Association of major and minor ECG abnormalities with traditional cardiovascular risk factors in the general population: a large scale study.

Cardiovascular disease (CVD) can be determined and quantified using the electrocardiogram (ECG) analysis. Identification of the risk factors associated with ECG abnormalities may advise prevention approaches to decrease CVD burden. In this study we aimed to investigate the association between CVD risk factors and minor and major ECG abnormalities in a general Iranian adult population. This study was conducted in 2010 and covered a population of 9035 males and females aged 35 to 65 years recruiting from the phase I of Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) cohort study. The participants were drawn by a stratified cluster random sampling technique. The Bivariate and multinomial logistic regression analysis were conducted considering gender stratification to explore the association of ECG abnormalities with traditional cardiovascular risk factors. There was a significant association between minor and major ECG abnormalities and hypertension (HTN), type 2 diabetes (T2DM), smoking, and physical activity (p < 0.005). There was a significant trend, in both genders, for increasing major abnormalities as the number of CVD risk factors increased. But, only in women, the minor abnormalities increase in frequency as the number of CVD risk factors increased. The results of multinomial logistic regression showed that men with HTN [ARRR = 1.25, 95% CI 0.99, 1.57] and T2DM [ARRR = 1.31, 95% CI 0.99, 1.74] had the highest likelihood to have major abnormalities, although these are not statistically significant. For women, those with HTN had the highest likelihood to have major [ARRR = 1.36, 95% CI 1.13, 1.63] and minor [ARRR = 1.35, 95% CI 1.15, 1.58] abnormalities. Also, women aged > 60 years were more likely to have major [ARRR = 2.01, 95% CI 1.49, 2.74] and minor [ARRR = 1.59, 95% CI 1.20, 2.10] abnormalities compared to women aged < 45 years. Age and HTN were significantly associated with major and minor ECG abnormalities in women, and, on the other hand, HTN and T2DM were associated with major abnormalities in men. Taken together, these findings suggest that healthcare providers should advise preventive approaches to the asymptomatic adults with both major and minor electrocardiographic abnormalities that may predict cardiovascular risk.

Effects of Vitamin D3 Fortified Low-fat Dairy Products on Bone Density Measures in Adults with Abdominal Obesity: A Randomized Clinical Trial.

Background: Bone disease-related fractures constitute a heavy burden on the healthcare systems and economy. Vitamin D is an important regulator of bone health and its deficiency is a global problem. This study aimed to evaluate the effect of the 1,500 IU nano-encapsulated vitamin D used for fortifying low-fat dairy products (milk and yogurt) on bone health parameters. Methods: This parallel totally blinded, randomized controlled trial was part of the Ultraviolet Intake by Nutritional Approach study and conducted on 306 individuals with abdominal obesity. Individuals were randomly assigned to four groups, including fortified low-fat milk (1,500 IU nano-encapsulated vitamin D3 per 200 g/d), non-fortified low-fat milk, fortified low-fat yogurt (1,500 IU nano-encapsulated vitamin D3 per 150 g/d), and non-fortified low-fat yogurt, for 10 weeks between January and March 2019. Bone mineral density (BMD) and trabecular bone score (TBS) were measured at the baseline and end of the trial. Trabecular bone score and BMD were defined as primary and secondary outcomes. Results: There were no significant differences in TBS and BMD between the intervention and control groups at the end of the trial (P>0.05). Conclusion: This trial demonstrated no significant effect of nano-encapsulated vitamin D fortified milk and yogurt on BMD and TBS. There remains a need for longer-term trials regarding bone health outcomes to establish optimal doses of fortification.

Hookah smoking is strongly associated with diabetes mellitus, metabolic syndrome and obesity: a population-based study.

OBJECTIVES: The adverse effects of cigarette smoking have been widely studied before, whilst the effects of hookah smoking has received less attention, although it is a common habit in the Middle East. Here we have investigated the effects of cigarette and hookah smoking on biochemical characteristics in a representative population sample derived from the Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort study, from Northeastern Iran. STUDY DESIGN: A total of 9840 subjects from the MASHAD population study were allocated to five groups; non-smokers (6742), ex-smokers (976), cigarette smokers (864), hookah smokers (1067), concomitant cigarette and hookah smokers (41). METHODS: Baseline characteristics were recorded in a questionnaire. Biochemical characteristics were measured by routine methods. Data were analyzed using SPSS software and p < 0.05 was considered significant. RESULTS: After adjustment for age and sex; the presence of CVD, obesity, metabolic syndrome, DM and dyslipidemia were significantly (p < 0.001) related to smoking status. After multivariate analysis, HDL (p < 0.001), WBC (p < 0.001), MCV (p < 0.05), PLT (p < 0.01) and RDW (p < 0.001), and the presence of CVD (p < 0.01), obesity (p < 0.001), metabolic syndrome (p < 0.05) and DM (p < 0.01) remained significant between cigarette smokers and non-smokers. Between hookah smokers and non-smokers; uric acid (p < 0.001), PLT (p < 0.05) and RDW (p < 0.05), and the presence of obesity (p < 0.01), metabolic syndrome (p < 0.001), diabetes (p < 0.01) and dyslipidemia (p < 0.01) remained significant after logistic regression. CONCLUSION: There was a positive association between hookah smoking and metabolic syndrome, diabetes, obesity and dyslipidemia which was not established in cigarette smoking.