Obesity Indices in relation to Lipid Abnormalities among Medical University Students in Zahedan, South-East of Iran.

BACKGROUND: There is no statement on the ability of obesity indices in prediction of lipid abnormalities among young adults. The present study was conducted to determine the ability of obesity indices as predictors of lipid abnormalities among a group of young adults. MATERIALS AND METHODS: A total of 353 medical university students aged 18-25 years (188 males and 165 females) participated in this cross-sectional study in 2014. Weight, height, waist circumference (WC), and hip circumference were measured to calculate obesity indices including body mass index (BMI), waist-to-hip ratio, and waist-to-height ratio (WHtR). Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured by commercially available kits and were applied to calculate low-density lipoprotein cholesterol (LDL-C) and atherogenic parameters including LDL-C/ HDL-C ratio, TC/HDL-C ratio, non-HDL-C, and atherogenic index of plasma (AIP). RESULTS: Subjects with BMI ≥25 kg/m2 had a greater value of all lipid profiles and atherogenic parameters (P < 0.05) except for HDL-C (P > 0.05) compared to subjects with BMI <25 kg/m2. In logistic regression model, BMI ≥25 kg/m2 was significantly associated with the highest odds for elevated TC (odds ratio [OR] = 7.67, P = 0.003), LDL-C (OR = 3.24, P = 0.01), TC:HDL-C (OR = 4.98, P = 0.01), and non-HDL-C(OR = 4.32, P = 0.001) in males, as well as high values of TG (OR = 8.80, P = 0.002), LDL-C:HDL-C (OR = 3.64, P = 0.01), and AIP (OR = 9.65, P < 0.001) in females. In terms of central obesity indices, males with WC ≥102 cm and females with WC ≥88 cm had the highest odds of increased LDL-C:HDL-C (OR = 6.71, P = 0.01) and TC:HDL-C (OR = 3.25, P = 0.050), respectively. In addition, females with WHtR ≥0.50 had the highest odds of high TC (OR = 3.56, P = 0.02) and non-HDL-C (OR = 2.70, P = 0.02). CONCLUSIONS: Overall, the findings of the present study showed that BMI was a stronger index for prediction of classical lipid parameters and atherogenic parameters than central obesity indices in medical students.

Frequency of overweight/obesity among a group of children with celiac disease in Iran.

INTRODUCTION: A small number of overweight and obese children with celiac disease (CD) has been reported. AIM: To estimate the prevalence of obesity, underweight and normal weight in a group of Iranian pediatric patients. MATERIAL AND METHODS: In a retrospective study from 2007 to 2015, 225 children less than 18 years old with biopsy-proven CD were enrolled. Data collected included demographic characteristics, clinical presentation, antibody titers and severity of small-bowel mucosal damage. Body mass index (BMI) profile of subjects was calculated based on the age and gender percentile at presentation. RESULTS: The mean ± standard deviation (SD) for age was 7.4 ±3.8 and 62% of patients were female. Fifty-four percent of patients presented with a normal BMI, 43% were underweight, and the remaining patients (3.5%) were overweight/obese. The mean age of underweight and normal weight patients was higher than that of obese/overweight patients. Mean ± SD of TTG titer was higher in overweight/obese and normal weight children compared to underweight subjects. The majority of patients (195/225) had severe enteropathy compatible with Marsh III on duodenal biopsy. Most of the children had gastrointestinal (GI) and extra-intestinal manifestations on presentation. There was no association between severity of histological disease and BMI for age. Five out of eight cases in the obese/overweight group had an index case with CD in their family. CONCLUSIONS: This study highlights the importance of considering celiac disease in children regardless of their BMI. Failure to diagnose CD in children leads to unnecessary diagnostic delays and long-term adverse health consequences.

Dietary habits and obesity indices in patients with gastro-esophageal reflux disease: a comparative cross-sectional study.

BACKGROUND: Gastro-esophageal reflux disease (GERD) is suggested to be associated with some socio-demographic and lifestyle factors. Although the roles of some factors such as obesity are well documented, evidence on the impact of other factors such as dietary habits are still inconclusive. The aim of this study was to determine the relationship between socio-demographic and lifestyle factors with GERD in participants referred to a teaching hospital in Zahedan, South-East of Iran. METHODS: This comparative cross-sectional study was conducted during 2014-2015. All patients completed a structured questionnaire regarding information on socio-demographic status, lifestyle factors and dietary habits. Anthropometric indices including body mass index (BMI) and waist circumference (WC) were used to determine general and central obesity, respectively. Data were analyzed using SPSS software version 22. Value of p < 0.05 was considered as statistically significant. RESULTS: Five hundred and five participants, including 285 GERD and 220 Non-GERD participants participated in the study. In univariate analysis, being married (OR = 1.57, 95%CI = 1.04, 2.36), general obesity (OR = 1.77, 95%CI = 1.11, 2.81), central obesity (OR = 2.09, 95%CI = 1.46,3.01) and consumption of citrus fruits between meals (OR = 1.69, 95%CI = 1.04, 2.73) were associated with higher odds of GERD, while higher educational level (OR = 0.53, 95%CI = 0.36,0.77) and regular physical activity ≥2 h/week (OR = 0.53, 95%CI = 0.30, 0.94) were associated with lower odds of GERD. In the adjusted model, central obesity (OR = 1.88, 95%CI = 1.18, 3.01) and consumption of citrus fruits between meals (OR = 2.22, 95%CI = 1.30, 3.81) were positively associated with odds of GERD, while higher educational level (OR = 0.55, 95%CI = 0.33, 0.91) was associated with decreased odds of GERD. CONCLUSION: According to the results of the current study, central obesity as determined by WC and citrus fruit intake were independent factors associated with GERD. Therefore, lifestyle modification might have a positive effect in the treatment of GERD in an urban population of Iran.

Association of Helicobacter pylori infection with metabolic parameters and dietary habits among medical undergraduate students in southeastern of Iran.

BACKGROUND: To date, there is still inconclusive evidence on the extra-gastric manifestations of Helicobacter pylori (H.pylori) infection. This study aimed to determine whether there is an association between H.pylori infection with metabolic syndrome and dietary habits among medical undergraduate students in south-eastern of Iran, Zahedan. MATERIALS AND METHODS: This cross-sectional study was done among 363 undergraduate students in Zahedan University of Medical Sciences during spring 2014. All subjects completed a questionnaire including demographic factors and dietary habits. Serum H. pylori-specific IgG antibodies, total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), and fasting blood sugar (FBS) levels were measured after an overnight fast. RESULTS: The seroprevalence of H. pylori infection was 45.7%. H. pylori-positive subjects had lower mean levels of TC and TG and higher levels of HDL-C compared to H. pylori-negative subjects. In addition, lower levels of LDL-C (P = 0.044) and FBS (P = 0.05) were observed among subjects with positive H pylori infection. Only rare consumption of raw vegetables (odds ratio [OR] =3.74, 95% confidence interval [CI] =1.37-5.24) as well as higher levels of FBS (OR = 1.031, 95% CI = 1.001-1.99) were significantly associated with higher odds of H. pylori infection in both the univariate and multiple logistic regression analysis. CONCLUSION: In a small population of young students in southeastern of Iran, H. pylori infection was associated with low consumption of raw vegetables and higher serum blood glucose.

Clinical Spectrum of Celiac Disease in Children in Sistan and Baluchestan Province.

BACKGROUND: The clinical manifestations of celiac disease (CD) have changed in the past decades. There are currently little data describing the initial clinical manifestations of CD in children in Iran. This study describes the initial presentation of children with suspected CD from a geographically defined region in Iran. METHOD: Medical records of children seen in 2007 - 2015 from Sistan and Baluchestan province, Iran, with suspected CD were reviewed. After obtaining TTG-IgA and IgA, subjects were divided into three groups according to presenting symptoms: GI, non-GI, and asymptomatic group. Those with elevated TTG-IgA or a strong clinical suspicion for CD underwent endoscopy with duodenal biopsy. Demographic data, symptoms, laboratory, histopathology findings and the presence of any CD related conditions were recorded. RESULTS: from 344 children who underwent upper endoscopy and intestinal biopsy, 105 cases with marsh 0 - 1 were excluded from the study and 239 cases considered as a definite celiac disease (Mean± SD of age was 6.8 ± 3.9 years with 145 females). GI symptoms were predominant in the younger age groups while non-GI symptoms were more common in the older children. The most frequent GI and Non-GI symptoms were abdominal pain (41.4%), distension (36.4%), diarrhea (32.2%), under nutrition (51.4%), anemia (36.4%), and decreased bone age (35%).  The most common co-morbidities were hypothyroidism (3.7%) and Type 1 diabetes (2.9%). CONCLUSION: GI complaints in Iranian children are a common feature. Screening of children with suspected CD, especially with GI symptom is highly recommended.

Prevalence of celiac disease in first-degree relative of children in Sistan and Baluchestan province (Iran).

OBJECTIVE: To determine the prevalence of elevated antibodies and histological changes of celiac disease (CD) on intestinal biopsies among first-degree relatives (FDR) of Iranian children with known CD and to describe the characteristics of the affected FDR. METHOD: The FDR of 119 patients with CD in Iran were tested for tissue transglutaminase (TTG) and immunoglobulin A (IgA) levels. Upper endoscopy and duodenal biopsy were recommended to those with elevated TTG-IgA antibodies. The characteristics and clinical features of all CD patients were recorded. RESULTS: Altogether 480 FDR (52.7% females) participated in the study, of whom 63 had an elevated TTG-IgA and 44 consented to undergo endoscopy with biopsies. Histology revealed Marsh 0 in six, Marsh I in seven, Marsh II in four and Marsh III in 27. Most of those with Marsh II or III changes were siblings (26/31). The prevalence of TTG-IgA positivity among FDR was 13.1% and for biopsy-confirmed CD (Marsh II and III) it was 6.5%. Most FDR with CD had symptoms, with the most common being abdominal pain (45.0%), followed by musculoskeletal pain (35.5%) and constipation (25.8%). FDR with Marsh III changes had significantly higher levels of TTG-IgA. CONCLUSIONS: The prevalence of CD in FDR in Iran is much higher compared with the general population (6.5% vs 0.5-0.6%). Testing should be considered for all FDR of Iranian patients with known CD and in particular in symptomatic cases.

Correlation of Body Mass Index and Physical Activity Among 7- to 11-Year Children at Zahedan, Iran.

BACKGROUND: Childhood obesity is currently one of the major concerns in pediatric field. In recent literature, correlation of obesity with some behavioral factors such as physical activity (PA) received attention. OBJECTIVE: The purpose of this study was to determine the relationship between body mass index (BMI) and PA. MATERIALS AND METHODS: This cross-sectional study was carried out in 2012 on 548 randomly selected 7- to 11-year schoolchildren from Zahedan, Iran. The underweight, normal weight, overweight, and obesity status were all based on BMI percentiles for age and sex. Moderate to vigorous PA during the previous 7 days was assessed by a modified version of the Physical Activity Questionnaire for Children. RESULTS: The prevalence of underweight, normal weight, overweight, and obesity among the participants was 18.3%, 47.9%, 11.8%, and 22.1%, respectively. Overweight and obesity were significantly higher among girls than boys. Mean PA score in participants was 2.4 ± 0.5. The results showed the PA score was significantly higher among boys than girls. The PA score had a significant association with BMI ( P = .018), and it was greater in normal participants than in obese participants. CONCLUSION: On the basis of observed data and due to the impact of PA on BMI as an indicator of nutritional status and health, teaching children to have better nutrition and lifestyle changes is very important. Therefore, more studies should focus on childhood obesity prevention programs to prevent nonoverweight children from becoming overweight or obese in the future.

Food pattern, lifestyle and diabetes mellitus.

BACKGROUND: Prevalence of Type 2 diabetes is increasing rapidly worldwide. Recent data is reprehensive of increasing diabetes prevalence from 285 millions in 2010 (6.4%) to 439 millions in 2030 in adults aged 20 to 79 in different countries. Lifestyle and particularly dietary habits play an important role in the development of diabetes. Additionally, specific individual food groups and diet components such as monounsaturated fatty acids, fruits, vegetables, whole grain cereals, dietary fiber, fish, magnesium and nuts may protect against the development of diabetes, possibly through the amelioration of insulin sensitivity and its anti-inflammatory actions, while consumption of red and processed meats and saturated fat may increase the risk of type 2 diabetes. OBJECTIVES: In this section, we studied dietary and other factors related to the effect of lifestyle in type 2 diabetes. These factors may affect the incidence of type 2 diabetes which could be corrected by lifestyle modifications. RESULTS: Unfortunately, dietary habits in the developed and developing countries are changing towards an unhealthier direction. Consequently, emphasis should be given on encouraging at population and individual levels for adopting a healthier lifestyle, including dietary habits, to prevent the development of type 2 diabetes. Here we reviewed epidemiologic and clinical trial evidence regarding nutrients, foods and dietary patterns to diabetes risk and involved possible mechanisms. CONCLUSIONS: Type 2 diabetes is increasingly growing in young population of developing countries, which causes a large burden on individuals and the society.

Association between body mass index and caries frequency among zahedan elementary school children.

BACKGROUND: A balanced nutrition schedule provides the essential substances for proper oral health. OBJECTIVES: The aim of this study was to investigate the association between dental caries and body mass index in 6-11 year-old children in Zahedan. MATERIALS AND METHODS: In this cross-sectional study 1213 children (670 girls, 543 boys) were included. Body mass index (BMI) and clinical examination for determination of DFT (decay filling teeth) index (based on WHO criteria) were taken. Collected data were analyzed using the t-test, chi-square and ANOVA. RESULTS: Among children, 20.8% had low weight, 66.3% normal weight, 7.8% were overweight and 5.1% obese. In the low weight, normal weight, overweight, and obese groups, the mean ± SD values for DFT were: 0.63 ± 1.1, 0.88 ± 1.36, 1.16 ± 1.33, and 0.87 ± 1.31, respectively. There was a significant association between BMI and DFT (P = 0.005). The overweight group had higher DFT compared to the low and normal weight groups. 13.5% of low weight, 12.2% of normal weight, 14.7% of overweight and 22.6% of obese children had DFT = 0. There was no statistical association between BMI and being caries free (P = 0.4). CONCLUSIONS: The mean DFT in the overweight group was higher than low and normal weight groups. There was a statistically significant association between BMI and DFT.

Prevalence of occult celiac disease in healthy Iranian school age children.

BACKGROUND:   Several studies have shown the prevalence of celiac disease (CD) to be around 1% in Iran, which is similar to the worldwide prevalence. There is scant information on occult CD in apparently healthy school age children. This study, as the first such study in Iran, aims to determine the prevalence of occult CD in healthy Iranian school age children. METHODS: In this cross-sectional study, we screened healthy school age children for CD by serum IgA and IgA anti-tissue transglutaminase antibody (tTG) levels. Measurement of these antibodies was by enzyme linked immunosorbent assay. A recheck of positive tTG tests was performed and patients who tested positive underwent endoscopic duodenal biopsies. The biopsy samples were scored according to the Marsh classification by an experienced pathologist. RESULTS: A total of 634 children (314 males, 320 females; mean age: 12.8 years) were included in the study. All children and/or their parents completed a questionnaire and children underwent an initial physical examination to determine study eligibility. Positive serum tTG was noted in 3 (0.5%; 2 females) out of 634 patients. Duodenal biopsies were consistent with CD in these 3 subjects. The mean age of patients with CD was 14.3 years (range: 12-17 years). The female to male ratio was 2:1. These cases had no signs and symptoms, but a gluten-free diet was recommended according to pathologic changes in their small bowels and results of the tTG test. CONCLUSION: The prevalence of occult CD in these children is 0.5%, which is half of the prevalence of CD in Iranian adults. The anti-tTG concentration at initial serological CD screening is highly informative in determining occult cases of CD. The question is whether all non-symptomatic cases should be treated with a gluten-free diet or not.

Which modifiable, non-modifiable, and socioeconomic factors have more effect on cardiovascular risk factors in overweight and obese women?

BACKGROUND: The aim of the present study was to assess which modifiable, non-modifiable, and socioeconomic factors are good predictors for cardiovascular risk in overweight and obese Iranian women. MATERIALS AND METHODS: This clinical cross-sectional study was conducted on 811 overweight and obese women of age 20-60 years in Islamic Republic of Iran. In this study, the dependent variables were fasting blood sugar (FBS) and lipid profile, and the independent variables were educational level, waist to hip ratio (WHR), body mass index (BMI), waist circumference (WC), age, fasting glycemia, and diabetes. RESULTS: Univariate analysis showed that the significant factors associated with FBS were age, BMI, education, and WHR, but the effect of age was more than that of others. For total cholesterol (TC), only glycemia had a significant effect [P = 0.004, odds ratio (OR) 1.9 vs. others independent variables' ORs]. Having diabetes, BMI ≥30 kg/m(2), and education ≤12 years were the significant factors associated with triglyceride (TG), but the effect of diabetes was more than that of others (OR: 2.7, 2.2, and 1.9 for diabetes, BMI, and education, respectively). The effect of age was more than that of other independent factors on low density lipoprotein-cholesterol (LDL-C). There was not any significant association between independent variables and high density lipoprotein-cholesterol (HDL-C) in multiple logistic regression models. CONCLUSION: Based on the obtained results, in clinic, for overweight and obese women, age, glycemia, and having diabetes can be considered as predictors for FBS, and LDL-C, TC, and TG, respectively.

Microscopic Enteritis; clinical features and correlations with symptoms.

AIM: To assess the clinical characteristic of CD as well as correlation of symptoms and the degrees of intestinal mucosal lesions in Iranian children. BACKGROUND: Microscopic Enteritis (Marsh 0-II) is associated with malabsorption. PATIENTS AND METHODS: From August 2005 to September 2009, 111 cases with malabsorption and classical gastrointestinal symptoms were evaluated. RESULTS: The mean (±SD) age of children with CD was 4.9±3.5 years (range, 6 month - 16 years) and the mean duration of symptoms was 8 ± 20.5 months. 50 cases (45%) were female and 61 cases (55%) were male. The most common clinical presentation was failure to thrive in 72%, chronic diarrhea in 65.8% and Iron deficiency anemia in 59.5%. Sensitivity of EMA was 100% in patients with Marsh IIIb and Marsh IIIc. EMA was also positive in 77% of cases with Marsh 0, 18% in Marsh I, 44% in Marsh II and 81.8% in patients with Marsh IIIa. CONCLUSION: Histopathology did not reflect the severity of gluten sensitivity. This would suggest that the degree of intestinal mucosal damage might not be a reliable prognostic factor. Significant symptoms can be present with minor histological change on biopsy.

Central obesity and coronary heart disease risk factors in referral outpatients to zahedan cardiology clinic, iran.

BACKGROUND: Coronary Heart Disease (CHD) is one of the most common and life-threatening diseases in both developed and developing countries and a close correlation has been found between different types of obesity and CHD. OBJECTIVES: The current study investigated the relationship between central obesity and coronary heart disease risk factors in CHD referral outpatients to Khatam Clinic, Zahedan, Iran. PATIENTS AND METHODS: In this clinical, cross-sectional study, data for 120 CHD patients aged 30-60 years were included. Based on waist-to-hip ratio (WHR), subjects were classified into two groups: not centrally obese (NCO; WHR ≤ 0.95 for men, ≤ 0.8 for women) and centrally obese (CO; WHR > 0.95 and > 0.8 for men and women, respectively). Triglyceride (TG), total cholesterol (TC), blood urea nitrogen, creatinine, and fasting blood sugar (FBS) were enzymatically determined. Sitting systolic and diastolic blood pressures were measured for each patient. RESULTS: Significantly more women than men and significantly more subjects with less education than subjects with more education were CO. Rates of CO were higher in subjects 45-60 years old than in those 30-45 years old (n.s.). CO subjects also had higher mean systolic and diastolic blood pressure, TG, and creatinine levels (n.s.). Significantly higher mean values were observed for FBS in CO subjects than in NCO subjects (P = 0.02). Mean values for smoking were significantly higher in the NCO group compared with the CO group (P = 0.004). CONCLUSIONS: According to the results of this study, in CHD patients, central obesity was associated with certain risk factors, especially FBS. Central obesity was more evident in women, less educated subjects, and older subjects. Further research is required to clarify these associations.

Which Life Style Anthropometric Index is a Better Predictor of Renal Function?

BACKGROUND: Obesity is a risk factor that has been associated scientifically with hypertension, diabetes, hyperlipidemia, cancer and other life threatening diseases. The results of some studies have also shown that obesity is an independent risk factor for the development and progression of renal damage. OBJECTIVES: The aim of the current study is to define which general and central obesity anthropometric indices are better predictors for ceratinine clearance (CC) in healthy, normal and obese Iranian women. PATIENTS AND METHODS: In this case-controlled study, a total of 62 healthy, normal and obese women from 18 to 30 years of age in Zahedan City, the Islamic Republic of Iran, were studied. The subjects were classified into two groups; case group (31 subjects) of healthy obese women (30 ≤ BMI ≤ 39.9 kg/m(2)) and control group (31 subjects) of healthy normal women (18.5 ≤ BMI ≤ 24.9 kg/m(2)). An assessment of body mass index (BMI) was considered as a general obesity index and an assessment of waist circumference (WC) and waist to hip ratio (WHR) were considered as central obesity indices. A measurement of CC was considered for renal function. RESULTS: The means of CC in subjects with increased BMI, WC, and WHR were significantly higher than those in subjects with normal BMI, WC, and WHR. Pearson correlation coefficient revealed that there was a stronger correlation between CC with WC than with WHR and BMI (r = 0.4, P = 0.009; r = 0.4, P = 0.01 in the case and control groups, respectively). CONCLUSIONS: It is suggested that in clinical practice, WC can be used as a better predictor of CC than WHR and BMI in both normal and obese, healthy women.

Underweight and overweight among children in Zahedan, south-east Iran.

OBJECTIVE: The present study examined the prevalence of underweight and overweight in a group of primary-school children in Zahedan, south-east Iran. DESIGN: A cross-sectional study in a randomly selected population of schoolchildren. SETTING: Primary-school children in Zahedan city. SUBJECTS: A random sample of 1079 students (boys = 500 and girls = 579). Data on child's age, parental educational levels, body weight and height were collected. RESULTS: The rate of overweight/obesity among boys and girls was 8.9 % and 10.3 %, respectively; and of underweight among boys and girls was 22.8 % and 19.9 %, respectively. Prevalence of overweight increased as the boys and girls approached adolescence and it was more prevalent among girls than boys. Prevalence of overweight was directly related to maternal education in this population. CONCLUSIONS: High prevalence of underweight in young children as well as increase in the prevalence of overweight in girls and boys near adolescence are of concern. Early poor growth and subsequent rapid weight gain near to adolescent stage is related to adulthood obesity.

Determination of hepatitis C genotypes and the viral titer distribution in children and adolescents with major thalassemia.

OBJECTIVE: Hepatitis C virus (HCV) is an etiological agent responsible for occurrence of post-transfusion hepatitis in thalassemic patients. This study identified hepatitis C genotypes in pediatric and adolescent thalassemic patients and their correlation with age, blood transfusion, HCV RNA viral titer and liver function. METHODS: This study considers cross-sectional data from the Center for Thalassemia in Zahedan (Iran) carried out between August 2005 and September 2007. Twenty multitransfused patients suffering from ß-thalassemia major and chronic HCV infection (13 males, 7 females) were included in the study. Patients were considered eligible for the study if they were seropositive for HCV RNA polymerase chain reaction (PCR) before initiation of evaluation. Blood sample was taken for HCV genotype and viral titer as well as biochemical markers. Type specific primer and real-time RT-PCR HCV were used for determination of viral genotype and HCV-RNA titer. FINDINGS: There was a significant positive correlation between serum HCV RNA titer and genotypes (P<0001). Serum HCV RNA levels were found higher in genotype 3a than in others. The most prevalent genotype in thalassemic patients was genotype 3a (40%) followed by 1b (25%), unclassified (20%) and la (15%). There was no meaningful relationship between genotype, Alanine aminotranferease, ferritin and alkaline phosphatase. Age, serum HCV RNA titer and number of transfusions were the only significant factors associated with genotypes (P<015, P<0.0001 and P<0.001 respectively). CONCLUSION: This study showed that HCV genotype and viral titer are related to the number of blood transfusions received by thalassemic patients. Screening donated blood in blood banks would prevent the occurrence of hepatitis C in this high-risk group.

Determination of the leading central obesity index among cardiovascular risk factors in Iranian women.

BACKGROUND: It is unknown whether the waist circumference (WC) or the waist-to-hip ratio (WHR) is a better predictor of cardiovascular risk factors at different ages. OBJECTIVE: To compare WC and WHR as predictors of cardiovascular risk factors and to determine the prevalence of some cardiovascular risk factors in overweight and obese adult women at different ages. METHODS: In this clinical cross-sectional study, 714 overweight and obese women aged 20 to 70 years who were referred to two nutrition clinics in Sistan and Baluchestan province, Islamic Republic of Iran, were studied. The subjects were classified into three groups, 20 to < 35, 35 to < 50, and > or = 50 years of age. Anthropometric indices were measured according to the standard protocol. Total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and TC/HDL-C ratios were enzymatically determined. RESULTS: Older subjects (> or = 50 years old) had significantly higher values of body mass index (BMI), WC, TC, TG, and LDL-C than those in the two younger age classes. The prevalence rates of obesity, high WC, high WHR, high TC, high TG, high LDL-C, and high TC/ HDL-C ratios were higher in the older subjects. After adjustment for age and BMI, multiple linear regression showed that WC was significantly related to TC and TG in the 20- to < 35-year-old group and to TG in the 35- to < 50-year-old group. In the older participants, WHR was significantly related to TG. CONCLUSIONS: The prevalence of cardiovascular risk factors increases with age. In clinical practice, WC is a better index for predicting some cardiovascular risk factors in younger and middle-aged women; however, for older women, WHR is better.

The effects of socio-economic status on BMI, waist:hip ratio and waist circumference in a group of Iranian women.

OBJECTIVE: To assess the effects of socio-economic status (SES) on BMI, waist:hip ratio (WHR) and waist circumference (WC) in a group of Iranian women. METHODS: A cross-sectional study was conducted on 888 women in Sistan and Baluchestan Province. SES was measured using level of education. In addition, parity, marital status and physical activity were assessed. Standardized measurements were taken, BMI and WHR were calculated. RESULTS: Low education level was a strong determinant of overweight and obesity among Iranian women. After controlling for age, women with higher education level had significantly lower BMI, WC and parity. Multiple linear regression analysis found a significant negative association of BMI and WC with education level and a significant positive association of BMI and WC with parity. Significant factors associated with obesity by a logistic regression model were education level (OR for university graduates v. illiterate or low literacy levels: 1.00 v. 3.70; P = 0.01), living with spouse (OR for married v. single subjects: 1.00 v. 0.15; P = 0.05), parity (OR for more than five v. less than two pregnancies: 1.00 v. 0.34; P = 0.03) and WC (OR for < 0.88 cm v. > or = 0.88 cm: 1.00 v. 11.20; P = 0.001). CONCLUSION: The present study revealed that educational level, multiple pregnancies, marital status and lack of exercise are some possible explanations for the obesity among Sistan and Baluchestan women.