Prevalence of Complementary and Alternative Medicine Use and Its Associated Factors among Iranian Diabetic Patients: A Cross-Sectional Study

Objective

This cross-sectional study aimed to assess the prevalence of complementary and alternative medicine (CAM) use and its associated factors among diabetic patients in Fasa, a city in southern Iran.

Methods

Data were collected from diabetic patients who visited the endocrinology clinics at Fasa University of Medical Sciences. A structured questionnaire was administered to gather information on CAM use, including the types of CAM modalities used, and reasons for use. The patient's demographic and clinical characteristics, such as age, gender, duration of diabetes, glycosylated hemoglobin (HbA1c) levels, and quality of life (QoL) were also recorded. Descriptive statistics were used to determine the prevalence of CAM use, while logistic regression analysis was employed to identify factors associated with CAM use.

Results

A total of 376 diabetic patients participated in the study, with more than 89% reporting CAM use within the past year. Herbal preparations were the most commonly used type of CAM, with a prevalence rate of 99.4%. Factors associated with CAM use included patients' psychological health, attitude towards the safety of CAM, belief in the synergistic effects of combining routine medications with CAM, and previous positive experiences with CAM.

Conclusion

The high prevalence of CAM use highlights the importance of considering it in diabetes management and the need for healthcare professionals' engagement in open discussions with patients about their CAM practices. Understanding the factors influencing CAM use can inform healthcare providers and policymakers in developing appropriate strategies for integrating CAM approaches into conventional diabetes care.

Evaluation of the Expression of Infection-Related Long Noncoding RNAs among COVID-19 Patients: A Case-Control Study

Background and Aims

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a worldwide pandemic, activates signaling cascades and leads to innate immune responses and secretion of multiple chemokines and cytokines. Long noncoding RNAs (lncRNAs) have a crucial role in inflammatory pathways. Through our search on the PubMed database, we discovered that existing research has primarily focused on examining the regulatory impacts of five lncRNAs in the context of viral infections. However, their role in regulating other conditions, including SARS-CoV-2, has not been explored. Therefore, this study aimed to investigate the expression pattern of lncRNAs in the peripheral blood mononuclear cells (PBMC) and their potential roles in SARS-CoV-2 infection. Potentially significant competing endogenous RNA (ceRNA) networks of these five lncRNAs were found using online in-silico techniques.

Methods

Ethylenediaminetetraacetic acid (EDTA) blood samples of the control group consisted of 45 healthy people, and a total of 53 COVID-19-infected patients in case group, with a written informed consent, was collected. PBMCs were extracted, and then, the RNA extraction and complementary DNA (cDNA) synthesis was performed. The expression of five lncRNAs (lnc ISR, lnc ATV, lnc PAAN, lnc SG20, and lnc HEAL) was assessed by real-time PCR. In order to evaluate the biomarker roles of genes, receiver operating characteristic (ROC) curve was drawn.

Results

Twenty-four (53.3%) and 29 (54.7%) of healthy and COVID-19-infected participants were male, respectively. The most prevalent symptoms were as follows: cough, general weakness, contusion, headache, and sore throat. The results showed that three lncRNAs, including lnc ISR, lnc ATV, and lnc HEAL, were expressed dramatically higher in the case group compared to healthy controls. According to ROC curve analysis, lnc ATV has a higher AUC and is a better biomarker to differentiate COVID-19 patients from the healthy controls. Then, using bioinformatics methods, the ceRNA network of these lncRNAs enabled the identification of mRNAs and miRNAs with crucial functions in COVID-19.

Conclusion

The considerable higher expression of ISR, ATV, and HEAL lncRNAs and the significant area under curve (AUC) in ROC curve demonstrate that these RNAs probably have a potential role in controlling the host innate immune responses and regulate the viral replication of SARS-CoV-2. However, these assumptions need further in vitro and in vivo investigations to be confirmed.

Association of Dietary Acid Load With Metabolic Syndrome and Its Components in Iranian Adults: A Cross-Sectional Study

Introduction Metabolic syndrome (MetS) remains one of the leading health challenges worldwide. A combination of genetic and environmental factors has been implicated in the etiology of MetS. Diet is a changeable environmental risk factor, and dietary modifications could significantly reduce the incidence and mortality of numerous diseases, including MetS. Certain dietary factors may contribute to MetS by affecting the acid-base balance within the body. This study examined the association of dietary acid load (DAL) with MetS and its components in Iranian adults. Materials and methods This cross-sectional study was conducted in 2022 on 6356 Iranian adults aged 35-70 years. Potential renal acid load (PRAL) and net endogenous acid production (NEAP) as two indicators of DAL were calculated based on nutrient intake data from validated food frequency questionnaires. MetS and its components were defined according to the Adult Treatment Panel III criteria. Logistic regression analysis was used to explore the associations between DAL and MetS and its components. Age, energy intake, physical activity, education, marital status, home ownership, socioeconomic status, history of obesity-related disease, and calcium supplements were included in model I. Further adjustment in model II was made for body mass index. Results Higher NEAP scores were associated with increased odds of low high-density lipoprotein cholesterol (HDL-C) in the crude model (OR: 1.26, 95% CI: 1.01-2.56, p trend = 0.06) in women, which was confirmed in the adjusted models. In model I, women in the last quintile of NEAP had 54% greater odds of having hypertriglyceridemia compared to the first quintile (OR: 1.54, 95% CI: 1.007-2.36, p trend = 0.02). This association was still significant and even stronger after further adjustment for BMI (OR: 1.55, 95% CI: 1.01-2.40, p trend = 0.01). In addition, in model I, men in the fourth quintile of NEAP had 5.68-fold greater odds of hyperglycemia compared to the first quintile (OR: 5.68, 95% CI: 1.18-27.25, p trend = 0.11). Similar results were found in the fully adjusted model (OR: 5.89, 95% CI: 1.19-28.99, p trend = 0.54). Conclusion There was no significant association between DAL and MetS. DAL was positively associated with the odds of low HDL-C and hypertriglyceridemia in women. Moreover, moderate DAL (NEAP) was associated with an increased odds of hyperglycemia in men.

Food co-consumption network as a new approach to dietary pattern in non-alcoholic fatty liver disease

Dietary patterns strongly correlate with non-alcoholic fatty liver disease (NAFLD), which is a leading cause of chronic liver disease in developed societies. In this study, we introduce a new definition, the co-consumption network (CCN), which depicts the common consumption patterns of food groups through network analysis. We then examine the relationship between dietary patterns and NAFLD by analyzing this network. We selected 1500 individuals living in Tehran, Iran, cross-sectionally. They completed a food frequency questionnaire and underwent scanning via the FibroScan for liver stiffness, using the CAP score. The food items were categorized into 40 food groups. We reconstructed the CCN using the Spearman correlation-based connection. We then created healthy and unhealthy clusters using the label propagation algorithm. Participants were assigned to two clusters using the hypergeometric distribution. Finally, we classified participants into two healthy NAFLD networks, and reconstructed the gender and disease differential CCNs. We found that the sweet food group was the hub of the proposed CCN, with the largest cliques of size 5 associated with the unhealthy cluster. The unhealthy module members had a significantly higher CAP score (253.7 ± 47.8) compared to the healthy module members (218.0 ± 46.4) (P < 0.001). The disease differential CCN showed that in the case of NAFLD, processed meat had been co-consumed with mayonnaise and soft drinks, in contrast to the healthy participants, who had co-consumed fruits with green leafy and yellow vegetables. The CCN is a powerful method for presenting food groups, their consumption quantity, and their interactions efficiently. Moreover, it facilitates the examination of the relationship between dietary patterns and NAFLD.

Home schooling during the COVID-19 pandemic: A randomized controlled trial of online exercise and ergonomics advice protocols on upper body symptoms

BACKGROUND

Understanding of students' musculoskeletal health under home-schooling during the COVID-19 pandemic is limited.

OBJECTIVES

(1) To investigate the prevalence and severity of musculoskeletal symptoms in home-schooled adolescents during the COVID-19 pandemic. (2) To evaluate the effect of an online exercise + ergonomics advice protocol on symptoms, compared with ergonomics advice alone.

DESIGN

Cross-sectional symptom survey identifying eligible participants, followed by a pragmatic randomized controlled trial.

SETTING

Online classes.

PARTICIPANTS

Survey: 354 students (mean 16.6 years).

TRIAL

188 students with upper body musculoskeletal symptoms.

INTERVENTIONS

Randomization to three groups (physical therapy exercises + ergonomics postural advice, ergonomics postural advice alone, nonintervention control) stratified by the site of symptoms (neck, shoulder, upper back). Interventions were orally delivered online (via WhatsApp) supplemented with written/illustrative material. Follow-up occurred at 8 weeks.

OUTCOME MEASURES

Survey: prevalence of symptoms (Nordic Questionnaire).

TRIAL

primary outcome = change in intensity of upper body symptoms (visual analogue scale); secondary outcome = number of participants reporting improvement in upper body symptoms.

RESULTS

The 12-month prevalence of musculoskeletal disorders in the survey was 38% neck, 28% shoulder, and 35% upper back, with mean pain intensity of 3.6, 3.9, and 3.8, respectively, on 0-10 visual analogue scale: Two-thirds reported symptoms in multiple anatomical regions. In the trial, there was no statistically significant difference between the exercise + ergonomics group and ergonomics alone group on the primary outcome, yet both groups showed reduced symptom intensity compared with control (p < .001). More participants in the exercise + ergonomics group reported improvement than in the ergonomics advice alone group (p < .02).

CONCLUSIONS

The prevalence of musculoskeletal symptoms was relatively high in home-schooled adolescents. Symptoms can be reduced by ergonomics advice with or without exercises, but the effect is enhanced by the addition of physical therapy exercises. The latter approach may be considered for improving schoolchildren's musculoskeletal health in the usual classroom setting.

Effect of tofacitinib on clinical and laboratory findings in severe and resistant patients with COVID-19

BACKGROUND

The efficacy and safety of a strong Janus kinase inhibitor, tofacitinib, in individuals suffering from severe coronavirus disease 2019 (Covid-19) pneumonia are not definite well.

METHODS

In this non-randomized and non-blinded trial, a total of 52 Iranian patients with severe COVID-19 associated with decreased oxygen saturation, elevated C-reactive protein, and/or persistent fever were included. A total of 52 patients were included in this study. Tofacitinib was administered to 29 patients (55.8%) in addition to the standard care treatments, whereas 23 patients (44.2%) were treated with the standard of care alone (mostly antiviral agents and corticosteroids). Tofacitinib was administered at a dose of 5 mg twice daily for up to 10 days. The primary outcomes were mortality rate, oxygen saturation level, CT findings, rate of breath, heart rate, and level of consciousness. Inflammatory cytokines and blood biomarkers were considered as the secondary outcomes.

RESULTS

Death from any cause through day 14 occurred in 51.7% of the tofacitinib group and 65.2% of the control group. There was no significant difference in lung radiographic findings between the intervention and control groups at the first day of the study and after the study period. However, a significant decrease was observed in the extent of lung tissue involvement in the intervention group after administration of tofacitinib. Regarding cell and blood biomarkers, a significant decrease in the CPK levels in the intervention group and Hct and ACE levels in the control group was observed after fourteen days of the study. Moreover, a significant increase in SGOT and ferritin values was detected in the control group 14 days after the beginning tofacitinib administration. Comparing control and intervention groups, there was a significant difference in hemoglobin, SGOT, LDH, ferritin, and ACE values between groups before the intervention, while after fourteen days of the study, no significant difference was found. In case of DHEAS and TSH levels, a significant decrease was seen in the intervention group compared to the control after the study period. No other significant improvement was detected in other outcomes of the tofacitinib group compared to the control.

CONCLUSIONS

The administration of tofacitinib combined with corticosteroids, is not effective enough to treat severe COVID-19 patients and the use of this medication should be considered before the disease deterioration.

An insight into the potential role of LINC00968 in luminal breast cancer: Case-control study and bioinformatics analysis

Background

Luminal A and B subtypes of breast cancer (BC) comprises up to 70% of all BC patients. LncRNAs can affect many biological and pathological processes, and dysregulation of them is related to human cancers. The potential role of lncRNA LINC00968 in luminal BC is still unclear.

Materials and methods

We analyzed the LINC00968 expression across 44 paired luminal BC tissues from the TCGA-BRCA RNA sequencing dataset. Besides, we used the GEPIA2 web server and GENEVESTIGATOR software, as well. Real-Time Quantitative Reverse Transcription PCR (qRT-PCR) assay was performed to confirm the LINC00968 expression in 71 paired luminal BC tissues and two luminal A cell lines (MCF7 and T47D). Moreover, to better understanding the potential role of LINC00968 in luminal BC, computational data analyses including co-expression analysis, functional annotation analysis, and genetic alteration analysis have been done.

Results

The results of data analyses retrieved from BRCA dataset and databases revealed the significant downregulation of LINC00968 in luminal A and B BC. Also, the results of qRT-PCR in luminal BC tissues and cell lines confirmed the earlier data. LINC00968 expression was negatively associated with tumor stage and lymph node metastasis. Additionally, functional annotation analyses revealed that LINC00968 might be involved in vascular development and angiogenesis, extracellular matrix organization, and cell motility and migration. LINC00968 might play role in some cancer-related signaling pathways.

Conclusion

Our study found that downregulation of LINC00968 might promote tumorigenesis, invasion, and metastasis of luminal BC.

Insilco prediction of the role of the FriZZled5 gene in colorectal cancer

INTRODUCTION

In this study, we aimed to elucidate the crosstalk between the Wnt/β-catenin signaling pathway and colorectal cancer (CRC) associated with inflammatory bowel disease (IBD) using a bioinformatics analysis of putative common biomarkers and a systems biology approach.

MATERIALS AND METHODS

The following criteria were used to search the GEO and ArrayExpress databases for terms related to CRC and IBD: 1. The dataset containing the transcriptomic data, and 2. Untreated samples by medications or drugs. A total of 42 datasets were selected for additional analysis. The GEO2R identified the differentially expressed genes. The genes involved in the Wnt signaling pathway were extracted from the KEGG database. Enrichment analysis and miRNA target prediction were conducted through the ToppGene online tool.

RESULTS

In CRC datasets, there were 1168 up- and 998 down-regulated probes, whereas, in IBD datasets, there were 256 up- and 200 down-regulated probes. There were 65 upregulated and 57 downregulated genes shared by CRC and IBD. According to KEGG, there were 166 genes in the Wnt pathway. FriZZled5 (FZD5) was a down-regulated gene in both CRC and IBD, as determined by the intersection of CRC- and IBD-related DEGs with the Wnt pathway. It was also demonstrated that miR-191, miR-885-5p, miR-378a-3p, and miR-396-3p affect the FriZZled5 gene expression.

CONCLUSION

It is possible that increased expression of miR-191 and miR-885-5p, or decreased expression of miR-378a -3p and miR396-3, in IBD and CRC results in decreased expression of the FZD5 gene. Based on the function of this gene, FZD5 may be a potential therapeutic target in IBD that progresses to CRC.

The relationship between pregnancy count and duration of breast-feeding with metabolic syndrome (Fasa Persian cohort study)

BACKGROUND

Changes that occur during pregnancy and after that during breastfeeding induce some symptoms similar to metabolic syndrome (MetS) risk factors. This study aims to determine the relationship between pregnancy, as well as the duration of breastfeeding and MetS controlling the effect of other risk factors like hypertension, glucose intolerance, triglyceride, central obesity, and reduction of high-density lipoprotein in women of Fasa Persian Cohort Study.

MATERIALS AND METHODS

In this cross-sectional study, 5015 women aged 35-70 years were investigated in the Sheshdeh region from 2016 to 2021, and the information related to the disease symptoms was collected through questionnaires, examinations, and laboratory tests. MetS was calculated based on two guidelines according to adult treatment panel III (ATP III) and international diabetes federation (IDF) methods. For reporting the data, the odds ratio with its 95% confidence interval was used. In order to eliminate the effect of confounders, logistic regression was used.

RESULTS

Prevalence of MetS showed a descending trend in women with up to two pregnancies and it reached 22.6% and 22.4% using ATPIII and IDF methods respectively, while with an increase in the number of pregnancies of more than two, MetS prevalence was ascending. The prevalence of MetS did not have any specific trend across various breastfeeding duration groups. Multivariate analysis approved that the odds ratio of developing MetS in comparison with women who had two pregnancies was significantly increasing trend when the pregnancy counts increased.

CONCLUSION

The chance of developing MetS based on both IDF and ATP III methods after adjustment for confounding effects would grow with an increase in the number of pregnancies to more than two and breast-feeding of more than seven years. It is recommended that women with more than two pregnancies or the long duration of breast-feeding women undergo a specialized examination to investigate and control MetS problems so that future diseases could be prevented.

Effectiveness of a school-based health education program to improve the symptoms of premenstrual syndrome in high school girls in Ilam

BACKGROUND

The premenstrual syndrome happens periodically and affects both the individual and family. The aim of this study was to determine the effect of the health education program on reducing premenstrual syndrome in high school girls in Ilam.

MATERIALS AND METHODS

This experimental study was conducted in girls' high schools in Ilam, in 2017-2018. In total, 120 students were enrolled in the study (intervention group = 61 and control group = 59) and selected through convenience sampling. In this study, a standard Premenstrual Symptoms Screening Tool (PSST) was used to diagnose students with premenstrual syndrome or Premenstrual Dysphoric Disorder (PMDD). The educational program for the intervention group was held in four sessions of 30 min for 4 consecutive weeks. The obtained data were analyzed by the SPSS statistical software at a significance level of less than 0.05.

RESULTS

The results showed a significant difference in the proportion of cases with moderate and severe PMS and PMDD between intervention and control groups in follow-up (P < 0.001). However, these proportions were not significantly different between the two groups in the baseline.

CONCLUSIONS

According to the results, the educational program can be recommended as an effective intervention for girls with moderate-to-severe premenstrual symptoms and premenstrual dysphoric disorder.

Rewiring of miRNA-mRNA bipartite co-expression network as a novel way to understand the prostate cancer related players

The differential expression and direct targeting of mRNA by miRNA are two main logics of the traditional approach to constructing the miRNA-mRNA network. This approach, could be led to the loss of considerable information and some challenges of direct targeting. To avoid these problems, we analyzed the rewiring network and constructed two miRNA-mRNA expression bipartite networks for both normal and primary prostate cancer tissue obtained from PRAD-TCGA. We then calculated beta-coefficient of the regression-model when miR was dependent and mRNA independent for each miR and mRNA and separately in both networks. We defined the rewired edges as a significant change in the regression coefficient between normal and cancer states. The rewired nodes through multinomial distribution were defined and network from rewired edges and nodes was analyzed and enriched. Of the 306 rewired edges, 112(37%) were new, 123(40%) were lost, 44(14%) were strengthened, and 27(9%) weakened connections were discovered. The highest centrality of 106 rewired mRNAs belonged to PGM5, BOD1L1, C1S, SEPG, TMEFF2, and CSNK2A1. The highest centrality of 68 rewired miRs belonged to miR-181d, miR-4677, miR-4662a, miR-9.3, and miR-1301. SMAD and beta-catenin binding were enriched as molecular functions. The regulation was a frequently repeated concept in the biological process. Our rewiring analysis highlighted the impact of β-catenin and SMAD signaling as also some transcript factors like TGFB1I1 in prostate cancer progression. Altogether, we developed a miRNA-mRNA co-expression bipartite network to identify the hidden aspects of the prostate cancer mechanism, which traditional analysis -like differential expression- was not detect it.

Expression analysis of hsa_circ_0020397, hsa_circ_0005986, hsa_circ_0003028, and hsa_circ_0006990 in renal cell carcinoma

Renal cell carcinoma (RCC) is a prevalent heterogeneous kidney cancer. So far, different genes have been reported for RCC development. However, its particular molecular mechanism remains unclear. Circular RNAs (circRNAs), a class of non-coding RNAs, are involved in numerous biological processes in different malignancies such as RCC. This study aims to assess the expression and underlying mechanism of four circRNAs (hsa_circ_0020397, hsa_circ_0005986, hsa_circ_0003028, hsa_circ_0006990) with possible new roles in RCC. In the experimental step, we investigated the expression of these four circRNAs in our RCC samples using quantitative real-time polymerase chain reaction. In the bioinformatics step, the differential expressed mRNAs (DEmRNAs), and miRNAs (DEmiRNAs) were obtained from the GEO datasets using the GEO2R tool. A protein-protein interaction network was constructed using the STRING database, and hub genes were identified by Cytoscape. Molecular pathways associated with hub genes were detected using KEGG pathway enrichment analysis. Then, we utilized the ToppGene database to detect the relationships between DEmiRNAs and hub genes. Furthermore, interactions between circRNAs and DEmiRNAs were predicted by the StarBase and circinteractome databases. Finally, a circRNA-DEmiRNA-hub gene triple network was constructed. Our results revealed that the expression of hsa_circ_0020397, hsa_circ_0005986, and hsa_circ_0006990 was downregulated in RCC tissues. Moreover, these circRNAs had a significantly lower expression in patients with a history of kidney disease. Furthermore, hsa_circ_0003028 and hsa_circ_0006990 showed higher expression in the tumor of participants with Lymphovascular/perineural invasion and oncocytoma type, respectively. Based on bioinformatic results, 15 circRNA-DEmiRNA-hub gene ceRNA regulatory axes were predicted, which included three hub genes, five miRNAs, and four selected circRNAs. In conclusion, the current work is the first to emphasize the expression of the hsa_circ_0020397, hsa_circ_0005986, hsa_circ_0003028, and hsa_circ_0006990 in RCC patients presents a novel perspective on the molecular processes underlying the pathogenic mechanisms of RCC.

Female high school students' knowledge and attitude toward breast cancer

BACKGROUND

Breast cancer is the most common cancer among women. Even though early detection and diagnosis of this disease can reduce mortality considerably, several studies have shown that more than 92% of women are unaware of the risk factors for breast cancer and of breast cancer screening tests. The simultaneous promotion of screening and provision of education can increase community health and reduce medical costs, and students can play a leading role in informing and educating people in society.

AIM

The present study aims to examine the level of knowledge and attitude of female students in senior high schools in Fasa regarding breast cancer screening.

METHODS

In this cross-sectional study, the random sampling method was applied to survey 350 female high school students, only 311 of whom completed the study. Questionnaires were completed in girls' high schools, and the data was analyzed by SPSS Software, Version 25.

RESULTS

The results revealed that more than 87% of students were unaware or had incorrect information regarding breast cancer screening. The link between the type of breast cancer information sources and students' general knowledge was significant. Most students were aware of the risk of breast cancer, but they were uninformed of its symptoms, risk factors, and prevention strategies, and students with a family history of breast cancer had a higher score in terms of mammography knowledge than students with no family history of breast cancer, although this difference was not significant (mean ± standard deviation = 0.94 ± 0.90 vs. 0.67 ± 0.81, p = 0.19).

CONCLUSION

The level of awareness and attitude of Fasa high school girls regarding breast cancer and screening methods is not acceptable. Therefore, it is recommended that educational programs be implemented to increase the awareness of students in schools, so that the number of screenings increases with the institutionalization of this information. Likewise, by transferring information through students to their families, the level of awareness in the whole society will hopefully increase as well.

Altered Expression of hsa_circ_0001445 and hsa_circ_0020397 in Breast Cancer Representing Associations with BMI and Reproductive Factors

BACKGROUND

Circular RNAs (circRNAs), one of the recent subclasses of non-coding RNAs (ncRNAs), show pivotal functions in regulation of gene expression and have significant roles in malignancies including breast cancer (BC). This study was aimed to assess the hsa_circ_0001445 and hsa_circ_0020397 expression and role in BC, as well as the potential circRNA/miRNA/mRNA crosstalk in these contexts.

METHODS

The expression of hsa_circ_0001445 and hsa_circ_0020397 in 50 breast tumors and 50 normal tissues adjacent to the tumors was investigated using quantitative real-time polymerase chain reaction (qRT-PCR). Finally, bioinformatics analyses were used to uncover hsa_circ_0001445, hsa_circ_0020397-miRNA-mRNA potential regulatory networks.

RESULTS

The hsa_circ_0001445 expression was considerably downregulated in malignant tissues compared to their normal counterparts (P=0.020), while the hsa_circ_0020397 showed an upregulated pattern (P<0.001). Additionally, it was observed that the higher expression of hsa_circ_0001445 was associated with hair dye avoidance (P=0.034) and normal body mass index (BMI) (P=0.016) while hsa_circ_0020397 over-expression had an important association with a lack of vitamin D consumption (P=0.039). On the other hand, lower expression of hsa_circ_0001445 was significantly associated with age at menarche ˂14 years (P=0.027). Our study also revealed that the two circRNAs have potential ability to regulate key mRNAs and miRNAs in competing endogenous RNA (ceRNA) networks.

CONCLUSION

It is suggested that hsa_circ_0001445 and hsa_circ_0020397 with two opposite roles may be involved in BC development through sponging some miRNAs regulating ceRNA networks. However, their molecular interactions should be validated by further functional studies.

Translation and psychometric properties of the Persian version of the Audit of Diabetes Dependent Quality of Life (IR-ADDQoL)

BACKGROUND

This study aimed to undertake linguistic validation and assess the psychometric properties of the Persian version of the Audit of Diabetes-Dependent Quality of Life (IR-ADDQoL) questionnaire in Iranian patients with type 1 and type 2 diabetes.

METHODS

The gold-standard linguistic-validation procedure required by the developer of the ADDQoL (see https://www.healthpsychologyresearch.com ) including cross-cultural adaptation was followed. Validity and reliability of the Persian ADDQoL were then evaluated in a cross-sectional study of a sample of 153 patients with diabetes. Exploratory and confirmatory factor analyses were applied to assess structural validity. Internal consistency reliability was assessed.

RESULTS

Both forced one-factor and unforced four-factor solutions were extracted from the exploratory factor analysis that jointly accounted for 48% and 66.53% of the variance observed, respectively. Confirmatory factor analysis indicated an acceptable model fit for the Persian ADDQoL. Cronbach's alpha showed excellent internal consistency for the questionnaire (alpha = 0.931 for the single scale).

CONCLUSION

The Persian ADDQoL (IR-ADDQoL) showed adequate structural validity and excellent internal consistency. Therefore, it could be efficiently used to evaluate the impact of diabetes on quality of life in outcome studies and research settings in Iran.

The barriers to whole-grain consumption among Iranian students

Studies show that regularly consuming whole grains reduce the risk of obesity and a wide range of chronic diseases. Despite this, studies reveal that students are consuming fewer whole grains. In the present study, we aimed to investigate the barriers to the consumption of whole grains among Iranian students. This cross-sectional study examined students at Fasa, Iran in 2020–2021. The online questionnaires were completed by students after receiving informed consent. Statistical analysis was performed using SPSS 26 and Chi-square, t-test, and logistic regression (P > 0.05). The current study involved 1890 students (1287 (68.1%) girls and 603 (31.9%) boys). Despite the preference for white flour bread among 53.8% of all students, 77.4% ate other whole-grain products, and 75.2% consumed all products at least once a week. Additionally, barriers such as access issues (70.5%), family supply issues (91.8%), lack appeal (72.8%), non-consumption by classmates (96.2%), and high prices in recent years (43.9%) were identified as obstacles to whole grain consumption. Furthermore, white bread eating students had significantly lower appetite levels and tended to eat fast food more often than those who ate whole grains (P < 0.05). We found that slightly more than half of the participants preferred to eat bread prepared with refined flour. Several other factors, including lack of access, lack of attractiveness, product price, parents not purchasing whole-grain products, students not paying attention to nutrition labels, peers’ effect, and eating with friends instead of family, also contribute to students avoiding whole-grain products.

The role of ACE1 I/D and ACE2 polymorphism in the outcome of Iranian COVID-19 patients: A case-control study

Background: Since the beginning of the pandemic of coronavirus disease 2019 (COVID-19), many countries have experienced a considerable number of COVID-19 cases and deaths. The etiology of a broad spectrum of symptoms is still debated. Host genetic variants might also significantly influence the outcome of the disease. This study aimed to evaluate the association of angiotensin-converting enzyme (ACE1) gene Insertion/Deletion (I/D) polymorphism (rs1799752) and ACE2 gene rs1978124 single nucleotide polymorphism with the COVID-19 severity.

Methods: This study was conducted on 470 COVID-19 patients and a control group of 56 healthy individuals across several major cities in Iran. The blood sample and clinical data were collected from the participants, and their ACE1 I/D and ACE2 rs1978124 polymorphisms were determined using polymerase chain reaction and PCR-RFLP, respectively. Serum levels of C-reactive protein (CRP), interleukin 6 (IL-6), and ACE1 were measured in the blood samples.

Results: We found that the ACE1 DD genotype frequency was inversely correlated with the risk of intubation (p = 0.017) and mortality in COVID-19 patients (p = 0.049). Even after adjustment, logistic regression demonstrated that this significant inverse association remained constant for the above variables at odds ratios of (OR) = 0.35 and Odds Ratio = 0.49, respectively. Also, in the expired (p = 0.042) and intubated (p = 0.048) groups with II + ID genotypes, the mean level of CRP was significantly higher than in the DD genotype group. Furthermore, in both intubated and expired groups, the mean serum level of ACE1 was higher compared with non-intubated and survived groups with II or II + ID genotypes. The results also indicated that ACE2 rs1978124 TT + CT genotypes in females have a significant positive role in susceptibility to COVID-19; however, in females, the TT + CT genotypes had a protective effect (OR = 0.098) against the severity of COVID-19.

Conclusion: These findings suggest that ACE1 I/D and ACE2 rs1978124 polymorphism could potentially influence the outcome of COVID-19 in the Iranian population.

Upregulation of hsa_circ_0004812 promotes COVID-19 cytokine storm via hsa-miR-1287-5p/IL6R, RIG-I axis

Background

SARS‐CoV‐2 is one of the most contagious viruses in the Coronaviridae (CoV) family, which has become a pandemic. The aim of this study is to understand more about the role of hsa_circ_0004812 in the SARS‐CoV‐2 related cytokine storm and its associated molecular mechanisms.

Materials and Methods

cDNA synthesis was performed after total RNA was extracted from the peripheral blood mononuclear cells (PBMC) of 46 patients with symptomatic COVID‐19, 46 patients with asymptomatic COVID‐19, and 46 healthy controls. The expression levels of hsa_circ_0004812, hsa‐miR‐1287‐5p, IL6R, and RIG‐I were determined using qRT‐PCR, and the potential interaction between these molecules was confirmed by bioinformatics tools and correlation analysis.

Results

hsa_circ_0004812, IL6R, and RIG‐I are expressed higher in the severe symptom group compared with the negative control group. Also, the relative expression of these genes in the asymptomatic group is lower than in the severe symptom group. The expression level of hsa‐miR‐1287‐5p was positively correlated with symptoms in patients. The results of the bioinformatics analysis predicted the sponging effect of hsa_circ_0004812 as a competing endogenous RNA on hsa‐miR‐1287‐5p. Moreover, there was a significant positive correlation between hsa_circ_0004812, RIG‐I, and IL‐6R expressions, and also a negative expression correlation between hsa_circ_0004812 and hsa‐miR‐1287‐5p and between hsa‐miR‐1287‐5p, RIG‐I, and IL‐6R.

Conclusion

The results of this in‐vitro and in silico study show that hsa_circ_0004812/hsa‐miR‐1287‐5p/IL6R, RIG‐I can play an important role in the outcome of COVID‐19.

Air pollution exposure and mammographic breast density in Tehran, Iran: a cross-sectional study

BACKGROUND

Air pollution is one of the major public health challenges in many parts of the world possibly has an association with breast cancer. However, the mechanism is still unclear. This study aimed to find an association between exposure to six criteria ambient air pollutants (PM_2.5, PM₁₀, SO₂, NO₂, O₃, and CO) and mammographic breast density (MBD), as one of the strongest predictors for developing breast cancer, in women living in Tehran, Iran.

METHODS

Participants were selected from women attending two university hospitals for screening mammography from 2019 to 2021. Breast density was rated by two expert radiologists. Individual exposures to 3-year ambient air pollution levels at the residence were estimated.

RESULTS

The final analysis in 791 eligible women showed that low and high breast density was detected in 34.8 and 62.2 of participants, respectively. Logistic regression analysis after considering all possible confounding factors represented that an increase in each unit of NO₂ (ppb) exposure was associated with an increased risk of breast density with an OR equal to 1.04 (95CI: 1.01 to 1.07). Furthermore, CO level was associated with a decreasing breast density (OR = 0.40, 95CI = 0.19 to 0.86). None of the other pollutants were associated with breast density.

CONCLUSION

Higher MBD was associated with an increased level of NO₂, as a marker of traffic-related air pollution. Furthermore, CO concentration was associated with a lower MBD, while other criteria air pollutants were not related to MBD. Further studies are needed to evaluate the association between ambient air pollutants with MBD.

The best QT correction formula in a non-hospitalized population: the Fasa PERSIAN cohort study

Background

QT interval as an indicator of ventricular repolarization is a clinically important parameter on an electrocardiogram (ECG). QT prolongation predisposes individuals to different ventricular arrhythmias and sudden cardiac death. The current study aimed to identify the best heart rate corrected QT interval for a non-hospitalized Iranian population based on cardiovascular mortality.

Methods

Using Fasa PERSIAN cohort study data, this study enrolled 7071 subjects aged 35–70 years. Corrected QT intervals (QTc) were calculated by the QT interval measured by Cardiax® software from ECGs and 6 different correction formulas (Bazett, Fridericia, Dmitrienko, Framingham, Hodges, and Rautaharju). Mortality status was checked using an annual telephone-based follow-up and a minimum 3-year follow-up for each participant. Bland–Altman, QTc/RR regression, sensitivity analysis, and Cox regression were performed in IBM SPSS Statistics v23 to find the best QT. Also, for calculating the upper and lower limits of normal of different QT correction formulas, 3952 healthy subjects were selected.

Results

In this study, 56.4% of participants were female, and the mean age was 48.60 ± 9.35 years. Age, heart rate in females, and QT interval in males were significantly higher. The smallest slopes of QTc/RR analysis were related to Fridericia in males and Rautaharju followed by Fridericia in females. Thus, Fridericia’s formula was identified as the best mathematical formula and Bazett’s as the worst in males. In the sensitivity analysis, however, Bazett’s formula had the highest sensitivity (23.07%) among all others in cardiac mortality. Also, in the Cox regression analysis, Bazett’s formula was better than Fridericia’s and was identified as the best significant cardiac mortality predictor (Hazard ratio: 4.31, 95% CI 1.73–10.74, p value = 0.002).

Conclusion

Fridericia was the best correction formula based on mathematical methods. Bazett’s formula despite its poorest performance in mathematical methods, was the best one for cardiac mortality prediction. Practically, it is suggested that physicians use QTcB for a better evaluation of cardiac mortality risk. However, in population-based studies, QTcFri might be the one to be used by researchers.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12872-022-02502-2.

Oral contraceptive pill and metabolic syndrome: Fasa Persian Cohort Study (Descriptive study)

BACKGROUND AND AIMS

The contraceptive use is 56% and prevalence of metabolic syndrome (MetS) is 30% in Iran. The aim of this study investigates relationship between oral contraceptive pills (OCP) use and MetS in women in the cohort population of Fasa city.

METHODS

In a cross-sectional study, 5489 women aged 35-70 years were studied for 5 years in the Sheshdeh area in 2016. MetS were calculated using adult treatment panel III (ATP III) and international diabetes federation (IDF) methods. The odds ratio (OR) with a 95% confidence interval (CI) was reported. Linear regression was used to eliminate the confounding effect.

RESULTS

The OR of developing MetS in the OCP recipients was estimated as higher than the non-recipients. The OR of developing MetS using IDF criteria in OCP recipients was (OR = 0.896,95% CI:0.800-1.004). that increased to (OR = 1.230,95% CI:1.084-1.395) after adjusting for confounding variables. Also, the odds ratio using ATP (III) criteria was (OR = 0.900,95% CI:0.804-1.009). that increased to (OR = 1.245,95% CI:1.098-1.413) after adjusting for confounding variables. Also, the OR of developing MetS in OCP recipients decreased with increasing the number of MetS components from 1.199 to 0.812,95% CI:0.771-1.864,0.467-1.413, but after adjustment, increased from 1.151 to 1.747,95% CI:0.733-1.805,0.815-3.746.

CONCLUSION

The results of the present study showed that the OR of developing MetS in OCP recipients using both IDF and ATP (III) methods was higher after adjusting by confounder effects so it is recommended monitoring by physicians.

Potential roles of hsa_circ_000839 and hsa_circ_0005986 in breast cancer

Background

Breast cancer (BC) is one of the leading causes of death among women around the world. Circular RNAs (circRNAs) are a newly discovered group of non‐coding RNAs that their roles are being investigated in BC and other cancer types. In this study, we evaluated the association of hsa_circ_0005986 and hsa_circ_000839 in tumor and adjacent normal tissues of BC patients with their clinicopathological characteristics.

Materials and methods

Total RNA was extracted from tumors and adjacent non‐tumor tissues by the Trizol isolation reagent, and cDNA was synthesized using First Strand cDNA Synthesis Kit (Thermo Scientific). The expression level of hsa_circ_0005986 and hsa_circ_000839 was quantified using RT‐qPCR. Online in silico tools were used for identifying potentially important competing endogenous RNA (ceRNA) networks of these two circRNAs.

Results

The expression level of hsa_circ_0005986 and hsa_circ_000839 was lower in the tumor as compared to adjacent tissues. The expression level of hsa_circ_0005986 in the patients who had used hair dye in the last 5 years was significantly lower. Moreover, a statistically significant negative correlation between body mass index (BMI) and hsa_circ_000839 expression was observed. In silico analysis of the ceRNA network of these circRNAs revealed mRNAs and miRNAs with crucial roles in BC.

Conclusion

Downregulation of hsa_circ_000839 and hsa_circ_0005986 in BC tumors suggests a tumor‐suppressive role for these circRNAs in BC, meriting the need for more experimentations to delineate the exact mechanism of their involvement in BC pathogenesis.

The first report of clonidine in vivo/in vitro effects on infertile women with polycystic ovary syndrome (in vivo/in vitro study)

The sympathetic nervous system (SNS) is hyperactive in women with polycystic ovary syndrome (PCOS). This study was designed in two sections: in vivo/in vitro with clonidine as the alpha-2 adrenoceptor (ADR-α₂) agonist for modulating this hyperactivity. Eighty women with PCO participated in this randomised clinical trial (in vivo). A clonidine (0.1 mg) tablet was given twice a day for two months. Polycystic ovary morphology (PCOM) and pregnancy rate were the main outcome measurements. In the candidates for in vitro fertilisation (IVF), clonidine was added to the culture medium during IVF for two study groups (PCO-clonidine/PCO-without) and two control groups (egg donors-clonidine/egg donors-without). Our results showed that the pregnancy rate significantly was higher in the study group (p = .002). The mRNA expression of ADR-α₁ and ADR-β₂ in PCO was higher than control group (p value <.001). But ADR-α₁ expression in PCO-clonidine group decreased (p value = .042), the same as ADR-α₂ expression. The intensity of this effect showed a pattern for ADR-α₁<ADR-β₂<ADR-α₂. Increase of antral follicle count (AFC) growth and pregnancy rate indicate the significant role of ADR-α₂ in PCOS. Clonidine reduced gene expression and protein levels, confirming the above results. These results would aid in pharmacological treatments, as well as assisted reproductive technologies (ARTs).Impact StatementWhat is already known on this subject? In women with PCOS, sympathetic nerve activity is higher than in healthy women. Clonidine is widely used as an alpha-2 presynaptic adrenoceptor (autoreceptor) agonist to modulate the output of the sympathetic nervous system (SNS). Our in vivo/in vitro results showed that the optimal dose of clonidine can increase the oocyte maturity and pregnancy rate in PCO women. This finding was also confirmed by the results in cumulus cell culture.What do the results of this study add? The results of administration of 0.2 mg of clonidine (in vivo) for oocyte maturation and pregnancy rate confirms the in vitro response in the cumulus cell culture of PCO women's follicle.What are the implications of these findings for clinical practice and/or further research? These findings can be used in pharmacological treatment of anovulation and assisted reproductive technology (ART).

Expression profiles and functional prediction of long non-coding RNAs LINC01133, ZEB1-AS1 and ABHD11-AS1 in the luminal subtype of breast cancer

Background

Luminal breast cancer (BC) is the most frequent subtype accounting for more than 70% of BC. LncRNAs, a class of non-coding RNAs with more than 200 nucleotides, are involved in a variety of cellular processes and biological functions. Abberant expression is related to the development of various cancers, such as breast cancer. LINC01133, ZEB1-AS1, and ABHD11-AS1 were reported to be dysregulated in different cancers. However, their expression level in luminal BC remains poorly known. The aim of the present study was to evaluate the potential roles of these lncRNAs in BC, especially in luminal subtypes.

Methods

A comprehensive analysis was performed using the Lnc2Cancer database to identify novel cancer-associated lncRNA candidates. After conducting a literature review, three novel lncRNAs named LINC01133, ZEB1-AS1, and ABHD11-AS1 were chosen as target genes of the present study. Quantitative real‐time polymerase chain reaction (qRT-PCR) was used to evaluate the expression level of the mentioned lncRNAs in both luminal BC tissues and cell lines. Then, the correlation of the three mentioned lncRNAs expression with clinicopathological characteristics of the patients was studied. Moreover, several datasets were used to discover the potential roles and functions of LINC01133, ZEB1-AS1 and ABHD11-AS1 in luminal subtype of BC.

Results

According to the qRT-PCR assay, the expression levels of LINC01133 and ZEB1-AS1 were decreased in luminal BC tissues and cell lines. On the other hand, ABHD11-AS1 was upregulated in the above-mentioned samples. The expression levels of LINC01133, ZEB1-AS1, and ABHD11-AS1 were not associated with any of the clinical features. Also, the results obtained from the bioinformatics analyses were consistent with qRT-PCR data. Functional annotation of the co-expressed genes with the target lncRNAs, protein–protein interactions and significantly enriched Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways across luminal BC were also obtained using bioinformatics analysis.

Conclusions

Taken together, our findings disclosed the dysregulation of LINC01133, ZEB1-AS1, and ABHD11-AS1 in luminal BC. It was revealed that LINC01133 and ZEB1-AS1 expression was significantly downregulated in luminal BC tissues and cell lines, while ABHD11-AS1 was upregulated considerably in the mentioned tissues and cell lines. Also, bioinformatics and systems biology analyses have helped to identify the possible role of these lncRNAs in luminal BC. However, further analysis is needed to confirm the current findings.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12967-021-03026-7.

Sleep duration and anthropometric indices in an Iranian population: the Fasa PERSIAN cohort study

Recent decades have seen a dramatic rise in the prevalence of obesity. While genetic factors can influence obesity, environmental factors and lifestyle may play important roles as well. Sleep can be regarded as one of these factors. This study aimed to examine sleep duration, as a potential risk factor for obesity in an Iranian population. In this cross-sectional study, the Fasa PERSIAN cohort study data was used and 10,136 subjects aged 35-70 were entered. Anthropometrics indices have been measured and the total body fat percentage (BFP) was obtained by Bio-Impedance Analysis. Also, physical activity and dietary intake have been recorded. Sleep duration was obtained and individuals categorized into two groups of "< 8" and "≥ 8" h of sleep. The mean age and sleep duration of the participants were 48.63 ± 9.57 years and 6.92 ± 1.62 h in the total population, respectively. All of the anthropometric indices were significantly higher in the "< 8 h of sleep" group than in the "≥ 8 h of sleep" group. Regarding BFP and fat mass index (FMI) the same results was seen (p-value < 0.05). Body mass index (BMI), Waist and hip circumferences (WC, HC), and waist-to-height ratio (WHtR) were in a significant negative association with night time sleep (p-value < 0.001), while these associations with daytime napping were positive (p-value < 0.001). After multi-variable adjusting, BMI, WC, HC, WHtR, and wrist circumference showed significant negative associations with 24-h sleep duration (p-value < 0.05). This study established the association between nocturnal, daytime napping, 24-h sleep duration and obesity parameters. Daytime napping was positively associated with obesity parameters and short 24-h sleep duration was associated with higher risk of overweight/obesity. These results indicate that insufficient sleep can be a screening indicator for an unhealthy lifestyle and poor health outcomes.

Exploring the relationship between health literacy and fast food consumption: a population-based study from southern Iran

Background

Health literacy (HL) may affect the consumption of fast food. We aimed to evaluate the effect of HL on fast food consumption among adult populations in Iran.

Methods

We evaluated HL and fast food consumption in 421 adult participants with age range of 18–65 years old in Fasa, Fars Province, southern Iran. Two-step cluster and systematic sampling was performed to recruit the study sample. Data were collected using a fast food consumption checklist, and the Health Literacy Instrument for Adults (HELIA) by face-to-face interviews. Population data across groups with and without fast food intake were compared.

Results

Most participants used fast food every few months (49.9%). People with low or unstable income consumed more fast food than others (P < 0.05). Sandwich and hotdog were the most consumed fast food (60.8%) followed by pizza (34.9%). Sausage and soda were the most seasoning food (66.7%). Most participants used fast food as dinner (67.9%) and with family (72.2%), suggesting the institutionalized consumption of this type of food in the family. Fun was the most frequent reason for the use of fast food (66.5%). Most participants completely knew about the raw materials for fast food and their adverse effects. Finally, we found that overall health literacy was lower among those who used fast food than those who did not. Consumed fast food (68.16 ± 23.85 vs. 73.15 ± 20.15; p = 0.021). This difference was also observed for some components of health literacy including reading skills, and decision-making subscales.

Conclusions

The findings suggest there is a negative relationship between general health literacy and fast food consumption indicating that who possess lower level of health literacy is likely to consume more fast food. Specifically, the findings suggest that reading skills, and decision-making (behavioral intention) are more associated with decreased or increased fast food intake.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10763-3.

Interpretation of Hematological, Biochemical, and Immunological Findings of COVID-19 Disease: Biomarkers Associated with Severity and Mortality

The severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) spread rapidly all over the world in late 2019 and caused critical illness and death in some infected patients. This study aimed at examining several laboratory factors, especially inflammatory and immunological mediators, to identify severity and mortality associated biomarkers. Ninety-three hospitalized patients with confirmed coronavirus disease 2019 (COVID-19) were classified based on disease severity. The levels of biochemical, hematological, immunological, and inflammatory mediators were assessed, and their association with severity and mortality were evaluated. Hospitalized patients were mostly men (77.4%) with an average (standard deviation) age of 59.14 (14.81) years. The mortality rate was significantly higher in critical patients (85.7%). Increased serum levels of blood sugar, urea, creatinine, uric acid, phosphorus, total bilirubin, serum glutamic-oxaloacetic transaminase, serum glutamic-oxaloacetic transaminase, lactic dehydrogenase, C-reactive protein, ferritin, and procalcitonin were significantly prevalent (p=0.002, p<0.001, p<0.001, p=0.014, p=0.047, p=0.003, p<0.001, p<0.001, p<0.001, p<0.001, P<0.001, and p<0.001, respectively) in COVID-19 patients. Decreased red blood cell, hemoglobin, and hematocrit were significantly prevalent among COVID-19 patients than healthy control subjects (p<0.001 for all). Troponin-I, interleukin-6, neutrophil/lymphocyte ratio (NLR), procalcitonin, and D-dimer showed a significant association with the mortality of patients with specificity and sensitivity more than 60%. Age, sex, underlying diseases, blood oxygen pressure, complete blood count along with C-reactive protein, lactic dehydrogenase, procalcitonin, D-dimer, and interleukin-6 evaluation help to predict the severity and required management for COVID-19 patients. Further investigations are highly recommended in a larger cohort study for validation of the present findings.

A methylation signature at the CpG island promoter of estrogen receptor beta (ER-β) in breasts of women may be an early footmark of lack of breastfeeding and nulliparity

Although little is known regarding the mechanisms behind the onset of breast cancer (BC) through reproductive risk factors, new researches have highlighted some early tumor-related methylation footmarks in the breast tissue of apparently clinically healthy women as their potential epigenetic mechanism. Previous evidence supports that the estrogen receptor beta (ER-β), whose anti-cancer roles had already been revealed in BC, is downregulated in the breasts of healthy nulliparous women. Nevertheless, data on such a link about its methylation alterations have not been reported. The goal of current study was to determine possible methylation alterations at CpG island promoter of the ER-β gene, including promoter 0 N and exon 0 N, in relation to aspects of reproductive history in the healthy breasts. The DNA was extracted from the breasts of 120 subjects undergoing cosmetic mammoplasty. Thereafter, the methylation levels of targeted regions in ER-β gene were determined by using MeDIP-qPCR assay. The results revealed that ER-β exon 0 N had no methylation in 84.2 % of the women, whereas the rest, comprising 2.5 % and 13.3 % of the samples, showed a lower and higher of its methylation, respectively. Interestingly, nulliparous women were found to have an elevated methylation level of the ER-β exon 0 N than parous women (P = 0.036). Moreover, we observed a high methylation of the ER-β exon 0 N in the breasts of non-breastfeeding women compared to breastfeeding subgroup (P = 0.048). Likewise, the non-breastfeeding subgroup showed exon 0N high methylation in comparison to women with breastfeeding >24 months (P = 0.023). Finally, although we found that 6.67 % of the samples had a high methylation level at the promoter 0N, no any relationship was found between its methylation and reproductive history. These results may provide key clues to revealing the epigenetic mechanism through which the nulliparity and lack of breastfeeding influencing the risk factor of BC as well as introducing the potential new early prediction and prevention strategies. Although further investigations need to be done in order to gain a better understanding the roles of these epigenetic signatures.

Investigating the prevalence of hypertension and its associated risk factors in a population-based study: Fasa PERSIAN COHORT data

Background

A high prevalence rate of hypertension (HTN) and its subsequent serious complications made this disease a major health-treatment concern in many societies. The current study aimed to investigate the prevalence of hypertension and its associated risk factors in Fasa PERSIAN COHORT in south of Iran in 2019.

Methods

This was an analytical-cross sectional study. The study population were the individuals covered by Fasa cohort. Information of the first phase of Fasa Persian cohort in south of Iran was used in this study. Independent t test, chi-square test, analysis of variances, Pearson correlation coefficient, and multiple stepwise regression were used to analyze the obtained data. Thereafter, the data was analyzed using SPSS software version 22, and P value < 0.05 was considered as statistically significant.

Results

Out of 10,111 individuals included in the study, 5546 (54.86%) subjects were women and 4565 (45.16%) other were men. The overall prevalence rate of hypertension was estimated as 46.6%. In the present study, (16/1%) of the participants were with HTN stage 1, and (17/9%) of them were with HTN stage 2. The results show that there were significant positive correlations among HTN and age, BMI, HDL, TG, BUN, ALP, smoking, physical activity, cardiovascular diseases, diabetes, and renal failure (P < 0.5).

Conclusions

Prevalence of HTN in this study population is considerable. Therefore, it is suggested that health system should program some plans to prevent hypertension’s prevalence and eliminate its risk factors.

Evaluation of the potential role of long non-coding RNA LINC00961 in luminal breast cancer: a case-control and systems biology study

Background

Luminal subtype is the most common subgroup of breast cancer (BC), accounting for more than 70% of this cancer. Long non-coding RNAs (lncRNAs) are a group of RNAs which play critical roles in diverse cellular processes. It is proved that dysregulation of them can contribute to the development of various cancers, including BC. LINC00961 was reported to be downregulated in several cancers, however, its expression level in BC remains largely unknown. The purpose of the present study was to investigate the possible role of LINC00961 in luminal A and B subtypes of BC.

Methods

To obtain novel lncRNAs associated with different cancers and differentially expressed lncRNAs (DElncRNAs) between BC tumor and normal tissues, Lnc2Cancer and GDC databases were used, respectively. After performing literature review, the expression level of the selected lncRNA (LINC00961) was evaluated in 79 luminal A and B BC specimens and adjacent non-cancerous tissues by Quantitative Reverse Transcription PCR (qRT-PCR). LINC00961 expression was also evaluated in two luminal A BC cell lines, compared to a normal breast cell line. The comparison of the differences between tumor and adjacent non-tumor samples was performed by paired sample t-test. Moreover, correlation analysis between LINC00961 expression and clinicopathological features was performed using the chi-square, fisher exact, and independent t-test. In order to investigate the possible roles of LINC00961 in luminal A and B BC, different bioinformatics analyses such as functional annotation of the LINC00961 co-expressed genes and protein–protein interaction (PPI) networks construction were also performed.

Results

LINC00961 was selected as a significant DElncRNA which had not been studied in BC. According to q-RT PCR assay, LINC00961 was downregulated in luminal BC tissues and cell lines. Its expression was correlated with smoking status and the age of menarche in luminal BC patients. Also, the results of the bioinformatics analysis were consistent with the data obtained from q-RT PCR assay. The final results indicated that LINC00961 might be involved in multiple cancer-associated pathways such as chemokine, Ras and PI3K–Akt signaling pathways, GPCR ligand binding, and signal transduction in luminal subtypes of BC. CDH5, GNG11, GNG8, SELL, S1PR1, CCL19, FYN, ACAN, CD3E, ACVRL1, CAV1, and PPARGC1A were identified as the top hub genes of the PPI networks across luminal subgroup.

Conclusion

Our findings suggested that LINC00961 was significantly downregulated in luminal A and B subtypes of BC. Moreover, bioinformatics analysis provided a basis for better identification of the potential role of LINC00961 in luminal subtype of BC.

Expression of ADR-α1, 2 and ADR-β2 in cumulus cell culture of infertile women with polycystic ovary syndrome and poor responder who are a candidate for IVF: the novel strategic role of clonidine in this expression

OBJECTIVE

Alpha and beta-adrenoceptors (ADR-α1, 2, and β2) play a regulatory role in the folliculogenesis and steroidogenesis in the ovarian follicles. This study aimed to measure these adrenoceptors mRNA and its protein levels in cumulus cells (CCs) culture of poor ovarian reserve (POR) and polycystic ovarian syndrome (PCOS) infertile women (IVF candidate) and the effect of clonidine treatment at CCs culture.

METHODS

This case/control study was conducted in 2017 includes a control (donation oocytes) and two studies (PCO and POR) groups. The ovulation induction drugs were prescribed in all groups. After the oocyte puncture, the follicular fluid was collected and CCs were isolated were cultured. RNA was extracted and cDNA was synthesized and designed the primer for the ADR-α1, 2 and ADR-β2 gene expression. The protein levels were investigated by Western Blot.

RESULTS

The results showed a high level of three adrenergic expressions in PCO women compared to the control group (p-value <.001), which can be reduced by clonidine. POR group showed a significant decrease in the gene expression of ADR-α1 (p-value = .004) and ADR-α2 (p-value = .003) compared to the control group and clonidine treatment had no effect.

CONCLUSION

The significant increase of three adrenoceptors gene expression and protein levels in CCs culture indicate to the hyperactivity of the ovarian sympathetic nervous system at the receptor levels in women with PCOS, and clonidine confirmed it by reducing this expression. In POR women, the reduction of ADR-α1, 2 expressions maybe lead to the aging process in the ovary.

The immunomodulatory effects of mesenchymal stem cells on long term pulmonary complications in an animal model exposed to a sulfur mustard analog

INTRODUCTION

Sulfur Mustard (SM) is one of the most lethal chemicals with major complications manifested in the lungs. Although the pathogenesis behind SM-induced lung injury still remains poorly understood, prolonged activation and the imbalance of two major macrophage populations (M1 and M2) have been suggested to be involved. Here, we tried to investigate the effectiveness of adipose-derived mesenchymal stem cells (AD-MSC) on long-term lesions induced by CEES, an SM analog. The modulation of pulmonary immune cells and alveolar macrophage phenotype alteration was studied in the animal model used.

METHODS

Histopathological changes were investigated in the lungs and analysis of surface markers of alveolar macrophages as well as their cytokine expression in the BAL fluid was carried out by flow cytometry and ELISA, respectively.

RESULTS

Treatment of mice with AD-MSC after intraperitoneal administration of CEES (10 mg/kg) reduces progressive histopathologic changes in the lung. Flow cytometric analysis of isolated alveolar macrophages in the bronchoalveolar lavage showed that the accumulation of both M1 and M2 macrophages in response to CEES was reduced by MSC administration. AD-MSCs caused a marked reduction in the CD86- and CD206-expressing macrophages compared to the untreated groups. The modulating effect of AD-MSCs in the M1-subset was much more significant compared to M2. These findings suggest that AD-MSCs understand their environment and restore the balance in disorders associated with Th1 or Th2 imbalance. Our results indicate that MSCs may represent an effective approach to repair lung injury induced by mustards.

SP-A and TLR4 localization in lung tissue of SM-exposed patients

INTRODUCTION

Long-term pulmonary complications are one of the major long-term consequences of sulfur mustard (SM) exposure. Toll-like receptor 4 (TLR4) involves in the pathogenesis of several pulmonary disorders. Surfactant protein-A (SP-A) regulates LPS-induced TLR4 localization and activation responses. However, the intensity and significance of TLR4 and SP-A expression by lung cells in SM-exposed patients is not clear.

METHODS

The gene expression of TLR4 (through real-time PCR) and TLR4 and SP-A positive cells and alveolar type II cells, as SP-A producers, (using IHC) were assessed in formalin fixed paraffin embedded (FFPE) specimens from SM-exposed (n = 17), and non-SM exposed individuals (n = 12).

RESULTS

TLR4 gene expression did not change between study groups. However, its cell surface presentation was significantly reduced in SM-exposed patients and particularly in which with constrictive bronchiolitis compared with the control group (P < 0.001 and P = 0.002, respectively). Frequency of alveolar type II cells was lower in the case group rather than the control group while the number of SP-A positive cells did not alter.

CONCLUSIONS

These findings suggest that reduced TLR4 cell surface presentation may have anti-inflammatory function and SP-A may have a critical role in regulation of inflammatory responses in SM-exposed patients. Further investigation on other possible mechanisms involved in TLR4 internalization maybe help to illustrate the modulatory or inflammatory activity of TLR4 in these patients.

Angiogenesis modulatory factors in subjects with chronic ocular complications of Sulfur Mustard exposure: A case-control study

BACKGROUND

Chronic ocular complications of Sulfur Mustard (SM) exposure leads to severe ocular morbidity during time. The aim of this study was to compare serum levels of Interleukin 17 (IL-17), IL-12, vascular endothelial growth factor (VEGF)-C, VEGF-D and nitric oxide (NO) in SM-exposed patients versus the control group and to measure tear concentration of VEGF-C only in the SM-exposed group.

METHODS

In this prospective case control, 128 SM-exposed patients and 31 healthy control subjects were included. In the case group ocular manifestations were classified to three subgroups of mild (19 cases), moderate (31 cases) and severe (78 cases) forms of disease. Serum levels of IL-17, IL-12, NO, VEGF-C and VEGF-D, in all subjects and tear concentration of VEGF-C in SM-exposed group was evaluated.

RESULTS

All subjects were male and mean ± standard deviation (SD) of age in the case and control groups were 44.9 ± 8.8 and 40.9 ± 10.1 years, respectively. Except for significantly lower serum level of IL-17 (p < 0.001) and NO (p = 0.003), other values were not significantly different. The tear concentration of VEGF-C and serum level of IL-12 were not different between subgroups in the SM-exposed group, yet were significantly lower among those with abnormally dilated and tortuous conjunctival vessels and corneal pannus, respectively (p = 0.01, p = 0.015).

CONCLUSIONS

Exposure to SM significantly reduced serum level of IL-17 and NO in the delayed phase, yet did not influence VEGF-C; VEGF-D or IL-12.

Alteration in serum levels of ICAM-1 and P-, E- and L-selectins in seriously eye-injured long-term following sulfur-mustard exposure

INTRODUCTION

In this study, the serum levels of soluble intercellular adhesion molecule 1 (ICAM-1), P-, E-, and L-selectins were investigated in seriously eye-injured patients exposed to sulfur mustard (SM).

MATERIAL AND METHODS

A total of 128 individuals with SM-induced serious eye injuries and 31 healthy male controls were included in this study. The serum concentration of soluble forms of adhesion molecules was measured by enzyme-linked immunosorbent assay (ELISA) method.

RESULT

The serum level of soluble ICAM-1 was significantly higher in the SM-exposed individuals with an abnormality in tear meniscus height, corneal verticillata, and pannus compared with SM-exposed individuals without these abnormalities. There were no significant differences in the level of all three measured selectins between the SM-exposed group and the control groups. SM-exposed individuals with corneal defect had a significantly higher level of soluble E-selectin than SM-exposed individuals without this abnormality. The serum level of soluble P-selectin in the SM-exposed group with limbal abnormality was significantly lower than that in the SM-exposed without this abnormality; also it was significantly higher in SM-exposed group with fundus abnormality compared to that in the control group or SM-exposed group without this abnormality.

CONCLUSION

The changes in the levels of selectins and ICAM-1 in the SM-exposed group with various ocular abnormalities is a defense mechanism against the toxicity of SM. Further analysis is required to understand the molecular mechanisms of the relationship between adhesion molecules with ocular complications in SM-exposed individuals.

Investigation of the Association between 5-Hydroxytryptamine Transporter Gene-Linked Polymorphic Region with Type 2 Diabetes Mellitus, Obesity and Biochemical Profiles of Serum in Iranian Population

BACKGROUND

Type 2 Diabetes Mellitus (T2DM) is a serious problem in the world. 5-Hydroxytryptamine (5-HT, serotonin) plays an important role in obesity, glucose control and insulin resistance. The polymorphism of the serotonin transporter gene linked promoter region (5-HTTLPR) might influence 5-HTT expression and serotonin uptake. The polymorphism results in two alleles of L (Long) and S (Short). The aim of the present study was to evaluate the association between 5-HTTLPR genotypes in type 2 diabetes mellitus (T2DM), obesity as well as serum biochemical profiles in Iranian population from 2012 until 2015.

METHODS

180 patients with T2DM and 180 controls were selected and the frequency of S and L alleles was determined by PCR. Then, the relationship between genotypes, body mass index (BMI) and serum biochemical variables was investigated.

RESULTS

The frequency of S and L alleles in experimental and control groups was the same [for the L allele p=0.754, OR (95%CI)=1.103 (0.597 to 2.041) and for the S allele p=0.906, OR (95%CI)=(0.490 to 1.676)]. However, the mean triglyceride, cholesterol, LDL-C, systolic and diastolic blood pressure levels in the diabetic subjects with LL genotype were significantly higher than LS and SS genotypes (p<0.001) in this population.

CONCLUSION

The L allele of 5-HTTLPR was related to the increased serum lipids and blood pressure in the diabetic patients. However, there was no relationship between the polymorphism of 5-HTTLPR L/S and T2DM in Iranian population.

Assessment of Preventive Behavior for Cervical Cancer with the Health Belief Model

Introduction:

Cervical cancer is a leading cause of death in developing countries. However, taking regular Pap smears screening, one of the most effective screening tests, can reduce chance of cervical cancer remarkably. The first step in health education is choosing the right model, one of the best known being the Health Belief Model (HBM). Here, we evaluated different HBM factors with regard to cervical cancer preventive behavior in Fasa, Iran.

Materials and methods:

This cross-sectional study included 200 married women between the ages of 17 and 64 in Fasa during 2013. Participants were selected through stratified sampling from urban health centers. The questionnaire of the HBM included four sections and was filled out by interview. Data analysis was with SPSS 21, ANOVA and t-tests and Internal correlations between components of model were analyzed in terms of the Spearman Pearson correlation coefficient.

Results:

The mean age of the participants was 35.6±9.89 years. Some 52% had undergone a Pap test. The percentage values for participants’ knowledge and perceived susceptibility were 49.5% and 46%, respectively, considered as moderate. Perceived severity and benefits were good at 56.5% and 73%, respectively, while perceived barriers was moderate (46.5%). Also, 57.1% demonstrated a good self-efficacy and 61% good behavior.

Discussion:

We found that the most predictable factors for knowledge and behavior were age, income level, perceived benefits, perceived severity and self-efficacy according to the HBM. These factors should be taken into account for achieving acceptable preventive behaviors in health programs.

Expression levels of breast cancer-related GAS5 and LSINCT5 lncRNAs in cancer-free breast tissue: Molecular associations with age at menarche and obesity

Long noncoding RNAs (lncRNAs) constitute a major class of the human transcriptome which play crucial roles in the key biological processes of both normal and malignant breast cells. Although the aberrant expression of lncRNAs has been well-documented in breast cancer (BC), little is currently known about the association between their expression levels in the breast tissue of healthy women and BC risk factors, especially the reproductive or demographic characteristics that are among the most well-known BC risk modifiers. This study was an attempt to investigate the correlation between the expression levels of 2 breast cancer-related lncRNAs, including GAS5 and LSINCT5, and reproductive and demographic characteristics in 145 normal breast tissues that were obtained from women without breast cancer undergoing cosmetic surgery. Total RNA was extracted from fresh normal breast tissues, and the expression level of target lncRNAs was quantified using real-time qPCR. Differences in the mean normalized gene expression among the subgroups of different variables were analyzed. The expression levels of both genes was lower in the overweight-obese (BMI ≥ 25) subgroup than that in the normal BMI (BMI < 25) subgroup (GAS5 P = .019, LSINCT5 P = .036). Moreover, the expression level of GAS5 was negatively correlated with BMI (r: -.170, P: .041). The expression level of GAS5 was higher in women with late menarche (>13 years) than that with early menarche (≤13 years; P = .017). These findings may assist to obtain insights into the molecular mechanisms through which the reproductive or obesity-related estrogen changes contribute to the breast carcinogenesis. In conclusion, this study presents the first evidence for the presence of a link between the lncRNA expression and the reproductive or obesity related factors in the breast tissue of healthy women.

Dietary pattern in pregnancy and risk of gestational diabetes mellitus (GDM)

AIM

Among the most common metabolic disorders during pregnancy is gestational diabetes mellitus (GDM). This research was conducted to examine the dietary pattern in women with GDM.

MATERIAL AND METHODS

In this case-study, 204 pregnant women (104 cases and 100 control women) were chosen through convenient sampling and random sampling. The subjects' food intakes were assessed using semi-quantitative food frequency questionnaire, while their activities evaluated by physical activity questionnaire. Anthropometric indices were measured based on standard instructions, and the body mass index was calculated. The dietary patterns were determined using principal component analysis and its relationship with preeclampsia was tested using logistic regression method.

RESULTS

Unhealthy and healthy dietary patterns were found among the pregnant women. In the unhealthy group, after modifying the effect of confounding variables, a significant relationship was observed between dietary pattern and having gestational diabetes (OR = 2.838,95% CI:1.039-7.751). In the healthy group, on the other hand, the people in the fourth quartile had 149% and 184% higher chance not to catch gestational diabetes before and after modification with confounders, respectively (OR = 0.284,95% CI:0.096-0.838), when compared with people in the first quartile.

CONCLUSION

The findings indicated that selection of foods including fruits, vegetables, low-fat dairies, etc. as healthy dietary pattern is associated with diminished risk of GDM among pregnant women. Determining healthy dietary pattern during pregnancy, considering the foods consumed among pregnant women, as a useful and practical guide during this period can be publicized for training and nutritional interventions.

A link between expression level of long-non-coding RNA ZFAS1 in breast tissue of healthy women and obesity

BACKGROUND

Epidemiological and experimental literature indicates that the risk of breast cancer incidence is strongly linked to hormone-dependent factors, including reproductive history and obesity. However, the molecular mechanisms underlying the association between these factors and breast cancer risk are poorly understood. The aim of this study, therefore, was to determine whether obesity and reproductive history are associated with expression levels of two breast cancer-related long non-coding RNAs (lncRNAs), namely ZFAS1 and SRA1 in cancer-free breast tissues of women.

METHODS

In the current research, 145 healthy women were recruited, and the quantitative expression levels of the two lncRNAs were determined through qPCR assay after gathering the mammoplasty breast tissue samples.

RESULTS

It was found that women with body mass index (BMI)≥30 kg/m² and BMI 25-29 kg/m² show a low expression of ZFAS1 compared to the BMI<25 kg/m² (P=0.031 and P=0.027, respectively). Then, the correlation analysis disclosed a negative correlation of ZFAS1 low expression with increasing BMI (r=-0.194, P=0.019). Interestingly, this analysis demonstrated a negative correlation between low expression of the ZFAS1 and high BMI in women with menarche age below 14 (r=-221; P=0.028). Lastly, it was also revealed that there was a negative association of the low expression level of ZFAS1 with increasing BMI in women through regression models (B=-0.048, P=0.019).

CONCLUSIONS

These findings suggest interesting clues about the links between high BMI and the expression levels of ZFAS1 in non-diseased breasts that may help us better understand the underlying mechanisms through which obesity contributes to breast carcinogenesis. However, such results need more validations in future research.

Waist circumference is a mediator of dietary pattern in Non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is an example of pathological fat accumulation in the liver and one of the major health conditions in the world. This study aimed to examine the independent role of dietary patterns in the development of NAFLD. In a cross-sectional study, 1500 individuals referred to a nutrition clinic were randomly selected, their demographic, anthropometric and blood metabolic indices were obtained, and food frequency questionnaires were completed for them. Liver stiffness was calculated using the NAFLD score formula and fibroscan. The two dominant dietary patterns identified were the “healthy” and “unhealthy dietary patterns”. A significant percentage of those with NAFLD (45%) were in the upper quartile of the unhealthy model; however, only 10% had the healthy pattern (p < 0.001). In this study, 32.9 and 13.9% of the healthy and unhealthy participants were in the upper quartile of the healthy diet pattern. Also, it was shown that waist circumference is a strong mediator of dietary patterns and NAFLD relationship, and the indirect effect of diet through abdominal circumference is 28 times greater than the direct effect on NAFLD. The results suggested that healthy and unhealthy dietary patterns are respectively associated with lower- and higher-risk of NAFLD but the role of waist circumference as a mediator deserves more consideration.

Association of Sulfur Mustard-Induced Ocular Problems with Serum and Blood Biochemical Parameters Changes

BACKGROUND & OBJECTIVE

Many biochemical features of sulfur mustard (SM) intoxication have remained unknown. So far, the direct association between biochemical parameter changes and ocular problems in patients exposed to SM is not evaluated. The current study aimed at evaluating the associations between the ocular findings in patients with SM intoxication and the changes of serum and blood biochemical parameters.

METHODS

In the current study, 372 patients exposed to SM and 128 matched controls were compared concerning the association between their ocular problems and biochemical parameters. Ocular problems include photophobia, ocular surface discomfort (OSD), etc. Biochemical parameters include uric acid, creatinine (Cr), hematocrit (HCT), total, direct and indirect bilirubin, high-density lipoproteins (HDL), alanine aminotransferase (ALT), calcium (Ca), fasting blood sugar (FBS), mean corpuscular hemoglobin concentration (MCHC), etc.

RESULTS

The SM-exposed group with photophobia, OSD, tearing, blurred vision, abnormal tear status, and slit-lamp findings had significantly higher mean serum and blood levels of uric acid, Cr, HCT, and total and indirect bilirubin than the controls. The SM-exposed group with photophobia, tearing, ocular pain, blurred vision, bulbar conjunctival and limbal abnormalities had significantly higher mean serum and blood levels of HDL, ALT, Ca, FBS, MCHC, and HDL, indirect and total bilirubin, compared to the control group.

CONCLUSION

The association of photophobia with uric acid, OSD and tearing with Cr, photophobia with HDL, ocular pain with Ca, and blurred vision with FBS may be explained for their known ocular effects in the SM-exposed subjects. SM-induced biochemical changes may intensify the ocular problems induced by the direct effects of SM.

Relationship between metabolic syndrome and osteoarthritis: The Fasa Osteoarthritis Study

BACKGROUND

An association between metabolic syndrome (MeS) and osteoarthritis (OA) has been reported in recent years; however, conflicting findings have been reported regarding this matter. Inhere we evaluated the relationship between different components of MeS and OA in a Fasa osteoarthritis registry (FOAS).

METHODS

The registry includes all OA cases who referred to Fasa hospital (Iran) since 2013. Overall, 131 patients with OA with a Kellgren & Lawrence (K&L) score >1 and 261 controls were compared.

RESULTS

Overall, 82.4% of individuals in the OA group and 40.8% of participants in the control group had MeS (P<0.001). Patients with OA had a 6.8 (95% CI: 4.1-11.4) higher chance of acquiring MeS. After adjusting for sex, age, and BMI, odds' ratio (OR) for acquiring MeS in OA group increased to 10.9 (95% CI: 5.5-21.8). Among MeS criteria's, high waist circumference (WC) has strongest correlation for acquiring OA (OR=27.535, 95% CI: 6.003-126.306).

CONCLUSION

Our findings revealed that metabolic markers are strongly associated with OA and the addition of each component of the MeS, significantly increases the risk of developing OA, therefore control of metabolic factors and appropriate screening must be considered in health policy making and prevention programs.

New anthropometric indices or old ones: Which is the better predictor of body fat?

BACKGROUND

The percent and distribution of body fat are important factors in the pathogenesis of numerous diseases. Our aim was to investigate common anthropometric indices in their relationship with body fat content.

METHODS

In a cross-sectional study 1360 healthy individuals (580 men and 780 women) in a cluster sampling, from Ahvaz, Iran, body fat content (using bioelectrical impedance) and anthropometric measurements [weight, waist circumference, a body shape index, abdominal volume index, body adiposity index, conicity, body mass index, hip circumference, waist to hip ratio and waist to height ratio] was obtained. The ROC curve analysis was used to compare each index with body fat percent.

RESULTS

Significant difference was found between men and women in all anthropometric parameters (p < 0.001). Women displayed higher percentages in the overweight and obese categories (33.6% vs. 32.9% and 26.4% vs. 22.1%, respectively). In both men and women, the strongest correlations were seen between body fat percent and BMI, AVI and WHtR (r>7.9 and p<0.001). BMI, WHtR and AVI in men and BAI, BMI and WHtR in women showed the most accuracy for estimating body fat percent, respectively.

CONCLUSION

All anthropometric parameters could predict body fat percent with relatively good power, however BMI, WHtR and AVI are more powerful predictors. Based on our findings, we suggest using the AVI and WHtR instead of other indexes, as they are better able to assess the accumulation of fat in the abdominal area and are able to more accurately assess body fat percent, which are indicators of chronic disease.