Relationship Between Clinical, Demographic and Socioeconomic Factors with Suicide Ideation; A Cross-sectional Study.

BACKGROUND: Suicide has grown in global prevalence as a public health problem. We aimed to evaluate the association of socioeconomic factors, biochemical and hematologic tests, and suicide ideation. METHODS: In this cross-sectional study, 8267 Iranian adults aged 35 - 65 years old were enrolled. The assessment of suicide ideation was made by the completion of Beck's depression inventory (BDI) questionnaire; according to one specific item on the questionnaire: "have you ever decided to suicide in the past week?" RESULTS: According to our results, 6.9 % of subjects had ideation of suicide. The results showed high levels of FBG, RBC, MCHC, and hs-CRP were associated with suicide ideation. Obese, single subjects, and current-smokers had a higher risk of suicide ideation. CONCLUSION: Increased physical activity, obesity, and smoking are associated with a high risk of suicide ideation; whilst, a high MCHC is related to a low risk of suicide ideation in Iranian adults.

Age and sex-specific reference intervals for prooxidant-antioxidant balance, anti-heat-shock protein 27 (anti-hsp27), and routine laboratory tests in the middle-aged adult population.

INTRODUCTION: We aimed to define specific reference intervals (RIs) for 11 biomarkers including inflammatory and oxidative stress biomarkers, liver, and renal function tests in a healthy Iranian adult population for the first time. METHODS: CLSI Ep28-A3 guidelines were then used to calculate accurate age- and sex- as well as body mass index (BMI)-specific RIs. RESULTS: RIs for studied biomarkers showed no significant age and sex-specific differences, except for uric acid, which had higher concentrations in men when compared to women. Additionally, after partitioning the participants based on the BMI with a cutoff point of 25 kg/m2 , only the levels of hs-CRP were positively associated with higher BMI (RI for BMI>25: 0.51-7.85 mg/L and for BMI<25: 0.40-4.46 mg/L). RI for PAB and anti-hsp-27 were reported 4.69-155.36 HK and 0.01-0.70 OD in men and women aged 35-65 years old. CONCLUSION: Partitioning by sex and BMI was only required for uric acid and hs-CRP, respectively, while other biomarkers required no partitioning. These results can be expected to valuably contribute to improve laboratory test result interpretation in adults for improved monitoring of various diseases in the Iranian population.

Age- and sex-specific reference intervals for superoxide dismutase enzyme and several minerals in a healthy adult cohort.

INTRODUCTION: The aim of this study was to establish RIs for clinically important markers including superoxide dismutase (SOD), serum copper, zinc, calcium, magnesium, and phosphate in a cohort of healthy Iranian adults. MATERIALS: A subsample from MASHAD cohort study was used to assess serum SOD, copper, zinc, calcium, magnesium and phosphate. Serum SOD was measured according to its inhibitory potential of pyrogallol oxidation. Micro- and macro-minerals were measured using flame atomic absorption spectrometry and a BT3000 autoanalyzer, respectively. Sex- and age-specific RIs were then calculated based on CLSI Ep28-A3 guidelines. RESULTS: Reference value distributions for studied parameters did not demonstrate any age-specific differences that were statistically significant. In addition, sex partitioning was not required for all parameters, apart from serum magnesium, which showed a wider range in females (0.81-1.26 mg/dl) compared with males (0.82-1.23 mg/dl). CONCLUSION: The RIs established in this study can be expected to improve mineral assessment and clinical decision-making in the Iranian adult population.

Serum Pro-oxidant-antioxidant Balance in Subjects with Type 2 Diabetes Mellitus.

AIM AND OBJECTIVE: Diabetes mellitus is associated with inflammation and increased oxidative stress. In the current study, we aimed to investigate the relationship between type 2 diabetes mellitus (T2DM) and serum pro-oxidant-antioxidant balance (PAB) in a large populationbased study. METHODS: In this cross-sectional study, 7888 individuals were recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study. Participants were divided into three groups based on their serum PAB values (levels < 36.4, 36.4-82.6 and > 82.6 HK). Serum PAB values were measured using a colorimetric method and enzyme-linked immune sorbent assay (ELISA). RESULTS: Serum PAB in subjects with and without diabetes was reported 76.85 ± 61.07 HK and 69.51 ± 55.50 HK. In subjects with a serum PAB > 82.6 HK the risk of T2DM was 1.2 fold higher in comparison to subjects with a serum PAB < 36.4 HK (OR: 1.26, 95% CI: 1.09 - 1.47, P-value: 0.002). This association remained significant after adjustment for confounding factors in multivariable analysis (OR: 1.19, 95% CI: 1.02 - 1.38, P-value: 0.027). CONCLUSION: Increased pro-oxidant levels may be a major complication of T2DM in our study subjects and PAB could be an indicator of higher oxidative stress in T2DM patients from northeastern Iran.

Reference intervals for routine biochemical markers and body mass index: A study based on healthcare center database in northeastern Iran.

Age- and sex-specific reference intervals (RIs) for some biochemical tests may be useful for their interpretation, due to the variations in lifestyle and genetic, or ethnic factors. The aim of this study was to obtain RIs for some routine biochemical markers including a serum lipid profile, fasting blood glucose (FBG), aspartate and alanine aminotransferase (AST and ALT), uric acid, and body mass index (BMI) in subjects who attended primary healthcare centers. The large database of primary healthcare centers uses RIs to report results for children, adolescents, and young and old adults. RIs were obtained by using the indirect method, recommended by the CLSI Ep28-A3 guidelines. RIs for FBG, BMI, and serum lipid profile, including triglyceride, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol in people aged 18 to 120 years, were obtained without age/sex segmentation. RIs for serum AST, ALT, and uric acid were obtained without age segmentation, though these RIs were higher in males than females. The RIs for AST, ALT, and uric acid were higher in men, while the RIs for the other variables were similar in both sexes. This is the first study reporting the use of indirect RIs for BMI.

Comprehensive laboratory reference intervals for routine biochemical markers and pro-oxidant-antioxidant balance (PAB) in male adults.

BACKGROUND: Reference values of biochemical markers are influenced by various parameters including age, sex, region, and lifestyle. Hence, we aimed to determine age- and BMI-specific reference intervals (RIs) for important clinical biomarkers in a healthy adult male population from northeastern Iran. This is also the first study to investigate reference values for pro-oxidant-antioxidant balance (PAB). METHODS: Seven hundred and twenty (720) healthy men, aged 20-60 years, were recruited from Sarakhs in the northeast region of Iran. Reference values for lipid profiles (total cholesterol, triglyceride, HDL-C and LDL-C), fasting blood glucose, inflammatory factors (hs-CRP and PAB), minerals (zinc and copper), uric acid, and blood pressure were measured and statistically analyzed to establish accurate age- and BMI-specific RIs in alignment with CLSI Ep28-A3 guidelines. RESULTS: RIs for lipid profiles, inflammatory factors, minerals, and uric acid required no age partitioning with the exception of fasting blood glucose and blood pressure, which demonstrated significantly higher values in subjects aged 50 years and older. Among these biomarkers, only uric acid, blood pressure, and triglycerides demonstrated statistically significant increases in reference value concentrations with increasing BMI. CONCLUSION: In this study, age- and BMI-specific RIs for several biochemical markers were determined in healthy adult Iranian men. Partitioning by age and BMI was only required for a few analytes with most demonstrating no statistically significant changes with these covariates. These data can be useful to monitor various diseases in male adults with varying BMI in this region and others.

Evaluation of ABO blood group in subjects with CVD risk factors in a population sample from northeastern Iran.

BACKGROUND AND AIMS: The ABO blood group system is a genetic polymorphism which can affect the clearance of von Willebrand factor. We aimed to assess the levels of newer biomarkers of cardiovascular disease (CVD) risk; pro-oxidant-antioxidant balance (PAB), high sensitivity C-reactive protein (hs-CRP) and anti-heat-shock protein27 (anti-Hsp27) antibody titers in subjects with various blood groups (A, B, AB and O) and with or without traditional CVD risk factors. METHODS: The cross-sectional study comprised 6910 subjects. Antigen-antibody agglutination was evaluated by the slide test method for identification of ABO blood groups. RESULTS: Among three markers, only Serum anti-Hsp27 titers significantly differed between the four blood groups and showed the highest and lowest values in AB and O blood groups (0.26 ± 0.22 and 0.23 ± 0.18 OD, respectively; P < 0.05). Serum anti-Hsp27 was higher in individuals with an AB blood group with metabolic syndrome (MetS), dyslipidemia, hypertension (HTN) and obesity and it was lower in subjects with O blood group; though, two other biomarkers, serum PAB and hs-CRP, were not significantly different between the ABO blood groups. However, they were not different among blood groups in participants with or without diabetes mellitus (DM) (P > 0.05). CONCLUSION: Individuals with an AB blood group and high levels of anti-Hsp27 antibody titers may be predisposed to CVDs that can be mediated through the traditional CVD risk factors among middle-aged subjects from northeastern Iran. The fact that differences in anti Hsp27 are only found in the subgroup with other risk factors suggest that the difference between ABO blood groups is a consequence rather than a cause.

Comprehensive hematological reference intervals in a healthy adult male population.

Reference intervals (RIs) are important tools for improving medical decision-making. Hematology reference values can be influenced by important covariates such as genetic and environmental factors, rendering it essential to define RIs for specific populations. Therefore, we aimed to establish accurate and robust RIs for hematological markers in a healthy adult male Iranian population. This cross-sectional study was conducted in a population of 723 males aged 20-60 years old. Hematological parameters were routinely measured using a Sysmex auto analyser system (KX-21 N). The quality of assays was monitored using commercial quality control samples. The nonparametric rank method, as recommended by the Clinical and Laboratory Standards Institute (CLSI) guidelines, was used to calculate the 2.5th and 97.5th percentiles as the lower and upper reference limits, respectively. Of the 12 hematological parameters assessed, only mean platelet volume (MPV) demonstrated significant age-specific differences, requiring two partitions from 20 to 35 years (8.7-12.2 fL) and 35 to 65 years (8.5-11.5 fL). The remaining hematological parameters (e.g. leukocyte, erythrocyte, and platelet parameters) could be defined by one age range. This study established RIs for 12 routinely used hematological parameters in a healthy male population living in the northeastern region of Iran. Established RIs differed from those previously reported by other cohorts, highlighting the importance of population-specific RIs.

Association between obesity categories with cardiovascular disease and its related risk factors in the MASHAD cohort study population.

BACKGROUND: Cardiovascular disease (CVD) is a significant cause of morbidity and mortality globally. Obesity is an important CVD risk factor and is increasing in prevalence. METHODS: In this study, 3829 men and 5720 women (35-65 years) were enrolled as part of the MASHAD cohort study. Four categories were identified according to body mass index and waist circumference that was defined by the World Health Organization. Logistic regression analysis was used to determine the adjusted odds ratio (OR) for the occurrence of CVD, and Cox regression model was used to evaluate the association of obesity with CVD incidence. RESULTS: We found that the higher risk groups defined by categories of adiposity were significantly related to a higher prevalence of a high serum total cholesterol (TC), and triglycerides (TG), and lower high-density lipoprotein cholesterol (HDL), and higher fasting blood glucose (FBG) in both genders and a higher low-density lipoprotein cholesterol (LDL) in women (P < .001). Additionally, a high percentage of participants with dyslipidemia, high LDL, high TC, and low HDL and a high percentage of participants with metabolic syndrome, diabetes, hypertension, and a high serum TG were observed across obesity categories (P < .001). Moreover, women with the very high degrees of obesity had a greater risk of CVD (HR: 1.91, 95% CI: 1.06-3.43, P = .03). CONCLUSION: Obesity strongly predicts several CVD risk factors. Following 6 years of follow-up, in individuals within increasing degrees of obesity, there was a corresponding significant increase in CVD events, rising to approximately a twofold higher risk of cardiovascular events in women compared with men.

Effect of melatonin and gabapentin on anxiety and pain associated with retrobulbar eye block for cataract surgery: a randomized double-blind study.

OBJECTIVES: To compare the effect of melatonin and gabapentin on anxiety, pain, sedation scores, and satisfaction of surgeon in patients of cataract surgery. MATERIALS AND METHODS: One hundred thirty patients aged between 35 and 85 years scheduled for cataract surgery were randomly allocated to three study groups to receive melatonin (6 mg), gabapentin (600 mg) or placebo 90 min before arrival in the operating room. Pain, anxiety, and sedation scores during block and surgery as well as the surgeon's satisfaction with the surgery were assessed. RESULTS: Anxiety scores decreased significantly in melatonin and gabapentin groups compared to the placebo group after premedication and extended to early postoperative period. The level of anxiety showed no statistically significant difference between melatonin and gabapentin groups at any time of measurement. There were significant differences between the pain scores during retrobulbar placement in gabapentin versus placebo (95% CI 3 to 4; P = 0.001) and melatonin (95% CI 3 to 4; P = 0.040) groups. Also, there were significant differences between the sedation scores during retrobulbar placement in gabapentin and placebo groups (95% CI 2 to 2.5; P = 0.046). The difference in sedation scores during retrobulbar placement in melatonin versus gabapentin and placebo groups was not significant. Neither the intraoperative pain scores nor the postoperative pain scores were different between the three groups. The surgeon reported similar quality of operation conditions during surgery for the three study groups. CONCLUSION: The level of anxiety was significantly lower with both anxiolytic drugs compared to placebo. Furthermore, gabapentin decreased the pain and improved the sedation scores only during retrobulbar placement compared to the placebo.

Glucokinase gene promoter -30G>A polymorphism: a cross-sectional association study with obesity, diabetes Mellitus, hyperlipidemia, hypertension and metabolic syndrome in an Iranian hospital / Polimorfismo -30G

OBJECTIVE: A -30G>A single nucleotide polymorphism in the promoter region of the glucokinase gene has been previously associated with obesity, insulin resistance and diabetes. The present study aimed to evaluate the association of this polymorphism with obesity and its comorbidities in a population from Northeast Iran. METHODS: Five hundred and forty-two subjects aged 18 to 65 years were included in the study and divided into normal (BMI<25, n=220), overweight (2530, n=187) groups. All subjects were genotyped for the -30G>A polymorphism using the polymerase chain reaction-restriction fragment length polymorphism technique. RESULTS: The genotypes and allele frequencies of the three groups did not differ significantly (p>0.05). When the study population was categorized according to diabetes mellitus, hyperlipidemia, hypertension and metabolic syndrome status, no significant difference in -30G>A genotypes and alleles was found between the subgroups with and without these disorders (p>0.05), apart from a significantly higher frequency of the G allele in the hyperlipidemic vs. non-hyperlipidemic subgroup (p<0.05). CONCLUSION: The findings of the present study do not support an association between the -30G>A polymorphism and high body mass index in the Iranian population.

OBJETIVO: O polimorfismo de nucleotídeo único -30G>A, na região promotora do gene da glucoquinase, já foi associado à obesidade, resistência insulínica e diabete. O objetivo deste estudo foi avaliar a associação deste polimorfismo com a obesidade e suas comorbidades em uma população do nordeste iraniano. MÉTODOS: Quinhentos e quarenta e dois indivíduos com idades entre 18 e 65 anos foram divididos em três grupos: normal (BMI<25, n=220), sobrepeso (2530, n=187). Todos os indivíduos foram genotipados para o polimorfismo -30G>A através da técnica da reação em cadeia da polimerase - polimorfismo do comprimento do fragmento de restrição. RESULTADOS: As frequências dos genótipos e alelos dos 3 grupos não diferiram entre si (p>0,05). Quando a população de estudo foi categorizada de acordo com a presença de diabete, hiperlipidemia, hipertensão arterial e síndrome metabólica, os genótipos e alelos -30G>A dos subgrupos com e sem essas doenças não diferiram entre si (p>0,05), exceto por uma frequência maior do alelo G no grupo de hiperlipidêmicos quando comparados aos não hiperlipidêmicos (p<0,05). CONCLUSÃO: Os achados do presente estudo não confirmam uma associação entre o polimorfismo -30G>A e excesso de peso na população iraniana.

Prevalence and causes of severe visual impairment and blindness among children in the lorestan province of iran, using the key informant method.

PURPOSE: To estimate the prevalence and causes of severe visual impairment and blindness among children in Lorestan province of Iran, and to assess the feasibility of the Key Informant Method in this setting. METHODS: Potential cases were identified using the Key Informant Method, in 3 counties of Lorestan province during June through August 2008, and referred for examination. Causes of severe visual impairment/blindness were determined and categorized using standard World Health Organization methods. RESULTS: Of 123 children referred for examination, 27 children were confirmed to have severe visual impairment/blindness or blindness. The median age was11 years (interquartile range 6-13), and 59% were girls. After adjusting for non-attenders, the estimated prevalence of severe visual impairment/blindness was 0.04% (0.03-0.05). The main site of abnormality was retina (44%), followed by disorders of the whole eye (33%). The majority of causes had a hereditary etiology (70%), which was associated with a family history of blindness (P = 0.002). Potentially avoidable causes of severe visual impairment/blindness were found in 14 children (52%). Almost all children with severe visual impairment/blindness had a history of parental consanguinity (93%). CONCLUSIONS: Our findings suggest a moderate prevalence of childhood blindness in the Lorestan province of Iran, a high proportion of which may be avoidable, given improved access to ophthalmic and genetic counselling services in rural areas. The Key Informant Method is feasible in Iran; future research is discussed.