Usefulness of Neck Circumference, Waist-to-Height Ratio and Waist-to-Hip Ratio in Predicting Non-Alcoholic Fatty Liver Disease in Saudi Population Without Type 2 Diabetes.

Background: Early identification and treatment of non-alcoholic fatty liver disease (NAFLD) could reduce overall mortality. Anthropometric measurements offer a simple and cost-effective method to potentially improve early detection of NAFLD and prevent its complications. This study aims to estimate the prevalence of NAFLD using the fatty liver index (FLI) and evaluate the effectiveness of certain anthropometric measurements in predicting NAFLD as diagnosed by FLI. Method: A cross-sectional analytical study was conducted with 1264 Saudi population without Type 2 diabetes mellitus (T2DM) non-alcoholic individuals at primary health care centers (PHCCs) in Jeddah city. Measurements included triglycerides, gamma-glutamyl transferase (GGT), glycated hemoglobin (HbA1c), and fasting plasma glucose (FPG). Measurements for neck circumference (NC), and calculations for weight-to-height ratio (WHtR) and weight-to-hip ratio (WHpR), along with FLI, were performed. NAFLD was identified in individuals with an FLI ⩾60. The receiver operating characteristic (ROC) curve analysis was utilized to assess the accuracy of WHtR, WHpR, and NC in detecting NAFLD, with Youden's index determining the optimal cutoff points for these 3 indices. Result: The prevalence of NAFLD was found to be 30.9%. Among the markers, WHtR emerged as the most significant in indicating NAFLD, achieving an area under the curve (AUC) of 0.916; whereas NC and WHpR exhibited identical AUC values of 0.783. WHtR demonstrated superior diagnostic efficacy for identifying elevated FLI, with gender-specific cutoff values established at >0.57 for females and >0.61 for males. In all 3 markers, females exhibited higher sensitivity, specificity, and negative predictive value (NPV) compared to males. Conclusion: WHtR could serve as a useful tool in the initial clinical screening for NAFLD among Saudi population without T2DM to identify those who may benefit from more comprehensive testing. Further local studies are warranted to confirm the levels of accuracy and the calculated cutoffs.

Perceived COVID-19 Severity, Risk of Infection, and Prevention Self-Efficacy in Saudi Arabia During Lockdown: A Population-Based National Study.

Evidence shows that the risk perception of humans can significantly affect their response to a threat. This population-based, cross-sectional study explored the determinants of perceived disease seriousness, perceived disease infectiveness, and perceived prevention self-efficacy of coronavirus disease (COVID-19), during the lockdown period, using the health belief model for preventive behavior (HBMPB) among 4423 adults in Saudi Arabia from 13 provinces. Multivariate binary regression was used to analyze the independent factors of three risk perception variables and to measure their effect on adherence to preventive measures. Overall, COVID-19 seriousness was perceived to be higher than that of diabetes and lower than that of a heart attack, while its infectiousness was perceived to be high by 75.3% of the participants. Furthermore, 66.6% had a low perception of their prevention self-efficacy. The HBMPB showed independent effects of all three risk perception parameters on adherence to the preventive measures, including perceived seriousness (Odd's ratio [OR] = 1.26; 95% confidence interval [95% CI] = 1.01-1.56), infectiousness (OR = 1.90; 95% CI = 1.52-2.38), and prevention self-efficacy (OR = 1.51; 95% CI = 1.20-1.91). Authorities should maintain an optimal level of communication on the COVID-19 risk, communicate more about the virus' cycle and the disease to demystify the rationale of the preventive measures, and enhance confidence in their efficiency.

Burden of COVID-19 infection and lockdown measures on individuals with chronic diseases in Saudi Arabia: A national population-based study.

BACKGROUND: The recent COVID-19 crisis has placed a huge strain on the global health and economy. The toll of the damage on the human society exceeds the morbidity and mortality of the pandemic and the associated burden, considering the multidimensional impact on all aspects of life. OBJECTIVES: The present study assessed the specific impact of COVID-19 on individuals with chronic diseases including the Years Lost for Disability (YLD) burden of COVID-19 infection, and multidimensional impact on the disease management, adaptive lifestyle, and socioeconomic dimensions. METHOD: A national, population-based cross-sectional study was conducted among adult Saudi population. An internet-based questionnaire was used to collect sociodemographic characteristics, medical history, impact of COVID-19 lockdown on the management of the chronic disease, adaptive lifestyle, and impact of COVID-19 on family members. Additionally, data regarding eventual COVID-19 infection, severity and management were collected. YLD was estimated and normalized per 100,000 persons. RESULT: Having a chronic disease was not associated with a greater risk of COVID-19 (relative risk [RR]=0.83, p = 0.153); however, it was associated with higher risk of declined physical activity (RR=1.30, p < 0.0001), deteriorated eating habit (RR=1.20, p = 0.002), sleep quality (RR=1.25, p < 0.0001), and overall health perception (RR=1.61, p < 0.0001), loss of family members due to COVID-19 (RR=1.96, p = 0.0001), and impacted household income (RR=1.11, p = 0.010). In case of COVID-19 infection, having a chronic disease was associated with increased risk of hospitalization (RR=5.04, p = 0.005) and having a moderate-to-severe form of COVID-19 (RR=6.00, p = 0.013). The overall YLD was estimated to be 17.7 per 100,000 individuals, and there was no significant difference between individuals with chronic diseases and those without. CONCLUSION: COVID-19 entailed a substantial burden on the Saudi society in 2020, and individuals with preexisting chronic diseases suffered more important multidimensional impact, which need further research to assess the real impact of the pandemic and draw the pertinent lessons from the experience for future possible epidemics.

Burden of Middle East respiratory syndrome coronavirus infection in Saudi Arabia.

MERS-coronavirus infection is currently responsible for considerable morbidity and mortality in Saudi Arabia. Understanding its burden, as an emerging infectious disease, is vital for devising appropriate control strategies. In this study, the burden of MERS-CoV was estimated over 31months period from June 6, 2012 to January 5, 2015. The total number of patients was 835; 528 (63.2%) patients were male, 771 (92.3%) patients were ≥25 years of age, and 210 (25.1%) patients were healthcare workers. A total of 751 (89.9%) patients required hospitalization. The median duration between onset of illness and hospitalization was 2 days (interquartile range, 0-5). The median length of hospital stay was 14 days (IQR, 6-27). The overall case fatality rate was 43.1%. Basic reproductive number was 0.9. Being Saudi, non-healthcare workers, and age ≥65 years were significantly associated with higher mortality. In conclusion, MERS-CoV infection caused a substantial health burden in Saudi Arabia.

The characteristics of dental occlusion in patients with moderate to severe obstructive sleep apnea in Saudi Arabia.

OBJECTIVES: To evaluate characteristics of dental occlusion among non-obese Saudi adult patients suffering from moderate to severe obstructive sleep apnea(OSA). METHODS: Following ethical approval, a cross-sectional study was conducted at Sleep Disorders Center, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, between January and March 2017. Non-obese adult Saudi patients with moderate/severe OSA (apnea-hypopnea index more than 15) and without history of malocclusion or edentulism were included with an estimated sample size of 50. Demographic details and severity of OSA as diagnosed by polysomnography were recorded. Characteristics of dental occlusion, namely molar, canine and incisor relationship, overjet, overbite, crossbite and arch form were obtained through calibrated examiners (kappa 0.81). Descriptive statistical analysis and Chi-square test, with 95% significance level (p less than 0.05), were used to identify relationships between the severity of OSA and characteristics of dental occlusion. RESULTS: A total of 51 patients (31 males, 20 females; mean age 49.45±10.35 years), were enrolled in the study. Severity of OSA was moderate in 17 patients and severe in 34 patients. Severe form of OSA was more among males (64.7%) and in patients with Class-II division-1 incisor relationship (94.1%). Neither the demographic characteristics, nor characteristics of dental occlusion showed statistically significant relationship with the severity of OSA. CONCLUSION: The results of the present cross-sectional study indicate that the characteristics of dental occlusion are not related to the severity of OSA among non-obese adult Saudi patients.

Prevalence of lifestyle practices that might affect bone health in relation to vitamin D status among female Saudi adolescents.

BACKGROUND: Prevention of osteoporosis begins in childhood and adolescence, as most bone mass is accumulated during the first 2 decades of life, with 90% to 95% of an adult's bone mineral content being achieved by the end of adolescence. Therefore, targeting modifiable behaviors among adolescents has an important effect on attaining adequate peak bone mass and minimizing risks for future fractures. OBJECTIVES: The aims of this study were to estimate the prevalence of behaviors affecting bone health and vitamin D status and to identify factors associated with vitamin D deficiency among female Saudi adolescents. METHODS: Several modifiable risk factors that influence bone health include low consumption of dairy products, physical inactivity, insufficient sun exposure, smoking, excessive consumption of soft drinks and caffeine, and vitamin D deficiency. A cross-sectional analytical study was conducted in secondary schools in Jeddah City with 421 randomly selected female adolescents. A predesigned questionnaire was used for data collection, and blood samples were collected to measure levels of vitamin D. A χ2 test and correlation coefficient were used to identify the association between vitamin D and the independent variables. Mean (SD) age was 17.2 y (+1.2 y). Mean vitamin D level was 46 nmol/L (+24.6 nmol/L), ranging from 10.8 to 150.8 nmol/L. RESULTS: The adolescents reported low consumption of dairy products, low prevalence of sun exposure, and low physical inactivity. Prevalence of vitamin D deficiency was 67.5%, and insufficiency was 21%. There were no significant associations between vitamin D status and sociodemographic characteristics; coffee and tea intake; anthropometric measurements; and calcium and/or vitamin D supplementation. Intake of dairy products was significantly positively correlated with vitamin D levels. CONCLUSIONS: This study indicated that female Saudi adolescents are at significant risk for developing osteoporosis on the basis of the prevalence of risky behaviors, including low consumption of dairy products, high consumption of soft drinks, deficiency in physical exercise, low sun exposure, and high prevalence of vitamin D deficiency and insufficiency.

Prevalence and predictors of hepatitis B in Jeddah City, Saudi Arabia: a population-based seroprevalence study.

INTRODUCTION: Despite solid preventive strategies to reduce the risk of hepatitis B virus (HBV) infection, recent reports about its prevalence and predictors are lacking in several Saudi cities at the community level. This study aimed to assess the seroprevalence of HBV and to identify the most important predictors among the Saudi population in Jeddah city, Saudi Arabia. METHODOLOGY: A cross-sectional study was conducted among 5,584 Saudi people attending primary health-care centers in Jeddah city during 2012/2013. Sociodemographic and hepatitis-related data were collected. HBV was diagnosed by ELISA test. The seroprevalence of HBV was estimated, and appropriate statistical analyses were performed, including univariate and multivariable regression analyses. RESULTS: The seroprevalence of HBV was 2.2% (95% CI = 1.82-2.58) in the studied participants. The prevalence was higher among non-governmental workers (3.5%), male participants (3.4%) and those aged ≥ 25 years (2.4%). The most important predictors for increasing the risk of HBV in this study were HBV contacts, male sex, history of dental procedures and blood transfusion. The significant positive risks associated with these predictors were 3.3, 2.5, 2.0 and 1.65, respectively. HBV vaccination, on the other hand, was associated with a significant risk reduction of 88% (OR = 0.12; 95% CI = 0.03-0.51). CONCLUSIONS: The seroprevalence of HBV was relatively low among the Saudi population in Jeddah city reflecting the actions taken by health authorities to control HBV infection. However, more efforts, particularly in relation to health education programmes, strict control of blood banks and dental clinics, are still needed.