Association of body mass index with serum calcium and phosphate levels.

OBJECTIVE: It has been shown that several environmental and physiological factors can affect on the serum levels of calcium and phosphate. The objective of the present study was explored the relationship between serum calcium and phosphate levels with anthropometric and hematological markers. METHODS: 908 subjects were recruited from the Mashhad stroke and heart atherosclerosis disorder (MASHHAD) program. Anthropometric parameters, liver/kidney function tests (e.g., Urea nitrogen, creatinine, urea and uric acid, creatinine, AST, ALT) were determined in all participants. Serum concentrations of calcium and phosphate were measured using Autoanalyzer BT3000P (Pars Azmoon kit, Tehran, Iran). SPSS software was used for statistical analyses. RESULTS: We observed that obese subjects had a lower level of serum calcium (p˂0.05). Moreover, a relationship was detected between serum phosphate level and different menopausal status (p˂0.05). Serum calcium and phosphate did not change by increasing age in the population. Additionally, there was a correlation between lymphocyte count with serum phosphate level (p˂0.05). No statistically different were detected for the levels of calcium/phosphate with respect to smoking status, physical activity, lipid profile, liver and renal function markers. CONCLUSION: We found an association between serum calcium and BMI as well as with serum phosphate and menopausal status.

Interaction between a variant of CDKN2A/B-gene with lifestyle factors in determining dyslipidemia and estimated cardiovascular risk: A step toward personalized nutrition.

BACKGROUND & AIMS: Several genome-wide-association-studies have identified genetic variants in a region on chromosome 9p21 that are associated with an increased risk of Cardiovascular disease (CVD) and diabetes. Here we have explored the interaction of a genetic variant of the CDKN2A/B-rs10811661 gene locus with cardiovascular risk factors and environmental-exposures (e.g., diet and physical activity) in 1165 individuals recruited from the Mashhad-Stroke and Heart-Atherosclerotic-Disorders cohort. METHODS: Genotyping was carried out using TaqMan-real-time-PCR based method. The association of CDKN2A/B-rs10811661 locus and its interaction with dietary intake in association with the main determinants of dyslipidemia, and cardiovascular-risk-factors were assessed in 2 cohorts. RESULTS: Our data showed that obese subjects with a TT genotype had a higher level of TG, TG/HDL ratio and Hs-CRP, compared to the subjects with the wild type genotype, or individuals with a normal BMI. Moreover, the presence of a TT genotype was associated with increased risk of hypercholesterolemia, insulin resistance and CVD. These effects were more pronounced in the sub-group with low physical activity and a high dietary energy intake (e.g., the interaction between TT genotype and total energy intake on serum cholesterol was positive (RERI: 0.2, 95%CI (-0.96-1.3), AP: 0.1, 95%CI (-0.5-0.7) and SI: 1.2, 95%CI (0.3-5.1))). CONCLUSIONS: We have found a significant association between the CDKN2A-rs10811661 polymorphism with cardiovascular risk factors and dyslipidemia in a non-diabetic population. It is possible that a low energy diet and high physical activity could ameliorate the unfavorable effects of T allele of CDKN2A/B locus. Functional analysis is warranted to investigate the value of this genetic biomarker of CVD risk in obese people.

Association of a Vascular Endothelial Growth Factor genetic variant with Serum VEGF level in subjects with Metabolic Syndrome.

BACKGROUND: The metabolic syndrome (MetS) is a clustering of metabolic disorders that is associated with an increased risk of developing cardiovascular-disease, diabetes, and related diseases. Against this background, Vascular Endothelial Growth Factor (VEGF) plays an essential role in angiogenesis, vascular permeability, and hematopoiesis and its increased level is reported to be associated with increasing the risk of developing cardiovascular-disease, stroke and diabetes. Therefore the aim of present study was to explore the association of serum VEGF level and its associated genetic-polymorphism, rs10738760 (A>G) at 9p24.2, in 850 subjects with/without MetS. METHODS: MetS was defined according to the International-Diabetes-Federation criteria. Genotyping was carried out using Polymerase chain reaction-amplification refractory mutation system. Anthropometric/biochemical parameters, including FBG, Triglyceride, HDL, TC, etc., were determined followed by univariate and multivariate analyses. RESULTS: MetS patients had significantly higher levels of BMI, waist-circumference, cholesterol, triglyceride, Hs-CRP and SBP/DBP, while the HDL-C levels was lower in patients group, compared to control group (P<0.05). Moreover, our analysis showed that MetS patients with GA or AA genotypes had a significantly (P=0.03) higher serum level of VEGF. CONCLUSIONS: we demonstrate an association between a VEGF genetic variant with MetS, suggesting its role as a risk stratification factor for MetS.

The Value of ABCD2F Scoring System (ABCD2 Combined with Atrial Fibrillation) to Predict 90-Day Recurrent Brain Stroke.

Background. The ABCD2 score is now identified as a useful clinical prediction rule to determine the risk for stroke in the days following brain ischemic attacks. Aim. The present study aimed to introduce a new scoring system named "ABCD2F" and compare its value with the previous ABCD2 system to predict recurrent ischemic stroke within 90 days of the initial cerebrovascular accident (CVA). Methods. 138 consecutive patients with the final diagnosis of ischemic CVA or TIAs who referred to emergency ward of Rasoul-e-Akram general hospital in Tehran from September 2012 to December 2013 were eligible. By adding a new score in the presence of atrial fibrillation to ABCD2 system, the new scoring system as ABCD2F was introduced and the risk stratification was done again on this new system. Results. The area under the curve for ABCD2 was 0.434 and for ABCD2F it was 0.452 indicating low value of both systems for assessing recurrence of stroke within 90 days of primary event. Multivariable logistic regression analysis showed that none of the baseline factors could predict 90-day recurrent stroke. Conclusion. ABCD2 and/or atrial fibrillation are not good scoring candidates for assessing the risk of recurrent stroke within first 90 days.

Assessment of testicular perfusion prior to sperm extraction predicts success rate and decreases the number of required biopsies in patients with non-obstructive azoospermia.

OBJECTIVES: To assess the role of power and color Doppler ultrasonography (US) in patients with azoospermia prior to testicular sperm extraction. METHODS: One hundred and thirty consecutive patients with azoospermia were assessed in this prospective study. Based on a semiquantitative method, the results of power Doppler US were graded into three categories: grade 1, no visible vessels; grade 2, between one and three detectable vessels; grade 3, more than three detectable vessels. The location of each visible vessel was also recorded as upper, middle or lower third of the testis. RESULTS: Seventy-four patients with non-obstructive azoospermia (NOA) and 27 with obstructive azoospermia (OA) fulfilled the study criteria. OA patients revealed a significantly higher intratesticular perfusion compared with NOA patients. NOA patients with higher intratesticular perfusion required fewer biopsies for successful sperm retrieval. Moreover, a correlation was noted between the presence of visible vessels in each segment and the probability of successful sperm retrieval during biopsy from the corresponding segment. CONCLUSIONS: Our data indicate that a semiquantitative, simplified power Doppler US assessment is capable of localizing areas containing viable sperm with the potential to direct biopsies to specific sites and subsequent decrease in the number of required biopsies.

Management of nonpalpable incidental testicular masses: experience with 10 cases.

PURPOSE: To determine the proportion of benign and malignant testicular lesions among patients with nonpalpable incidental testicular masses. METHODS AND MATERIALS: Ten patients with nonpalpable incidental testicular masses underwent surgical exploration. Surgery was performed via an inguinal approach with temporary cord occlusion and frozen section examination (FSE) of the lesions. Benign findings allowed for testicular sparing surgery (TSS), whereas cancer prompted total orchiectomy. RESULTS: The lesions measured 6-19 mm in the largest diameter. Four of the 10 lesions were benign (40%) and TSS was accomplished in these cases. Complete concordance was observed between the results of FSE and permanent histopathology examination. Of the six patients with cancer, four had pure seminoma and two were mixed germ cell tumor. Surveillance was applied in four of these patients, radiotherapy was used in one patient with seminoma and retroperitoneal lymph node dissection was done in one patient with mixed germ cell tumor. With an average follow-up duration of 24 months, all patients were alive and free of disease. All four patients in whom TSS was accomplished had an uneventful postoperative course, and after an average follow-up duration of 20 months, all had normal results in scrotal physical examination and ultrasound. CONCLUSION: Malignant lesion always should be considered in nonpalpable incidental testicular masses and surgical exploration is mandatory. TSS is safe and effective in patients with small benign lesions. Cancer is reliably detected by FSE.