Analysing cardiovascular risk factors and related outcomes in a middle-aged to older adults population in Iran: a cohort protocol of the Shiraz Heart Study (SHS).

INTRODUCTION: The significant increase in the rate of morbidity and mortality due to cardiovascular diseases has become a health challenge globally. Lack of enough knowledge on the underlying causes in Iran and taking the unique characteristics of the Shiraz metropolitan city (the capital city of Fars Province) into consideration prompted us to conduct the Shiraz Heart Study. The aim of this study is to determine the predisposing elements leading to coronary heart disease, cerebrovascular disease and peripheral arterial disease. METHODS AND ANALYSIS: In this population-based, prospective study, family physician clinics will become the executive arms. Participants aged 40-70 years old will be recruited to achieve a sample size of 10 000. Socioeconomicta and anthropometric indices supplemented by physical activity, nutritional and psychological questionnaires, as well as routine blood laboratory tests, medical history and electrocardiographic records, will be collected at enrolment in clinics. In addition, blood samples will be obtained to explore the possible role of genetics in outcome occurrence. Follow-up with blood sampling, completion of a lifestyle questionnaire and evaluation of clinical risk factors will be carried out five times in a 2-year interval for all participants. Advanced statistical methods such as mixed model and time-to-event models will be used for data analysis. ETHICS AND DISSEMINATION: This study is in accordance with the Helsinki Declaration and has been approved by the Research Ethics Committee of Shiraz University of Medical Sciences (No: 2017-358). Signing a written informed consent is the preliminary step. Participants are free to withdraw on their request at any time. Collected data are kept encrypted in a software with authorities' access only. Findings of the study will be published at a national or international scale through peer-reviewed journals.

Investigation of the Association Between 584C/T Polymorphism of EL Gene and Risk of Premature Coronary Artery Disease in Fars Province.

INTRODUCTION: Endothelial lipase (EL) is a protein from the triglyceride lipase family which plays an important role in high-density lipoprotein (HDL) metabolism. One of the most frequently studied variants is 584C/T which causes the amino acid threonine at codon 111 to convert to isoleucine. Many studies have shown the association of this variant with HDL-C level and CAD disease. METHODS: The population of this study consists of 140 patients (all males) with angiographically confirmed coronary artery disease (CAD) and 80 controls. Polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) was carried out for genotyping of LIPG 584C/T. Data were analyzed using SPSS. RESULTS: The results of the study indicated that the frequency of T allele was significantly lower among CAD patients than among controls (0.27 vs 0.36, P = .004). However, no significant correlation was found between the 584C/T variant and serum HDL-C level. Multivariate regression analysis confirmed that the T allele is significantly associated with CAD disregarding the age, hypertension, hypercholesterolemia, diabetes and HDL-C (OR = 0.494, 95% CI = 0.253- 0.968, P =.040). CONCLUSION: It was concluded that the T allele was associated with protection from CAD in Fars province independent of HDL-C level.

The Association of Lipoprotein Lipase Genes, HindIII and S447X Polymorphisms With Coronary Artery Disease in Shiraz City.

INTRODUCTION: Several polymorphisms at the lipoprotein lipase (LPL) locus are associated with variations in LPL activity serum lipid concentrations and the risk of coronary artery disease (CAD). The aim of this study was to investigate the role of the LPL S447X and HindIII polymorphism in a sample of subjects with CAD and compare them with healthy subjects. METHODS: The study enrolled 115 patients and 89 healthy subjects who were recruited from Namazi hospital in 2010-2012. The presence of two common polymorphisms of the LPL gene (HindIII and S447X) was determined by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) analysis using genomic DNA. SPSS 16.0 was used for statistical analysis. RESULTS: S447X was significantly different between the patients with CAD and the healthy subjects (P < 0.001). But HindIII was not significantly different between the patients with CAD and the healthy subjects (P = 0.741). Risk factors such as smoking, hypertension, hyperlipidemia, triglyceride (TG) and high-density lipoprotein (HDL) levels had a significant association with CAD. CONCLUSION: In our study, the presence of G allele S447X polymorphism increases the TG level and decrease HDL level, so it increases the susceptibility CAD. Moreover, HindIII polymorphism did not have any significant association with CAD.