Association between modified youth healthy eating index and nutritional status among Iranian children in Zabol city: a cross-sectional study.

Diet quality in childhood and adolescence can affect health outcomes such as physical and cognitive growth and preventing chronic diseases in adulthood. This study aimed to evaluate the relationship between diet quality using the modified youth healthy eating index (MYHEI) with socioeconomic factors and nutrition status in 7-12-year-old children in Iran. This descriptive-cross-sectional study was performed on 580 students in Zabol, Iran, selected through multistage cluster sampling. The diet was assessed through the 168-item food frequency questionnaire (FFQ) and eating behaviors. Then, the MYHEI scoring system was used to calculate the diet quality. In addition, we used the WHO growth indices, such as weight to age, height to age, and body mass index (BMI) to age ratios, to evaluate nutrition status. The mean total MYHEI score in children was 56.3 ± 11.2. Among children with the highest MYHEI score quartile, the number of girls was significantly higher than boys (p = 0.001). The prevalence of underweight, stunting, and wasting was 25.3%, 17.4%, and 21.7%, respectively. The prevalence of underweight (OR: 2.2; 95% CI 1.26, 3.90, p = 0.001) and stunting (OR: 3.2; 95% CI 1.65, 6.14, p = 0.006) were significantly lower in the higher MYHEI score quartile compared to the lower quartile. The overall diet quality of most children should be modified. Therefore, to improve the children's health and nutrition status, it is necessary to perform nutritional interventions such as training and promotional programs, especially in schools.

Rectal versus intravenous administration of acetaminophen; Clinical investigation of plasma level, analgesic, and antipyretic effects on 6-month to 6-year-old children in Zabol city, Iran.

OBJECTIVES: Acetaminophen is the most widely antipyretic analgesic medicine used in adults and children worldwide. Rectal acetaminophen is widely used in children who resist or cannot take oral medications. This study was designed to compare the efficacy of rectal and IV acetaminophen in children with fever and mild to moderate pain. PATIENTS AND METHODS: Total 60 children aged six months to 6 years, with fever and pain, that were treated with rectal or intravenous acetaminophen were selected and assigned in two groups. The IV group received 10mg/kg paracetamol as an IV infusion, and the rectal group received a 15mg/kg dose immediately after admission. Pain score was calculated using the FLACC method, and the axillary temperature was recorded at baseline and then 0.5, 1, 2, 4, and 6hours after drug administration. Blood samples were collected at baseline and then at 30min-intervals for the first 90minutes. RESULTS: The trend of changes in mean pain score at different time intervals was significantly different between the two groups. Body temperature decrease was more prominent in the IV group. The plasma concentration increased in both groups significantly with time. This increase was sharper in the IV group, just in the first 60minutes after drug administration. CONCLUSIONS: IV acetaminophen has more rapid onset of action, while rectal dosage form control fever and pain for longer duration. Considering its favorable effects with ease of administration and lower cost, rectal acetaminophen can be a reasonable option in selected patients with pain or fever.

Association of Serum Selenium and Selenoprotein P with Oxidative Stress Biomarkers in Patients with Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age which is characterized by various reproductive and metabolic disorders. Oxidative stress (OS) is now recognized to be involved in the pathogenesis of PCOS which could be targeted in the management of PCOS-related complications. Selenium (Se), as an antioxidant trace element, has been shown to decrease in PCOS patients. This study aimed to investigate the relationship between the Se and selenoprotein P (SELENOP) levels with OS markers in women with PCOS. In this cross-sectional study, 125 females aged 18-45 years diagnosed with PCOS were included. Demographic, clinical, and lifestyle information of participants were obtained using the relevant questionnaires. Fasting blood samples were collected to measure biochemical parameters. Serum levels of thiobarbituric acid reactive substances (TBARS), total antioxidant capacity (TAC), erythrocyte superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase activities as well as anthropometric measurements were assessed across tertiles of serum concentrations of Se and SELENOP. Higher serum levels of Se were associated with higher serum TAC levels (ß=0.42, P<0.001) and erythrocytes GPx activity (ß=0.28, P=0.002) as well as with lower serum TBARS levels (ß= -0.26, P=0.003). Similarly, higher serum levels of SELENOP were associated with higher TAC (ß=0.32, P<0.001) and erythrocyte GPx activity (ß=0.30, P=0.001). SELENOP also showed an inverse association with serum levels of TBARS (ß= -0.40, P<0.001). Nevertheless, erythrocytes SOD and CAT activities showed no significant relationships with serum Se and SELENOP concentrations (all P>0.05). The present study found that serum Se and SELENOP levels were inversely associated with TBARS levels and positively associated with TAC levels and erythrocytes GPx activity.

Association Between Selenium and Circulating Adipokine Levels in Patients with Polycystic Ovary Syndrome.

There is increasing evidence that selenium (Se) and its major transport protein, selenoprotein-P (SePP), may be associated with polycystic ovary syndrome (PCOS). However, the association of serum Se and SePP levels with circulating adipokines in this population has not received sufficient attention. In the present study, we aimed to investigate the associations of serum Se and SePP with circulating adipokine levels in patients with PCOS. In this cross-sectional study, 115 patients aged 18-45 years with PCOS diagnosed according to the Rotterdam Consensus Criteria were recruited. The general characteristics of the participants were collected using a general questionnaire and anthropometric measurements were taken. Blood samples were obtained and serum levels of leptin, adiponectin, visfatin, resistin, and omentin-1, as well as markers of glucose metabolism, were measured. Serum levels of Se and SePP were inversely correlated with fasting blood glucose (FBS), serum insulin, and homeostatic model assessment for insulin resistance (HOMA-IR). In addition, serum levels of Se and SePP were positively correlated with serum levels of adiponectin and visfatin. Although there was no significant correlation between serum Se and serum omentin-1 levels, a significant positive correlation was found between serum SePP levels and this adipokine. The present study found that serum Se and SePP levels were positively correlated with serum adiponectin and visfatin levels. Further studies are needed to confirm these findings.

Dietary total antioxidant capacity is associated with lower disease severity and inflammatory and oxidative stress biomarkers in patients with knee osteoarthritis.

BACKGROUND: This study was designed to evaluate the association between dietary total antioxidant capacity and clinical and biochemical variables in patients with osteoarthritis. METHODS: This cross-sectional study was conducted among 160 patients with mild-to-moderate knee osteoarthritis. The Likert version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC Index) was used to assess the severity of clinical symptoms in patients with knee osteoarthritis. The secondary outcomes included inflammatory and oxidative stress biomarkers. The participants' usual diets were assessed using a food frequency questionnaire (FFQ), and the dietary total antioxidant capacity (TAC) was calculated based on the ferric reducing antioxidant power method. Additionally, clinical and biochemical variables were evaluated using standard methods. RESULTS: The mean age of the participants was 57.2 ± 8.1 years, and 55.6% of them were females. The dietary TAC scores in this study ranged from 3.67 to 24.72, with a mean of 12.05 ± 5.3. We found a significant inverse trend between the dietary TAC score and the total Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score (P = 0.001), as well as the WOMAC stiffness (P = 0.008) and WOMAC physical function scores (P = 0.001). Furthermore, dietary TAC was inversely associated with serum concentrations of interleukin-6 (IL-6) (ß = - 0.18, P = 0.020), tumor necrosis factor-α (TNF-α) (ß = - 0.67, P < 0.001), matrix metalloproteinase-1 (MMP-1) (ß = - 0.33, P < 0.001), and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) (ß = - 0.22, P = 0.005) levels. CONCLUSION: The results of this study demonstrate an inverse association between dietary total antioxidant capacity and clinical and biochemical variables in patients with osteoarthritis.

Dietary phytochemical index is favorably associated with oxidative stress status and cardiovascular risk factors in adults with obesity.

Phytochemicals are bioactive compounds found in plant-based foods. Consumption of phytochemical-rich foods has been associated with cardiovascular and metabolic diseases prevention in various populations. To quantify the phytochemical content of the diet, dietary phytochemical index (DPI) was established which is defined as the proportion of daily energy intake derived from foods rich in phytochemicals. The purpose of this study was to evaluate the association between the DPI and oxidative stress markers and cardiovascular risk factors in obese adults. In this cross-sectional study, a total of 140 adults aged 20-60 years and body mass index (BMI) of ≥ 30 kg/m2 were included. A validated food frequency questionnaire (FFQ) was used to collect information on dietary intakes. The DPI was calculated based on the following formula: DPI = [daily energy obtained from foods rich in phytochemicals (kcal)/total daily energy intake (kcal) × 100]. There was an inverse association between DPI and serum concentrations of Malondialdehyde (MDA) (P = 0.004), triglyceride (TG) (P-trend = 0.003), high-sensitive C-reactive protein (hs-CRP) (P = 0.017), and erythrocyte superoxide dismutase (SOD) activity (P = 0.024). Total antioxidant capacity (TAC) was positively associated with DPI score (P = 0.045). No significant relationship was found between the DPI score and fasting blood sugar (FBS), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total oxidant status (TOS), glutathione peroxidase (GPx), catalase (CAT), and anthropometric parameters as well as systolic and diastolic blood pressure. The current study found that there was a significant inverse association between DPI and oxidative stress, inflammation, and hypertriglyceridemia as cardiovascular disease (CVD) risk factors in obese population. However, further research is needed to confirm these findings.

The association of vitamin D status with oxidative stress biomarkers and matrix metalloproteinases in patients with knee osteoarthritis.

Objective: The association of vitamin D status with osteoarthritis (OA) has been demonstrated previously. The current study was performed to examine the association of vitamin D status with oxidative stress markers and matrix metalloproteinases (MMPs) in patients with knee OA. Methods: This case-control study was conducted on 124 subjects with mild to moderate knee OA and 65 healthy controls. Demographic data was collected from all participants at baseline. Serum levels of vitamin D as well as markers of oxidative stress including malondialdehyde (MDA), total oxidant status (TOS), superoxide dismutase (SOD), oxidative stress index (OSI), paraoxonase-1 (PON-1), glutathione peroxidase (GPX), catalase (CAT), and total antioxidant capacity (TAC) were evaluated for each participant. Furthermore, serum concentrations of MMP-1, MMP-3, MMP-13, and cartilage oligomeric matrix protein (COMP) were measured. Results: The results of the present study indicated that individuals with vitamin D insufficiency had higher levels of MDA, TOS, SOD, and OSI as well as lower levels of PON-1 and TAC. Based on the linear regression analysis, serum vitamin D levels were inversely correlated with MDA, TOS, SOD, OSI, MMP-1, and MMP-13 and positively associated with TAC levels (p < 0.0001). Patients with sufficient vitamin D levels had lower MMP-1 and MMP-13 levels compared to patients with vitamin D insufficiency (p < 0.001 and p < 0.001, respectively). Conclusion: Findings from this study showed a strong association between vitamin D deficiency and increased oxidative stress and MMPs activity in patients with knee OA.

Vitamin D insufficiency and its association with adipokines and atherogenic indices in patients with metabolic syndrome: A case-control study.

Introduction: Vitamin D deficiency is one of the most common nutritional disorders in most countries of the world. The present study was designed and implemented with the aim of investigating the relationship between vitamin D deficiency and the level of adipokines, atherogenesis indicators and factors related to metabolic syndrome. Methods: This case-control study was done on 195 patients with metabolic syndrome aged 20-50 y who attended the health centers in Zabol County, northeast Iran, between April 2021 and January 2022. Anthropometric and biochemical parameters were measured for all subjects with standard methods. To determine serum 25(OH)D levels, we used enzymatic linked immunosorbent assay (ELISA) kits. Atherogenic index of plasma (AIP) was calculated as log (TG/HDL-c). The visceral adiposity index (VAI) and the lipid accumulation product (LAP) were estimated according to standard formulas. Results and Discussion: Participants in the case group had lower serum levels of 25(OH)D compared to controls (19.8 ± 6.2 ng/ml vs. 41.2 ± 9.7ng/ml, P<0.001). We found that the mean serum levels of fasting blood sugar (P=0.023) and TG (P=0.008) as well as HOMA-IR (P=0.023) were significantly higher in the cases compared to controls. Also, patients with MetS and vitamin D insufficiency (cases) had higher AIP (P=0.040) and LAP (P=0.012) than controls. Furthermore, serum 25(OH)D levels showed significant inverse correlations with serum RBP-4 and a positive correlation with serum omentin-1 concentrations. The results of the present study showed that vitamin D deficiency correlated with some of the cardiometabolic risk factors among the patients with MetS.

Correlations of selenium and selenoprotein P with asymmetric dimethylarginine and lipid profile in patients with polycystic ovary syndrome.

BACKGROUND: Polycystic ovary syndrome (PCOS) is associated with an increased risk of cardiovascular diseases (CVD). Accumulating evidence has suggested that selenium (Se) is of importance for optimal function of the cardiovascular system. This study aimed to investigate the associations of selenium and selenoprotein P (SePP) with asymmetric dimethylarginine (ADMA) and lipid profile in women with PCOS. METHODS: In this cross-sectional study, 125 females aged 18-45 years diagnosed with PCOS were recruited. An interviewer-administered questionnaire was applied to gather the relevant demographic characteristics, detailed clinical information, and lifestyle habits of participants. Fasting blood samples were obtained to measure biochemical parameters. Serum concentrations of total testosterone, sex hormone-binding globulin (SHBG), ADMA, and lipid profiles as well as anthropometric measurements were assessed across tertiles of serum Se and SePP concentrations. RESULTS: There was a positive correlation between serum Se and SePP concentrations (r = 0.434, p < 0.001). Serum Se level was inversely correlated with ADMA (r = -0.21, p = 0.025) and TG (r = -0.17, p = 0.041) concentrations. There were also inverse correlations between SePP and ADMA (r = -0.34, p < 0.001), TG (r = -0.21, p = 0.019), and oxidized low density lipoprotein (ox-LDL) (r = -0.25, p = 0.007) levels. No significant relationship was found between serum Se and SePP concentrations with total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), apolipoprotein-A1 (Apo-A1), apolipoprotein-B (Apo-B100), total testosterone, SHBG, and free androgen index as well as anthropometric parameters (All p > 0.05). CONCLUSION: The present study found that Se and SePP levels were inversely correlated with ADMA and TG concentrations as well as ox-LDL levels.

Vitamin D insufficiency is associated with inflammation and deregulation of adipokines in patients with metabolic syndrome.

BACKGROUND: Previous studies have been reported that vitamin D deficiency increased the risk of metabolic syndrome (MetS). Nonetheless, the exact mechanisms underlying this association is unclear. Besides, inflammation and deregulation of adipokines secretion have been recognized as pivotal factors that contribute to the pathogenesis of these conditions. Therefore, we assessed whether serum vitamin D status is associated with serum levels of adipokines and inflammatory markers in these patients. METHODS: This case-control study was carried out among 65 patients with MetS who had vitamin D insufficiency (cases) and 130 MetS patients who had vitamin D sufficiency (controls). Cases and controls were recruited from among those referred to health centers in Zabol County, Iran. Vitamin D insufficiency was regarded as a serum 25-hydroxyvitamin D [25(OH)D] concentration below 30 ng/ml. Serum concentrations of leptin, adiponectin, visfatin, and resistin and also adiponectin/leptin ratio along with serum levels of interleukin 6 (IL-6), IL-10 and tumor necrosis factor-alpha (TNF-α), were evaluated. RESULTS: Serum levels of leptin, resistin, and TNF-α were significantly higher, whereas, serum adiponectin and adiponectin/leptin ratio were significantly lower in cases than the controls. There was no significant difference in serum visfatin, IL-6, and IL-10 between the groups. Serum levels of 25(OH)D were inversely correlated with leptin, resistin, and TNF-α in both unadjusted models and after adjustment for potential confounders. CONCLUSION: Our findings indicated that vitamin D insufficiency in MetS patients is associated with increased inflammation and serum adipokine abnormalities which may be associated with developing metabolic complications in these patients.

Higher dietary phytochemical index is associated with lower odds of knee osteoarthritis.

Previous studies have shown that adherence to dietary patterns rich in plant-based foods may reduce the odds of osteoarthritis; however, limited data are available on the association of consumption of diets rich in phytochemicals and odds of knee osteoarthritis (KOA). In this case-control study conducted in Iran, we aimed to investigate whether a higher dietary phytochemical index (DPI) is associated with decreased odds of having KOA. A total of 124 cases aged 20-60 years diagnosed with bilateral primary KOA according to the American College of Rheumatology criteria and 124 controls frequency-matched on age, sex, and body mass index (BMI) were included in the study. A validated food frequency questionnaire (FFQ) was used to collect information on dietary intakes. To calculate DPI scores, the dietary energy derived from foods rich in phytochemicals (kcal) was divided by the participant's total daily energy intake (kcal). Patients with KOA had lower intakes of dietary fiber (P = 0.004), vitamin A (P = 0.007), vitamin C (P = 0.001), and folate (P = 0.021) compared to controls. In the crude model, individuals in the third tertile of DPI had 65% lower odds of having KOA compared to those in the first tertile (OR 0.35, 95% CI 0.19 to 0.67, P-trend = 0.001). After adjustment for potential confounders, including age, sex, physical activity, smoking, and supplement use, this inverse association remained significant (OR 0.37, 95% CI 0.19 to 0.73, P-trend = 0.004). After further adjustment for BMI, this inverse association between DPI and odds of KOA also remained significant (OR 0.35, 95% CI 0.18 to 0.69, P-trend = 0.003). These findings suggest that adherence to a phytochemical-rich diet, as indicated by the increasing DPI score, is associated with lower odds of KOA.

Vitamin D status is associated with inflammatory biomarkers and clinical symptoms in patients with knee osteoarthritis.

BACKGROUND AND AIM: The association between vitamin D status and osteoarthritis (OA) and bone remodeling has been shown previously. The present study was conducted to determine the association between vitamin D status and inflammatory biomarkers and clinical symptoms in patients with knee OA. METHODS: This case-control study was performed on 124 subjects with mild to moderate knee OA and 65 healthy controls. Demographic data was collected from all participants at baseline. We used Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC Index) for evaluating the severity of clinical symptoms in these patients. Serum levels of vitamin D as well as markers of inflammation including interleukin 1-ß (IL-1ß), interleukin 6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor-alpha (TNF-α), high-sensitivity C-reactive protein (hs-CRP), and nuclear factor k-B (NF-κB) p65 were evaluated for each participant. RESULTS: The results of the present study showed that patients with knee OA had lower levels of vitamin D and higher levels of IL-1ß, TNF-α, hs-CRP, and NF-кB p65 compared with healthy controls (P < 0.0001). The levels of IL-1ß, TNF-α, and NF-кB p65 in knee OA patients with vitamin D insufficiency were significantly higher compared with the knee OA patients with sufficient vitamin D (P < 0.05). Based on the linear regression analysis, serum vitamin D levels were inversely correlated with IL-1ß, TNF-α, hs-CRP, and NF-кB p65 levels (P < 0.0001). Patients with sufficient vitamin D levels had lower total and physical function WOMAC scores compared with patients with vitamin D insufficiency (P = 0.011 and P = 0.010, respectively). CONCLUSION: The results suggest a strong link between vitamin D deficiency and increased inflammatory biomarkers as well as increased severity of clinical symptoms in knee OA patients.

Vitamin D status is favorably associated with the cardiovascular risk factors in adults with obesity.

BACKGROUND & AIMS: Previous investigations have been indicated that vitamin D deficiency is an amendable risk for cardiovascular disease (CVD) in the general populations. Limited data is available concerning the relationship of vitamin D status and risk factors of CVD in the individuals with obesity and the existing data are highly controversial. We investigated whether serum vitamin D situation is related to multiple traditional CVD risk factors in Iranian obese subjects. METHODS: A cross-sectional study was done among 214 Iranian adults with obesity (94 males and 120 females) aged 20-60 years, who attended the specialized outpatient clinics in Zabol city. Participants were categorized as vitamin D sufficient, insufficient, and deficient according to their serum 25(OH)D concentrations. Afterward, the presence of hypercholesterolemia, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), high low-density lipoprotein cholesterol (LDL-C) as well as diabetes, hypertension, and high serum concentrations of high-sensitivity C-reactive protein (hs-CRP) as CVD risk factors were evaluated in the participants. RESULTS: There was a noticeable regular trend regarding hypercholesterolemia (p = 0.008), high LDL-C (p = 0.024), hypertension (p = 0.021), and high hs-CRP (p < 0.0001) across various categories of vitamin D status. In adjusted model, vitamin D-deficient subjects were at higher risk for having hypercholesterolemia (OR: 3.22, p = 0.031), high LDL-C (OR: 2.37, p = 0.047), hypertension (OR: 2.32, p = 0.042), and high hs-CRP (OR: 5.49, p = 0.001) than ones with sufficient vitamin D status. CONCLUSIONS: Vitamin D deficiency in obese subjects was found to be strongly related to higher risk of unfavorable lipid profile, hypertension, and high hs-CRP.

Vitamin D status and systemic redox biomarkers in adults with obesity.

BACKGROUND & AIMS: Vitamin D has been proposed to have a protective role against oxidative stress. The present study was conducted to test the hypothesis that suboptimal levels of 25(OH)D are related to oxidative/antioxidative biomarkers in adults independently of obesity. METHODS: In this case-control study, 140 subjects with obesity and 90 age- and sex-matched 25(OH)D sufficient normal weight controls were selected. Subjects with obesity were categorized as 25(OH)D sufficient, insufficient, and deficient based on their serum 25(OH)D concentrations. Serum malondialdehyde (MDA), total oxidant status (TOS), and total antioxidant capacity (TAC) as well as erythrocytes superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT) along with serum paraoxonase-1 (PON1) and arylesterase (AREase) activities were assessed. RESULTS: Serum concentrations of 25(OH)D were inversely correlated with BMI, WC, fat mass, and visceral fat. Serum levels of MDA and TOS, and erythrocyte SOD activities were significantly higher, whereas, serum TAC, PON1, and AREase were significantly lower in subjects with obesity compared to the controls (p < 0.0001). 25(OH)D deficient obese subjects exhibited higher serum levels of MDA as well as erythrocyte SOD activity (p < 0.05) and lower serum levels of TAC (p < 0.0001), PON1 (p < 0.05), and AREase (p < 0.0001) compared to obese subjects with 25(OH)D sufficiency and controls even when adjusted for BMI. CONCLUSIONS: The present findings demonstrated a strong association between the severity of 25(OH)D deficiency and oxidative/antioxidative related parameters independently of obesity.

Food Insecurity and Cardiovascular Risk Factors among Iranian Women.

We evaluated whether food insecurity is associated with clinical evidence of diet-sensitive cardiovascular diseases (CVD) risk factors, including obesity, hypertension, dyslipidemia, and diabetes. In this population-based cross-sectional study, 630 women aged 18-50 years under cover of health centers in Iran randomly selected and interviewed face-to-face. Food insecurity was evaluated using a household food insecurity access scale (HFIAS) questionnaire, which its validity and reliability was determined in the Iranian population. Logistic regression was used to assess the associations between food insecurity and having CVD risk factors including general and abdominal obesity, hypertension, hypercholesterolemia, high low-density lipoprotein cholesterol (LDL), low high-density lipoprotein cholesterol (HDL), hypertriglyceridemia, and diabetes. The probability of having hypertriglyceridemia (Adjusted OR = 2.04, P = .031), general obesity (Adjusted OR = 2.43, P = .029), abdominal obesity (Adjusted OR = 2.09, P = .024), and hypertension (Adjusted OR = 2.04, P = .038) increased with exacerbation of women's food insecurity condition. The odds ratio of having CVD risk factors became stronger after adjusting for confounders. Food insecurity was associated with increased risk of CVD risk factors among Iranian reproductive-age women. Efforts to improve food security conditions among women might be associated with reductions in the incidence of CVD-related metabolic risks.

Systemic redox imbalance in patients with nonalcoholic fatty liver disease.

BACKGROUND: Oxidative stress is one of the major pathologic mechanisms for the progression of nonalcoholic fatty liver disease (NAFLD). The aim of this study was to evaluate the relationship between the extent of steatosis and oxidative stress parameters in patients with NAFLD. METHODS: The data obtained from 122 patients with NAFLD and 106 healthy controls aged 20-60 years with body mass index (BMI) ranging from 25 to 35 kg/m2 . Abdominal ultrasonography was performed in participants in order to the grading of hepatic steatosis. Fasting blood samples and anthropometric measurements were collected for all study subjects. Oxidative stress was evaluated by measurement of serum malondialdehyde (MDA), oxidized low-density lipoprotein (ox-LDL), total antioxidant capacity (TAC) and erythrocyte superoxide dismutase (SOD) as well as glutathione peroxidase (GPx) activities. RESULTS: Serum levels of liver enzymes (P < .0001) and MDA (P = .018), as well as erythrocyte SOD activity (P < .0001), were significantly higher in patients with NAFLD compared to healthy controls. Furthermore, patients with NAFLD had significantly lower serum TAC levels compared to healthy controls (P < .0001). No significant differences were observed in serum ox-LDL level and erythrocyte GPx activity between the groups. The probability of being NAFLD increased with increasing serum levels of MDA (P = .020) and SOD activity (P < .0001). In contrast, decreased serum TAC levels predicted the probability of being NAFLD (P < .0001). CONCLUSIONS: Increased extent of hepatic steatosis could be considered as a pathological mechanism for enhancing oxidative stress in patients with NAFLD, independent of obesity, and is exacerbated further in patients with more severe condition.

Health-related quality of life and medication adherence in elderly patients with epilepsy.

OBJECTIVE: Considering the high prevalence of epilepsy in the elderly and the importance of maximising their quality of life (QoL), this study aimed to investigate the relationship between medication adherence and QoL, and the mediating effects of medication adherence on the association between serum antiepileptic drug (AED) level and seizure severity with QoL in elderly epileptics. METHODS: In a longitudinal study, 766 elderly patients with epilepsy who were prescribed a minimum of one antiepileptic drug were selected by convenience sampling method. A Medication Adherence Report Scale (MARS-5) questionnaire was completed at the baseline. Seizure severity and QoL were assessed after six months using the Liverpool Seizure Severity Scale (LSSS) and the QoL in Epilepsy (QOLIE-31) questionnaires respectively. Serum level of AED was also measured at six-month follow-up. RESULTS: Medication adherence was significantly correlated with both seizure severity (ß = -0.33, p < 0.0001) and serum AED level (ß = 0.29, p < 0.0001) after adjusting for demographic and clinical characteristics. Neither QoL nor its sub-classes were correlated with seizure severity. In addition, a significant correlation was not observed between serum AED level and QoL. However, medication adherence was significantly correlated with QoL (ß = 0.30, p < 0.0001). The mediating effects of medication adherence on the association between serum AED level (Z = 3.39, p < 0.001) and seizure severity (Z = -3.47, p < 0.001) with QoL were supported by the Sobel test. CONCLUSION: This study demonstrates that medication adherence has a beneficial impact on QoL in elderly epileptics. Therefore, adherence to treatment should be monitored to improve their QoL.

Socioeconomic inequities in health services' utilization following the Health Transformation Plan initiative in Iran.

Health equity has become a progressively popular research topic in recent years. Therefore, this study was made to identify the contributions made by socioeconomic determinants in order to quantify their roles to healthcare utilization inequity and to show their status especially after the recent reform in Iran, i.e. Health Transformation Plan, which one of its main goals is providing access to healthcare for all people. This study is a cross-sectional study conducted on a national level in Iran in 2015. For the sampling frame, three-stage cluster sampling was used. A total of 22 470 households from the whole country were surveyed by questionnaires through face-to-face interviews. A total of 78 378 subjects responded to the survey, 18 984 subjects (24.2%) reported the need to outpatient healthcare services in the 2 weeks preceding the interview and 12 944 (68.2%) of them had utilized the outpatient services. In addition, 5928 participants (7.6% of total population) reported the need to inpatient healthcare in the 15-month interval prior to the interview. Of these, 5405 subjects (91.2%) had received the inpatient cares. Several factors such as age group, education, marital status and status of household economy play significant roles in seeking inpatient cares. In addition, age group and household economic status have significant impacts on the utilization of outpatient services. While there are several variables that have different effects in determining the need for both outpatient and inpatient services, most of them are not any more significant than what are on the receiving end of these services.

Sex differences in MDMA-induced toxicity in Sprague-Dawley rats.

Recent evidence demonstrates that female subjects show exaggerated responses to 3,4-methylenedioxymethamphetamine (MDMA) compared with males. The aim of our study was to evaluate sex differences and the role of endogenous gonadal hormones on the effects of MDMA. Fifty-six intact and gonadectomized male and female Sprague-Dawley rats were randomly assigned to either MDMA (5 mg/kg) or saline treatment. Learning and memory were assessed using the Morris water maze (MWM). The expression of Bax and Bcl-2 in the hippocampus was detected by Western blotting. Behavioral analysis showed that MDMA led to memory impairment in both male and female rats. The female rats showed more sensitivity to impairment than the males, as assessed using all the memory parameters in the MWM. Ovariectomy attenuated the MDMA-induced memory impairment. By contrast, orchiectomized rats showed more impairment than MDMA-treated intact male rats. Bcl-2 and Bax were down-regulated and up-regulated in MDMA-treated male and female rats, respectively. MDMA treatment in the orchiectomized rats led to upregulation of Bax and down-regulation of Bcl-2. Ovariectomy attenuated the MDMA-induced up-regulation of Bax and caused more expression of Bcl-2 compared with what was observed in the MDMA-treated intact female rats. In summary, female rats showed exaggerated responses to the effects of MDMA and this may be explained by endogenous gonadal hormones.