Biomedical subjects

F Azizi

Publications and source records attributed to F Azizi.

At least 19 recordsLinked to original sources

PubMed2006

Changes in calcium, 25(OH) vitamin D3 and other biochemical factors during pregnancy.

INTRODUCTION AND AIMS: Calcium and vitamin D play major roles in calcium homeostasis and skeletal development, especially during pregnancy. This study was conducted to determine changes in calcium, 25 hydroxy [25(OH)] vitamin D3 and other biochemical factors (PTH, osteocalcin, alkaline phosphatase, magnesium, phosphorus) related to calcium homeostasis and bone turnover during pregnancy and compare the values to those of non-pregnant women. MATERIALS AND METHODS: In a cohort study, 48 pregnant women, in their first trimester of pregnancy (12+/-2.7 weeks), from 5 prenatal care centers, and 47 non-pregnant women randomly selected from the Tehran Lipid and Glucose Study (TLGS) population were enrolled. These pregnant women were followed in their second (26+/-1.9 weeks) and third trimesters (37+/-3.2 weeks) of pregnancy. Samples were drawn from June 2002 to March 2003. Including criteria were healthy women with no background of disease. Women using photo protection and calcium and vitamin D supplementation were excluded. A questionnaire was used to obtain demographic information for both groups. Venous blood samples were taken after 12-14 h of overnight fasting to measure serum calcium, phosphorus, magnesium, alkaline phosphatase, PTH, 25 (OH) vitamin D3 and serum osteocalcin levels. The repeated measures analysis of variance and t-test were used for statistical analysis. Data were matched for age and weight in both the case (in the first trimester) and control groups. RESULTS: Significant differences were found in the mean serum levels of osteocalcin and alkaline phosphatase between the three trimesters of pregnancy (p< 0.001). Osteocalcin was significantly higher in the first trimester as compared to second and third trimesters of pregnancy. Alkaline phosphatase was significantly lower in the first trimester as compared to the second and third trimesters of pregnancy and their controls. There was also a significant difference in osteocalcin in the second and third trimesters and alkaline phosphatase in the first and third trimesters of pregnancy in comparison to the control group. The mean values of osteocalcin were 12.7+/-8.5, 8.1+/-6.9, 5.6+/-5.0 and 13.9+/-7.9 ng/ml, respectively, and mean values for alkaline phosphatase were 115+/-38, 125+/-37, 174+/-61 and 134+/-35.0 Iu/l, respectively. In the first trimester, alkaline phosphatase was lower and osteocalcin was higher than in the second and third trimesters. In the first trimester of pregnancy, 20 and 40% of women had 25(OH) vitamin D3 < 10 and < 20 ng/ml, respectively, and 19% of women had serum calcium levels < 8.6 mg/dl. CONCLUSION: 60% of women in the first trimester, 48% in the second and 47% in the third trimester had either severe or moderate vitamin D deficiency. It is recommended that the importance of calcium supplements with vitamin D in pregnant women be stressed for these individuals.

Adult↗

PubMed2006

Treatment of post-partum thyrotoxicosis.

Thyrotoxicosis occurs more frequently during the post-partum period than at other times in women of childbearing age. Graves' disease and post-partum thyroiditis are two major causes of thyrotoxicosis in this period. The major task lies in differentiation of these two diseases in the post-partum period; since throtoxicosis caused by post-partum thyroiditis usually does not require treatment. The radioiodine uptake is elevated or normal in Graves' disease and low in post-partum thyroiditis, and TSH-receptor antibodies are positive in Graves' and negative in post-partum thyroiditis. Post-partum thyrotoxicosis due to Graves' disease may be treated with radioiodine but it requires radiation safety measurements for infant and is contraindicated if the mother is breast-feeding. Antithyroid drugs are the mainstay of the treatment of post-partum thyrotoxicosis. Recent investigations conclude that neither propylthiouracil nor methimazole cause any alterations in thyroid function and physical and mental development of infants breast-fed by lactating thyrotoxic mothers, and both can be safely administered in moderately high doses during lactation.

Antithyroid Agents↗

PubMed2006

Waist/height ratio as a better predictor of type 2 diabetes compared to body mass index in Tehranian adult men--a 3.6-year prospective study.

OBJECTIVE: To investigate whether central obesity variables are more important than general obesity variables in predicting the incidence of type 2 diabetes in Iranians. METHODS: In this population-based longitudinal study, a representative sample of 1852 males aged > or = 20 years, participants of the Tehran Lipid and Glucose Study, were followed for a mean duration of 3.6 years. Demographic data were collected; blood pressure and anthropometric variables such as body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were measured according to a standard protocol. Biochemical analyses including measurements of plasma glucose in the fasting state and 2 hours after ingestion of 75 g glucose as well as fasting serum lipids were done. Diabetes and abnormal glucose tolerance (impaired fasting glucose or impaired glucose tolerance) were defined according to ADA criteria. Logistic regression models with the stepwise conditional method were used to estimate the relative risk (RR) of developing diabetes associated with each quartile of each anthropometric variable in a multivariate model adjusted for age, hypertension, smoking, family history of diabetes (model 1), and a full model adjusted for all the variables in model 1 plus abnormal glucose tolerance (model 2). Receiver operating characteristic (ROC) curves were used to determine the predictive power of each variable for development of type 2 diabetes, after adjustment for age. RESULTS: A total of 69 new cases of type 2 diabetes (3.7%) were diagnosed during 3.6 years of follow-up, with an incidence rate of approximately one percent per year. The RR of developing diabetes associated with the highest quartile of anthropometric variables, was highest for WHtR in model 1. After further adjustment for abnormal glucose tolerance (model 2) only WHtR and WC were significantly associated with type 2 diabetes. According to the ROC curve analysis, among central obesity variables only WHtR had a higher ROC curve than BMI. WHtR also continued to be the best predictive central obesity variable compared to BMI, even when the analysis was restricted to subjects with BMI < 27 kg/m2 (0.678 vs. 0.631, p < 0.05). In those with BMI > or = 27 kg/m2, none of the central obesity variables proved to be superior to BMI. CONCLUSION: Among abdominal obesity variables, WHtR appears to be stronger than BMI in identifying men with type 2 diabetes in the future.

Adult↗

PubMed2006

Predicting isolated postchallenge hyperglycaemia: a new approach; Tehran Lipid and Glucose Study (TLGS).

AIMS: To determine factors predicting isolated postchallenge hyperglycaemia (IPH) defined as fasting plasma glucose (FPG) < 7.0 mmol/l and 2-h plasma glucose (2-hPG) >or= 11.1 mmol/l after an oral glucose tolerance test (OGTT) and factors influencing the value of 2-hPG in a population-based study. MATERIALS AND METHODS: From 15,005 participants in the Tehran Lipid and Glucose Study (TLGS), we analysed the results of OGTTs in 5386 individuals (2909 women and 2437 men) aged >or= 20 years, free of known diabetes and any other disorders influencing glucose metabolism. Logistic and multiple linear regression models were developed to predict IPH and the 2-hPG, respectively. RESULTS: The overall prevalence of non-diabetic subjects, IPH and undiagnosed Type 2 diabetes mellitus (FPG >or= 7.0 mmol/l) were 94.5% (n = 5088), 2.5% (n = 133) and 3.1% (n = 165), respectively. Of subjects with IPH, 29.3% (n = 39) had FPG levels < 5.6 mmol/l. Factors associated with IPH were FPG (mmol/l) [odds ratio (OR) 11.05, 95% confidence interval (CI) 7.9, 15.4], age >or= 40 years (OR 2.0, 95% CI 1.3, 3.2), abnormal waist circumference (OR 2.1, 95% CI 1.4, 3.1) and serum triglycerides >or= 1.7 mmol/l (OR 2.0, 95% CI 1.3, 3.1). In the multiple linear regression model, six explanatory factors (FPG, age, female sex, triglycerides, systolic blood pressure, waist circumference) were positively related to 2-hPG. CONCLUSIONS: The model could predict 47.7% of total variance of 2-hPG. Based on our results in this Iranian population, OGTT can be recommended in subjects with FPG < 7.0 mmol/l in the presence of abnormal waist circumference and triglycerides, age >or= 40 years and in particular when FPG is close to 7.0 mmol/l.

Adult↗

PubMed2005

Reappraisal of the risk of iodine-induced hyperthyroidism: an epidemiological population survey.

The occurrence of iodine-induced hyperthyroidism (IIH) has been reported after iodine supplementation from clinics and hospitals, but not following an epidemiologic survey. We studied the prevalence of thyroid derangement in a population following iodine supplementation. One yr after more than 75% of the population had been consuming 40 ppm iodized salt; information regarding history of endemic goiter and iodized salt production, distribution, consumption and monitoring were collected in four cities of the Islamic Republic of Iran. A total of 6048 subjects were randomly selected. All subjects were assessed for size of goiter, and urinary iodine and serum T4, T3, TSH, anti-thyroglobulin and anti-thyroperoxide were measured. Before iodine supplementation, all four cities were areas of endemic goiter. The rate of household consumption of iodized salt was 50, 75 and 90% in 1994, 1995 and 1996, respectively. Ninety-one percent of the salt samples contained 15-55 ppm iodide. Total goiter rate was 57, 62 and 68%; median urinary iodine was 188, 197 and 190 microg/l in the age groups of 6-18, 19-40 and >40 yr, respectively. Prevalence of clinical and subclinical hyperthyroidism was 0.34 and 0.41 and those of clinical and subclinical hypothyroidism were 0.51 and 1.07%, respectively. Nine point eight and 18% in the 19-40 yr age group and 17.6 and 25.6% in >40 yr old subjects had positive anti-thyroperoxidase and anti-thyroglobulin, respectively. This systemic epidemiologic study in an iodine deficient population showed that, following a well-executed iodine supplementation program, the occurrence of IIH is rare.

Adolescent↗

PubMed2005

Ultrasonographic characteristics and follow-up in post-partum thyroiditis.

Post-partum thyroiditis (PPT) is an autoimmune disorder of the thyroid gland, which occurs in the first year after parturition. This study was designed to evaluate sonographic characteristics in a group of PPT patients in Tehran. The study group consisted of 119 PPT patients and 97 normal post-partum women as the control group. Physical examination of thyroid and ultrasonography were carried out monthly in PPT patients until remission for up to 12 months post-partum and 65 patients were followed-up until the end of the study. Visible goiter was detected in 21.8% of patients and 6.7% of the control group (p < 0.001). Hypoechogenecity in thyroid sonography was present in 98.5% of patients and 7% of the control group (p < 0.001). Initially mean thyroid volume in PPT patients was found to be 77% more than that of the control group. After remission, mean thyroid volume decreased by 25% in PPT patients. At 12 months after delivery, only 6 patients had abnormal thyroid function tests, while 4 patients with TSH > 10 mU/I still showed hypoechogenicity in thyroid sonography. In conclusion, sonography may be recommended as an adjuvant to laboratory tests in evaluation of PPT patients.

Adult↗

PubMed2005

Prevalence of goiter among schoolchildren from Gorgan, Iran, a decade after national iodine supplementation: association with age, gender, and thyroperoxidase antibodies.

BACKGROUND: One decade after universal salt iodization in Iran, goiter prevalence, urinary iodine concentration (UIC) and thyroperoxidase antibody (TPOAb) values were assessed among schoolchildren in Gorgan, Iran. METHODS: From 2003-2004, 500 girls and 900 boys aged 7-11 yr were evaluated for goiter by palpation. UIC was measured in 183 randomly-selected goitrous children. Serum TSH, T4, and TPOAb were measured in 53 goitrous and 30 non-goitrous children with adequate UIC. RESULTS: Goiter was detected in 370 (26.4%) children. Goiter was present in 31% of girls and 17% of boys age 9 (p<0.012); 37% of girls and 20% of boys age 10 (p<0.003); and 52% of girls and 19% of boys age 11 (p<0.0001). Median (range) UIC for all goitrous children sampled was 190 (20-600) microg/l; 220 (30590) in boys and 170 (20-600) in girls (p=0.001). Eight point seven percent of goitrous children and 22% of goitrous girls aged 10-11 had UIC<100 microg/l, while 47% of the goitrous children had UIC> or =200 microg/ l. TPOAb was present in 52.8% of goitrous children and 10% of non-goitrous children (p=0.0001). TPOAb was present in 53.9% of 10-11 and 22.7% of 7-9 yr old goitrous and non-goitrous children (p=0.003) with adequate UIC. Median (range) TSH was 2.9 (0.3-10.9) mlU/I in TPO-positive and 1.8 (0.5-4.1) in TPO-negative children (p=0.001). CONCLUSIONS: Gorgan, Iran, is an iodine-sufficient area and almost half of schoolchildren have more than adequate UIC. TPOAb is associated with endemic goiter. Despite sufficient UIC overall, some school-aged girls remain at risk of iodine deficiency.

Age Factors↗

PubMed2005

Whole-grain consumption and the metabolic syndrome: a favorable association in Tehranian adults.

BACKGROUND: Although dietary guidelines recommend increased intake of grain products to prevent chronic diseases, epidemiologic data regarding whole-grain intake association with metabolic syndrome are sparse. OBJECTIVE: To evaluate the relationship between whole-grain intakes, metabolic syndrome and metabolic risk factors in Tehranian adults. DESIGN: Population-based cross-sectional study. SETTING: Tehran, the capital of Iran. SUBJECTS: A representative sample of 827 subjects (357 men and 470 women) aged 18-74 y. METHODS: Usual dietary intake was assessed using a food frequency questionnaire. The procedure developed by Jacobs et al was used to classify grain products into whole and refined grains. Weight and height were measured according to standard protocols and body mass index was calculated. Fasting blood samples were taken for biochemical measurements and blood pressure was assessed according to standard methods. Hypertriglyceridemia, hypercholestrolemia, high LDL, low HDL and metabolic syndrome were defined according to ATP III guidelines and hypertension based on JNC VI. Diabetes was defined as fasting plasma glucose level of > or = 126 mg/dl or 2-h postchallenge blood glucose level of > or = 200 mg/dl. Subjects were categorized based on quartile cut-points of whole- and refined-grain intake. RESULTS: Mean (+/-s.d.) consumptions of whole and refined grains were 93+/-29 and 201+/-57 g/day, respectively. Both men and women reported higher intakes of refined grain than of whole grains. Compared with subjects in the lower quartile category, those in the upper category of whole-grain intake had lower prevalence of metabolic risk factors. Conversely, those in the higher category of refined-grain intake had higher prevalence of metabolic risk factors, except for diabetes. After controlling for confounders, a significantly decreasing trend was observed for the risk of having hypertriglyceridemia (odds ratios among quartiles: 1.00, 0.89, 0.74, 0.61, respectively), hypertension (1.00, 0.99, 0.93, 0.84) and metabolic syndrome (1.00, 0.84, 0.76, 0.68). Higher consumption of refined grains was associated with higher odds of having hypercholestrolemia (1.00, 1.07, 1.19, 1.23), hypertriglyceridemia (1.00, 1.17, 1.49, 2.01), hypertension (1.00, 1.22, 1.48, 1.69) and metabolic syndrome (1.00, 1.68, 1.92, 2.25). CONCLUSION: Whole-grain intake is inversely and refined-grain intake is positively associated with the risk of having metabolic syndrome. Recommendations to increase whole-grain intake may reduce this risk.

Adolescent↗

PubMed2005

Variety scores of food groups contribute to the specific nutrient adequacy in Tehranian men.

OBJECTIVE: To examine the relationship between variety scores of food groups (between and within food groups) and the probability of nutrient adequacy in Tehranian men. DESIGN: A cross-sectional study assessing food intake by two 24-h recall questionnaires. Dietary diversity was defined according to diet quality index revised, which was used by Haines et al in 1999. The mean probability of adequacy across 14 nutrients was calculated using the Dietary Reference Intakes. SETTING: District 13 of Tehran, Iran. SUBJECTS: A total of 295 males, aged 18 y and over. RESULTS: Whole grain variety mostly correlated with protein and vitamin B2 (r=0.3, P<0.05). Fruit variety was correlated with vitamin C (r=0.4, P<0.05). Dairy variety was correlated with calcium intake (r=0.4, P<0.05). Meat variety was correlated with protein intake (r=0.3, P<0.05). Most subjects failed to meet vitamin B6, zinc, magnesium, calcium, copper, and vitamin B12 adequacy. Energy intake was a strong predictor of the mean probability of adequacy in models controlled for age, body mass index, education level and job status (model R2=0.48). Adding the number of servings from each of the food group to the models significantly improved the model fit (model R2=0.55). Adding the dietary variety improved the model fit significantly (model R2=0.61). Dairy variety and meat variety had the strongest association with improved nutrient adequacy. CONCLUSION: Variety of different food groups is a useful indicator of specific nutrient adequacy. Hence, to determine the adequacy of a specific nutrient, the variety scores of specific food groups should be taken into account.

Adult↗

PubMed2005

Dairy consumption and body mass index: an inverse relationship.

OBJECTIVE: To assess the relationship between consumption of dairy products and body mass index (BMI) in Tehranian adults. DESIGN: Cross-sectional study. SUBJECTS: A total of 462 healthy subjects (223 men and 239 women) aged over 16 y selected randomly from among participants of the Tehran Lipid and Glucose Study (TLGS). MEASUREMENTS: Dietary data were collected by means of a food frequency questionnaire for 1 y and two 24-h dietary recalls. Height and weight were measured and BMI was calculated. Physical activity was assessed by the Lipid Research Clinic (LRC) questionnaire. RESULTS: Consumption of dairy products was 3.7+/-1.0 and 2.9+/-1.2 servings per day in men and women, respectively. As the servings of dairy consumption increased per day, the proportion of normal-weight subjects rose and that of obese ones declined. As BMI increased, the proportion of subjects with lower consumption of dairy products increased, whereas that of those with higher consumption decreased. There was a significant inverse correlation between the servings of dairy consumption per day and BMI after controlling for the effect of age, physical activity, energy, carbohydrate, dietary fiber, protein and fat intake (r=-0.38, P<0.05). After adjustment for potential confounding variables, men and women in the top quartile of dairy consumption had lower chances for being overweight (OR=0.78, 95% CI=0.43-0.92 for men and OR=0.89, 95% CI=0.53-0.95 for women) and obese (OR=0.73, 95% CI=0.40-0.83 for men and OR=0.69, 95% CI=0.34-0.80 for women) compared to those in the first quartile. CONCLUSION: The results suggest an inverse relationship between dairy consumption and BMI. It is recommended that further studies address this issue by focusing on the dairy components responsible for this effect.

Adult↗

PubMed2005

Dietary diversity score is favorably associated with the metabolic syndrome in Tehranian adults.

OBJECTIVE: Assessing overall diet instead of the effects of a single nutrient on diet-disease relations may be more informative. This study was conducted to evaluate the relationship between dietary diversity score (DDS) and metabolic syndrome in Tehranian adults. DESIGN: Cross-sectional study. SUBJECTS: A representative sample of 581 healthy subjects aged over 18 y selected randomly from among participants of the Tehran Lipid and Glucose Study. MEASUREMENTS: Usual dietary intake was assessed using a validated semi quantitative food frequency questionnaire. DDS was calculated based on scoring to the five-food group. The DDS range was 0-10. Weight and height were measured according to standard protocols and body mass index (BMI) was calculated. Fasting blood samples were taken for biochemical measurements and blood pressure was assessed according to standard methods. Metabolic syndrome was defined according to ATPIII. Subjects were categorized based on quartile cut-points of DDS. RESULTS: Means (+/-s.d.) of age and BMI were 37+/-12 y and 25.7+/-4.3 kg/m(2), respectively. Mean (+/-s.d.) of DDS was 6.15+/-1.02. The probability of having metabolic syndrome decreased with quartiles of DDS (odds ratios among quartiles: 1.00, 0.82, 0.76, 0.70, P<0.05, and odds ratios among quartiles after further adjustment for BMI: 1.00, 0.88, 0.80, 0.77, P<0.05). After controlling for confounders, a significantly decreasing trend was observed for the risk of having high blood pressure, impaired glucose homeostasis and high triglyceride levels. CONCLUSION: DDS had inverse association with metabolic syndrome and some of its features in this cross-sectional study. A higher dietary diversity, therefore, might be associated with lower possibility of having some metabolic disorders.

Adult↗

PubMed2005

Effect of long-term continuous methimazole treatment of hyperthyroidism: comparison with radioiodine.

OBJECTIVE: To investigate the long-term effects of continuous methimazole (MMI) therapy. DESIGN AND METHODS: Five hundred and four patients over 40 years of age with diffuse toxic goiter were treated with MMI for 18 months. Within one year after discontinuation of MMI, hyperthyroidism recurred in 104 patients. They were randomized into 2 groups for continuous antithyroid and radioiodine treatment. Numbers of occurrences of thyroid dysfunction and total costs of management were assessed during 10 years of follow-up. At the end of the study, 26 patients were still on continuous MMI (group 1), and of 41 radioiodine-treated patients (group 2), 16 were euthyroid and 25 became hypothyroid. Serum thyroid and lipid profiles, bone mineral density, and echocardiography data were obtained. RESULTS: There was no significant difference in age, sex, duration of symptoms and thyroid function between the two groups. No serious complications occurred in any of the patients. The cost of treatment was lower in group 1 than in group 2. At the end of 10 years, goiter rate was greater and antithyroperoxidase antibody concentration was higher in group 1 than in group 2. Serum cholesterol and low density lipoprotein-cholesterol concentrations were increased in group 2 as compared with group 1; relative risks were 1.8 (1.12-2.95, P<0.02) and 1.6 (1.09-2.34, P<0.02) respectively. Bone mineral density and echocardiographic measurements were not different between the two groups. CONCLUSION: Long-term continuous treatment of hyperthyroidism with MMI is safe. The complications and the expense of the treatment do not exceed those of radioactive iodine therapy.

Adult↗

PubMed2005

The occurrence of permanent thyroid failure in patients with subclinical postpartum thyroiditis.

OBJECTIVE: The long-term effect of the subclinical form of postpartum thyroid dysfunction (PPTD) has not been well established. This study was conducted to evaluate the outcome of permanent hypothyroidism in a large cohort of women with PPTD. DESIGN AND METHODS: Of 213 women with PPTD, 172 (81%) returned for follow-up. There were 27 (16%) with subclinical (group 1) and 145 (84%) with overt hypothyroidism (group 2). They were all treated with levothyroxine for 23 +/- 16 months and followed-up for thyroid function after thyroxine (T(4)) withdrawal. RESULTS: In group 1, the time of occurrence of PPTD was longer, serum T(4) was higher and TSH was lower than in group 2. After T(4) withdrawal, 59 and 64% of patients became hypothyroid in groups 1 and 2 respectively; however, serum TSH was increased in group 2 as compared with group 1 (29.7 +/- 8.4 vs 16.4 +/- 15.4 mU/l, P < 0.002). The duration of euthyroidism, serum free T(4) and triiodothyronine indices and thyroperoxidase antibodies were not significantly different between the two groups. CONCLUSION: It was concluded that a high percentage of patients with the subclinical form of PPTD proceed to permanent thyroid failure. The timely recognition of mild to severe cases of PPTD is important for the improvement of life for mothers and infants.

Adult↗

PubMed2004

Age as a predictor of recurrent hypothyroidism in patients with post-partum thyroid dysfunction.

The long term effect of post-partum thyroid dysfunction (PPTD) is not well established. This study was conducted to evaluate the outcome of permanent hypothyroidism and factors predictive of thyroid dysfunction in a large cohort of women with PPTD. In 164 women, treated with levothyroxine for moderate and severe post- partum hypothyroidism, the treatment was discontinued and subjects were followed-up for the recurrence of hypothyroidism. Factors such as thyroid function tests, tyroid peroxidase antibodies (TPOAb) titers, multiparity, history of autoimmune disorders, smoking habits, use of oral contraceptives, family history of thyroid disease, goiter size and age at active phase of PPTD were assessed. Seventy-one post-partum women without PPTD were considered as control group. One hundred forty-eight women (90%) returned for follow-up, and 93 subjects (63%) developed hypothyroidism with a median of 2 months after T4 withdrawal. Of factors predicting recurrence of hypothyroidism, only age, and serum TSH and T3 concentrations at the time of occurrence of PPTD entered the model in multiple stepwise regression analysis. Hypothyroidism occurred earlier and more frequently in women aged 30 and over, as compared to younger ones (p < 0.01), hazard ratio 1.69. In 55 euthyroid subjects with history of PPTD, serum TSH was significantly increased as compared to the control group (3.0 +/- 1.6 vs 0.8 +/- 0.5 mU/l, p < 0.001). These data, representing the largest cohort of women with PPTD who have been followed, show that a significant proportion of women with moderate and severe PPTD, in particular those aged 30 yr and over, develop recurrent hypothyroidism. Proper follow-up of all women with PPTD, the older ones in particular, is recommended.

Adult↗

PubMed2004

Goiter prevalence and urinary iodine excretion in schoolchildren of Jordan.

Iodine deficiency disorders (IDD) are considered a major health problem in the eastern Mediterranean region. In Jordan, an IDD assessment was performed in 1993 following which, a salt iodization and consumption program was implemented and a monitoring survey performed in 2000. In schoolchildren 8 to 10 years of age (2457 in 1993 and 2601 in 2000) goiter was graded according to WHO classification. Urinary iodine was measured in 10% of the children in 1993 and in all of them in 2000. Percent of iodine consumption in households was assessed by rapid kit test in 2000. Prevalence of goiter was 37.7 and 32.1 % and median urinary iodine was 40 and 154 microg/L, in 1993 and 2000, respectively. Before salt iodization, the prevalence of goiter and severity of iodine deficiency was more pronounced in rural regions and in the southern part of Jordan. In 2000, all but one governorate had a median urinary iodine (MUI) of above 100 microg/L. The percentage of urinary iodine levels < 50 microg in two governorates was > 20%. Iodine consumption rate of households was 88.3% throughout the country, but was < 70% in three governorates. It is concluded that moderate and severe IDD existed before 1993 in Jordan. Although the iodized salt program has been successful in optimizing MUI, the program for the control of IDD needs further improvement.

Child↗

PubMed2004

Detection of cardiovascular risk factors by anthropometric measures in Tehranian adults: receiver operating characteristic (ROC) curve analysis.

OBJECTIVE: To determine optimal cutoff points of anthropometric measures as cardiovascular indicators in an Iranian adult population. DESIGN: : Population-based cross-sectional study. SETTING: Tehran, the capital of Iran. SUBJECTS: A total of 10 522 subjects (4449 men and 6073 women) aged 18-74 y. METHODS: Demographic data were collected and anthropometric indices were measured. Blood pressure was evaluated and hypertension was defined based on JNC VI. Biochemical measurements were done. Diabetes was considered as FBS> or =126 mg/dl (> or =7.0 mmol/l) and dyslipidemia was defined according to ATP II. Risk factors were considered as: hypertension, diabetes, dyslipidemia, 'hypertension or diabetes', 'hypertension and diabetes', 'hypertension or dyslipidemia', 'hypertension and dyslipidemia', ' diabetes or dyslipidemia', 'diabetes and dyslipidemia', 'at least one risk factor' and 'at least two risk factors'. ROC curve analysis was performed to determine optimal cutoff values-where the sensitivity approximates specificity. RESULTS: Younger men (the age category of 18-34 y) had higher WC than women. Men had higher waist-to-hip ratio (WHpR) and lower waist-to-height ratio (WHtR) than women in all age categories. Dyslipidemia, 'hypertension or dyslipidemia', 'diabetes or dyslipidemia' and 'at least one risk factor' were more prevalent risk categories in both genders. Range of areas under ROC curves for BMI and WC was 0.55-0.94 and 0.56-0.93 for men and 0.41-0.94 and 0.53-0.92 for women in various age groups, respectively. Range of areas for WHpR and WHtR in men was between 0.58-0.87 and 0.56-0.94, respectively, and for women varied between 0.53-0.91 and 0.53-0.90 in various age groups, respectively. Cutoff points of BMI for various risk factors were between 24 and 29 kg/m(2) in men and 25-31 kg/m(2) in women. Range of WHpR was between 0.86 and 0.97 in men and between 0.78 and 0.92 in women. Cutoff points for WC and WHtR were between 80 and 93 cm and 0.47 and 0.56 for men and between 79 and 96 cm and 0.50 and 0.63 for women in different age groups to detect various risk factors, respectively. In general, values were lowest for the most prevalent risk factors and highest for less prevalent conditions. CONCLUSION: The results suggested cutoff points of anthropometric measures as indicators of cardiovascular risk factors. It seems that these cut-points are higher for Iranians than for other Asian populations. SPONSORSHIP: Endocrine Research Center, Shaheed Beheshti University of Medical Sciences.

Adolescent↗

PubMed2004

Cardiovascular risk factors in males with hypertriglycemic waist (Tehran Lipid and Glucose Study).

BACKGROUND: Many studies performed on nontraditional risk factors have proposed a metabolic triad including increased serum level of apolipoprotein B, hyperinsulinemia and high small, dense LDL-C as a risk factor of cardiovascular diseases. Hypertriglycemic waist (increased waist circumference as well as high fasting triglyceride level) can be used as a simple criterion to predict the metabolic triad. The aim of this study was to investigate the prevalence of hypertriglycemic waist and the frequency of cardiovascular risk factors in the affected population. MATERIALS AND METHODS: The study was performed on 4169, 18-70 y-old male subjects of the population of Tehran Lipid and Glucose Study (TLGS). The subjects fell into four groups with respect to serum level of fasting triglycerides (Tg) and waist circumference (WC). Subjects of group 1 had serum Tg > or =1.8 mmol/l as well as WC > or =95 cm, while those of group 2 had Tg > or =1.8 mmol/l and WC <95 cm. The triglycerides level was less than 1.8 mmol/l in groups 3 and 4, whereas WC was > or =95 cm and lower than 95 cm, respectively. Cardiovascular risk factors, anthropometric and laboratory variables were compared between the groups. RESULTS: In total, 784 subjects had high serum levels of Tg as well as increased WC. The mean age of subjects was significantly higher in groups 1 and 3 compared to others (37+/-15, 48+/-14, 41+13 and 46+/-13 y of age in groups 4, 3, 2 and 1, respectively, P<0.001). The prevalence of cardiovascular risk factors was significantly higher in group 1 as compared with others. Systolic and diastolic blood pressure, body mass index and WC were significantly higher in group 1 than in the others. Serum total cholesterol, Tg and LDL-C were significantly higher in group 1 compared to others, whereas HDL-C was significantly lower in this group. The prevalence of subjects who had at least four risk factors was 75 and 8% in groups 1 and 4, respectively. CONCLUSION: Hypertriglycemic waist can be used as a simple criterion to predict cardiovascular risk factors.

Adolescent↗

PubMed2004

Waist-to-hip ratio is a better screening measure for cardiovascular risk factors than other anthropometric indicators in Tehranian adult men.

BACKGROUND: It is essential to identify the best anthropometric index in any population to predict chronic disease risk. OBJECTIVE: To compare the ability of waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR) to predict cardiovascular risk factors in an urban adult population of Tehranian men. DESIGN: Population-based cross-sectional study. SUBJECTS: A representative sample of 4,449 men aged 18-74 y, participants of the Tehran Lipid and Glucose Study METHODS: Demographic data were collected; anthropometric indices and blood pressure were measured according to standard protocol. In the 18-34 y age category, cutoff points for BMI, WHpR, WHtR and WC were 24 kg/m(2), 0.86, 0.47 and 81 cm, respectively. In the 35-54 y age category these cut points were 26 kg/m(2), 0.91, 0.52 and 89 cm, and in the 55-74 y age category 26 kg/m(2), 0.95, 0.54 and 91 cm, respectively. Hypertension was defined based on JNC VI. Biochemical analysis was conducted on fasting blood samples. Diabetes was defined as fasting plasma glucose > or =126 mg/dl or 2hPG > or =200 mg/dl and dyslipidemia based on ATP III. The presence of 'at least one risk factor' from the three major cardiovascular risk factors (hypertension, dyslipidemia and diabetes) was also evaluated. RESULTS: Mean age of men was 41.8+/-15.4 y. Mean BMI, WHpR, WC and WHtR for subjects were 25.6+/-4.2 kg/m(2), 0.91+/-0.07, 87.7+/-11.7 cm and 0.51+/-0.02, respectively. Dyslipidemia and 'at least one risk factor' are more prevalent risk categories. Although all anthropometric indicators had a significant association to cardiovascular risk factors, WHpR had the highest correlation coefficients compared to other anthropometric measures. For all risk factors in all age categories, the highest odds ratios were pertained to WHpR. Of the four individual indicators, WHpR had the highest sensitivity, specificity and accuracy to predict cardiovascular risk factors. Cutoff points for WHpR were seen to have a higher percentage of correct prediction than BMI, WC and WHtR in all age categories. CONCLUSION: It is concluded that WHpR is a better predictor for cardiovascular risk factors than BMI, WC and WHtR in Tehranian adult men.

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