Risk factors for gastroesophageal reflux disease: a population-based study.

BACKGROUND: Gastroesophageal reflux disease (GERD) in the long term reduces the quality of life, leading to digestive diseases. The present study aims to determine the risk factors for GERD. METHOD: This study was conducted on 9,631 adults aged 35-65 years. The demographic characteristics, behavioral habits, nutritional intake, physical activity, anthropometric indices, and GERD data were extracted from the databank related to the Ravansar non-communicable diseases (RaNCD). Statistical analysis was performed using logistic regression models. RESULTS: The prevalence of GERD was 10.99% (n = 1,058). The GERD was higher among older age and women. After adjusting for age and sex, the odds of GERD among current smokers was 23% higher than non-smokers. Drinking increased odds of GERD (OR: 1.51; 95% CI: 1.13, 1.99). The odds of GERD among depressed individuals were 46% higher than non-depressed. In addition, a significant relationship was observed between the high intake of sweets and desserts with increased GERD (OR: 1.02, 95% CI: 1.01, 1.03). Further, high intake of fiber (OR: 0.98, 95% CI: 0.97, 0.99) and dairy (OR: 0.99, 95% CI: 0.98, 0.99) was related to reducing the odds of GERD. Furthermore, a significant relationship was reported between the waist hip ratio (WHR) and visceral fat area (VFA) with increased odds of GERD. Finally, the physical activity level was inversely related to GERD. CONCLUSION: Based on the results, smoking, alcohol, inactivity, high intake of sweets and desserts, low intake of fiber, depression, visceral fat, and obesity are considered as risk factors for GERD. Modifying lifestyle and behavioral habits prevent GERD.

Association between obesity phenotypes and non-alcoholic fatty liver: a large population- based study.

BACKGROUND: The aim of this study was to examine the association between different metabolic obesity phenotypes and the non-alcoholic fatty liver disease (NAFLD). METHODS: This cross-sectional analysis utilized data from the baseline phase of the Ravansar non-communicable diseases (RaNCD) cohort study, which involved 8,360 adults. Participants with a Fatty Liver Index (FLI) score of ≥ 60 was classified as having NAFLD. The FLI score was calculated using liver non-invasive markers and anthropometric measurements. Participants were categorized into four phenotypes based on the presence or absence of metabolic syndrome and obesity. Logistic regression analysis was used to evaluate the association of NAFLD and obesity phenotypes. RESULTS: According to the FLI index, the prevalence of NAFLD was 39.56%. Participants with FLI scores of ≥ 60 had higher energy intake compared to those in the FLI < 60 group (P = 0.033). In subjects with metabolically unhealthy phenotypes, the level of physical activity was lower compared to those with metabolically healthy phenotypes. The risk of NAFLD in males with the metabolically healthy-obese phenotype increased by 8.92 times (95% CI: 2.20, 15.30), those with the metabolically unhealthy-non-obese phenotype increased by 7.23 times (95% CI: 5.82, 8.99), and those with the metabolically unhealthy-obese phenotype increased by 32.97 times (95% CI: 15.70, 69.22) compared to the metabolically healthy-non-obese phenotype. Similarly, these results were observed in females. CONCLUSION: This study demonstrated that the risk of NAFLD is higher in individuals with metabolically healthy/obese, metabolically unhealthy/non-obese, and metabolically unhealthy/obese phenotypes compared to those with non-obese/metabolically healthy phenotypes.

The mediating effect of sleep duration on metabolic syndrome severity in adults: a structural equation modeling approach.

BACKGROUND: Metabolic syndrome (MetS) is associated to sleep duration. It is crucial to identify factors that disrupt sleep regulation. The study aimed to assess the indirect effect of risk factors related to MetS severity through sleep duration by utilizing a structural equation model (SEM). METHODS: The study involving 3,935 adults from the baseline data of the Ravansar Non-Communicable Disease (RaNCD) cohort study. MetS severity scores were the outcome variables. SEM was employed to explore the relationships, utilizing IBM SPSS and AMOS version 23. RESULTS: The mean MetS severity score was higher in women compared to men (0.25 vs. 0.16, P = 0.003). In men, socioeconomic status (SES) has a positive direct effect (ß = 0.048) and a negative indirect effect (ß=-0.006) on MetS severity. Increased physical activity is directly (ß=-0.036) and indirectly (ß=-0.093) associated with reducing MetS severity. Nap duration is directly linked to an increase (ß = 0.072) but has an indirect effect (ß=-0.008) in decreasing MetS severity. In women, SES has a direct (ß=-0.020) and indirect (ß=-0.001) inverse relationship with MetS severity. Increased physical activity is directly (ß=-0.048) and indirectly (ß=-0.036) associated with decreasing MetS severity in women. Nap duration is directly associated with an increase in MetS severity (ß=-0.018) but indirectly contributes to its reduction (ß=-0.002). Sleep duration not only directly affects MetS severity but is also influenced by age, SES, physical activity, obesity and nap duration. CONCLUSION: Physical activity, SES, and nap duration directly and indirectly effect the MetS severity. Sleep duration was recognized as a mediating variable that supports the indirect effects.

The interaction between general or abdominal obesity and hypertension on the risk of type 2 diabetes mellitus: a cross-sectional analysis in Iranian adults from the RaNCD cohort study.

BACKGROUND: Interactions between risk factors may influence disease severity. Knowing this relationship is important for preventive interventions and disease control. The purpose of this study was to determine the interactions effects of obesity and hypertension on the risk of type 2 diabetes mellitus (T2DM). METHODS: The data of 9,283 adults 35 to 65 years were examined from the cohort study of Ravansar Non-Communicable Disease (RaNCD). Waist circumference (WC) was used to identify both general and abdominal obesity based on body mass index (BMI). To assess the interaction between hypertension and obesity (general/abdominal) and the risk of T2DM, the additive interaction was calculated. RESULTS: The adjusted odds ratios for T2DM were 2.38 (1.67, 3.41) in men and 4.02 (2.47, 6.47) in women for the combinations of hypertension and abdominal obesity. The adjusted odds ratios for T2DM were 2.53 (1.63, 3.82) in men and 2.66 (1.92, 3.70) in women for the combinations of hypertension and general obesity. The results of the additive interaction indicators were inconsistent with gender. The relative excess risk due to interaction (interaction between hypertension and central obesity) (RERI), attributable proportion due to interaction (AP) and synergy index (SI) were0.27 (-1.01, 1.54), 0.11 (-0.41, 0.63) and 1.23 (0.41, 3.68) in male and were 0.61 (-1.12, 2.33), 0.23 (0.08, 0.37) and 1.26 (0.60, 2.61) in female, respectively. CONCLUSION: General/abdominal obesity and hypertension have a synergistic effect on the risk of T2DM. The recommendation for preventing T2DM is lifestyle modification. Large longitudinal studies are necessary to investigate causal relationships.

Socioeconomic disparities in Papanicolaou test utilization in Western Iran.

BACKGROUND: Cervical cancer remains the fourth most frequently diagnosed cancer among women, and its impact is particularly significant in women residing in less developed countries. This study aims to assess socioeconomic inequality in using Papanicolaou tests, commonly known as Pap tests, which are crucial for detecting cervical cancer. The research also seeks to decompose this inequality, identifying its contributing factors. This investigation is conducted within a sizable population-based study focused on the Kurdish population, with an additional examination of potential variations between urban and rural areas. METHOD: The study utilized baseline data from the Ravansar Non-Communicable Disease Cohort Study (RaNCD), involving 3,074 ever-married women aged 35-65. Asset data was employed to determine socioeconomic status (SES), and Principal Component Analysis was applied. The uptake of Papanicolaou tests was assessed for inequality using the Concentration Index (Cn). Additionally, decomposition analysis was conducted to identify and understand the factors contributing to socioeconomic inequality. RESULTS: The study found that overall, 86% of women reported having undergone cervical cancer screening at least once in their lifetime. The Concentration Index (Cn) for the total population was 0.21 (p < 0.0001), indicating a higher concentration of Papanicolaou test uptake among wealthier groups. In urban areas, the Cn was 0.34 (p < 0.0001), reflecting a significant concentration among the rich. However, in rural areas, the Cn was -0.10 (p = 0.3006), suggesting no significant socioeconomic inequality. Factors such as socioeconomic status (SES), education, and age contributed to reducing inequality, explaining 62.7%, 36.0%, and 1.7% of the observed inequality, respectively. Interestingly, place of residence had a negative influence on inequality. CONCLUSION: The uptake of Papanicolaou tests varies across different socioeconomic status levels, with a higher concentration among wealthier groups. The results enable health policymakers and researchers to tailor health intervention toward increasing public awareness, especially among women with lower levels of education women in economically deprived groups.

Association Between Plant-based Diet and Kidney Function in Adults.

OBJECTIVE: A plant-based diet has both antioxidant and anti-inflammatory properties. Therefore, it is hypothesized that adherence to a plant-based diet may have a positive effect on kidney function. The study aimed to determine the association between the plant-based diet index (PDI) and chronic kidney disease (CKD). METHODS: This cross-sectional analysis used information from the Ravansar noncommunicable diseases cohort study, which included 9,746 participants between the ages of 35 and 65. By measuring the estimation glomerular filtration rate (eGFR) with the modification of diet in the renal disease equation, CKD was determined. Using a food frequency questionnaire, the PDI was computed based on food intake. To determine odds ratios (ORs), multivariable logistic regression models were utilized. RESULTS: 1,058 (10.86%) participants had CKD (eGFR<60 mL/min/1.73 m2), and the mean PDI was 54.22 ± 6.68. The mean eGFR in the group with a high PDI score was significantly higher than the group with a low PDI score (fourth quartile: 79.20 ± 0.36 vs. first quartile: 72.95 ± 0.31, P < .001). Adherence to a plant-based diet was more prevalent in those with a higher socioeconomic status (P < .001). After adjusting for potential confounders, the odds of CKD in the third and fourth quartiles of PDI were 25% (OR: 0.75; 95% confidence interval: 0.62-0.91) and 39% (OR: 0.61; 95% confidence interval: 0.48-0.78, P trend<.001) lower than the first quartile, respectively. CONCLUSIONS: The findings of this study suggest that having a plant-based diet may prevent the prevalent CDK. However, further studies with a cohort design are recommended.

Mortality and disability-adjusted life years for smoking-attributed cancers from 1990 to 2019 in the north Africa and middle east countries: a systematic analysis for the global burden of disease study 2019.

AIM AND BACKGROUND: Smoking is a modifiable risk factor for cancers. The aim of the study is to estimate the trend of mortality and DALYs of smoking-attributed cancers in the North Africa and Middle East (NAME) countries. METHODS: In this study, estimates from the Global Burden of Disease 2019 (GBD-2019) study were used to report the mortality and DALYs for 16 smoking-attributed cancers. The mortality and DALYs rates from smoking-attributed cancers were evaluated by age, sex, and the 21 countries of the NAME countries from 1990 to 2019. RESULTS: Age standardized mortality rates (ASMR) for the 29 smoking-attributed cancers in the NAME countries in 1990 and 2019 were estimated to be 24.7 (95% Uncertainty Interval: 21.5, 27.8) and 22.4 (95%UI: 19.8, 25.4) respectively, which shows a 9.2% decrease in the three decades. DALYs/100,000 for smoking-attributed cancers was, also, estimated to be 600.3 (95%UI: 521.6, 682.6) and 515.6 (95%UI: 454.9, 585.4) respectively, which indicates a 14.1% decreased in these three decades. In the last three decades, the percentage changes in DALYs/100,000 for smoking-attributed cancers in males and females were - 0.16 and - 0.03, respectively. Plus, The percentage changes in ASMR in males and females were - 12% and 8%, respectively. Furthermore, The highest ASMR and DALYs were observed in Lebanon, Turkey, and Palestine in 2019. CONCLUSION: The mortality rates of cancers from smoking have increased substantially among females, in most countries of the NAME region, in recent years. The burden caused by smoking can be reduced through modifying lifestyle and applying strict laws on smoking by governments and policymakers.

Fatty liver index relationship with biomarkers and lifestyle: result from RaNCD cohort study.

BACKGROUND: Lifestyle intervention can effectively treat patients with non-alcoholic fatty liver disease (NAFLD). The present study aimed to investigate the association between lifestyle factors with fatty liver index (FLI) in Iranian adults. METHODS: This study enrolled 7114 subjects from the Ravansar Non-Communicable Diseases (RaNCD) cohort study in western Iran. To compute the FLI score, anthropometric measures, and a few non-invasive liver status indicators were used. Binary logistic regression models examined the association between FLI score and lifestyle. RESULTS: Participants with FLI < 60 had a lower daily energy intake compared to those with FLI ≥ 60 (2740.29 vs. 2840.33 kcal/day, P = < 0.001). The risk of NAFLD in males with high socioeconomic status (SES) was 72% higher than in those with low SES (OR: 1.72; 95% CIs 1.42-2.08). An adjusted logistic regression model showed a significantly negative association between high physical activity and fatty liver index in both men and women. (OR: 0.44, p-value < 0.001 and OR: 0.54, p-value < 0.001, respectively). The odds of NAFLD in female participants with depression were 71% higher than in non-depressed participants (OR: 1.71, 95% CI: 1.06-2.64). Dyslipidemia and high visceral fat area (VFA) were also associated with a significant increase in the risk of NAFLD (P < 0.05). CONCLUSION: In our study, we found that good SES, high VFA, and dyslipidemia were associated with an increased risk of NAFLD. Conversely, high physical activity reduces the risk of NAFLD. Therefore, lifestyle modification may help improve liver function.

Triglyceride glucose-body mass index and hypertension risk in iranian adults: a population-based study.

BACKGROUND: Insulin resistance (IR) and obesity are risk factors for hypertension; triglyceride-glucose (TyG) is known as a surrogate for IR. The present study investigated the association between the triglyceride-glucose body mass index (TyG-BMI) index and the risk of hypertension in Iranian adults. METHODS: This study was conducted on a sample of 8,610 participants from the baseline phase of the Ravansar non- communicable diseases (RaNCD) in Iran. A logistic regression model was used to evaluate the relationship between TyG-BMI and hypertension. Receiver operating characteristic (ROC) curve analysis was conducted to estimate the predictive power of TyG-BMI for hypertension. RESULTS: A total of 4176 men and 4434 women with an average age of 46.74 years were examined. The anthropometric indices were significantly higher in hypertensive than normotensive subjects (P < 0.001). The level of physical activity was significantly higher in the bottom quartiles (P < 0.001). The odds of hypertension in the highest quartile and 3.10 (95% CI: 2.28, 4.16) times significantly higher than the bottom quartile of the TyG-BMI index. The discriminating ability of TyG-BMI to predict blood pressure was 61% (AUC: 0.61; 95% CI: 0.57, 0.63), and higher than BMI and TyG. CONCLUSION: The TyG-BMI index is associated with an increase in the odds of hypertension. Therefore, the TyG-BMI index can be a new clinical index for early diagnosis of hypertension. Lifestyle modifications such as weight control through physical activity and a healthy diet can help improve IR and prevent hypertension.

Pro-inflammatory diet, cardio-metabolic risk factors and risk of type 2 diabetes: A cross-sectional analysis using data from RaNCD cohort study.

BACKGROUND: Inflammation and cardiometabolic risk factors can be involved in developing type 2 diabetes mellitus (T2DM). This study aimed to investigate and compare the association between a pro-inflammatory diet and cardiometabolic risk factors in patients with T2DM and non-T2DM cases. METHODS: In this cross-sectional population-based study, considering the baseline data of the Ravansar Non-Communicable Disease (RaNCD) cohort, patients with T2DM (n = 785) and non-T2DM cases (n = 8254) were included. The dietary inflammatory index (DII) was calculated using a food frequency questionnaire (FFQ) and was classified into four groups (quartiles) with lowest to highest scores. Logistic regression analysis was conducted to determine the association between DII and cardiometabolic risk factors in both groups. RESULTS: The participants were 9,039 (4140 men and 4889 women) with a mean age of 47.4 ± 8.2 years; the mean body mass index (BMI) and DII were 27.49 ± 4.63 kg/m2 and - 2.49 ± 1.59, respectively. After adjustment for confounding factors, we found that DII can increase the risk of T2DM by 61% (95% CI 1.27 to 2.05, P < 0.001). A comparison of two groups revealed that the association of DII, obesity/overweight and dyslipidemia were also significant in both diabetic (P < 0.05) and non-diabetic cases (P < 0.05). However, no significant association was found between DII, MetS, and hypertension in either of the groups. The association between DII and cardiovascular diseases (CVDs) was only significant in diabetic patients (1.65; 95%CI: 1.02 to 2.65, P = 0.04) and T2DM showed an interaction with the association between DII and CVDs. CONCLUSION: Inflammatory potential of diet may increase the risk of T2DM. Although it can increase the risk of some cardiometabolic risk factors in both diabetic and non-diabetic cases, its effects were greater among patients with T2DM. However, further prospective studies are required to confirm these associations.

Association between dietary inflammatory index and infertility of women; Results from RaNCD Cohort Study.

BACKGROUND: In recent decades, more and more attention has been paid to the influence of nutrition on reproductive health. Nevertheless, the imminent association between diet-related inflammation and the risk of infertility has not yet been established. The aim of the current study was to investigate the ability of the Dietary Inflammatory Index (DII) to estimate infertility incidence in women. METHODS: This cross-sectional study was conducted using data from Ravansar non-communicable diseases (RaNCD) cohort study on 4437 participants. The DII was calculated based on the reported consumption of up to 31 food parameters measured via a validated and reproducible 118-item food-frequency questionnaire (FFQ). Multiple logistic regression analysis was applied to estimate the multivariable odds ratio (OR) adjusted for potential confounding variables. RESULTS: Out of all participants, 411 women (9.26%) were infertile. The mean ± SD age and weight of infertile women were 43.67 ± 7.47 years and 72.86 ± 13.02 kg, respectively. Statistical analyses showed the odds ratio of infertility in the fourth quartile (pro-inflammatory diet) was 1.76 times higher than in the first quartile (anti-inflammatory diet) of DII (95% CI: 1.57-2.02). CONCLUSIONS: The findings of this study provide compelling evidence about the association between infertility and the quality of diet in women. Therefore, interventions and programs aimed at promoting a healthy lifestyle and using healthy diets can be considered as one of the effective approaches in the prevention and treatment of infertility in women.

Comparison of the physical activity levels between shift workers and non-shift workers in a large-scale cross-sectional study in Iran.

BACKGROUND: Shift work has been related to adverse health outcomes that can partially be attributed to physical inactivity. However, our knowledge of the influence of shift work on physical activity and sedentary behavior is inconclusive. Therefore, this study aimed to assess physical activity levels among shift and non-shift workers among a sample of Iranian adults. METHODS: Baseline data of the Ravansar Non-Communicable Disease (RaNCD) cohort study were used. All participants of RaNCD except those excluded due to unemployment or considerable disability were included in the study. We evaluated participants' physical activity levels using the PERSIAN cohort questionnaire and examined its associations with being a shift worker. RESULTS: A total of 4695 participants with a mean age of 46.1 (SD = 7.74) were included in the study. In total, 1108 (23.6%) participants were shift workers, 1420 (30.2%) had insufficient physical activity levels, and 4283 (91.2%) were male. The prevalence of physical inactivity was significantly lower among shift workers compared to non-shift workers (21% vs. 33.1%, p < 0.001). Multiple backward stepwise binary logistic regression tests indicated that being a shift worker was significantly associated with a lower chance of having insufficient physical activity levels (OR = 0.77, 95% CI = 0.65-0.92, p = 0.003). CONCLUSIONS: The prevalence of insufficient physical activity was higher among non-shift workers than shift workers in our study. By providing the factors associated with insufficient physical activity among the workers in a region of Iran, the current study findings might help policymakers target groups at higher risk of physical activity in Iran and design interventions to improve physical activity, especially among non-shift workers.

Epidemiology of musculoskeletal disorders among iranian adults: results from a non-communicable disease cohort study.

BACKGROUND: Persistent pain and reduced mobility and dexterity are the typical characteristics of Musculoskeletal disorders (MSDs). We aimed to determine the prevalence of back and joint pain, back, and joint stiffness, arthritis, and osteoporosis among adults and their distribution according to sociodemographic characteristics and comorbidities. METHODS: This cross-sectional study was conducted on 9,520 participants aged 35-65 years from baseline data of the Ravansar Non-Communicable Disease (RaNCD) cohort study, in the west of Iran. MSDs were evaluated by the RaNCD cohort study physician using a standard questionnaire. Binary logistic regression was used to determine associations and reported by odds ratios (OR) and 95% confidence intervals (CI). RESULTS: The MSDs in women were significantly more than in men (59.06% vs. 40.94%, P < 0.001). Skeletal muscle mass (SMM) was significantly lower in subjects with MSDs, and waist circumference (WC) and visceral fat area (VFA) were higher than in the non-MSDs (P < 0.001). MSDs were significantly more common in urban men and women (OR = 1.33; 95% CI: 1.14-1.50 and OR = 1.59; 95% CI: 1.39-1.82, respectively). Obesity increased the odds of MSDs in women (OR = 1.57; 95% CI: 1.33-1.84), whereas there was no association between BMI and MSDs in men. Men with high socioeconomic status (SES) had lower odds of MSDs than men with weak SES (OR = 0.77; 95% CI: 0.64-0.92). CONCLUSION: The MSDs were more prevalent among older people, women, obese people and urban dwellers. Lifestyle modification, especially weight loss may be helpful in reducing and controlling MSDs.

Metabolically healthy versus unhealthy obese phenotypes in relation to hypertension incidence; a prospective cohort study.

BACKGROUND: Although obesity increases the risk of hypertension, the effect of obesity based on metabolic status on the incidence of hypertension is not known. This study aimed to determine the association between obesity phenotypes including metabolically unhealthy obesity (MUO) and metabolically healthy obesity (MHO) and the risk of hypertension incidence. METHODS: We conducted a prospective cohort study on 6747 adults aged 35-65 from Ravansar non-communicable diseases (RaNCD) study. Obesity was defined as body mass index above 30 kg/m2 and metabolically unhealthy was considered at least two metabolic disorders based on the International Diabetes Federation criteria. Obesity phenotypes were categorized into four groups including MUO, MHO, metabolically unhealthy non obesity (MUNO), and metabolically healthy non obesity (MHNO). Cox proportional hazards regression models were applied to analyze associations with hypertension incidence. RESULTS: The MHO (HR: 1.37; 95% CI: 1.03-1.86) and MUO phenotypes (HR: 2.44; 95% CI: 1.81-3.29) were associated with higher hypertension risk compared to MHNO. In addition, MUNO phenotype was significantly associated with risk of hypertension incidence (HR: 1.65; 95% CI: 1.29-2.14). CONCLUSIONS: Both metabolically healthy and unhealthy obesity increased the risk of hypertension incidence. However, the increase in metabolically unhealthy phenotype was higher.

Association between dietary total antioxidant capacity and hypertension in Iranian Kurdish women.

BACKGROUND: Antioxidants intake from diet has been identified as one of the effective factors in the development of hypertension (HTN). The present study aimed to investigate the association between total antioxidant capacity (TAC) and HTN in women. METHODS: This cross-sectional study was performed using the baseline phase data of the ravansar non-communicable disease cohort study. The TAC was calculated using food items of the food frequency questionnaire. TAC scores were classified into four groups (quartile). The first and fourth quartiles had the lowest and highest TAC scores, respectively. Logistic regression analysis was utilized to estimate the odds ratio. RESULTS: A total of 5067 women were included in the study. Women with the highest socioeconomic status (SES) had a significantly higher TAC intake compared to those with the lowest SES (P < 0.001). The participants in the third and fourth quartiles of the TAC had significantly lower odds of HTN, respectively by 21% (OR = 0.79; 95% CI: 0.64, 0.972) and 26% (OR = 0.74; 95% CI: 0.60, 0.91), compared to the first quartile. After adjusting for confounding variables was found to significantly reduce the odds of developing HTN in the fourth quartile of TAC by 22% compared to the first quartile (OR = 0.78; 95% CI: 0.62, 0.97). CONCLUSION: A high dietary TAC was associated to a decreased odd of HTN in women. We could suggest a diet rich in natural antioxidants as it may help prevent development of HTN.

Metabolic obesity phenotypes and chronic kidney disease: a cross-sectional study from the RaNCD cohort study.

BACKGROUND: Investigating the effect of metabolic disorders on chronic kidney disease (CKD) in the presence or the absence of obesity is of great importance. This study aimed to examine the independent and joint relationships of obesity and metabolic syndrome (MetS) with CKD.  METHODS : The present study was performed on 9,762 participants from the baseline phase of the Ravansar non- communicable diseases (RaNCD) study. Thereafter, the CKD was estimated by glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) equation. All the included participants were categorized into the following four phenotypes: metabolically healthy non-overweight/obesity (MHNO), metabolically unhealthy non-overweight/obesity (MUNO), metabolically healthy overweight/obesity (MHO), and metabolically unhealthy overweight/obesity (MUO). Finally, Logistic regression analysis was used to estimate the odds ratio (ORs). RESULTS: The mean age of the included participants was 47.33 ± 8.27 years old, %48.16 (4,701) of whom were men. As well, 1,058(10.84%) participants had CKD (eGFR less than 60 ml/min/1.73m2). The overweight/obesity was not significantly associated with odds of CKD. The odds of CKD in male subjects with MetS was 1.48 times higher than non-MetS ones (95% CI: 1.10, 2.01). After adjusting the confounders, the odds of CKD were 1.54 times (95% CI: 1.12, 2.11) higher in the MUNO and 2.22 times (95% CI: 1.44, 3.41) higher in the MUO compared to MHNO phenotype in male subjects. The odds of CKD in the MUNO and MUO was 1.31 times (95% CI: 1.10, 1.60) and 1.23 times (95% CI: 1.01, 1.54) higher than MHNO phenotype in female subjects, respectively. CONCLUSION: The odds of CKD were higher in MUNO and MUO phenotypes. Therefore, lifestyle modification is recommended to control normal weight and healthy metabolism.

Healthy eating index 2015 and major dietary patterns in relation to incident hypertension; a prospective cohort study.

BACKGROUND: Since hypertension (HTN) is responsible for more than half of all deaths from cardiovascular disease, it is vital to understand the nutritional factors that reduce its risk. Little information, however, is known about it in the Kurdish population. This study was aimed to evaluate the healthy eating index (HEI) 2015 and major dietary patterns concerning incident HTN. METHODS: This case-cohort study was designed using Ravansar non-communicable diseases (RaNCD) cohort study data (294 participants with incident HTN and 1295 participants as representative random sub-cohort). HEI 2015 and major dietary patterns were extracted using data from their dietary intake, and three major dietary patterns were identified, including plant-based, high protein, and unhealthy dietary patterns. To analyses the association between HEI 2015 and major dietary patterns with incident HTN Cox proportional hazards regression models were applied. RESULTS: There was a significant positive correlation between HEI 2015 and plant-based diet (r = 0.492). The participants in the highest quartile of HEI-2015 had a 39% and 30% lower risk of incident HTN, compared to participants in the first quartile in both crude and adjusted model (HR: 0.61; 95% CI: 0.46-0.82) and (HR: 0.70; 95% CI: 0.51-0.97), respectively. Furthermore, participants with the highest tertile of the plant-based dietary pattern were at lower risk of incident HTN in both crude and adjusted models (HR: 0.69; 95% CI: 0.54-0.9) and (HR: 0.70; 95% CI: 0.53-0.94), respectively. However, the other two identified dietary patterns showed no significant association with incident HTN. CONCLUSIONS: We found evidence indicating higher adherence to HEI 2015 and plant- based diet had protective effects on incident HTN. The HEI 2015 emphasizes limited sodium intake and adequate intake of vegetables and fruits.

Disability-Adjusted Life Years and Mortality Rate Attributed to Brain and Central Nervous System Cancer in the Middle East and North Africa Countries.

BACKGROUND: Primary brain tumors are among the main causes of death. This study aimed to determine the epidemiological features of the brain and central nervous system cancer in the Middle East and North Africa (MENA) region. METHODS: In this study, data of the Global Burden of Disease (GBD) study were used to estimate the incidence, prevalence, deaths, disability-adjusted life years (DALYs), and mortality in 21 countries in the MENA region from 1990 to 2019 based on age and sex. The percentage of the changes of epidemiologic indicators was calculated between 1990 and 2019. RESULTS: Palestine and Turkey had the highest rate of brain and central nervous system cancer in 2019. Saudi Arabia, Oman, Iraq, and Lebanon had the highest percentage of incidence rate changes from 1990 to 2019. The prevalence of brain and central nervous system cancer in the MENA region was increased from 7.51 (95% CI: 4.95-11.01) in 1990 to 16.45 (95% CI: 10.83-19.54) in 2019 (percentage of changes = 54.35%). The standardized age mortality rate in the MENA region was increased by 2.7% in 2019 compared to that in 1990. The rate of standardized age of DALY per 100,000 individuals in the MENA region decreased from 135.09 (95% CI: 92.57-199.92) in 1990 to 128.34 (95% CI: 87.81-151.3) in 2019. CONCLUSION: The incidence rate, prevalence, and standardized age mortality (per 100,000) had increased significantly in the MENA region in 2019 compared to those in 1990. Focusing on the diversity of the estimates of such indices in different countries of MENA can lead to the identification of important risk factors for brain cancer in future studies.

Visceral adiposity index and atherogenic index of plasma as useful predictors of risk of cardiovascular diseases: evidence from a cohort study in Iran.

BACKGROUND: Visceral adiposity index (VAI) and atherogenic index of plasma (AIP) are relatively new indicators for predicting non-communicable diseases (NCDs). Therefore, the present study was done to assess the association of AIP and VAI with risk of cardiovascular diseases (CVDs). METHODS: This cross-sectional study was conducted on 7,362 individuals aged between 35 and 65 years old participated in Ravansar non-communicable diseases (RaNCD) cohort study. AIP was calculated based on levels of triglyceride and high -density lipoprotein cholesterol (HDL-C). VAI was calculated using values of body mass index (BMI), waist circumference (WC), triglyceride, and HDL-C. Logistic regression models were used to assess the association of AIP and VAI with risk of CVDs. RESULTS: Mean values of anthropometric indices, lipid profile, AIP, and VAI were significantly higher in patients with CVDs than individuals without CVDs (P < 0.001). Mean values of anthropometric indices, lipid profile, and NCDs including hypertension, dyslipidemia, diabetes, metabolic syndrome (MetS), and CVDs in the third tertile of AIP and VAI were significantly increased compared to the first tertile (P < 0.001). After adjusting confounding factors, risk of CVDs in the third tertile of AIP was (OR = 1.32, 95 % CI: 1.03, 1.69) significantly increased compared to the first tertile. Risk of CVDs in the third tertile of VAI was (OR = 1.48, 95 % CI: 1.12, 1.97) significantly increased compared to the first tertile. CONCLUSIONS: According to the findings, AIP and VAI were positively associated with risk of CVDs. Therefore, AIP and VAI can be useful in identifying high-risk subgroups of CVDs in general population.

Association of Dietary Inflammatory Index with cardiovascular disease in Kurdish adults: results of a prospective study on Ravansar non-communicable diseases.

BACKGROUND: Various diets and dietary compounds, through their inflammatory properties, are involved in the pathogenesis of chronic diseases including Cardiovascular Diseases (CVDs). Dietary Inflammatory Index (DII) can evaluate the inflammatory properties of diet. The purpose of this study was to determine the association between DII and CVDs in participants of the Ravansar Non-Communicable Diseases (RaNCD) cohort study, Kermanshah, Iran. MATERIALS: The present cross-sectional study was conducted using the recruitment phase data of the RaNCD cohort study on 6369 participants aged 35 to 65 years. The Food Frequency Questionnaire (FFQ) was used to assess diet. The DII scores were calculated using FFQ data. Participants with a history of myocardial infarction, stroke and coronary artery disease, and/or taking medications for the CVDs were considered as the CVDs patients. RESULTS: Of the 6369 studied participants, 9% (n = 579) had CVDs history. The mean DII score in this study was - 0.84 ± 1.6. Odds ratio (OR) of CVDs in women was 1.6 times higher than in men (CI 95% = 1.3-1.9), which this association was remained after adjusting for confounding variables (OR = 1.5, CI% = 1.2-1.9). The risk of CVDs in the fourth quartile of DII was 1.4 times higher than the first quartile of DII (OR: 1.4, CI 95% = 1.1-1.8). We found that higher adhere to DII was associated with risk of CVDs. CONCLUSION: According to current documents, given the role of diet through inflammatory properties on the risk of CVDs, it is recommended to use DII as an appropriate index to measure the effect of diet on CVDs in Iranian population. In addition, a diet with lower DII may be healthier diet for cardiovascular health.