The Association between Cardio-metabolic and hepatic indices and anthropometric measures with metabolically obesity phenotypes: a cross-sectional study from the Hoveyzeh Cohort Study.

BACKGROUND: This study aimed to compare the cardio-metabolic, anthropometric, and liver function indices among metabolic obesity phenotypes. METHODS: In this cross-sectional study, which was carried out in Hoveyzeh, Khuzestan Province, Iran, a total of 7,464 individuals (male: 2859, female: 4605), were recruited and classified into four groups, based on Body Mass Index (obese, BMI ≥ 30 kg/m2; non-obese, BMI = 18.5-29.9 kg/m2) and the National Cholesterol Education Program and Adult Treatment Panel (NCEP ATP) III criteria (Healthy group, ≤ 1 of the criteria; Unhealthy group, ≥ 2 of the criteria), as follows: Metabolically Healthy Non-Obese (MHNO, 28.14%), Metabolically Unhealthy Non-Obese (MUNO, 33.06%), Metabolically Healthy Obese (MHO, 6.54%), and Metabolically Unhealthy Obese (MUO, 32.26%). Anthropometric indices (Waist/Hip Ratio (WHR), Waist/Height Ratio (WHtR), Body Adiposity Index (BAI), Visceral Adiposity Index (VAI), and Weight adjusted Waist Index (WWI)), cardio-metabolic indices (Atherogenic Index of Plasma (AIP), Lipid Accumulation Product (LAP), Cardio-Metabolic Index (CMI), Lipoprotein Combine Index (LCI), Triglyceride-Glucose (TyG), TyG-BMI, TyG-WC, and Thrombolysis In Myocardial Infarction (TIMI) risk index), and hepatic indices (Hepatic Steatosis Index (HSI) and ALD/NAFLD index (ANI)) were calculated and compared between the groups. RESULTS: WHR,VAI, AIP, LAP, CMI, LCI, TyG, and TIMI risk index values were significantly higher in the MUNO phenotype compared to the MHO phenotype (WHR: 0.97 vs. 0.95; VAI: 3.16 vs. 1.33; AIP: 0.58 vs. 0.25; LAP: 78.87 vs. 55.79; CMI: 2.69 vs. 1.25; LCI: 27.91 vs. 12.11; TyG: 9.21 vs. 8.41; TIMI: 18.66 vs. 15.63; p < 0.001). The highest and lowest HSI and ANI values were detected in the MUO phenotype. After adjustment for age, sex, physical activity, and years of education, VAI showed the highest Odds Ratio for MUNO (OR: 5.65; 95% CI: 5.12, 6.24) and MUO (OR: 5.40; 95% CI: 5.89, 5.95) compared to the MHNO phenotypes (p < 0.001). The ANI indices was associated with a reduced risk of MUO (OR: 0.76; 95% CI: 0.75-0.78), MUNO (OR: 0.88; 95% CI: 0.87-0.90), and MHO (OR: 0.79; 95% CI: 0.77-0.81) phenotypes (p < 0.001). CONCLUSION: MUNO phenotype was exposed to a higher risk of cardiovascular disease compared to the MHO phenotype. VAI was found to be the optimal index for cardiovascular risk assessment.

Effect of Sitagliptin Versus Glibenclamide on Glycemic Markers, Lipid Profile Inflammatory and Oxidative Stress Factors in Type 2 Diabetes Patients: a Double-Blinded Randomized Controlled Trial.

Objectives:Diabetes mellitus is leading to chronic complications, including cardiovascular diseases. The aim of this study was to compare the effect of Sitagliptin and Glibenclamide on glycemic markers, lipid profile inflammatory, and oxidative stress factors in type 2 diabetes patients. Methods: This double-blinded randomized controlled trial was performed on patients with type 2 diabetes mellitus (n=54). The treatment group (27 patients) received 100 mg of Sitagliptin once daily + 500 mg Metformin twice daily, orally, for 12 weeks, and the control group (27 patients) was given 5 mg of Glibenclamide once daily + 500 mg Metformin twice daily, also orally, for 12 weeks. Serum levels of tumor necrosis factor alpha (TNF-α), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), lipid profile [cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglyceride (TG)], fasting blood sugar (FBS) and hemoglobin A1C (HbA1c), body weight, and body mass index (BMI) were measured before and after the study. Results:In both groups, the FBS level was significantly reduced from baseline (P=0.03 in the Sitagliptin group and P=0.02 in the Glibenclamide one). The percent of HbA1c was also significantly reduced from baseline in both the Sitagliptin group (P=0.01) and the Glibenclamide one (P=0.008). However, comparing the groups, these changes were not different. In the Sitagliptin group, IL-6 was significantly reduced from baseline (P=0.01) as well as in comparison with the Glibenclamide group (P=0.001). The TG level was significantly lower than the baseline in the Sitagliptin group (P=0.03), so changes between groups were significant (P=0.04). Weight and BMI were significantly increased from baseline in the Glibenclamide group (P=0.02 and P=0.03, respectively), and their changes between the two groups were also significant (P=0.001). Conclusion:These finding support the favorable effects of Sitagliptin on cardiovascular risks beyond its advantages on insulin-glucose hemostasis in patients with type 2 diabetes.

Frequency of type I and II diabetes in newly diagnosed diabetic patients: Measuring C-Peptide level.

AIMS: Diabetes mellitus is a metabolic disease that manifested as hyperglycemia due to the defect in secretion or function of insulin. This study aimed was to survey about frequency type I and II diabetes in newly diagnosed diabetic patients base on c-peptide and anti-glutamate acid decarboxylase (GAD) tests. MATERIALS & METHODS: This study was conducted as a prospective study on 70 diabetic patients aged 15-45 years old who referred to diabetes clinics in Ahvaz city during 2012-2014 and their diabetes was diagnosed for the first time, but their type of diabetes was not clinically definitive. Patients with anti-GAD positive and fasting C-peptide level of less than 0.65 were diagnosed as type I diabetes. Patients with anti-GAD negative fasting C-peptide level of greater than or equal to 0.65 were considered as type II diabetes. RESULTS: Eighty two patients (49 males and 33 females) with a mean age of 21.64 ±â€¯4.36 years (range 15-34) and a mean BMI of 22.05 ±â€¯4.41 kg/m2 (range 14-18) were studied. Twenty three patients (28.5%) had type I diabetes and 59 patients (71.95%) had type II diabetes. In patients with type I diabetes, the mean BMI was 24.86 ±â€¯2.36 kg/m2 and the number of patients with family history (56.22%) was higher. In type II diabetic patients, the number of women (62.71%) was higher than that of men. CONCLUSION: Anti-GAD test can be used as a predictive test for early diagnosis of disease and screening of people with a diagnosis of diabetes based on the type of diabetes.

Incidence of obesity, overweight and hypertension in children and adolescents in Ahvaz southwest of IRAN: Five-years study.

OBJECTIVE: The purpose of this study was to investigate the incidence of obesity, overweight and hypertension in children and adolescents aged 10-15 in Ahvaz. METHODS: This is a epidemiologic study performed on 176 people aged 10-15 in Ahvaz. In 2009, 300 people underwent weight, height and blood pressure measurements. Five years later, the same people were reassessed for obesity, overweight and hypertension, of whom a total of 176 people agreed to repeat the procedure. RESULTS: The study included 100 (57%) males and 76 (43%) females. Mean BMI was 22.1 ±â€¯4.3 kg / m2 in year 2014, without any significant difference between the two sexes (P = 0.518). In the same year, the prevalence of obesity and overweight was 26 (14.8%) and 13 (7.4%), respectively. After 5years, BMI increased significantly (P < 0.001). Of the 150 norma participants with normal BMI in 2009, 15 (10%) and 6 (4%) became overweight and obese in 2014 respectively. The mean systolic and diastolic blood pressures increased significantly over 5 years P = 0.042 and P < 0.001. CONCLUSIONS: This study shows an increase in mean BMI and mean systolic and diastolic blood pressures after 5 years among people aged 10-15 in Ahvaz.

Vitamin D level in non-diabetic adult people with metabolic syndrome.

AIMS: The aim of this study is comparison the level of Vitamin D deficiency in non-diabetic adult people with metabolic syndrome in Ahvaz. MATERIAL & METHODS: This descriptive study investigation carried out on a population of individuals with metabolic syndrome. ATPIII criteria were used for metabolic syndrome. Serum concentration of 25 (OH Vit D) of below 5 ng/ml was considered as severe deficiency, 5-10 ng/ml as average deficiency, 10-20 ng/ml as slight deficiency, and above 20 ng/ml as normal. RESULTS: The results showed mean level of vitamin D was not significant in individuals with and without HTN and in different genders (P > 0.5). No significant difference was found between case and control groups in terms of the distribution level of vitamin D (P > 0.5). In both groups, the difference between blood pressure (systole and diastole) was not significant in cases of severe and average deficiencies. But it was significant different in the group with slight deficiency (P = 0.03). In the case group, 58% of the participants had FBS>100. CONCLUSION: The group with metabolic syndrome had a higher intensity of vitamin D deficiency compared to the control group.

Evaluation of psychological resistance to insulin treatment in type II diabetic patients.

AIMS: Various studies have demonstrated that the majority of the factors affecting the reluctance of individuals to insulin injections are rooted in psychological factors. Present study aimed to determine relationships between main causes of refusal to insulin injection in diabetic patients and factors such as age, gender, and educational degree of patients. MATERIAL & METHODS: This was a descriptive study which was conducted on diabetic patients (n = 505) who need insulin therapy. The data were collected with a questionnaire in following steps. First, the most important causes of patients' reluctance, in the patients' opinion, to insulin therapy were determined using the data of the previous studies. In the second step, the patients were asked to express their opinion on each of these factors and the recorded responses were analyzed. RESULTS: The results of the study showed that fear of ampoules, fear of pain caused by insulin and the embarrassment of patients from injections in public significantly depended on the gender of the patients, so that these factors were much lower in men than women. In addition, these factors in the patients with higher degrees of education led to lower level of refusal to insulin injections. Another factor influencing the reluctance to insulin injections was the forming of a sense of addiction due to daily insulin injections, which was significantly lower among the patients with higher education, but did not have a significant relationship with sex of the patients. In this regard, another factor was fear of hypoglycemia and insulin side effects, which did not have a significant relationship with gender and educational degree. In addition, there was no significant relationship between the patient's age and any of the factors effective in patients' reluctance to insulin injections. CONCLUSION: Psychological factors seem to be effective in the emergence of the sense of reluctance to insulin injections. Therefore, not only patients but also the entire society need to receive training and appropriate services to improve their attitude to this issue with a psychological approach and help to solve this problem.

Prevalence of hypertension and prehypertension in adolescence in Ahvaz, Iran.

BACKGROUND: High blood pressure is a risk factor for some disease like stroke, coronary heart disease, and renal failure. High blood pressure in children is an increasing health problem. OBJECTIVES: The aim of this study was to determine prevalence of hypertension and pre-hypertension age between 10 to 17 years old. PATIENTS AND METHODS: This descriptive analytic study was conducted using multiphase sampling method in Ahvaz (Southwest of Iran). A questionnaire include: height, weight, and body mass index, systolic and diastolic blood pressures filled for each participant. Blood pressure was measured twice for each person. For the diagnosis of hypertension, the fourth report of the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents of the National Health Institute of United States was used. RESULTS: Total participants of the study were 1707children and adolescents including 922 boys (54%) and 785 girls (46%). The prevalence of high blood pressure was 1.7% (2.5% in boys and 0.8%). The prevalence of pre-hypertension was 9%(7.6% in boys, 10.6% in girls). The mean systolic and diastolic blood pressures increased with increasing body mass index. CONCLUSIONS: The prevalence of high blood pressure was found to be lower than other studies in our country. The prevalence of the high blood pressure in boys was significantly higher than girls. This study, like other studies showed high correlation between being overweight and an increase in systolic and diastolic blood pressure.

Prevalence of metabolic syndrome and its correlated factors among children and adolescents of Ahvaz aged 10 - 19.

BACKGROUND: Population-based studies for prevalence of metabolic syndrome (M.S) in children and adolescents are relatively rare. The aim of this study was to assess the Prevalence of M.S and correlated factors among children and adolescents aged 10 to 19 years in Ahvaz. METHODS: In this descriptive-analytical population- based study, 2246 children and adolescents, 10-19 years old (1113 male and 1133 female) in Ahvaz, were evaluated. Anthropometry, biochemical measurement and blood pressure (BP) were assessed. Modified ATP III criteria 2005 were used for M.S. definition. Center for disease and Control preventions (CDC) percentile were applied to define cut off points of waist circumference and BP. RESULTS: Prevalence of M.S. was 9% (95% CI: 8-10%) with prevalence in male 11% (95% CI: 10-12%) and female 7% (95% CI 6-8%). Among individuals with M.S, triglyceride (TG) and decreased high density lipoprotein (HDL) cholesterol levels were the most common components (33.5% and 24.1%, respectively). Prevalence of M.S was higher in overweight persons comparing to participants with at risk and normal weight group (in male: 24.1%, 14.3% and 9.9% respectively P = 0.0001), (in female: 22.6%, 18.3% and 4.5% respectively P = 0.0001). Among the correlated factors of M.S age (P = 0.0006), sex and BMI (P = 0.0001) had significant differences between subjects with and without M.S. whereas there was no significant difference between two groups in ethnicity, history of breast fed, birth weight neonatal ICU admission, maternal history(GDM, gestational HTN, Parity) and family history of HTN, obesity and DM (P > 0.05). CONCLUSION: This study shows high prevalence of M.S in Children and Adolescents in south west of Iran (Ahvaz) especially in overweight persons.