Relationship between Lifestyle and Frailty among Iranian Community-Dwelling Older Adults: Pilot Study.

Background: Aging affects physical, mental, and social functions, which can lead to an increase in frailty. Old adults with frailty syndrome are prone to disabilities and hospitalization. Lifestyle is a context-based factor that has the potential to prevent frailty. Objectives: This study aimed to assess the relationship between lifestyle and frailty among Iranian community-dwelling older adults. Design Setting: This is a descriptive-analytical cross-sectional study. The participants were 513 older adults over 60 years by the convenience sampling method from the retirement center. Measurements: Data were collected using Tilberg's frailty index, the Iranian elderly lifestyle questionnaire, and the Mini-Cog test. Data were analyzed with SPSS v.26 software by chi-square and logistic regression tests. Results: The age of the participants was 66.43 ± 4.69 years. The male-to-female sex ratio was 1.5 (39.2% women). The lifestyle of 96 (19.3%) old adults was unfavorable. 18.7 percent of older adults had Frailty syndrome. The logistic regression test showed that moderate and favorable lifestyle (OR= 0.06; 95% CI: 0.02-0.16), age over 75 years (OR= 5.25; 95% CI: 2.35-11.69), retired employment status (OR= 0.13; 95% CI: 0.29-0.05) are factors that have a significant relationship with frailty (P< 0.05). Conclusion: The findings showed that lifestyle can predict frailty. Therefore, it seems that an optimal lifestyle can prevent the frailty of older adults.

The Modified Hospital Elder Life Program (HELP) in geriatric hospitalized patients in internal wards: A double-blind randomized control trial.

BACKGROUND: Hospital Elder Life Program (HELP) provides protocols based on factors for reducing delirium. Due to the lack of geriatric wards and aged care teams in Iran, it seems that some of the original HELP interventions need to be modified through a trial study. Hence, this study was conducted to determine whether the Iranian modified HELP could reduce delirium in geriatric hospitalized patients. METHODS: This double-blind randomized controlled trial was designed and conducted in a hospital at Kashan University of Medical Sciences in Iran. A total of 195 hospitalized patients aged ≥70 years, were 84 in the Intervention Group (IG) and 111 in the Control Group (CG). After assessing delirium risk factors, participants in the IG group received interventions based on the cognitive, vision/hearing, sleep, mobility, feeding, and hydration protocols by nursing students and the CG group received routine care. Delirium incidence was assessed by the Confusion Assessment Method. Delirium incidence, cognitive and functional abilities, frailty, fall, and length of stay were outcomes. RESULTS: The mean age of the patients was 78.53(Standard Deviation = 5.87) years. Delirium incidence was higher in the CG comparing to IG (14.71% vs 3.66%).Significant reduction observed in risk incidence of delirium because of interventions [Odds Ratio:0.124, Confidence Interval: 0.03-0.48]. CONCLUSION: The modified HELP effectively reduced delirium rates in geriatric hospitalized patients. TRIAL REGISTRATION: This study was registered at the Iranian Registry of Clinical Trials IRCT20180910040995N1 .

Efficient Coverage Path Planning for Mobile Disinfecting Robots Using Graph-Based Representation of Environment.

The effective disinfection of hospitals is paramount in lowering the COVID-19 transmission risk to both patients and medical personnel. Autonomous mobile robots can perform the surface disinfection task in a timely and cost-effective manner, while preventing the direct contact of disinfecting agents with humans. This paper proposes an end-to-end coverage path planning technique that generates a continuous and uninterrupted collision-free path for a mobile robot to cover an area of interest. The aim of this work is to decrease the disinfection task completion time and cost by finding an optimal coverage path using a new graph-based representation of the environment. The results are compared with other existing state-of-the-art coverage path planning approaches. It is shown that the proposed approach generates a path with shorter total travelled distance (fewer number of overlaps) and smaller number of turns.

Comparison effectiveness of acute coronary syndrome treatments on geriatric function.

OBJECTIVES: The study objectives were to compare short time complications, mortality, and effectiveness of primary Percutaneous Coronary Intervention (PCI) with optimal medical therapy in older adults with acute coronary syndromes (ACS). METHODS: A prospective cohort study, which patients 60 years old and over with ACS were collecting by face to face interview and assessment of the electronic document, in two educational hospitals of Tehran medical university from May 2018 to Jan. 2019. Patients were evaluated in two groups (primary PCI and medical) in terms of complications, mortality and effectiveness, 24hours and 30 days after treatment. Initially, 312 patients were enrolled in the study that 192 were excluded for different reasons. In the final, 120 patients have met all inclusion criteria. RESULTS: One hundred and twenty patients were collected with mean age 71.2±8.2 years old. In both groups every 1 point increase in Instrumental Activity Daily Living (IADL), the Major Adverse Cardiac Effect (MACE) was significantly reduced up to 88% (P=0.007). Short-term mortality was significantly higher in the optimal medical therapy group (P=0.006). In comparison complications 24hours between two groups, atrial fibrillation was significantly higher in the medical group which risk increased 11 times (OR=10.93, CI95%=1.38-87.04, P=0.02). CONCLUSIONS: Notwithstanding, primary PCI reduced poor outcomes, and improve quality of life, but a lesser option for older adult patients. Primary PCI in older adult patients could maintain independence in functional daily living that results in reduced mortality and MACE considerably.

Effects of metabolic syndrome on bone health in older adults: the Bushehr Elderly Health (BEH) program.

Based on the clinical, BMD, and TBS data of 2380 participants aged ≥ 60 which was gathered during the BEH program, stage II, we showed that MetS was positively associated with BMD, while a negative or no association was observed between MetS and TBS depending on the sex and the adjustment model. INTRODUCTION: The results of previous reports in regard to the effect of metabolic syndrome (MetS) on bone health are not conclusive. This study aimed to evaluate the association between MetS with bone mineral density (BMD) and trabecular bone score (TBS) as an indicator of bone quantity and quality, respectively. METHODS: Using a cross-sectional design, this study was carried out based on the data collected during the BEH Program, stage II. MetS was defined according to NCEP-ATP III criteria. BMD (at the lumbar spine and the hip) and lumbar spine TBS were assessed by dual-energy X-ray absorptiometry device. RESULTS: The data of 2380 participants (women = 1228, men = 1152) aged ≥ 60 were analyzed. In the fully adjusted regression models (including BMI), significant associations between MetS and mean BMD were observed across all locations in men (P values ≤ 0.001) and in the lumbar spine in women (P value = 0.003). In addition, the prevalence of osteoporosis (based on BMD) was significantly lower in those with MetS than those without MetS in both sexes, even after full adjustments (women, OR = 0.707, P value = 0.013; men, OR = 0.563, P value = 0.001). In contrast, in age-adjusted regression analyses, the prevalence of degraded bone microarchitecture (TBS ≤ 1.2) was significantly increased in those with MetS than those without, irrespective of the participants' sex (P values < 0.05). The mean TBS was also negatively associated with MetS in women (ß = - 0.075, P value = 0.007) but not in men (ß = - 0.052, P value = 0.077), in age-adjusted regression models. However, after including BMI in the adjusted models, all significant associations between TBS values and MetS disappeared. CONCLUSION: It seems that a positive association exists between MetS and BMD, while MetS is either not associated or negatively correlated with bone quality as measured by TBS.

Perinatal outcomes for untreated women with gestational diabetes by IADPSG criteria: a population-based study.

OBJECTIVE: To estimate the risk for adverse perinatal outcomes for women who met the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria but not the two-step criteria for gestational diabetes mellitus (GDM). DESIGN: Population-level cross-sectional study. SETTING: Ontario, Canada. POPULATION: A total of 90 140 women who underwent a 75-g oral glucose tolerance test. METHODS: Women were divided into those who met the diagnostic thresholds for GDM by two-step criteria and were therefore treated, those who met only the IADPSG criteria for GDM and so were not treated, and those who did not have GDM by either criteria. MAIN OUTCOME MEASURES: Hypertensive disorders of pregnancy, preterm delivery, primary caesarean section, large-for-gestational-age, shoulder dystocia and neonatal intensive care unit admission. RESULTS: Women who met the IADPSG criteria had an increased risk for all adverse perinatal outcomes compared with women who did not have GDM. Women with GDM by two-step criteria also had an increased risk of most outcomes. However, their risk for large-for-gestational-age neonates and for shoulder dystocia was actually lower than that of women who met IADPSG criteria. CONCLUSION: Women who met IADPSG criteria but who were not diagnosed with GDM based on the current two-step diagnostic strategy, and were therefore not treated, had an increased risk for adverse perinatal outcomes compared with women who do not have GDM. The current strategy for diagnosing GDM may be leaving women who are at risk for adverse events without the dietary and pharmacological treatments that could improve their pregnancy outcomes. TWEETABLE ABSTRACT: Women who meet IADPSG criteria for GDM have an increased risk for adverse perinatal outcomes compared with women without GDM.

Pulicaria gnaphalodes powder in broiler diets: consequences for performance, gut health, antioxidant enzyme activity, and fatty acid profile.

The search constantly continues to identify potential alternatives to the use of antimicrobial growth promoters (AGP) in broiler production. This trial was conducted with broiler chicks to investigate the effect of different levels of Pulicaria gnaphalodes powder (PGP) in comparison with AGP, and probiotic (PRO) on growth performance, gut microflora, intestinal morphology, antioxidant enzyme activity, and fatty acid profile of meat. Ross 308 male broiler chicks (n = 576) were randomly assigned into 6 dietary treatments with 8 replicate pens per treatment and 12 birds per pen. The dietary treatments consisted of a basal diet as control (CON, with no additive), CON + 0.1% PGP, CON + 0.2% PGP, CON + 0.3% PGP, CON + 0.1% probiotic mixture (PRO), and CON + 0.05% bacitracin methylene disalicylate (AGP). Higher body weight gain and lower feed conversion ratio were obtained in birds fed AGP and 0.3% PGP compared with those fed CON and 0.1% PGP during grower, finisher, and the entire study (P < 0.05). On day 42, birds on PRO, 0.2 and 0.3% PGP treatments had lower counts of Escherichia coli and higher lactobacillus spp. in ileum and cecal contents compared to the CON and 0.1% PGP (P < 0.05). Villus height and villus height to crypt depth ratio of the duodenum were increased (P < 0.05) in response to dietary AGP, PRO, and 0.3% PGP. The diets containing PRO and different levels of PGP increased superoxide dismutase and glutathione peroxidase activities and decreased malondialdehyde level in serum, liver, and thigh muscle (P < 0.05). Total polyunsaturated fatty acid and n-3 fatty acid of birds fed PRO and PGP diets were higher than birds in CON and AGP groups (P < 0.05). In summary, supplementation of PGP could be a potential alternative to AGP in broiler diets due to its combined positive impacts on performance, serum cholesterol, intestinal health, antioxidant activity, and fatty acid profile in meat. Such effects, however, need to be further verified under compromised health or a disease challenge condition.

Investigation of anti-leishmanial efficacy of miltefosine and ketoconazole loaded on nanoniosomes.

Leishmaniasis is a group of parasitic disease caused by protozoa of Leishmania genus. Leishmania major accounts for the cutaneous leishmaniasis (CL). The current treatments of this disease are expensive with high toxicity and are associated to difficulties of healing and parasite resistance. Miltefosine and ketoconazole have been found to be effective against CL. In this study, miltefosine- and ketoconazole-loaded nanoniosomes were prepared by the thin film-hydration method, and their anti-leishmanial effects against Leishmania major promastigotes and amastigotes were evaluated. The particle size and zeta potential of the nanoniosomes were determined. Release from the formulations showed enhanced and controlled dissolution of the drugs. The miltefosine- and ketoconazole-loaded nanoniosomes inhibited the growth of promastigote and amastigote forms of Leishmania major in vitro after 48 h of incubation and had IC50 values of 53.39 ±â€¯0.02 and 86.38 ±â€¯0.07 µg mL-1, respectively. The formulations provided improved anti-leishmanial activities for the treatment of cutaneous leishmaniasis.

Flow mediated dilation with photoplethysmography as a substitute for ultrasonic imaging.

Flow mediated dilation (FMD) is a non-invasive method for endothelial function assessment providing an index extracted from ultrasonic B-mode images. Although utilized in the research community, the difficulty of its application and high cost of ultrasonic devices prevent it from being widely used in clinical settings. In this study we show that substituting the ultrasonic device with more easily handled and low cost photoplethysmography and electrocardiography is possible. We introduce new indices based on the photoplethysmogram (PPG) and electrocardiogram (ECG) and show that they are correlated with the ultrasound-based FMD Index. To this end, a conventional ultrasound FMD test was carried out whereas PPG and ECG were simultaneously recorded from 20 healthy volunteers (13 M, 7 F) in the age range of 23-32 years. Our results show a significant correlation between our proposed index and ultrasound FMD when using the ECG in conjunction with the PPG (R = 0.77, p < 0.000 01). Using the PPG alone produces a lower correlation (R = 0.72, p < 0.0001). Compared to conventional FMD, the proposed method is low cost and does not require any special operator skills. Hence it may be easily utilized as a screening tool in locations deprived of high-end ultrasound imaging devices.

Association of Mycoplasma pneumoniae infection with Henoch-Schonlein purpura.

We present a child with Henoch-Schonlein purpura and Mycoplasma pneumoniae infection, an association that was rarely described in the literature. The infection was confirmed serologically and by using PCR.

An apparatus for concurrent measurement of thermoelectric material parameters.

We describe an apparatus which concurrently and independently measures the parameters determining thermoelectric material conversion efficiency: the Seebeck coefficient, thermal conductivity, and electrical resistivity. The apparatus is designed to characterize thermoelectric materials which are technologically relevant for waste heat energy conversion, and may operate from room temperature to 400 °C. It is configured so the heat flux is axially confined along two boron nitride rods of known thermal conductance. The Seebeck coefficient and thermal conductivity are obtained in steady-state using a differential technique, while the electrical resistivity is obtained using a four-point lock-in amplification method. Measurements on the newly developed NIST Seebeck standard reference material are presented in the temperature range from 50 °C to 250 °C.

Spatial distribution and molecular identification of leishmania species from endemic foci of South-eastern iran.

BACKGROUND: Cutaneous leishmaniasis constitutes a major public health problem in many parts of the world including Iran. The primary objective of this study was to identify Leishmania species in endemic districts of Kerman Province, south-eastern Iran. METHODS: This study was conducted by random sampling as cross- sectional descriptive between 2008 and 2010. Overall, 203 skin scraping smears were taken from the patients. Nested -PCR was performed to amplify variable minicircle fragments of Leishmania kDNA. RESULTS: Bam was the most infected district (71.1%), followed by Kerman (14.7%), Jiroft (5.4%), Baft (2.7%), Sirjan (1.6%), Shahr-e Babak (1.5%) and others (3.0%). L. tropica was the most common species identified (194 cases, 95.6%), while L. major was found in only 9 cases (4.4%). Of 203 identified patients, all species in Bam (l07 cases), Kerman (32 cases), Jiroft (l6 cases) and Shahr-e- Babak (l1 cases) were detected as L. tropica, whereas infected subjects in Baft and Sirjan showed L. tropica or L. major. Characterization of Leishmania species resulted in generation of 750 bp and 560 bp fragments, corresponding to those of L. tropica and L. major, respectively. CONCLUSION: L. tropica is the main species (95.6%) caused ACL in endemic areas of Kerman Province; however L. major is present in low level (4.4%).

Trajectory Learning for Robot Programming by Demonstration Using Hidden Markov Model and Dynamic Time Warping.

The main objective of this paper is to develop an efficient method for learning and reproduction of complex trajectories for robot programming by demonstration. Encoding of the demonstrated trajectories is performed with hidden Markov model, and generation of a generalized trajectory is achieved by using the concept of key points. Identification of the key points is based on significant changes in position and velocity in the demonstrated trajectories. The resulting sequences of trajectory key points are temporally aligned using the multidimensional dynamic time warping algorithm, and a generalized trajectory is obtained by smoothing spline interpolation of the clustered key points. The principal advantage of our proposed approach is utilization of the trajectory key points from all demonstrations for generation of a generalized trajectory. In addition, variability of the key points' clusters across the demonstrated set is employed for assigning weighting coefficients, resulting in a generalization procedure which accounts for the relevance of reproduction of different parts of the trajectories. The approach is verified experimentally for trajectories with two different levels of complexity.

Investigation on some biological aspects of Chrysoperla lucasina (Chrysopidae: Neuroptera) on Bemisia tabaci in laboratory conditions.

Bemisia tabaci is one of the most important key pests of many types of cultivated plants. Lacewings (Chrysopidae: Neuroptera) are predatory insects, widely used in biological control programs. Between them green lacewing is a promising biological control agent of pests in green houses and crop fields. In this study, gravid females of the green lacewing Chrysoperla lucasina (Lacroix) were captured from Sarepolzahab ( altitude 540m, latitude 34 degrees ,14' N 46 degrees, 9' E) in western part of Iran. Collected insects were reared in a growth chamber, under experimental conditions (25 +/- 1 degrees C, 70 +/- 5% RH and a photoperiod of 16:8 L: D). Different diets were offered to larvae which consisted of a whitefly species B. tabaci, an aphid Myzus persica and also lyophilized powder of drone honeybee (Apis melifera). As different foods were used to nurish larvae, so for each diet, mean larval period were calculated, and finally means were compared to each other. Anova in MSTAT-C was used for analysis of variance, and Duncan multiple range test (DMRT) to compare between means. The results showed that larvae had maximum duration of 27 +/- 0.33 days when fed on honeybee lyophilized powder and the minimum value was 17.9 +/- 0.3 days for B. tabaci. 25 +/- 0.27 day recorded for M. persicae. Food preference of the 3rd instar larvae of green lacewing was surveyed, they showed a food preference to M. persicae, to compare with B. tabaci, as the former has a bigger body size, so more easily to be captured by the predator larvae. The 3rd instar larvae of lacewing were more voracious on preys, than the 1st or the 2nd instar larvae. Statistically speaking, there were a significantly difference when mean of different preys consumed by predator larvae were compared. We found, that when the predator larvae have fed on B. tabaci, their development time was shorter, and when arrived to adult stage, the adults showed, an improved fertility. The results indicated that the suitable prey not only can increase the rate of through accelerating developmental stages of the predator and by means of an increase in its pupal body weight consequently promoting the fecundity of resulting adults, but also can alter predators population density in relation to own production numbers.

Predicting the value of the Mini Nutritional Assessment (MNA) as an indicator of functional ability in older Iranian adults (Kahrizak elderly study).

OBJECTIVE: We aimed to investigate the appropriateness of the Mini Nutritional Assessment (MNA) in predicting functional ability in older adults. DESIGN: Cross-sectional study. SETTING: Participants were recruited from the Kahrizak Charity Foundation (KCF). MEASUREMENTS: Nutritional and ability status were examined using the MNA and the Barthel Index (BI). Participants were divided according to MNA (≤ 23.5 and > 23.5). RESULTS: Two hundred and thirty-five ≥ 60-year-old subjects were studied. The MNA and BI were positively correlated (r = 0.199; P = 0.001). The optimal cut-off point for BI with the highest sensitivity and specificity derived from the ROC curve was approximately 91.5 for males and 83.5 for females. The BI was significantly associated with MNA (odds ratio (OR): 1.89; 95% CI: 1.17-3.05, P = 0.009), mobility (OR: 6.39; 95% CI: 3.43-11.89, P < 0.001), consuming ≥ 2 servings of fruit and vegetables (OR: 2.27; 95% CI: 1.09-4.72, P = 0.02) and self-view of nutritional status (OR: 4.15; 95%CI: 1.26-13.63, P = 0.01). The sensitivity (62.9% in males; 68.2% in females) and specificity (51.4% in males and 52.9% in females) of these cut-off points justifies the appropriateness of the MNA for determining functional ability. CONCLUSION: The MNA is potentially able to verify functional status among the elderly (as BI ≥ 91.5 with those of < 91.5 in males and ≥ 83.5 with those of < 83.5 in females) of KCF. It is suggested that this relationship should be further studied in a larger prospective population-based study.

Association of physical activity with risk of type 2 diabetes.

BACKGROUND: Physical activity has shown to prevent type diabetes 2. However, the type, intensity and amount of effective physical activity as well as individuals' needs according to level of their risk for type 2 diabetes have not been clarified comprehensively. This study investigated a relation between moderate aerobic physical activity ≥150 minuets/week with decreased risk of type 2 diabetes among obese and non-obese residents of south of Tehran, Iran. METHODS: This study, which was a part of the Cardiovascular Risk Factors Survey in Tehran population Lab region, was designed and conducted based on MONICA/WHO project. Totally, 1552 adult inhabitants of 17th district of Tehran were enrolled in this cross-sectional study. Physical activity was assessed by MONICA Optional Study of Physical Activity questionnaire. Diabetes was defined as a history of a prior diagnosis of diabetes or fasting serum glucose ≥126 mg/dl. All data analyses were conducted using SPSS 17 software for Windows RESULTS: In a multivariate model, moderate aerobic physical activity ≥150 minuets/week was significantly associated with decreased risk of type 2 diabetes in all and non-obese subjects [OR= 0.56; 95%CI: 0.35-0.91 and OR= 0.50; 95%CI: 0.26-0.94, respectively]. There was no significant relation between the physical activity and type 2 diabetes risk in obese subjects [OR=0.64; 95%CI: 0.30-1.39]. CONCLUSION: Moderate aerobic physical activity ≥150 minuets/week was significantly associated with decreased risk of type 2 diabetes in non-obese people and could be an acceptable exercise goal for these individuals. However, obese people should be investigated more to produce a tailored exercise guideline to this population at high risk of type 2 diabetes.

Modeling, simulation, and optimal initiation planning for needle insertion into the liver.

Needle insertion simulation and planning systems (SPSs) will play an important role in diminishing inappropriate insertions into soft tissues and resultant complications. Difficulties in SPS development are due in large part to the computational requirements of the extensive calculations in finite element (FE) models of tissue. For clinical feasibility, the computational speed of SPSs must be improved. At the same time, a realistic model of tissue properties that reflects large and velocity-dependent deformations must be employed. The purpose of this study is to address the aforementioned difficulties by presenting a cost-effective SPS platform for needle insertions into the liver. The study was constrained to planar (2D) cases, but can be extended to 3D insertions. To accommodate large and velocity-dependent deformations, a hyperviscoelastic model was devised to produce an FE model of liver tissue. Material constants were identified by a genetic algorithm applied to the experimental results of unconfined compressions of bovine liver. The approach for SPS involves B-spline interpolations of sample data generated from the FE model of liver. Two interpolation-based models are introduced to approximate puncture times and to approximate the coordinates of FE model nodes interacting with the needle tip as a function of the needle initiation pose; the latter was also a function of postpuncture time. A real-time simulation framework is provided, and its computational benefit is highlighted by comparing its performance with the FE method. A planning algorithm for optimal needle initiation was designed, and its effectiveness was evaluated by analyzing its accuracy in reaching a random set of targets at different resolutions of sampled data using the FE model. The proposed simulation framework can easily surpass haptic rates (>500 Hz), even with a high pose resolution level ( approximately 30). The computational time required to update the coordinates of the node at the needle tip in the provided example was reduced from 177 s to 0.8069 ms. The planning accuracy was acceptable even with moderate resolution levels: root-mean-square and maximum errors were 1 mm and 1.2 mm, respectively, for a pose and PPT resolution levels of 17 and 20, respectively. The proposed interpolation-based models significantly improve the computational speed of needle insertion simulation and planning, based on the discretized (FE) model of the liver and can be utilized to establish a cost-effective planning platform. This modeling approach can also be extended for use in other surgical simulations.

Prevalence of metabolic syndrome in an adult urban population of the west of Iran.

OBJECTIVES: We determine the prevalence of the metabolic syndrome in an urban population of Zanjan, a province located to the west of Tehran. METHODS: Randomly selected adults >20 years were studied using stratified sampling. Target study sample was 2941 (1396 males and 1545 females). Metabolic syndrome was diagnosed using Adult Treatment Panel-III (ATP-III) guidelines when any three of the following were present: central obesity, raised triglycerides > or =150 mg/dl, low high-density lipoprotein (HDL) cholesterol, blood pressure > or = 130/ > or = 85 mm Hg, and diabetes or fasting plasma glucose (FPG) > or = 100 mg/dl. RESULTS: Metabolic syndrome was present in 697 (23.7%) subjects (CI 95%:22%-25%, P = .001), prevalence was 23.1% in men and 24.4% in women (P : .4). The prevalence increased from 7.5% in the population younger than 30 y to 45.6% in ages more than 50 years. Low HDL was the most common metabolic abnormality in both sexes. Most of those with metabolic syndrome had three components of the syndrome (75.6%), 170 subjects (24.4%) had four and none had five components simultaneously. The prevalence of obesity (BMI > or = 30 kg/m(2)), hypercholesterolemia (> or =200 mg/dl) and high LDL cholesterol (> or =130 mg/dl) was greater in the metabolic syndrome group than normal subjects (P = .00). CONCLUSIONS: There is a high prevalence of metabolic syndrome in this urban population of the northern west of Iran. Focus of cardiovascular prevention should be undertaken in this area.

High prevalence of low high-density lipoprotein cholesterol concentrations and other dyslipidemic phenotypes in an Iranian population.

OBJECTIVE: This study was designed to determine the prevalence of different atherogenic dyslipidemic phenotypes, especially decreased serum high-density lipoprotein cholesterol (HDL-C) in an Iranian population and its relationship to other coronary artery disease (CAD) risk factor. METHODS: The prevalence of lipid abnormalities was assessed in 2941 people, including 1396 males and 1545 females, aged more than 20 years. The population is representative of Iranian urban adults living in northwestern Iran. In addition to isolated forms of hypertriglyceridemia, hypercholesterolemia, and hypoalphalipoproteinemia, some dyslipidemic phenotypes including hypertriglyceridemia/low high-density lipoprotein (HDL) combination, mixed dyslipidemias, and severe dyslipidemias were assessed. RESULTS: The most prevalent abnormality was low HDL cholesterol (HDL-C; 73% including 63% for men and 93.3% for women). Hypertriglyceridemia (>150 mg/dL) was the second most prevalent abnormality (40.6%). Increased total cholesterol (>200 mg/dL) was observed in 35.4% of the subjects. The combination of hypertriglyceridemia and low HDL-C was observed in 9.9% of the population. Fifty eight percent of the low HDL-C cases were not accompanied with hypertriglyceridemia, and 24.4% of hypertriglyceridemic subjects had low HDL-C. Among subjects younger than 30 years, 19% had hypercholesterolemia, 13% had isolated low HDL-C less than 35 mg/dL, and 63% had HDL-C less than 40 mg/dL. Unexpectedly, except for the hypertriglyceridemia/low HDL-C pattern, which was more common in males, the other abnormal lipid profiles were more common in females. CONCLUSION: The prevalence of dyslipidemia, especially low HDL cholesterol, in Iranian adults is very high. Urgent preventive programs and changes in lifestyle are needed in this area.

Cutoff point of waist circumference for the diagnosis of metabolic syndrome in an Iranian population.

BACKGROUND: Proposed cutoffs for waist circumference (WC) in western populations may be not appropriate for Asian populations. The published data among Iranians are insufficient to address this issue. This study was designed to identify cutoffs for WC that confer increased risk of metabolic syndrome in Iranian adults living in Zanjan, a province located in the west of Tehran. MATERIALS AND METHODS: Data of a cross-sectional sample of 3277 Iranian adults aged more than 20 years were analyzed. In the original study individual body weight, height, WC, and blood pressure were assessed and fasting plasma glucose, triglycerides, total cholesterol, low- and high-density lipoprotein cholesterol were measured. After excluding WC, existence of two or more of the remaining four risk factors of the modified NCEP III criteria for metabolic syndrome were defined as multiple risk factors. Receiver operating characteristic (ROC) analysis was used to find out the optimal cutoff values of WC to predict metabolic syndrome. RESULTS: The cutoff level yielding the maximal sensitivity and specificity for predicting the presence of metabolic syndrome (multiple risk factors) was 87 cm in men and 82 cm in women. Cutoffs corresponding to body mass index (BMI) 25 and 30 kg/m(2) to predict metabolic syndrome were 84 and 97 cm in men and 78 and 91 cm in women, respectively. CONCLUSIONS: Lower cutoffs for WC should be considered in the identification of Iranian population at high risk of metabolic syndrome.