ABSTRACT
Context: the prevalence of overweight and obesity are increasing worldwide and have frequently been associated with health risks. This review highlighted several studies regarding obesity, outlining contributions of over a span of almost two decades in the Tehran Lipid and Glucose Study [TLGS]
Evidence Acquisition: a systematic review was undertaken to retrieve articles related to all aspects of obesity from the earliest available date up to January 30, 2017
Results: prevalence of excess weight, including overweight and obesity were 20.8 and 63.6% among those aged below and above 20 years, respectively. TLGS found a high incidence of obesity with higher incidence in women among Tehranian adults; the cumulative incidence of obesity was 31.3, 38.1 and 23.4% for the whole population, women, and men, respectively. In children and adolescents, younger non-obese 7 - 9 years old, compared to 10 - 11 year olds are at greater risk of obesity. Prevalences of abdominal obesity in men and women were 52.8% and 44.4% respectively. Similar to generalized obesity, a high incidence of abdominal obesity was observed; the total cumulative incidence of abdominal obesity was 76.0% [83.6% for men and 70.9% for women]. Metabolically healthy obese [MHO] and metabolically healthy abdominal obese [MHAO] are two important obesity phenotypes. People with these phenotypes have different risks for cardiovascular disease [CVD], type 2 diabetes [T2DM], and mortality. In the TLGS participants, MHO was found in 2% and 7.7% of the whole and obese population, respectively, whereas MHAO phenotype was reported in 12.4% and 23.5% of the whole and abdominal obese population. In these unstable conditions, during the long term follow up the metabolic risks developed in nearly half of the individuals. During a 12-year follow-up, incident CVD did not increase in the MHO phenotype compared to metabolically healthy normal weight [MHNW] individuals, but the risk of CVD events had increased in all metabolically unhealthy phenotypes. However in another report, over a 10-year follow-up, MHAO phenotype had an increased risk for CVD in comparison to the reference group, metabolically healthy non-abdominal obese [MHNAO] individuals
Conclusions: the TLGS studies bridged the significant gap in knowledge regarding prevalence, incidence, trends, morbidities and mortalities for obesity among Iranian population
ABSTRACT
Context: chronic kidney disease [CKD], is correlated with a substantial upsurge in mortality and morbidity worldwide. In this review, we aimed to review the 20-year-findings on CKD of the Tehran lipid and glucose study [TLGS]
Evidence Acquisition: we conducted a systematic review of all studies on CKD that had been performed in the context of TLGS
Results: age adjusted prevalence of CKD, according to estimated glomerular filtration rate [eGFR] assessed with the two abbreviated equations of the modification of diet in renal disease [MDRD] and the CKD epidemiology collaboration [CKD-EPI] were 11.3% [95% confidence interval [CI]: 10.7, 12.0] and 8.5% [95% CI: 7.9, 9.1], respectively. Using MDRD equation, over a mean follow up of 9.9 years, the incidence density rates of CKD were 285.3 person years in women and 132.6 per 10000 person-years in men. Studies on the TLGS population documented that abdominal adiposity defined as waist circumference [WC] categories [P for trend < 0.02] and waist gain inmen[hazard ratio [HR] = 1.7, CI: 1.3, 2.2] significantly affected CKD development. Also, CKD had a significant effect on coronary heart disease [CHD] only in participants with low body mass index [HR = 2.06; CI: 1.28, 3.31 and HR = 2.56; CI: 1.04, 6.31 in men and women, respectively]. Moreover, CKD was among the strongest independent predictors of stroke [HR = 2.01, CI: 1.22, 3.33]. Also, compared to diabetic patients, an abnormal ECG was more prevalent in moderate CKD [P = 0.02]
Conclusions: increased waist circumference and waist gain [only in men] were associated with developing CKD in the TLGS population. CKD was an independent predictor of CHD [in lean individuals] and stroke
ABSTRACT
To determine epidemiologic and metabolic characteristics of renal stone in the northern Iran. We prospectively analyzed demographic, clinical and metabolic findings in children less than 16 years old with renal stone revealed by ultrasonography from September 2003 to May 2012. Evaluations included serum and urine measurement of main elements predisposing patients to stone formation. 271 children [160 males] aged 2 months to 16-years [mean 30 months] were evaluated. 91 [33.6%] had a positive family history, abdominal discomfort [18.8%], UTI [11.8%] and hematuria [11.4%] were main presenting features. 45 children were diagnosed accidentally without any specific compliant. Nearly all [99%] stones lay in kidney., 35.1% had metabolic, 10% infective and 4.1% obstructive trends, 110 children had no definable etiology. Hypercalciuria [25.5%] hyperoxaluria [18.4%] and hypocitraturia [18.1%] were more frequent than uricosuria [8.5%] and cystinuria [3.1%]. Metabolic derangement plays significant role in stone formation in our area. Patients should be carefully evaluated considering this point of view
ABSTRACT
The patient was a 67-year-old female who presented with severe rectal bleeding since three days prior to hospital admission. She complained of mild abdominal pain. Rectal examination revealed the presence of fresh blood and a clot. She had a normal upper endoscopy. A colonoscopy showed a large clot with bloody secretions up to the cecum, with no obvious origin. Because of the severity of bleeding, a laparotomy was performed. Resection included large areas of the ileum and jejunum which were involved. Pathology report was remarkable for diffuse large B cell lymphoma.
ABSTRACT
This study examines the characteristics and agreement between different definitions of metabolic syndrome [MetS] and insulin resistance [IR]. A total of 347 non-diabetic individuals who were >/= 20 years of age were selected from the Tehran Lipid and Glucose Study [TLGS]. Subjects were categorized as having MetS by the Adult Treatment Panel III [ATP III] and the Joint Interim Statement [JIS]. IR was estimated by using the homeostasis model assessment [HOMA-IR]. According to ATP III and JIS criteria 38.9% and 38.2% of subjects had MetS respectively. The sensitivity of ATP III was 52.3% and specificity was 65%; for JIS the sensitivity was 52.3%, with a specificity of 66.5%. Kappa between ATP III or JIS and HOMA-IR was 0.14 and 0.16, respectively. Based on receiver operating characteristic [ROC] analysis, the use of waist circumference [WC] and fasting plasma glucose [FPG] for the diagnosis of IR in women showed a diagnostic accuracy equal to or instead of counting MetS components using modified ATP III or JIS. WC optimal cut points for prediction of IR were 93.5 cm for men and 92.5 cm for women. ATP III and JIS definitions have low sensitivities and specificities for detecting IR. There is poor agreement between these criteria and IR
Subject(s)
Humans , Male , Female , Insulin Resistance , Waist Circumference , Body Mass IndexABSTRACT
Background and Aim: Treatment of low-grade glioma [LLG] is one of the problems of neurosurgeon. According to reports, treatment of LGG tumors has been successful with stereotactic brachytherapy [SBT with temporary [125] Iodine seeds]. Due to the lack of reported experience in our country in this regard, this study was conducted on patients treated in Shohada-Tajrish Hospital between 2004 and 2011
Materials and Methods: This case series was conducted on consecutive patients with diagnosed LGG tumors treated with SBT [125 Iodine seeds]. Patients follow-up were at least 6 months. Survival of patients was assessed with the Kaplan-Meier method
Results: During the study period 8 patients [7 male and 1 female] with a mean age of 31.1 +/- 10.6 y were treated. One patient died due to respiratory and cardiac problems. The overall survival was 42% and 7 patients were alive by the last follow-up
Conclusion: It seems using SBT [temporary [125] Iodine seeds] in the treatment of LGG tumors is acceptable. It is recommended to compare the efficacy of this method in newly diagnosed patients compared with those who did not respond to the previous treatments