A Positive Association between a Western Dietary Pattern and High LDL-C among Iranian Population.

BACKGROUND: The association between the presence of dyslipidemia and major dietary patterns was examined in an adult Iranian population. STUDY DESIGN: A cross-sectional study. METHODS: This cross-sectional study was conducted among 4672 adults aged 35-65 yr old based on data from the Mashhad Stroke And Heart Atherosclerotic Disorder (MASHAD) Study initiated in 2010. Anthropometric and blood laboratory measurements were collected for all participants. Dietary intake was assessed using a validated 65-item food frequency questionnaire (FFQ). Dietary patterns were identified using factor analysis. RESULTS: The overall prevalence of dyslipidemia was 88% including elevated total cholesterol (38.9%), triglyceride (35.2%), low-density lipoprotein cholesterol (LDL-C) (35.3%) or decreased level of high-density lipoprotein cholesterol (HDL-C) (68.9%). After adjusting for potential confounding factors, participants with higher scores for a Western pattern with lower physical activity level and educational attainment, and higher current smoking habit, increased the risk of having a raised LDL-C (OR=1.17; 95% CI: 1.02, 1.34; P=0.02). However, there was no significant association between adherence to this dietary pattern and other types of dyslipidemia. There was no significant association between a balanced dietary pattern and dyslipidemia and its components (OR=0.90; 95% CI: 0.68, 1.18; P=0.431). CONCLUSION: Dyslipidemia was more prevalent among individuals with higher consumption of a western dietary pattern. A direct association was found between adherence to Western dietary pattern and LDL-C level.

Association between obesity categories with cardiovascular disease and its related risk factors in the MASHAD cohort study population.

BACKGROUND: Cardiovascular disease (CVD) is a significant cause of morbidity and mortality globally. Obesity is an important CVD risk factor and is increasing in prevalence. METHODS: In this study, 3829 men and 5720 women (35-65 years) were enrolled as part of the MASHAD cohort study. Four categories were identified according to body mass index and waist circumference that was defined by the World Health Organization. Logistic regression analysis was used to determine the adjusted odds ratio (OR) for the occurrence of CVD, and Cox regression model was used to evaluate the association of obesity with CVD incidence. RESULTS: We found that the higher risk groups defined by categories of adiposity were significantly related to a higher prevalence of a high serum total cholesterol (TC), and triglycerides (TG), and lower high-density lipoprotein cholesterol (HDL), and higher fasting blood glucose (FBG) in both genders and a higher low-density lipoprotein cholesterol (LDL) in women (P < .001). Additionally, a high percentage of participants with dyslipidemia, high LDL, high TC, and low HDL and a high percentage of participants with metabolic syndrome, diabetes, hypertension, and a high serum TG were observed across obesity categories (P < .001). Moreover, women with the very high degrees of obesity had a greater risk of CVD (HR: 1.91, 95% CI: 1.06-3.43, P = .03). CONCLUSION: Obesity strongly predicts several CVD risk factors. Following 6 years of follow-up, in individuals within increasing degrees of obesity, there was a corresponding significant increase in CVD events, rising to approximately a twofold higher risk of cardiovascular events in women compared with men.

Association Between Hypertension in Healthy Participants and Zinc and Copper Status: a Population-Based Study.

The prevalence of hypertension (HTN) is increasing globally. It has been shown that there is an association between micronutrient deficiency and HTN. In the current study, we aimed to assess the association between HTN with serum copper and zinc concentrations in a large representative Iranian population. The participants were enrolled into the Mashhad stroke and heart atherosclerotic disorders study (MASHAD study), a cohort study that was initiated in 2010. Anthropometric indices were assessed using standard procedures. Systolic (SBP) and diastolic (DBP) blood pressures were measured using a standard mercury sphygmomanometer. Fasting blood glucose (FBG), lipid profile, uric acid and blood urea nitrogen (BUN), and hs-CRP were measured using routine methods. HTN defined as persons who had SBP ≥ 130 mmHg and/or DBP ≥ 85 mmHg and/or medication use. Flame atomic absorption (Varian AA240FS) was used to measure serum Zn and Cu concentrations. SPSS software was used for all statistical analyses. A total of 9588 participants were recruited into the MASHAD study project. Participants were divided into two groups; 5695 healthy (non-hypertensive) (mean age 45.85 ± 7.5 years) and 3893 hypertensive participants (mean age 51.18 ± 7.67 years). Systolic (p < 0.001) and diastolic blood pressure (p < 0.001) were significantly different for different serum copper quartiles. The participants with serum copper levels < 80 µg/dl had 1.33 times greater risk of an increased blood pressure than other participants. Participants with serum copper levels > 130 µg/dl had a 1.94-fold higher risk of raised blood pressure. Serum zinc was not associated with systolic blood pressure, but individuals in the first quartile level of serum zinc had a diastolic blood pressure that was significantly higher than other quartiles (p = 0.035). Serum copper is associated with blood pressure status in adults in a U-shaped relationship, with a range of serum copper between 80 and 130 µg/dl being associated with normal blood pressure.

Systolic and diastolic blood pressure percentiles by age and gender in Northeastern Iran.

Hypertension (HTN) is a major risk factor for coronary artery disease. Its frequency is increasing globally. The aim of our study was to evaluate the reference range of blood pressure (BP) in the Iranian population stratified for age and gender. A total of 1449 subjects without diabetes, CVD, dyslipidemia, HTN history and with a normal BMI (18.5 ≤ BMI<25) were recruited in the present study. Participants were enrolled from the Mashhad stroke and heart atherosclerotic disorder study. Anthropometric indices and demographic data were collected by two health care specialists. A quantile regression model was used to estimate the expected systolic BP (SBP) and diastolic BP (DBP) at specific ages. A P-value of <.05 was considered significant for all analyses. All statistical analyses were performed using R (version 3.4.1) and SPSS software. The population included more men than women (51.6% vs. 48.4%). The mean and standard deviation of age in men (47.5 ± 8.4) was 2 years higher than women (45.63 ± 7.9; P < .001). SBP and DBP were higher in men than women (P < .001). By using a quantile regression model, we concluded that the 5th to 90th percentile of SBP in men, aged 30-69 years, ranged from 95 to 148.08 mm Hg and in women ranged from 86.66 to 140 mm Hg. The 5th to 90th percentile of DBP in men, aged 30-69 years, ranged from 60 to 91.66 mm Hg and in women ranged from 60 to 91.22 mm Hg. We have, for the first time, established the BP percentiles (1st, 5th, 10th, 50th, 90th, 95th, 99th) in an Iranian population stratified by age and gender. These data suggest that a local program for health promotion is necessary for the early identification of HTN in adults aged ≥30 years.

Prevalence of combined and noncombined dyslipidemia in an Iranian population.

BACKGROUND: Combination of dyslipidemic phenotypes, including elevated plasma levels of low-density lipoprotein cholesterol (LDL-C), elevated plasma triglycerides (TG), and decreased low-density lipoprotein cholesterol (HDL-C) concentrations, is important because of the association of individual phenotypes with increased risk of cardiovascular disease (CVD). We investigated the prevalence of combined dyslipidemias and their effects on CVD risk in an Iranian large population. METHOD: A total of 9847 individuals were recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study. Anthropometric parameters and biochemical indices were measured in all of the subjects. Different types of combined dyslipidemias including high TG + low HDL-C, high TG + low HDL-C + high LDL-C, low HDL-C + high LDL-C, high TG + high LDL-C, and finally high TG + high LDL-C + low HDL-C were considered. Ten-year CVD risk was calculated using the QRISK2 risk algorithm and adjustments were made as suggested by the Joint British Societies' (JBS2). Logistic regression analyses were performed to determine the association between different combined dyslipidemias and categorical QRISK. RESULTS: A total of 3952 males and 5895 females were included in this current study. Among the included subjects, 83.4% had one form of dyslipidemia, and 16.6% subjects were not dyslipidemic. The mean age was 48.88 ± 7.9 and 47.02 ± 8.54 years for dyslipidemic and nondyslipidemic groups, respectively. The results showed that the frequency of dyslipidemia was 98%, 87.1%, and 90% in subjects with metabolic syndrome, CVD, and diabetes, respectively. Our results suggested that around 15.7% of study population were at 10 years CVD risk (high ≥20) and it was higher in men than women (P < .001). Moreover, risk of CVD was higher in TG↑ & HDL↓ & LDL↑ group than other groups. CONCLUSION: Prevalence of dyslipidemia was 83.4% among Iranian adults. The results showed that individuals with increased plasma TG and LDL-C, and low HDL-C levels had the highest 10 years CVD risk compared to other combined dyslipidemic phenotypes.