Overweight and obesity: findings from 20 years of the Tehran lipid and glucose study

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

Legacy of the Tehran lipid and glucose study: chronic kidney disease

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

Hypertension awareness, treatment, control and prevalence in Zanjan Province, Iran

Hypertension is a frequent and treatable risk factor for cardiovascular, cerebrovascular, renal and peripheral arterial disease. There are simple criteria for its diagnosis and no expensive equipment arterial disease. There are simple criteria for its diagnosis and no expensive equipment is needed. This article aims to determine how many hypertensive subjects are aware of their disease, how many of them actually treat it, what they utilize to treat it, and finally how many complete treatments successfully. A cross-sectional descriptive study was conducted on 1000 people in Zanjan Province in 2007. Random stratified cluster sampling based on postal code was used to enroll people aged between 15 to 67 years old. Their blood pressures were measured three times by automated device in the sitting position from the right arm at home. Hypertension was defined as recorded blood pressure above 140/90mmHg or taking anti-hypertensive medications. Two hundred seventy-eight [27.8%] hypertensive patients were detected in our sample. The prevalence of hypertension after age adjustment was 18.7% [95%, CI, 16.1% - 21.3%] in Zanjan. Only 101 [36.3%] patients were aware of their disease, 38 [13.6%] of all hypertensives took medication, and the blood pressures of only 6 [2.1%] of all hypertensives were controlled. 70 [25.1%] used non-pharmacologic treatment and 27 [9.7%] used traditional medications. The potential for both better detection and treatment would appear to be huge in our region. Implementation of health care systems for this purpose is needed

Relative electropermeability and electric pulse effectiveness in human breast adenoeareinoma: an in vitro study

This study was carried out in order to evaluate the effects of electrochemotherapy, electrical pulses and chemotherapeutic drugs on the killing of cancerous cells and their probable synergistic effects. Electrochemotherapy treatments conducted on MCF-7 cell line derived from human breast adenocarcinoma tumor using four chemotherapeutic drugs including bleomycin, cisplatin, adriamycin and cyclophosphamide and six electrical doses. Cell survival assayed using MTT method, 72 hrs after the treatment; also the killing effects of each drug and electric dose determined. Finally, "Relative Pulse Effectiveness" and "Relative Electropermeability Effectiveness" calculated. All electrical doses decreased cell survival, significantly for bleomycin and cisplatin, however, they were only, significant in high concentration of cyclophosphamide and adriamycin. For the applied drugs, "Relative Electropermeability Effectiveness" was more than one [1.00], except for adriamycin. It seems that for the diffusion of molecules into cells, application of high duration electric pulses is more efficient for high molecular weight drugs while for low molecular weight drugs, strong pulses are more effective. In intermediate molecular weight, there is no difference between increasing the pulse strength and/or duration to achieve additional electropermeability. Electropermeability effect of different electric doses and electrochemotherapy efficiency can be evaluated by "REE" and "RPE", respectively