Effects of purified anthocyanins supplementation on serum concentration of inflammatory mediators: A systematic review and dose-response meta-analysis on randomized clinical trials.

Anthocyanins, due to their antioxidant effects, are candidates to reduce inflammation and the risk of inflammatory diseases. Therefore, through conducting a systematic review and meta-analysis, we tried to find the effect of purified anthocyanins on serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). Databases including, ISI Web of Science, Scopus, ClinicalTrials.gov, PubMed, and Cochrane Library were searched up to June 2023. The meta-analysis was done by calculating mean differences and their standard deviations. Calculating the statistical heterogeneity of intervention effects was performed through I-squared statistics and Cochran's Q test. The pooled estimate showed a significant decrease in serum levels of CRP, TNF-α, and IL-6 (weighted mean difference (WMD) = -0.12 mg/L, 95% confidence interval (CI) = -0.21 to -0.02, p = 0.013; WMD = -1.37 pg/mL, 95% CI = -1.79 to -0.96; p < 0.001; WMD = -1.43 pg/mL, 95% CI = -1.87 to -1.00; p < 0.001, respectively). Subgroup analysis results revealed purified anthocyanins significantly decreased serum levels of CRP among participants with serum levels of CRP≥1.52 mg/L, at-risk/unhealthy status, and in trials with intervention duration ≥84 days, anthocyanins dose ≥320 mg/day, and sample size ≥85 subjects. Regarding TNF-α and IL-6, out results showed that there was a significant effect of purified anthocyanins on serum levels of TNF-α and IL-6 in most subgroups. The results of our study indicated that purified anthocyanins significantly decreased serum levels of CRP, TNF-α, and IL-6. However, further high-quality studies are needed to firmly establish the efficacy of purified anthocyanins.

Relationship between dietary macronutrient composition and non-alcoholic fatty liver disease in lean and non-lean populations: a cross-sectional study.

OBJECTIVE: The current study aimed to customize dietary changes for lean patients with non-alcoholic fatty liver disease (NAFLD). DESIGN: The current study was done with a population-based cross-sectional design. The FFQ was used to analyse dietary macronutrient intake and ultrasonography results for NAFLD diagnosis. The study subjects were divided into the lean and non-lean groups based on their BMI (< 25 and ≥ 25). Multivariable logistic regression was used to evaluate the relationship between dietary macronutrients and NAFLD. Substitution analyses were also performed. SETTING: Amol and its suburban areas in Iran. PARTICIPANTS: Adults in the age range of 18 to < 65 with full relevant data. RESULTS: Among the total study subjects (2308), 46·7 % had fatty liver. The substitution of polysaccharides for animal protein and SFA in the lean group resulted in a significant NAFLD reduction, whereas the substitution of SFA for all types of macronutrients, except for n-6 and mono-disaccharides, led to a significant increase in NAFLD (P < 0·05). In non-lean participants, the substitution of MUFA for mono-disaccharides resulted in a significant reduction of NAFLD (P < 0·05). In this group, the substitution of SFA and mono-disaccharides for MUFA, and n-6 for all macronutrients, except vegetable protein and SFA, were significantly related to an increase in NAFLD (P < 0·05). CONCLUSIONS: Lower lean NAFLD is correlated with increasing polysaccharides in exchange for SFA and animal protein intake, whereas lower non-lean NAFLD is correlated with increasing MUFA in exchange for mono-disaccharides and reducing n-6 and SFA.

Erythrocyte membrane fatty acid profile & serum cytokine levels in patients with non-alcoholic fatty liver disease.

Background & objectives: Fatty acids may affect the expression of genes, and this process is influenced by sex hormones. Cytokines are involved in the pathogenesis of non-alcoholic fatty liver disease (NAFLD), so this study was aimed to assess the association of erythrocyte membrane fatty acids with three cytokines and markers of hepatic injury in NAFLD patients and to explore whether these associations were the same in both sexes. Methods: In this cross-sectional study, 62 consecutive patients (32 men and 30 women) with NAFLD during the study period. Tumour necrosis factor-α (TNF-α), interleukin 6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), aspartate aminotransferase and alanine aminotransferase were measured in a fasting serum sample, and Fibroscan was conducted for each individual. Gas chromatography was used to measure erythrocyte membrane fatty acids. Univariate and multiple linear regressions were used to analyze data. Results: In men, IL-6 had a significant (P <0.05) positive association with total ω-3 polyunsaturated fatty acids (PUFAs). In women, TNF-α had a significant positive association with total ω-3 (P <0.05) and ω-6 (P <0.01) PUFAs, IL-6 had a significant (P <0.05) positive association with total monounsaturated fatty acids and MCP-1 had a significant positive association with total trans-fatty acids (P <0.05). No significant associations were observed between erythrocyte membrane fatty acids and liver enzymes or Fibroscan report in both sexes. In this study, women were significantly older than men [51 (42.75-55) vs 35.5 (29-52), P <0.01], so the associations were adjusted for age and other confounders. Interpretation & conclusions: Erythrocyte membrane fatty acid profile was not associated with serum liver enzymes or Fibroscan reports in NAFLD patients, but it had significant associations with serum TNF-α, IL-6 and MCP-1 and these associations were probably sex dependent.

Association between Nicotinamide Phosphoribosyltransferase and de novo Lipogenesis in Nonalcoholic Fatty Liver Disease.

OBJECTIVE: This study explored the association between serum nicotinamide phosphoribosyltransferase (NAMPT) and hepatic de novo lipogenesis (DNL) in nonalcoholic fatty liver disease (NAFLD) and determined whether or not this association is sex dependent. SUBJECTS AND METHODS: In this cross-sectional study, 62 consecutive patients (32 males, 30 females) with NAFLD were recruited. Serum NAMPT (by ELISA), palmitic acid, and the DNL index of erythrocyte membranes as markers of hepatic DNL (by gas chromatography) were analyzed. The controlled attenuation parameter (CAP) and body impedance analyzer were used to assess hepatic and body fat, respectively. Univariate and multiple linear regressions (to adjust for confounders) were used to analyze the association of serum NAMPT with palmitic acid, DNL index, CAP, and body fat. RESULTS: The respective values of serum NAMPT (2.44 ± 1.03 vs. 2.45 ± 1.13 ng/mL, p = 0.98), DNL index (3.11 [2.60-3.71] vs. 3.05 [2.40-3.59], p = 0.90), and palmitic acid (20.55% [15.34-24.04] vs. 22.64% [21.15-25.95], p = 0.07) were not significantly different between men and women, but those of CAP (326 [300-340] vs. 300 [261.25-329], p = 0.002) and body fat (37.71 ± 3.80 vs. 26.60 ± 5.70, p < 0.001) were significantly higher in women. In women, serum NAMPT had a significant negative association with the DNL index (ß = -0.56, p = 0.01). The DNL index also had a significant negative association with body fat (ß = -0.46, p = 0.02). In men, the only significant association was the positive association between serum NAMPT and CAP (ß = 0.35, p = 0.035). CONCLUSION: Higher serum NAMPT in women was associated with a lower hepatic DNL index, while in men it was associated with higher hepatic fat and had no association with the DNL index. Therefore, the serum NAMPT level interpretation for NAFLD prognosis is probably sex dependent.

The Effect of Parenteral Selenium Therapy on Serum Concentration of Inflammatory Mediators: a Systematic Review and Dose-Response Meta-Analysis of Randomized Clinical Trials.

Selenium can protect against inflammation through its incorporation in selenoenzymes; therefore, in this study, we assessed the effect of parenteral selenium on C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) through a systematic review and meta-analysis on randomized controlled trials (RCTs). A systematic search was performed in the databases, including PubMed, Scopus, Cochrane, clinicaltrials.gov, and ISI Web of Science, up to October 2022, with no limitation in study location or publication time. We calculated the effect size by the mean change from baseline in serum concentration of selected inflammatory mediators and their standard deviations. DerSimonian and Laird random effects model was used to estimate the heterogeneity and summary of the overall effects. Included studies in this systematic review and meta-analysis were 10 and 8 RCTs, respectively. Our results revealed parenteral selenium significantly decreased serum IL-6 (Weighted Mean Difference (WMD) = -3.85 pg/ml; 95% confidence interval (CI) = -7.37, -0.34 pg/ml; p = 0.032) but did not significantly change serum levels of CRP (WMD = 4.58 mg/L; 95% CI = -6.11, 15.27 mg/L; P = 0.401) compared to the comparison groups. According to our results, parenteral selenium supplementation might reduce serum levels of inflammatory mediators.

The association of food insecurity with non-alcoholic fatty liver disease (NAFLD) in a sample of Iranian adults: a path analysis of a cross-sectional survey.

OBJECTIVES: The present study aims to examine the hypothetical model of the relationship between food insecurity and Non-alcoholic fatty liver disease (NAFLD) in a sample of Iranian adults. METHODS: In this cross-sectional study, 275 subjects (18-70 years old) who met the inclusion criteria were recruited. Fatty liver was diagnosed by abdominal ultrasonography, and eligible patients underwent liver fibro scan assessment to determine fibrosis and steatosis. Food insecurity was assessed using the validated six-item Short Questionnaire of Household Food Security Scale (SQHFSS). Data were analyzed using SPSS 24.0 and IBM SPSS Amos 24.0. RESULTS: Among 275 subjects (44.37 ± 11.67 years old, 51.6% male) included in the analysis, 23.6% were food insecure. Food insecurity, general and abdominal obesity were associated with an increased risk of NAFLD, even after multiple adjustments (OR: 2.95, 95% CI: 1.02, 8.57; OR: 3.27, 95% CI: 1.50, 7.11; and OR: 3.81, 95% CI: 1.55, 9.32, respectively). According to the primary hypothesis, food insecurity and NAFLD were fitted into a model (χ2/df = 1.36, GFI = 0.982, AGFI = 0.952, CFI = 0.954, IFI = 0.959, SRMR = 0.040, RMSEA = 0.037); accordingly, food insecurity and obesity (general and abdominal) directly affected NAFLD (ß = 0.12, P = 0.03; ß = 0.13, P = 0.02; ß = 0.31, P < 0.001, respectively). CONCLUSION: Food insecurity was a predictor of, and directly associated with, NAFLD. Social determinants should be considered in the pathogenesis of NAFLD, although the possible underlying biological mechanisms in this association are yet to be determined.

Path analysis model to identify the effect of poor diet quality on NAFLD among Iranian adults from Amol Cohort Study.

Nonalcoholic fatty liver disease (NAFLD) is expanding as a global health problem with approximately 25% of the world's population affected by it. Dietary modification is one of the most important strategies for preventing NAFLD. The association between nutrient density and the Healthy Eating Index 2015 (HEI2015) with NAFLD demonstrates that nutrient density is an independent predictor of NAFLD in Iranian adults [fully adjusted model: OR (95% CI)tertile3vs.1: 0.68 (0.54-0.85), P for trend = 0.001]. However, a favorable association between NAFDL and diet quality (HEI 2015) is more pronounced in participants with abdominal obesity [fully adjusted model: OR (95% CI)tertile3vs.1: 0.63 (0.41-0.98), P for trend = 0.03]. Based on the gender-stratified path analysis, diet quality indirectly through Waist-to-Height Ratio (WHtR), C-reactive protein (CRP), and metabolic syndrome in women, and men through WHtR, hemoglobin A1c (HBA1c), CRP, and metabolic syndrome affects NAFLD. Nutrient density directly and indirectly in women through WHtR, CRP, and metabolic syndrome, and in men indirectly through WHtR, hemoglobin A1c, and metabolic syndrome negatively affect NAFLD. Hence, in these subjects; we can provide early dietary intervention and education to prevent progression to NAFLD.

The association between dietary inflammatory index (DII) scores and c-reactive protein (CRP) and nonalcoholic fatty liver disease (NAFLD) in a general population cohort.

BACKGROUND AND AIMS: Although there is extensive literature showing the ability of the dietary inflammation index (DII®) to predict concentrations of plasma inflammatory markers, few studies are testing the association between DII scores and nonalcoholic fatty liver disease (NAFLD). Considering the high prevalence of NAFLD and its complications, we conducted a validation study of DII scores and examined its association with NAFLD in the general adult population of Iran. METHODS: This cross-sectional study was conducted on 3110 adult participants in the Amol Cohort Study (AmolCS) who underwent abdominal ultrasonography to diagnose NAFLD. DII and energy-adjusted DII (E-DII™) scores were computed using data from a valid semi-quantitative 168-item food frequency questionnaire (FFQ). Multivariable logistic regression adjusting for socio-demographic, lifestyle, and health-related factors was used to assess association. RESULTS: The EDII was associated with CRP inflammatory biomarker. Participants in the highest, i.e., most pro-inflammatory tertile had the highest odds of NAFLD by ultrasound in all models [fully adjusted model: OR (95 % CI) tertile3vs.1:1.54 (1.05-2.05); Ptrend = 0.04, and 1.63 (1.19-2.21); Ptrend = 0.03 in women and men, respectively]. The highest tertile had the highest OR for NAFLD by fatty liver index (FLI) only in men [fully adjusted model OR (95 % CI) tertile3vs.1: 1.77 (1.15-2.71); Ptrend = 0.01]. Similar results were also obtained for NAFLD by hepatic steatosis index (HSI) in women [fully adjusted model: OR (95 % CI) tertile3vs.1: 1.70 (1.12-2.58); Ptrend = 0.03]. The results of the fully adjusted multivariable model of liver markers and NAFLD status, stratified by gender and abdominal obesity, revealed that the highest tertiles had the highest OR for NAFLD by ultrasound and NAFLD by FLI only in men without abdominal obesity [fully adjusted model: OR (95 % CI) tertile3vs.1: 1.83 (1.17-2.84); Ptrend = 0.03, and, respectively]. NAFLD by FLI tended to increase strongly with tertile E-DII scores in men without abdominal obesity in crude and three adjusted models [full-adjusted model: OR (95 % CI) tertile3vs.1: 3.64 (1.56-8.46); Ptrend = 0.005]. By contrast, women with abdominal obesity in the highest tertile had the highest OR for NAFLD by ultrasound in all models [full-adjusted model: OR (95 % CI) tertile3vs.1: 1.67 (1.07-2.62); Ptrend = 0.02]. CONCLUSIONS: Our results suggest that diet plays a role in regulating inflammation. Additionally, we observed an inflammatory diet predicts the risk of NAFLD in Iranian adults. However, longitudinal studies are required in order to further substantiate the utility of the DII in the development of more effective dietary interventions among populations at risk of chronic disease.

A population-based prospective study on obesity-related non-communicable diseases in northern Iran: rationale, study design, and baseline analysis.

Background: Iran is facing an epidemiological transition with the increasing burden of non-communicable diseases, such as obesity-related disorders and cardiovascular diseases (CVDs). We conducted a population-based prospective study to assess the prevalence and incidence rates of CVDs and obesity-related metabolic disorders and to evaluate the predictive ability of various CVD risk assessment tools in an Iranian population. Method: We enrolled 5,799 participants in Amol, a city in northern Iran, in 2009-2010 and carried out the first repeated measurement (RM) after seven years (2016-2017). For all participants, demographic, anthropometric, laboratory, hepatobiliary imaging, and electrocardiography data have been collected in the enrollment and the RM. After enrollment, all participants have been and will be followed up annually for 20 years, both actively and passively. Results: We adopted a multidisciplinary approach to overcome barriers to participation and achieved a 7-year follow-up success rate of 93.0% with an active follow-up of 5,394 participants aged 18-90 years. In the RM, about 64.0% of men and 81.2% of women were obese or overweight. In 2017, about 16.2% and 5.2% of men had moderate or severe non-alcoholic fatty liver disease, while women had a significantly higher prevalence of metabolic syndrome (35.9%), and type 2 diabetes mellitus (20.9%) than men. Of 160 deceased participants, 69 cases (43.1%) died due to CVDs over seven years. Conclusion: The most prevalent obesity-related chronic disease in the study was metabolic syndrome. Across the enrollment and RM phases, women exhibited a higher prevalence of obesity-related metabolic disorders. Focusing on obesity-related metabolic disorders in a population not represented previously and a multidisciplinary approach for enrolling and following up were the strengths of this study. The study outcomes offer an evidence base for future research and inform policies regarding non-communicable diseases in northern Iran.

A systematic review and dose-response meta-analysis of the effect of selenium supplementation on serum concentration of C-reactive protein.

BACKGROUND: Despite conducting new studies on the potential effect of selenium in reducing inflammation; results held contradictory weights and turns into an intriguing area of research. Concerns have been raised on this matter on hand to reach conclusive/consistent results. Therefore, this study seeks to address this scientific gap by assessing randomized controlled trials (RCTs) investigating the effect of selenium intake on C-reactive protein (CRP). METHOD AND MATERIALS: To find all the relevant English-language RCTs, databases including SCOPUS, Web of Science, Clinical Trials.gov, PubMed, and Cochrane Library were searched with no time limit (up to June 2022). Based on the mean changes for both comparison and intervention groups, the effect sizes were calculated. Further, DerSimonian and Laird random-effects model was performed to determine the summary of overall effects and their heterogeneity. RESULTS: Fifteen studies were selected for systematic review and thirteen studies were known to be eligible for meta-analysis. Meta-analysis results indicated a significant effect in serum CRP concentrations compared to the control group (weighted mean difference (WMD)= -0.22 mg/L 95 % confidence interval (CI): - 0.39, - 0.04; p = 0.014). CONCLUSION: In conclusion, our study confirms the downward effect of selenium on the serum concentration of CRP. On a wider level, further research is also needed to assess the selenium effect on other inflammatory mediators.

A systematic review and meta-analysis of almond effect on C-reactive protein and interleukin-6 in adults.

BACKGROUND: The previous articles have shown that the almond might reduce the serum concentration of inflammatory mediators. Therefore, the studies reported in this article aimed to assess the almond effect on serum concentration of C-reactive protein (CRP) and interleukin-6 (IL-6) in adults. METHOD AND MATERIALS: To find the related English-language studies, an electronic search was run in databases including Web of Science, PubMed, SCOPUS, ClinicalTrials.gov, and Cochrane library with no time limit (up to August 2022). The effect sizes were calculated based on the mean changes for both intervention and comparison groups. DerSimonian and Laird random-effects model was used to determine the summary of overall effects and their heterogeneity. Cochran's Q test and I-squared statistic were used to explore the statistical heterogeneity. RESULTS: In total, eleven studies were included in this study. The overall estimate indicated that the almond consumption had no significant effect on serum CRP level (weighted mean difference (WMD) = -0.28 mg/l, 95 % confidence interval (CI): - 0.81, 0.25; p = 0.29). Regarding IL-6, almond consumption significantly decreased serum IL-6 level (WMD = -0.1 pg/ml, 95 % CI: -0.15, -0.05; p < 0.001). CONCLUSION: The overall results support the beneficial effects of almond consumption on serum concentration of IL-6; but even so, our study revealed that the almond consumption non-significantly reduced serum concentration of CRP. We still need more well-designed trials to confirm the beneficial effects of almond.

Mediators of dietary diversity score (DDS) on NAFLD in Iranian adults: a structural equation modeling study.

BACKGROUND: The current study examines the association between the Dietary Diversity Score (DDS) and nonalcoholic fatty liver disease (NAFLD) in Iranian adults using structural equation modeling (SEM). METHODS: A sample of 3220 adults from the Amol Cohort Study was recruited for this cross-sectional study. Dietary acid load (DAL) and DDS were calculated using the data obtained from a validated food frequency questionnaire. Anthropometric parameters, blood pressure, biochemical measurements, and liver ultrasonography were evaluated according to standard protocols. RESULTS: DDS was neither directly nor indirectly associated with a greater prevalence of NAFLD. In the second model (DDS sub-scores model), the association of DAL with NAFLD was fully mediated through waist circumference (WC) (of DAL to WC: ß = 0.14, P < 0.0001, and of WC to NAFLD: ß = 0.50, P < 0.001). Vegetable and fruit diversity scores had a significant negative indirect relationship with NAFLD prevalence through DAL (ß = -0.06, P = 0.001, ß = -0.10, P < 0.001, respectively). Meat diversity score was positively associated with NAFLD prevalence in a full mediational process through DAL (ß = 0.12, P < 0.001). The SEM fit indices suggested a reasonably adequate fit of the data to the DDS model (Χ2/df = 4.76, GFI = 0.98, AGFI = 0.97, IFI = 0.97, CFI = 0.97, RMSEA = 0.03, and SRMR = 0.02) and its sub-scores model (Χ2/df = 4.72, GFI = 0.98, AGFI = 0.97, IFI = 0.95, CFI = 0.95, RMSEA = 0.03, and SRMR = 0.02). CONCLUSION: Meat diversity and lack of vegetable and fruit diversity were indirectly associated with NAFLD prevalence through DAL and WC mediators. Interventions for NAFLD may be more successful if they target a lower intake of animal protein sources and dietary diversity, particularly vegetable and fruit diversity.

The beneficial effect of tart cherry on plasma levels of inflammatory mediators (not recovery after exercise): A systematic review and meta-analysis on randomized clinical trials.

BACKGROUND: Chronic inflammation has been classified as one of the most important threats to health. Scientists suggested that tart cherry (TC) can reduce plasma levels of inflammatory mediators. Therefore, the aim of this study was to summarize the effect of TC on circulating C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) among adult participants in non-exercise randomized clinical trials (RCTs). METHODS AND MATERIALS: The eligible English-language RCTs were found by searching databases including PubMed, Web of Science, Cochrane Library, Scopus, and clinical Trials.gov up to May 2022, with no time limit. We used the mean change from baseline and its standard deviation for both intervention and comparison groups to calculate the effect size. The random-effects model proposed by DerSimonian and Laird was used to estimate the overall summary effect and the heterogeneity. We used PRISMA 2020 guidelines to report this study. RESULTS: Ten RCTs were included in this study. The results demonstrated that TC had a significant decreasing effect on plasma CRP level compared with the comparison group (weighted mean differences (WMD) = -0.55 mg/L; 95% confidence interval (CI): - 1.03, - 0.06; p = 0.029), but had no significant effect on plasma IL-6 compared with comparison group (WMD = 0.08 pg/mL; 95% CI: -0.02, 0.17; p = 0.10). The effect of TC consumption on plasma TNF-α level was evaluated in only three studies that showed no significant effects (p>0.05). CONCLUSION: Our results confirmed a significant decreasing effect of TC on CRP. Regarding IL-6 and TNF-α, our study did not present any significant effect of TC.

Can soy isoflavones in combination with soy protein change serum concentration of adiponectin and resistin? A systematic review and meta-analysis on randomized clinical trials.

Some studies proposed the anti-inflammatory effect of soy protein and soy isoflavones by changing the serum adiponectin and resistin levels. The purpose of this research was to determine the impact of soy isoflavones and soy protein on blood adiponectin and resistin levels in adults. Scopus, PubMed, Cochrane Library, ISI Web of Science, and ClinicalTrials.gov databases were searched until April 2022. The effect size was computed by the mean changes from the beginning for intervention and comparison groups and their standard deviation. In the case of significant heterogeneity, DerSimonian and Laird random-effects model was used. Six and five clinical trials were selected for the systematic review and meta-analysis, respectively. The overall estimate indicated that soy isoflavones in combination with soy protein did not significantly change serum adiponectin level (weighted mean differences (WMD) = 0.36 µg/ml; 95% confidence interval (CI): -0.26, 0.99; p = .25), but significantly increased serum resistin level (WMD = 0.64 ng/ml, 95% CI: 0.25, 1.04; p = .001). In combination with soy protein, soy isoflavones nonsignificantly increased serum adiponectin levels, but significantly increased resistin levels. New intervention studies with a high dose of soy isoflavones and soy protein in different parts of the world and an updated meta-analysis are needed to confirm the results of our study.

SARS-CoV-2 antibody response after BBIBP-CorV (Sinopharm) vaccination in cancer patients: A case-control study.

Background: Long-term safety and efficacy of BBIBP-CorV vaccine especially in individuals with chronic diseases, like cancer, is under investigation. In the present prospective study, we aimed to evaluate severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) antibody response with BBIBP-CorV vaccine in Iranian cancer patients. Methods: All the patients registered to receive BBIBP-CorV (Sinopharm) vaccine were divided into two groups of with (cases = 107) and without (controls = 45) history of cancer. Serum levels of SARS-CoV anti-spike recombinant receptor binding domain (anti-sRBD) and anti-nucleocapsid (anti-N) IgG serum levels were measured on days 0 (phase 0), 28-32 (phase I), and 56-64 (phase II) of vaccination. The data were analyzed using SPSS, version 22. Results: Totally, 152 individuals (67.1% females) with the mean age of 46.71 ± 15.36 years were included. Solid cancers included 87.8% of the cancer cases (46.7% gynecological and 31.8% gastrointestinal cancer). At Phases I and II, positive anti-sRBD IgG and anti-N IgG were significantly lower among the cases in total analysis. Side effects were not significantly different between the cases and controls. The lowest positive anti-sRBD IgG test was observed among the cancer patients who were simultaneously receiving chemotherapy (35.3%). Anti-sRBD IgG and anti-N IgG serum levels significantly increased at phases I and II in total analysis and in each group. In addition, serum anti-sRBD IgG increased during the three phases and it was significantly higher in the control group. Conclusion: Full vaccination of COVID-19 by BBIBP-CorV in immunocompromised patients such as cancer patients is safe and effective and could induce antibody response but in lower levels compared to healthy people. Probable causes to have minor antibody response found in males, older ages, individuals with BMI ≥ 25, those without past history of COVID-19 and with hematologic cancers. No significant side effects after vaccination were seen.

Empirically-Derived Dietary Patterns in Relation to Non-Alcoholic Fatty Liver Diseases Among Adult Participants in Amol, Northern Iran: A Structural Equation Modeling Approach.

Dietary modifications remain the mainstay in managing nonalcoholic fatty liver disease (NAFLD). Published data on the effect of overall dietary patterns on NAFLD is scarce. The present study aims to extract the dietary patterns and investigate their association to NAFLD by gender, using structural equation modeling, among adult participants in Amol, northern Iran. In this cross-sectional study, data from 3,149 participants in the Amol cohort study (55.3% men, n = 1,741) were analyzed. Usual dietary intake was assessed by a validated 168-items semiquantitative food frequency questionnaire. We classified major dietary patterns by explanatory factor analysis (EFA) and confirmatory factor analysis (CFA). NAFLD diagnosis was based on ultrasound scanning, including increased hepatic echogenicity, abnormal appearance of hepatic arteries, and diaphragm in the absence of excessive alcohol consumption. Multivariable logistic regression and structural equation modeling (SEM) were used to explore the relationship between dietary patterns and NAFLD. Three distinct dietary patterns, including western, healthy, and traditional/mixed dietary patterns, were identified. Adult male who adhere to the western dietary pattern were more affected with NAFLD risk [Q1, Q2, Q3, Q4, odds ratio (OR) = 1, 1.16, 1.34, 1.39; 95% confidence interval (CI) = 0.83-1.61, 0.96-1.85, 0.98-1.96, p trend = 0.04, respectively]. A full mediating effect of healthy dietary pattern, western dietary pattern, and traditional dietary pattern via dietary acid load (DAL) proxy (of dietary patterns to DAL: ßstd = -0.35, p < 0.006, ßstd = 0.15, p = 0.009, and ßstd = 0.08, p = 0.001, respectively), on NAFLD was found through mediation analysis using SEM. A western dietary pattern comprising frequent intake of salty and sweet snacks, soft drinks, refined grains, processed meats, cooked and fried potatoes, eggs, and coffee was associated with a higher odds of NAFLD in an Iranian male population. Additionally, our findings might provide a mechanistic explanation for the association between dietary patterns and NAFLD via DAL proxy. However, further prospective studies, including assessing acid-base biomarkers, are needed.

Is melatonin associated with pro-inflammatory cytokine activity and liver fibrosis in non-alcoholic fatty liver disease (NAFLD) patients?

AIM: The associations between serum levels of melatonin and concentrations of tumor necrosis factor (TNF)-a and interleukin (IL)-6 were assessed among patients with different degrees of non-alcoholic fatty liver disease. BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) has become a very common worldwide disease. METHODS: In this cross-sectional study, adult patients diagnosed with fatty liver disease by Fibroscan evaluation were included if they met the inclusion/exclusion criteria for NAFLD. The participants were categorized into the three following groups: 1) fibrosis> 9.1KP and steatosis >290 dbm; 2) fibrosis: 6-9.0 KP and steatosis 240-285; and 3) fibrosis < 5.8 KP and steatosis<240 dbm. Post-fasting, 5 ml of venous blood was collected for laboratory assessment, and a questionnaire including demographic, anthropometric, laboratories and clinical data was completed. RESULTS: A total of 97 participants were included. The mean age was 42.21±11 years, and 59 patients (60.0%) were female. Melatonin levels as well as pro-inflammatory cytokines levels were correlated with advancing fibrosis and steatosis in univariate analysis. A significant association was observed between these cytokines and advancing fibrosis, severe steatosis levels, and melatonin concentrations. Furthermore, in the multiple linear regression model, melatonin levels showed a significant association with these cytokines. CONCLUSION: Melatonin may have protective effects on tissue injury during advancing liver fibrosis via cytokines modulation. Therefore, it can be considered as a potential therapeutic management strategy for NAFLD.

Evaluation of the Mini Nutritional Assessment in the elderly, Tehran, Iran.

OBJECTIVE: To determine whether the Mini Nutritional Assessment (MNA) can screen and diagnose for malnutrition in the Iranian elderly. DESIGN: The MNA was administered to all volunteers. Each patient underwent anthropometric and serum albumin measurements. Reliability, validity, sensitivity, specificity, positive- and negative-predictive values were estimated. To identify optimal threshold values for predicting malnutrition, receiver-operating characteristic curve analysis was performed for MNA scores. SETTING: Kahrizak Charity Foundation (Tehran, Iran). SUBJECTS: Two hundred and twenty-one consecutive elderly patients entered into the cross-sectional study. Amputees and patients with liver or renal disorders, oedema or any end-stage diseases were excluded. RESULTS: According to MNA score, 3.2 % were malnourished, 43.4 % were at risk of malnutrition and 53.4 % were well nourished. The proportions in these categories according to ideal body weight and serum albumin were 2.3 %, 17.1 % and 80.6 %, respectively. Cronbach's alpha coefficient (reliability) was 0.61. The correlations between total MNA score, anthropometric values and serum albumin (criterion-related validity) were all significant. There were significant differences in total MNA score between two BMI groups but not between two categories according to serum albumin and skin ulcers (construct validity). The sensitivity and specificity of the MNA according to its established cut-off points were 82 % and 63 %, respectively. Positive-predictive value was 35 % and negative-predictive value was 93 %. By using the best cut-off point (MNA score of 22 according to Youden index), the sensitivity, specificity, positive-predictive value and negative-predictive value were 88 %, 62 %, 57 % and 89 %, respectively. CONCLUSIONS: The MNA with its established cut-off points may not be a good fit for Asian populations, including Iranian elderly.

Comparison of Harris Benedict and Mifflin-ST Jeor equations with indirect calorimetry in evaluating resting energy expenditure.

BACKGROUND: An understanding of energy expenditure in hospitalized patients is necessary to determine optimal energy supply. The metabolic rate can be measured or estimated by equations, but estimation is by far the most common method. AIM: This study tests the degree of agreement between measured resting energy expenditure by indirect calorimetry and predicted resting energy expenditure by Harris Benedict and Mifflin-St Jeor equations. Patients were categorized according to sex and diagnosis. SETTINGS AND DESIGN: Cross-sectional study. MATERIALS AND METHODS: In 60 randomly selected patients, aged between 18 and 83 years, resting energy expenditure (REE) was measured by indirect calorimetry and compared with the predicted equations of Harris Benedict and Mifflin-St Jeor. STATISTICAL ANALYSIS: Statistical analysis was performed by using the method of Bland-Altman, one sample t-test and Pearson's correlation. RESULTS: There was no statistically significant difference between measured and predicted resting energy expenditure by both equations, in all cases as a whole and each group. The only statistically significant difference was seen between measured resting energy expenditure and its predicted equivalent by Mifflin-St equation when patients were categorized according to their sex. Limits of agreements were wide for both equations in all cases and each category so clinical significance was considerable. CONCLUSIONS: At a group level Harris-Benedict equation is suitable for predicting REE but at an individual level, both equations have wide limits of agreement and clinically important differences in REE would be obtained.

Under- and overreporting of energy in a group of candidates for CABG surgery and its association with some anthropometric and sociodemographic factors, Tehran, Iran.

INTRODUCTION: Numerous studies have documented a high prevalence of misreporting energy intakes. This paper examines the prevalence of under- and overreporting of energy intake in a group of candidates for coronary artery bypass graft (CABG) surgery and its association with body mass index (BMI) and some sociodemographic factors. SUBJECTS AND METHODS: Dietary assessment (using a food frequency questionnaire) and demographic evaluation of 449 CABG surgery candidates was performed. Weight and height was also measured. McCrory equation was used to identify inaccurate records of energy intake. With this equation, reporting energy intake less than 78% and more than 122% of predicted energy expenditure was considered as under- and overreporting, respectively. RESULTS: Less than half of the participants reported energy intakes within the plausible limits. There were more overreporters than underreporters in this sample. The only significant association between misreporting and related factors was seen in BMI groups. As BMI increased, the number of underreporters increased significantly. Expressed as a percentage of total energy, mean carbohydrate intake was significantly lower and mean fat and protein intake was significantly higher in underreporters compared to overreporters. CONCLUSION: The high prevalence of misreporting suggests more research to examine the characteristics of misreporters. Calibrating data with these characteristics can help to improve intake estimates.