impact of metabolic multimorbidity on healthcare and health outcomes at the national level. This study aims to examine the association of metabolic multimorbidity with health service utilization, spending, functional and mental health. Materials and Methods: This is a nationally representative cross-sectional study, utilizing the data from the China Health and Retirement Longitudinal Study in 2015, including 11,377 participants aged 45 years and older. Multivariable regression models were used to assess the association of metabolic multimorbidity with healthcare, out-of-pocket expenditure (OOPE), the activities of daily living (ADL) limitation, the instrumental activities of daily living (IADL) limitation, and depression. Results: Overall, 30.50% of total participants had metabolic multimorbidity in 2015 in China. Compared with single disease, metabolic multimorbidity were associated with the number of outpatient visits [incident rate ratio (IRR) = 1.30, 95% CI = 1.05, 1.62] and days of inpatient care (IRR = 1.52, 95% CI = 1.28, 1.81). Metabolic multimorbidity was positively associated with the OOPE on outpatient care (coefficient = 82.99, 95% CI = 17.70, 148.27) and physical functional difficulties, including ADL limitation (odds ratio = 1.36, 95% CI = 1.18, 1.57). Conclusions: Metabolic multimorbidity is associated with higher levels of health-care service use, greater expenditure for outpatient care, and more difficulties in ADL among Chinese adults. China's health-care systems need to shift from single-disease models to new financing and service delivery models to effectively manage metabolic multimorbidity.
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Affiliation(s)
- Yang Zhao
- Stroke and Women and Children Health Program, The George Institute for Global Health at Peking University Health Science Center, Beijing, China.,Non-communicable Disease Unit, The Nossal Institute for Global Health, The University of Melbourne, Melbourne, VIC, Australia.,WHO Collaborating Centre on Implementation Research for Prevention and Control of Non-communicable Diseases, The University of Melbourne, Melbourne, VIC, Australia
| | - Puhong Zhang
- Stroke and Women and Children Health Program, The George Institute for Global Health at Peking University Health Science Center, Beijing, China.,Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - John Tayu Lee
- Non-communicable Disease Unit, The Nossal Institute for Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Brian Oldenburg
- Non-communicable Disease Unit, The Nossal Institute for Global Health, The University of Melbourne, Melbourne, VIC, Australia.,WHO Collaborating Centre on Implementation Research for Prevention and Control of Non-communicable Diseases, The University of Melbourne, Melbourne, VIC, Australia
| | - Alexander van Heusden
- Non-communicable Disease Unit, The Nossal Institute for Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Tilahun Nigatu Haregu
- Non-communicable Disease Unit, The Nossal Institute for Global Health, The University of Melbourne, Melbourne, VIC, Australia.,WHO Collaborating Centre on Implementation Research for Prevention and Control of Non-communicable Diseases, The University of Melbourne, Melbourne, VIC, Australia
| | - Haipeng Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
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20
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Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Cheng S, Delling FN, Elkind MSV, Evenson KR, Ferguson JF, Gupta DK, Khan SS, Kissela BM, Knutson KL, Lee CD, Lewis TT, Liu J, Loop MS, Lutsey PL, Ma J, Mackey J, Martin SS, Matchar DB, Mussolino ME, Navaneethan SD, Perak AM, Roth GA, Samad Z, Satou GM, Schroeder EB, Shah SH, Shay CM, Stokes A, VanWagner LB, Wang NY, Tsao CW. Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association. Circulation 2021; 143:e254-e743. [PMID: 33501848 DOI: 10.1161/cir.0000000000000950] [Citation(s) in RCA: 3142] [Impact Index Per Article: 1047.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2021 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors related to cardiovascular disease. RESULTS Each of the 27 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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21
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Naghipour M, Joukar F, Nikbakht HA, Hassanipour S, Asgharnezhad M, Arab-Zozani M, Mansour-Ghanaei F. High Prevalence of Metabolic Syndrome and Its Related Demographic Factors in North of Iran: Results from the PERSIAN Guilan Cohort Study. Int J Endocrinol 2021; 2021:8862456. [PMID: 33859688 PMCID: PMC8024063 DOI: 10.1155/2021/8862456] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 02/14/2021] [Accepted: 03/20/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION The prevalence of metabolic syndrome has increased in recent decades around the world and is currently reaching epidemic levels as it is a major public health and clinical concern. The aim of this study was to evaluate the prevalence of metabolic syndrome and its related demographic factors in a population-based study. METHODS In this cross-sectional study, the target population consisted of 10520 individuals aged 35-70 years in Phase 1 of the Persian Guilan cohort study (Guilan site/Some'e Sara) that was conducted in 2014-2017. Demographic, anthropometric, blood pressure, and biochemical data were used in this study. The IDF definitions were used to diagnose the metabolic syndrome. RESULTS The prevalence of the syndrome according to IDF and ATP definition was 42.87% (95% CI: 41.92-41.81) and 40.68% (95% CI: 39.74-41.62), respectively. The prevalence of components for central obesity, high triglyceride, HDL cholesterol, blood glucose, and hypertension components was 75.8%, 43.1%, 40.6%, 39.2% and 37.9%, respectively. All demographic variables were related to the syndrome, and among them age, gender, and residence were identified as independent and strong predictive variables in the regression model. More than 92% of the population had at least one component of the syndrome. CONCLUSION The results of the study show a high prevalence of metabolic syndrome risk factors. It is essential to educate healthy lifestyle behaviors and further health education in the high-risk groups identified in this study, especially the elderly, women, and rural residents.
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Affiliation(s)
- Mohammadreza Naghipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Hossein-Ali Nikbakht
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Soheil Hassanipour
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mehrnaz Asgharnezhad
- Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
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22
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Saberi-Karimian M, Ghazizadeh H, Mohammadzadeh E, Ferns GA, Ghayour-Mobarhan M, Sahebkar A. Does curcumin have an effect on sleep duration in metabolic syndrome patients? AVICENNA JOURNAL OF PHYTOMEDICINE 2021; 11:190-198. [PMID: 33907677 PMCID: PMC8051315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVE Sleep-duration is related to obesity. Curcumin can affect behavioral changes that arise from sleep deprivation in animal models. In this study, we assessed the effects of curcumin on sleep-duration in metabolic-syndrome (MetS) patients. MATERIALS AND METHODS This study was a double-blind clinical trial in 120 adults with MetS. All participants received crude curcuminoids in a simple formulation (n=40), phospholipidated curcuminoids (n=40) or placebo (n=40) 1 g/day during 6 weeks. Demographic data, anthropometric indices and serum biochemical factors were documented for all volunteers at baseline and after the intervention. A standard questionnaire was used for evaluating physical-activity-level (PAL) and patients' sleep-duration, including night time sleep and daily napping. Based on the time of sleep, sleeping hours were classified into: night time sleep; daily naps and total sleeping hours in 24 hours. RESULTS A total of 120 participants aged 38.72±10.05 years old were enrolled into the study. We did not find significant differences in biochemical factors, sleep-duration or PAL at baseline among the 3 groups (p>0·05). Moreover, curcumin did not exert any significant effect on sleep-duration before, or after, adjustment for confounding factors in the overweight and obese individuals, or in total population (p>0.05). CONCLUSION The results showed that curcumin does not have an effect on sleep-duration in subject with MetS.
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Affiliation(s)
- Maryam Saberi-Karimian
- International UNESCO center for Health Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran,Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamideh Ghazizadeh
- International UNESCO center for Health Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran,Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elham Mohammadzadeh
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran,Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A. Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, UK
| | - Majid Ghayour-Mobarhan
- International UNESCO center for Health Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran,Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran,Equal Corresponding Author: Tel: +985138002288, Fax: +985138002287, ,
| | - Amirhosein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,Equal Corresponding Author: Tel: +985138002288, Fax: +985138002287, ,
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23
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Faraji S, Alizadeh M. Mechanistic Effects of Vitamin D Supplementation on Metabolic Syndrome Components in Patients with or without Vitamin D Deficiency. J Obes Metab Syndr 2020; 29:270-280. [PMID: 32747610 PMCID: PMC7789020 DOI: 10.7570/jomes20003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/21/2020] [Accepted: 05/17/2020] [Indexed: 12/11/2022] Open
Abstract
The prevalences of metabolic syndrome (MetS) and vitamin D deficiency are increasing dramatically worldwide. MetS is a major challenge because it can increase the risk of most non-communicable diseases. The beneficial effect of vitamin D on MetS components remains controversial, so the present review focused on the clinical effects of vitamin D supplementation on MetS components. Vitamin D can inhibit the protein expression of nuclear factor beta; improve arterial stiffness; decrease renin-angiotensin-aldosterone system activity, parathyroid hormone levels, inflammatory cytokines, 3-hydroxy-3-methylglutaryl-coenzyme A reductase, and lanosterol 14 α-demethylase enzyme activity; increase the activity of lipoprotein lipase; alter gene expression in C2C12 cells; and improve phospholipid metabolism and mitochondrial oxidation. We tried to elucidate and analyze almost all evidence from randomized controlled trial studies of the efficacy of vitamin D supplementation in patients with MetS. The findings of the present study reported beneficial effects of vitamin D supplementation on mentioned factors. Vitamin D supplementation is recommended in people with vitamin D deficiency even if it has no considerable effect on most MetS factors. However, existing data from interventional studies are insufficient to reach a definitive conclusion about the effect of vitamin D supplementation on MetS components in patients without vitamin D deficiency. Thus, new clinical studies are needed to test the hypothesis that vitamin D supplementation could alleviate MetS components in patients with sufficient intake of vitamin D.
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Affiliation(s)
- Samira Faraji
- Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran.,Department of Nutrition, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Mohammad Alizadeh
- Department of Nutrition, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.,Food and Beverages Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran
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24
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Mohsenzadeh-Ledari F, Taghizadeh Z, Keramat A, Moosazadeh M, Yazdani S, Najafi A, Motaghi Z. The effect of caring intervention (physical activity, diet and counseling) on gestational diabetes for pregnant women with metabolic syndrome. J Matern Fetal Neonatal Med 2020; 35:4168-4174. [PMID: 33243041 DOI: 10.1080/14767058.2020.1849088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Metabolic syndrome and its indexes is one of the critical health problems during pregnancy. This study aimed to examine the effects of a care intervention program on pregnancy outcome in pregnant women with Metabolic Syndrome during 2017-2018. METHODS This randomized clinical trial study was conducted in 120 singleton pregnant women with metabolic syndrome. The participants were selected using purposive sampling method from pregnant women referred to two health centers of Babol. They were randomly divided in two control and intervention groups (60 samples in each group). Intervention group received one motivational interview session for 120 min, two consultation sessions with expert for nutritional recommendations based on Nutrition Guidelines of Ministry of Health for Pregnant Women. They were also theoretically and practically provided by three training sessions for physical activity and pregnancy exercises combining pelvic floor muscles, bodybuilding, muscle strengthening, stretching, and relaxation and walking activities. To follow up on the intervention, the researcher made a phone call with the participants in intervention group every 10 days to two weeks. Pregnancy outcomes were assessed using SPSS software. RESULTS The obtained results showed that there was a significant difference between the two groups in maternal complications including gestational diabetes, hospitalization due to gestational diabetes, nutritional diet for gestational diabetes, pregnancy weight gain and 2-hour post-prandial blood glucose test (p ≤ .01). There was no significant difference in terms of demographic, midwifery and metabolic syndrome indices between the intervention and control groups. CONCLUSION The results of the study indicated that intervention program improved the maternal pregnancy outcome such as gestational diabetes and weight gain during the pregnancy in the intervention group. This program had no adverse effects for the mother who is consistent with pregnancy health objectives.
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Affiliation(s)
- Farideh Mohsenzadeh-Ledari
- Infertility and Health Reproductive Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ziba Taghizadeh
- Faculty Member of Nursing and Midwifery Research care Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Keramat
- Department of Midwifery and Reproductive Health School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research center, Addiction Institute Mazandaran University of Medical Sciences, Sari, Iran
| | - Shahla Yazdani
- Infertility and Health Reproductive Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ali Najafi
- Shahroud University of Medical Sciences, Shahroud, Iran
| | - Zahra Motaghi
- Department of Midwifery and Reproductive Health School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
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25
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Hlushchenko TA, Batig VM, Borysenko AV, Tokar OM, Batih IV, Vynogradova OM, Boychuk-Tovsta OG. Prevalence and Intensity of Periodontal Disease in Individuals with Metabolic Syndrome. J Med Life 2020; 13:289-292. [PMID: 33072198 PMCID: PMC7550136 DOI: 10.25122/jml-2020-0073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Metabolic syndrome is one of the actual problems of modern medicine because of its high prevalence in the general population and its essential role in the development and progression of cardiovascular diseases. In the last decade, studying the relationship between metabolic syndrome and periodontal diseases has attracted many scientists’ attention. Based on this, the study of the clinical features of periodontal diseases in the early stages of metabolic syndrome is relevant and necessary for timely and successful pathogenetic therapy. The purpose of our study was to investigate and analyze the prevalence and intensity of periodontal disease in people with metabolic syndrome. To solve this goal, we surveyed 190 people with metabolic syndrome who were registered at the endocrinological clinic in Chernivtsi. They formed the main observation group. The comparison observation group included 90 people without metabolic disorders. The age of the patients ranged from 25 to 55 years. Periodontal disease was detected in 155 of 190 patients with metabolic syndrome (81.58 ± 2.82%). In 90 patients without endocrinological pathology, the prevalence of periodontal disease was 1.2 times lower (65.56 ± 5.04%; p <0.01). Generalized periodontitis prevailed in the structure of periodontal diseases in patients with metabolic syndrome: 26.45±3.56% cases were in the second stage of generalized periodontitis (GP), and 21.94±3.33% in the third stage of GP, р<0.01. Therefore, the metabolic syndrome, as a state with a high risk of diabetes development, creates conditions for the formation and rapid progression of inflammatory-destructive periodontal lesions.
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Affiliation(s)
| | | | | | - Olha Mykhaylivna Tokar
- Department of Pediatric Dentistry, Bukovinian State Medical University, Chernivtsi, Ukraine
| | - Iryna Viktorivna Batih
- Department of Therapeutic Stomatology, Bukovinian State Medical University, Chernivtsi, Ukraine
| | - Olena Mykolayivna Vynogradova
- Department of Therapeutic Dentistry, Faculty of Postgraduate Education, Danylo Halytsky Lviv National Medical University,Lviv, Ukraine
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26
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Lorzadeh E, Sangsefidi ZS, Mirzaei M, Hosseinzadeh M. Dietary Habits and their Association with Metabolic Syndrome in a sample of Iranian adults: A population-based study. Food Sci Nutr 2020; 8:6217-6225. [PMID: 33282272 PMCID: PMC7684605 DOI: 10.1002/fsn3.1918] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Central obesity, insulin resistance, dyslipidemia, and hypertension are the core components of metabolic syndrome (MetS) which is coincident with unhealthy dietary habits in the Middle-Eastern countries. The aim of this study was to explore the association between dietary habits and MetS of the adult population living in Yazd Greater Area, Iran. METHODS This is a cross-sectional study that uses the data of a population-based cohort study on Iranian adults, known as Yazd Health Study (YaHS). The relationship between dietary habits and metabolic syndrome among adults (n = 2,896) was analyzed using multiple logistic regression method. RESULTS The prevalence of MetS among the participants was 32.2%. Outcomes from logistic regression examination show that breakfast consumption has a significant inverse effect on the occurrence of MetS after adjustment for age, education level, physical activity statue, history of chronic diseases, and smoking (odds ratio (OR) = 0.38, 95% confidence interval (CI) = 0.14, 0.97). This effect remains significant even after adjustment for body mass index (BMI) and reveals that odds of having MetS is 69% lower in breakfast consumers in contrast to nonconsumers (OR = 0.31, 95% CI = 0.11, 0.87). However, no significant relationship was observed between other dietary habits including consumption of sweetened drinks, sugar cubes, and fast foods and MetS after adjustment for all potential confounders. CONCLUSIONS This study revealed that eating breakfast has an inverse relationship with metabolic syndrome. To find out stronger evidence in relation to dietary habits and MetS, more researches especially population-based cohort studies are needed to be conducted.
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Affiliation(s)
- Elnaz Lorzadeh
- Nutrition and Food Security Research CenterShahid Sadoughi University of Medical SciencesYazdIran
- Department of NutritionSchool of Public HealthShahid Sadoughi University of Medical SciencesYazdIran
| | - Zohreh Sadat Sangsefidi
- Nutrition and Food Security Research CenterShahid Sadoughi University of Medical SciencesYazdIran
- Department of NutritionSchool of Public HealthShahid Sadoughi University of Medical SciencesYazdIran
| | - Masoud Mirzaei
- Yazd Cardiovascular Research CentreShahid Sadoughi University of Medical SciencesYazdIran
| | - Mahdieh Hosseinzadeh
- Nutrition and Food Security Research CenterShahid Sadoughi University of Medical SciencesYazdIran
- Department of NutritionSchool of Public HealthShahid Sadoughi University of Medical SciencesYazdIran
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27
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Pirouzeh R, Heidarzadeh-Esfahani N, Morvaridzadeh M, Izadi A, Yosaee S, Potter E, Heshmati J, Pizarro AB, Omidi A, Heshmati S. Effect of DASH diet on oxidative stress parameters: A systematic review and meta-analysis of randomized clinical trials. Diabetes Metab Syndr 2020; 14:2131-2138. [PMID: 33395773 DOI: 10.1016/j.dsx.2020.10.031] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/27/2020] [Accepted: 10/31/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS Oxidative stress (OS) is one of the main risk factors for several chronic diseases. The Dietary Approaches to Stop Hypertension (DASH) contain many antioxidants and may contribute to managing OS. OBJECTIVE To perform a systematic review and meta-analysis to examine the impacts of the DASH diet on OS parameters. METHODS A comprehensive electronic search in MEDLINE, Scopus, EMBASE, and the Cochrane Central Register of Controlled Trials was performed through September 2020 to find related studies evaluating the impact of the DASH diet on OS parameters. Standardized mean differences were pooled using random-effects meta-analysis. RESULTS Eight studies with a total of 317 subjects met our inclusion criteria. Four studies included in meta-analysis model with 200 participants (100 in treatment and 100 in control group). The DASH diet was associated with a statistically significant decrease in malondialdehyde (MDA) (SMD: -0.53; 95% CI: -0.89, -0.16; I2 = 42.1%), and a significant increase in glutathione (GSH) (SMD: 0.83; 95% CI: 0.36, 1.03; I2 = 42.1%). Meta-analysis found no statistically significant effect of DASH diet on nitric oxide (NO) (SMD: -1.40; 95% CI: -0.12, 1.93; I2 = 92.6%) or total antioxidant capacity (TAC) levels (SMD: 0.95; 95% CI: -0.10, 1.99; I2 = 87.6%). CONCLUSION Our results demonstrated that a DASH diet could significantly increase GSH and decrease MDA levels. Furthermore, there is a trend to improve TAC, NO, and f2-isoprostanes by the adherence to the DASH diet. However, long-term, large sample size and well-designed randomized clinical trials are still needed to draw concrete conclusions about DASH diet's effects on OS parameters.
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Affiliation(s)
- Razieh Pirouzeh
- Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Neda Heidarzadeh-Esfahani
- Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Mojgan Morvaridzadeh
- Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Azimeh Izadi
- Department of Biochemistry and Diet therapy, Faculty of Nutrition and Food sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Somaye Yosaee
- Department of Nutrition, School of Health, Larestan University of Medical Sciences, Larestan, Iran.
| | - Eric Potter
- Baylor Scott & White Research Institute, Dallas, TX, USA.
| | - Javad Heshmati
- Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | | | - Amirhosein Omidi
- Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shilan Heshmati
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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28
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Abbasi-Ghahramanloo A, Moshiri E, Afrashteh S, Gholami A, Safiri S, Mohammadbeigi A, Ansari H. Comorbidity of metabolic syndrome components in a population-based screening program: A latent class analysis. Med J Islam Repub Iran 2020; 34:69. [PMID: 32974235 PMCID: PMC7500419 DOI: 10.34171/mjiri.34.69] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Indexed: 01/10/2023] Open
Abstract
Background: The prevalence of metabolic syndrome (MS) is rapidly increasing in the world. Thus, the aim of the present study was to identify the latent subgroups of Iranian male adults based on MS components and investigate the effect of abnormal alanine aminotransferase (ALT) and aspartate aminotransferase (AST), high total cholesterol (TC), and low-density lipoprotein (LDL) on the odds of membership in each class. Methods: In the present study, we used the data of a population-based screening program conducted on 823 urban adult men aged 25 years and older in city of Qom in 2014. Abdominal obesity, fasting blood sugar (FBS), blood pressure, and serum lipid profile were measured in participants after for at least 8 hours. MS was defined according to the Adults Treatment Panel III criteria. Latent class analysis was used to achieve the aims of study. Analyses were conducted using PROC LCA in SAS 9.2 software. In all analysis, p value < 0.05 was considered statistically significant. Results: There were 3 different latent classes among participants. Latent class 1, non-MS, 55.1%; latent lass 2, at risk, 21.3%; and finally latent class 3, MS, with 23.6% of the participants. Age (OR=0.98, 95% CI: 0.98-0.99, high LDL (OR=0.27, 95% CI: 0.13-0.56), high TC (OR=8.12, 95% CI: 4.40-15.00), and abnormal ALT (OR=2.25, 95% CI 1.49-3.41) were associated with at risk class. Also, only age (OR=1.02, 95% CI: 1.01-1.04) was associated with MS class. The most prevalent components among the participants were having low HDL (34.0%) and high WC (33.9%). Conclusion: Notable percent of samples fell in "at risk" and "MS" classes, which stress the necessity of designing preventive interventions for these specific stratums of population.
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Affiliation(s)
- Abbas Abbasi-Ghahramanloo
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Esmail Moshiri
- Department of Anesthesiology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Sima Afrashteh
- Department of Public Health, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Ali Gholami
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran.,Department of Epidemiology & Biostatistics, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Saeid Safiri
- Social Determinants of Health Research Center, Department of Community Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abolfazl Mohammadbeigi
- Research Center for Environmental Pollutants, Department of Epidemiology and Biostatistics, Qom University of Medical Sciences, Qom, Iran
| | - Hossein Ansari
- Health Promotion Research Center, Department of Epidemiology and Biostatistics, Zahedan University of Medical Sciences, Zahedan, Iran
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29
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Annani-Akollor ME, Laing EF, Addai-Mensah O, Fondjo LA, Adu EA, Owiredu EW. Population-derived cut-off for HbA1c could enhance the identification of metabolic syndrome among non-diabetic population. Heliyon 2020; 6:e04583. [PMID: 32775749 PMCID: PMC7396902 DOI: 10.1016/j.heliyon.2020.e04583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 05/08/2020] [Accepted: 07/27/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a multifactorial disorder and a predisposing factor for diabetes, heart diseases, and stroke. Glycated haemoglobin (HbA1c) has recently received considerable attention as a potential marker to identify subjects at risk of MetS. This study aimed at assessing the performance of fasting plasma glucose (FPG), the American Diabetes Association (ADA) HbA1c cut-off, and a population-derived HbA1c (pHbA1c) cut-off value as the glycaemic criterion for MetS in a non-diabetic population. METHODS In this cross-sectional study, we recruited 728 non-diabetic Ghanaian adults. Venous blood sample was obtained and fasting plasma insulin and glucose, HbA1c, lipid profile, blood pressure and anthropometric measurements were performed for each respondent. RESULTS The prevalence of MetS using the FPG, ADA HbA1c and pHbA1c criteria were 35.2%, 38.5% and 41.8%, respectively. The pHbA1c cut-off identified 6.6% and 3.3% more subjects with MetS when compared with FPG and the ADA HbA1c cut-offs, respectively while the ADA HbA1c cut-off identified 3.3% more subjects with MetS compared with the FPG criterion. The ADA HbA1c criterion showed a substantial agreement (ĸ = 0.79) with the FPG criterion while pHbA1c showed an almost perfect concordance (ĸ = 0.82) with the FPG criterion and an excellent sensitivity and specificity for identifying subjects with MetS in the study population. CONCLUSION Screening of MetS by introduction of the ADA HbA1c criterion in addition to the traditional FPG criterion enhances the detection of more people with MetS. However, the use of population-derived HbA1c cut-off value could potentially identify even greater number of high risk subjects in that specific population.
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Affiliation(s)
- Max Efui Annani-Akollor
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Edwin Ferguson Laing
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Otchere Addai-Mensah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Linda Ahenkorah Fondjo
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Evans Asamoah Adu
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eddie-Williams Owiredu
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Bahar A, Kashi Z, Kheradmand M, Hedayatizadeh-Omran A, Moradinazar M, Ramezani F, Afshari M, Moosazadeh M. Prevalence of metabolic syndrome using international diabetes federation, National Cholesterol Education Panel- Adult Treatment Panel III and Iranian criteria: results of Tabari cohort study. J Diabetes Metab Disord 2020; 19:205-211. [PMID: 32550169 PMCID: PMC7270474 DOI: 10.1007/s40200-020-00492-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 01/08/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Metabolic syndrome is defined by co-incidence of multiple metabolic disorders such as central obesity, high triglycerides, low HDL, hyperglycemia and high blood pressure, which increases the risk of cardiovascular disease and diabetes. The aim of this study was to estimate the prevalence of metabolic syndrome using Adult Treatment Panel III (ATP-III), International Diabetes Federation (IDF) and Iranian criteria in large-scaled population based cohort study and to determine the concordance between these criteria. METHODS In the present study all information collected in Tabari cohort study(TCS) were utilized. These information were collected using a structural questionnaire and taking blood samples from all the participants. Blood pressure and anthropometric indices were measured for all participants by trained practitioners. Categorical variables were compared using chi-square test. In addition, the quantitative variables were compared between the two the groups using independent t-test. Kappa coefficient was estimated to show the agreement between the results of the three criteria. RESULTS The prevalences of Metabolic syndrome were 41.10%(CI 95%:40.10-42.02), 44.60%(CI 95%:43.61-45.54), and 30.80% (CI 95%:29.89-31.69) based on ATPIII, international IDF and IDF Iranian criteria respectively. The Kappa agreement coefficients between Iranian IDF with ATPIII definition and international IDF were estimated as 61.80% and 71.20% in the total population respectively. CONCLUSION Kappa coefficient showed that the Iranian IDF had a good agreement with International IDF and an intermediate agreement with the ATP-III. Considering more emphasis of international and Iranian IDF on waist circumference (WC), a better agreement between these two criteria is plausible. Regarding the high prevalence of abdominal obesity among Iranian population, applying these criteria to identify high risk persons might be helpful.
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Affiliation(s)
- Adeleh Bahar
- Diabetes research center, Mazandaran University of medical sciences, Sari, Iran
| | - Zahra Kashi
- Diabetes research center, Mazandaran University of medical sciences, Sari, Iran
| | - Motahareh Kheradmand
- Health Sciences Research center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Mahdi Moradinazar
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Ramezani
- Diabetes research center, Mazandaran University of medical sciences, Sari, Iran
| | - Mahdi Afshari
- Department of Community Medicine, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
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Baygi F, Qorbani M, Motlagh ME, Shafiee G, Nouri K, Ahadi Z, Mahdavi-Gorab A, Heshmat R, Kelishadi R. Is frequency of potato and white rice consumption associated with cardiometabolic risk factors in children and adolescents: the CASPIAN-V study. BMC Cardiovasc Disord 2020; 20:239. [PMID: 32429894 PMCID: PMC7236272 DOI: 10.1186/s12872-020-01524-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 05/12/2020] [Indexed: 12/31/2022] Open
Abstract
Background This study evaluated the association of frequency of potato and rice consumption with cardiometabolic risk factors in children and adolescents. Methods This nationwide cross-sectional survey was conducted on 14,400 children and adolescents. Fasting blood was obtained from a sub-sample of 4200 randomly selected students. Physical examination and laboratory tests were conducted under standard protocols. Metabolic Syndrome (Mets) was defined based on the Adult Treatment Panel III criteria modified for the pediatric age group. The self-reported frequency consumption of white rice and potato was reported on a daily or non-daily basis. Results The participation rate for the whole study and for blood sampling were 99 and 91.5%, respectively. Overall, 49.4% of the participants were girls while 50.6% were boys. The frequency of daily consumption of white rice and potato was 84.4 and 21.3%, respectively. In the multivariable linear regression model, daily consumption of potato increased body mass index (β: 0.05, SE: 0.20, p = 0.010), waist (β: 0.63, SE: 0.24, p = 0.008), and hip circumferences (β: 0.62, SE: 0.26, p = 0.019). Moreover, in the multivariable logistic regression, daily consumption of potato was significantly associated with an increased risk of overweight (OR: 1.21, 95% CI: 1.04–1.39, P = 0.012). The potato and rice consumption had no statistically significant association with other cardiometabolic risk factors. Conclusions Daily consumption of potato was significantly associated with higher anthropometric measures, whereas rice consumption had no statistically significant association with cardiometabolic risk factors. Future research to examine the possible obesogenic effects of intake of potato on children and adolescents is recommended.
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Affiliation(s)
- Fereshteh Baygi
- Center of Maritime Health and Society, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, School of Medicine, Alborz University of Medical Sciences, Baghestan Blvd, Karaj, 31485/56, Iran. .,Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kourosh Nouri
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Zeinab Ahadi
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Armita Mahdavi-Gorab
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Sareban Hassanabadi M, Mirhosseini SJ, Mirzaei M, Namayandeh SM, Beiki O, Gannar F, Boffetta P, Pakseresht M, Tabesh M, Ahmadi N, Kazeminasab M, Salehi- Abargouei A. The Most Important Predictors of Metabolic Syndrome Persistence after 10-year Follow-Up: YHHP Study. Int J Prev Med 2020; 11:33. [PMID: 32363020 PMCID: PMC7187548 DOI: 10.4103/ijpvm.ijpvm_215_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 02/12/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is one of the world's largest health epidemics, and its management is a major challenge worldwide. The aim of this 10-year follow-up study was to assess the most important predictors of MetS persistence among an Iranian adult population. METHODS In this cohort study, 887 out of 2000 participants with MetS aged 20-74 years in the central part of Iran were followed-up for about 10 years from 2005-2006 to 2015-2016. MetS was defined based on the criteria of NCEP-ATP III adopted for the Iranian population. Cox proportional hazards regression was conducted to evaluate the predictors of MetS persistence in crude- and multivariate-adjusted models. RESULTS Our analyses showed that 648 out of 887 participants (73%) completed the follow-up and 565 (87.2%) of them had persistence of MetS after 10-year follow-up. There was a significant association between age, weight, body mass index, triglyceride, and waist circumference in participants who had MetS compared to those without MetS after 10-year follow-up (P < 0.05). There was a direct association between increases in the mean changes of systolic/diastolic blood pressure, waist circumference, and low HDL-C and risk of MetS persistence after adjusting the model for sex and age in the total population (P trend < 0.05). The trends were the same for women except in diastolic blood pressure. After adjustment for potential confounders, the risk of MetS persistence in men was significantly higher than women (HR = 1.98, 95% CI: 1.38-2.85, Ptrend = 0.001). CONCLUSIONS Most of the risk factors of MetS were positively associated with persistence of MetS. Therefore, modification of lifestyle is recommended to reduce MetS.
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Affiliation(s)
| | - Seyed Jalil Mirhosseini
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Masoud Mirzaei
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Omid Beiki
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
- Department of Epidemiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fadoua Gannar
- Research Unit “Integrated Physiology”, Laboratory of Biochemistry- Human Nutrition, Faculty of Sciences of Bizerte, Carthage University, Tunis, Tunisia
| | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Mohammadreza Pakseresht
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Maryam Tabesh
- Baker Heart and Diabetes Institute, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Nastaran Ahmadi
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahmood Kazeminasab
- Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amin Salehi- Abargouei
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Shay CM, Spartano NL, Stokes A, Tirschwell DL, VanWagner LB, Tsao CW. Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association. Circulation 2020; 141:e139-e596. [PMID: 31992061 DOI: 10.1161/cir.0000000000000757] [Citation(s) in RCA: 4882] [Impact Index Per Article: 1220.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2020 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, an enhanced focus on social determinants of health, a focus on the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors, implementation strategies, and implications of the American Heart Association's 2020 Impact Goals. RESULTS Each of the 26 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, healthcare administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Menopause-Associated Lipid Metabolic Disorders and Foods Beneficial for Postmenopausal Women. Nutrients 2020; 12:nu12010202. [PMID: 31941004 PMCID: PMC7019719 DOI: 10.3390/nu12010202] [Citation(s) in RCA: 196] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/19/2019] [Accepted: 01/07/2020] [Indexed: 12/12/2022] Open
Abstract
Menopause is clinically diagnosed as a condition when a woman has not menstruated for one year. During the menopausal transition period, there is an emergence of various lipid metabolic disorders due to hormonal changes, such as decreased levels of estrogens and increased levels of circulating androgens; these may lead to the development of metabolic syndromes including cardiovascular diseases and type 2 diabetes. Dysregulation of lipid metabolism affects the body fat mass, fat-free mass, fatty acid metabolism, and various aspects of energy metabolism, such as basal metabolic ratio, adiposity, and obesity. Moreover, menopause is also associated with alterations in the levels of various lipids circulating in the blood, such as lipoproteins, apolipoproteins, low-density lipoproteins (LDLs), high-density lipoproteins (HDL) and triacylglycerol (TG). Alterations in lipid metabolism and excessive adipose tissue play a key role in the synthesis of excess fatty acids, adipocytokines, proinflammatory cytokines, and reactive oxygen species, which cause lipid peroxidation and result in the development of insulin resistance, abdominal adiposity, and dyslipidemia. This review discusses dietary recommendations and beneficial compounds, such as vitamin D, omega-3 fatty acids, antioxidants, phytochemicals—and their food sources—to aid the management of abnormal lipid metabolism in postmenopausal women.
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Baveicy K, Mostafaei S, Darbandi M, Hamzeh B, Najafi F, Pasdar Y. Predicting Metabolic Syndrome by Visceral Adiposity Index, Body Roundness Index and a Body Shape Index in Adults: A Cross-Sectional Study from the Iranian RaNCD Cohort Data. Diabetes Metab Syndr Obes 2020; 13:879-887. [PMID: 32273739 PMCID: PMC7102908 DOI: 10.2147/dmso.s238153] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 03/09/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The use of anthropometric indices is one of the new and low-cost diagnostic methods of metabolic syndrome (MetS). The present study aimed to determine optimal cutoff points for the visceral adiposity index (VAI), body roundness index (BRI), and a body shape index (ABSI) in the prediction of MetS. METHODS This cross-sectional study was performed on 10,000 individuals aged from 35 to 65 years, recruited in Ravansar Non-Communicable Diseases (RaNCD) cohort study, in the west region of Iran, in 2019. MetS was defined according to International Diabetes Federation (IDF) criteria. The receiver operating characteristic (ROC) curve analysis was used to assess predictive anthropometric indices and determine optimal cutoff values. RESULTS The optimal cutoff points for VAI were 4.11 (AUC: 0.82; 95% CI: 0.81-0.84) in men and 4.28 (AUC: 0.86; 95% CI: 0.85-0.87) in women to prediction of MetS. The optimal cutoff points for BRI were 4.75 (AUC: 0.75; 95% CI: 0.74-0.77) in men and 6.17 (AUC: 0.62; 95% CI: 0.61-0.64) in women to prediction of MetS. The optimal cutoff points for ABSI were 0.12 (AUC: 0.49; 95% CI: 0.47-0.51) in men and 0.13 (AUC: 0.49; 95% CI: 0.47-0.51) in women to prediction of MetS. The risk of MetS in men and women with a VAI higher than the optimal cutoff point was, respectively, 9.82 and 11.44 times higher than that in those with a VAI lower than the cutoff point. CONCLUSION Although VAI might not be very cost-beneficial compared to IDF, our study showed VAI is a better predictor of MetS than BRI in adults. ABSI was not a suitable predictor for MetS.
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Affiliation(s)
- Kamran Baveicy
- Student Research Committee, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shayan Mostafaei
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Epidemiology and Biostatistics Unit, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Darbandi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Correspondence: Yahya Pasdar Tel +98 83 38262005Fax +98 83 38263048 Email
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Sourinejad H, Shayan A, Niyati S, Moghaddam-Banaem L. The effect of metabolic syndrome and its components in midpregnancy on neonatal outcomes. Med J Islam Repub Iran 2019; 33:147. [PMID: 32280653 PMCID: PMC7137841 DOI: 10.34171/mjiri.33.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Indexed: 12/03/2022] Open
Abstract
Background: The prevalence of metabolic syndrome has been rising worldwide in recent decades. Determining the associations between metabolic syndrome and its components in midpregnancy with neonatal anthropometric indices and outcomes is a major challenge in both public health and clinical care. Methods: This prospective cohort study was performed on 238 pregnant women at 24-28 weeks of gestation. Metabolic syndrome was recognized with 3 or more of the following criteria: triglyceride ≥ 247 mg/dL; HDL < 61 mg/dL; GCT ≥ 140 mg/dL; prepregnancy body mass index ≥ 30 kg/m2; and blood pressure ≥ 130/85 mmHg. Statistical analysis was performed through descriptive statistics, including mean, standard deviation, frequency, and percentage, Mann-Whitney test, Chi-square test, Fisher's exact test, linear and logistic regression in SPSS 21.0. P values < 0.05 were considered significant. Results: There was a significant association between blood hypertriglyceridemia in weeks 24-28 and anthropometric indices, including weight, height, and jaundice, in the first 24 hours of birth. Metabolic syndrome also had a significant relationship with jaundice (P=0.002). The results of linear regression analysis revealed that metabolic syndrome was positively associated with birth weight (B=0.18, P=0.003) and height (B=0.18, P=0.009). Among the components of metabolic syndrome, the results showed a direct relationship between increased blood triglyceride of the mother and newborn's weight (B=0.11, P=0.011) and height (B=0.14, P=0.007). Also, increased BMI had a significant direct relationship with the newborn's weight (B=0.11, P=0.023) and height (B=0.12, P=0.023). Moreover, decreased HDL had a significant reverse relationship with the newborn's weight (B=0.09, P=0.042). Conclusion: Presence of metabolic syndrome and its components in midpregnancy may influence neonatal outcomes, especially anthropometric indices. However, more studies should be conducted to further investigate these relationships.
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Affiliation(s)
- Hadis Sourinejad
- 1Department of Reproductive Health and Midwifery, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran
| | - Arezoo Shayan
- 2Departmnt of Midwifery, Fauclty Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shiva Niyati
- 1Department of Reproductive Health and Midwifery, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran
| | - Lida Moghaddam-Banaem
- 1Department of Reproductive Health and Midwifery, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran
,Corresponding author: Dr Lida Moghaddam-Banaem,
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Ebrahimi H, Emamian MH, Khosravi A, Hashemi H, Fotouhi A. Comparison of the accuracy of three diagnostic criteria and estimating the prevalence of metabolic syndrome: A latent class analysis. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2019; 24:108. [PMID: 31949459 PMCID: PMC6950349 DOI: 10.4103/jrms.jrms_858_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/26/2019] [Accepted: 08/28/2019] [Indexed: 12/16/2022]
Abstract
Background: Metabolic syndrome (MetS) is a growing public health problem with a worldwide distribution, and its prevalence is rapidly increasing worldwide. Hence, this study aimed to compare the prevalence of MetS based on the International Diabetes Federation (IDF), the National Cholesterol Education Program Expert Panel Adult Treatment Panel III (NCEP ATP III), and the American Association of Clinical Endocrinologists (AACE) diagnostic criteria. Materials and Methods: In this cross-sectional study, a total of 4737 people aged 45–69 years were enrolled in the 2nd phase of Shahroud Eye Cohort Study. We evaluated the prevalence of MetS with 95% confidence intervals by age and sex groups and according to MetS components. The accuracy (sensitivity and specificity) of these three methods was compared using latent class analysis. Finally, kappa statistic was used to determine the agreement between the diagnostic methods. Results: The prevalence of MetS varied from a minimum of 47.2% (as defined by the AACE) to a maximum of 60.0% (as defined by the IDF). The sensitivity of the three diagnostic methods of IDF, NCEP ATP III, and AACE was 98.9%, 94.4%, and 91.1%, respectively, and the specificity of these three methods was 94.6%, 97.0%, and 98.4%, respectively. Moreover, the highest agreement was found between the definition of the IDF and the NCEP ATP III. Conclusion: The IDF diagnostic method has a higher sensitivity for the diagnosis of MetS in Iranian middle-aged people. It is recommended to use this method for identifying more people at risk of MetS.
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Affiliation(s)
- Hossein Ebrahimi
- Randomized Controlled Trial Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ahmad Khosravi
- Center for Health-Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Das SR, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Jordan LC, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, O'Flaherty M, Pandey A, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Spartano NL, Stokes A, Tirschwell DL, Tsao CW, Turakhia MP, VanWagner LB, Wilkins JT, Wong SS, Virani SS. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation 2019; 139:e56-e528. [PMID: 30700139 DOI: 10.1161/cir.0000000000000659] [Citation(s) in RCA: 5363] [Impact Index Per Article: 1072.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Mansourian M, Babahajiani M, Jafari-Koshki T, Roohafza H, Sadeghi M, Sarrafzadegan N. Metabolic Syndrome Components and Long-Term Incidence of Cardiovascular Disease in Eastern Mediterranean Region: A 13-Year Population-Based Cohort Study. Metab Syndr Relat Disord 2019; 17:362-366. [DOI: 10.1089/met.2018.0136] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Marjan Mansourian
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
- Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Midia Babahajiani
- Student Research Committee, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tohid Jafari-Koshki
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamidreza Roohafza
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Long-term nuts intake and metabolic syndrome: A 13-year longitudinal population-based study. Clin Nutr 2019; 38:1246-1252. [DOI: 10.1016/j.clnu.2018.05.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 04/09/2018] [Accepted: 05/08/2018] [Indexed: 01/31/2023]
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Khoshdel AR, Eshtiaghi R. Assessment of Arterial Stiffness in Metabolic Syndrome Related to Insulin Resistance in Apparently Healthy Men. Metab Syndr Relat Disord 2019; 17:90-96. [PMID: 30620239 DOI: 10.1089/met.2018.0090] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Assessment of subclinical atherosclerosis in metabolic syndrome is one of the global health targets' priorities. This study aimed to evaluate the subclinical atherosclerosis in metabolic syndrome related to insulin resistance in healthy and physically active men. METHODS A consecutive group of 68 healthy men, 30-55 years of age, was studied. Anthropometric parameters, proinflammatory factors, and insulin level were measured, and pulse wave analysis (PWA) was performed by applanation tonometry and then processed with dedicated software (SphygmoCor®). The metabolic syndrome was defined according to International Diabetes Federation (IDF) and metabolic health as ≤1 component of metabolic syndrome according to the Joint Interim Statement criteria. RESULTS The odds ratio of insulin resistance for metabolic syndrome was 5.16 (95% confidence interval: 1.44-18.5), P = 0.008. In PWA, metabolically healthy subjects had lower aortic systolic and diastolic, and cardiac end-systolic pressures (103.5 ± 9.9 vs. 108.8 ± 11.0), P = 0.03, (76.2 ± 8.8 vs. 80.6 ± 7.8), P = 0.04, and (96.5 ± 9.2 vs. 101 ± 10.1), P = 0.05, respectively. Furthermore, metabolic syndrome was accompanied by higher ejection duration% (38.8 ± 3.5 vs. 36.9 ± 2.8), P = 0.04, and lower subendocardial viability ratio (SEVR) (139.8 ± 17.7 vs. 150.9 ± 17.6), P = 0.05. Insulin resistance was associated with higher cardiac end-systolic pressure (103.0 ± 6.9 vs. 96.7 ± 10.4), P = 0.015. CONCLUSION Metabolic risk factors had incremental correlations with central arterial pressures and cardiac end-systolic pressure. Furthermore, the composite of metabolic syndrome components imposed additional load on cardiac muscle by higher cardiac ejection duration and impairment in perfusion with lower Buckberg SEVR. Likewise, insulin resistance could be an early marker of arterial stiffness in healthy and active young to middle-age men.
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Affiliation(s)
- Ali Reza Khoshdel
- 1 Epidemiology Research Center, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
- 2 Department of Nephrology, John Hunter Hospital, University of Newcastle, New South Wales, Australia
| | - Radina Eshtiaghi
- 3 Division of Metabolic Diseases, Epidemiology Research Center, AJA University of Medical Science, Tehran, Iran
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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: 82] [Impact Index Per Article: 16.4] [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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Sepandar F, Rashidbeygi E, Maghbooli Z, Khorrami-Nezhad L, Hajizadehoghaz M, Mirzaei K. The association between resting metabolic rate and metabolic syndrome May Be mediated by adipokines in overweight and obese women. Diabetes Metab Syndr 2019; 13:530-534. [PMID: 30641760 DOI: 10.1016/j.dsx.2018.10.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 10/09/2018] [Indexed: 11/22/2022]
Abstract
AIMS Adipokines play a major role in developing metabolic syndrome (MetS), and it has been found that there is a significant relationship between MetS and resting metabolic rate (RMR) in obese people. The present study aimed to investigate the mediatory effect of adipokines on the RMR-MetS relationship. METHODS This cross-sectional study included 263 obese and overweight women, mean BMI 33.28 (4.93) kg/m, and mean age 39.02 (11.60) who were assessed for RMR using indirect calorimetry. Moreover, using the body composition analyzer the Body composition was measured. Also, Enzyme-linked Immunosorbent Assay (ELISA) test provided a quantitative measurement of biochemical parameters. RESULTS The results indicated that women in low RMR group had higher fat mass (P < 0.0001), FFM (P = 0.002), weight (P = 0.006), BMI (P < 0.0001), age (P = 0.01), and hs-CRP (P = 0.001). The results did not confirm any significant mediating roles for RBP4 (P = 0.051, β = -0.28) and Vaspin (P = 0.06, β = 0.32) in the RMR-MetS relationship. Additionally, after a binary regression test, Omentin-1 showed a significant mediating role (P = 0.25, β = 0.04) as an interrelated agent to RMR and MetS. CONCLUSION As this study shows, Omentin-1 was found to play a significant mediating role as a mediatory agent in relationship between RMR and MetS.
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Affiliation(s)
- Farnaz Sepandar
- Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
| | - Elaheh Rashidbeygi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
| | - Zhila Maghbooli
- Multiple Sclerosis Research Center, Sina Hospital, Tehran University of Medical Sciences, Iran
| | - Leila Khorrami-Nezhad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
| | | | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran.
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Asadi Z, Shafiee M, Sadabadi F, Saberi-Karimian M, Darroudi S, Tayefi M, Ghazizadeh H, Heidari Bakavoli A, Moohebati M, Esmaeily H, Ferns GA, Ghayour-Mobarhan M. Association Between dietary patterns and the risk of metabolic syndrome among Iranian population: A cross-sectional study. Diabetes Metab Syndr 2019; 13:858-865. [PMID: 30641822 DOI: 10.1016/j.dsx.2018.11.059] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 11/30/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND The role of dietary patterns in metabolic syndrome has not been investigated sufficiently among Iranian population. The aim of this study is to investigate the association of major dietary patterns with the risk of metabolic syndrome and its components among healthy individuals of Iran. METHODS This is a cross-sectional study that was performed on 5895 men and women who participated in MASHAD study project. Factor analysis was employed to determine major dietary patterns with regard to a validated 65-item food frequency questionnaire. Metabolic syndrome was diagnosed using international diabetes federation (IDF). Logistic regression analysis was used to evaluate the association between dietary patterns and metabolic syndrome risk to generate odds ratios (ORs) and 95% confidence intervals (CI). RESULTS Three major dietary patterns (Balanced, Western and high carbohydrate) were identified. The Western pattern showed a positive association with metabolic syndrome (OR [95%CI] for highest vs. lowest tertile: 1.58 [1.21-2.06]; p value = 0.001). The high carbohydrate dietary pattern was associated with higher metabolic syndrome risk (OR [95%CI] for highest vs. lowest tertile: 1.17 [1.02-1.33]; P value = 0.022). The Balanced dietary pattern was unrelated to metabolic syndrome, but was related to some individual risk factors for metabolic syndrome. CONCLUSIONS These results suggest that the Western and high carbohydrate patterns are associated with an increased risk for metabolic syndrome among Iranian adults. The causality of these associations needs to be confirmed.
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Affiliation(s)
- Zahra Asadi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mojtaba Shafiee
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Fatemeh Sadabadi
- Molecular Medicine Group, Department of Modern Science and Technologies, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
| | - Maryam Saberi-Karimian
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Susan Darroudi
- Molecular Medicine Group, Department of Modern Science and Technologies, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
| | - Maryam Tayefi
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Hamideh Ghazizadeh
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Alireza Heidari Bakavoli
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mohsen Moohebati
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Habibollah Esmaeily
- Social Determinants of Health Research, Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex, BN1 9PH, UK.
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Naseri R, Farzaei F, Haratipour P, Nabavi SF, Habtemariam S, Farzaei MH, Khodarahmi R, Tewari D, Momtaz S. Anthocyanins in the Management of Metabolic Syndrome: A Pharmacological and Biopharmaceutical Review. Front Pharmacol 2018; 9:1310. [PMID: 30564116 PMCID: PMC6288909 DOI: 10.3389/fphar.2018.01310] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 10/26/2018] [Indexed: 12/14/2022] Open
Abstract
The term "metabolic syndrome" (MetS) refers to a combination of diabetes, high blood pressure, and obesity. The origin of MetS includes a combination of multiple factors, such as sedentary lifestyle, unhealthy diet choice, and genetic factors. MetS is highly prevalent and adversely affects the general population by elevating risk of cardiovascular complications, organ failure, and much other pathology associated with late-stage diabetes. Anthocyanins (ANTs) are health-promoting bioactive compounds belonging to the flavonoids subclass of polyphenols. Numerous studies have reported the potential therapeutic benefits on MetS syndrome and diabetes from fruits rich in ANTs. This review summarizes the role of several dietary ANTs on preventing and managing MetS as well as the pharmacological mechanisms and biopharmaceutical features of their action. We also discuss potential nanoformulation and encapsulation approaches that may enhance the bioefficacy of ANTs in MetS. Experiments have demonstrated that ANTs may attenuate the symptoms of MetS via improving insulin resistance, impaired glucose tolerance, dyslipidaemia, cholesterol levels, hypertension, blood glucose, protecting β cells, and preventing free radical production. In brief, the intake of ANT-rich supplements should be considered due to their plausible ability for prevention and management of MetS. Additionally, randomized double-blind clinical trials are obligatory for evaluating the bioefficacy and pharmacological mechanisms of ANTs and their pharmaceutical formulations in patients with MetS.
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Affiliation(s)
- Rozita Naseri
- Internal Medicine Department, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Farzaei
- Pharmaceutical Sciences Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Pouya Haratipour
- Department of Chemistry, Sharif University of Technology, Tehran, Iran
- Phyto Pharmacology Interest Group, Universal Scientific Education and Research Network, Los Angeles, CA, United States
| | - Seyed Fazel Nabavi
- Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Solomon Habtemariam
- Pharmacognosy Research Laboratories, Medway School of Science, University of Greenwich, Kent, United Kingdom
| | - Mohammad Hosein Farzaei
- Pharmaceutical Sciences Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Khodarahmi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Devesh Tewari
- Department of Pharmaceutical Sciences, Faculty of Technology, Kumaun University, Nainital, India
| | - Saeideh Momtaz
- Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran
- Toxicology and Diseases Group, The Institute of Pharmaceutical Sciences, Tehran University of Medical Sciences, Tehran, Iran
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Ferns GA, Ghayour-Mobarhan M. Metabolic syndrome in Iran: A review. TRANSLATIONAL METABOLIC SYNDROME RESEARCH 2018. [DOI: 10.1016/j.tmsr.2018.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Tabatabaei-Malazy O, Djalalinia S, Asayesh H, Shakori Y, Esmaeili Abdar M, Mansourian M, Mahdavi Gorabi A, Noroozi M, Qorbani M. Menopause and metabolic syndrome in the Middle East countries; a systematic review and meta-analysis study. J Diabetes Metab Disord 2018; 17:357-364. [PMID: 30918871 PMCID: PMC6405407 DOI: 10.1007/s40200-018-0375-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/15/2018] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Metabolic syndrome (MetS) prevalence that is associated with increasing risk of diabetes and cardiovascular diseases (CVD) has accelerated with age. Since, menopause is known as a partial cause of CVD accelartion with againg among women, determining the prevalence of MetS is important in this condition. We aimed to assess critically the prevalence rate of MetS among menopaused women in the Middle East Countries in this systematic review meta-analysis study. METHODS & MATERIALS International webdata bases including Scopus, ISI web of Science and PubMed were systematically searched using Medical Subject Headings terms from January 2000 to February 2017. We included all cross-sectional conducted in the Middle East that reported prevalence of MetS in menopause status regardless of MetS definition. Quality assessment was considered for each included study. The pooled prevalence of MetS based on the Adult Treatment Panel III (ATP III) was estimated using random effect method due to between-study heterogeneity by STATA software, version 11.0 (StataCorp, USA). RESULTS Within 60 studies, 21 and 17 studies were included in qualitative synthesis and meta-analysis respectively. The prevalence of MetS among menopaused women was estimated 54.87% (95% CI: 53.76-55.97) in the Middle East countries. In sub-group analysis based on country the prevalence rate of MetS in Iran and Turkey was estimated 58.78% (95% CI: 57.54-60.02), and 39.02% (95% CI: 36.57-41.47), respectively. CONCLUSIONS MetS was highly prevalent as an alarming sign among menopaused women in the Middle East countries. Thus, it is an emergency requirement to promote healthy lifestyle. Also, early detection and treatment of women who reach menopause and are at great risk of developing MetS is necessary for prevention of diabetes and CVD in the region.
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Affiliation(s)
- Ozra Tabatabaei-Malazy
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Yalda Shakori
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Esmaeili Abdar
- Social Determinants of Health Research Center, Alborz University of Medical Science, Karaj, Iran
| | - Morteza Mansourian
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Armita Mahdavi Gorabi
- Department of Basic and Clinical Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Noroozi
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, ehran University of Medical Sciences, Tehran, Iran
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Rho kinase, a potential target in the treatment of metabolic syndrome. Biomed Pharmacother 2018; 106:1024-1030. [DOI: 10.1016/j.biopha.2018.07.060] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/08/2018] [Accepted: 07/10/2018] [Indexed: 12/11/2022] Open
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Lira Neto JCG, Oliveira JFDSF, Souza MAD, Araújo MFMD, Damasceno MMC, Freitas RWJFD. PREVALÊNCIA DA SÍNDROME METABÓLICA E DE SEUS COMPONENTES EM PESSOAS COM DIABETES MELLITUS TIPO 2. TEXTO & CONTEXTO ENFERMAGEM 2018. [DOI: 10.1590/0104-070720180003900016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022] Open
Abstract
RESUMO Objetivo: identificar a prevalência da Síndrome Metabólica e seus componentes em pessoas com Diabetes Mellitus tipo 2. Método: estudo transversal com 201 pessoas cadastradas e acompanhadas em Unidades de Saúde. Foram investigadas variáveis sociodemográficas, antropométricas, clínicas e às relacionadas à Síndrome Metabólica. A coleta de dados foi realizada nas Unidades Básicas de Saúde, durante a consulta de enfermagem. Resultados: a prevalência da Síndrome Metabólica de 46,3%, significativamente associada ao sexo feminino (p=0,001) e às pessoas com excesso de peso (p=0,001). Quando os componentes da síndrome foram analisados de forma isolada, as taxas de circunferência da cintura, glicemia de jejum, triglicerídeos e pressão arterial, se mostraram elevados em 62,0%, 58,5%, 55,8% e 49,8%, respectivamente. Já a taxa de HDL se mostrou baixa em 47,3%. Conclusão: com 46,3% dos investigados apresentando Síndrome Metabólica, atenção especial deve ser dada às mulheres e pessoas com excesso de peso, pois além de apresentarem percentuais significativamente maiores de Síndrome Metabólica, também apresentaram alterações nos principais componentes.
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Safarian H, Parizadeh SMR, Saberi-Karimain M, Darroudi S, Javandoost A, Mohammadi F, Moammeri M, Ferns GA, Ghayour-Mobarhan M, Mohebati M. The Effect of Curcumin on Serum Copper and Zinc and Zn/Cu Ratio in Individuals with Metabolic Syndrome: A Double-Blind Clinical Trial. J Diet Suppl 2018; 16:625-634. [PMID: 30020812 DOI: 10.1080/19390211.2018.1472711] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Metabolic syndrome is a complex disorder with high socioeconomic costs and a high global prevalence. The serum concentrations of some trace elements are higher in people with metabolic syndrome compared to normal individuals. Curcumin is derived from turmeric and has antioxidant and anti-inflammatory properties. Curcumin may therefore have a potential role in the management of cardiovascular risk. The aim of this study was to investigate the effects of curcumin on serum copper (Cu), zinc (Zn), and Zn/Cu ratio levels in patients with metabolic syndrome. A double-blind clinical trial was designed in which 120 individuals with metabolic syndrome were randomly assigned to one of three groups: curcumin 1gr/day, phospholipidated curcumin 1gr/day, or a placebo, each taken for 6 weeks. Serum copper and zinc were measured before and after intervention. At baseline, in addition to obtaining the anthropometric characteristics of participants, a fasting blood sample was taken from each participant, and the concentrations of serum Cu and Zn were measured by atomic absorption (Varian AA 240 FS model). Serum Zn concentrations rose significantly in the phospholipidated curcumin and curcumin groups, being significantly higher (p <.001) in the phospholipidated curcumin group than in the curcumin group (p <.05). Serum Zn concentration fell in the control group (p <.05). Changes in serum Zn level from baseline to the levels after six weeks' intervention were significantly different between the groups, but changes in serum Cu from between baseline until after intervention were not significantly different. The serum Zn/Cu level in phospholipidated curcumin and curcumin groups after intervention was higher than for the control group, but it was more significant in the group taking phospholipidated curcumin (p <.001). Curcumin and phospholipidated curcumin complex, given at a dose of 1 g per day for six weeks, were associated with an increase in serum zinc and consequently zinc-to-copper ratio.
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Affiliation(s)
- Hamide Safarian
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran
| | | | - Maryam Saberi-Karimain
- Student Research Committee, Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran
| | - Susan Darroudi
- Student Research Committee, Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran
| | - Ali Javandoost
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran
| | - Farzaneh Mohammadi
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran
| | - Malihe Moammeri
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran
| | - Gordon A Ferns
- Department of Medical Education, Brighton & Sussex Medical School , Falmer, Brighton , Sussex , UK
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran.,Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran
| | - Mohsen Mohebati
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran
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