Reza Ghadimi

Body Mass Index and Gonadotropin Hormones (LH & FSH) Associate With Clinical Symptoms Among Women With Polycystic Ovary Syndrome

To evaluate the relevance of body mass index (BMI), luteinizing hormone (LH), follicle-stimulating hormone (FSH) and LH/FSH ratio with clinical symptoms in polycystic ovary syndrome (PCOS) women. Methods: We reviewed the medical records of all women visited in the PCOS Clinic of Babol (Iran) from 2008 to 2012. A retrospective cross-sectional study was conducted on 175 PCOS women; aged 18–38 years diagnosed based on the Rotterdam criteria. Among the PCOs women, the prevalence of oligomenorrhea, acne, and hirsutism were found to be 92.0%, 31.4%, and 78.9%, respectively. Positive finding of polycystic ovaries was observed in 89.1% of PCOS women with by using sonography. A total of 69.2% overweight/obesity patients had polycystic ovary morphology on ultrasound image. Compared with non- overweight/obesity, the adjusted OR of PCOS women for sonographic view of polycystic ovaries was 4.33 (95% CI, 1.42-13.15, p=0.001), Nevertheless, the adjusted odds ratio (OR) showed no significant associations between LH, FSH, and LH/FSH ratio with clinical symptoms in these women. The findings of this study indicated that the overweight/obese women with PCOS are at an increased risk for sonographic view of polycystic ovaries. Therefore, it is suggested that successful weight loss is the most effective method of restoring ovulation, menstruation that should be used as major advice in obese PCOS patients.

Development and validation of a Semi-quantitative food frequency questionnaire among older people in north of Iran

Background: The study was conducted to assess reliability of modified semi-quantitative food frequency questionnaire (SQFFQ) as a part of the Amirkola Health and Aging Project (AHAP). Methods: The study was carried out in a sample of 200 men and women aged 60 years and older. A 138-item SQFFQ and two 24-hour dietary recalls were completed. The reliability of SQFFQ was evaluated by comparing eighteen food groups, energy and nutrient intakes derived from both methods using Spearman and Pearson’s correlation coefficients for food groups and nutrients, respectively. Bland-Altman plots and Pitman’s tests were applied to compare the two dietary assessment methods. Results: The mean (SD) age of subjects was 68.16 (6.56) years. The average energy intake from 24-hour dietary recalls and the SQFFQ were 1470.2 and 1535.4 kcal/day, respectively. Spearman correlation coefficients, comparing food groups intake based on two dietary assessment methods ranged from 0.25 (meat) to 0.62 (tea and coffee) in men and from 0.39 (whole grains) to 0.60 (sugars) in women. Pearson correlation coefficients for energy and macronutrients were 0.53 for energy to 0.21 for zinc in male and 0.71 for energy to 0.26 for vitamin C in females. The Pitman’s test reflected the reasonable agreement between the mean energy and macronutrients of the SQFFQ and 24-hour recalls. Conclusions: The modified SQFFQ that was designed for the AHAP was found to be reliable for assessing the intake of several food groups, energy, micro-and macronutrients.

Cohort Profile Update: The Amirkola Health and Ageing Project (AHAP)

The original cohort study of AHAP started in 2011 on 1616 elderly residents of Amirkola, northern part of Iran near the Caspian Sea. The main goal of this study was to comprehensively evaluate the health of the elderly in the region with the emphasis on chronic diseases such as osteoporosis. The first cohort profile was published in the International Journal of Epidemiology in 2014. The phase 1 AHAP showed the elevated level of some diseases and conditions including osteoporosis, metabolic syndrome, obesity, vision problems and relatively low levels of oral health. Therefore, the second phase of this cohort started with more complete population coverage in 2016, not only to collect and record the information based on previous protocol, but also consider new areas such as nutritional status, complete eye and dental examinations and health assessment on the basis of Iranian Traditional Medicine. The new aspect of this project is to conduct clinical and laboratory examinations at the health center to extend more facilities to the elderly. In addition to serum and DNA, samples of saliva, hair and nails are collected and kept under standard conditions in the biobank of this cohort. Researchers can apply for access to data or suggest a collaborative study by submitting the proposal to AHAP committee.

The effect of metformin treatment on the serum levels of homocysteine, folic acid, and vitamin B12 in patients with polycystic ovary syndrome

Background and Objective: Hyperhomocysteinemia is a well-known risk factor for cardiovascular disease. Although metformin therapy can increase homocysteine (Hcy) levels, it frequently is used as an oral medicine in women with polycystic ovary syndrome (PCOS), who might be at risk of catching diabetes mellitus. The aim of this study was to investigate the effect of metformin on the levels of serum Hcy, vitamin B12 (vit B12), and folic acid in patients with PCOS. Materials and Methods: An interventional study was designed with 18 patients with PCOS at the Fatemehzahra infertility Hospital in Babol, Iran. Metformin treatment (500 mg twice daily) was initiated in all patients for a period of consecutive 6 months. The levels of serum Hcy, vit B12, and folic acid were measured in the participants before and after metformin treatment. Results: The mean vit B12 level showed a significant decrease in patients after 6 months of metformin treatment (P = 0.002). However, there was no significant difference in serum folic acid levels. The mean Hcy levels increased after treatment, but this difference not was statistically significant. When patients were stratified into four subgroups by their insulin sensitivity and body mass index (BMI), relatively similar results were obtained in the subgroups, except that Hcy levels in the overweight/obesity group (BMI > 25 kg/m2) after treatment showed a significant increase (P = 0.01). Conclusion: These findings indicate that metformin increases the serum Hcy concentration in patients with PCOS especially in the women with BMI > 25 kg/m2. The possible mechanism for this effect would be the obvious reduction in the levels of vit B12.

Obesity among Elementary Schoolchildren: A Growing Concern in the North of Iran, 2012

Background: The aim of the present study is to assess the elementary schoolchildrens nutritional status based on anthropometric indices due to the sudden spread of obesity in children and adolescents in both developed and developing countries. Methods: This cross-sectional study was conducted on 3647 children with an age range of 7–11 years of primary schools in Babol using cluster random sampling method in 2012. Children younger than 7 years or older than 11 years, children with chronic diseases, pupils treated with corticosteroids or growth hormone replacement therapy and children with chromosomal abnormalities were excluded from the study. Anthropometric indices were measured by medical students and evaluated according to the Centers for Disease Control and Prevention standard percentiles. Data were analyzed using statistical software SPSS version 18 with Chi-square and independent samples t-test. Results: The body mass index of 26.1% of children was greater than the 85th percentile, and 4.7% was less than the 5th percentile. The prevalence of obesity among boys was significantly higher than girls (P = 0.007). Moreover, urban children (P = 0.0001) and children who studied in private schools (P = 0.0001) had a significantly higher proportion of obesity and overweight than the urban and private schoolstudents. The highest prevalence of obesity and overweight belonged to 18.0% of the students among fifth graders and 15.3% of schoolchildren among third graders, respectively (P < 0.001). Conclusions: The results showed that the prevalence of overweight and obesity in the study was higher. It seems it is necessary to implement the intervention programs to prevent overweight and obesity among schoolchildren.

Obesity paradox on the survival of elderly patients with diabetes: an AHAP-based study

Background and objectivesOverweight and obesity are among the important challenges in health issues and survival of elderly people. The current study aimed to evaluate the survival rate of elderly patients with diabetes, and its influencing factors, on the basis of body mass index (BMI).Methods and materialsThe design of the current study was based on the Amirkola Health and Aging Project (AHAP) cohort. The 5–year survival rate of elderly people with diabetes and the factors that influence the mortality rate by Cox regression model were analyzed.ResultsOut of 1616 elderly people who were evaluated in the current study, 501 (31%) had diabetes. The results showed that diabetes significantly increased the mortality rate (adjusted hazard ratio [HR] = 2.10; 95% confidence interval [CI]: 1.57–2.81; P < 0.001). Furthermore, overweight (HR = 0.41; 95%CI: 0.24–0.75; P = 0.002), obesity (HR = 0.30; 95% CI: 0.41–0.63; P = 0.002), history of diabetes (HR = 0.56; 95%CI: 0.34–0.93; P = 0.024), moderate and high physical activity level (HR = 0.36; 95%CI: 0.13–0.99; P = 0.049) decreased the risk of mortality and central obesity (HR = 1.76; 95% CI: 1.01–3.11; P = 0.049), fasting blood sugar ≥200 (HR = 2.46; 95% CI: 1.46–4.15; P < 0.001), brain stroke, and neurological diseases (HR = 3.12; 95% CI: 1.78–5.49; P < 0.001) increased the risk of mortality.ConclusionAlthough overweight and obesity significantly improved the risk of mortality in elderly patients with diabetes, central obesity is still considered as an important risk factor.

The First Step of Health Policy-Making for Lifestyle Modifications at Middle Age: Problem Identification in 40- to 60-Year-Old Population, Northern Iran

Background The purpose of this study was to determine the current situation of lifestyle behaviors and related outcomes, as the first step to make proper local health policies for improvement of health lifestyle behaviors. Materials and Methods This analytic research has been conducted as a cross-sectional study on the middle-aged (40–60 years old) population of Amirkola, Northern Iran. The Persian translation of the Health-Promoting Lifestyle Profile II questionnaire and the International Physical Activity Questionnaire were used for data collection. Also, anthropometric variables, blood pressure, fasting blood sugar, and serum lipids profile were examined. Results Three hundred one individuals have been enrolled in the study. Results showed that 10.6% of the participants had unhealthy lifestyle behaviors in the subdomain of spiritual growth; 46.8% in the subdomain of health responsibility; and 48.2% in the subdomains of stress management, physical activity, and nutrition; men had more physical activity than women (p < 0.001). Totally, 189 persons (63.9%) had serum cholesterol greater than or equal to 200 mg/dL; seventy-five individuals (25%) had high blood pressure. One hundred twenty-six persons (81.8%) of women and 103 (70.1%) of men were overweight or obese. Conclusions Health lifestyle behaviors in 40- to 60-year-old population need a proper intervention to improve the current situation.

Food bioactive components, a possible adjuvant for H. pylori eradication

Dear Editor, Helicobacter pylori (H. pylori) is a Gram-negative bacillus. Since its discovery in the early eighties by warren and marshall, for the first time in the history of medicine H. pylori was isolated from human gastric biopsy specimens (1). Many studies have presented that H. pylori can be isolated from the oral cavity and salivary secretions. Colonization of the gastric pits in the stomach by this brachium is a serious risk factor for peptic ulcers and stomach cancer (2). Several antibiotic regimens have been assessed for H. pylori therapy. Despite that, few regimens have shown high eradication rates. Therapeutic regimens of H. pylori infection are usually based on at least two types of antibiotics (imidazoles, macrolides and amoxicillin) combined with a double dose of the proton-pump inhibitor (omeprazole or pantoprazole). The problem of eradication therapy is the potentially undesirable increasing resistance of H. pylori to the commonly used antibiotics. Moreover, eradication therapy is associated with some side effects. Long-term therapy with the antibiotic can result in pervasive alterations in gut flora and lead to susceptibility infections. So, the development of the adjuvant therapy for the eradication of H. pylori which also prevent adverse side effects would be a valuable item. Accordingly, different potential adjuvant therapies for H. pylori have been considered. The major research on alternative therapies contains foods like plant origin, probiotics, and polysaccharides. Some compounds from medicinal plants with anti-H.pylori activity consist of polyphenolic, sulforaphane, flavonoids, carvacrol, tannins, quercetin and β-hydrastine (3, 4). Green tea contains polyphenols, which hamper the growth of bacteria. Some studies have shown that drinking green tea can decrease H. pylori colonization during standard treatments (5). Broccoli sprouts (high in sulphorafane), cruciferous vegetables include kale, cabbage, cauliflower, brussels sprouts, redheaded cabbage, and radishes (high in isothiocyanates) can diminish the H. pylori growth (6). Apples contain flavonoids that defend the lining materials of the stomach against H.pylori infection (7). Honey exhibits potent in vitro bacteriostatic activity against H. pylori and inhibits urease activity. Antibacterial activity of honey is attributable to its hydrogen peroxide content (5). Probiotic bacteria can modulate H. pylori activity by either immunological (reduction of IL-1 and IL-6) or non-immunological mechanisms (competition with potential microorganisms) (3). Therefore, the use of antibiotics as first-line therapies may be appropriate for the eradication of H.pylori, but the results confirm the medicinal properties of some foods and compounds as a new adjuvant therapy for H.pylori eradication. Moreover, further studies should be required to support their use.

Does Serum lipid profile differ in anemia and non-anemic older subjects?

Background: There is some evidence that shows the symptoms of anemia are fewere in overweight and obese people, so, the purpose of this research was to study the relationship between anemia and iron deficiency anemia (IDA) with lipid profile status of the elderly. Methods: This cross-sectional study came from the Amirkola Health and Ageing Project (AHAP). A demographic questionnaire was given to the older people and a blood sample was obtained to assay their lipid indexes (triglyceride, cholesterol, HDL and LDL) and the parameters related to anemia after 12 hours fasting. The data were analyzed by chi-square test, t-test and Pearson correlation using SPSS. A p<0.05 was considered as the significance level of the tests. Results: The average age of the people was 68.95±7.43 years old. In this study, the prevalence of anemia and IDA was 31% and 9%, respectively. The mean concentration of serum triglyceride, cholesterol and LDL in the anemia group and the IDA group was less than the control groups. The amount of HDL in different groups was almost the same, although the difference was statistically significant with respect to variables like age and obesity (P=0.001). Conclusion: The study showed that the amount of lipid profile (triglyceride and cholesterol) in the elderly with anemia and IDA was less compared to other people. This result was achieved in some other research studies too, but further research is suggested to find possible mechanisms.

بررسی میزان شیوع دردهای عضلاني- اسكلتي و ارتباط آن با ناتوانی عملکردی در سالمندان

Introduction: In process of getting old, different systems of the body get weak and this increases the dependence of adults on other people. The purpose of this study was to investigate the epidemiology of musculoskeletal pain and its correlation with functional disability. Methods: In this cross-sectional study 1614 old persons participated. The study was done in Amir cola in 1390-91. The information was gathered by three questionnaires of demographic features, pain and functional disability (Katz Scale). The data was analyzed by the chi-square statistical test. Results: 54.7% of the participants were male and 45.35 were female. Pain was reported for 1330 people (82.4%) that 47.5% was in upper body, 73.2% in lower body and 24.5% in head and neck. Pain in upper body was mostly reported in shoulders for 606 people (37.5%) and for lower body mostly in knees for 1018 people (63.1%). Pain was reported in females more than males and females had pain in lower body (knee) more than other parts of the body. In this study 3.7% of people had functional disability. There was no significant correlation between pain and functional disability (P=0.24) . Conclusions: The results of this research showed high prevalence of musculoskeletal pain in old people of Amir cola. Prevalence of pain in women was higher than in man. The most prevalent of pain area was knee joint. This indicates the necessity of medical interventions in form of prevention training.