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Background: Polycystic ovary syndrome (PCOS) is a common endocrinological disorder associated with abdominal obesity (AO) and some reproductive complications including low pregnancy rate. Embryo-endometrium cross-talk has a key role in successful embryo implantation and subsequent normal pregnancy rate. The primary objective of this study is to evaluate the decidualization potential of endometrial stromal cells (ESCs) using the embryo condition media (ECM) collected from PCOS patients with AO, compared to ECM of those patients without AO. Materials and Methods: In this experimental study, we measured the capacity of ECM collected from PCOS patients with or without AO for decidualization induction in healthy ESCs after coculture. A total number of 53 embryos from 40 couples belonging to PCOS with AO, PCOS without AO, nonPCOS with AO, and nonPCOS without AO patients, were included in our study. The embryosof four groups were single-cultured up to the blastocyst stage. Their ECM (45λ/well) were pooled and added to healthy ESCs monolayer culture media to investigate their effects on decidualization potential via gene (PRL, IGFBP1, IL1-β, HOXA10, IL-6 and TNF-α) and protein (PRL, IGFBP1, IL1-β) expression analysis and ESCs migration assay. Results: The morphological analysis, migration assay (P≤0.0321), protein (P≤0.0139) and gene expression analysis showed PCOS with AO accounted for the highest gene (PRL, IGFBP1, IL1-β, HOXA10, IL-6, TNF-α) and protein markers (PRL, IGFBP1, IL1-β) (P≤0.05). NonPCOS individuals without AO had the lowest level of both gene and protein decidualization markers (P≤0.05). Conclusion: Considering decidualization as an inflammatory process, a higher level of decidualization markers was associated with a higher inflammatory status created by AO and PCOS, separately. Inflammation may disrupt the process of inflammatory to anti-inflammatory phase required for prevention of pregnancy loss, this could explain the high rate of abortion in these cases. [ABSTRACT FROM AUTHOR]

Background: Overweight or obese middle-aged women are at a greater risk of chronic diseases. This study aimed to evaluate the relationship between a weight-efficacy lifestyle and anthropometric indices in middle-aged women. Methods: In this study, 500 middle-aged women were recruited randomly from ten public health centres in Ahvaz. A sociodemographic questionnaire and weight-efficacy lifestyle (WEL) questionnaire were used to collect the data. Anthropometric indices including weight, height, waist and hip circumference, waist–hip ratio, body fat percentage, and mid-upper arm circumference were measured. The Pearson correlation coefficient and logistic regression were used to analyse the data. Results: Women with higher negative emotions and those with a higher availability of food were 0.93 (OR 0.93, 95% CI 0.86–0.99, p = 0.03) and 0.89 (OR 0.89, 95% CI 0.82–0.96, p = 0.003) times more likely to have a higher BMI, respectively. Women with increased negative emotion (OR 0.92, 95% CI 0.85–0.99, p = 0.04), and lower positive activities (OR 1.15, CI 1.05–1.27, p = 0.003) were more likely to have a wider waist circumference. A weight-efficacy lifestyle was found to have a significant relationship with body mass index, waist circumference, hip circumference, waist–hip ratio, body fat percentage, and upper mid-arm circumference. Middle-aged women should be specifically educated regarding a weight-efficacy lifestyle. [ABSTRACT FROM AUTHOR]

Background & Aims: According to the World Health Organization, cardiovascular diseases account for approximately 30% of deaths worldwide. Obesity is one of the most important risk factors for developing cardiovascular diseases and other non-communicable diseases. Excessive obesity plays an important role in the development of cardiovascular risk factors such as hypertension, dyslipidemia, and diabete. Currently, body mass index and waist circumference are recommended for classification of overweight and obesity . Increased body mass index and waist circumference have been shown as a risk factor for cardiovascular disease . However, studies have shown that the discriminative capacity of BMI is questionable due to the inability to distinguish between adipose tissue and lean mass. This issue has led to the idea that by combining traditional anthropometric indices (such as height, weight, body mass index or waist circumference), a better physical index can be designed that considers and examines body shape Recently, Body Shape Index (BSI) has been proposed as a new body index. Krakower et al. (2012) reported a significant correlation between body shape index and visceral fat tissue and showed that premature deaths are more related to this index than waist circumference and body mass index. Body Roundness Index (BRI=BRI) is another new index proposed that based on waist circumference and height, can better predict the percentage of body fat and visceral fat compared to the traditional indices of body mass and circumference. Recently, several studies have shown that body circumference index can be used as an index of obesity to determine the presence of left ventricular hypertrophy, hyperthermia, cardiovascular disease and diabetes .The purpose of this study was to predict the relationship between physical activity and some new and traditional obesity indicators in women with cardiovascular disease and to determine the power of these indicators in the diagnosis of cardiovascular diseases. Methods: This descriptive-correlation study was conducted on 334 women with CVD (middle: n=189, elderly: n=145) referring to a heart centers in Mashhad. The inclusion criteria included female patients in the age range of 40 to 75 years, myocardial infarction, heart attack, high blood pressure and cholesterol, and willingness to participate in the research. Cardiovascular disease factors were diagnosed by consulting a specialist doctor and reviewing medical records for each patient. To investigate the relationship between different factors, the study was conducted in different age groups. For this purpose, the subjects were divided into two groups: middle-aged (40-55 years, 189 people) and elderly (60-75 years, 145 people). Written informed consent was obtained from all study participants. The convenience sampling method was used. Physical activity level was measured with International Physical Activity Questionnaire (IPAQ). The body shape index (BSI), body roundness index (BRI), Waist circumference (WC), body mass index (BMI), Waist-Hip Ratio (WHR), fat mass percentage (%FM) were measured and calculated. Body shape index was calculated based on height (meters), body mass index and waist circumference (meters) using the formula. Body circumference index is based on height (meters) and waist circumference (meters). First, the irregularity (non-dimensional value) of the body (€) was determined using the formula. Irregularity measures the degree of ovality or roundness and ranges from zero (full circle) to one (vertical line). Independent t test was used for show difference between middle age and elderly groups. To evaluate the possible correlations between obesity indices, Pearson and Spearman correlation coefficients were used. The Receiver operating characteristic (ROC) curve was used to determine the sensitivity and specificity and the best cut-off point of anthropometric indices. Results: The results showed that there is no significant difference for physical activity, body mass index, body roundness index, body shape index, waist circumference, waist-to-thigh ratio and body fat percentage between middle-aged and elderly groups. The results of the correlation coefficient showed that in both middle-aged and elderly groups, body roundness index has a positive relationship with waist circumference, body mass index, waist-to-thigh ratio and fat mass. In middle-aged people, the level of physical activity had no significant relationship with any of the variables, but in elderly patients, the level of physical activity had a negative relationship with body roundness index and body shape index. In the middle-aged group, the body roundness index had the largest area under the curve, and the body shape indices and waist-to-hip ratio are in the second place with a small difference. In the elderly, the waist circumference had the largest area under the curve and the body roundness index ranked second. The level of physical activity in both groups had the lowest area under the curve. The values of the cut points using the highest sensitivity and the lowest specificity in the middle)aged group for the physical activity level is greater than 984.5, body roundness index is less than 5.41, body shape index is less than 0.0834, waist circumference is less than 89.7, Body mass index less than 26.3, body fat percentage less than 31.8 and waist to hip ratio less than 0.91 and in the elderly group, physical activity level more than 789.7, body roundness index less than 5.8, index Body shape was less than 0.0865, waist circumference was less than 91.5, body mass index was less than 28.03, body fat percentage was less than 30.46 and waist to hip ratio was less than 0.9. Conclusion: Contrary to the initial hypothesis of the researchers, the research findings showed that the level of physical activity had the least ability to predict the presence of cardiovascular disease. According to the present research, there was a weak relationship between the level of physical activity and obesity indicators. Considering that prospective studies in adults have shown that low physical activity is closely related to the development of cardiovascular disease, however, it may be that if the amount of physical activity is low, its changes are not very reliable and cannot be a good predictor for the factors Cardiovascular risk. The level of physical activity in the present study was average (1135.7 meters/minute/week for the middle-aged group and 916.4 meters/minute/week for the elderly group) and the subjects were divided according to the International Physical Activity Questionnaire in terms of physical activity. According to Maisen et al.'s study (2011), the activity level is less than 600 met-minutes per week as inactive, between 600-1500 met-minutes per week as semi-active and more than 1500 met-minutes per week as active was considered. Among the possible reasons for the difference in the results of the mentioned studies, we can mention the physical fitness of the subjects, the disease and pathological conditions of the subjects, and gender. Body roundness index was created in order to predict body fat and visceral fat tissue percentage by using waist size in comparison with height, which makes it possible to estimate the body shape as an egg or oval. Body shape index independent of body size (height, weight and body mass index) creates a quantitative scale to estimate body shape. In preliminary studies, researchers have shown that BSI is a better predictor of premature mortality than BMI and WC in the general US population. According to the results of the study, BRI and WC are best indices for predicting the possibility of CVD in patient middle age and elderly women. [ABSTRACT FROM AUTHOR]

Background: We investigated the impact of weight change on mortality in a population-based cohort setting.Methods: We conducted two weight measurements for 5436 participants aged ≥ 30 years with an approximate 3-year interval. Based on their weight change, we categorized participants to: > 5% weight loss, 3-5% weight loss, stable weight (± < 3%), 3-5% weight gain, > 5% weight gain. We followed participants for mortality annually up to March 20th 2018. We applied the multivariable Cox proportional hazard models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of weight change categories for all-cause, cardiovascular (CV), and cancer mortality, considering stable weight as reference. The Cox models was adjusted for age, sex, educational level, body mass index, smoking status, hypertension, hypercholesterolemia, diabetes, and cardiovascular disease (CVD) at baseline.Results: During a median follow-up of 14.4 years, 629 deaths (247 CV and 126 cancer deaths) have occurred. Over 5% weight loss and gain were associated with increased risk of all-cause mortality in multivariable analysis with HRs of 1.47 [95% CI: 1.17-1.85] and 1.27 [1.02-1.57], respectively; however, a 3-5% loss or gain did not alter the risk of all-cause mortality significantly. These significant risks for wight change > 5% were not modified by the presence of diabetes, obesity, and smoking status; however, the unfavorable impact of weight change on mortality events was more prominent in those older than > 65 years (P-value for interaction: 0.042). After excluding those with history of CVD, diabetes, and cancer during the weight measurements period, these associations significantly attenuated (HR: 1.29 [0.89-1.87] for > 5% weight loss and 1.12 [0.84-1.50] for > 5% weight gain). Additionally, a > 5% weight loss was also associated with about 60% higher risk for CV mortality (HR: 1.62 [1.15-2.28]), and a 3-5% weight loss was associated with about 95% higher risk of cancer mortality (HR: 1.95 [1.13-3.38]).Conclusions: Our findings showed a U-shaped association across weight change categories for all-cause mortality risk with over 5% weight gain and loss causing higher risk. Moreover, weight loss can have adverse impact on CV and cancer mortality events. [ABSTRACT FROM AUTHOR]

Background: The goal of this study is to clarify clinical, functional, and biochemical features of postmenopausal women who are at risk of developing osteosarcopenia.Methods: This is a cross-sectional study undertaken to investigate the co-accordance of osteoporosis and sarcopenia and common risk factors on 305 postmenopausal Iranian women. Sarcopenia and osteoporosis were defined based on the European Working Group on sarcopenia in Older People guidelines and WHO criteria, respectively. Confounding factors including age, menopausal age, obesity, sun exposure, physical activity, macronutrient composition, and calcium and vitamin D supplementations were considered for all participants. A multivariate model was used to consider the common risk factors of both disorders; osteoporosis and sarcopenia.Results: The mean age was 57.9 years ± 6.0 SD (range: 48-78 years) and 37.4% of patients were 60 years or older. Among all participants, 35.7% were obese (BMI ≥ 30 kg/m2). Approximately 45% of all the study population had insufficient physical activity and at least half of participants had insufficient intake of protein. There was a significant correlation between bone density and muscle mass and basal metabolic rate (BMR) (p < 0.01). In multivariate-multivariable regression model, after Bonferroni correction for obesity, lower BMR was the only one associated with both lower muscle mass and bone density in lumbar and hip sites (p < 0.007).Conclusions: Our data suggest that low BMR might be an early predictor for concordance of osteoporosis and sarcopenia in postmenopausal women. [ABSTRACT FROM AUTHOR]

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]

Over the past two decades, non-alcoholic fatty liver disease (NAFLD) has progressed from a relatively unknown disease to one of the leading causes of chronic liver disease with an increasing prevalence that can lead to cirrhosis and liver failure. Due to the obesity prevalence and the increasing prevalence of metabolic syndrome, non-alcoholic fatty liver and its progressive form, Non - Alcoholic Steatohepatitis (NASH), is more common in different parts of the world. However, there is no exact and noninvasive way to diagnose this disease. It is estimated that the obesity prevalence will continue to exacerbate non-alcoholic fatty liver prevalence and its long-term complications, leading to enormous clinical and economic burdens. This article reviews the epidemiology of non-alcoholic fatty liver disease in Iran and the world and related risk factors. Google Scholar and PubMed databases were used to identify studies on the epidemiology of non-alcoholic fatty liver worldwide. [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. High blood pressure (HBP) is a proven risk factor for cardiovascular diseases. So, determining the extent of the contribution of the factors associated with HBP seems to be necessary. Accordingly, this study aimed to investigate how much the prevalence of HBP attributed to obesity and high blood glucose (HBG). Methods. Data were collected from 7612 participants extracted from a screening program in 2018, in Iran, which was conducted on the subjects with the age of 30 years old and older to investigate the prevalence of HBP and their associated risk factors. To collect data, we used a standard checklist in terms of the WHO STEPS manual, and a stratified multistage sampling method was also applied. The adjusted population attributable risk of overweight, obesity, and HBG for HBP was calculated by the logistic regression model using the aflogit module. Results. Among the studied people, 7.4% of male and 10.8% of female subjects were hypertensive. The adjusted analysis showed that, in men, 27% and 41% and, among women, 19% and 37% of HBP prevalence rates were attributable to obesity (BMI ≥ 30) and fast blood sugar (FBS) (≥126), respectively. In people with both obesity and HBG, 59% of the prevalence rate of HBP in men and 46% of the prevalence in women were due to the abovementioned risk factors altogether. The results show that, if obesity and HBG were eliminated, the prevalence of HBP could be theoretically decreased from 7.4% to 5.4% and 4.3% in male subjects and from 10.8% to 8.7% and 6.8% in female subjects, respectively. Conclusions. Our findings indicate that how much the prevalence of HBP attributes to obesity and HBG in middle-age and older population. It seems that the prevention programs should be administered in the general population, and excess body weight prevention programs should also be implemented in childhood. [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: Cardiovascular events are the leading cause of mortality and are highly associated with lifestyle. We aimed to evaluate the prevalence of coronary artery disease (CAD) and its major risk factors in the western Iranian city of Borujerd. Methods: This cross-sectional study was conducted on 801 subjects older than 35 years of age, recruited via cluster sampling in Borujerd. The diagnosis of CAD was based on the positive results of Rose Angina Questionnaire, Minnesota coding, or prior history of CAD. Then, the risk factors were measured by biochemistry and relevant laboratory examinations, or data extraction from the subjects' history. Results: The study sample consisted of 412 men and 389 women at a mean age of 54.82±12.11 years. The prevalence of risk factors including hypertension, diabetes mellitus, dyslipidemia, smoking, and obesity was 38.2%, 17.4%, 64%, 23.2%, and 22.8%, respectively. Based on the criteria, 19.1% and 31.7% of the CAD cases were definite and probable, respectively. Furthermore, 12.5% had definite signs and symptoms of CAD, and 5.4% had positive Rose Angina Questionnaire outcomes. Conclusion: The current study demonstrated the distribution of CAD in the Iranian city of Borujerd and it was demonstrated that obesity and smoking are the most common risk factors, respectively. [ABSTRACT FROM AUTHOR]

Aims: To investigate future diabetes in different abdominal obesity phenotypes during 12 years of follow-up.Methods: For this population-based cohort, 7982 adults without diabetes including 3533 men and 4449 women, aged ≥20 years were selected from the Tehran Lipid and Glucose Study. Abdominal obesity was defined according to the national cutoffs for waist circumference (WC). Metabolic health was defined as having ≤1 metabolic abnormality based on Joint Interim Statement (JIS) criteria other than WC. Participants were classified into 4 groups of abdominal obesity phenotypes: Metabolically healthy non-abdominal obese (MHNAO), metabolically healthy abdominal obese (MHAO), metabolically unhealthy non-abdominal Obese (MUNAO), and metabolically unhealthy abdominal obese (MUAO).Results: In total, 1018 cases of incident diabetes occurred. Compared to the MHNAO phenotype, based on multivariate Cox regression models, diabetes risk was increased in all unhealthy phenotypes except the MUNAO phenotype in men. Regarding the association of the MHAO phenotype with incident diabetes, borderline statistical significance in men [HR 1.5 (95% CI: 1.0-2.36), p-value: 0.07] and statistical significance in women [HR 1.68 (95% CI: 1.08-2.6)] were detected.Conclusions: In addition to unhealthy phenotypes except the MUNAO phenotype in men, the MHAO phenotype is also associated with incident diabetes, highlighting the importance of preventive strategies in this subgroup of abdominally obese subjects. [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]

Introduction: Obesity and the associated consequences is a major health concern. Infertility is considered as one of the most important health problems. Studies have shown that there is a relationship between obesity and infertility. Obesity causes hormonal disturbance and also interferes with the normal ovulation process. Objective: This study investigated the relationship between obesity and risk factors for infertility. Materials and Methods: this study is a comparative analytical one done on 200 women (100 women infertile and 100 fertile women), admitted to Kowsar hospital in Qazvin during 2013-2015. Sampling method was simple. Tool for data collection was a check list including: demographic data, blood pressure, BMI and the waist to hip ratio, cholesterol, triglycerides, HDL cholesterol and LDL cholesterol. Statistical analysis was done using descriptive and analytical methods in spss.16. Results: The results showed mean body mass index and waist-to-hip ratio between the two groups were significantly different (P<0.05).Survey of lipid profile showed that cholesterol and triglyceride levels in infertile women were significantly different from that in fertile women, being higher in infertile women (P =0.04). Also, a positive correlation between BMI and cholesterol and triglycerides levels in the two groups was shown (P<0.05). Conclusion: The present study revealed a positive association between infertility and increased lipid profile in infertile women. Therefore, due to the increasing prevalence of obesity in the society, we need to pay special attention to this issue and take into account public awareness and lifestyle change programs. [ABSTRACT FROM AUTHOR]

Migraine can be accompanied by some gastrointestinal (GI) disorders. In this study, we aimed to investigate the relationship between migraine and tension-type headache (TTH) and different lower and upper GI disorders as well as non-alcoholic fatty liver (NAFLD) and cholelithiasis. This cross-sectional study included 1574 overweight and obese participants who were referred to the Obesity Research Center of Sina Hospital, Tehran, Iran. The diagnosis of migraine and TTH was made by an expert neurologist based on the international classification of headache disorders-III β (ICHD III β). GI disorders, including irritable bowel syndrome (IBS), constipation, heartburn, dyspepsia, non-alcoholic fatty liver (NAFLD), and cholelithiasis, were diagnosed by a gastroenterology specialist. The overall mean age of participants was 37.44 ± 12.62. A total of 181 (11.5%) migraine sufferers (with and without aura) and 78 (5%) TTH subjects were diagnosed. After adjusting for potential confounders by multivariable regression models, migraine had significant association with IBS (OR = 5.16, 95% CI = 2.07-12.85, P = 0.000), constipation (OR = 3.96, 95% CI = 2.25-6.99, P = 0.000), dyspepsia (OR = 4.12, 95% CI = 2.63-6.45, P = 0.000), and heartburn (OR = 5.03, 95% CI 2.45-10.33, P = 0.000), while the association between migraine and NAFLD was marginally significant (OR = 2.03, 95% CI = 0.98-4.21, P = 0.055). Furthermore, the prevalence of NAFLD (OR = 2.93, 95% CI 1.29-6.65, P = 0.010) and dyspepsia (OR = 4.06, 95% CI = 2.24-7.34, P = 0.000) was significantly higher in TTH patients than the headache-free group. These findings show an association between GI disorders and primary headaches especially migraine and are, therefore, of value to the management of migraine and TTH. Further studies should investigate the etiology of the relationship between all subtypes of primary headaches and GI disorders. [ABSTRACT FROM AUTHOR]

Objective: Obesity could be associated with abnormalities in reproductive functioning and fertility in women. This was a retrospective study performed to evaluate the weight loss after laparoscopic sleeve gastrectomy (LSG) and its effect on infertility of childbearing women in Shiraz, Iran. Materials and Methods: A study was performed with 221 female patients who underwent LSG from September 2009 until April 2014, in Shiraz. Data were analyzed from patients; mean age was 36.66 ± 0.7; mean education was 13.21 years; and mean body mass index (BMI) was 43.99 ± 0.5 kg/m2. Of these patients, 66.1% were of childbearing age ( n = 146). Participants were chosen as 'infertile patients' based on histories from self-report questionnaires. The effectiveness of sleeve gastrectomy was evaluated for improving fertility, while assessing the influence of comorbidities, weight loss, and BMI before and after surgery. Results: There were 15 infertile women who underwent LSG because of obesity. Weight loss and resolution of infertility were evaluated and showed that, of these 15 women who had tried unsuccessfully to become pregnant before weight loss, 7 became pregnant afterward. The pregnancies proceeded without complications and ended with live births. Conclusions: LSG is a surgical procedure for addressing morbid obesity and produces weight-loss effects and resolution of comorbidities. LSG could be effective in young infertile obese women who wish to become pregnant. Weight loss appears to increase the pregnancy rate and improve irregular menstruation cycles. Time and amount of weight reduction are essential components of infertility management. (J GYNECOL SURG 33:43) [ABSTRACT FROM AUTHOR]

Purpose To evaluate the incidence and predictors of early adulthood pre-diabetes/type 2 diabetes ( T2D) among Iranian adolescents during a median follow-up of 9.2 yr. Method A total of 2563 subjects aged 10-19 yr, without pre-diabetes/ T2D at baseline, were entered in the study. Pre-diabetes was defined as those with fasting plasma glucose ( FPG) 5.6 to <7 mmol/L. T2D was defined as anti- T2D drug consumption or FPG ≥7 mmol/L. Multivariate Cox-proportional analysis was applied to examine the association between different risk factors that showed attained statistical significance < 0.2 in univariate analysis, with incident pre-diabetes/ T2D. Same method was repeated on 1803 subjects with complete parental data to find the relation between parental risk factors and pre-diabetes/ T2D. Result The mean age of participants was 14.45 ± 2.78 yr, and 53.6% were female. During follow-up 208 cases of pre-diabetes/ T2D occurred, resulting in an incidence rate of 9.61 per 1000 person-years. Multivariate-adjusted hazard ratios (HRs) for incident pre-diabetes/ T2D showed significant risk for 1 standard deviation increase in FPG and body mass index with corresponding HR of 1.89 (1.6-2.23) and 1.435 (1.080-1.905), respectively. Among parental potential risk factors, the paternal history of T2D was independently associated with increased risk for pre-diabetes/ T2D in the adolescence ( HR = 1.63(1.02-2.60)). Conclusion About 1% of Iranian adolescents developed pre-diabetes/ T2D each year. Among the non-modifiable risk factors paternal history of T2D and, among modifiable risk factors, the presence of general adiposity as well as the higher level of FPG should be considered among adolescents for development of pre-diabetes/T2D later in the young adulthood. [ABSTRACT FROM AUTHOR]

Purpose: The determinants of the health-related quality of life of women with polycystic ovary syndrome are not fully understood. The aim of this study was to develop a comprehensive instrument to assess the health-related quality of life of Iranian women with PCOS and to assess its psychometric properties.Methods: We used a mixed-method, sequential, exploratory design including both qualitative [in-depth interview to define the components of health-related quality of life questionnaire (PCOSQ)] and quantitative approaches (to assess the psychometric properties of PCOSQ).Results: A preliminary questionnaire was developed including 147 items which emerged from the qualitative phase of the study. Considering the optimum cutoff points for content validity ratio (CVR), content validity index (CVI), and impact score, items of the preliminary questionnaire were reduced from 147 to 88 items. Finally, by excluding highly correlated items using the exploratory factor analysis, a 50-item questionnaire was obtained. The Kaiser criteria (eigenvalues >1) and Scree plot tests demonstrated that six factors were optimum with an estimated 47.3 % of variance. Assessment of the psychometric properties of the questionnaire demonstrated a mean CVI = 0.92, CVR = 0.91, Cronbach's alpha for whole questionnaire = 0.88 (0.61-0.88 for subscales), Spearman's correlation coefficients of test-retest = 0.75, and the intra-class correlation coefficient for the PCOS questionnaire subscales ranging from 0.57 to 0.88. Eventually the final questionnaire included 50 items in six domains, 'psychosocial and emotional,' 'fertility,' 'sexual function,' 'obesity and menstrual disorders,' 'hirsutism,' and 'coping' and rated on a 5-point Likert scale.Conclusion: The PCOSQ-50 is a valid and reliable instrument for the assessment of quality of life of women with PCOS, capable of assessing some obscure aspects overlooked by previous HRQL questionnaires. [ABSTRACT FROM AUTHOR]

Background: Coronary artery disease is considered as the most common cause of death in all societies including Iran. This study seeks to compare the new risk factors of coronary-artery diseases in obese adolescents and control group. Methods: In this cross-sectional study, amongst the obese adolescents registered in the nutrition clinic of Ghaem Hospital, 80 individuals were selected. As the control group, additional 80 adolescent students having the same gender and age as the obese group, but with normal weight were selected. These two groups were selected randomly and their serum level of vitamin D, anti-heat shock protein27 (HSP27), balance of oxidants and antioxidants, and homocysteine were determined and compared. Results: In this study, 42 (53.2%) and 37 (46.8%) of the obese and normal weight groups were male, respectively. The mean value of triglyceride, cholesterol, and LDL in the obese group was higher than the normal group, but the mean value for HDL, vitamin D, homocysteine, PAB (Preoxidant and Antioxidants Balance), and anti-HSP27 was not significantly different between the groups. In the base of homocysteine >15 µmol/1, 26.6% of the obese group had hyperhomocysteinemia, therefore homocysteine may be a new risk factor for coronary artery disease in obese adolescents (χ²=4.072; P value=0.091). Conclusion: The findings of this study showed that despite the presence of obesity in adolescence and adolescents, new risk factors are not present among them more than the control group. This was in contrast to what was seen in adults. [ABSTRACT FROM AUTHOR]

Adenosine deaminase (ADA) is an important regulator of insulin action. The single nucleotide polymorphism (SNP) G22A in the ADA gene decreases enzymatic activity of ADA. The aim of this study was to investigate the relationship between the SNP G22A and blood glycemic control, insulin resistance, and obesity of gestational diabetes mellitus (GDM) patients in an Iranian population. SNP G22A was determined in women with GDM (N=70) and healthy pregnant women (control, N=70) using polymerase chain reaction-restriction fragment length polymorphism. Fasting plasma glucose (FPG), hemoglobin A1C (HbA1c), plasma insulin levels and plasma lipids were measured using commercial kits. Homeostasis model of assessment for insulin resistance (HOMA-IR) was calculated. The distribution of genotypes and alleles among GDM patients was similar to that of the control group. FPG and HbA1c were significantly higher in GDM patients with GG genotype compared with GDM patients with GA+AA genotype and non-GDM patients. The frequency of GG genotype was significantly higher in obese GDM patients compared to lean GDM patients. The SNP G22A in the ADA gene was not associated with the risk of GDM in our population. GG genotype was associated with poor glycemic control and obesity in GDM patients. [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]

Objective: Retinol-binding protein 4 (RBP4) has recently been reported to be associated with insulin resistance (IR) and the metabolic syndrome by a number of researchers in various populations. However, controversies are present among different studies, which might be due to the differences between various ethnic, age, and sex groups. This study aimed to determine whether RBP4 can be assumed as a marker of IR and the metabolic syndrome in the Iranian obese children. Methods: In the present longitudinal cross-sectional study, 100 5-17 years old obese children were recruited from January 1, 2011 to February 1, 2012. The patients' information including the demographic variables, health status and behavior, and daily physical activity were collected. Moreover, serum RBP4 was measured and correlated with the homeostasis model assessment of IR index (HOMA-IR), components of the metabolic syndrome, and lipoprotein metabolism. Findings: The results revealed a positively significant correlation between RBP4 and the HOMA-IR index (P=0.02). Partial Spearman test also revealed a significant correlation between RBP4 plasma concentrations and the components of the metabolic syndrome, including waist circumference, systolic (but not diastolic) blood-pressure, and fasting blood sugar (P<0.05). However, no significant correlation was observed between RBP4 and HDL (P=0.3) as well as triglycerides concentration (P=0.1). Moreover, plasma RBP4 level gradually increased with the increasing number of the metabolic syndrome components. Conclusion: Regarding the results of the present study and previous investigations, RBP4 seems to be a suggestible predictive marker for both insulin resistance and metabolic syndrome in Iranian obese children; however, further studies are needed to be conducted among different ethnicities and age groups in order to determine the predictive value of this correlation. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between obesity indices, abdominal fat distribution, and lipid profile in patients with stable angina (SA). Methods: Body weight, height, waist circumference (WC), body mass index (BMI), and waist/height ratio (WHtR) of 123 patients with SA who underwent coronary angiography were measured. Fasting blood samples were taken to measure the levels of fasting blood sugar (FBS), total cholesterol (TC), low- and high-density lipoprotein cholesterol (LDL-C, HDL-C), apolipoproteins A and B (apo A and apo B), and triglycerides (TG). According to angiography reports, the participants were divided into patients with or without coronary heart disease (CHD). All patients underwent an abdominal computerized tomography (CT) scan to measure the visceral, superficial, and deep subcutaneous fat. Results: The mean ages of the patients with CHD (n = 73) and without CHD (n = 50) were 50.5 ± 7.6 and 53.7 ± 7.6 years, respectively (P = 0.03). The patients with CHD had significantly higher levels of TC, TG, and superficial subcutaneous fat, while the patients without CHD had higher levels of apo A (P ≤ 0.05). Multivariate analyses showed a significant association of visceral fat with TC, LDL-C, TG, and apo B, in the patients without CHD, while significant inverse associations were found between WC and HDL-C, WHtR, and apo A as well as visceral fat and LDL-C in the patients with CHD. Conclusions: Among anthropometries and imaging indices of obesity, WC and WHtR have shown better association between central obesity with dyslipidemia in the patients with CHD, while CT-measured visceral adipose tissue area was the best correlate of dyslipidemia in the patients without CHD. [ABSTRACT FROM AUTHOR]

Background: The prevalence of obesity and its related comorbidities, such as fatty liver, in children is increasing worldwide mostly due to changes in diet and life-style. Many serological markers have been suggested for screening of fatty liver but investigations for finding more reliable factors are still in progress. Objectives: This study aimed to investigate the correlation between the level of retinol binding protein-4 (RBP4) in the serum and sonographic grading of fatty-liver severity in obese Iranian children. Patients and Methods: This case-control, double-blind study involved 51 obese children aged between five and 17 years as the case group. In addition, 35 healthy lean children with no liver problems were selected as the control group. Plasma RBP4 (using an ELISA), serum triglycerides (TG), low-density-lipoproteins (LDL), high-density-lipoproteins (HDL), total-cholesterol (Chol), and body mass index (BMI) were measured. Grading the severity of the fatty liver condition was done by an expert radiologist in the case group. Results: RBP4 levels in obese children (19 482.9 ± 3 302.2 pg/ml) were higher than those found in the lean control group (14 295.68 ± 2 381.3 pg/ml) (P < 0.05). In the obese patients, RBP4 levels showed a significant correlation with the grade of fatty liver and BMI (P < 0.05). Conclusions: It was found that the level of RBP4 had a strong correlation with the severity of fatty liver. Therefore, RBP4 may be considered as a useful, noninvasive predictive biomarker of intrahepatic lipid content in obese children prior to using radiological investigations. In particular, abdominal sonography, for the evaluation of intrahepatic lipid content in obese patients, as the sensitivity of a sonography is decreased due to the increased thickness of the abdominal wall as a result of fat deposits. [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. Studies have reported that obesity has an adverse effect on iron metabolism. Obesity is characterized by chronic, low-grade, systemic inflammation and anemia of chronic disease with elevated serum ferritin and decreased level of serum iron, transferrin saturation, and hemoglobin. Therefore, we examined the association of body mass index with hemoglobin concentration and iron parameters in this study. Methods. This cross-sectional study was conducted in Yazd to assess the relation of body mass index with hemoglobin and iron parameters among 406 adult patients 18-65 years old. Diabetes and conditions that could influence body iron stores were excluded. Results. There is no difference in hemoglobin concentrations, MCV, serum iron, TIBC, transferrin saturation index, and ferritin between normal weight, overweight, and obese persons. Conclusion. Nutritional status of persons and intake of high iron foods by obese persons should be considered. Also, other inflammatory markers should be evaluated in the future studies. [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]

Both asthma and obesity have become more common in affluent societies during the recent decades, and several studies have shown a correlation between the presence of asthma and obesity. [ABSTRACT FROM AUTHOR]

This article presents a study on the prevalence of iron deficiency in obese and overweight children and teenagers. Iron deficiency is related to several problems among children and teenagers. Methods used in the study are described. First menstruation are experienced earlier by obese and overweight children. Groups with the highest prevalence of iron deficiency include overweight and obese children and teenagers.