Assessment of the appropriate cutoff points for anthropometric indices and their relationship with cardio-metabolic indices to predict the risk of metabolic associated fatty liver disease.

BACKGROUND: Research on Metabolic Associated Fatty Liver Disease (MAFLD) is still in its early stages, with few studies available to identify and predict effective indicators of this disease. On the other hand, early diagnosis and intervention are crucial to reduce the burden of MAFLD. Therefore, the aim of this research was to investigate the effectiveness of eleven anthropometric indices and their appropriate cut-off values as a non-invasive method to predict and diagnose MAFLD in the Iranian population. METHODS: In this cross-sectional study, we analyzed baseline data from the Hoveyzeh Cohort Study, a prospective population-based study conducted in Iran that enrolled a total of 7836 subjects aged 35 to 70 years from May 2016 through August 2018. RESULTS: The optimal cut-off values of anthropometric indices for predicting MAFLD risk were determined for waist circumference(WC) (102.25 cm for males and 101.45 cm for females), body mass index (BMI) (27.80 kg/m2 for males and 28.75 kg/m2 for females), waist-to-hip ratio (WHR) (0.96 for both males and females), waist-to-height ratio (WHtR) (0.56 for males and 0.63 for females), body adiposity index (BAI) (23.24 for males and 32.97 for females), visceral adiposity index (VAI) (1.64 for males and 1.88 for females), weight-adjusted waist index (WWI) (10.63 for males and 11.71 for females), conicity index (CI) (1.29 for males and 1.36 for females), body roundness index (BRI) (4.52 for males and 6.45 for females), relative fat mass (RFM) (28.18 for males and 44.91 for females) and abdominal volume index (AVI) (18.85 for males and for 21.37 females). VAI in males (sensitivity: 77%, specificity: 60%, Youden's Index: 0.37) and RFM in females (sensitivity: 76%, specificity: 59%, Youden's Index: 0.35) were found to have higher sensitivity and specificity compared to other anthropometric indices. Furthermore, anthropometric indices demonstrated statistically significant correlations with various hepatic and cardiometabolic indices. Among these, the strongest positive correlations were observed between WC, BMI, BAI, BRI, and AVI with the Hepatic Steatosis Index (HSI), TyG-BMI, and TyG-WC, as well as between VAI and the Atherogenic Index of Plasma (AIP), Lipid Accumulation Product (LAP), Cardiometabolic Index (CMI), and the Triglyceride and Glucose (TyG) Index. CONCLUSION: Anthropometric indices are effective in predicting MAFLD risk among Iranian adults, with WWI, VAI, and RFM identified as the strongest predictors. The proposed cutoff values could serve as a straightforward and non-invasive methods for the early diagnosis of MAFLD.

Mental health status in healthcare workers during COVID-19 pandemic: An online questionnaire study in the southwest Iran.

OBJECTIVES: This study aimed to evaluate Mental Health Status, such as stress, anxiety, or depression symptoms, during the Covid-19 pandemic in healthcare workers at Ahvaz Jundishapur University of Medical Sciences. METHODS: This study is an online cross-sectional study conducted on healthcare professionals at Ahvaz Jundishapur University of Medical Science from November 25, 2020, to March 30 2021. PHQ9 and Kessler collected outcome variables of depression, anxiety, and psychological distress questionnaires. RESULTS: In total, 2552 healthcare workers in 24 hospitals and 212 Comprehensive health centers were enrolled in this study. The mean age of participants was 37.94 ± 8.07 years, and 25.3% were male. There was a significant difference between the mean Kessler and PHQ9 Scale scores on males and females (P< 0.001). Also, the results showed a significant difference between depression, anxiety, and stress and working in the intensive care unit. According to the result of the Kessler scale, 27% of participants had moderate to severe. Most respondents (65.5%) in all professions had moderate to severe mental distress scores according to the Kessler scale. The logistic regression model results illustrated the relationship between depression and anxiety with gender, workplace, support from families, and collogue job satisfaction, and feeling the stress of media coverage of COVID-19 were statistically significant (P< 0.05). CONCLUSIONS: The present study revealed that medical and health workers suffer from mental health problems. In this study, up to one-fifth of medical staff had stress, anxiety, or depression symptoms, and more than half had psychological distress. Low educational level, lack of family support, lack of colleague's support, and being a female were the significant risk factors for stress, anxiety, and psychological distress in medical staff.

Association between Age at Menarche and Metabolic Syndrome in Southwest Iran: A Population-Based Case-Control Study.

BACKGROUND: Age at menarche affects women's health outcomes and could be a risk factor for some diseases, such as metabolic syndrome (MetS). We assessed the association between age at menarche and MetS components in women aged 35-70 in Hoveyzeh, southwest Iran. STUDY DESIGN: A case-control study. METHODS: This case-control study was conducted on 5830 women aged 35-70 years in the Hoveyzeh cohort study (HCS), a part of the PERSIAN cohort study, from 2016-2018. The case group included women with MetS, while the controls were women without MetS. The MetS is determined based on standard NCEP-ATP III criteria. Data from demographic, socioeconomic, and reproductive history were gathered face-to-face through trained interviews. Moreover, laboratory, anthropometrics, and blood pressure measurements were assayed for participants. Multiple logistic regression was used to estimate the association between age at menarche and MetS, with adjustment for potential confounding variables. RESULTS: The mean age at menarche was 12.60 ± 1.76 years old. Urban and rural women differed in age at menarche (12.58 ± 1.71 and 12.63 ± 1.83 years, respectively). The study revealed a statistically significant relationship between MetS and menarche age. The odds of developing MetS were 14% higher in women with menstrual age ≤ 11 years than in other groups. CONCLUSION: As evidenced by the results of this study, the odds of having MetS were higher in women whose menarche age was ≤ 11 years. Furthermore, the association between MetS components and age groups at menarche was statistically significant.

Cohort profile: The Hoveyzeh Cohort Study (HCS): A prospective population-based study on non-communicable diseases in an Arab community of Southwest Iran.

Background: The Hoveyzeh cohort study (HCS) is a population-based cohort study that conducted in Hoveyzeh County (South-west Iran). HCS focus on common chronic diseases, disorders and risk factors of NCDs in the Arab ethnicity. Methods: A total number of 10009 participants (35-70 years old) were recruited in this prospective cohort study from May 2016 to August 2018. The HCS data were gathered by trained interviewer through interviewer-administered questionnaires. Also anthropometric measurements, physical examinations, clinical assessments, ophthalmology evaluation, auditory examinations, respiratory and cardiovascular assessments was conducted by means of standard instruments. Biological samples including blood, urine, hair, and nail collected and stored in the biobank. Results: The overall participation rate was 82.7%. The prevalence of obesity was 27.4% in males and 47% in females. Cigarette smoking prevalence was 20.9% (40.6 % in men and 7.6 % in women). Prevalence of major non communicable diseases such as diabetes, hypertension, metabolic syndrome, cardiac ischemic, myocardial infarction and stroke was 22.2%, 26.4% 31.9 %, 13.6%, 1.85% and 1.6% respectively. Conclusion: Considering the high prevalence of obesity and smoking in the population of Hoveyzeh and since the important role of these risk factors in development of common non communicable diseases, this issue should be taken into consideration and the necessary interventions in this context must be considered to modify lifestyle. The HCS is the only comprehensive cohort in the region, enabling it to provide valuable evidence about NCDs for a wide geographical area covering millions of people in both Iran and Iraq.

Socioeconomic gradient in physical activity: findings from the PERSIAN cohort study.

BACKGROUND: The level of socioeconomic-related inequality in physical activity in Iran is largely unknown. This study investigates socioeconomic-related inequality in poor-physical activity (PPA) among Iranian adults. METHODS: A total of 129,257 adult participants enrolled in the PERSIAN (Prospective Epidemiological Research Studies in IrAN) Cohort were included in this study. Physical activity of adults was measured using metabolic equivalent rates (METs). Physical activity less than 41 METs/hour/day was considered PPA. The Concentration index (C) was used to quantify socioeconomic-related inequality in PPA. Moreover, the C was decomposed to identify the relative contribution of explanatory variables to inequality in PPA. RESULTS: There were significant regional variations in physical activity level among Iranian adults (29.8-76.5%). The positive value of C (0.098, 95% CI = 0.092 to 0.104) suggested that the higher concentration of PPA among higher socioeconomic status (SES) adults in Iran which was consistently observed in all cohort sites. CONCLUSIONS: The higher prevalence of PPA among Iranian adults, especially, women and older adults, warrant further public health attention. Since PPA is concentrated more among the high-SES population in Iran, strategies for the promotion of physical activity should focus more on economically well-off population.

Prevalence and Correlated Factors for Obesity, Overweight and Central Obesity in Southwest of Iran.

BACKGROUND: We assessed the prevalence of obesity, overweight, central obesity and their associated risk factors in an urban population in Ahvaz, southwest of Iran. METHODS: This population-based cross-sectional study was performed via random cluster sampling method in 6 health centers in Iran in 2015. A questionnaire was completed by each individual. RESULTS: Of 2575 participants, 1187 (46%) were men. Nearly 50% of the participants' level of education was high school or higher. About 82% of the population was married and about one-third had positive family history of parental obesity. The total prevalence of obesity, overweight, and central obesity were 26.5%, 38.7%, and 28.6%, respectively. The rate of obesity in men was lower than in women (P<0.001). The prevalence of obesity increased until the age of 60 yr in both genders and decreased thereafter except for central obesity in women, which increased without any lag. Low level of education, marriage, positive history of parental obesity and parity ≥five were associated with increased odds of obesity (OR=2.14(1.52, 3.00), OR=2.4(1.75, 2.99), OR=2.7(1.71, 3.2) and 4.16(2.17, 7.65), respectively). CONCLUSION: Obesity and overweight have a high prevalence in southwest of the country, increasing with age. Although several risk factors are associated with obesity, the prevalence of obesity and overweight can be reduced by controlling the risk factors in the community.

Analyzing the long-term survival of the patients undergoing peritoneal dialysis in the peritoneal dialysis center in Shiraz, 2002-2011.

One of the advantages of peritoneal dialysis (PD) compared to hemodialysis is it can be performed at home. The present study aims at determining the long-term survival of patients and technique survival and investigates the risk factors affecting the mortality rate in PD patients. The study was conducted on 290 patients undergoing PD in the main PD center in Shiraz, Iran, between April 2002 and March 2012. The patients' survival rate and the factors affecting their survival were assessed using the Kaplan-Meier method. Besides, log-rank method was used to compare survival among different levels of the categorized variables. Cox regression model was used for introducing the risk factors affecting the patients' survival. The mean of the patients' survival at the end of the follow-up period was 15.42 ± 13.97 months. The patients' 1-, 2-, 3-, and 5-year survival rates were 85%, 72%, 57%, and 22%, respectively, and the median survival time was 11.64 months. Forty-three patients (14.8%) changed their treatment method to hemodialysis. The patients' 1-, 2-, 3-, and 5-year technique survival rates were 90%, 81%, 72%, and 47%, respectively. Age and hemoglobin level were the most significant factors in the patients' survival. Hemoglobin level was the most important factor in technique survival.