Outcomes of a longitudinal population-based cohort study and pragmatic community trial: findings from 20 years of the Tehran lipid and glucose study

Context: the Tehran lipid and glucose study [TLGS] is one of the oldest population-based longitudinal cohort studies, providing knowledge about the incidence and risk factors of some non-communicable diseases [NCDs] in West Asia which hitherto was relatively scarce. We reviewed the methods and results related to the outcome measurements of this study

Evidence Acquisition: we reviewed all the TLGS papers which reported the incidence of NCDs

Results: the TLGS was initiated in 1999 - 2001 on a population in district no. 13 of Tehran with the same age distribution of the overall Tehran population and with a middle socioeconomic status. Totally, 15005 individuals, aged >/= 3 years, participated in the first examination; reexaminations were conducted in a triennial manner and 3550 individuals were added in the second examination. All participants were also followed up annually and asked about any medical event leading to hospitalization or death. A part of participants was assigned to an educational program for lifestyle modification. High incidence of cardiovascular disease [CVD], premature CVD, diabetes and hypertension [around 19, 6, 10 and 31 in men and 11, 5, 11 and 29 in women per 1000 person-year, respectively] besides the high incidence of pre-diabetes and pre-hypertension [around 46 and 76 in men and 37 and 49 in women per 1000 person-year, respectively] showed a worrying situation. Fortunately, the results of the community interventions were promising with around 20% reduction in the risk of metabolic syndrome up to six years

Conclusions: these precise detections of different outcomes in the TLGS provided valuable evidences for prediction and prevention of NCDs in Iran with some novelties in the middle-income countries in the world. The Tehran thyroid study [TTS] and the Tehran cardiometabolic genetic study [TCGS], conducted in the framework of the TLGS, are among few studies aiming to determine the natural course of thyroid function and to identify patterns of genetic polymorphisms related to cardiometabolic outcomes, respectively

Effect of the receptor activator of nuclear factor [ka]B and rank ligand on in vitro differentiation of cord blood CD133[+] hematopoietic stem cells to osteoclasts

Objective: receptor activator of nuclear factor-kappa B ligand [RANKL] appears to be an osteoclast-activating factor, bearing an important role in the pathogenesis of multiple myeloma. Some studies demonstrated that U-266 myeloma cell line and primary myeloma cells expressed RANK and RANKL. It had been reported that the expression of myeloid and monocytoid markers was increased by co-culturing myeloma cells with hematopoietic stem cells [HSCs]. This study also attempted to show the molecular mechanism of RANK and RANKL on differentiation capability of human cord blood HSC to osteoclast, as well as expression of calcitonin receptor [CTR] on cord blood HSC surface

Materials and Methods: in this experimental study, CD133[+] hematopoietic stem cells were isolated from umbilical cord blood and cultured in the presence of macrophage colony-stimulating factor [M-CSF] and RANKL. Osteoclast differentiation was characterized by using tartrate-resistant acid phosphatase [TRAP] staining, giemsa staining, immunophenotyping, and reverse transcription-polymerase chain reaction [RT-PCR] assay for specific genes

Results: hematopoietic stem cells expressed RANK before and after differentiation into osteoclast. Compared to control group, flow cytometric results showed an increased expression of RANK after differentiation. Expression of CTR mRNA showed TRAP reaction was positive in some differentiated cells, including osteoclast cells

Conclusion: presence of RANKL and M-CSF in bone marrow could induce HSCs differentiation into osteoclast

Lentiviral vectors titration using real-time PCR

Lentiviral vectors [LVs] are useful vehicle for genetransfer to dividing and non-dividing cells and genetic manipulations. However, the use of lentiviruses in studies requires an accurate titration technique.Quantitative real-time PCR [qPCR] is a sensitive technique for the indication and quantitation of retrovirals particles. In this study, we used the qPCR for lentiviral vector titeration. The puromycin resistance gene as templates for an SYBR green-based real-time qPCR method and detect lentiviral copy number integrated lentiviral DNA. Consequently, this studyshowed that theusing ofantibioticresistance genesviral particles titration maybeefficient with highly accuracy

Differentiation of human mesenchymal stem cells into insulin producing cells by using A lentiviral vector carrying PDX1

Type I diabetes is an immunologically-mediated devastation of insulin producing cells [IPCs] in the pancreatic islet. Stem cells that produce beta-cells are a new promising tool. Adult stem cells such as mesenchymal stem cells [MSCs] are self renewing multi potent cells showing capabilities to differentiate into ectodermal, mesodermal and endodermal tissues. Pancreatic and duodenal homeobox factor 1 [PDX1] is a master regulator gene required for embryonic development of the pancreas and is crucial for normal pancreatic islets activities in adults. We induced the over-expression of the PDX1 gene in human bone marrow MSCs [BM-MSCs] by Lenti-PDX1 in order to generate IPCs. Next, we examine the ability of the cells by measuring insulin/c-peptide production and INSULIN and PDX1 gene expressions. After transduction, MSCs changed their morphology at day 5 and gradually differentiated into IPCs. INSULIN and PDX1 expressions were confirmed by real time polymerase chain reaction [RT-PCR] and immunostaining. IPC secreted insulin and C-peptide in the media that contained different glucose concentrations. MSCs differentiated into IPCs by genetic manipulation. Our result showed that lentiviral vectors could deliver PDX1 gene to MSCs and induce pancreatic differentiation

On the estimation of survival time and contributory risk factors in the elderly participants in the Tehran lipid and glucose study. A 10-year follow-up

In the increasing population of the elderly in Iran, so far no prospective health studies have been undertaken. This study was conducted to identify the risk factors of survival time of the elderly of ages above 60 years

Material and Methods: Individuals above 60 years old were recruited in the primary phase of the Tehran Lipid and Glucose Study [TLGS] during 1998-2001. They were followed up for 10 years and their vital status were registered [1998-2008]. Age and sex mortality rates for age groups [60-69, 70-79, 80+] were calculated and by using Cox proportional hazard model the hazard rates were estimated

Results: Out of 929 males, 154 [17%] and out of 869 women 85[10%] died during the follow-up years. Cox model showed that diabetes on an average reduces 4.4 years and 2.5 years and smoking reduces 5 and 6.6 years of males' and females' survival time, respectively. BMI>33Kg/m2 and dis-lipoproteinemia reduce 4.5 years and 4 years of women's life span. Tehranian native men on an average live 3 years shorter than other male residents. In addition, hypertension and history of MI, stroke or sudden death of father, brother or son reduce 3.3 years and 4.1 years of men's life time

Conclusion: The elderly population is in need of a healthy ageing to be gained from prevention and intervention. Identification of life time reducing risk factors of elderly helps the policymakers to develop some protocols to increase the life span of the population