ABSTRACT
BACKGROUND: Rheumatoid arthritis is a complex multifactorial chronic disease, the importance of human leukocytic antigen (HLA) as a major genetic risk factor for rheumatoid arthritis was studied worldwide. The objective of this study is to identify the association of HLA-DRB1 subtypes with rheumatoid arthritis and its severity in Kurdish region. METHODS: A case-control study recruited 65 rheumatoid arthritis patients and 100 healthy individuals as control group all over the Kurdistan region/Iraq. Both patient and control groups are genotyped using polymerase chain reaction with sequence specific primer. Anti-CCP antibodies were measured by ELISA test. Rheumatoid factor, C-reactive protein, and disease activity score 28 which measured by DAS-28 values were calculated. The DAS-28 was used to assess the clinical severity of the patients. RESULTS: HLA-DRB1-0404 and HLA-DRB1-0405 frequencies showed a strong association with disease susceptibility (P < 0.001). The frequency of HLA-DRB1-0411 and HLA-DRB1-0413 were significantly higher in control group (P < 0.001). The frequency of rheumatoid factor and Anti-CCP were significantly higher among shared epitope-positive patients compared to shared epitope-negative patients (P < 0.001). Regarding the disease activity by DAS-28, rheumatoid arthritis patients didn't show significant difference between the shared epitope-positive and shared epitope-negative patients. CONCLUSIONS: HLA-DR0404 and HLA-DR0405 alleles are related to RA, while HLA-DR1-0411 and HLA-DRB1-0413 protect against RA in the Kurdistan region in the North of Iraq.
ABSTRACT
INTRODUCTION: The purpose of this study is to compare the change in the metabolic syndrome prevalence and risk factors between participants who followed a low carbohydrate diet and those who followed a low fat diet for six months in Erbil city/ Iraqi Kurdistan. METHODS: Out of 289 apparently healthy obese adults who were chosen by a stratified multistage probability sampling method, 94 of them agreed to participate in the study. They were assigned to low carbohydrate and low fat diet groups. Both groups were followed up for 6 months and the data were taken at baseline, after 3 months and after 6 months of intervention. Ninety-four obese adults completed the intervention. One-way repeated measures ANOVA was used to compare differences of metabolic dependent variables between the two independent variables, the low carbohydrate and low fat diet, at baseline, after 3 months and after 6 months of intervention. RESULTS: The Participants in low carbohydrate diet group had greater decrease in the prevalence of MetS. At the baseline, according to the ATP III criteria, the prevalence of metabolic syndrome was 44.4% (24/54) in low carbohydrate diet group and 60% (24/40) in low fat diet group. The prevalence of MetS was decreased significantly to 16.7% (9/54) after 3 months and to 3.7% (2/54) after 6 months in low carbohydrate diet (p < 0.001). Moreover, the prevalence of MetS was decreased significantly to 32.5 (13/40) after 3 months and to 22.5% (9/40) after 6 months in low fat diet (p < 0.001). No statistically significant difference was found between low carbohydrate diet & low fat diet at the baseline (p-value = 0.136) and after 3 months and after 6 months of intervention. CONCLUSIONS: Both low carbohydrate diet and low fat diet have significant effects on reducing the prevalence of MetS in obese adults when followed up for 6 months. Compared to low fat diet, low carbohydrate diet had greater effect in reducing the prevalence of metabolic syndrome. Both diet programs were found to be effective in improving the metabolic state of obese adults. TRIAL REGISTRATION: The trial is registered retrospectively at the US National Institutes of Health ( ClinicalTrials.gov ). The registration in the US National Institutes of Health was done in 23/12/2020 with the registration number: NCT04681924 .
