Body Weight Misperception and Psychological Distress Among Children and Adolescents: The CASPIAN-V Study

OBJECTIVES: Misperception of weight status is a risk factor that affects psychological health. The aim of this study was to evaluate the association between weight misperception patterns and psychological distress among Iranian children and adolescents. METHODS: This was a cross-sectional nationwide study where data was collected from 14,440 students, aged 7–18 years who participated in the national school-based surveillance program (CASPIAN-V). The students’ weight perception and psychological distress were assessed by validated questionnaires. Weight misperception was classified as misperception of being either underweight or overweight with respect to actual weight. RESULTS: The rate of weight misperception in all study participants was 59.1%. In groups with a perception of being underweight or overweight, the risks of worthlessness, being worried, experiencing aggression, insomnia, or depression, were significantly higher than groups with an accurate weight perception (p < 0.05). The risk of anxiety in girls of normal weight who perceived themselves as underweight, decreased by 57% compared to girls with an accurate weight perception (OR: 0.43; 95% CI, 0.28–0.66). CONCLUSION: Weight misperception is highly prevalent among Iranian children and adolescents and is associated with their psychological health status. Appropriate education intervention needs to be developed to improve the children and adolescents’ perception of their body weight status.

Is the association of continuous metabolic syndrome risk score with body mass index independent of physical activity? The CASPIAN-III study

BACKGROUND/OBJECTIVES: Although the association of body mass index (BMI) with metabolic syndrome (MetS) is well documented, there is little knowledge on the independent and joint associations of BMI and physical activity with MetS risk based on a continuous scoring system. This study was designed to explore the effect of physical activity on interactions between excess body weight and continuous metabolic syndrome (cMetS) in a nationwide survey of Iranian children and adolescents. SUBJECTS/METHODS: Data on 5,625 school students between 10 and 18 years of age were analyzed. BMI percentiles, screen time activity (STA), leisure time physical activity (LTPA) levels, and components of cMetS risk score were extracted. Standardized residuals (z-scores) were calculated for MetS components. Linear regression models were used to study the interactions between different combinations of cMetS, LTPA, and BMI percentiles. RESULTS: Overall, 984 (17.5%) subjects were underweight, whereas 501 (8.9%) and 451 (8%) participants were overweight and obese, respectively. All standardized values for cMetS components, except fasting blood glucose level, were directly correlated with BMI percentiles in all models (P-trend < 0.001); these associations were independent of STA and LTPA levels. Linear associations were also observed among LTPA and standardized residuals for blood pressure, high-density lipoprotein, and waist circumference (P-trend < 0.01). CONCLUSIONS: Our findings suggest that BMI percentiles are associated with cMetS risk score independent of LTPA and STA levels.

nationwide survey on the daily screen time of Iranian children and adolescents: the Caspian - IV study

Leisure time activity is an important life-style habit. This study aims to determine the screen time of a nationally representative sample of Iranian children and adolescents. This nationwide cross-sectional study was conducted as part of the fourth survey of a surveillance system. The participants consisted of 14880 students, with aged range from 6 to 18 years, living in 30 provinces in Iran. Screen time, i.e. the time spent on watching television [TV]/video and computer games during leisure time, was assessed by using the questionnaire of the Globasl Student Health Survey of the World Health Organization. The study participants were 13486 school students [participation rate of90.6%] with a mean age of12. 47 [3.36] years. Overall, 75.6% of students were from urban and 24.4% from rural areas and 50.8% were boys respectively. Overall, 33.4% and 53% of students watched TV/video more than 2 h a day in their leisure time during school days and holidays, respectively. Likewise, 6.3% and 10.9% of students used computer more than 2 h a day in their leisure time during the school days and holidays, respectively. Overall, 47.1% of urban students and 24.2% of rural students used personal computer in their leisure time during the school days. The corresponding figures were 50.8% and 27.2% in weekends and holidays, respectively. The time spent on screen activities is long in a considerably high number of Iranian children and adolescents. It should be reduced by increasing the public awareness and by providing facilities for regular daily physic activity for students' leisure times

Association of overweight and obesity with mental distress in Iranian adolescents: the CASPIAN-III study

Excess weight may be associated with mental distress and this relationship varies according to the socio-cultural background of different populations. This study aims to assess the relationship of overweight and obesity with some psychological disorders in a nationally representative sample of Iranian adolescents. This nationwide study was conducted in 2009-2010 among 5570 students, aged 10-18 years, living in 27provinces in Iran. Data were collected by using the translated and validated questionnaire of the World Health Organization Global School-based Health Survey. Data of 5528 students [49.7% girls] were complete for this study. Their mean age was 14.7 [2.4] years. Overall 7.9% of participants were overweight and 8.8% were obese. 58.7% of students had anxiety, without significant association of overweight [odds ratio [OR]: 0.86, 95% confidence interval [CI]: 0.68-1.09] and obesity [OR: 1.11, 95% CI: 0.88-1.40] with an anxiety. Nearly 62.6% of students reported to have depression, there was no significant relationship between overweight [OR: 1.11, 95% CI: 0.86-1.43] obesity and [OR: 1.01, 95% CI: 0.79-1.29] with the depression. About 49.4% of students had insomnia, without significant association of overweight [OR: 1.17, 95% CI:, 0.91-1.51] and obesity [OR: 0.91, 95% CI: 0.71-1.17] with the insomnia. In Iranian adolescents, excess weight did not increase the risk of psychological distress. This finding might be due to the positive attitude of family and peers to fatness in adolescence

Frequency, causes, and places of unintentional injuries in a nationally representative sample of Iranian children and adolescents: the CASPIAN-IV study

This study aims to assess the frequency, causes, and places of injuries in a nationally representative sample of Iranian children and adolescents, as well as the referral, places allocated for injured individuals. This nationwide study was conducted in 2011-2012 among 13486 elementary, secondary and high-school students who were selected by random cluster stratified multistage sampling from 30 provinces in Iran. The Global School-based Health Survey questionnaire of the World Health Organization was used. The study participants consisted of 50.8% boys, 75.6% urban resident with a mean age of 12.5 years. Overall, 20.25% of participants reported that they were minimally injured once in the last 12 months; this prevalence was higher in boys than in girls [25.74% vs. 14.58%, respectively, P < 0.001], without significant difference in urban [20.11%] and rural [20.69%] areas. Most of them [39.92%] were injured at homes or house yards with higher prevalence in girls than in boys [48.61% vs. 35.17%, respectively, P < 0.001] and in rural than in urban areas [27.30% vs. 20.89%, respectively, P < 0.001]. Schools were reported as the second prevalent site of injury occurrence [22.50%]. Emergency departments and physician offices were the most prevalent referral places for injured individuals [32.31% and 22.38%, respectively]. Most of the school injuries occurred during play or sport activities [45.92%]. Prevention of unintentional injuries should be considered as a health priority. Appropriate preventive strategies should be enhanced at homes and schools

Relationship of serum magnesium and vitamin D levels in a nationally-representative sample of Iranian adolescents: the CASPIAN-III study

This study aims to assess the relationship of serum Mg and vitamin D levels in a nationally-representative sample of Iranian adolescents. The study participants consisted of 330 students, aged range from 10 to 18 years, consisting of an equal number of individuals with and without hypovitaminosis D. The correlation between serum 25 hydroxy vitamin D [25[OH] D] and magnesium [Mg] concentrations was determined. The mean age of participants was 14.74 +/- 2.587 years, without significant difference between those with hypovitaminosis D and those without it. The mean 25[OH] D level was 6.34 +/- 1.47 ng/ml in the group with hypovitaminosis D and 39.27 +/- 6.42 ng/ml in the group without it. The mean Mg level was 0.80 +/- 0.23 mg/dl with lower level in the group with hypovitaminosis D than in others [0.73 +/- 0.22 mg/dl vs. 0.87 +/- 0.22mg/dl, respectively] and according to t-test analysis, significant lower levels in the deficient group was observed [P = 0.0001]. The linear regression analysis showed the meaningful relationship between Mg and 25[OH] D serum levels [P = 0.0001]. Our study revealed significant associations between serum Mg and 25[OH] D levels. This finding may be of use for further studies on the prevention and management of hypovitaminosis D in children and adolescents. Further longitudinal studies shall evaluate the underlying mechanisms and the clinical significance of the current findings

nationwide survey on some hygienic behaviors of iranian children and adolescents: the caspian-iv study

This study aims to assess the frequency of some hygienic behaviors that is, tooth brushing and hand-washing, in Iranian school students at national level. This nationwide study was conducted in 2011-2012 among 14,880 elementary, secondary and high school students who were selected by random cluster stratified multistage sampling from 30 provinces in Iran. We used the global school-based health survey questionnaire of the World Health Organization. The population of this survey consisted of 13,486 children and adolescents [participation rate of 90.6%] including 49.2% girls and 75.6% urban inhabitants. The mean age of participants was 12.5 years [12.3-12.6, 95% confidence interval] According to the self-report of students, 26.9% of them [20.2% of boys and 33.9% of girls] brushed their teeth more than once a day, 37.8% of boys and 42.1% of girls brushed their teeth once a day. In general, girls brushed their teeth more than boys. The frequency of those students who never brushed their teeth was twice in rural than in urban students [11.4% vs. 6.2%, respectively]. In total, 3.4% of the students stated that their school had not an appropriate place for washing hands after toilet, with three-fold higher frequency in rural than in urban schools [6.8% vs. 2.3%, respectively]. 85% of students [87% of girls vs. 83% of boys] reported that they had always washed their hands after toilet, 10.1% did it occasionally and 4.1% did not. This nationwide survey revealed that Iranian students have an acceptable level of hygienic behaviors both in urban and rural areas; however, still it is necessary to improve school health facilities and hygienic habits in Iranian students

Goiter Frequency Is More Strongly Associated with Gastric Adenocarcinoma than Urine Iodine Level

PURPOSE: We designed our study to evaluate the hypothesis that gastric cancer is correlated with iodine deficiency or thyroid dysfunction. MATERIALS AND METHODS: We investigated the total body iodine reserve, thyroid function status and autoimmune disorder in 40 recently diagnosed gastric adenocarcinoma cases versus 80 healthy controls. The participants came from a region with high gastric cancer rate but sufficient iodine supply due to salt iodination. The investigation included urine iodine level, thyroid gland clinical and ultrasonographic examination, and thyroid function tests. RESULTS: Goiter was detected more frequently in the case group (P=0.001); such a finding, however, was not true for lower than normal urine iodine levels. The free T3 mean level was significantly lower in the case group compared to the control group (P=0.005). CONCLUSIONS: The higher prevalence of goiter rather than low levels of urinary iodine in gastric adenocarcinoma cases suggests that goiter, perhaps due to protracted but currently adjusted iodine deficiency, is more likely to be associated with gastric adenocarcinoma compared to the existing iodine deficiency itself.

Serum Sodium and Potassium Levels in Cerebro-vascular Accident Patients

Background: We aim to assess serum sodium and potassium levels in patients with different types of cerebro-vascular accidents (CVA) in comparison to control group. Methods: A comparative cross-sectional study conducted on patients admitted to the emergency department from January to August 2012. Control group consisted of patients admitted to emergency department due to common cold, urinary tract infection, low back pain, cluster, and tension headache or migraine. Serum sodium and potassium levels were measured via standard laboratory methods. Results: There were 77 patients in control group and 78 in CVA group. Forty nine patients from the CVA group had ischemic CVA, 11 had hemorrhagic CVA and 18 suffered a transient ischemic attack (TIA). Serum sodium level in control group was significantly lower than in patients with TIA, ischemic CVA, and hemorrhagic CVA (P < 0.001). Serum potassium level in control group was higher than patients with TIA, ischemic CVA, and hemorrhagic CVA (P < 0.001). Patients with hemorrhagic CVA showed significantly lower serum potassium level than patients with TIA and ischemic CVA (P < 0.001). Correspondingly, it was observed that serum sodium to potassium ratio was higher in patients with TIA, ischemic CVA, and hemorrhagic CVA (P < 0.001). In patients with hemorrhagic CVA serum sodium to potassium ratio was higher when compared to patients with TIA and ischemic CVA (P < 0.001). Conclusion: This study shows that higher serum sodium and lower serum potassium level may be associated with higher incidence of CVA. Further studies are paramount to elucidate the role of serum electrolyte levels in vascular events.

Methodology and early findings of the fourth survey of childhood and adolescence surveillance and prevention of adult non-communicable disease in Iran: the CASPIAN-IV study

The fourth survey of the surveillance system named ''childhood and adolescence surveillance and prevention of adult non-communicable disease'' [CASPIAN-IV study], was conducted among a national representative sample of Iranian students. This paper describes the methods and early findings of this survey. This nationwide school-based study was conducted in 2011-2012 in 30 provinces of Iran among 13,486 students, 6-18 years [6640 girls, 75.6% from urban areas] and one of their parents. Mean age of students was 12.5 years. Based on the World Health Organization growth curves, 12.2% were underweight, 9.7% overweight and 11.9% were obese. Abdominal obesity was observed in 19.1% of students. The dominant type of cooking oil in urban families was liquid oil and hydrogenated fat [39% and 32%], most rural families used hydrogenated fat [53%], respectively. A total of 18% of students had at least 30 min of daily physical activity; 41% of students used computer in weekdays and 44% used it in weekends. Almost 34.5% of students reported to have at least one cigarette smoker and 21.5% reported to have a waterpipe smoker in their relatives. Moreover, 20.3% of students reported that they had suffered an injury needing the help of school health providers during the year prior to the study. Current evidence on the health risky behaviors among Iranian children and adolescents confirms the importance of conducting comprehensive surveillance surveys to identify health risk behaviors. Data of this survey and the trend of variables provide necessary information for health policy makers to implement action-oriented interventions

Changes of bone density in pediatric patients with beta-thalassemia major after allogenic hematopoietic stem cell transplantation

Thalassemia major and its treatment by stem cell transplantation can have deleterious effects on bone integrity. This study assesses the adverse effects of transplantation on growing bones of pediatric thalassemic patients. Bone mineral density [BMD] of 20 patients from three thalassemia classes whose mean [SD] age was 7.4 [3.8] years were tested with a Norland XR-46 device at baseline [before transplantation], 6 and 12 months after transplantation. At 6 and 12 months after transplantation we observed no significant changes in mean BMD. There were no Z-scores less than -2 among patients. Class 3 thalassemia did not negatively impact BMD. Calcium [Ca], phosphorous [P] and ferritin levels were not significantly related to patients' BMD scores. Transfusion duration and chelation therapy showed positive significant relationships to BMD [g/ cm2], but no significant relation with the BMD Z-score. The deleterious relation between corticosteroid use and changes in BMD was not significant. In contrast, patients who developed acute graft versus host disease [aGVHD] after transplantation showed significant adverse effects on BMD of their femur [P = 0.020] and spine [P = 0.027]. Stem cell transplantation in pediatric thalassemic patients who do not develop aGVHD does not appear to have any significant positive or negative effects on BMD

First report on self-rated health in a nationally-representative sample of Iranian adolescents: the Caspian-III study

To evaluate predictive factors of adolescents' appraisal of their health. The nationwide study, entitled "Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Diseases [CASPIAN] study," was conducted in 2010 among Iranian school students, aged 10-18. In addition to demographic factors and physical examination, variables as family structure, nutrition habits, physical activity, smoking, hygienic habits, violence, school attachment, family smoking, and family history of chronic diseases were assessed. The dependent variable is the self-rated health [SRH] and it was measured by 12 items, which had already been combined through latent class analysis. We had taken a dichotomous variable, i.e. the higher values indicate better SRH. The dependent variable was regressed on all predictors by generalized additive models. 75% of adolescents had a good SRH. The linear and smooth effects of independent variables on SRH were observed. Among all the variables, physical activity had a positive linear effect on SRH [beta = 0.08, P value = 0.003]. Smoking, violence, and family history of disease associated to SRH non-linearly [P value < 0.05]. Family smoking [beta = -0.01] and hygienic habits [beta = 0.27] related to SRH both linearly and non-linearly. Physical health and high risk behavior, either of linear or non-linear effect, are factors, which seem to shape the adolescents' perception of health

Tooth brushing and cardiometabolic risk factors in adolescents: Is there an association? The CASPIAN-III study

A growing body of evidence supports an association between oral health and cardiovascular diseases and diabetes in adults. This study aimed to investigate the relationship between tooth brushing frequency and cardiometabolic risk factors in adolescents. This nationwide population-based study was conducted among 5258 Iranian students, aged 10-18 years, living in urban and rural areas of 27 provinces in Iran. The association of tooth brushing frequency was assessed with anthropometric indexes and cardiometabolic risk factors after adjustment for potential confounders. Higher frequency of tooth brushing was associated with lower mean levels of low-density lipoprotein cholesterol [LDL-C] in both genders [P < 0.0001] and lower frequency of elevated LDL-C in girls [P = 0.03]. The frequency of elevated blood pressure decreased with higher tooth brushing frequency in boys [P = 0.03]. After adjustment for many potential cofounders such as age, gender, anthropometric indexes, screen time, socioeconomic status, and family history of non-communicable diseases, participants who washed their teeth at least once a day had lower risk of high LDL-C and low high-density lipoprotein cholesterol [HDL-C] levels in comparison to those who reported lower frequency of tooth brushing; some different associations were observed among girls and boys. Our findings suggest an independent and protective role of teeth brushing frequency for some cardiometabolic risk factors in adolescents. Increasing both the general health awareness and improving oral health should be considered in primordial and primary prevention of non-communicable diseases

effect of fetal liver-derived cell suspension allotransplantation on patients with diabetes: first year of follow-up

Stem cell-based therapies have recently opened up new horizons for treatment of various types of diseases including diabetes mellitus. However, long-term efficacy and safety of these novel modalities still remain a serious question. Hereby, we aim to report the one-year follow-up results in the diabetic patients who underwent fetal liver-derived hematopoietic stem cell allotransplantation. Fifty six patients with type one [n=30] and type two [n=26] diabetes, aged 10-58 years old [32.8 +/- 16.3] were divided into the intervention and placebo group. The patients in the intervention group underwent fetal liver-derived hematopoietic stem cell transplantation while the patients in the placebo group received 5 ml of normal saline both via an intravenous route. The patients were visited at regular intervals to evaluate the efficacy of transplantation in glycemic control as well as possible complications. In the 6[th] month of the follow-up, there was a significant decrease in HbA[1]c levels in all groups without any rise in the fasting c-peptide. However, none of the precipitants transiently or continuously became insulin free in the first year after transplantation. It can be concluded that, in this study, fetal liver-derived hematopoietic stem cell transplantation had no significant effects on glycemic control. The heterogeneity of our patients might account for the negative results. Hence, longer follow-up results will be reported in the near future.

Methodology and early findings of the third survey of CASPIAN study: a national school-based surveillance of students' high risk behaviors

A school-based surveillance system entitled the childhood and adolescence surveillance and prevention of Adult No communicable disease [CASPIAN] Study is implemented at national level in Iran. This paper presents the methods and primary findings of the third survey of this surveillance system. This national survey was performed in 2009-2010 in 27 provinces of Iran among 5570 students and one of their parents. In addition to physical examination, fasting serum was obtained. Body mass index was categorized based on the World Health Organization growth charts. Data of 5528 students [2726 girls, 69.37% urban, mean age 14.7 +/- 2.4 years] were complete and are reported. Overall, 17.3% [17.3% of girls and 17.5% of boys] were underweight, and 17.7% [15.5% of girls and 19.9% of boys] were overweight or obese. Abdominal obesity was documented in 16.3% of students [17.8% of girls and 15% of boys]. 57.6% of families consumed breads, the staple food for Iranians, prepared with white flour. Most families [43.8% in urban areas and 58.6% in rural areas] used solid hydrogenated fats. 22.7% of students did not add salt to the table food. 14.2% of students reported to have a regular daily physical activity for at least 30 min a day. Overall, 10.4% of students [11.7% in urban areas and 7.3% in rural areas] reported that they used tobacco products, often water pipe. 32.8% of students experienced at least three times of bullying in the previous 3 months. During the year prior to the survey, 14.46% of students had an injury needing the interference by school health providers. This survey is confirmatory evidence on the importance of establishing surveillance systems for risk behaviors to implement action-oriented interventions

Development and evaluation of a questionnaire for assessment of determinants of weight disorders among children and adolescents: the caspian-IV study

Little experience exists on valid and reliable tools for assessment of the determinants of underweight and overweight in children and adolescents living in the Middle-East and North Africa [MENA]. This study aimed to develop a valid and wide-ranging questionnaire for assessment of these parameters in a nationwide sample of Iranian children and adolescents. This national study was conducted in 31 provinces in Iran. The first phase consisted of focus group discussion with 275 children and adolescents and their parents. After a qualitative content analysis, the initial items were extracted. In the next step, the face validity was assessed by expert panelists using the quantitative method of the Impact Score. To assess the content validity, the content validity rate [CVR] and the content validity index [CVI] were determined. The internal consistency was examined by Cronbach alpha, and its test-retest reliability was determined. The socio-demographic variables, perinatal factors, lifestyle factors, family history, knowledge and attitude were assessed. Dietary intakes were assessed using a validated 168-item semi-quantitative food frequency questionnaire. A validated questionnaire for quality of life was filled in anonymously. A team of expert researchers conducted the data analysis of 576 interviews by using qualitative content analysis method. The analysis process began by determining the semantic units associated with the understanding of participants about the concepts studied. The initial questionnaire was developed in four domains by including Likert scale questions. In the face validity step, all questions of the primary questionnaire obtained a score of more than 1.5. In the phase of CVR assessment, 6 questions obtained a score of less than 0.62, and were omitted. The rest of questions were assessed for CVI, and got a score of more than 0.75. Cronbach's alpha coefficient of the whole questionnaire was 0.97, and the Pearson correlation coefficient of the test-retest phase was 0.94. The developed questionnaire is a valid and reliable tool for assessment of the determinants of weight disorders in a nationally representative sample of children and adolescents in the MENA

Adverse reactions following immunization with MMR vaccine in children at selected provinces of Iran

Several adverse events following immunization [AEFI] have been attributed to immunization with live attenuated measles, mumps, and rubella [MMR] vaccines. The MMR vaccine was introduced into the routine infant immunization schedule in 2003, followed by a second dose of vaccine at school-entry for children 4 to 6 years of age. The objective of this study was to characterize adverse reactions following MMR vaccination in Iran. Children who received the MMR vaccine and resided in five selected provinces of Iran were examined weekly for four weeks to detect well-known AEFIs that included: parotitis, fever and convulsions, convulsions without fever, encephalopathy, and anaphylactic reactions. Incidence of AEFIs were calculated and compared among recipients in both age groups. During the follow-up period, trained providers reported 792 AEFIs. Parotitis was the most frequent event occurring in 1.8% of recipients. Of 14, 109 children vaccinated at 12 months of age the following AEFIs occurred: parotitis [147], fever and convulsions [8], convulsions [7], encephalopathy [1], and anaphylactic reactions [1]. Of 29,338 children vaccinated to 4 to 6 years of age, parotitis, fever and convulsions, encephalopathy, and anaphylaxis occurred in 626, 5, 1, and 1 child, respectively; no convulsions without fever were reported in this age groups. Parotitis is the most frequent AEFI among MMR vaccine recipients in Iran. Incidence rates of AEFIs following MMR vaccination in Iran are similar to rates of AEFIs reported in other studies

relationship between survivin expression in thyroid follicular adenoma and carcinoma

Survivin is one of the eight members of the human inhibitors of apoptosis [IAP], which appears to be differentially expressed in cancer cells. This study was conducted to evaluate the clinical usefulness of survivin immunostaining to distinguish between follicular adenoma and carcinoma of thyroid. This study was a cross-sectional descriptive-analytical research. The study population was tissue samples from surgery patients at Shariati Hospital in Tehran, Iran. All samples were studied through immunohistochemical staining for survivin. Survivin expression was significantly [p<0.005] higher in patients with follicular carcinoma diagnosis than those with adenoma. Odds ratio of follicular carcinoma for survivin expression was reported to be 21.375 [95% CI: 3.283-139.177]. The study indicated that survivin can play an effective role in distinguishing follicular thyroid adenoma from follicular thyroid carcinoma

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