Prevalence and Risk Factors of Anemia in the MASHAD Cohort Study

BACKGROUND

Anemia is a serious public health problem which may be associated with cardiovascular diseases (CVDs) and brain damage. This survey aims to determine the prevalence of anemia and its association with demographic and biochemical factors and metabolic syndrome in a human sample derived from the MASHAD cohort study.

METHODS

This survey was conducted on a sub-sample of 9847 individuals aged 35 to 65 as part of the MASHAD cohort study. Demographic characteristics and biochemical and anthropometrics indices were recorded. Data were analyzed using SPSS version 20.

RESULTS

Anemia was seen in 11.5% of the population. Anemia was significantly more prevalent in younger subject (P<0.001), females (P<0.001) and those with elevated body mass index (BMI) (P<0.001). Mean high-density lipoprotein (HDL) was higher in anemic participant (P=0.032). The incidence of anemia was significantly lower in smokers (P<0.001) and also participant with hypertension (HTN) (P<0.001), diabetes mellitus (DM) (P<0.001) and metabolic syndrome (MetS) (P<0.001). Mean FBG (P<0.001), TG (P<0.001), total cholesterol (P<0.001), LDL (P<0.001) and uric acid (P<0.001) were significantly lower in anemic subjects. Cholesterol, MetS, low-density lipoprotein (LDL), BMI, uric acid, diabetes mellitus and also TG remained significantly different after multivariate analysis between anemic and healthy participants.

CONCLUSION

The studied population had a lower prevalence of anemia compared to the previous WHO report for Iranians. Iron deficiency is recognized as the most important cause of anemia in Iran; however, further investigations will be need to confirm this pattern. We demonstrated that anemia is adversely associated with MetS and DM.

Circulating and Tissue microRNAs as Biomarkers for Ovarian Cancer Prognosis

Ovarian cancer (OC) is one of the most common cancers globally with a high rate of cancer- associated mortality. OC may be classified into epithelial cell neoplasms, germ cell neoplasms and stromal cell neoplasms. The five-year survival in the early and advanced stages of disease is approximately 90% and 15%, respectively. microRNAs are short, single-stranded, non-coding ribonucleic acid (RNA). miRNAs play critical roles in post transcriptionally regulations of gene expression. miRNAs are found in different tissues and body fluids. In carcinogenesis the expression of miRNAs are altered. Recent studies have revealed that there is a relationship between alteration of miRNAs expression and the prognosis of patients with OC. The aim of this review was to summarize the findings of recent studies that have investigated the expression of circulating and tissue miRNAs as novel biomarkers in the prognosis of OC.

MicroRNAs as Potential Diagnostic and Prognostic Biomarkers in Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is a common cancer, and the second most common cause of cancer-associated death globally. One of the major reasons for this high rate of mortality is a failure to make an early diagnosis. The average survival in untreated HCC patients is estimated to be approximately three months. The 5-year overall survival rate after radical resection is about 15-40% and within two years, more than two third of patients experience a relapse. To date, the most common biomarker which has been used for the diagnosis of HCC is serum alpha-fetoprotein (AFP). However, there is a lack of sensitive and specific tumor biomarkers for the early diagnosis of HCC. MicroRNAs are a class of short endogenous RNA with crucial role in many biological activities and cellular pathways and can be found in various tissues and body fluids. The aim of this review was to summarize the results of recent studies investigating miRNAs as novel biomarkers for the early diagnosis and prognostic risk stratification of patients with this type of liver cancer.

Circulating Exosomes as Potential Biomarkers in Cardiovascular Disease

Cardiovascular disease (CVD) is the first leading cause of morbidity and mortality in developing and developed countries. Circulating exosomes have recently been identified as extracellular transporters, detectable in biological fluids. Exosomes have established a new era in diagnosing diseases, especially CVD. Determination of exosome profiles, e.g., miRNAs, for different health states such as myocardial injury still requires further studies. In this review, we will discuss the role of exosomes as a potential biomarker in CVD, with particular emphasis on recent advances in the methods to study exosomes, isolation, detection, and characterization.

Association of cyclin-dependent kinase inhibitor 2A/B with increased risk of developing breast cancer

There is a growing body of data reporting the association of genetic alterations in chromosome 9P21 with the risk of developing cancer. In the current study, we studied the association of a genetic variant in CDKN2A/B, rs1333049, with the risk of developing breast cancer. A total of 339 participants with and without breast cancer entered to the study. Genotyping was done by the TaqMan real-time polymerase chain reaction (RT-PCR) method and gene expression analysis was ran by RT-PCR. Our data showed that the minor allele homozygote in the total population was 10%, whereas for heterozygote was 38%. The dominant genetic model demonstrated that individuals with breast cancer had advanced TNM classification. Moreover, the logistic regression revealed that individuals who had CC/CG genotypes might have an enhanced risk of developing breast cancer when compared to the holders of GG genotype (e.g., OR = 2.8; 95% CI,1.4-5.4; p = .001), after regulated for confounders; age and body mass index. Furthermore, our analysis showed that the CDKN2A/B gene was downregulated in patients (p < .001). We showed a meaningful relationship of CDKN2A/B with the risk of breast cancer, cancer, showing the importance of studies in great sample size and several centers for studying the value of the marker as a risk classification in the management of patients with breast cancer.

Epigenetic Drug Therapy in the Treatment of Colorectal Cancer

Colorectal Cancer (CRC) is one of the most common cancers with a high rate of morbidity and mortality worldwide. It has been demonstrated that epigenetic alterations which may cause changes in the expression of microRNA, DNA methylation and histone acetylation that results in inheritable modifications in gene expression in colorectal epithelial cells, plays a crucial role in the development of CRC. Recently, targeting epigenetic modification has emerged as a potentially important treatment approach in CRC. The US Food and Drug Association has approved the use of some epigenetic drugs that may be able to inhibit or reverse these alterations and also enhance sensitivity to chemotherapeutic agents and radiotherapy in CRC. In this review we have summarized the recent pre-clinical and clinical trial studies investigating the therapeutic value of using epigenetic drugs as novel therapeutic approach in CRC treatment.

The potential therapeutic and prognostic impacts of the c-MET/HGF signaling pathway in colorectal cancer

Colorectal cancer (CRC) is the third most common cancer and a common cause of cancer-related mortality globally. In spite of the improvements in the early diagnosis of CRC, approximately one-third of patients develop metastasis and then have a very poor survival rate. The mesenchymal-epithelial transition factor (c-MET) is a tyrosine kinase cell surface receptor activated by hepatocyte growth factor (HGF). Activation of c-MET/HGF signaling pathway regulates a variety of biological processes including cell motility, cell proliferation, angiogenesis, the epithelial-to-mesenchymal transition, and the development and progression of cancer cells. Recent studies have suggested that the c-MET/HGF signaling pathway is involved in the carcinogenesis of CRC. In this review, we summarize the main findings of recent studies investigating the role of c-MET/HGF signaling pathway in CRC and the potential of the c-MET/HGF signaling pathways in the diagnosis and treatment of CRC. © 2019 IUBMB Life, 2019.

HSP27 expression in the human peripheral blood mononuclear cells as an early prognostic biomarker in coronary artery disease patients

BACKGROUND

Coronary artery disease (CAD), is one of the leading causes of death globally. CAD risk factors, such as smoking, dyslipidemia, and obesity, are mainly associated with increased oxidative stress. Heat Shock Protein-27 (HSP27) has a protective role in conditions of oxidative stress. The aim of the current study was to investigate the relationship between HSP27 mRNA copy numbers in the peripheral blood mononuclear cell (PBMCs) and the degree of CAD progression.

METHODS

A total of 103 subjects aged 49-71 years were recruited; Patients with CAD were categorized into two groups: patients having <50% stenosis (Angio^-) and ≥50% stenosis (Angio⁺). The mRNA copy numbers of HSP-27 in PBMCs, anthropometric-parameters, fasting blood glucose (FBG), and the fasted serum lipid profile were evaluated.

RESULTS

Angio⁺ patients had a significantly higher level of TC and LDL-C values compared with Angio^- patients and the control group (p < 0.05). The HSP27 expression in PBMCs was significantly increased in Angio⁺ and Angio^- subjects, compared to the control group. Moreover, there was a significant association between the FBG, TC, LDL-C and TG among the groups (p < 0.05).

CONCLUSION

It was shown that the increased expression of HSP27 in PBMCs of CAD patients is significantly correlated with CAD severity in Angio⁺ subjects, which can be used as an early prognostic biomarker, indicating the degree of overall oxidative stress in patients. In order to verify this statement, it is suggested to measure Pro-oxidant- Antioxidant Balance (PAB) test by the same design in subsequent studies.

Evaluation of the serum prooxidant-antioxidant balance before and after vitamin D supplementation in adolescent Iranian girls

PURPOSE

Oxidative stress is caused by an imbalance between the antioxidant defenses and pro-oxidant production in favor of pro-oxidant production. Vitamin D has the potential for both pro- and anti-oxidative effects. The aim of this study was to assess the effect of high dose vitamin D supplementation on the prooxidant-antioxidant balance (PAB) in Iranian girls attending High School.

MATERIALS AND METHODS

A total of 464 girls aged 12-18 years were asked to take vitamin D capsules containing 50000IU vitamin D₃ once a week for a period of 9 weeks. All variables were determined at baseline and after 9 weeks of intervention. Fasting blood samples were taken from all subjects. The serum levels of 25OHD were measured using an electrochemiluminescence method. Serum PAB levels were determined using an ELISA reader at a wavelength of 450 nm.

RESULTS

Vitamin D supplementation was associated with an increase in serum PAB (P < 0.001) and a reduction in serum LDL-C (P < 0.001), total cholesterol (P < 0.001) and HDL-C (P < 0.01) serum levels in Iranian adolescent girls. The results obtained from the current study show that there were significant improvements in weight (P < 0.001), BMI (P < 0.001) and FBG (P = 0.02) in adolescent girls who had 50-74.9 nmol/L serum 25OHD levels compared to <50 nmol/L ones after the vitamin D supplementation. There was no significant association between the serum PAB and all biochemical factors (P > 0.05 for all variables).

CONCLUSIONS

The results showed that vitamin D supplementation has increased the PAB levels in teenage girls.

The diagnostic and prognostic value of circulating microRNAs in coronary artery disease: A novel approach to disease diagnosis of stable CAD and acute coronary syndrome

Coronary artery disease (CAD) is the most common manifestation of CVD and the acute coronary syndrome (ACS) is associated with a substantial morbidity and mortality in most populations globally. There are several biomarkers for diagnosis of MI. Troponin is routinely used as a biomarker in patients with chest pain, but it lacks sensitivity in the first hours of onset of symptoms, and so there is still a clinical need for new biomarkers for the diagnosis of CAD events. Recent studies have shown that miRNAs are involved in atherosclerotic plaque formation and their expression is altered during CAD events. Whilst studies have shown that several miRNAs are not superior to troponin in the diagnosis of a MI, they may be useful in the early diagnosis and prognosis of patients with CAD, however further studies are required. In this review we have summarized the recent studies investigating circulating miRNAs as novel biomarkers for the early detection of MI, CVD risk stratification and in the assessment of the prognosis of patients with ACS.

The effects of curcumin and a modified curcumin formulation on serum Cholesteryl Ester Transfer Protein concentrations in patients with metabolic syndrome: A randomized, placebo-controlled clinical trial

OBJECTIVE

Cholesteryl Ester Transfer Protein (CETP) mediates the transfer of cholesteryl ester from HDL-C to LDL-C and VLDL-C. The aim of the present trial was to evaluate the effect of curcumin and its modified formulation on serum CETP concentrations in patients with metabolic syndrome.

MATERIALS AND METHODS

Participants were randomly allocated to one of three groups of 40 subjects receiving either unmodified curcumin or its phospholipid complex or placebo. Lipid profile and plasma CETP were measured at the start and six weeks after initiation of the treatment. The normality of data distribution was assessed by Kolmogorov-Smirnov test. Wilcoxon test was used for comparing the data before and after the intervention. The percent changes of CETP and biochemical factors among the three groups were compared using Kruskal-Wallis test.

RESULTS

Serum CETP levels were not significantly altered among patients receiving curcumin.

CONCLUSION

Curcumin and its complex had no significant effect on serum CETP concentrations.

Hookah smoking is strongly associated with diabetes mellitus, metabolic syndrome and obesity: a population-based study

OBJECTIVES

The adverse effects of cigarette smoking have been widely studied before, whilst the effects of hookah smoking has received less attention, although it is a common habit in the Middle East. Here we have investigated the effects of cigarette and hookah smoking on biochemical characteristics in a representative population sample derived from the Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort study, from Northeastern Iran.

STUDY DESIGN

A total of 9840 subjects from the MASHAD population study were allocated to five groups; non-smokers (6742), ex-smokers (976), cigarette smokers (864), hookah smokers (1067), concomitant cigarette and hookah smokers (41).

METHODS

Baseline characteristics were recorded in a questionnaire. Biochemical characteristics were measured by routine methods. Data were analyzed using SPSS software and p < 0.05 was considered significant.

RESULTS

After adjustment for age and sex; the presence of CVD, obesity, metabolic syndrome, DM and dyslipidemia were significantly (p < 0.001) related to smoking status. After multivariate analysis, HDL (p < 0.001), WBC (p < 0.001), MCV (p < 0.05), PLT (p < 0.01) and RDW (p < 0.001), and the presence of CVD (p < 0.01), obesity (p < 0.001), metabolic syndrome (p < 0.05) and DM (p < 0.01) remained significant between cigarette smokers and non-smokers. Between hookah smokers and non-smokers; uric acid (p < 0.001), PLT (p < 0.05) and RDW (p < 0.05), and the presence of obesity (p < 0.01), metabolic syndrome (p < 0.001), diabetes (p < 0.01) and dyslipidemia (p < 0.01) remained significant after logistic regression.

CONCLUSION

There was a positive association between hookah smoking and metabolic syndrome, diabetes, obesity and dyslipidemia which was not established in cigarette smoking.

The 9p21 Locus and its Potential Role in Atherosclerosis Susceptibility; Molecular Mechanisms and Clinical Implications

Cardiovascular disease (CVD) is the leading cause of global mortality. Although extensive efforts have been made to identify valid biomarkers for CVD risk, relatively few are of proven clinical utility. It is recognized that genetic factors play a major role in determining the susceptibility to CVD. Recent genome-wide-association-studies have demonstrated common genetic variants in a region on chromosome 9p21 associated with an increased risk of CVD. Several genetic-polymorphisms have been identified in this region that are highly associated with CVD, and these are clustered around the gene loci for CDKN2B (coding for p15ink4b), CDKN2A (coding for p16ink4a and p14ARF) and the 3' end of CDKN2BAS, which has been termed antisense noncoding RNA in the INK4 locus (ANRIL). Targeted deletion of the 9p21 locus reduces the cardiac expression of CDKN2A/B and is the most frequent mechanism for methylthioadenosine phosphorylase inactivation, leading to a less stable plaque phenotype in the artery. Further investigations will be essential to explore the clinical utility of emerging-markers in larger and multicenter setting in order to establish their values for risk stratification or prediction a chance of future CVD events. The aim of the current review was to provide an overview of the possible molecular mechanisms by which the chromosome 9p21 locus may confer CVD risk, and the consequential clinical implications with particular emphasis on preclinical/clinical trials on genetic changes of this locus and CVD risk.

The interaction between a HSP-70 gene variant with dietary calories in determining serum markers of inflammation and cardiovascular risk

BACKGROUND

The high prevalence of cardiovascular disease (CVD) globally is attributable to an interaction between environmental and genetic factors. Gene × diet interaction studies aim to explore how a modifiable factor interacts with genetic predispositions. Here we have explored the interaction of a heat shock protein (HSP70) gene polymorphism (+1267A > G) with dietary intake and their possible association with serum C-reactive protein (CRP), an inflammatory marker, that is a major component of CVD risk.

METHODS

HSP70 genotype was determined using a TaqMan real time PCR based method.Dietary intake was assessed using a dietary questionnaire. Serum high sensitivity (Hs) CRP and other cardiovascular risk factors were assessed by routine methods. This included coronary angioplasty to determine the presence of coronary artery stenosis.

RESULTS

There were significant differences between serum lipid profile and Hs-CRP across the genotypes for Hsp70. The carriers of G allele had higher serum hs-CRP concentrations, compared with the AA homozygotes, with the wild genotype. Interaction analysis showed the association was modulated by total energy intake; the interaction of high energy intake with GG genotype: RERI = 0.77, AP = 0.26, S = 1.6.

CONCLUSION

We have found a significant association between the +1267A > G variant of the HSP70 gene with cardiovascular risk factors and serum hs-CRP concentrations. It is possible that a low energy diet could ameliorate the unfavorable effects of G allele of HSP70.

Relationship between serum anti-heat shock protein 27 antibody levels and obesity

BACKGROUND

Heat shock protein 27 (HSP27) is an intracellular molecular chaperone that is expressed at high levels following the exposure of cells to environmental stressors such as heat, toxins, and free radicals. High levels of HSP antigens and antibody titers have been reported in several conditions including cardiovascular disease and cancers. We measured serum anti-HSP27 antibody levels in 993 subjects and assessed the associations between serum anti-HSP27 antibody levels and demographic characteristics including coronary risk factors.

METHODS

A total of 993 subjects were recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study. Demographic, clinical, and biochemical parameters and serum anti-HSP27 antibody titers were determined in all the subjects.

RESULTS

Serum anti-HSP27 antibody levels increased with increasing age in men. No significant differences in levels were detected between men and women. Serum anti-HSP27 antibody levels were significantly higher in obese subjects than in nonobese subjects (P=0.046); however, no significant influence of smoking status was observed. Moreover, serum anti-HSP27 antibody titers were positively associated with age, body mass index, waist/hip ratio, the presence of diabetes mellitus, nonsmoking habit, serum triglycerides, cholesterol, and high-sensitivity c-reactive protein.

CONCLUSION

We have found that serum anti-HSP27 antibody titers are related to several cardiovascular risk factors, necessitating further studies on the value of this emerging marker for risk stratification.

The application of a decision tree to establish the parameters associated with hypertension

INTRODUCTION

Hypertension is an important risk factor for cardiovascular disease (CVD). The goal of this study was to establish the factors associated with hypertension by using a decision-tree algorithm as a supervised classification method of data mining.

METHODS

Data from a cross-sectional study were used in this study. A total of 9078 subjects who met the inclusion criteria were recruited. 70% of these subjects (6358 cases) were randomly allocated to the training dataset for the constructing of the decision-tree. The remaining 30% (2720 cases) were used as the testing dataset to evaluate the performance of decision-tree. Two models were evaluated in this study. In model I, age, gender, body mass index, marital status, level of education, occupation status, depression and anxiety status, physical activity level, smoking status, LDL, TG, TC, FBG, uric acid and hs-CRP were considered as input variables and in model II, age, gender, WBC, RBC, HGB, HCT MCV, MCH, PLT, RDW and PDW were considered as input variables. The validation of the model was assessed by constructing a receiver operating characteristic (ROC) curve.

RESULTS

The prevalence rates of hypertension were 32% in our population. For the decision-tree model I, the accuracy, sensitivity, specificity and area under the ROC curve (AUC) value for identifying the related risk factors of hypertension were 73%, 63%, 77% and 0.72, respectively. The corresponding values for model II were 70%, 61%, 74% and 0.68, respectively.

CONCLUSION

We have developed a decision tree model to identify the risk factors associated with hypertension that maybe used to develop programs for hypertension management.

Nutrient patterns and their relationship to metabolic syndrome in Iranian adults

BACKGROUND

The prevalence of metabolic syndrome (MetS) is increasing globally. It is associated with a significant risk of developing type 2 diabetes mellitus and cardiovascular disease.

MATERIALS AND METHODS

The relationship between adherence to several different dietary patterns and the presence of MetS was explored in an Iranian population sample of 5764 subjects.

RESULTS

We observed that the prevalence of MetS was 13% and 18% in men and women, respectively. There were three main dietary patterns: the first pattern was characterized by protein, carbohydrate, starch, glucose, fructose, sucrose, maltose, dietary fibre, potassium, calcium, magnesium, phosphorus, iron, zinc, manganese, thiamine, riboflavin, carotene, vitamin c and lactose; second representative of fat, saturated fat, monounsaturated fat, polyunsaturated fat, cholesterol, sodium, calcium, zinc, phosphorus, iodine, vitamin D, chloride, betaine, niacin; third consisting of copper, selenium, vitamin A, riboflavin, vitamin B12. In this dietary pattern, individuals in first quintile had a higher consumption of total fat, saturated fatty acid, monounsaturated fatty acid, polyunsaturated fatty acid, cholesterol and vitamin A. In the second pattern, individuals in the fifth quintile ate less carbohydrate, dietary fibre, glucose, Fructose, potassium compared to first quintile. We found that individuals in the first quintile in pattern 3 had higher intakes of protein, zinc and calcium compared to other quintiles.

CONCLUSIONS

We have found that a nutrient pattern which mostly characterized by dietary protein, carbohydrate, starch, glucose, fructose, sucrose, maltose was associated with a higher risk of MetS in both genders, while a pattern which was represent of copper, selenium, Vitamin A, riboflavin, vitamin B12 was associated with greater odds of Mets, in women.

Metabolic improvement of morbid obese patients following Roux-en-Y gastric bypass surgery: A prospective study in Mashhad, Iran

BACKGROUND AND AIM

Obesity is one of the greatest public health concerns worldwide. Weight loss surgeries have been increased in recent decades due to the world's epidemic of obesity. The aim of this prospective study is investigating metabolic factors of morbid obese patients following Roux-en-Y gastric bypass surgery.

METHODS

This was a nonrandomized prospective cohort study conducted from 2010 to 2013 on 60 consecutive patients who had body mass index (BMI) of more than 40 kg/m(2) and met the surgical indication criteria of bariatric surgery. Upon discharge, patients were followed in outpatient clinic of Qaem Hospital, Mashhad, Iran, each 3 months for 12 months. Measurement of anthropometric and metabolic indices was done in each postoperative visit.

RESULTS

Mean BMI reduction was 15.26 ± 3.45 kg/m(2) in the patients with an average value of 28.84 ± 3.94 (range from 22 to 40 kg/m(2)), which was significantly lower than the base value (p < 0.001). After a 12-month follow up, patients had lower low-density lipoprotein, triglycerides, and total cholesterol (p < 0.001 for all the variables), while achieving a greater high-density lipoprotein (p = 0.004). An improvement was seen in all of hypertensive patients after a 3-month follow up and blood pressure remained within normal limit in further follow ups. Complete remission was observed in all the patients with obstructive sleep apnea.

CONCLUSION

It appears reasonable that multidisciplinary treatment including surgical alternatives should be concerned for all morbidly obese patients, considering high rate of failure of conservative medical therapy in this setting.

Insulin resistance and endocrine-metabolic abnormalities in polycystic ovarian syndrome: Comparison between obese and non-obese PCOS patients

BACKGROUND

Insulin resistance has an important role in pathophysiology of polycystic ovarian syndrome (PCOS). Yet there are certain controversies regarding the presence of insulin resistance in non-obese patients.

OBJECTIVE

The aim was to compare the insulin resistance and various endocrine and metabolic abnormalities in obese and non-obese PCOS women.

MATERIALS AND METHODS

In this cross-sectional study which was performed from 2007-2010, 115 PCOS patients, aged 16-45 years were enrolled. Seventy patients were obese (BMI ≥25) and 45 patients were non-obese (BMI <25). Presence of insulin resistance and endocrine-metabolic abnormalities were compared between two groups. Collected data were analyzed with SPSS version 16.0 and p<0.05 was considered as statistically significant.

RESULTS

There was no significant difference in presence of insulin resistance (HOMA-IR >2.3) between two groups (p=0.357). Waist circumference (p<0.001), waist/hip ratio (p<0.001), systolic (p<0.001) and diastolic (p<0.001) blood pressures, fasting blood sugar (p=0.003) and insulin (p=0.011), HOMA-IR (p=0.004), total cholesterol (p=0.001) and triglyceride (p<0.001) were all significantly higher in obese PCOS patients. There was no significant difference in total testosterone (p=0.634) and androstenedione (p=0.736) between groups whereas Dehydroepiandrotendione sulfate (DHEAS) was significantly higher in non-obese PCOS women (p=0.018). There was no case of fatty liver and metabolic syndrome in non-obese patients, whereas they were seen in 31.3% and 39.4% of obese PCOS women, respectively.

CONCLUSION

Our study showed that metabolic abnormalities are more prevalent in obese PCOS women, but adrenal axis activity that is reflected in higher levels of DHEAS was more commonly pronounced in our non-obese PCOS patients.

Association of Serum hs-CRP Levels With the Presence of Obesity, Diabetes Mellitus, and Other Cardiovascular Risk Factors

BACKGROUND

Diabetes mellitus remains one of the major health problems of the 21st century and is associated with comorbidities including obesity and metabolic abnormalities. The study was conducted to evaluate serum high-sensitivity C-reactive protein (hs-CRP) levels, as a marker of inflammation, in a large sample of Iranian population without a history of cardiovascular or inflammatory disease and cancer, and to relate this to fasting blood glucose (FBG) and the presence of diabetes mellitus.

METHODS

The study consisted of 7,762 subjects divided into four groups-nonobese/nondiabetic, obese/nondiabetic, nonobese/diabetic and obese/diabetic-based on the BMI classification and their FBG. Anthropometric characteristics were measured and blood was collected for the evaluation of fasted lipid profile, FBG and serum hs-CRP levels.

RESULTS

Several clinical and biochemical characteristics were significantly different among the four groups: FBG, P < 0.001; total cholesterol (TC), P < 0.001; and triglyceride (TG), P < 0.001. The subjects with a serum hs-CRP >3 mg/dl had higher TC (P < 0.001), low-density lipoprotein cholesterol (LDL-C, P < 0.001), TG (P < 0.001), fat percentage (P < 0.001), and systolic and diastolic blood pressure (P < 0.001) compared with subjects with a serum hs-CRP <3 mg/dl. Multivariate analysis showed FBG, LDL-C, and waist circumference (WC) associated with increased serum hs-CRP levels (P < 0.001).

CONCLUSIONS

FBG, LDL-C, WC and gender are independently associated with serum hs-CRP concentrations.

Mashhad stroke and heart atherosclerotic disorder (MASHAD) study: design, baseline characteristics and 10-year cardiovascular risk estimation

OBJECTIVE

The Mashhad stroke and heart atherosclerotic disorder (MASHAD) study is a 10-year cohort study that aims to evaluate the impact of various genetic, environmental, nutritional and psychosocial risk factors on the incidence of cardiovascular events among an urban population in eastern Iran.

METHODS

The MASHAD study comprises a cohort of 9704 individuals aged 35-65 years using a stratified cluster random sampling design. This cohort will be followed up until 2020, with follow-up examinations being undertaken every 3 years. Ten-year cardiovascular disease (CVD) risk estimation was determined using NCEP ATP III criteria.

RESULTS

Overall, 88.4 % of women and 79.2 % of men (P < 0.001) had at least one lipid abnormality. The 10-year risk for CVD of <10, 10-20 and >20 % were observed to be 86.6, 11 and 2.5 %, respectively. Predicted risk of CVD > 10 % using the Framingham algorithm was considerably higher in men compared to women. Overall, 9.5 % [95 % confidence interval (CI) 8.9-10.1 %] of our subjects had prevalent CAD.

CONCLUSION

The prevalence of CVD risk factors within our population is high compared to Western countries, indicating the necessity for interventional risk modifications.

The lipoprotein lipase S447X and cholesteryl ester transfer protein rs5882 polymorphisms and their relationship with lipid profile in human serum of obese individuals

BACKGROUND

Obesity is often associated with an alter lipid profile, e.g., raised serum triglycerides (TG) and low high-density lipoprotein (HDL) cholesterol levels, both important risk factor for cardiovascular-diseases. The aim of current study was to explore the association of a polymorphism of the lipoprotein lipase (LPL) rs328 and cholesteryl-ester-transfer-protein (CETP) rs5882 genes in relation to lipid profile in subjects with/without obesity.

SUBJECTS/METHODS

Genotyping was carried out in 271 individuals, (151 obese subjects and 120 non-obese). Univariate/multivariate analyses were conducted to evaluate the association of these genetic-polymorphisms with obesity and lipid components.

RESULTS

Obese subjects had a significantly (P<0.05) higher level of triglyceride (TG), blood pressure, waist-circumference and fasting-blood-glucose, and lower level of HDL-C. LPL and CETP polymorphisms were not associated with obesity in our population. However, the LPL rs328-GG-GC genotype was significantly related to a higher concentration of TG, compared to the CC wild-type; and a higher HDL-C level in the obesity-group with respect to the control group. Moreover, obese-subjects carrying the G allele of CETP had a significantly lower level of HDL-C (P<0.05) compared to those with C allele.

CONCLUSION

We demonstrate a significant association of LPL and CETP polymorphisms with serum triglycerides and HDL-cholesterol.

Prooxidant-antioxidant balance and hs-CRP in patients with beta-thalassemia major

BACKGROUND

Beta-thalassemia major is one of the most frequent hemoglobinopathies in the world. This is a study on the levels of prooxidant-antioxidant balance (PAB) that can measure the pro-oxidant burden and the anti-oxidant capacity simultaneously in one assay, giving a redox index, as well as an assessment of high-sensitivity C-reactive protein (hs-CRP) in patients with beta-thalassemia major. It also determines the impact both on kidney function tests.

METHODS

Ninety subjects with beta-thalassemia major (betaTM) and 90 more healthy subjects as the control group were enrolled in the study. Laboratory parameters, serum hs-CRP, and the novel assay of prooxidant-antioxidant balance were measured.

RESULTS

Biochemical and hematological variables, except MCHC, were significantly decreased in patients. Ferritin (p < 0.001) and PAB (p < 0.001) values were statistically increased in patients, whereas hs-CRP (p > 0.05) did not significantly increase in patients. Spearman's correlation univariate analysis showed no significant correlation between PAB with hs-CRP or ferritin. However, there was a significant statistical correlation between hs-CRP with creatinine and triglycerides. Also we found a slight and negative correlation between high-density lipoprotein cholesterol, hemoglobin, and hemotocrit with inflammatory factor.

CONCLUSIONS

Briefly, we found higher levels of PAB values and a slight increase in hs-CRP concentration in patients, which may be involved in the pathological consequences of beta-thalassemia major and contribute to the gradual development of injury to the organs.

Serum antibody titers against heat shock protein 27 are associated with the severity of coronary artery disease

Antibody titers to several heat shock proteins (anti-Hsps) have been reported to be associated with the severity and progression of cardiovascular disease. However, there are little data regarding anti-Hsp27 titers in patients with coronary artery disease (CAD). A total of 400 patients with suspected CAD were recruited. Based on the results of coronary angiography, these patients were classified into CAD(+) (n = 300) and CAD(-) (n = 100) groups defined as patients with ≥50% and <50% stenosis of any major coronary artery, respectively. Eighty-three healthy subjects were also recruited as the control group. Serum anti-Hsp27 IgG titers were measured using an in-house enzyme-linked immunosorbent assay. CAD(+) patients had significantly higher anti-Hsp27 titers compared with both CAD(-) and control groups. Anti-Hsp27 titers were also higher in the CAD(-) group compared with the control group. With regard to the number of affected vessels in the CAD(+) group, patients with three-vessel disease had higher anti-Hsp27 titers compared with both two-vessel disease (2VD) and one-vessel disease (1VD) subgroups. However, there was no significant difference between 1VD and 2VD subgroups. In multiple linear regression analysis, the number of narrowed vessels and smoking were significant independent determinants of serum anti-Hsp27 titers. The present findings indicate that serum anti-Hsp27 titers may be associated with the presence and severity of coronary artery disease.

Anthropometric indices of obesity and the prediction of cardiovascular risk factors in an Iranian population

The prevalence of hypertension, diabetes, dyslipidemia, and metabolic syndrome are increasing globally. The present study was conducted in an attempt to define optimal cutoff values for several anthropometric variables in an Iranian population, as these may vary with ethnicity. Iranian subjects (2483 men and 2445 women), aged 15–65 years, were recruited using a cluster-stratified sampling method from rural and urban areas within the Khorasan province. Receiver operating characteristics (ROC) analysis was used to define optimal anthropometric cutoff values. The prevalence of hypertension, diabetes, dyslipidemia, and metabolic syndrome were 28, 5.5, 67, and 39.9%, respectively. The gender-specific cutoff values for waist:height ratio to predict hypertension, diabetes, dyslipidemia, and metabolic syndrome among men were 0.52 (sensitivity = 66%; specificity = 66%), 0.54 (sensitivity = 65%; specificity = 65%), 0.50 (sensitivity = 58%; specificity = 57%), and 0.53 (sensitivity = 73%; specificity = 70%), and for women were 0.59 (sensitivity = 61%; specificity = 61%), 0.61 (sensitivity = 64%; specificity = 64%), 0.57 (sensitivity = 61%; specificity = 61%), and 0.59 (sensitivity = 77%; specificity = 77%) (p < 0.05). Significant correlations were found between waist:height ratio and hypertension, diabetes mellitus, dyslipidemia, and metabolic syndrome, particularly in women. Waist circumference cutoffs were higher for women than men for hypertension, diabetes mellitus, and dyslipidemia.

The relationship between established coronary risk factors and serum copper and zinc concentrations in a large Persian cohort

INTRODUCTION

The relationship between demographic and biochemical characteristics, including several established coronary risk factors, and serum copper and zinc was assessed in a large Iranian population sample.

MATERIALS AND METHODS

A group of 2233 individuals, 15-65 years of age [1106 (49.5%) males and 1127 (50.5%) females] was recruited from residents of the Greater Khorasan province in northeast of Iran. Demographic data were collected using questionnaires. Coronary risk factors were determined using standard protocols, and trace elements were measured in serum using atomic absorption spectroscopy.

RESULTS

Degree of glucose tolerance and smoking habit were not associated with serum zinc and copper levels. Serum copper levels were significantly higher in obese and hypertensive than in normal subjects (p<0.001). In the whole group and for the female subgroup, serum zinc (p<0.01) and copper (p<0.001) were both significantly lower in individuals with normal versus high levels of low-density lipoprotein cholesterol. A strong positive correlation was found between serum copper and body mass index (BMI) (r=0.85, p<0.001). Weaker positive associations were found between serum copper and calculated 10 years' coronary risk (r=0.11, p<0.001). Serum zinc/copper ratio was strongly inversely associated with calculated 10 years' coronary risk (r=-0.10, p<0.001). The partial Eta squared (PES) values for factors determining serum zinc were hypertension (0.007, p=0.01) and BMI (0.004, p=0.01); and for serum copper, they were gender (0.02, p=0.001), hypertension (0.004, p=0.009), and 10 years' coronary risk for men (0.003, p=0.03) and women (0.002, p=0.07).

CONCLUSION

Significant associations between serum trace element concentrations and several coronary risk factors, including calculated 10 years' coronary risk scores, were found.

Natural honey and cardiovascular risk factors; effects on blood glucose, cholesterol, triacylglycerole, CRP, and body weight compared with sucrose

It has been found that honey ameliorates cardiovascular risk factors in healthy individuals and in patients with elevated risk factors. The present study investigated the effect of natural honey on total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triacylglycerole, C-reactive protein (CRP), fasting blood glucose (FBG), and body weight in overweight individuals. There were 55 patients, overweight or obese, who were randomly recruited into the study and assigned into two groups: control group (17 subjects) and experimental group (38 subjects). Patients in the control group received 70 g of sucrose daily for a maximum of 30 days and patients in the experimental group received 70 g of natural honey for the same period. In the control and experimental groups, body weight, body mass index, body fat weight, total cholesterol, LDL-C, HDL-C, triacylglycerole, FBG, and CRP were measured before treatment and at day 31 after the commencement of treatment. Results showed that honey caused a mild reduction in body weight (1.3%) and body fat (1.1%). Honey reduced total cholesterol (3%), LDL-C (5.8), triacylglycerole (11%), FBG (4.2%), and CRP (3.2%), and increased HDL-C (3.3%) in subjects with normal values, while in patients with elevated variables, honey caused reduction in total cholesterol by 3.3%, LDL-C by 4.3%, triacylglycerole by 19%, and CRP by 3.3% (p < 0.05). It is our conclusion that consumption of natural honey reduces cardiovascular risk factors, particularly in subjects with elevated risk factors, and it does not increase body weight in overweight or obese subjects.