The Role of Dietary Glycemic Index and Glycemic Load in Mediating Genetic Susceptibility via MC4R s17782313 Genotypes to Affect Cardiometabolic Risk Factors among Apparently Healthy Obese Individuals.

Background: The association of genetic and dietary factors with occurrence and progression of chronic diseases such as metabolic syndrome (MetS) has long been addressed but there is a lack of evidence for complex interrelationships, including direct and indirect effects of these variables. Hence, this study is aimed at evaluating the mediating role of glycemic indices in the association of melanocortin-4 receptor (MC4R) rs17782313 polymorphism, sociodemographic, and psychological factors with the risk of MetS in obese adults using structural equation modeling. Methods: We performed a cross-sectional analysis of data from 287 apparently healthy adults. Dietary glycemic index (GI) and glycemic load (GL) were calculated from a validated 147-item food frequency questionnaire (FFQ). MC4R s17782313 genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Structural equation modeling was used to explore direct and indirect effects of genetic and nongenetic factors on MetS. Results: MC4R gene variant was directly associated with the risk of MetS (B = 0.010; P = 0.023). On the other hand, this variant was found to be indirectly and positively associated with LDL-C (B = 6.589; P = 0.042) through mediatory effects of GI and GL. Moreover, GI and GL also mediated indirect positive effects of sex and age on LDL-C (B = 3.970; P ≤ 0.01; B = 0.878; P ≤ 0.01, respectively) and HDL (B = 2.203; P ≤ 0.01; B = 0.129; P ≤ 0.01, respectively). MC4R rs17782313 polymorphism had positive effects on GI (B = 1.577; P ≤ 0.01) and GL (B = 1.235; P ≤ 0.01). Conclusion: Our data may state a hypothesis of the mediating effect of quantity and quality of carbohydrates consumed in relationship between genetic susceptibility to obesity and cardiometabolic risk factors. Further analyses should be carried out in high-quality cohort studies in order to confirm the findings.

The interaction between dietary Non-Enzymatic Antioxidant Capacity (NEAC) with variants of Melanocortin-4 receptor (MC4R) 18q21.23-rs17782313 locus on hypothalamic hormones and cardio-metabolic risk factors in obese individuals from Iran.

Background: In the current study, we aimed to evaluate the interaction between dietary Non-Enzymatic Antioxidant Capacity (NEAC) and rs17782313 polymorphism on hypothalamic hormones and cardio-metabolic risk factors. Methods: A total of 287 subjects (aged 20-50 years, 147 males and 140 females) enrolled in the cross-sectional study. Dietary NEAC was assessed using databases of NEAC measurements compiled from outcomes for three different analyses: oxygen radical absorbance capacity (ORAC), ferric reducing-antioxidant power (FRAP), and total radical-trapping antioxidant parameter (TRAP) and genotyping for the near MC4R rs17782313 was carried out by Polymerase chain reaction-restriction fragments length polymorphism (PCR-RFLP) method. Results: The significant interactions were found between adherence to the dietary NEAC and MC4R rs17782313 in relation to high-density lipoprotein-cholesterol (HDL-C), glucose, α-melanocyte stimulating hormone (α-MSH), insulin and quantitative insulin sensitivity check index (QUICKI) (P Interaction = 0.03, 0.01, 0.04, 0.04 and 0.04, respectively). In homozygous subjects for the minor allele, the serum insulin level and QUICKI in participants with the highest adherence to TRAP were significantly higher than those with the lowest adherence (p < 0.001). There was a significant inverse association between high ORAC score and risk of metabolic syndrome even after adjusting for potential confounders (OR: 0.33; 95%CI:0.13-0.81) and also a significant inverse association between high NEAC (ORAC, FRAP and TRAP assays) score and high triglyceride (TG) level was found in obese adults. Conclusion: In conclusion, our study found for the first time that the NEAC significantly interacts with the rs17782313 genotypes to influence several metabolic risk factors in obesity.

Dietary patterns interact with the variations of 18q21.23 rs17782313 locus on regulation of hypothalamic-pituitary axis hormones and cardio-metabolic risk factors in obesity.

BACKGROUND: Evidence shows the role of polymorphisms in rs17782313 MC4R gene with increased risk of obesity in Asians adult. In the current report, we investigated the interaction between rs17782313 MC4R gene and major dietary patterns on α-melanocyte stimulating hormone (α-MSH), Agouti-related peptide (AgRP), serum lipids and blood pressure among obese individuals. METHODS: This cross-sectional study was performed in 288 obese adults between 20 and 50 years of age. Anthropometric measurements and biochemical assays were conducted with standard methods. To evaluate appetite, the Visual Analogue Scale (VAS) was used. Dietary patterns were obtained by principal component analysis (PCA). Genotyping of rs17782313 was assessed by restriction fragment length polymorphism (PCR-RFLP) method. RESULTS: Three major dietary patterns were extracted: Prudent Dietary Pattern (PDP), Legume Dietary Pattern (LDP) and Mixed Dietary Pattern (MDP). Higher PDP score was associated with reduced SBP and insulin concentration while highest MDP score was associated with lower TG concentration (P < 0.05). Significant interactions were observed between higher adherence to PDP and rs17782313 CC genotype on increased SBP (PInteraction = 0.04), serum insulin (PInteraction = 0.05) and AgRP (PInteraction = 0.03) and also between higher adherence to MDP and CC genotype of rs17782313 on reduced serum TG (P = 0.03). CONCLUSIONS: The findings of the current study showed that being on CC genotype of rs17782313 polymorphism made obese individuals more prone to have higher SBP, insulin and AgRP even in highest adherence to PDP. However, adherence to MDP could attenuate the risky effects of being on CC genotype of rs17782313 by reducing serum TG concentrations. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Hysterosalpingographic findings in women with genital tuberculosis.

BACKGROUND: Genital tuberculosis (TB) is an important cause of infertility in the developing countries, where hysterosalpingography (HSG) remains an initial diagnostic procedure in the evaluation of tubal and peritoneal factors leading to infertility. OBJECTIVE: The aim of this study was to determine the HSG findings of genital TB in infertile women. MATERIALS AND METHODS: We retrospectively reviewed HSG findings in 20 women with genital tuberculosis. HSG was performed in these women as part of infertility work up over 5 years. The other diagnostic procedures used included endometrial curettage and biopsy, histological examination, culture, laparoscopy, hysteroscopy and polymerase chain reaction. RESULTS: The mean age of the participants was 30.5±8 years. All women had clinical history of infertility for at least 4 years. Women presented with pelvic abdominal pain (30-35%) and menstrual disturbances (20-25%). Reviewing 20 cases of female genital TB were encountered various presentations on HSG. CONCLUSION: HSG is an invaluable procedure in suggesting the diagnosis of genital TB in patients being investigated for infertility.

The Association between Carotid Intima-Media Thickness and the Duration of Type 1 Diabetes in Children.

OBJECTIVE: Carotid intima-media thickness (cIMT) has been known as a criterion of generalized atherosclerosis and a marker of cardiovascular disease progression in many studies which can be measured by ultrasound using high-resolution device. METHODS: This is a case-control study. A total of 40 children (16 males and 24 females) with type1 diabetes mellitus and control group consisting of equal numbers (17 males and 23 females) who were otherwise healthy were included in the study from May 2007 to January 2008. The two groups were age matched, with the mean age of 10.56±3.21 years in control group and 10.67±4.18 years in diabetic patients. Left and right cIMT were measured by ultrasound. Findings : There was a significant difference between case and control subjects in terms of mean cIMT (P<0.001). cIMT was significantly higher in the diabetic group. Among variables including age, BMI and diabetes, diabetes was the only influential parameter in this respect. The mean time length of type 1 diabetes in our diabetic group was reported 4.24±3.02 years, with a minimum of four months and a maximum of ten years. There was a statistically significant difference between the two diabetic patients with below and above four years of disease duration (P=0.03 for right carotid artery and P=0.01 for left carotid artery). CONCLUSION: cIMT has been identified as an early indicator of atherosclerosis in many studies. It increases in patients with type 1 diabetes as the disease progresses and this can be followed by macro and microvascular atherosclerotic changes.

The role of intraprostatic inflammation in the acute urinary retention.

OBJECTIVES: Almost 20% of patients with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) might also have symptoms of prostatitis. But, the interrelationship between BPH and prostatic inflammation, and how one can influence the other, is under controversy. The aim of our study was to determine the incidence of prostatic inflammation in BPH patients presented with acute urinary retention (AUR). METHODS: This crosssectional study was conducted in a hospital at Guilan, the northern province of Iran. A total of 280 patients undergoing transurethral resection of the prostate (TURP) or open prostatectomy from 1999 to 2002 were enrolled. Histopathologic samples of prostate were examined for existence of acute and/or chronic intraprostatic inflammation (ACI). RESULTS: Overall, 150 (536%) of patients undertook surgery for AUR and 130 (464%) for LUTS. Among them, 130 patients (46.4%) showed ACI in the pathologic examinations whereas 150 patients (53.6%) did not. The patients with AUR were significantly older than those with LUTS. ACI was significantly associated with AUR. The mean prostate weight was significantly higher in AUR group compared the LUTS group. Those patients who showed ACI according to pathologic examinations had heavier prostates than those who did not. The association of ACI and AUR should be considered in secondary prevention for BPH patients. CONCLUSIONS: ACI may increase the degrees of urinary obstruction and AUR.