Prevalence of dyslipidemia in Iran: a systematic review and meta-analysis study

More than 80% cardiovascular disease [CVD] is preventable despite the fact that it is currently the ultimate cause of disability in the world. Assessment of the nationwide prevalence of dyslipidemia as a major CVD risk factor is essential to efficiently conduct prevention programs. We extracted data according to the cut-off points of dyslipidemia used in each study. All published papers on this topic in Iranian and international journals with affiliation of [Iran] were reviewed using standard keywords up to September 2011. We included all available population-based studies and national surveys conducted in individuals aged > 15 years. We excluded studies with < 300 individuals, non-population-based studies, or duplicated citations. We analyzed by random effect method due to between-study heterogeneity. The estimated prevalence and 95% confidence intervals in 29 eligible articles and one un-published data for hypercholesterolemia [>/= 200 mg/dl], hypertriglyceridemia [>/= 150 mg/dl], high levels of low density lipoprotein cholesterol [[LDL-C] [>/= 130 mg/dl]] and low levels of high density lipoprotein cholesterol [[HDL-C] <40 mg/dl in males, <50 mg/dl in females], in Iranian people were 41.6% [36.1-47.0], 46.0% [43.3-48.7], 35.5% [24.0-47.1] and 43.9% [33.4-54.4], respectively among both sexes and in both rural and urban areas. Hypercholesterolemia, high LDL-C and low HDL-C were more prevalent in women, whereas hypertriglyceridemia was more prevalent in men. All types of lipid component abnormalities were more prevalent in urban residents. Prevalence of dyslipidemia is considerable in Iran. It is necessary to enforce current measures of dyslipidemia control in the Iranian people to reduce CVD burden

Association of vitamin D receptor with longevity and healthy aging

Longevity is a multifaceted trait in which variety of genes and environmental factors are involved. Newly, the role of vitamin D has been revived regarding its potential advantage on delaying the aging process. Vitamin D exerts its effect through vitamin D receptor [VDR]. VDR-FokI is the only polymorphism which alters the VDR length. We examined the frequency of FokI genotypes in old age population as compared to young adults to determine the discerning genotype of FokI polymorphism leading to longer living. In addition, to highlight the position of FokI polymorphism in quality of life; a cognitive function assessment was performed. 728 participants participated in this study of which 166 individuals were elderly residents of Kahrizak Charity Foundation. The rest were participants of Iranian Multicenter Osteoporosis Study [IMOS]. Genomic DNA was extracted from peripheral blood and VDR genotype was detected by the polymerase chain reaction. The participants in the elderly group underwent a cognitive function assessment. Cognitive function was measured with the mini mental state examination [MMSE]. Data were analyzed by SPSS 16.5. The prevalence of ff genotype showed 48% decrease in elderly population as compared to young adults [P=0.06]. In addition, F allele was over-represented in the elderly group as compared to controls [P=0.05]. Also, "FF" participants of elderly group had higher MMSE as compared to "ff" genotype [18.16Vs17.12]. Our data suggest that single nucleotide polymorphisms [SNPs] in FokI may be possibly involved in longevity and cognitive function

[Adiponectin and markers of subclinical atherosclerosis in early type 2 diabetes: Evaluation of carotid artery intima-media thickness and coronary artery calcium score]

The aim of this study was to assess the association of serum adiponectin and a set of traditional cardiovascular risk factors with carotid artery intimal-medial thickness [CIMT] and coronary artery calcium score [CACS], as markers of subclinical atherosclerosis in subjects with early type 2 diabetes mellitus. Carotid artery intima- media thickness [measured by B-mode ultrsonogra-phy], coronary artery calcium score [determined by high resolution computed tomography], serum adiponectin, Fasting blood sugar, serum lipids, body mass index [BMI], systolic blood pressure, diastolic blood pressure and mean arterial pressure were measured in 123 asymptomatic newly diagnosed cases of type 2 diabetes mellituss and 152 age and sex matched healthy control subjects. Serum adiponectin and lipids were significantly lower in those with type 2 diabetes mellitus [P<0.01]. Left, right and mean carotid artery intima- media thickness, coronary artery calcium score, fasting blood sugar, systolic blood pressure, diastolic blood pressure and mean arterial pressure were significantly higher among diabetic patients compared to healthy controls [P<0.05]. Mean carotid artery intima- media thickness was positively and independently related to age [P<0.001] and triglyceride [P=0.01] in diabetic group. Coronary artery calcium score was associated positively with age [P=0.004] and inversely with high density lipoprotein [HDL] cholesterol [P=0.002] among diabetics. Although adiponectin was lower in diabetics compared to controls, it had no significant association with carotid artery intima- media thickness and coronary artery calcium score as markers of subclinical atherosclerosis. In patients with type 2 diabetes in addition to age, serum triglyceride levels are correlated with carotid artery intima- media thickness, while HDL cholesterol is inversely correlated with coronary artery calcium score

[ association between high blood pressure and cognitive impairment in elderly: a brief report]

Epidemiological studies have reported positive, negative, U-shaped or J-shaped association between high blood pressure and cognitive function as well as dementia whereas other studies have not reported any significant association. The aim of this study was to examine the association between hypertension and cognitive impairment in the elderly residents of Kahrizak Charity Foundation [KCF]. This cross sectional study was done in Kahrizak Charity Foundation in suburban areas of Tehran, Iran during 2008. The data were collected over one week. Among the 850 elderly residents of the Foundation who were >/= 65 years old, 185 individuals were chosen randomly. The Mini-Mental State Examination [MMSE] was completed for all. Mean of all blood pressure readings were recorded while anthropometric and biochemical measurements were performed. The findings indicated that in participants with cognitive impairment, systolic blood pressure, diastolic and mean blood pressures were higher than people with normal cognitive function but the differences were not significant statistically. The odds ratio of cognitive impairment in patients with and without hypertension was 1.52 and 1.58, respectively [P>0.05]. This study did not show any significant association between hypertension and cognitive impairment in the elderly residents of Kahrizak Charity Foundation

[ role of homocysteine in health and disease]

High plasma homocysteine is identified as an important risk factor for cardiovascular disease. Epidemiological studies have shown that increased plasma homocysteine is related to a higher risk of coronary heart disease, stroke and peripheral vascular disease. Homocysteine may have an effect on atherosclerosis by damaging the inner lining of arteries and promoting blood clots. Folic acid and other B group vitamins help break down homocysteine in the body and fortification of foods reduces the average homocysteine level in the population. Low blood levels of folate are also linked with a higher risk of fatal coronary heart disease and stroke. Homocysteine levels are strongly influenced via diet, as well as via genetic factors. Many common genetic disorders and problems [such as vitamin deficiency] adversely affect the metabolism of homocysteine. Common causes of a high homocysteine level include dietary of folate and B group vitamins, hypothyroidism, kidney disease, psoriasis, and some medicines. Clinical trials to have not provided consistent evidence that lowering homocysteine levels reduce strokes, heart attacks and other cardiovascular events; notwithstanding it is recommended to lower a high homocysteine level because it is a risk factor for heart disease, Homocysteine abnormalities also contribute to birth defects and dementia and folic acid supplementation in the pre-conceptual period is effective in preventing recurrent and primary neural tube defects

[ effect of folate fortified bread on homocysteine, folate and vitamin B12 status among hyperhomocysteinemic subjects: Tehran homocysteine study]

Fortification of corn with folic acid has beneficial effects on hyperhomocysteinemia and heart disease. Folate fortification was contributed to an increase in average folate status and a reduction in serum homocysteine concentration. In this randomized clinical trial 17 men and women aged 61 +/- 5 years old with hyperhomocysteinemia with mean homocysteine concentration of 15/32 +/- 6/13 micro mol/L were recruited. Subjects received fortified bread which contained 100 micro g folic acid daily for 8 weeks. Three-day food record, food frequency questionnaire and BMI [Body Mass Index] data at baseline and week 8 were completed. Plasma homocysteine and serum folate at baseline and week 8 were measured. All dietary and statistical analyses were undertaken using Nutritionist III and SPSS release 15.0 software with paired t-test. Mean plasma homocysteine concentration decreased significantly in hyperhomocysteinemic subjects after daily consumption of folate fortified bread for 8 weeks [P<0.001].After 8 weeks serum folate concentration increased%26 [P=0.06]. Mean BMI, energy and other components of dietary intake did not change significantly. Dietary vitamin C decreased significantly [P<0.001]. Daily consumption of folic acid fortified bread, with 100 micro g folic acid, in hyperhomocysteinemic subjects for 8 weeks led to significant decrease in plasma homocysteine and an increase in serum folate

Cardiovascular health education of families: the importance of school-based prevention strategies

Many people do not have sufficient knowledge about cardiovascular risk factors in Iran. We used a school-based educational intervention program to promote the health knowledge in all participating families. A total of 1100 fifth-grade school children and their parents were invited; 603 families were included in the study. The children attended a single session and were supplied with family information packages. Pre- and post-test questionnaires were completed by these families before and after the session. There was a significant increase in the overall cardiovascular risk factor knowledge of families [P<0.001]. The parents of boys achieved a greater level of health knowledge in comparison to the parents of girls [P<0.005]. This school-based educational intervention was effective in improving cardiovascular risk factor knowledge of families. Similar programs with more comprehensive methodology could be more effective in promoting healthy behaviors

Homocysteine levels and its correlation to metabolic syndrome in 25-64 years old residents of the Tehran medical university population lab

Homocysteine is regarded as a risk factor for metabolic syndrome and cardiovascular diseases. It is of great importance to determine exact risk factors of these disorders because of their high prevalence. The 25-64 year old individuals in 17th district of Tehran were studied. It was designed according to the WHO MONICA [Multinational Monitoring of Trends and Determinants in Cardiovascular Disease] project using the ATP III criteria. Homocysteine levels higher than 15 mmol/l and Folate and vitamin B12 lower than 11 nmol/l and 185 pmol/l, respectively were considered as abnormal. Of the whole population, prevalence of abnormal homocysteine, Folic acid and vitamin B12 was 54.5%, 98.2% and 27%, respectively. Homocysteine levels were higher in men than women [P= 0.026]. None of the differences between the means of these three risk factors were statistically significant in people with and without the metabolic syndrome. The only significant difference was higher homocysteine levels in women with metabolic syndrome [P= 0.010]. According to this study, hyperhomocysteinemia and Folate and vitamin B12 deficiency are more prevalent in our population. But there was no correlation between these factors and risk of metabolic syndrome. Because of the controversy about this issue and high prevalence of cardiovascular diseases in our country, further studies are suggested

Determinants of total plasma homocysteine concentration in healthy Iranian adults: the Tehran homocysteine survey [2003-2004]

Elevated total plasma Homocysteine, is an independent risk factor for cardiovascular disease. Folate and vitamin B12 have not only a protective effect on cardiovascular disease but also an essential effect on total Homocysteine concentrations [tHcy]. This survey has been conducted to evaluate the determinants of tHcy in 1191 healthy Iranian adults. This study which was a part of the Cardiovascular Risk Factors Survey in the Population Lab Region has been designed and conducted based on MONICA/WHO project. A total of 1191 people have been recruited and assessed on serum Homocysteine, Folic acid and vitamin B12, triglycerides, cholesterol, HDL-C, LDL-C, FBS, BMI, BP and smoking, with interview, questionnaires, examination and blood sampling. Blood samples were analyzed according to standard methods. The variables were assessed in 1191 participants include 416 men [34.9%] and 775 women [65.1%]. Prevalence of hyperhomocysteinemia was correlated significantly with male sex and aging. Hcy levels were inversely related to serum Folate and vitamin B12 concentrations. After further adjustments, we detected a positive correlation between tHcy and age, male sex, smoking and BMI, and a negative one with LDL-C and diabetes. Although there was a correlation between tHcy and blood pressure, after age, sex, BMI and smoking adjustment, it just remained significant in women and with systolic blood pressure. We found that dietary and lifestyle parameters such as Folate intake and smoking habit are the main determinants of distribution of plasma Homocysteine in an apparently healthy population. We assumed that lifestyle changes could have considerable subsequences in public health. Our findings confirm the potential advantages of dietary improvements and increased intake of nutrients along with smoking cessation in order to prevent cardiovascular diseases in high-risk patients

Knowledge, practice status and trends in risk factors for cardiovascular disease in inhabitants of Tehran University of medical sciences [population lab region]

Cardiovascular diseases are described as the most important health problems in developing countries which are developed in parallel with industrialization of communities. Based on the high morbidity and mortality of cardiovascular disease, this study was performed for examining the population lab inhabitants' knowledge and practice. In this cross - sectional study, 1576 inhabitants of the Population Lab Region were studied by cluster random sampling in 2002. 181 persons were selected from this population. The frequency of each cardio- vascular diseases risk factor such as; hyperlipidemia, smoking, obesity, hypertension, Diabetes, family history of heart attack, being man, stress and excitement, sedentary life style, salty food, vegetables fruits, fatty food and red meat consumption, were assessed. In addition, the population study's practice regarding controlling the risk factors of cardiovascular diseases was determined, as well. Moreover, specific questionnaire and direct interview were used for collecting data and then the gathering data was analyzed by SPSS and EPI - Info soft wares. In this study, 71.8% of people were women while 28.2% of them were men. Besides, there was a significant relationship between the people's knowledge about cardiovascular disease and the level of their education [P < 0.001]. According to the results, 65.2% of population believed that heart attack was the most prevalent cause of death in comparison with 44% of them considered car accident and 13.3% agreed with cancers. On the other hand, 74% of people used liquid oil in their food and 77.9% of them knew the side effects of unhealthy foods such as; salty food as one of the cardiovascular risk factors. The inhabitants' knowledge regarding to the risk factors of cardiovascular diseases was approximately acceptable. However, there was a significant different between their knowledge and practice. Therefore, providing suitable educational programs for improving people's nutrition, physical activity and the other relevant factors for preventing cardiovascular risk factors would be mentioned

[Cardiovascular screening of children and parents in high-risk families]

Background: cardiovascular disease is one of the major leading cause of death in Iran. There is a strong association between parental history of cardiovascular disease clustering of risk factors in the offspring. Detection and treatment of cardiovascular risk factors since childhood is essential to reduce the incidence of disease in adulthood. This study was performed to identify major cardiovascular risk factors in middle school-aged children and their parents in high risk compared to control families

Methods: the middle schools of the 6th of Tehran were divided randomly into two groups. A total of 169 high-risk children with their families were recruited from the first group while 105 control children with their families were recruited from the second group of schools. Coronary risk factor survey was performed in the participants

Results: prevalence of increased total- and LDL-cholesterol and high FBS were higher in high-risk parents and children. Prevalence of increased BMI was higher in fathers and children of high-risk families. More fathers in high-risk families were smoker. The means of waist circumference and WHR were significantly higher in high-risk fathers. The means of total- and LDL- cholesterol were significantly higher both in parents and children of high-risk group. The means of FBS were significantly higher in fathers and offspring of high-risk families

Conclusion: cardiovascular risk factors are more prevalent and clustered in high-risk families. Screening of these families is essential to prevent progression of cardiovascular disease since childhood and reduce its burden in adulthood

[Obesity and associated cardiovascular risk factors in Iranian children]

Background: obesity is a serious public health problem in developing countries due to its association with the cardiovascular risk factors. Childhood obesity is responsible for a number of different complications both during childhood and adulthood. The aim of the present study was to determine the cardiovascular risk factors in overweight and obese Iranian children

Methods: we screened 13086 children aged 7-12 years by measuring waist circumference. Those with a waist circumference 261 cm were selected for further evaluation. Antjfropometric measurements were'done and blood samples were taken from 563 enrolled ovenveightlobese children [284 boys and 279 girls]. We determined cardiovascular risk factors [including fasting total cholesterol, LDL-C, HDL-C, triglycerides, blood pressure]. In addition we measured the fasting blood .sugar, insulin, apo-A , apo-B and leptin levels

Results: only 2.7% of overweight or obese children had no risk factors. While, 20.6% had one and 70.85% had two or more risk factors. The prevalence of high total Cholestrol levels was 42.6%. HDLC showed an acceptable level in 92.4%of children .There were strong correlations between BMI and serum apoB and leptin levels [p<0.005]

Conclusion: the high prevalence of cardiovascular risk factors in overweight and obese Iranian children emphasizes the need for prevention and control of childhood obesity from early childhood in our country

[ clinical trial of silybum marianum seed extract [silymarin] on type ii diabetic patients with hyperlipidemia]

Background: previous clinical and experimental studies suggest the valuable effect of antioxidants on lipids status. The present study was designed to investigate the efficacy of silymarin treatment as an antioxidants on lipids profile in type II diabetic hyperlipidemic patients

Methods: a 4-month randomized double blind clinical trial was conducted in 54 non-insulin dependent diabetic hyperlipidemic patients in a two well - matched groups. First group [n=29] received 200mg silymarin tablet 3 times a day plus standard therapy, while the control group [n=25] received placebo tablet 3 times a day plus standard therapy. The patients were visited monthly and fasting blood glucose, total cholesterol, LDL, HDL cholesterol, triglyceride, SGOT and SGPT were determined at the beginning and at the end of the study after four months

Results: results revealed that in silymarin treated patients, fasting blood glucose, LDL and total cholesterol, triglycerid, SGOT, SGPT and glucose level at the end of the study were significantly decreased as compared to beginning of the study. In placebo treated patients fasting blood glucose level at the end of the study were significantly increased as compared to beginning of the study

Conclusion: in conclusion, the silymarin as an herbal antioxidant have beneficial effects on reducing glucose and lipids profile in type II diabetic patients