Insulin resistance surrogate markers and risk of hyperuricemia among patients with and without coronary artery disease: a cross-sectional study.

Background: Although emerging evidence emphasizes the associations between both insulin resistance and hyperuricemia with coronary artery disease (CAD) risk, no definite relationship has yet been established. In this respect, time-efficient and affordable methods to estimate insulin resistance (IR) status, and to predict risk of hyperuricemia, are needed. Thus, the goal of this investigation was to examine the associations between IR, as assessed by novel surrogate markers [triglyceride-glucose (TyG) and TyG-body mass index (TyG-BMI)], and risk of hyperuricemia in patients with and without diagnosed CAD. Methods: This cross-sectional study used data from the medical records of 1,170 patients who were referred to the cardiology outpatient clinic. Medical records, anthropometrics, and serum analytes were determined at the initial visit. Hyperuricemia was defined as serum uric acid ≥ 5.6 mg/dL. IR was estimated through surrogate markers (TyG and TyG-BMI). Multiple regression analysis was performed to assess the relationship between these indices and odds of hyperuricemia among patients with and without CAD. Results: Overall, 814 angiographically-confirmed CAD cases (mean age (SD) = 52 (8)yrs) were compared with 356 patients without CAD (mean age (SD) = 48 (8)yr). There were positive associations between TyG and TyG-BMI indices and odds of hyperuricemia in CAD patients after controlling for confounders (adjusted odds ratio (aOR) = 1.60; 95%CI: 1.02-2.51; p-value = 0.036; and aOR = 1.83; 95%CI: 1.24-2.70; p-value = 0.002, third tertiles for TYG and TYG-BMI, respectively). Conclusion: The present findings suggest that higher levels of the IR surrogate markers, TyG and TyG-BMI, are associated with higher odds of hyperuricemia in patients with CAD. However, given the cross-sectional design of this study, the sensitivity and specificity of these novel markers could not be determined for confirming the diagnosis of IR and hyperuricemia, further studies are needed to determine such outcomes and to confirm the current findings.

Overall, plant-based, or animal-based low carbohydrate diets and all-cause and cause-specific mortality: A systematic review and dose-response meta-analysis of prospective cohort studies.

INTRODUCTION: In this study, we sought to summarize the associations between overall, plant-, and animal-based low carbohydrate diet (LCD) scores and the risk of all-cause, cardiovascular disease (CVD), and cancer mortality from prospective cohort studies. METHODS: We searched PubMed, Scopus, and Web of Science up to January 2022. We included prospective cohort studies that investigated the relationship between LCD-score and risk of overall, CVD, or cancer mortality. Two investigators assessed the studies for eligibility and extracted the data. Summary hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a random-effects model. RESULTS: Ten studies, with 421022 participants, were included in the analysis. In the high-versus-low meta-analysis, overall (HR:1.05,95%CI:0.97, 1.13, I2 =72.0%) and animal-based LCD-scores (HR: 1.08, 95% CI: 0.97-1.21; I2 = 88.0%) were not associated with all-cause mortality, but plant-based LCD-score was associated with a risk reduction (HR:0.87, 95%CI:0.78,0.97; I2 = 88.4%). CVD mortality was not associated with overall, plant-, or animal-based LCD-scores. Overall (HR:1.14, 95%CI:1.05,1.24; I2 = 37.4%) and animal-based LCD scores (HR:1.16,95%CI:1.02,1.31; I2 = 73.7%) were associated with a higher risk of cancer mortality, while plant-based LCD-score was not. A U-shaped relationship was revealed between overall LCD-score and all-cause and CVD mortality. The shape of relationship between LCD and cancer mortality was a linear dose-response. CONCLUSION: In conclusion, diets with a moderate carbohydrate content were associated with the lowest risk of all-cause and CVD mortality. If the sources of macronutrients that replaced carbohydrates were plant-based, the risk of all-cause mortality was reduced linearly with lower carbohydrate content. The risk of cancer mortality increased linearly with the increase in carbohydrate content. Considering the low certainty of evidence, more robust prospective cohort studies are suggested.

The effects of purslane consumption on glycemic control and oxidative stress: A systematic review and dose-response meta-analysis.

Purslane (Portulaca oleracea L.) is a herbal remedy with wide range of pharmaceutic properties. Although the beneficial effect of purslane on the treatment of Type 2 Diabetes Mellitus (T2DM) has been shown, there is an inconsistency among the results of previous studies. Therefore, this study is aimed at conducting a systematic review and meta-analysis on the effect of purslane on glycemic profile and oxidative stress markers. A systematic search was performed in the Scopus, Web of science, PubMed and the Cochrane Library to find articles related to the effect of the purslane on Malondialdehyde (MDA) and Total Antioxidant Capacity (TAC), Fasting Blood Sugar (FBS), Hemoglobin A1c (HbA1c), insulin resistance, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) up to September 2022. Among the 611 initial studies that were identified from searching electronic databases, 16 Randomized Clinical Trials (RCTs) involving 1122 participants (557 cases and 565 controls) were included for data analysis. The results of random-effects modeling demonstrated that purslane consumption significantly reduced FBS (p < .001), MDA (p < .001) and increased TAC (p < .001). However, purslane consumption did not affect HbA1c (p < .109), fasting insulin (p = .298) and HOMA-IR (p = .382). Meta-analyses were performed using both the random- and fixed-effects model where appropriate, and I 2 index was used to evaluate the heterogeneity. This meta-analysis study suggests that purslane has beneficial effects on oxidative stress markers and glycemic parameter. Therefore, it may be a promising adjuvant therapy in T2DM because of its benefits and negligible adverse effects.

The Association between DASH Diet Adherence and Cardiovascular Risk Factors.

Background: The dietary approaches to stop hypertension (DASH) encourages high fruit, vegetable, and lean protein consumption and low salt, red meat, and fat intake to prevent or treat hypertension. However, besides hypertension, adherence to this diet has been shown to decrease other cardiovascular risk factors. Methods: This study assessed the relationship between the DASH diet and cardiovascular risk factors in a cross-sectional study of 2,831 adults chosen by multistage cluster sampling from 27 counties of Khuzestan province, Iran. DASH scores were calculated using data obtained from a qualitative food frequency questionnaire. Regression models were used to evaluate the association of DASH scores and common cardiovascular risk factors. Results: Significant trends were observed across quintiles of DASH scores for systolic blood pressure, fasting blood sugar, triglyceride, total cholesterol, and its components (p < 0·05). After adjusting for potential confounders such as sex, age, ethnicity, residence, wealth score, physical activity, energy intake, and family history of heart disease, the multiple regression analysis for each cardiovascular risk factor revealed that being in the highest quintile of total DASH score (OR = 0.72, 95% CI 0.52-0.99) was negatively associated with hyperglycemia. Conclusions: This study showed a positive relationship between DASH diet adherence and lower serum levels of glucose, triglycerides, and cholesterol. Prospective studies are needed to confirm these findings.

The effect of probiotic and synbiotic supplementation on appetite-regulating hormones and desire to eat: A systematic review and meta-analysis of clinical trials.

Recent studies have demonstrated the effect of probiotics, prebiotics, and synbiotics on adiponectin and leptin levels; however, those findings remain contested. The present study aimed to explore the impact of probiotics/synbiotics on appetite-regulating hormones and the desire to eat. METHODS: A systematic review was conducted by searching the Medline (PubMed) and Scopus databases from inception to December 2021, using relevant keywords and MeSH terms, and appropriate randomized controlled trials (RCTs) were extracted. The standardized mean differences (SMD) and 95% confidence intervals (95%CIs) were calculated as part of the meta-analysis using a random-effect model to determine the mean effect sizes. Analysis of Galbraith plots and the Cochrane Chi-squared test were conducted to examine heterogeneity. RESULTS: Meta-analysis of data from a total of 26 RCTs (n = 1536) showed a significant decrease in serum/plasma leptin concentration following probiotic/synbiotic supplementation (SMD: -0.38, 95%CI= -0.638, -0.124); P-value= 0.004; I2= 69.4%; P heterogeneity < 0.001). The leptin level decrease from probiotic/synbiotic supplementation was higher in patients with NAFLD than those with overweight/obesity or type 2 diabetes mellitus/ metabolic syndrome/ prediabetes. Probiotic/synbiotic supplementation was associated with a trending increase in adiponectin levels, stronger in patients with type 2 diabetes mellitus, metabolic syndrome, and prediabetes (SMD: 0.25, 95%CI= 0.04, 0.46) µg/mL; P-value= 0.021; I2 = 16.8%; P heterogeneity= 0.30). Additionally, supplementation with probiotic/synbiotic was linked to a slight increase in desire to eat (SMD: 0.34, 95%CI= 0.03, 0.66) P-value = 0.030; I2 = 39.4%; P heterogeneity= 0.16). CONCLUSION: Our meta-analysis indicates a favorable impact of probiotic/synbiotic supplementation on regulating leptin and adiponectin secretion.

Evaluating the use of novel atherogenicity indices and insulin resistance surrogate markers in predicting the risk of coronary artery disease: a case‒control investigation with comparison to traditional biomarkers.

BACKGROUND: Due to the contribution of coronary artery disease (CAD) to serious cardiovascular events, determining biomarkers that could robustly predict its risk would be of utmost importance. Thus, this research was designed to assess the value of traditional cardio-metabolic indices, and more novel atherogenicity indices and insulin resistance surrogate markers in the identification of individuals at risk of CAD. METHODS: A case‒control survey was conducted, in which 3085 individuals were enrolled. Their clinical and biochemical data were gathered at baseline. The investigated indices included the atherogenic index of plasma (AIP), triglyceride-glucose (TyG) index, TyG-body mass index (TyG-BMI), lipoprotein combine index (LCI), cholesterol index (CHOLINDEX), Castelli's risk indices-I, II (CRI-I, CRI-II), and metabolic score for insulin resistance (METS - IR). To examine the relationship between these variables and CAD risk, multiple regression analyses adjusted for potential confounders were conducted. RESULTS: Overall, 774 angiographically confirmed CAD patients (mean age = 54 years) were compared with 3085 controls (mean age = 51 years). Higher triglyceride, total cholesterol and fasting blood sugar levels and lower HDL-C levels were related to an elevated risk of CAD (P-for-trend < 0.001), while the direct association between increased serum LDL-C concentrations and a greater risk of CAD only became apparent when excluding those with diabetes, and statin users. Among novel indices, greater values of the majority of these markers, including AIP, CRI-I, and -II, CHOLINDEX, LCI, and TyG-index, in comparison to the lower values, significantly elevated CAD risk (P-for-trend < 0.001). CONCLUSION: According to the current findings, novel atherogenicity indices and insulin resistance surrogate markers, in particular, AIP, CRI-I and II, CHOLINDEX, LCI, and TyG-index, may be useful in predicting CAD risk.

Dietary Total Antioxidant Capacity and Risk of Polycystic Ovary Syndrome: A Case-Control Study.

BACKGROUND: Among multiple factors that affect the etiology of polycystic ovary syndrome (PCOS), diet has
an important contribution. Chronic oxidative stress has also been implicated in the development of PCOS. The
present study is an attempt to evaluate dietary total antioxidant capacity (TAC) and its relationship with odds of
PCOS in Iran.
Materials and Methods: The study was carried out as a case-control study in hospital outpatient clinics, Tehran,
Iran. Totally, 310 female participants with a history of PCOS and 602 age-matched controls took part in this
study between June 2015 and December 2018. A reproducible and valid 168-item semi-quantitative food frequency
inventory was utilized to determine the entire antioxidants of the usual diet in order to calculate dietary
TAC. The relationship of dietary TAC with odds of PCOS were assessed adjusting for potential confounders
through an estimation of two multivariable conditional regression models. The first tertile was presented as a
reference category.
Results: In a fully adjusted model, the highest tertile of dietary TAC was associated with a reduced odds of
PCOS [odds ratio (OR): 0.81, 95% confidence interval (95% CI): 0.59, 0.96, P for trend: 0.038). In addition, PCOS odds decreased in the highest tertile of α-tocopherol intake (OR: 0.73, 95% CI: 0.56, 0.88, P for trend:
0.023). The adjusted ORs in the highest tertile of vitamin C, ß-carotene and magnesium were 0.79 (95% CI: 0.83-0.97), 0.81 (95% CI: 0.67-0.98) and 0.91 (95% CI: 0.55-0.9 8) respectively, with a significant trend.
Conclusion: Our results provide evidence that there was a relationship between high TAC diets and lower odds of
PCOS.

The association between fertility diet score and polycystic ovary syndrome: A Case-Control study.

We performed this case-control study with 303 polycystic ovarian syndrome (PCOS) patients and 588 age-matched controls to evaluate the relation between fertility diet score and odds of PCOS. In a fully adjusted model, the top tertile of fertility diet score compared to the bottom was associated with 22% [95%CI 0.71-0.93] lower odds of PCOS (P trend = 0.012). Ratio of monounsaturated to trans fat and vegetable protein was associated with a lower odd of PCOS. Animal protein intake and glycemic load were associated with a higher odd of PCOS. Based on our results, increasing the quality of the diet according to fertility diet score can reduce the odds of PCOS.

Inflammatory Markers and Atherogenic Coefficient: Early Markers of Metabolic Syndrome.

Background: Considering the close link between metabolic syndrome (MetSyn) and cardiovascular diseases, considerable attention has been devoted to the identification of their shared underlying pathological mechanisms in recent decades. Objectives: This study aimed to investigate the association between pro-inflammatory factors and newly-diagnosed MetSyn. Methods: This case-control study recruited obese and nonobese individuals who were newly diagnosed with MetSyn (cases, n = 84) and healthy individuals (controls, n = 83). The medical and sociodemographic data of the participants were collected on enrollment. Serum analysis was performed to ascertain the concentrations of tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), fasting blood sugar (FBS), total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and atherogenic coefficient (AC). Multiple regression analysis was carried out to explore the relationship between inflammatory markers and AC with MetSyn odds. The Pearson correlation test was also performed to investigate the correlations between metabolic and inflammatory parameters. Results: Positive relationships were observed between the serum levels of TNF-α and CRP with the odds of MetSyn following controlling for confounders (adjusted odds ratio [AOR] = 1.32; 95% confidence interval [CI]: 1.01 - 1.72; AOR = 1.29; 95% CI: 1.18 - 1.41; respectively, P ≤ 0.03). Additionally, higher AC was accompanied by increased odds of MetSyn (AOR = 1.98; 95% CI: 1.31 - 2.98; P = 0.001). The Pearson correlation analysis also showed positive correlations between TNF-α levels and serum metabolic abnormalities, including elevated LDL-C, FBS, and AC and lowered HDL-C levels (P ≤ 0.02). Conclusions: The present results revealed that higher serum concentrations of pro-inflammatory and atherogenic indices, including CRP, TNF-α, and AC, might be associated with elevated odds of newly diagnosed MetSyn regardless of potential confounders, particularly body mass index. The obtained findings might be moderated by the positive correlations observed between serum TNF-α, as the chronic inflammatory state indicator, and impaired lipid and glycemic markers.

Association between the socio-economic status of households and a more sustainable diet.

OBJECTIVE: A sustainable diet is an affordable diet with low environmental impact, high food security and sufficient healthiness. The present study aimed to assess the correlation between the socio-economic status of households and a sustainable diet. DESIGN: The food basket and socio-economic data of Iranian households were evaluated during 2016-2018. The households were classified based on the sustainability of their diet by determining the dietary carbon footprint, dietary water footprint, lower dietary costs of the household than the median and a higher dietary quality index than the median. Logistic regression was used with four models to calculate the OR of a more sustainable diet as the dependent variable regarding the different quartiles of socio-economic status (SES) as the independent variable. SETTING: Iran. PARTICIPANTS: Iranian households (n 102 303), nationally representative, were studied. RESULTS: Lower SES was associated with the higher OR of a sustainable diet (OR: 0·90; (95 % CI 0·87, 0·91)). Higher quartiles of SES compared with the lower SES group indicated the higher energy intake and consumption of more dairies, meat, poultry, fish, eggs, legumes, nuts and fruits, as well as the lower intake of bread, cereal, rice and pasta. CONCLUSION: In countries such as Iran, where nutrition transition occurs rapidly, better economic and social levels in the populations with a higher SES are associated with increased energy intake and higher consumption of animal-based foods, which decreases sustainable diets compared with the groups with a lower SES.