Nutritional Education and Its Effects on Household Food Insecurity in Southeastern Iran

Background:

Food insecurity can affect health directly or indirectly through its impact on nutritional status. We aimed at determining the effects of nutrition education intervention on household food insecurity in Zahedan, southeast Iran.

Methods:

The study was conducted using multi-stage sampling method. The first stage was a cross-sectional investigation whereby 2,160 households were studied in Zahedan in 2015. The prevalence of food insecurity was determined and food-insecure households were identified. Household food security status was assessed through the 18-item US Household Food Security Survey Module. In the second stage, based on the determined sample size of 150 households in each group, eligible households were randomly divided into the intervention and control groups. Before the educational intervention, questionnaires including demographic and socioeconomic information were completed for both groups. Then, data analysis was performed and the intervention was conducted on the intervention group. Six months post-intervention, a final assessment was made by interviewing the two groups to complete demographic, socioeconomic, and household food security questionnaires.

Results:

The prevalence of food insecurity in the 2,160 households was 58.8%. After the intervention, the number of food-insecure households diminished by 22% in the intervention group, and these households were assigned to the food secure category. After controlling the confounding variables, the educational intervention was significantly effective in reducing food insecurity score (P<0.001).

Conclusion:

The findings demonstrated the beneficial role of nutritional education and the skills of resource management in modifying nutritional behaviors and improving food security in the study population.

Effects of vitamin D supplementation on circulatory YKL-40 and MCP-1 biomarkers associated with vascular diabetic complications: A randomized, placebo-controlled, double-blind clinical trial

AIM

Diabetic patients predispose to vascular diseases such as nephropathy, and retinopathy. Poor adherence to medical treatment and dietary recommendations in uncontrolled diabetes leads to vascular damages. Vitamin D has been extensively studied and found to be protective against diabetes mellitus. YKL-40 and Monocyte chemoattractant protein-1 (MCP-1) are considered to exert crucial role in diabetes and its complications. Therefore, this study was designed to investigate effects of vitamin D supplementation on serum levels of YKL-40 and MCP-1 involved in the development of diabetic complications.

METHODS

For 12 weeks, 48 type 2 diabetic patients enrolled in the trial and randomly were divided into two groups (n = 24 per group), receiving one of the following: 100 μg (4000 IU) vitamin D or placebo. Before and after intervention, serumYKL-40, MCP-1, insulin, IL-6, TNF-α, 25- (OH) vitamin D and HbA1c were measured.

RESULTS

Our results revealed that serum levels of 25 (OH) vitamin D significantly increased in vitamin D group (p < 0.001). Vitamin D supplementation also significantly reduced serum YKL-40 levels (-22.7 vs. -2.4 ng/ml; (p-value = 0.003)). There was a significant decline in MCP-1 concentration in intervention group at the end of the study (-45.7 vs. -0.9 pg/ml; (p = 0.001)). Furthermore, there was a significant decrease in IL-6, fasting insulin and HOMA-IR in intervention group after 3 months supplementation.

CONCLUSIONS

Daily vitamin D supplementation effectively reduced circulatory YKL-40 and MCP-1 levels in patients with type-2 diabetes and vitamin D deficiency. Vitamin D might contribute in reducing diabetic complications via modulating YKL-40 and MCP-1 signaling pathways.

Effects of vitamin D supplementation on depressive symptoms in type 2 diabetes mellitus patients: Randomized placebo-controlled double-blind clinical trial

AIM

Diabetes increases the odds of depression and depression is often associated with poor glycemic control and complications of diabetes. Vitamin D is also believed to improve glycemic control and ameliorate depressive symptoms. Therefore, we examined effects of vitamin D monotherapy (without antidepressant drugs) on depressive symptoms in Type 2 diabetic patients with mild to moderate depressive symptoms.

METHODS

We conducted 12 weeks, placebo-controlled, double-blind, randomized trial on 68 subjects with T2DM and mild to moderate depressive symptoms. Subjects received 100 μg (4000 IU) vitamin D (n = 32) or placebo (n = 34) daily. Beck Depression Inventory-II (BDI-II-PERSIAN) was applied for assessment of the severity of depression. Depression scores and metabolic profiles were measured at the beginning and end of trail.

RESULTS

after 3 months of vitamin D supplementation, mean values of 25(OH) D increased from 15.5 ± 8.8 to 32.2 ± 8.9 ng/ml (p-value <0.001) in the vitamin D group. Moreover, BDI-II scores decreased from 15.2 ± 9.6 to 9.8 ± 7.2 (p-value <0.001) in the vitamin D group and 15.5 ± 11.2 to 13.7 ± 11.5 (p-value = 0.03) in placebo group. This decrease in BDI-II scores were significant (27.6% vs 10.8%) compared with placebo (p-value = 0.02). In term of metabolic profiles, mean change in level of Hemoglobin A1c (HbA1c), insulin and triglycerides (TG) were significantly higher in response to the treatment with vitamin D compared to placebo (p-value <0.02).

CONCLUSIONS

In conclusion, supplementation of vitamin D in T2DM patients may protect these patients against the onset of major depressive disorder (MDD), with noticeable favorable effects on measures of metabolic profiles.

TRIAL REGISTRATION

NCT03008057.

The Effect of Vitamin D on Cellular Pathways of Diabetic Nephropathy

BACKGROUND

Diabetic nephropathy is one of the most important microvascular complications and a major cause of morbidity and mortality in diabetic patients. This study was designed to investigate the effect of vitamin D on the expression of three key genes involved in the development of diabetic nephropathy.

METHODS

Twenty-four male Sprague-Dawley rats were randomly divided into three groups. The first group served as control and the other two groups received intraperitoneal injections of 45 mg/kg STZ to develop diabetes. The groups were treated for four weeks either with placebo or two vitamin D injections of 20,000 IU/kg. Serum glucose, insulin, and HbA1c levels, and AGE cellular receptor (RAGE), aldose reductase (AR) and glutamine: fructose-6-phosphate aminotransferase (GFAT) gene expression were assessed in kidney tissue at the end of the experiment.

RESULTS

Vitamin D treatment resulted in a significant increase in insulin concentration, which could improve hyperglycaemia in diabetic rats. Serum HbA1c decreased slightly but insignificantly following the vitamin D injections. In addition, expression of GFAT, a key regulatory enzyme in the hexosamine pathway, was significantly reduced following vitamin D administration.

CONCLUSION

Vitamin D may reduce diabetic nephropathy not only by improving blood glucose and insulin levels, but also by modulating hexosamine pathways in kidney.

Resolvin D1 impacts on insulin resistance in women with polycystic ovary syndrome and healthy women

AIMS

The aim of this study was to determine the association between the intake of omega-3 PUFAs and the serum level of resolvin D1 and insulin resistance in women with Polycystic Ovary Syndrome (PCOS) compared to healthy women.

METHODS

A cross-sectional study was conducted in 2015-2016 in Tehran, Iran, among females referred to the infertility clinic at Valie-Asr Reproductive Health Research Centre. Thirty-one patients with PCOS (according to the criteria of the European Society for Human Reproduction and Embryology (ESHRE) and the American Society for Reproductive Medicine (ASRM)) and 29 healthy, normal cycling (NC) women of similar age, weight and height were enrolled. Anthropometric measurements, levels of resolvin D1, fasting insulin, glucose levels and insulin resistance index (HOMA) for each of the patients were determined.

RESULTS

Intakes of macronutrients (protein, carbohydrates, and total fat) and omega-3 PUFAs were higher in the PCOS group compared to the control group; also, the PCOS group had significantly higher resolvin D1, fasting insulin, glucose levels and HOMA when compared with the control group. Moreover, resolvin D1 correlated negatively with HOMA and fasting insulin levels among both the PCOS and control women.

CONCLUSION

PCOS is associated with insulin resistance. We showed that omega-3 PUFAs can increase the synthesis of resolvin D1. Resolvin D1 is involved in insulin sensitivity by affecting insulin signaling and inflammatory pathways. Therefore, it can be a contributing factor in reducing insulin resistance in PCOS patients.

Effects of vitamin D supplementation on advanced glycation end products signaling pathway in T2DM patients: a randomized, placebo-controlled, double blind clinical trial

BACKGROUND

Several researches have recommended vitamin D possible health benefits on diabetic complications development, but a few number of studies have been accomplished on the molecular and cellular mechanisms. Certain cellular pathways modification and also some transcription factors activation may protect cells from hyperglycemia condition induced damages. This study purpose was to determine the vitamin D supplementation effect on some key factors [advanced glycation end products (AGEs) signaling pathway] that were involved in the diabetic complications occurrence and progression for type-2 diabetes participants.

METHODOLOGY

48 type-2 diabetic patients (T2DM) randomly divided into two groups (n = 24 per group), receiving: 100-µg vitamin D or placebo for 3 months. At this study beginning and the end, the receptor expression for advanced glycation end products (RAGE) and glyoxalase I (GLO1) enzyme from peripheral blood mononuclear cells (PBMCs) and AGEs and tumor necrosis factor-α (TNF-α) serum levels were measured by the use of real-time PCR and ELISA methods, respectively.

RESULTS

This study results demonstrated that vitamin D supplementation could down-regulate RAGE mRNA [fold change = 0.72 in vitamin D vs. 0.95 in placebo) P = 0.001)]. In addition, no significant changes were observed for GLO1 enzyme expression (P = 0.06). This study results also indicated that vitamin D serum level significantly increased in vitamin D group (P < 0.001). Moreover, AGES and TNF-α serum levels significantly reduced in vitamin D group, but they were remained unchanged in the placebo group.

CONCLUSION

In conclusion, vascular complications are more frequent in diabetic patients, and vitamin D treatment may prevent or delay the complications onset in these patients by AGEs serum level and RAGE gene expression reducing.Trial registration NCT03008057. Registered December 2016.

Role of Melatonin in Body Weight: A Systematic Review and Meta-Analysis

BACKGROUND

Some trials on animals and human claim that melatonin can influence body weight. So we conducted a systematic review of controlled trials of melatonin effects on weight of human subjects.

METHODS

First we performed a systematic and comprehensive search in June 2015 on MEDLINE/PubMed, Scopus, Google scholar, hand searching in key journals, the list of references of selected articles and gray literature.

RESULTS

We included 7 clinical trials with a total of 244 patients. All studies were parallel clinical trials conducted at the clinic. Evaluating standardized mean difference (SMD) using Cohen's method shows that none of the included studies have found a strong and significant effect of melatonin on body weight. However, some have reported decreasing or increasing effect of melatonin on body weight. We pooled SMDs using random effects (DerSimonian and Laird). Pooled SMD was still not significant SMD (95% CI) = 0.09(-0.17-0.34), with lack of heterogeneity I2=0.0%, p=0.66.

CONCLUSION

We concluded that once the standard treatment had increasing effect on body weight, melatonin could be able to slightly diminish this effect and vice versa. Subgroup analysis showed that melatonin was more effective in child and adolescents. According to the results hypothesis of the buffering role of melatonin on body weight fluctuations can be proposed.

Association between uncoupling protein 2, adiponectin and resting energy expenditure in obese women with normal and low resting energy expenditure

Obesity is recognized as the most prevalent metabolic disease worldwide. Decreases in energy expenditure may increase risk of obesity. One of the key regulators of energy balance is uncoupling protein2 (UCP2), a transporter protein presents in mitochondrial inner membrane. Moreover, adiponectin is the most abundant adipocytokine, it may play a role in energy metabolism and gene expression of UCP2. The aim of this study was to investigate potential associations between the level of uncoupling protein 2 and adiponectin and their relationship with REE (Resting Energy Expenditure) in obese women with normal and low resting energy expenditure. A total of 49 subjects (women, 25-50 years old), were included in current study, 16 subjects with BMI > 30 and low resting energy expenditure, 17 subjects with BMI > 30 and normal resting energy expenditure and 16 non-obese subjects as a control group. Anthropometric, body composition parameters and resting energy expenditure were measured. Plasma adiponectin, UCP2 protein and total protein in PBMC were determined. Measured resting energy expenditure in obese subjects with low REE was significantly lower than other groups. Plasma adiponectin in the obese subjects with low REE was significantly lower compared to normal weight group. There was a significant relationship between 'UCP2 protein/Total protein' ratio and plasma adiponectin in obese group with low REE and in three groups when we pooled. There was a significant association between REE and plasma adiponectin in three groups when we pooled. There was a significant association between plasma adiponectin and REE. Moreover, there was a significant relationship between UCP2 and REE.

Relationship between estrogen and body composition, energy, and endocrine factors in obese women with normal and low REE

OBJECTIVE

The aim of this study was to investigate the relationship between estrogen and leptin, thyroid (T3), Uncoupling Protein2 (UCP2), sex hormone binding globulin (SHBG), and resting energy expenditure(REE) in obese subjects with normal and low REE, and to investigate the relationship of estrogen with body composition and energy intake.

METHOD

A total 49 subjects (25-50 years old) were selected. Anthropometric measurements, body composition, and resting energy expenditure were measured. Fasted circulating leptin, T3, SHBG and UCP2 levels were also measured. Subjects were divided to three groups: BMI > 30 and low resting energy expenditure (group I, n = 16), BMI > 30 and normal resting energy expenditure (group II, n = 17), and non-obese women as the control group (group III, n = 16).

RESULT

A significant association was observed between estrogen and REE in obese women with normal REE. There was a significant association between estrogen and leptin in groups I (β = 0.98, p < .0001), and II (β = 0.84, P < .0001). However, no significant association was observed between estrogen and T3 and UCP2 protein in the three groups. Regression analyses demonstrated no correlation between fat mass, percent fat mass, and plasma estrogen. Plasma estrogen was not correlated with caloric intake or macronutrients of the diet.

CONCLUSION

Estrogen has been shown to affect metabolism and hemostasis in obesity and increases resting energy expenditure via leptin. Production of UCP2 in PBMC is not affected by estrogen.

No genetic association between A118G polymorphism of μ-opioid receptor gene and schizophrenia and bipolar disorders

BACKGROUND

Schizophrenia (SZ) and bipolar disorder (BD) are chronic and multifactorial psychiatric disorders that might be affected by different genes in combination with environmental factors. There is evidence of association between polymorphisms of μ-opioid receptor gene (OPRM1) with these disorders.

OBJECTIVES

The aim of this study was to investigate the genetic association between OPRM1 A118G SNP in SZ and BD patients in comparison with healthy controls (HCs).

MATERIALS AND METHODS

One single-nucleotide polymorphism in OPRM1 was genotyped using TaqMan real-time PCR assay in 203 SZ and BD patients and 389 HCs.

RESULTS

There was no statistically significant difference in genotypic and allelic frequencies of OPRM1 A118G SNP between HCs and SZ/BD patients.

CONCLUSIONS

To find the underlying genetic factors associated with these complex disorders, further studies need to be conducted using larger sample size, different genetic populations, and different gene variations.

Beneficial effects of n-3 polyunsaturated fatty acids on adiponectin levels and AdipoR gene expression in patients with type 2 diabetes mellitus: a randomized, placebo-controlled, double-blind clinical trial

INTRODUCTION

There is evidence that n-3 polyunsaturated fatty acids (n-3 PUFAs) exert beneficial effects to improve type 2 diabetes mellitus (T2DM), but its complications remain poorly understood. Hypoadiponectinemia is one of the important mechanisms responsible for T2DM which necessitates developing novel therapeutic strategies. We aimed to determine the effect of n-3 PUFA supplementation on circulating adiponectin and mRNA expression of adiponectin receptors (AdipoR1, AdipoR2) and Sirt-1 in T2DM patients.

MATERIAL AND METHODS

A randomized, double-blind, placebo-controlled trial of 10-week follow-up of n-3 PUFAs (2.7 g/day) vs. placebo in T2DM patients (n = 88) was conducted. In detail, T2DM patients (n = 44) were treated with n-3 PUFAs and the remainder received placebo. Anthropometric and metabolic characteristics were assessed in all participants. Circulating level of adiponectin and mRNA expression of AdipoR1, AdipoR2 and Sirt-1 were measured in peripheral blood mononuclear cells (PBMC) using real-time polymerase chain reaction before and after the intervention.

RESULTS

It was found that n-3 PUFAs increased AdipoR1 gene expression (fold change = 1.321 in n-3 PUFAs vs. 1.037 in placebo) and AdipoR2 mRNA (fold change = 1.338 in n-3 PUFAs vs. 1.034 in placebo). No significant changes were observed for Sirt-1 expression. The serum level of adiponectin significantly (p = 0.035) increased in n-3 PUFAs (5.09 to 5.58 μg/ml) but remained unchanged in the placebo group.

CONCLUSIONS

Daily supplementation with n-3 PUFAs (2.7 g) was effective to significantly improve gene expression of AdipoR1 and AdipoR2 and the serum level of adiponectin in T2DM patients. Therefore, n-3 PUFAs might emerge as an adjuvant for current antidiabetic therapies. However, confirmatory long-term studies are required.

The Reliability and Validity of the Persian Version of Three-Factor Eating Questionnaire-R18 (TFEQ-R18) in Overweight and Obese Females

Objective: The Three-Factor Eating Questionnaire Reduced (TFEQ-R18) is one of the most widely used instruments for assessing eating behavior worldwide. The present study aimed at confirming the reliability and validity of the Persian version of TFEQ-R18 among overweight and obese females in Iran. Method: In the present study, 168 overweight and obese females consented to participate. We estimated the anthropometric indices and asked the participants to complete the TFEQ-R18. Beck Depression Inventory (BDI), Spielberger Anxiety Scale, Appetite Visual Analogue Rating Scale, Food Craving Questionnaire (FCQ), Compulsive Eating Scale (CES), and Restraint Eating Visual Analogue Rating Scale were performed simultaneously to assess concurrent validity. Two weeks later, TFEQ-R18 was repeated for 126 participants to assess test-retest reliability. Moreover, we reported the internal consistency and factor analysis of this questionnaire. Results: Using the results of the reliability analysis and exploratory factor analysis of the principal component by varimax rotation, we extracted 3 factors: hunger, cognitive restraint, and emotional eating. After removing the Items 16 and 18, the Cronbach's alpha was increased to 0.73 (The Cronbach's alpha of the factors was 0.84, 0.64, and 0.7, respectively). The results of the Pearson correlation revealed a consistency of 0.87 between the test and retest administrations (p = 0.001). Significant positive correlations were observed between TFEQ-R18 and BDI, Spielberger Anxiety Scale, FCQ, CES, appetite, body weight, fat percentage, and calorie intake. Moreover, a negative correlation was observed in Restraint Eating Visual Analogue Rating Scale and muscle percentage.Conclusion: This study aimed at presenting preliminary support for the reliability and validity of the Persian version of TFEQ-R18 and its psychometric characteristics. This instrument may be helpful in clinical practice and research studies of obesity, appetite, and eating behavior.

Impact of depression and disability on quality of life in Iranian patients with multiple sclerosis

Multiple sclerosis (MS) can influence all aspects of a patient's health. This study determines the main factors affecting quality of life (QoL) in Iranian MS patients. QoL (Multiple Sclerosis Impact Scale; MSIS-29), disability (Expanded Disability Status Scale; EDSS) and depression (Beck Depression Inventory; BDI) were assessed in 106 MS patients. EDSS, clinical course and MS duration significantly correlated with physical MSIS-29. Depression highly correlated with both physical and psychological MSIS-29. Regression analyses showed that depression and EDSS predicted physical health. Psychological health was predicted by depression. These findings highlight that depression and physical disability strongly influence QoL in Iranian MS patients. Multiple Sclerosis 2007; 13: 275–277. http://msj.sagepub.com

Various Effects of Omega 3 and Omega 3 Plus Vitamin E Supplementations on Serum Glucose Level and Insulin Resistance in Patients with Coronary Artery Disease

BACKGROUND

Omega 3 and vitamin E are two critical nutrients which include beneficial effects in coronary artery disease (CAD). The aim of this study was to assess the effects of omega 3 alone supplementation or in combination with vitamin E on serum glucose and lipid levels and insulin resistance in CAD patients.

METHODS

Participants of this clinical trial included 60 male patients with CAD who selected from Tehran Heart Center in Tehran, Iran in 2014. They received 4 g/day omega 3 plus 400 IU/day vitamin E (OE), 4 g/day omega 3 with vitamin E placebo (OP), or omega 3 and vitamin E placebo (PP) for two months. Serum glucose, lipids and insulin were assessed and HOMA-IR was calculated before and after the trial and effects of these nutrients on the highlighted parameters were compared within the study groups.

RESULTS

Serum glucose level increased significantly in OP group (P=0.004), but not in OE group. OE and OP groups showed a significant decrease in fasting serum TG (P=0.020 and P=0.001, respectively). Serum insulin and HOMA-IR decreased significantly in OE group (P=0.044 and P=0.039, respectively) but did not change significantly in OP group.

CONCLUSION

Although, omega 3 supplementation may include adverse effects on serum glucose level, co-administration of omega 3 and vitamin E can beneficially decrease serum insulin and insulin resistance in CAD patients.

The effect of 1, 25(OH)2 D3 (calcitriol) alone and in combination with all-trans retinoic acid on ROR-γt, IL-17, TGF-β, and FOXP3 gene expression in experimental autoimmune encephalomyelitis

OBJECTIVES

It has been shown that calcitriol and all-trans retinoic acid (ATRA) have modulatory effects on the immune system. The present study investigates the synergistic effects of combination treatment of calcitriol and ATRA in experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis (MS).

METHODS

The mice were allocated to four preventive groups, each consisting of eight animals, ATRA (250 μg/mouse), calcitriol (100 ng/mouse), combination of ATRA and calcitriol (125  μg/mouse and 50 ng/mouse) and vehicle groups. EAE was induced by MOG35-55 peptide in female C57BL/6 mice. Treatments were initiated at day 1 before immunization and continued every other day throughout the study until the day 21 post-immunization. Splenocytes were isolated from EAE-induced mice and the expression of retinoic acid receptor-related orphan receptor gamma t (ROR-γt), Interleukin-17 (IL-17), transforming growth factor beta (TGF-β), and forkhead box P3 (FOXP3) genes was measured using real-time polymerase chain reaction.

RESULTS

The expression of FOXP3 and TGF-β genes in the splenocytes of combination-treated and calcitriol alone-treated mice was significantly increased compared to vehicle group (P < 0.05). The expression of ROR-γt and IL-17 genes in the splenocytes of ATRA, calcitriol and combination- treated mice was significantly reduced compared to those of vehicle- treated mice (P < 0.05). The relative expression level of ROR-γt was significantly (P < 0.05) lower in the combination group than in the mice treated by ATRA or calcitriol alone.

DISCUSSION

This study demonstrated that treatment with combination of calcitriol and ATRA can be considered as a new strategy for MS prevention and treatment.

Longitudinal Serum Creatinine Levels in Relation to Graft Loss Following Renal Transplantation: Robust Joint Modeling of Longitudinal Measurements and Survival Time Data

BACKGROUND

Chronic kidney disease (CKD) is a major public health problem that may lead to end-stage renal disease (ESRD). Renal transplantation has become the treatment modality of choice for the majority of patients with ESRD. It is therefore necessary to monitor the disease progression of patients who have undergone renal transplantation. In order to monitor the disease progression, the continuous assessment of kidney function over time is considered.

OBJECTIVES

This study aimed to investigate the etiological role of recipient characteristics in serum creatinine changes within the follow-up period and in relation to the graft failure risk, as well as to evaluate whether or not the serum creatinine level represents an indicator of graft failure following renal transplantation.

METHODS

This retrospective cohort study was conducted at the department of nephrology, Baqiyatallah Hospital, Baqiyatallah University of Medical Sciences, between April 2005 and December 2008. The study involved 413 renal transplantation patients. The primary outcomes were the determination of the serum creatinine levels at each attendance and the time to graft failure. Robust joint modeling of the longitudinal measurements (serum creatinine level) and time-to-event data (time to graft failure) were used for the analysis in the presence of outliers in the serum creatinine levels. The data analysis was implemented in WinBUGS 1.4.3.

RESULTS

There was a positive association between the serum creatinine level and graft failure (HR = 5.13, P < 0.001). A one unit increase in the serum creatinine level suggests an increased risk of graft failure of up to 5.13 times. The serum creatinine level significantly decreased over time (95% CI: (-1.58, -1.08)). The recipient's age was negatively associated with the serum creatinine level (95% CI: (-0.02, -0.001)).

CONCLUSIONS

Graft failure is more likely to occur in patients with higher serum creatinine levels.

High Insecticides Resistance in Culex pipiens (Diptera: Culicidae) from Tehran, Capital of Iran

BACKGROUND

During recent years transmission of Dirofilaria immitis (dog heart worm) by Culex pipiens and West Nile virus have been reported from Iran. The present study was preformed for evaluating the susceptibility status of Cx. pipiens collected from capital city of Tehran, Iran.

METHODS

Four Insecticides including: DDT 4%, Lambdacyhalothrin 0.05%, Deltamethrin 0.05% and Cyfluthrin 0.15 % according to WHO standard methods were used for evaluating the susceptibility status of Cx. pipiens from Tehran moreover For comparison susceptibility status a Laboratory strain also was used. Bioassay data were analyzed using Probit program. The lethal time for 50% and 90% mortality (LT₅₀ and LT₉₀) values were calculated from regression line.

RESULTS

The susceptibility status of lab strain of Cx. pipiens revealed that it is susceptible to Lambdacyhalothrin, Deltamethrin, Cyfluthrin and resistant to DDT. Moreover cyfluthrin with LT₅₀=36 seconds and DDT with LT₅₀=3005 seconds had the least and most LT₅₀s. Field population was resistance to all tested insecticides and DDT yielded no mortality.

CONCLUSION

Highly resistance level against all WHO recommended imagicides were detected in field populations. We suggest more biochemical and molecular investigations to detect resistance mechanisms in the field population for further decision of vector control.

Reliability and Validity of the Persian Version of Compulsive Eating Scale (CES) in Overweight or Obese Women and Its Relationship with Some Body Composition and Dietary Intake Variables

Objective: Compulsive or binge eating is a kind of disturbed eating behavior, which is mostly observed among dieting women, and is integrated with appetite disorder, and uncontrolled eating of plenty of junk food. The Compulsive Eating Scale (CES) created first by Kagan & Squires in 1984, is an eight-item self-reporting instrument that is made to measure the severity of binge eating disorder. The aim of this study was to provide the reliability and validity of the Persian version of Compulsive Eating Scale (CES) among overweight and obese women in Iran. Method: One hundred and twenty six (N = 126) overweight and obese women consented to participate in this study. We estimated the anthropometric indices, including body weight, height, waist and hip circumferences, a total body fat percentage, and visceral fat level with body analyzer all in standard situations. Then, the participants completed the CES. Next, to assess concurrent validity, Beck Depression Inventory, Spielberger anxiety scale, appetite visual analogue rating scale, Food Craving questionnaire, Three-Factor Eating Questionnaire-R18, and Restraint eating visual analogue rating scale were performed simultaneously. To assess test-retest reliability, CES was repeated for all the participants two weeks later. Moreover, we reported the internal consistency and factor analysis of this questionnaire. Furthermore, we estimated the concurrent correlation of CES with logically relevant questionnaires and body composition and anthropometric indices. Results: Based on the reliability analysis and factor analysis of the principal component by Varimax rotation, we extracted two factors: eating because of negative feelings, and overeating. Internal consistency (Cronbach's alpha) of the CES was 0.85 (Cronbach alpha of the factors was 0.85, and 0.74, respectively). The test-retest correlation of the CES was 0.89. Also, the split-half reliability of the questionnaire was established with the correlation coefficient between Sets I and II. The correlation was 0.85. Conclusion: This study provides preliminary support for the reliability and validity of the Persian version of the CES. This instrument would be helpful in measuring the clinical practice and research studies of obesity, appetite and eating disorders reliably and validly.

The Effect of Coenzyme Q10 Supplementation on Circulating Levels of Novel Adipokine Adipolin/CTRP12 in Overweight and Obese Patients with Type 2 Diabetes

Background: Adipolin, the novel adipokine that is proposed to be reduced in diabetes, obesity and inflammation, may improve glycemic control. It is known that coenzyme Q10 could improve insulin sensitivity. The aim of the current study was to investigate the effect of Q10 supplementation on adipolin concentration and glucose metabolism in overweight and obese diabetic patients. Material & Methods: Sixty four patients with type 2 diabetes and 25<BMI<35 kg/m² were randomly divided to receive 200 mg Q10 or placebo daily for 12 weeks. Fasting serum levels of adipolin, glucose, insulin, HbA1c and HOMA-IR were measured before and after supplementation. Results: Following supplementation, adipolin levels decreased significantly in Q10 group (38.19±32.02 to 29.03±34.23 ng/ml;P=0.001). HbA1c decreased dramatically following supplementation only in Q10 group (8.6±2.2% to 7.9±2.1%, P<0.001). It was also marginally lower in Q10 compared to placebo group at the end of study (P=0.056). Moreover, weight (P=0.003), BMI (P=0.003) and waist circumference (P=0.016) decreased significantly in Q10 group. No significant alterations were observed in FBS, fasting insulin and HOMA-IR within or between Q10 and placebo groups. Conclusions: Coenzyme Q10 reduced HbA1c considerably in overweight and obese patients with diabetes, although interestingly adipolin levels declined simultaneously. In this study, Q10 modulated glucose homeostasis, which was expected to be mediated by increasing adipolin. The similar mechanisms of action of Q10 and adipolin may justify lowering effect of Q10 on adipolin. In addition, the possible anti-adipogenic effect of Q10 might explain the significant reduction in weight and waist circumference and hence the adipolin decrease. Further studies are required to evaluate the precise role of adipolin in glucose metabolism as well as the probable effects of coenzyme Q10 on adipose tissue and adipokines.

Longitudinal Assessment of Serum Creatinine Levels on Graft Survival After Renal Transplantation: Joint Modeling Approach

Background

Chronic kidney disease (CKD) is a major public health problem. The eventual outcome of CKD is end-stage renal disease (ESRD). Early diagnosis and proper management play an important role in preventing CKD progression to ESRD. Dialysis and kidney transplantation are the only treatment options available for patients suffering from ESRD.

Objectives

This study was designed to investigate the etiological role of recipient and donor characteristics on serum creatinine changes within the follow-up period, graft failure risk, and the impact of longitudinal serum creatinine levels on graft survival after renal transplantation.

Patients and Methods

This study was carried out at the department of nephrology, Baqiyatallah hospital, Baqiyatallah University, Tehran, Iran, between April 2005 and December 2008. During that time period, 461 patients who had undergone renal transplantation were entered in the current study. Time to graft loss and serum creatinine levels at each visit were the primary data gathered for the study. A joint modeling of survival and longitudinal nonsurvival data was used to assess the association between the two processes and investigate the influential factors.

Results

Median follow-up time was 6.80 months. A linear decreasing trend in serum creatinine level over time was found (P < 0.001). The results showed a positive correlation between serum creatinine levels and risk of graft failure (P < 0.001).

Conclusions

The major finding of this study is that one unit increase in serum creatinine level suggests an increased risk of graft failure of up to four times.

Beneficial effects of omega-3 and vitamin E coadministration on gene expression of SIRT1 and PGC1α and serum antioxidant enzymes in patients with coronary artery disease

BACKGROUND AND AIM

SIRT1 and PGC1α are two important genes, which play critical roles in regulating oxidative stress and inflammation processes. The study aimed assess the effects of coadministration of omega-3 and vitamin E supplements on SIRT1 and PGC1α gene expression and serum levels of antioxidant enzymes in coronary artery disease (CAD) patients.

METHODS AND RESULTS

Participants of this randomized controlled trial included 60 CAD male patients who were categorized into three groups: Group 1 received omega-3 (4 g/day) and vitamin E placebo (OP), group 2 omega-3 (4 g/day) and vitamin E (400 IU/day; OE), and group 3 omega-3 and vitamin E placebos (PP) for 2 months. Gene expression of SIRT1 and PGC1α in peripheral blood mononuclear cells (PBMCS) was assessed by reverse transcription polymerase chain reaction (RT-PCR). Furthermore, serum antioxidant enzyme and high-sensitivity C-reactive protein (hsCRP) levels were assessed at the beginning and end of the intervention. Gene expression of SIRT1 and PGC1α increased significantly in the OE group (P = 0.039 and P = 0.050, respectively). Catalase and hsCRP levels increased significantly in the OE and OP groups. However, glutathione peroxidase (GPX) and superoxide dismutase (SOD) levels did not statistically change in all groups. The total antioxidant capacity (TAC) increased significantly in the OE group (P = 0.009) but not in OP and PP groups.

CONCLUSION

Supplementation of omega-3 fatty acids in combination with vitamin E may have beneficial effects on CAD patients by increasing gene expression of SIRT1 and PGC1α and improving oxidative stress and inflammation in these patients.

Defective T-cell Proliferation and IL-2 Production in a Subgroup of Patients with Coronary Artery Disease

Atherosclerosis is a chronic inflammatory disease of the arterial wall characterized by innate and adaptive immune responses to a variety of microbial and self-antigens. Given the crucial role of adaptive immunity in the pathogenesis of atherosclerosis, this study was performed to investigate the proliferative response of peripheral blood mononuclear cells (PBMC) and interleukin (IL)-2 production in patients with coronary artery disease (CAD). In this study, 25 patients with chronic stable CAD and 25 healthy individuals were investigated. The PBMCs were separated and stimulated with phytohaemagglutinin (PHA). MTT assay was performed to measure cell viability and proliferation. IL-2 concentrations in cell culture supernatants were determined by Enzyme-Linked Immunosorbent Assay. PHA-stimulated cells revealed a significantly increased optical density (OD) in both groups of patients (p=0.004) and controls (p<0.001). However, the patient group showed a significantly lower Stimulation index (SI) (p=0.001). Upon in vitro stimulation with PHA, IL-2 levels were significantly increased in both groups of patients and controls (p<0.001). However, IL-2 concentrations were significantly lower in the patient group (p=0.018). Six patients showed defective IL-2 production, whereas similar finding was not observed in the normal control subjects (p=0.022). PBMCs from patients with coronary artery disease showed defective PHA-induced mitogenesis and IL-2 production. Considering the autoimmune nature of atherosclerosis, decreased IL-2 production may potentially enhance the atherogenic process, leading to spontaneous activation of autoreactive T lymphocytes.

Serum C1q and tumor necrosis factor (TNF)-related protein 9 in women with Polycystic Ovary Syndrome

AIMS

To compare CTRP9 levels in women with Polycystic Ovary Syndrome (PCOS) and without PCOS. Furthermore, to determine the correlation between serum CTRP9 levels and some variety of anthropometric and biochemical parameters.

METHODS

The study included 29 PCOS patients and 27 healthy volunteers of the same age and BMI. Body weight, height and waist circumference were assessed. Blood samples were taken for assessment of serum CTRP9 by enzyme-linked immunosorbent assay (ELISA) technique. In addition, blood samples were collected for fasting insulin, glucose, and lipid profiles, and homeostasis model of assessment-insulin resistance (HOMA-IR) values were calculated.

RESULTS

Similar serum CTRP9 were found in PCOS subjects and controls (8.8±19.9 vs 5.0±7.6ng/mL). Serum CTRP9 concentration positively correlated with serum LDL-C and total cholesterol in patient group. However, no correlation between CTRP9 and other biochemical and anthropometric variables was found.

CONCLUSION

Serum CTRP9 logs of PCOS participants exhibit a positive association with unfavorable lipid profile in this report.

Association of Major Dietary Patterns with General and Abdominal Obesity in Iranian Patients with Type 2 Diabetes Mellitus

BACKGROUND

The aim of this study was to identify dietary patterns associated with general and abdominal obesity in type 2 diabetic patients.

METHODS

We included 728 patients (35 - 65 years) with type 2 diabetes mellitus in this cross-sectional study. The usual dietary intake of individuals over 1 year was collected using a validated semi-quantitative food frequency questionnaire. Weight, height, and waist circumference were measured according to standard protocol.

RESULTS

The two major dietary patterns identified by factor analysis were healthy and unhealthy dietary patterns. After adjustment for potential confounders, subjects in the highest quintile of the healthy dietary pattern scores had a lower odds ratio for the general obesity when compared to the lowest quintile (OR = 0.45, 95 % CI = 0.26 - 0.79, P for trend = 0.02), while patients in the highest quintile of the unhealthy dietary pattern scores had greater odds for the general obesity (OR = 3.2, 95 % CI = 1.8 - 5.9, P for trend < 0.001). There were no significant associations between major dietary patterns and abdominal obesity, even after adjusting for confounding factors.

CONCLUSION

This study shows that in patients with type 2 diabetes mellitus, a healthy dietary pattern is inversely associated and an unhealthy dietary pattern is directly associated with general obesity.

Human bocavirus infections among children less than two years old in Iran during fall and winter 2012-2013

BACKGROUND AND OBJECTIVES

Human bocavirus (HBoV) is a newly discovered parvovirus. It has been detected primarily in children with acute respiratory tract infections. This study was conducted to clarify the frequency and genotype circulation pattern of HBoV in Iran.

MATERIALS AND METHODS

Conventional PCR was performed on throat swabs of patients less than two years of age with respiratory illnesses during fall and winter 2012-2013.

RESULTS

HBoV virus DNA was detected in 15 of 140 samples (10.7 %). Sequencing and phylogenetic analysis on 5 samples showed that all were HBoV1. The positive samples were negative for influenza A and B viruses while co-infection with RSV was found in 2 (13.3%).

CONCLUSION

This study adds to the body of knowledge about the role of HBoV in acute respiratory illnesses in children in Iran.

Risk Factors of Graft Survival After Diagnosis of Post-kidney Transplant Malignancy: Using Cox Proportional Hazard Model

Background:

All recipients of kidney transplantation, especially those with posttransplant malignancy, are at risk of long-term graft failure.

Objectives:

The purpose of our study was to evaluate the risk factors associated with graft survival after diagnosis of malignancy.

Patients and Methods:

To reach this purpose, we conducted a historical cohort study in Iran and 266 cases with posttransplant malignancy were followed up from diagnosis of malignancy until long-term graft loss or the date of last visit. These patients were taken as a census from 16 Transplant Centers in Iran during 22 years follow-up period since October 1984 to December 2008. A Cox proportional hazards model was performed to determine the important independent predictors of graft survival after malignancy.

Results:

At the end of the study, long-term graft failure was seen in 27 (10.2%) cases. One-year and 2-year graft survival after diagnosis of cancer were 93.6% and 91.7%, respectively. The univariate analysis showed that the incidence of chronic graft loss was significantly higher in male patients with solid cancers, withdrawal of immunosuppressant regimen, no response to treatment, and tumor metastasis. In continuation, the Cox model indicated that the significant risk factors associated with graft survival were type of cancer (P < 0.0001), response to treatment (P < 0.0001, HR = 0.14, 95% CI: 0.06 - 0.32), metastasis (P < 0.0001, HR = 5.68, 95% CI: 2.24 - 14.42), and treatment modality (P = 0.0001).

Conclusions:

By controlling the modifiable risk factors and modality of treatment in our study, physicians can reach more effective treatment.

Vitamin A Decreases Cytotoxicity of Oxidized Low-Density Lipoprotein in Patients with Atherosclerosis

BACKGROUND

Oxidized low-density lipoprotein (ox-LDL) is implicated in initiation and progression of atherosclerosis. Previously, we found that ox-LDL increases vulnerability of peripheral blood mononuclear cells (PBMCs) in atherosclerotic patients compared to controls. Vitamin A induces proliferation of PBMCs. The aim of this study was to determine the effect of vitamin A supplementation on PBMC survival against LDL and different doses of ox-LDL.

METHOD

In this double-blind placebo-controlled trial, we recruited 35 atherosclerotic patients and 38 healthy controls and randomly allocated them into placebo and vitamin A groups, which received either placebo or 25,000 IU/day of vitamin A for 3 months. PBMCs were isolated, cultured, and stimulated by 1 µg/mL LDL as well as 1 µg/mL and 50 µg/mL ox-LDL. The stimulation indexes (SIs) of PBMCs were calculated to identify cell viability. Additionally, the circulating ox-LDL levels were measured by ELISA.

RESULTS

Viability of PBMCs stimulated by 50 µg/mL ox-LDL significantly increased following vitamin A supplementation in patients (p < 0.01). The levels of circulating ox-LDL were not changed by vitamin A treatment. Ox-LDL levels were strongly and positively correlated to SI of PBMCs stimulated by 1 µg/mL LDL and1 µg/mL ox-LDL in all groups.

CONCLUSION

Vitamin A decreases cytotoxicity of high-dose ox-LDL and improves PBMC viability. The protective effect of vitamin A is not mediated by an antioxidative mechanism, but may instead have been due to intracellular protection of the apoptotic machinery or induction of proliferation of the cells. Higher levels of ox-LDL increase PBMC irritability in all participants.

Association of nesfatin-1 level with body composition, dietary intake and resting metabolic rate in obese and morbid obese subjects

AIMS

Nesfatin-1 identified neuroendocrine peptide is involved in regulation of homeostasis via modulation of metabolism, energy homeostasis and food intake. We aimed to investigate the associations of circulating nesfatin-1 level with food intake, body composition and resting metabolic rate (RMR) and also examine the correlation between circulating peroxisome proliferator-activated receptor gamma (PPARγ) and nesfatin-1 levels in obese and morbid obese subjects.

METHODS

A total of 96 obese subjects (including 18 morbid obese subjects) were participated in the current cross-sectional study. We assessed the body composition with the use of Body Composition Analyzer. RMR was measured by means of the MetaCheck™, an instrument designed to measure RMR using indirect calorimetry. All baseline blood samples were obtained following an overnight fasting. Plasma concentrations of nesfatin-1 and circulating PPARγ were measured with the use of an ELISA method. Statistical analyses were performed using SPSS.

RESULTS

We found significant associations between fat percent and circulating nesfatin-1 in obese and morbid obese subjects. There was main association between circulating nesfatin-1 and PPARγ concentration in obese subjects and it was more strong association in morbid obese participants. There was marginally significant differences between percent predicted RMR between different categorized nesfatin-1 levels. There were also higher intakes of calorie, carbohydrate and protein in obese group who had lower concentration of nesfatin-1.

CONCLUSIONS

Our data indicated the fat percent as main determinant factor in circulating nesfatin-1 level. It appears nesfatin-1 and PPARγ might be concurrently involved in adipogenesis pathway.

The Effects of Vitamin D Supplementation on Glucose Control and Insulin Resistance in Patients with Diabetes Type 2: A Randomized Clinical Trial Study

Background:

Vitamin D deficiency is prevalent in diabetes type 2 and this vitamin may be related to insulin action. This randomized controlled trial study was done to evaluate the effect of vitamin D supplementation on glucose control and insulin resistance in patients with diabetes type 2.

Methods:

Participants of this randomized clinical trial study consisted of 28 patients with type 2 diabetes who received 100 microgram (4000 IU) vitamin D and 30 diabetic patients who received placebo for 2 months between September 2012 and February 2013. The effect of vitamin D on glucose control was assessed by measuring HbA1c and insulin resistance as HOMA-IR at the baseline and the end of the intervention.

Results:

The results showed a significant decrease in HbA1c (from 7.29 ± 0.22 % to 6.76 ± 0.18 %, P<0.001) and insulin concentration (from 8.24 ± 0.97 μIU/mL to 6.55 ± 0.28 μIU/mL, P=0.048), but a non-significant decrease in HOMA-IR in vitamin D group. Also, HDL-C level increased significantly in both of vitamin D (P=0.046) and placebo groups (P=0.028).

Conclusion:

It seems that vitamin D supplementation has beneficial effects on glucose homeostasis and can increases insulin sensitivity in diabetic 2 patients.

Patients and Public Involvement in Patient Safety and Treatment Process in Hospitals Affiliated to Kashan University of Medical Sciences, Iran, 2013

Background:

In the recent decades, healthcare providers had a perspective of benevolent paternalism. Nowadays, the patients’ role has changed and they have a significant obligation to participate in their caring decisions.

Objectives:

The current study aimed to investigate the involvement of patients and public in the patient safety and treatment process in hospitals affiliated to Kashan University of Medical Sciences, Kashan, Iran, 2013.

Patients and Methods:

A cross-sectional study was conducted in the hospitals affiliated to Kashan University of Medical Sciences in 2013. Subjects included all of the 18 chief managers, 10% of nurses in each hospital, and 375 patients. Data collection instruments included a questionnaire and a checklist designed according to the research objectives. Data analysis was performed using the SPSS ver. 13. Descriptive statistics, percentage and frequencies, were calculated for all variables and analyzed by Chi-square test.

Results:

In the treatment process, 81 patients (21.61%), 50 nurses (80.6%) and 15 chief managers (83.3%) had awareness about Patient Bill of Rights. In patient Safety, 19.73% of the patients stated that hospitals received their feedbacks. Management activities were weak in evaluation. All of the six hospitals (100%) had a defined process to perform satisfaction surveys’ quality improvement and patient authentication policy.

Conclusions:

Patient and public participation in Kashan hospitals are not adhered well. As the patient has an important role in improving the quality of services, more use of mass media especially local newspapers, hospital websites, and training programs are suggested to inform both the patients and public on their rights and roles in improving the healthcare services.

The effect of weight reduction on antioxidant enzymes and their association with dietary intake of vitamins A, C and E

OBJECTIVE

Our goal was to assess the effects of weight loss on antioxidant enzymes of red blood cells and it's relation with vitamins A, E and C intake in 30 obese women.

SUBJECTS AND METHODS

General information, anthropometric measurements, 3-day food recall, and fasting blood samples were collected from 30 obese women at the beginning of the study and after 3 months intervention. Weight loss was set at about 10% of their weight before the intervention.

RESULTS

Glutathione reductase and catalase activities showed a significant increase (P < 0.01) after weight reduction, but no significant changes were seen in the superoxide dismutase and glutathione peroxidase activities. There was a positive linear correlation between daily vitamin C intake with superoxide dismutase enzyme after intervention (P = 0.004, r = 0.507). There was a negative linear correlation between vitamin E intake and glutathione peroxidase activity before intervention (P = 0.005, r = -0.5). A negative correlation was found between daily vitamin A intake and glutathione reductase enzyme before and after intervention (r = -0.385, r = -0.397, P < 0.05) respectively. No significant correlation was observed between vitamins A, C, E amounts and catalase activity.

CONCLUSIONS

Ten percent weight reduction can have a significant role in increasing antioxidant enzymes activities, especially glutathione reductase, and catalase enzymes in obese women. However, it is important to take into consideration a balanced amount of certain nutrients while administering a diet with limited energy.

Effects of supplementation with omega-3 on insulin sensitivity and non-esterified free fatty acid (NEFA) in type 2 diabetic patients

OBJECTIVE

The aim of this study was to determine the role of omega-3 supplementation on NEFA concentration, insulin sensitivity and resistance, and glucose and lipid metabolism in type 2 diabetic patients.

SUBJECTS AND METHODS

Forty-four type 2 diabetic patients were randomly recruited into two groups. Group A received 4 g/day omega-3 soft gels, and group B received a placebo for 10 wks. Blood samples were collected after 12-h fast. Physical activity records, three-day food records, and anthropometric measurements were obtained from all participants at the beginning and end of the study.

RESULTS

Omega-3 supplementation caused a significant reduction in NEFA in the intervention group compared with the placebo group (P = 0.009). Additionally, the administration of omega-3 resulted in significantly greater changes (Diff) for the intervention group in various parameters, such as insulin and Quicki indices compared with the placebo group (P < 0.05).

CONCLUSIONS

Omega-3 fatty acid supplementation in type 2 diabetic patients improved insulin sensitivity, probably due to the decrease in NEFA concentrations.

Effects of administration of omega-3 fatty acids with or without vitamin E supplementation on adiponectin gene expression in PBMCs and serum adiponectin and adipocyte fatty acid-binding protein levels in male patients with CAD

OBJECTIVE

Adiponectin is a unique anti-atherogenic adipocytokine. Regulation of adiponectin secretion is dysfunctional in cardiovascular diseases. The current trial study assessed the effects of omega-3 fatty acids with or without vitamin E on adiponectin gene expression in peripheral blood mononuclear cells and serum adiponectin and adipocyte fatty acid-binding protein (A-FABP; also called ap2 and FABP4) levels in patients with coronary artery disease (CAD).

METHODS

This randomized, double-blind, placebo-controlled trial included 67 male patients with CAD. First of the four group of participants received 4 g/day omega-3 fatty acids plus 400 IU/day vitamin E (OE), second group 4 g/day omega-3 fatty acids plus vitamin E placebo (OP), or both omega-3 fatty acid and vitamin E placebos (PP) for 8 weeks. Adiponectin gene expression and serum adiponectin and FABP4 levels were evaluated.

RESULTS

The combination of omega-3 fatty acids and vitamin E in patients with CAD affected their serum adiponectin and FABP4 levels and the adiponectin/FABP4 ratio significantly. In the OP group, serum adiponectin levels did not change significantly. Consumption of omega-3 fatty acids with and without vitamin E had no significant effect on adiponectin gene expression.

CONCLUSION

Omega-3 fatty acids with or without vitamin E improve adiponectin levels in patients, without any significant changes in adiponectin gene expression. This nutritional intervention may prevent complications in patients with CAD because of increased adiponectin levels.

Evaluation of antioxidant enzyme activity and antioxidant capacity in patients with newly diagnosed pemphigus vulgaris

BACKGROUND

Pemphigus vulgaris (PV) is an autoimmune blistering disorder of the skin and/or mucosa. Increased levels of reactive oxygen species (ROS) were previously reported in PV.

AIM

Because oxidative stress has an important role in the inflammatory process, we designed this study to evaluate the antioxidant status in patients with PV and to compare it with that of healthy controls (HCs).

METHODS

In this case-control study, 43 newly diagnosed patients with PV were compared with 58 HCs. The severity of the disease was estimated according to Harman scores. Erythrocyte glutathione peroxidase (GPx), superoxide dismutase (SOD), CAT and serum malondialdehyde (MDA) activities and total antioxidant capacity were measured. Data were analyzed by independent t-test.

RESULTS

Both groups were similar in sex, age and body mass index. Mean duration of disease was 5.6 months. Mean oral and skin severities were 1.79 and 2.3 respectively, based on Harman scores. SOD activity was not significantly different between groups (1003.30 ± 39.96 vs. 1009.76 ± 32.68 U/gHb). Levels were noticeably higher in patients with PV than in HCs for both GPx (52.13 ± 2.85 vs. 36.63 ± 1.49 U/gHb, respectively; P < 0.001) and CAT (205.69 ± 8.10 vs. 130.26 ± 6.80 kU/gHb, respectively; P < 0.001) activities, and CAT activity correlated with disease severity. In addition, patients had lower total antioxidant capacity than controls (3.39 ± 0.06 vs. 3.72 ± 0.09 mmol/L, P = 0.006). There was no noticeable difference in serum MDA between the two groups (P = 0.45).

CONCLUSIONS

Patients with PV have significantly higher antioxidant enzyme activities and lower total antioxidant capacity compared with HCs. These data indicate the importance of improving antioxidant level in patients with pemphigus.

Maternal obesity and energy intake as risk factors of pregnancy-induced hypertension among Iranian women

Pregnancy-induced hypertension is causing striking maternal, foetal and neonatal mortality and morbidity in the world. A case-control study was conducted on 113 women with gestational hypertension and 150 healthy pregnant women at Shahid Akbarabadi Hospital of obstetrics and gynaecology in south of Tehran. Women who were obese (OR 4.44; 95% CI 1.84-10.72) before pregnancy were more likely to develop gestational hypertension. Proportion of having excessive gestational weight gain was positively and significantly associated with development of gestational hypertension (OR 2.70; 95% CI 1.19-6.13). Furthermore, findings revealed that women who were in the highest quartile of mid-arm-circumference had a 3-fold increased risk of gestational hypertension compared to women in the lowest quartile (OR 8.93; 95% CI 2.16-36.93). We found that having been in the highest quartile of energy intake positively correlated with increased risk of gestational hypertension (OR 9.66; 95% CI 3.30-28.21). The results suggest pre-pregnancy obesity, excessive gestational weight gain, and increased intake of energy as potential risk factors of developing gestational hypertension.

A study of lipid- and protein- bound sialic acids for the diagnosis of bladder cancer and their relationships with the severity of malignancy

BACKGROUND

The gold standard for detection of bladder cancer is cystoscopy, which is an invasive and complicated procedure. Our study was conducted to find a tumor marker with high specificity, sensitivity, and accuracy for the diagnosis of bladder cancer.

METHODS

Serum samples were collected from 58 bladder cancer patients and 60 healthy control subjects. Levels of lipid-bound sialic acid (LBSA), and protein-bound sialic acid (PBSA) were measured spectrophotometrically by Aminoff's method.

RESULTS

Mean levels of both markers were found to be significantly higher in the patients than the healthy controls. Positive correlations were observed between serum levels of lipid- (r=0.283, p<0.05) and protein- bound (r=0.56, p<0.05) sialic acids and the grade of malignancy. To differentiate patients with bladder tumors from healthy controls, cut-offpoints were determined for each of the two parameters based on Receiver Operating Characteristic (ROC) curve analysis (LBSA=21.25 mg/dL, PBSA=6.15 mg/dL). The data showed good sensitivities (LBSA=89%, PBSA=79%), specificities (LBSA=70%, PBSA=70%) and accuracies (LBSA=83%, PBSA=81%) for both markers.

CONCLUSION

Measuring serum LBSA and PBSA by this simple, reproducible, noninvasive, and inexpensive method can accurately discriminate cancer patients from healthy individuals.

Development, validation and comparison of two nomograms predicting prostate cancer at initial 12-core biopsy

AIM

Our aim was to establish, validate and compare two nomograms in an Iranian population for the first time using clinical, laboratory and transrectal ultrasonography (TRUS) findings for predicting prostate cancer at initial biopsy.

METHODS

Data were collected on a total of 916 men referred for an initial prostate biopsy in our center in a 7-year period. Variables analyzed included age, prostate-specific antigen (PSA), free/total PSA (%fPSA), digital rectal examination (DRE) findings, prostate volume (PV) and presence of hypoechoic lesion on TRUS. Univariate logistic regression models were fitted to test cancer predictors. Two multivariate logistic regression models were fitted to create nomograms. Both models were internally validated. Calibration of nomograms was assessed graphically. The area under the receiver operating characteristic curve (AUC) was calculated as a scale of discrimination and predictive accuracy and also used to compare models.

RESULTS

Prostate cancer was detected in 221/669 (33%) men. Based on univariate logistic regression, all of variables except DRE were significant predictors of prostate cancer, with highest AUC for PV (AUC 0.696, 95% CI 0.653-0.738).AUC of nomogram with and without TRUS findings and PSA alone were 0.791, 0.721 and 0.624, respectively. In internal validation, both nomograms had acceptable calibration plots.

CONCLUSION

Our nomogram based on age, DRE, PSA, %fPSA and TRUS finding was significantly more accurate in predicting initial prostate biopsy outcome in men.

Comparative analysis of NK cell subsets in menstrual and peripheral blood of patients with unexplained recurrent spontaneous abortion and fertile subjects

Natural killer (NK) cells play a fundamental role in maintaining pregnancy. Based on the availability and non-invasive method of collection of menstrual blood (MB), here we investigated for the first time a comparative analysis of NK cell subsets in MB and peripheral blood (PB) of women with recurrent spontaneous abortion (RSA) and fertile women. PB and MB of healthy fertile (n=15) and RSA women (n=15) were sampled simultaneously on the second day of the menstrual cycle. Proportions of CD56+CD3-CD16+/-, CD56+CD3-CCR7+/-, and CD56+CD3-CD45RO+/- cells were analyzed using flow cytometry. In the MB of both groups, proportions of CD16+ and CD45RO- NK cells were significantly lower than in the PB. In parallel, CD56+CD16+CCR7- and CCR7+ cells were present in significantly smaller amounts in MB than in PB. However, the amounts of CD56+CD16-CCR7- and CCR7+ cells were greater in MB. In comparison to the fertile group, the percentage of MB CD45RO+ NK cells was significantly lower and frequencies of PB CD16-, CD45RO- and CD56+CD16+CCR7+ subsets were significantly higher in RSA patients. Different subsets of NK cells are differentially distributed in MB in comparison with PB in women with RSA and fertile subjects. Population differences of NK cell subsets in RSA patients and normal controls were more clearly reflected at the systemic level.

Chronic graft loss and death in patients with post-transplant malignancy in living kidney transplantation: a competing risk analysis

Background:

Malignancy is a common complication after renal transplantation. Death with functioning graft and chronic graft loss are two competing outcomes in patients with post-transplant malignancies.

Objectives:

The purpose of our study was to evaluate the risk factors associated with cumulative incidence of these two outcomes.

Patients and Methods:

Fine-Gray model was used for 266 cases with post-transplant malignancy in Iran. These patients were followed-up from the diagnosis until the date of last visit, chronic graft loss, or death, subsequently.

Results:

At the end of the study, as competing events, chronic graft loss and death with functioning graft were seen in 27 (10.2%) and 53 cases (19.9%), respectively, while 186 cases (69.9%) were accounted as censored. The incidence rate of death was approximately two-time of the incidence rate of chronic graft loss (8.6 vs. 4.4 per 100 person-years). In multivariate analysis, significant risk factors associated with cumulative incidence of death included age (P < 0.007, subhazard ratio (SHR) = 1.03), type of cancer (P < 0.0001), and response to treatment (P < 0.0001, SHR = 0.027). The significant risk factors associated with cumulative incidence of chronic graft loss were gender (P = 0.05, SHR = 0.37), treatment modality (P < 0.0001), and response to treatment (P = 0.048, SHR = 0.47).

Conclusions:

Using these factors, nephrologists may predict the occurrence of graft loss or death. If the probability of graft loss was higher, physicians can decrease the immunosuppressive medications dosage to decrease the incidence of graft loss.

Effects of Eicosapentaenoic Acid Supplementation on Lipid and Lipoprotein Profile in Hypertriglyceridemic Subjects with Different Proliferator-activated Receptor Alpha Genotypes

BACKGROUND

We determined the blood lipid-lowering effects of eicosapentaenoic acid (EPA) on hypertriglyceridemic subjects with Leu162/Val in exon 5 and G/C in intron7 polymorphism of peroxisome proliferator-activated receptor alpha (PPARα)genotypes that, to our knowledge, have not been previously studied.

METHODS

A total of 170 hypertriglyceridemic subjects were enrolled and genotyped for Ala54Thr, Leu162Val, and intron7 polymorphism by the use of a polymerase chain reaction-restriction fragment length polymorphism method. After determination of their genotypes, the first 23 eligible subjects who were found as Ala54 carriers and the first 23 eligible Thr54 carriers were enrolled in the study and stratified for PPARα genotypes. Participants took 2 g of pure EPA daily for 8 weeks. Fasting blood lipid and lipoprotein profiles were determined and changes from baseline were measured.

RESULTS

We observed significant difference between EPA supplementation and Leu162 and Val162, Interon 7 (GG and GC) carriers (P < 0.001). We did not observe significant associations between the PPARα L162V single nucleotide polymorphism and multiple lipid and lipoprotein measures. Although EPA consumption lowered lipid and lipoprotein concentrations in Leu162 and Val162 carriers and Interon 7 CC and GC carriers, these differences between the studied groups were not statistically significant.

CONCLUSIONS

EPA consumption has a lipid-lowering effect in hypertriglyceridemic subjects in both Leu162 and Val162 carriers. But there was no significant interaction between EPA supplementation and PPARα genotypes. Thus, genetic variation within the PPARα Leu162/Val cannot modulate the association of EPA intakes with lipid and lipoprotein profile. However, we must note that the sample size in this study was small.

The influence of mothers' lifestyle and health behavior on their children: an exploration for oral health

Background:

Parents and teachers involvement reinforce health promotion programs for children's health.

Objectives:

The purpose of this study was to evaluate mothers’ lifestyle behavior and its association with children's oral health.

Materials and Methods:

The study was a cross sectional study on 383 children and their mothers who were selected from 6 primary schools in Tehran, Iran. Mothers and children who participated in this study were asked to complete a questionnaire containing demographic questions, knowledge of oral health, attitude towards the oral health behavior, and oral health behaviors. Furthermore, the Simplified Oral Hygiene Index (OHI-S) and Community Periodontal Index (CPI) were assessed by two calibrated dentists. Data were analyzed with multilevel mixed model analyses.

Results:

The average age of the children and their mothers were 11.6 and 38.4 years, respectively. Mothers’ higher knowledge, higher educational status, positive attitude, higher frequent oral health behaviors, lower DMFT and lower CPI were all associated significantly with children’s higher oral health status.

Conclusions:

The results suggest that to improve children’s oral health, educational interventions should focus on both children and mothers to obtain a more promising outcome.

Effect of omega-3 supplementation versus placebo on acylation stimulating protein receptor gene expression in type 2 diabetics

BACKGROUND

This randomized controlled trial investigated the role of omega-3 supplementation on C5L2 gene expression in type 2 diabetics.

METHODS

Subjects in the omega-3 group received 4 g omega-3 per day and subjects in the placebo group took four capsules of placebo per day for 10 weeks. Gene expression was measured by RT- PCR at the beginning and end of the study.

RESULTS

The results of this study show depletion in the omega-3 group, but the mean difference between two groups was not significant.

CONCLUSIONS

Understanding the effect of the omega-3 pathway could contribute to targeting treatment of diabetes and its comorbidities.

The effect of vitamin A supplementation on disease progression, cytokine levels and gene expression in multiple sclerotic patients: study protocol for a randomized controlled trial

Multiple Sclerosis (MS) is a chronic inflammatory disease that leads to degeneration of the brain and spinal tissue. Imbalances of CD4+ T cells including Thelper1 (Th1)/Thelper2 (Th2) and Thelper17 (Th17)/Tregulatory (Treg), their secreted cytokines and gene expressions, are important aspects of in immunopathogenesis of MS. Vitamin A and its metabolites can regulate the immune system and appears to be effective in preventing progression of the autoimmune disease such as MS. Disease progression was evaluated By Magnetic Resonance Imaging (MRI), Expanded Disability States Scale (EDSS) and Multiple Sclerosis Functional Composite (MSFC) tests. Cytokine levels were measured using ELISA kits and gene expression was quantified by Real time PCR (RT-PCR) system. According to the difference between the epidemiological and clinical data on the relationship between vitamin A and immune system regulation, this study of the first time assesses Immune function as well as gene expression and progression of the disease following administration of vitamin A supplement.

Crosstalk between circulating peroxisome proliferator-activated receptor gamma, adipokines and metabolic syndrome in obese subjects

BACKGROUND

Peroxisome proliferator-activated receptor gamma (PPARγ) has direct and indirect function in adipokines production process. We aimed to assess the possible influence of circulating PPARγ on relative risk of metabolic syndrome and also examine the association between circulating PPARγ and adipokines levels among obese subjects.

METHODS

A total of 96 obese subjects (body mass index (BMI) ≥30) were included in the current cross-sectional study. We assessed the body composition with the use of Body Composition Analyzer BC-418MA - Tanita. The MetS (metabolic syndrome) was defined based on the National Cholesterol Education Program Adult Treatment Panel III. All baseline blood samples were obtained following an overnight fasting. Serum concentrations of adipokines including Retinol binding protein 4 (RBP4), omentin-1, vaspin, progranulin, nesfatin-1 and circulating PPARγ was measured with the use of an enzyme-linked immunosorbent assay method. Statistical analyses were performed using software package used for statistical analysis (SPSS).

RESULTS

We found main association between circulating PPARγ and body composition in obese population. The risk of metabolic syndrome in subjects with higher concentration of PPARγ was 1.9 fold in compared with lower concentration of PPARγ after adjustment for age, sex and BMI. There was significant association between PPARγ and adipokines, specially nesfatin-1 and progranulin. Defined adipokines pattern among participants demonstrated the markedly higher concentration of vaspin, RBP4 and nesfatin-1 in participants with MetS compared to non-MetS subjects.

CONCLUSIONS

It appears all of studied adipokines might have association with PPARγ level and might simultaneously be involve in some common pathway to make susceptible obese subjects for MetS.