The effect of data balancing approaches on the prediction of metabolic syndrome using non-invasive parameters based on random forest.

BACKGROUND: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities (including obesity, insulin resistance, hypertension, and dyslipidemia), which can be used to identify at-risk populations for diabetes and cardiovascular diseases, the main causes of morbidity and mortality worldwide. The achievement of a simple approach for diagnosing MetS without needing biochemical tests is so valuable. The present study aimed to predict MetS using non-invasive features based on a successful random forest learning algorithm. Also, to deal with the problem of data imbalance that naturally exists in this type of data, the effect of two different data balancing approaches, including the Synthetic Minority Over-sampling Technique (SMOTE) and Random Splitting data balancing (SplitBal), on model performance is investigated. RESULTS: The most important determinant for MetS prediction was waist circumference. Applying a random forest learning algorithm to imbalanced data, the trained models reach 86.9% and 79.4% accuracies and 37.1% and 38.2% sensitivities in men and women, respectively. However, by applying the SplitBal data balancing technique, the best results were obtained, and despite that the accuracy of the trained models decreased by 7.8% and 11.3%, but their sensitivity improved significantly to 82.3% and 73.7% in men and women, respectively. CONCLUSIONS: The random forest learning method, along with data balancing techniques, especially SplitBal, could create MetS prediction models with promising results that can be applied as a useful prognostic tool in health screening programs.

Metabolic syndrome prediction using non-invasive and dietary parameters based on a support vector machine.

BACKGROUND AND AIMS: Metabolic syndrome (MetS) is a widely used index for finding people at risk for chronic diseases, including cardiovascular disease and diabetes. Early detection of MetS is especially important in prevention programs. Relying on previous studies that suggest machine learning methods as a valuable approach for diagnosing MetS, this study aimed to develop MetS prediction models based on support vector machine (SVM) algorithms, applying non-invasive and low-cost (NI&LC), and also dietary parameters. METHODS AND RESULTS: This population-based research was conducted on a large dataset of 4596 participants within the framework of the Shahedieh cohort study. An Extremely Randomized Trees Classifier was used to select the most effective features among NI&LC and dietary data. The prediction models were developed based on SVM algorithms, and their performance was assessed by accuracy, sensitivity, specificity, positive prediction value, negative prediction value, f1-score, and receiver operating characteristic curve. MetS was diagnosed in 14% of men and 22% of women. Among NI&LC features, waist circumference, body mass index, waist-to-height ratio, waist-to-hip ratio, systolic blood pressure, and diastolic blood pressure were the most predictive variables. By using NI&LC features, models with 78.4% and 63.5% accuracy and 81.2% and 75.3% sensitivity were yielded for men and women, respectively. By incorporating NI&LC and dietary features, the accuracy of the model in women improved by 3.7%. CONCLUSIONS: SVM algorithms had promising potential for early detection of MetS relying on NI&LC parameters. These models can be used in prevention programs, clinical practice, and personal applications.

Evaluating Neck Circumference as an Independent Predictor of Metabolic Syndrome and Its Components Among Adults: A Population-Based Study.

Background Metabolic syndrome (MetS), a public health problem worldwide, represents a high-risk condition for cardiovascular disease and diabetes. The reserve of subcutaneous fat in the upper torso is an important factor in the development of MetS and its risk factors. As neck circumference (NC) is a simple and reliable index that indicates upper-body subcutaneous fat accumulation, this study was conducted to investigate the association between NC with MetS and its components in a large population-based sample of Iranian adults. Methods The present cross-sectional study was conducted among 2094 individuals aged 20-70 years from Yazd Health Study (YaHS). MetS was defined based on the National Cholesterol Education Program Adult Treatment Panel III (ATP III) criteria. NC more than 40.25 cm for men and more than 35.75 cm for women was considered a high-risk NC. Logistic regression analysis was applied to obtain the associations of NC with MetS and its component. Results After adjusting for age, BMI, energy intake, physical activity, and smoking in those whose NC was higher than normal, the risk of the MetS (odds ratio {OR}: 2.32; 95%CI: 1.55-3.46, P<0.001 in men and OR: 2.56; 95%CI: 1.76-3.74, P<0.001 in women), abdominal obesity (OR: 4.39; 95%CI: 2.67-7.23, P<0.001 in men and OR: 1.92; 95%CI: 1.27-2.90, P=0.002 in women), high blood pressure (OR: 1.54; 95%CI: 1.07-2.21, P=0.02 in men and OR: 1.51; 95%CI: 1.06-2.14, P=0.02 in women), low high-density lipoprotein cholesterol (HDL-C) (OR: 1.47; 95%CI: 1.01-2.15, P=0.04 in men and OR: 1.69; 95%CI: 1.23-2.32, P=0.001 in women), and hypertriglyceridemia (OR: 1.41; 95%CI: 1.03-1.99, P=0.04 in men and OR: 1.68; 95%CI: 1.17-2.41, P=0.005 in women) were higher. There was no significant difference in the risk of hyperglycemia between the two NC groups in both sexes. The Pearson's correlation coefficients of NC with waist circumference, hip circumference, body mass index, and waist-to-height ratio were 0.52, 0.43, 0.41, and 0.31, respectively (P<0.001). Moreover, NC had a considerable correlation with serum triglyceride, high-density lipoprotein, systolic blood pressure, and diastolic blood pressure (0.27, -0.30, 0.29, 0.25, P<0.001), respectively. Conclusion Increased NC was significantly associated with higher odds of MetS and its components. Since NC measurement is simple, inexpensive, reliable, and less invasive, it can be used as a complementary tool in the screening and diagnosis of MetS and its risk factors in clinical and community programs especially in developing countries.

Effect of Cornus mas L. fruit extract on blood pressure, anthropometric and body composition indices in patients with non-alcoholic fatty liver disease: A double-blind randomized controlled trial.

BACKGROUND & AIMS: Obesity is linked to the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Patients with NAFLD are at increased risk for hypertension. Some investigations have hypothesized that Cornus mas L. fruit can improve obesity and hypertension. We investigated the effect of C. mas L. fruit extract on blood pressure, anthropometric and body composition indices in patients with NAFLD. METHODS: This 12-week double-blind randomized controlled trial was conducted on fifty patients with NAFLD. Patients received 20 cc/d C. mas L. fruit extract or placebo. We measured diastolic blood pressure (DBP), systolic blood pressure (SBP), weight, waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), body fat mass (BFM), body fat percent (BFP) and fat free mass (FFM) before and after intervention. RESULTS: Treatment group compared to control group showed a significant reduction in DBP (-8.62 ± 11.86 mmHg vs. 0.53 ± 8.53 mmHg; Pcrude = 0.003; Padjucted = 0.03) and SBP (-8.63 ± 14.37 mmHg vs. 0.0 ± 12.67 mmHg; Pcrude = 0.02; Padjucted = 0.02). We found no difference between groups in weight, WC, HC, WHR, BFM, BFP and FFM (P > 0.05). After adjusting for confounding factors, a significant reduction was observed in treatment group compared to control group in BFM (-0.2 ± 3.9 kg vs. 0.7 ± 2.4 kg; P = 0.01) and BFP (-0.2 ± 4.9% vs. 0.8 ± 2.8%; P = 0.02). CONCLUSIONS: C. mas L. fruit extract statistically reduced blood pressure and body fat. However, it had no effect on other anthropometric and body composition indices. Studies with larger sample sizes and higher dosages of extract are needed. TRIAL REGISTRATION: Registered on 30/9/2018 at Iranian Registry of Clinical Trials IRCT20180419039359N1 (https://www.irct.ir/trial/30707).

Empirically derived dietary patterns and postpartum depression symptoms in a large sample of Iranian women.

BACKGROUND: Postpartum Depression (PPD) is a major depressive disorder that mainly begins within one month after delivery. The present study aimed to determine the relationship between dietary patterns and the occurrence of high PPD symptoms in women participating in the initial phase of the Maternal and Child Health cohort study, Yazd, Iran. METHODS: This cross-sectional study was carried out in the years 2017-2019 included 1028 women after childbirth The Food Frequency Questionnaire (FFQ) and the Edinburgh Postnatal Depression Scale (EPDS) were study tools. The EPDS questionnaire was used to measure postpartum depression symptoms and a cut-off score of 13 was considered to indicate high PPD symptoms. The baseline data related to dietary intake was collected at the beginning of the study at the first visit after pregnancy diagnosis and the data related to depression, were collected in the second month after delivery. Dietary patterns were extracted by exploratory factor analysis (EFA). Frequency (percentage) and mean (SD) were used for description. Chi-square test, Fisher's exact test, independent sample t-test, and multiple logistic regression (MLR) were used for data analysis. RESULTS: The incidence of high PPD symptoms was 24%. Four posterior patterns were extracted including prudent pattern, sweet and dessert pattern, junk food pattern and western pattern. A high adherence to the western pattern was associated with a higher risk of high PPD symptoms than a low adherence (ORT3/T1: 2.67; p < 0.001). A high adherence to the Prudent pattern was associated with a lower risk of high PPD symptoms than a low adherence (ORT3/T1: 0.55; p = 0.001). There are not any significant association between sweet and dessert and junk food patterns and high PPD symptoms risk (p > 0.05). CONCLUSION: High adherence to prudent patterns was characterized by high intake of vegetables, fruit and juice, nuts and beans, low-fat dairy products, liquid oil, olive, eggs, fish, whole grains had a protective effect against high PPD symptoms, but the effect of western pattern was characterized by high intake of red and processed meats and organs was reverse. Therefore, it is suggested that health care providers have a particular emphasis on the healthy food patterns such as the prudent pattern.

Study Protocol for the Interactions between Dietary Patterns and ARL15 and ADIPOQ Genes Polymorphisms on Cardiometabolic Risk Factors.

Background: Cardiovascular diseases (CVDs) are recognized as one of the leading causes of death worldwide. Studies have shown the impact of genetic predisposition and dietary factors on developing these diseases. Dietary patterns and genetic factors such as polymorphisms related to the level of adiponectin may also interact with each other and produce variances in the effects of these factors on different individuals. The purpose of this study is to investigate the interactions between food intake patterns and polymorphisms on ADIPOQ and ARL15 genes in relation to cardiometabolic risk factors. Methods: This cross-sectional study is conducted on 380 adults (20 to 70 years old) living in Yazd, Iran. Individuals were selected from the participants in Yazd Health Study (YaHS) and its sub-study called Taghziyeh Mardom-e Yazd (TAMYZ) after reviewing the inclusion and exclusion criteria. YaHS is a population-based cohort study which has been conducted on 9962 adults living in Yazd since 2014. In the present study, rotated principle component analysis (PCA) with Varimax rotation is used to identify the major dietary patterns. The polymerase chain reaction-restricted fragment length polymorphism (PCR-RFLP) method is used in order to identify rs1501299 and rs6450176 variants (on ADIPOQ and ARL15 genes, respectively). General linear models (GLM) as well as regression models are used to investigate the interactions between the studied genotypes and the extracted dietary patterns. Conclusions: The results of this study can help to personalize dietary recommendations for the prevention of CVDs according to the genetic predisposition of individuals.

Effect of dietary approaches to stop hypertension, and standard diets with and without curcumin on interleukin-1 alpha, 5-alpha reductase gene expressions, and androgenic and glycemic profile in polycystic ovary syndrome women undergoing in vitro fertilization treatment: A study protocol.

Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases with major reproductive and metabolic complications with an impact on public health. Hyperandrogenism and chronic inflammation have been suggested as the leading cause of pathophysiology and clinical manifestations associated with PCOS. It seems that the altered expression of genes involved in the synthesis of pro-inflammatory cytokine and androgens contribute to the promotion of PCOS. Objective: This trial aims to determine the effects of dietary approaches to stop hypertension (DASH) and standard diets with and without curcumin supplementation on the gene expression of interleukin -1 alpha(IL1α), 5α reductase and androgenic and glycemic profile among PCOS patients, who are candidates for in vitro fertilization. Materials and Methods: 96 infertile women with PCOS, aged 18-40 yr, will participate in this randomized, placebo-controlled clinical trial. Based on treatment conditions and body mass index, the participants will be randomly divided into 4 equal groups using a randomized block design. They will receive a DASH or standard diet containing 52% carbohydrate, 18% protein, and 30% total fat, with the same prescribed sodium, plus 500 mg twice daily curcumin or placebo for 12 wk. The mRNA expression of IL-1α, 5α reductase, and androgenic and glycemic profiles will be measured at baseline and at the end of the study. Conclusion: Concomitant administration of DASH diet and curcumin supplementation may reduce IL-1α, 5α reductase gene expressions, and improve glycemic and androgenic profiles.

Effect of probiotic yogurt consumption on glycemic control and lipid profile in patients with type 2 diabetes mellitus: A randomized controlled trial.

BACKGROUND & AIMS: Type 2 diabetes mellitus (T2DM) is a common endocrine disease. Altered gut microbiota (Dysbiosis) is closely associated with development of T2DM. Growing body of evidence hypothesized that probiotics intake may be useful for patients with T2DM. We investigated the effect of probiotic yogurt consumption on glycemic control and lipid profile in patients with T2DM. METHODS: In this 12-week randomized controlled clinical trial, seventy-two patients with T2DM were randomly assigned to the intervention group (IG) that received 200 g/d probiotic yogurt containing 4.65 × 106 CFU/g Lactobacillus acidophilus and Bifidobacterium lactis) or placebo group (PG) that received 200 g/d conventional yogurt. RESULTS: We found no difference between two groups in fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-c) and low density lipoprotein-cholesterol (LDL-c) after intervention. After adjusting for baseline values of covariate, a significant reduction in HbA1c (mean change: -0.76 ± 1.3 vs. -0.15 ± 1.3; P = 0.01), TC (mean change: -10.61 ± 27.8 vs. -2.97 ± 35.0; P = 0.02) and LDL-c (mean change: -8.62 ± 21.7 vs. 0.02 ± 25.8; P = 0.004) was observed in the IG compared to the PG. In addition, a non-significant trend to reduction was observed in term of FPG (mean change: -19.61 ± 29.1 vs. -4.19 ± 24.2; P = 0.13). TG and HDL-c remained unchanged. CONCLUSIONS: Probiotic yogurt consumption may be useful for patients with T2DM. More well-designed clinical trials with longer intervention duration are required. Registered on 30 July 2022 at Iranian Registry of Clinical Trials (IRCT20220226054125N1) with URL: https://www.irct.ir/trial/62304.

The cluster of differentiation 36 (CD36) rs1761667 polymorphism interacts with dietary patterns to affect cardiometabolic risk factors and metabolic syndrome risk in apparently healthy individuals.

Several studies have examined the association between CD36 rs1761667 polymorphism with cardiometabolic risk factors and metabolic syndrome (MetS). This study aimed to investigate the interactions between rs1761667 polymorphism and dietary patterns on the cardiometabolic risk factors and the risk of MetS in apparently healthy individuals aged 20-70 years. Food consumption data were acquired using a validated semi-quantitative FFQ. Dietary patterns were identified by factor analysis. CD36 rs1761667 was genotyped by PCR-restriction fragment length polymorphism. The gene-diet interaction was detected by the general linear model or logistic regression. Significant or marginally significant interactions were observed between healthy dietary pattern (HDP) and CD36 rs1761667 on weight (P = 0·006), BMI (P = 0·009), waist circumference (P = 0·005), hip circumference (P = 0·06), body muscle percentage (P = 0·02), body fat percentage (P = 0·09), TAG-glucose index (P = 0·057), atherogenic index of plasma (P = 0·07), the risk of MetS (P = 0·02), risk of abdominal obesity (P = 0·02) and elevated blood pressure (P = 0·07). Besides, a gene-diet interaction was detected between the traditional dietary pattern and rs1761667 variants on odds of hypertriglyceridaemia (P = 0·02). The adherence to HDP was associated with a lower weight, BMI and higher odds of HDL-cholesterol only in A-allele carriers. In conclusion, adherence to HDP (a diet with high fibre, fish and dairy products) can be more effective on some cardiometabolic risk factors and risk of MetS components in the A-allele carrier than the GG genotype of rs1761667 polymorphism. However, future studies are required to shed light on this issue.

Does anthocyanins consumption affect weight and body composition? A systematic review and meta-analysis of randomized controlled trials.

Background and Aims: Anthocyanins (ACNs) are water-soluble plant pigments belong to flavonoids with beneficial effects on health and disease prevention. Some studies have examined the effect of ACNs on anthropometric and body composition indices, but the findings were inconsistent. This systematic review and meta-analysis aimed to investigate the effect of ACNs and sources rich in anthocyanins on body mass index (BMI), body weight (BW), waist circumference (WC), hip circumference (HC), waist-hip ratio (WHR), percentage of fat mass (PFM) and fat free mass (FFM). Methods: PubMed, Web of Science, Scopus, and Google Scholar were searched with no limitation until May 2021 to find relevant randomized controlled clinical trials (RCT). The risk of bias was assessed utilizing Cochrane collaboration's tool. Weighted mean differences (WMD) and 95% confidence intervals (CIs) were obtained using a random effects model. Results: A total of 31 RCTs (with 0.77-640 mg/day of ACNs supplementation for 28-90 days) with 1438 participants were included. No significant effect was found in BMI, WC, HC, WHR, PFM and FFM after ACNs consumption. Conclusions: The results showed that ACNs did not significantly affect anthropometric and body composition parameters. Further high-quality RCTs are required to validate these findings.

Association of Dietary Acid Load With Metabolic Syndrome and Its Components in Iranian Adults: A Cross-Sectional Study.

Introduction Metabolic syndrome (MetS) remains one of the leading health challenges worldwide. A combination of genetic and environmental factors has been implicated in the etiology of MetS. Diet is a changeable environmental risk factor, and dietary modifications could significantly reduce the incidence and mortality of numerous diseases, including MetS. Certain dietary factors may contribute to MetS by affecting the acid-base balance within the body. This study examined the association of dietary acid load (DAL) with MetS and its components in Iranian adults. Materials and methods This cross-sectional study was conducted in 2022 on 6356 Iranian adults aged 35-70 years. Potential renal acid load (PRAL) and net endogenous acid production (NEAP) as two indicators of DAL were calculated based on nutrient intake data from validated food frequency questionnaires. MetS and its components were defined according to the Adult Treatment Panel III criteria. Logistic regression analysis was used to explore the associations between DAL and MetS and its components. Age, energy intake, physical activity, education, marital status, home ownership, socioeconomic status, history of obesity-related disease, and calcium supplements were included in model I. Further adjustment in model II was made for body mass index. Results Higher NEAP scores were associated with increased odds of low high-density lipoprotein cholesterol (HDL-C) in the crude model (OR: 1.26, 95% CI: 1.01-2.56, p trend = 0.06) in women, which was confirmed in the adjusted models. In model I, women in the last quintile of NEAP had 54% greater odds of having hypertriglyceridemia compared to the first quintile (OR: 1.54, 95% CI: 1.007-2.36, p trend = 0.02). This association was still significant and even stronger after further adjustment for BMI (OR: 1.55, 95% CI: 1.01-2.40, p trend = 0.01). In addition, in model I, men in the fourth quintile of NEAP had 5.68-fold greater odds of hyperglycemia compared to the first quintile (OR: 5.68, 95% CI: 1.18-27.25, p trend = 0.11). Similar results were found in the fully adjusted model (OR: 5.89, 95% CI: 1.19-28.99, p trend = 0.54). Conclusion There was no significant association between DAL and MetS. DAL was positively associated with the odds of low HDL-C and hypertriglyceridemia in women. Moreover, moderate DAL (NEAP) was associated with an increased odds of hyperglycemia in men.

Meat consumption and the risk of general and central obesity: the Shahedieh study.

OBJECTIVE: This study aimed to investigate the relations of total meat intake and its subtypes, including red and processed meat, white meat, poultry, fish, and organ meat to the risk of general/central obesity. METHODS: This cross-sectional study included a total of 7312 Iranian adults with the age range of 35-70 years from the Shahedieh cohort study, Yazd, Iran. Dietary intake of subjects was evaluated using a validated 120-item Food Frequency Questionnaire. General obesity was defined as body mass index ≥ 30 kg/m2 and central obesity as waist circumference ≥ 102 cm in men and ≥ 88 cm in women. RESULTS: After controlling for potential covariates including energy intake, age, marital status, gender, physical activity, supplement use, house possession, education, family size, current smoking, night shift working, history of thyroid disease and depression, and intakes of vegetables, legumes, nuts, fruits, whole grains, and dairy, a significant direct association was found between the higher consumption of white meat (OR = 1.31; 95% CI: 1.06-1.61) and poultry (OR = 1.23; 95% CI: 1.04-1.45) with odds of general obesity. Processed meat was a significant predictor for central obesity in the fully adjusted model, so that individuals in the fourth quartile of processed meat intake, compared with those in the first quartile, had a 22% (OR = 1.22; 95% CI: 1.04-1.43) increased risk to be centrally obese. CONCLUSION: This study reveals that higher intakes of white meat and poultry are associated with increased risk of general obesity, while, processed meat consumption was associated with central obesity.

A systematic review of randomized controlled trials related to the effects of garlic supplementation on platelet aggregation.

The increment of platelet aggregation factors has been considered a key phenomenon in atherosclerosis. Studies have shown that garlic (Allium sativum) is associated with a reduction in platelet aggregation and thrombosis. Hence, the present systematic review was conducted to evaluate the effect of garlic on platelet aggregation. All randomized controlled trials (RCTs) with keywords related to garlic and platelet aggregation were thoroughly searched in electronic databases including PubMed, Scopus, ISI Web of Science, and Google Scholar up to January 2021. Moreover, the references of all related articles were screened to discover more relevant studies. The quality of each study was reported based on Cochrane Collaboration's tool. In total, 12 studies met the inclusion criteria from 18,235 identified articles (including 595 participants). Most of the studies assessed platelet aggregation in response to different inducers. Of the 12 clinical trials, six studies depicted the beneficial effect of garlic on reducing platelet aggregation. The summary of the quality assessment indicated that most of the studies had high-quality scores. Regarding the small number of RCTs and heterogeneity between studies, it is impossible to make a proper conclusion about the impacts of garlic on platelet aggregation. Therefore, further precise trials with a standard design are necessary to validate the anti-thrombotic effect of garlic.

Dietary habits are associated with the prevalence of type 2 diabetes: a study among a middle eastern population.

Worldwide type 2 diabetes (T2D) prevalence is increasing dramatically. The present study aimed to evaluate the association between dietary habits and T2D in an Iranian adult population using a cross-sectional analysis of the Shahedieh cohort study. Participants were adults aged 35-70 years (n 9261) from Zarch and Shahedieh, Yazd, Iran, who attended the baseline phase of the Shahedieh cohort study. Dietary habits including meal frequency, fried-food consumption, adding salt to prepared meals and grilled-food consumption were assessed by a standard questionnaire. T2D was defined as fasting plasma glucose (FPG) ≥126 mg/dl according to the American Diabetes Association. Multiple logistic regression assessed the association between dietary habits and T2D. Individuals who consumed a meal more than six times per day compared to three times per day had greater odds for T2D (OR 2⋅503, 95 % CI 1⋅651, 3⋅793). These associations remained significant in a fully adjusted model. There was a significant association between greater intakes of fried foods and prevalence of T2D (OR 1⋅294, 95 % CI 1⋅004, 1⋅668) in the adjusted model. No significant associations were observed between other dietary habits (adding salt to prepared meals and grilled-food consumption) and odds of T2D in all crude and adjusted models. In conclusion, we have highlighted the association between meal and fried-food consumption frequencies with risk of T2D. Large longitudinal studies in different ethnicities are needed to confirm these associations.

Effect of L-carnitine supplementation on lipid accumulation product and cardiovascular indices in women with overweight/obesity who have knee osteoarthritis: a randomized controlled trial.

BACKGROUND: Osteoarthritis is associated with obesity, dyslipidemia and cardiovascular diseases. It has been hypothesized that L-carnitine can improve cardiovascular risk factors. We aimed to investigate the effect of L-carnitine supplementation on lipid accumulation product (LAP) and atherogenic indices in women with overweight/obesity who have knee osteoarthritis. METHODS: In this double-blind randomized controlled trial, seventy-six women with overweight/obesity who had knee osteoarthritis were assigned into the intervention group and control group for 12 weeks. The intervention group received 1000 mg/day L-carnitine as capsule, and the control group received placebo. The primary outcomes were LAP, atherogenic index of plasma (AIP), atherogenic coefficient (AC) and Castelli risk index II (CRI-II). RESULTS: We found no significant difference between the groups in baseline values of LAP, AIP, AC and CRI-II. After the intervention, a significant reduction in LAP was observed in intervention group compared to the control group (- 11.05 (- 28.24 to 0.40) vs. - 5.82 (- 24.44 to 2.68); P = 0.03). However, there was no significant difference between two groups in AIP (- 0.05 ± 0.16 vs. - 0.01 ± 0.13; P = 0.19), AC (- 0.40 ± 0.81 vs. - 0.30 ± 0.67; P = 0.67) and CRI-II (- 0.20 ± 0.76 vs. - 0.21 ± 0.47; P = 0.11). CONCLUSIONS: L-carnitine supplementation for 12 weeks can improve LAP, but it has no effect on cardiovascular outcomes. To reach a definitive conclusion, further clinical trials with larger sample sizes and higher dosages of L-carnitine are needed. TRIAL REGISTRATION: Registered on 27/4/2017 at Iranian Registry of Clinical Trials IRCT2017011932026N2.

Dietary phytochemical consumption is inversely associated with liver alkaline phosphatase in Middle Eastern adults.

BACKGROUND: The hepatoprotective effects of phytochemicals are controversial. A dietary phytochemical index (DPI) has been suggested as an alternative method for quantifying the phytochemical content of foods. AIM: To assess the DPI in relation to liver function tests among a representative sample of Iranian adults. METHODS: A total of 5111 participants aged 35-70 years old were included in this cross-sectional study by a multistage cluster random sampling method. Dietary intakes were collected by a validated and reliable food frequency questionnaire with 121 items. DPI was calculated by the percent of daily energy intake taken from phytochemical-rich foods. Fasting serum concentrations of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and gamma glutamyl transferase (GGT) were determined. Linear regression was used to investigate the association between DPI and levels of liver enzymes using crude and adjusted models. RESULTS: There was an inverse association between DPI score and serum ALP in the crude model (ß = -0.05; P < 0.001). This association remained significant after adjustment for body mass index, age, smoking, energy intake, history of diabetes, and education (ß = -0.03; P = 0.01). No significant associations were found between DPI score and serum levels of AST, ALT, and GGT. The individuals with the highest DPI scores consumed significantly higher amounts of fruits, vegetables, legumes, nuts, and cereals, yet were shown to have significantly higher serum total cholesterol and low-density lipoprotein cholesterol, as well as several other metabolic abnormalities. CONCLUSION: Higher adherence to phytochemical-rich foods was associated with lower levels of ALP, but no change in other liver enzymes. Those with higher DPI scores also consumed food items associated with a healthier overall dietary pattern; however, they also presented several unexpected metabolic derangements. Additional randomised trials are needed to better determine the effects of phytochemical-rich foods on liver function.

Effect of resveratrol supplementation on hepatic steatosis and cardiovascular indices in overweight subjects with type 2 diabetes: a double-blind, randomized controlled trial.

BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) are prone to develop non-alcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVD). We aimed to investigate whether the resveratrol supplementation improves novel hepatic and cardiovascular indices in these patients. METHODS: We conducted a double-blind, randomized controlled trial for 8 weeks. Seventy-six patients with T2DM were randomly assigned to receive 1000 mg/day resveratrol or placebo. Levels of lipid accumulation product (LAP), visceral adiposity index (VAI), Castelli risk index I (CRI-I), CRI-II and atherogenic coefficient (AC) were measured at the beginning and after intervention. RESULTS: A total of 71 participants completed the trial. After adjusting for confounding factors including medications, diabetes duration, energy intake and physical activity, no significant difference was found between the intervention group and the control group in LAP (mean change: - 2.46 ± 23.3 vs. 1.43 ± 14.3; P = 0.43), VAI (mean change: - 0.25 ± 1.1 vs. - 0.02 ± 0.6; P = 0.47), CRI-I (mean change: - 0.25 ± 0.9 vs. - 0.09 ± 0.5; P = 0.79), CRI-II (mean change: - 0.23 ± 0.7 vs. - 0.06 ± 0.6; P = 0.38) and AC (mean change: - 0.25 ± 0.9 vs. - 0.09 ± 0.5; P = 0.79). CONCLUSIONS: Resveratrol supplementation had no effect on hepatic steatosis and cardiovascular indices. Further clinical trials, especially among subjects with dyslipidemia are needed to reach a firm conclusion. In addition, taking all medications should be controlled in future studies. Trial registration The protocol was registered on 29/12/2017 at the Iranian clinical trials website (IRCT20171118037528N1) with URL: https://en.irct.ir/trial/27734 .

A systematic review and meta-analysis on the association between CD36 rs1761667 polymorphism and cardiometabolic risk factors in adults.

The cluster of differentiation 36 (CD36) is one of the main receptors implicated in the pathogenesis of the cardiovascular disease. This study aimed to assess the association between CD36 rs1761667 polymorphism and cardiometabolic risk factors including body mass index (BMI), waist circumference (WC), total cholesterol (TC), triglyceride, HDL-C, LDL-C, blood pressure and fasting blood glucose (FBG). PubMed, EMBASE, Scopus, web of science, and Google Scholar were searched up to December 2021. Subgroup and meta-regression analyses were conducted to explore sources of heterogeneity. Eighteen eligible studies (6317 participants) were included in the study. In the overall analysis, a significant association was found between rs1761667 polymorphism of CD36 and TG in allelic (p < 0.001), recessive (p = 0.001) and homozygous (p = 0.006) models. A relationship between this polymorphism and HDL-C and FBG level was observed in the recessive genetic model. In the subgroup analysis, the A allele was associated with impaired lipid profiles (TC, LDL-C and HDL-C) in the Asian population. The influences of health status, design of the study, confounders, and other sources of heterogeneity should be considered when interpreting present findings. Cohort studies with large sample size and in different ethnicities are needed to confirm the relationship between rs1761667 SNP and cardiometabolic risk factors.

Effect of Cornus mas L. fruit extract on lipid accumulation product and cardiovascular indices in patients with non-alcoholic fatty liver disease: A double-blind randomized controlled trial.

BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) is associated with high risk of cardiovascular diseases. The experimental studies have suggested that Cornus mas L. (cornelian cherry) fruit can improve cardiovascular risk factors. We designed a study to investigate the effect of cornelian cherry fruit extract on cardiovascular outcomes in patients with NAFLD. METHODS: We conducted a double-blind, randomized controlled trial. Fifty patients with NAFLD were randomly assigned into the treatment and the control groups. The treatment group received 20 cc/d cornelian cherry fruit extract as liquid form and the control group received 20 cc/d placebo for 12 weeks. The primary outcomes included lipid accumulation product (LAP), atherogenic index of plasma (AIP), Castelli risk index I (CRI-I), CRI-II and atherogenic coefficient (AC). RESULTS: At the baseline, there was no significant difference between two groups in values of LAP, AIP, CRI-I, CRI-II and AC. After the intervention, no significant change was found in the treatment group compared to the control group in LAP (-0.64 (-6.25 to 8.29) vs. 0.0 (-8.66 to 19.01); P = 0.91), AIP (0.0 ± 0.08 vs. 0.0 ± 0.1; P = 0.84), CRI-I (-0.18 ± 0.63 vs. -0.31 ± 0.49; P = 0.42), CRI-II (-0.23 ± 0.56 vs. -0.15 ± 0.32; P = 0.52) and AC (-0.18 ± 0.63 vs. -0.31 ± 0.49; P = 0.42). CONCLUSION: Cornelian cherry fruit extract has no effect on cardiovascular outcomes. Further studies with longer intervention durations are needed. TRIAL REGISTRATION: Registered on 30 September 2018 at Iranian Registry of Clinical Trials (IRCT20180419039359N1).

Curcumin and zinc co-supplementation along with a loss-weight diet can improve lipid profiles in subjects with prediabetes: a multi-arm, parallel-group, randomized, double-blind placebo-controlled phase 2 clinical trial.

BACKGROUND: Diabetes is one of the major public health concerns. Prediabetes can increase the risk of developing some non-communicable diseases such as type 2 diabetes. Given the increasing trend of prediabetes, it is critical to control it and prevent its complications. Curcumin is a major bioactive component of turmeric. Zinc is an antioxidant nutrient. The present trial aimed to evaluate the effect of curcumin and zinc co-supplementation along with a loss-weight diet on serum lipid profiles in overweight or obese patients with prediabetes. METHODS: Eighty-four participants were randomized to four groups (curcumin (500 mg/day), zinc (30 mg/day), "curcumin and zinc", and placebo) for 90 days. Serum total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG), non-HDL, HDL/LDL ratio, weight, BMI, waist circumstance (WC), hip circumstance (HC), physical activity (PA) and dietary intake were determined pre and post-intervention. This study will be conducted at Yazd Diabetes Research Clinic, Shahid Sadoughi University of Medical Sciences. RESULTS: Totally, 82 participants were included in the final analysis. After the adjusted PA effect, changes in serum TG (adjusted p = 0.001), LDL (adjusted p = 0.035), non-HDL (adjusted p = 0.003), HDL/LDL ratio (adjusted p = 0.002), and HDL (adjusted p < 0.0001) revealed a significant difference between the groups. However, the changes in weight (adjusted p = 0.004) and BMI (adjusted p = 0.006) were significant but the changes in dietary intake, PA, WC, and HC were non-significant (adjusted p ≥ 0.05). Despite that there was a significant difference for post-intervention HDL levels (adjusted p = 0.016), other lipid profiles showed no significant difference (adjusted p ≥ 0.05). CONCLUSION: The beneficial effects of "curcumin and zinc" co-supplementation was reported for the changes of some lipid profiles (TG, LDL, HDL, non-HDL, and HDL to LDL ratio), BMI, and weight with no positive effects on TC, dietary intake, PA, WC, and HC. Therefore, it may play a potential role in the prevention of macro and microvascular complications. Trial registration The project is a registered clinical trial (Registration number: IRCT20190902044671N1, Iranian Registry of Clinical Trials (IRCT), registered October 11, 2019.