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Background: There is evidence for a bidirectional association between obesity and depression, and obesity is the main risk factor for metabolic syndrome (MetS). This study aimed to compare oxidative stress and MetS features between depressed and non-depressed obese women and study the association of depressive symptoms, oxidative stress, and components of MetS. Methods: In this case-control study conducted in Tabriz (East Azarbaijan, Iran), obese women (body mass index [BMI]: 30-40 kg/m²) with a primary diagnosis of major depressive disorder (MDD; based on diagnostic interview with a psychiatrist; n = 75) and their age-matched nondepressed controls (n = 150) were enrolled. Beck Depression Inventory-version II (BDI-II) was used to assess depressive symptoms in both groups. Anthropometric parameters, blood pressure, fasting blood sugar (FBS), lipid profile and malondialdehyde (MDA) were measured. Results: No significant differences in anthropometric parameters and blood pressure were observed between the two groups. However, FBS of the MDD group was significantly higher than the control (P < 0.05). FBS was significantly correlated with BDI-II scores (r = 0.158, P = 0.017). No significant difference in lipid profile was observed between the groups. Serum MDA level was significantly lower in the MDD group and was inversely associated with BDI-II scores (r = -0.328, P < 0.001). Overall, MDD was not significantly associated with MetS in our study (OR = 0.848, 95% CI: 0.484, 1.487; P = 0.566). Conclusion: Although we found a correlation between higher depressive symptoms and some adverse metabolic outcomes, our findings do not support a significant association between MDD and MetS. [ABSTRACT FROM AUTHOR]

Background: Gastroesophageal reflux disease (GERD) is a common gastrointestinal complaint in the adult population worldwide; nevertheless, few studies have assessed this disorder among medical students. The stress, lifestyle, and burdensome educational curriculum exposes this particular population to GERD. To the best of our knowledge, there was no information about the frequency of GERD in Iranian medical students. We aimed to assess the prevalence of GERD as well as its risk factors among the medical students. Materials and Methods: In this cross-sectional study, the symptoms of GERD were investigated among 290 medical students using the frequency scale for the symptoms of gastroesophageal reflux (FSSG) at Isfahan University of Medical Sciences during 2018-2019. Additional information, including age, sex, body mass index (BMI), and studying grade, were entered in the checklist. Results: Among the studied population, 104 (36.55%) students had GERD. Heartburn was associated with studying grade (p =0.022) and BMI (p < 0.001). Esophageal regurgitation was related to BMI only (p < 0.001). The logistic regression evaluations revealed overweight (p < 0.001; OR: 14.49; 95%CI: 7.29-28.81), obesity (p < 0.001; OR: 14.16; 95%CI: 4.38-45.74), studying the physiopathology course (p < 0.001; OR: 5.05; 95%CI: 2.07-12.30) and being in the stagership period (p = 0.007; OR: 3.50; 95%CI: 1.41-8.64) were independent predictors of heartburn, while overweight (p < 0.001; OR: 8.33; 95%CI: 4.26-16.28), obesity (p < 0.001; OR: 54.87; 95%CI: 11.31- 266.10) and being in the stagership period (p = 0.024; OR: 2.89; 95%CI: 0.87-6.22) were the predictors for esophageal regurgitation. Conclusion: Based on this study, GERD was prevalent among the medical students, and factors, including BMI and studying grade, were predictors of its incidence. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) is a cluster of conditions increasing the risk of serious diseases. This study aimed to define the predictors of MetS incident in a community-based cohort in Southern Iran, during a mean follow-up period of 5.1 years. Materials and Methods: During the mean follow-up period of 5.1 years, a cohort study was conducted on 819 Iranian adults aged ≥18 years at baseline and followed to determine the incidence and predictors of MetS progression in Shiraz, a main urban region in the southern part of Iran. The International Diabetes Federation Guideline was used to detect the MetS. Multiple Cox's proportional hazards models were also used to estimate the predictors of new-onset MetS. Results: The prevalence of MetS was 25.9% at baseline, and the overall incidence of subsequent MetS was 5.45% (95% confidence interval [CI]: 4.47--6.59). The incidence of MetS was significantly higher in women (7.12% [95% CI: 5.52--9.05]) than in men (3.92% [95% CI: 2.80--5.34]). Moreover, it increased by 5.02 (95% CI, 3.75--6.58) among individuals who had one metabolic component and by 12.65 (95% CI, 9.72--16.18) for those who had three or more components (P < 0001). The incidence of MetS was also analyzed using the multiple Cox's proportional hazards model for potential risk factors, and it was revealed that female gender (hazard ratio [HR] 2.45; 95% CI: 1.33, 4.50; P = 0.004), higher body mass index (HR 3.13; 95% CI: 1.43.6.84; P = 0.012), increased abdominal obesity (HR 1.45; 95% CI 0.85, 2.46; P = 0.045), smoking (HR 4.79; 95% CI 2.09, 10.97; P < 0.001), and lower high-density lipoprotein (HR 0.53; 95% CI: 0.29, 1.00;P = 0.044) significantly predicted the onset of MetS at baseline; however, age, systolic and diastolic blood pressure, serum uric acid, fasting blood glucose, cholesterol, triglyceride and creatinine, estimated glomerular filtration rate, marital status, level of education, and level of physical activity did not independently predict the onset of MetS when other covariates were considered. Conclusion: This study showed the high-incidence rates of MetS in males and females residing in Southern Iran. Therefore, the prevention through community-based lifestyle modification should be implemented to reduce the burden of MetS and its complications. [ABSTRACT FROM AUTHOR]

Background: Prediabetes is strongly associated with high blood pressure; however, a little is known about prediabetes and high blood pressure comorbidity in the high-risk individuals. This is the first study in the world to assess the long term effects of risk factors associated with high blood pressure and prediabetes comorbidity in the first degree relatives (FDRs) of type 2 diabetes mellitus (T2DM) patients. Materials and Methods: The longitudinal data obtained from 1388 nondiabetic FDRs of T2DM patients with at least two visits between 2003 and 2011. We used univariate and bivariate mixed effects logistic regressions with a Bayesian approach to identify longitudinal predictors of high blood pressure and prediabetes separately and simultaneously. Results: The baseline prevalence of high blood pressure, prediabetes, and the coexistence of both was 27.4%, 19.1%, and 29.8%, respectively. The risks of high blood pressure and prediabetes were increased by one unit raise in the age (odds ratio [OR] of high blood pressure: 1.419 (95% credible intervals [CI], 1.077-1.877), prediabetes: 1.055 (95% CI: 1.040-1.068)) and one unit raise in remnant-cholesterol (OR of high blood pressure: 1.093 (95%CI, 1.067-1.121), and prediabetes: 1.086 (95% CI, 1.043-.119)). Obese participants were more likely to have high blood pressure (OR: 2.443 [95% CI, 1.978-3.031]) and prediabetes (OR: 1.399 [95% CI, 1.129-1.730]) than other participants. Conclusion: We have introduced remnant cholesterol, along with obesity and age, as a significant predictor of prediabetes, high blood pressure, and the coexistence of both in the FDRs of diabetic patients. Obesity index and remnant cholesterol showed the stronger effects on high blood pressure and prediabetes comorbidity than on each condition separately. [ABSTRACT FROM AUTHOR]

Background: Today, nonalcoholic fatty liver disease (NAFLD) has become a major health problem owing to its high prevalence. Literature evidence about regression of NAFLD are not as high as its development or progression. Objectives: This cohort study was conducted to reveal the factors influencing the regression of the NAFLD. Methods: A population-based study conducted in Shiraz, Iran. Adults older than 18 years were recruited by multistage randomized sampling in 2012, and then in 2017. Demographic, anthropometric, nutritional, and medical characteristics of each interviewee were entered into a valid and reliable questionnaire. Interviewees were categorized into three groups according to the changing of their NAFLD status between two stages of this study; no change, regressed and progressed. Results: Of the 537 participants, 163 (30.3%) showed regression of their NAFLD compared to 93 (17.3%) that their NAFLD was progressed. Multinomial regression showed that each unit of decrease in BMI (Δ BMI= -1 kg/m²) augmented the relative risk (RR) of improvement of NAFLD by 13.3% (RR: 0.867; 95% CI: 0.776 - 0.969; P = 0.012) and reduced the relative risk of NAFLD deterioration by 14.3% (RR: 1.143; 95% CI: 1.009 - 1.294; P = 0.035). Conclusions: A significant portion of patients showed regression of their NAFLD by decreasing their BMI. Therefore, BMI as a modifiable variable should be regarded in the management of NAFLD patients. [ABSTRACT FROM AUTHOR]

Background: The burden of diabetes mellitus (DM) is increasing worldwide, especially in countries such as Iran. Modifiable correlates of the DM may be different across regions. We aimed to estimate the population-based prevalence of DM and its correlates among adults in southern Iran. Methods: Baseline data of the Pars Cohort Study (PCS) was analyzed. Demographic and socio-economic characteristics, alcohol consumption, opium and tobacco abuse and cigarette smoking, laboratory findings, anthropometric measurements and perceived body shape at 15 and 30 years of age using pictogram were measured and analyzed. The age-standardized prevalence of DM was estimated. Robust Poisson regression was applied to estimate adjusted prevalence ratio (aPR) and 95% robust confidence intervals (CI). A P value <0.05 was considered statistically significant. Results: Out of 9264 individuals, 919 (9.9%; 95% CI: 9.3-10.6) had DM. The prevalence of DM among the males and females was 7.6% (95% CI: 6.8-8.5) and 11.9% (95% CI: 10.9-12.9), respectively. Higher age, female gender, high socioeconomic status and using antihypertensive medication were associated with higher DM prevalence. Also, triglyceride level, physical inactivity, higher body mass index (BMI), pictogram score at 15, and its change from 15 to 30 years of age were significantly associated with DM. Conclusion: Higher prevalence of modifiable factors such as physical inactivity and obesity among DM patients in the study population highlights the necessity of more effective preventive interventions in such settings, especially in younger ages. [ABSTRACT FROM AUTHOR]

Background: Overweight and obesity are considered as non-communicable diseases (NCDs) risk factors with increasing prevalence worldwide. This nationwide study aimed to determine the socio-demographic determinants of obesity indexes in Iran. Methods: This cross-sectional study was conducted based on data from the sixth round of nationwide STEPwise approach to surveillance (STEPS) survey in the 31 provinces of Iran in 2011. A total of 9878 people aged ≥20 years were selected using a multi-stage cluster sampling method. Data were collected through three steps questionnaire including ecological, physical and biochemical measurements. We assessed body mass index (BMI), waist circumference (WC) and waist-hip ratio (WHR) as the main indicators of obesity. Results: In this study, the weighted prevalence of overweight and obesity were 34.5% (95% CI: 33.6, 35.5) and 21.5% (95% CI: 20.7, 22.3), respectively. The mean ± standard deviation (SD) of BMI among men and women were 25.4±4.4 and 26.9±5.2 kg/m² respectively. Older age, living alone, having lower education level, being housewife or retired were associated with overweight and obesity (P < 0.05). Urbanization was positively associated with BMI and WC. Being obese or overweight was associated with having a history of type 2 diabetes mellitus (T2DM), hypertension (HTN) and cardiovascular diseases (CVDs). Conclusion: The prevalence of overweight in this study was less than global rate while it was vice versa for obesity prevalence. Some socio-demographic characteristics were identified as determinants of obesity which should be considered for planning preventive and control action plans. [ABSTRACT FROM AUTHOR]

Objective: Childhood obesity is an important predisposing factor for most non-communicable diseases. The aim of this review was to provide evidence on the prevalence and trends of childhood obesity and overweight in Iran. Methods: Multiple international and Iranian scientific databases were searched for relevant literatures. Two independent reviewers identified relevant papers in several steps. Separatemeta-analyses (using fixed- or random-effect models) were performed to estimate the overall, age, sex, and age--sex specific prevalence of obesity and overweight. Stratified analysis based on Centers for Disease Control and Prevention, International Obesity Task Force, and World Health Organization definition criteria and study year also were performed. Results:We included 107 studies in the meta-analysis (49 English and 58 Persian). Based on Centers for Disease Control and Prevention definition criteria, the overall prevalence of obesity and overweight remained relatively constant in the 2000s and are estimated to be about 5.1% (95% confidence interval [CI], 4.4-5.8) and 10.8% (95% CI, 10.2-11.4), respectively. The meta-regression analysis showed that the prevalence of obesity and overweight did not vary significantly with respect to sex and age of study participants. Girls had a lower prevalence of obesity and higher prevalence of overweight than boys. Conclusion: This review, which is the first of its kind in the Middle East and North Africa, suggests that although the trend in the prevalence of childhood obesity in Iranian children is not considerably high, but the escalating trend of excess weight among young children is alarming and should be considered by providers of interventional preventive programs at national and regional levels. [ABSTRACT FROM AUTHOR]

Background: The aim of the present study was to assess which modifiable, non-modifiable, and socioeconomic factors are good predictors for cardiovascular risk in overweight and obese Iranian women. Materials and Methods: This clinical cross-sectional study was conducted on 811 overweight and obese women of age 20-60 years in Islamic Republic of Iran. In this study, the dependent variables were fasting blood sugar (FBS) and lipid profile, and the independent variables were educational level, waist to hip ratio (WHR), body mass index (BMI), waist circumference (WC), age, fasting glycemia, and diabetes. Results: Univariate analysis showed that the significant factors associated with FBS were age, BMI, education, and WHR, but the effect of age was more than that of others. For total cholesterol (TC), only glycemia had a significant effect [P = 0.004, odds ratio (OR) 1.9 vs. others independent variables' ORs]. Having diabetes, BMI ≥30 kg/m2, and education ≤12 years were the significant factors associated with triglyceride (TG), but the effect of diabetes was more than that of others (OR: 2.7, 2.2, and 1.9 for diabetes, BMI, and education, respectively). The effect of age was more than that of other independent factors on low density lipoprotein-cholesterol (LDL-C). There was not any significant association between independent variables and high density lipoprotein-cholesterol (HDL-C) in multiple logistic regression models. Conclusion: Based on the obtained results, in clinic, for overweight and obese women, age, glycemia, and having diabetes can be considered as predictors for FBS, and LDL-C, TC, and TG, respectively. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is the fourth most commonly diagnosed gastrointestinal (GI) malignancy and the third leading cause of cancer-related death worldwide. In the current case-control study, an association between diagnosis of CRC, obesity and diabetes was investigated. Methods: Demographic characteristics, colonoscopy reports, history of drug, smoking, and medical history were collected from patients referred to a colonoscopy unit. The location, size and number of the polyps were recorded during the colonoscopy. Statistically, t-test was conducted for mean comparison for the groups. Pearson's chi-squared test (χ2) was applied to categorize variables. Five classification methods based on the important clinicopathological characteristics such as age, BMI, diabetes, family history of colon cancer was performed to predict the results of colonoscopy. Results: Overall, 693 patients participated in this study. In the present study, 115 and 515 patients were evaluated for adenoma/adenocarcinoma and normal colonoscopy, respectively. The mean age of patients positive for adenoma or adenocarcinoma were significantly higher than the negative groups (p value < 0.001). Incidence of overweight and/or obesity (BMI > 25 kg/m2) were significantly higher in adenoma positive patients as compared to controls (49.9 and 0.9% respectively, p value = 0.04). The results also demonstrated a significant association between suffering from diabetes and having colon adenoma (OR = 1.831, 95%CI = 1.058–3.169, p value = 0.023). The experimental results of 5 classification methods on higher risk factors between colon adenoma and normal colonoscopy data were more than 82% and less than 0.42 for the percentage of classification accuracy and root mean squared error, respectively. Conclusions: In the current study, the occurrence of obesity measured based on BMI and diabetes in the adenoma positive patient group was significantly higher than the control group although there was no notable association between obesity, diabetes and adenocarcinoma. [ABSTRACT FROM AUTHOR]

Background: To investigate the association between different obesity phenotypes and the risk of incident hypertension among both genders. Methods: The study population included 3659 Iranians (men = 1540), aged ≥20 years free of hypertension at baseline. Participants were classified into six categories of body mass index (BMI)-metabolic health status, in which unhealthy metabolic status was defined based on the presence of > 1 component of metabolic syndrome (MetS) using the joint interim statement (JIS) criteria or the presence of insulin resistance (IR). The association between different obesity phenotypes and incident hypertension was assessed using multivariate Cox's proportional hazard models adjusted for age, current smoking, low physical activity, diabetes mellitus, family history of premature cardiovascular disease, estimated glomerular filtration rate, phase of recruitment, BMI and systolic blood pressure, considering metabolically healthy normal weight group as the reference. Results: After a median follow-up of 11.6 years 1122 participants (men = 493) experienced hypertension. Using JIS criteria, a significant higher risk of hypertension was observed among metabolically healthy obese and well as metabolically unhealthy groups among men in the age adjusted model; however, a significant higher risk in the fully adjusted model was seen among women in the metabolically healthy obese [hazard ratio (HR) 95% confidence interval (CI) 1.96(1.16–3.32)] as well as metabolically unhealthy normal weight [1.98(1.37–2.86)], overweight [2.08(1.49–2.90)] and obese [2.06(1.27–3.30)] groups. Using insulin sensitive normal weight group as the reference, among men, being overweight or obese with and without IR was significant predictors of incident hypertension in the age adjusted model; however, among women, insulin resistant overweight [1.46(1.06–2.02)] and obese groups, [1.63(1.01–2.62)] showed significant risk in the fully adjusted model. Conclusion: We concluded that first, there was significant difference between genders in the associations between obesity phenotypes and incident hypertension. Second, in general, metabolic status defined by MetS components as compared to IR could do better in identifying high risk women for hypertension. Third, women populations who are metabolically healthy obese using MetS definition or those with either > 1 component of metabolic syndrome or overweight/obese ones with IR should be prioritized for implementing urgent preventive strategies against hypertension focusing on lifestyle changes. [ABSTRACT FROM AUTHOR]