Publications by authors named "Hossein Fakhrzadeh"

54 Publications

Surrogate Markers of Subclinical Atherosclerosis and Its Associated Factors in Patients with β-Thalassemia Major.

Hemoglobin 2021 Apr 8:1-5. Epub 2021 Apr 8.

Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

β-Thalassemia major (β-TM) is a severe genetic hemoglobin (Hb) disorder with cardiovascular complications such as atherosclerosis due to transfusion-dependent iron overload. We aimed to determine the associated factors with surrogate markers of subclinical atherosclerosis in these patients. Sixty subjects with β-TM referred to the Thalassemia Clinic of the Iranian Blood Transfusion Organization (IBTO) were included in our study. The blood samples were collected for laboratory measurements. The carotid intima-media thickness (CIMT), was measured by ultrasonography, and ankle-brachial index (ABI) was calculated. The multivariate linear analysis was performed to determine the appropriate indicators of subclinical atherosclerosis in β-TM. There was no significant difference in baseline characteristics between the study groups. In multivariate linear analysis, age and systolic blood pressure (SBP) were negatively associated with inverse-transformed CIMT [unstandardized β coefficient (B): -0.024, 95% confidence interval (95% CI): -0.032- -0.010,  < 0.001; B: -0.009, 95% CI: -0.017- -0.001, 0.031, respectively]. There was also a significant correlation between the serum level of high-density lipoprotein cholesterol (HDL-C) and insulin with higher ABI, after adjustment for confounding variables (B: 0.003; 95% CI: 0.000-0.005;  = 0.030, and B: 0.004, 95% CI: 0.000-0.009,  = 0.037, respectively). Our results show that advancing age and increased SBP, HDL-C and insulin, associated with higher CIMT or ABI, are appropriate indicators of subclinical atherosclerosis in β-TM patients.
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http://dx.doi.org/10.1080/03630269.2021.1907405DOI Listing
April 2021

Comparison of Two Validation Nutrition Tools in Hospitalized Elderly: Full Mini Nutritional Assessment and Short-form Mini Nutritional Assessment.

Int J Prev Med 2019 9;10:168. Epub 2019 Oct 9.

Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: The aim was to determine validity, reliability, and cutoff of full-mini nutritional assessment (MNA) and MNA-short form (SF) also which one was better for the screening of malnutrition in the Iranian hospitalized elderly.

Methods: In this cross-sectional validation study, 96 hospitalized elderly ≥60 years selected from two hospitals in Tehran. Anthropometric measures (body mass index [BMI], mid-arm circumference [MAC], calf circumference [CC], abdomen, and waist skinfold thickness) and laboratory tests (albumin and hemoglobin levels, and red blood cell count were performed. Nutrition tools (full-MNA and MNA-SF), cognition tool (mini-mental state examination, depression scale (Geriatric Depression Scale15 and activities of daily living (ADL) index (Modified Barthel-ADL) were administered.

Results: The full-MNA scores were significantly correlated to measures of MAC, BMI, waist, and CC. The MNS-SF scores were significantly related to measures of MAC, waist, and CC. Serum albumin showed a poor correlation with both tools. At cutoff 24 in full-MNA had a sensitivity 75% and specificity 77.8% and the MNA-SF considered 62.5% sensitivity and 65.3% specificity at cutoff 10.50 to detect well-nourished from malnourished subjects. The internal consistencies of both tools were >90%. In exploratory factor analysis, six components found for full-MNA and two components for MNA-SF. Known group validity of full-MNA was reflected significant differences between geriatric patients with expected higher full-MNA scores and patients with expected lower scores (BMI ≥24 vs. BMI <24 or bed ulcer or assisted food intake).

Conclusions: It seems the Persian version of full-MNA is more appropriate in comparison to MNA-SF for screening malnutrition in the Iranian hospitalized elderly patients.
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http://dx.doi.org/10.4103/ijpvm.IJPVM_132_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826692PMC
October 2019

Validity and reliability of Bayer Activities of Daily Living (Bayer- ADL) scale in the Iranian elderly dementia population: Is there distinguish between illiterate and literate demented in functional dependency?

Appl Neuropsychol Adult 2021 Jan-Feb;28(1):60-70. Epub 2019 May 21.

Gerontology & Geriatric Department, Medical School Tehran University of Medical Sciences, Tehran, Iran.

This validation study is discriminant and concurrent, with the Bayer-Activities of Daily Living (Bayer-ADL) tool among the Iranian elderly dementia illiterate and literate. The tools Bayer-ADL, Global Deterioration Scale (GDS), Mini Mental State Examination (MMSE), ADL-Barthel, and instrumental activities of daily living (IADL) were applied to find Bayer-ADL correlations in 311 dementia outpatients that were ≥60 years old. The Iranian version Bayer-ADL scores between illiterate and literate dementia elderly, based on GDS, observed good discrimination values (0.923 sensitivity and 0.750 specificity) in illiterate people, and excellent discrimination values were achieved (sensitivity 0.919 and 0. 986 specificity) in literate dementia elderly. The suggested cutoff points were 1.79 for illiterate and for the Iranian literate dementia elderly 1.82, based on GDS. Both forms (24 and 25 items) of Bayer-ADL were correlated to GDS, ADL, and IADL. Bayer-ADL is a valid tool to distinguish physical dysfunction between illiterate and literate of the Iranian dementia elderly; however, some revisions in the components are needed for the illiterate elderly. Generally, the findings presented in the Iranian version Bayer-ADL could be useful to both clinical purpose and international studies.
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http://dx.doi.org/10.1080/23279095.2019.1594232DOI Listing
May 2019

Coronary artery stenosis and associations with indicators of anthropometric and diet in patients undergoing coronary angiography.

J Diabetes Metab Disord 2018 Dec 1;17(2):203-210. Epub 2018 Nov 1.

7Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Coronary artery diseases (CAD) are one of the major causes of mortality, which is related to the nutritional status and anthropometric indices of individuals. The aim of this study was to determine the relationship between anthropometric indices, the type of protein consumption in meat group and vegetable consumption with coronary artery stenosis.

Methods: This descriptive and analytical cross-sectional study was conducted in Shariati Hospital in Tehran in 2016. Out of the patients undergoing coronary angiography, 208 cases were assigned to participate in the study of simple random sampling. The required data were collected by Food Frequency questionnaire (FFQ), anthropometric indices and physical activity questionnaire. SPSS software (version #21) was used for statistical analysis.

Results: The number of coronary arteries with more than 50% stenosis was increased by high consumption of red meat ( = 0.014), egg ( = 0.006) and chicken ( = 0.030) and low consumption of legume ( = 0.000), soybean ( = 0.002) and vegetables ( = 0.003). Also, the consumption of garlic and onion was associated with a decrease in the severity of stenosis in left anterior descending (LAD) ( = 0.036), and right coronary artery (RCA) ( = 0.033). There was a significant and positive correlation among waist circumference, wrist circumference and body mass index in patients with coronary artery stenosis and a negative correlation between the height of the patient and the history of previous angiography.

Conclusion: High consumption of vegetable proteins, vegetables, maintaining BMI and waist circumference in the normal range, were associated with reduced severity of coronary artery stenosis. In addition high consumption of red meat, chicken and egg is associated with higher severity and number of coronary stenosis.
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http://dx.doi.org/10.1007/s40200-018-0362-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6405376PMC
December 2018

Psychometric properties of the Persian version of the nutritional form for the elderly (NUFFE) in nursing home residents.

Med J Islam Repub Iran 2018 30;32:105. Epub 2018 Oct 30.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

The Nutritional Form for the Elderly (NUFFE) is a newly developed tool. This study aimed to carry out a psychometric evaluation of the Persian version of NUFFE (NUFFE-P) among nursing home residents. Nursing home participant's aged ≥ 60 years (n=97) were enrolled. The inclusion criteria were residency for at least 6 months in the nursing home, and ability to communicate. Exclusion criteria included cognitive impairment, having depressed mood, severe hearing loss, problems in upper and lower extremities also, history of hospital admission during 6 months before enrollment. Anthropometric measures, laboratory tests, three-day food intake, NUFFE-P version, Mini Nutritional Assessment (MNA), Barthel Index (BI) and Geriatric Depression Scale (GDS-15) were assessed. The relationship between the NUFFE-P and MNA scores was considered as concurrent validity. The Cronbach's alpha coefficient of NUFFE-P tool was 0.76. The intraclass correlation coefficient for the total score between two raters obtained 0.98 (CI 0.97-0.99). The correlation coefficient between the NUFFE-P and the MNA scores was -0.75 (p<0.01). Four factors were extracted for the NUFFE-P in an exploratory factor analyses. Sensitivity 69.8% and 100% and specificity 75.7% and 85.6% were achieved to detect elderly at medium risk (cutoff=6), and at high risk of under-nutrition (cutoff=11) respectively. The NUFFE-P has sufficient psychometric properties in nutritional status screening among the Iranian elderly nursing homes residents.
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http://dx.doi.org/10.14196/mjiri.32.105DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6387812PMC
October 2018

Evaluation of fibrin-gelatin hydrogel as biopaper for application in skin bioprinting: An in-vitro study.

Biomed Mater Eng 2016 ;27(6):669-682

Department of Pharmacology, Iran University of Medical Science, Tehran, Iran.

Background: Recent advances in tissue engineering have led to the development of the concept of bioprinting as an interesting alternative to traditional tissue engineering approaches. Biopaper, a biomimetic hydrogel, is an essential component of the bioprinting process.

Objective: The aim of this work was to synthesize a biopaper made of fibrin-gelatin hybrid hydrogel for application in skin bioprinting.

Methods: Different composition percentages of the two biopolymer hydrogels, fibrin-gelatin, have been studied for the construction of the biopaper and were examined in terms of water absorption, biodegradability, glucose absorption, mechanical properties and water vapor transmission. Subsequently, tissue fusion study was performed on prepared 3T3 fibroblast cell line pellets embedded into the hydrogel.

Results: Based on the obtained results, fibrin-gelatin blend hydrogel with the same proportion of two components provides a natural scaffold for fibroblast-based bioink embedding and culture.

Conclusions: The suggested optimized hydrogel was a suitable candidate as a biopaper for skin bioprinting technology.
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http://dx.doi.org/10.3233/BME-161617DOI Listing
March 2017

Prevalence of Dementia and Associated Factors among Older Adults in Iran: National Elderly Health Survey (NEHS).

Arch Iran Med 2016 Dec;19(12):838-844

Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: The prevalence of cognitive impairment and dementia is increasing in Iran and the world. There is no study available on the prevalence of dementia at the national level in Iran. This study aimed to report the rate of dementia at the national level in Iran.

Methods: The National Elderly Health Survey (NEHS) was a cross-sectional study with multistage cluster random sampling on people aged ≥ 60 years in Iran. Dementia was diagnosed by trained general practitioners using Brief Cognitive Assessment Tool (BCAT). In this study, the dementia diagnosis rate was considered as the ratio of individuals previously diagnosed with dementia to individuals considered as dementia. Analyses were carried out using survey analysis method. The provincial rates were standardized based on the Iranian population in 2011 and the national rate was standardized based on WHO standard populations. Association between risk factors and dementia was assessed using a multivariable logistic regression model.

Results: The overall crude prevalence of dementia among people aged ≥ 60 years was 7.9% (8.7% in women and 6.9% in men) and age standardized dementia prevalence rate in Iran based on WHO standard population was 8.1% (9.6% in women and 6.5% in men). The prevalence of dementia was observed as 3.7% among people aged 60-64 years, 6.2% in the age-group 65-69 years, 10.4% in the age-group 70-74 years, 14.4% in the age-group 75-79 years, and 13.0% in the age-group ≥ 80 years. West Azerbaijan had the lowest and North Khorasan had the highest age-sex adjusted prevalence rate of dementia. Our results indicated that only 21.2% of subjects with dementia were diagnosed. We observed that diabetes mellitus, depressed mood, illiteracy, and increased age were associated with dementia.

Conclusion: It seems that dementia is more common in Iran than many other countries. However, the rate of dementia diagnosis is much lower than that in developed countries.
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http://dx.doi.org/0161912/AIM.005DOI Listing
December 2016

Prevalence of physical inactivity in Iran: a systematic review.

J Cardiovasc Thorac Res 2016 30;8(3):92-97. Epub 2016 Sep 30.

Department of Community Medicine, Alborz University of Medical Science, Karaj, Iran ; Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Physical inactivity is one of the most important risk factors for chronic diseases, including cardiovascular disease, cancer, and stroke. We aim to conduct a systematic review of the prevalence of physical inactivity in Iran. We searched international databases; ISI, PubMed/Medline, Scopus, and national databases Irandoc, Barakat knowledge network system, and Scientific Information Database (SID). We collected data for outcome measures of prevalence of physical inactivity by sex, age, province, and year. Quality assessment and data extraction has been conducted independently by two independent research experts. There were no limitations for time and language. We analyzed data for prevalence of physical inactivity in Iranian population. According to our search strategy we found 254 records; of them 185 were from international databases and the remaining 69 were obtained from national databases after refining the data, 34 articles that met eligible criteria remained for data extraction. From them respectively; 9, 20, 2 and 3 studies were at national, provincial, regional and local levels. The estimates for inactivity ranged from approximately 30% to almost 70% and had considerable variation between sexes and studied sub-groups. In Iran, most of studies reported high prevalence of physical inactivity. Our findings reveal a heterogeneity of reported values, often from differences in study design, measurement tools and methods, different target groups and sub-population sampling. These data do not provide the possibility of aggregation of data for a comprehensive inference.
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http://dx.doi.org/10.15171/jcvtr.2016.20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5075364PMC
September 2016

Relationship between insulin resistance and subclinical atherosclerosis in individuals with and without type 2 diabetes mellitus.

J Diabetes Metab Disord 2015 1;15:41. Epub 2016 Oct 1.

Pediatrics, Shahed University, Faculty of Medicine, Tehran, Iran.

Background: Insulin resistance is of utmost importance as an underlying mechanism for increased risk of cardiovascular disease (CVD). We assessed the association between Homeostatic Model Assessment (HOMA-IR) and two surrogate subclinical atherosclerosis markers (SCA) among individuals with and without type 2 diabetes (DM), those who did not have any clinical presentation of the CVD.

Methods: In a cross-sectional study, 208 participants (105 diabetics and 103 non-diabetics) were enrolled from referred patients with diabetes to an academic outpatient clinic and their non-diabetic relatives in-law. Fasting serum levels of insulin, blood glucose and lipid profile, were measured. Anthropometric and blood pressure were measuremented standardly. Body Mass Index (BMI) and Homeostatic Model Assessment-Insulin Resistance (HOMA-IR) index were calculated. Coronary Artery Calcium Score(CACS) was measured using a Multi-Detctor CT scanner. Flow mediated dilation (FMD) was measured using bimode ultrasonography (with linear transducer 13,000 MHZ). Univariate and multivariate logistic regression models were used to evaluate the association between these SCA markers and HOMA index in adjusting models.

Results: CACS and HOMA-IR were higher and FMD was lower in diabetic participants than non-diabetic ones ( < 0.01) In a stepwise logistic regression model, CACS and FMD were associated with HOMA-IR (odds ratio = 1.778; 95 % confidence interval (CI): 1.211-2.726 and odds ratio = 1.557; 95 % CI: 1.601-2.275, respectively) in non-diabetics but not among diabetic participants.

Conclusions: CACS and FMD are related to insulin resistance among non-diabetic individuals, but we could not find this relationship among diabetic patients.
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http://dx.doi.org/10.1186/s40200-016-0263-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5045581PMC
October 2016

Prevalence of Metabolic Syndrome and Its Components in the Iranian Adult Population: A Systematic Review and Meta-Analysis.

Iran Red Crescent Med J 2015 Dec 27;17(12):e24723. Epub 2015 Dec 27.

Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, IR Iran; Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Epidemiology, Iran University of Medical Sciences, Tehran, IR Iran.

Context: Metabolic syndrome (MetS) increases the risk of most non-communicable diseases; gathering information about its prevalence can be very effective in formulating preventive strategies for metabolic diseases. There are many different studies about the prevalence of MetS in Iran, but the results and the study populations of these studies are very different; therefore, it is very important to have an overall estimation of its prevalence in Iran.

Objectives: This study systematically reviewed the findings of all available studies on MetS in the adult Iranian population and estimated the overall prevalence of MetS in this population.

Data Sources: International databases (Scopus, ISI Web of Science, and PubMed) were searched for papers published from January, 2000 to December, 2013 using medical subject headings (MeSH), Emtree, and related keywords (metabolic syndrome, dysmetabolic syndrome, cardiovascular syndrome, and insulin resistance syndrome) combined with the words "prevalence" and "Iran." The Farsi equivalent of these terms and all probable combinations were used to search Persian national databases (IranMedex, Magiran, SID, and Irandoc).

Study Selection: All population-based studies and national surveys that reported the prevalence of MetS in healthy Iranian adults were included.

Data Extraction: After quality assessment, data were extracted according to a standard protocol. Because of between-study heterogeneity, data were analyzed by the random effect method.

Results: We recruited the data of 27 local studies and one national study. The overall estimation of MetS prevalence was 36.9% (95% CI: 32.7 - 41.2%) based on the Adult Treatment Panel III (ATP III) criteria, 34.6% (95% CI: 31.7 - 37.6%) according to the International Diabetes Federation (IDF), and 41.5% (95% CI: 29.8 - 53.2%) based on the Joint Interim Societies (JIS) criteria. The prevalence of MetS determined by JIS was significantly higher than those determined by ATP III and IDF. The prevalence of MetS was 15.4% lower in men than in women (27.7% versus 43.1%) based on the ATP III criteria, and it was 11.3% lower in men based on the IDF criteria; however according to the JIS criteria, it was 8.4% more prevalent in men.

Conclusions: There is a high prevalence of MetS in the Iranian adult population, with large variations based on different measurement criteria. Therefore, prevention and control of MetS should be considered a priority.
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http://dx.doi.org/10.5812/ircmj.24723DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4706734PMC
December 2015

Effect of metabolic control on oxidative stress, subclinical atherosclerosis and peripheral artery disease in diabetic patients.

J Diabetes Metab Disord 2015 10;14:84. Epub 2015 Nov 10.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: By rising diabetes mellitus prevalence, the prevalence of its most complication; cardiovascular disease (CVD) is also increasing. Moreover, oxidative stress has important role in pathogenesis of diabetes and its complications. We investigated relationship between total antioxidant status (TAS) and surrogate measures of subclinical atherosclerosis (SA) with glycemic status in diabetics.

Methods & Materials: In a cross-sectional study, we recorded height, weight, waist circumference (WC) and blood pressure of 267 subjects. Blood samples were collected to measure fasting blood sugar (FBS), glycated hemoglobin (HbA1c), lipid profiles and TAS. The surrogate measures of SA were Carotid Intima Media Thickness (CIMT), and Ankle Brachial Index (ABI).

Results: We found significantly lower TAS leves and ABI values and higher CIMT in diabetic patients especially in poor glycemic group. There was a nonsignificant, weak correlation between TAS, ABI and CIMT with glycemic status (r = -0.10, -0.16, and +0.09, respectively). Multivariate regression analysis showed a significant influence of increasing age and diabetes duration on worsening CIMT in poor glycemic group.

Conclusions: Our study showed poor glycemic control leads to worse CIMT by increasing age and duration of diabetes. However we did not find a significan correlation between glycemic status and TAS levels. We suggest CIMT measurement along with other SA markers in poor glycemic diabetics, especially in older patients with longer duration of diabetes, to identify high risk CVD patients.
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http://dx.doi.org/10.1186/s40200-015-0215-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4641427PMC
November 2015

Elevated serum levels of pregnancy-associated plasma protein-A in type 2 diabetics compared to healthy controls: associations with subclinical atherosclerosis parameters.

Acta Med Iran 2015 Jul;53(7):395-402

Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Type 2 diabetes mellitus is associated with increased inflammation and accelerated atherosclerosis. The association of the pro-inflammatory and potentially pro-atherosclerotic molecule, pregnancy associated plasma protein-A (PAPP-A) with diabetes and vascular diseases remains to be further established. A total of 107 patients with type 2 diabetes and 101 healthy controls participated in this study. Serum levels of PAPP-A was measured by Enzyme-linked Immunosorbent Assay (ELISA). We also evaluated the lipid profile, aortic augmentation index, coronary calcium score, ankle brachial index, flow mediated dilation, and carotid intima media thickness. Serum level of PAPP-A was significantly higher in patients with diabetes compared to controls (P<0.001). In the multivariable regression analysis, PAPP-A was positively correlated with diabetes (P<0.001), aortic augmentation index (P=0.021) and was negatively associated with coronary calcification (P=0.050). In conclusion, serum levels of PAPP-A were significantly higher in diabetics compared to healthy controls and correlated with aortic augmentation index and coronary calcification. Our study results suggest that PAPP-A can be a marker of subclinical atherosclerosis in patients with diabetes.
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July 2015

Predicting risk of the fall among aged adult residents of a nursing home.

Arch Gerontol Geriatr 2015 Sep-Oct;61(2):124-30. Epub 2015 Jun 22.

Hull and East Yorkshire NHS Hospitals Trust, East Riding of Yorkshire, UK.

Background: Fall is one of the most important outcomes of geriatric medicine. The European Assessment System (EASY) Care Standard provides a tool for assessing the risk of the falls. We aimed to evaluate the validity of the Easy-Care risk of the falls (ECRF) sub-score among the residents of a large nursing home.

Method: A longitudinal study was conducted within a maximum of 34 months following up for falling in Kahrizak Charity Foundation. At the baseline the demographic, mental status and the depression data of 194 subjects aged ≥60 was collected. The Easy-Care standard tools and Performance-Oriented Mobility Assessment (POMA) were also used for data collecting. The time, location, and cause of the falls were recorded immediately after each fall incident. The Correlation between POMA and ECRF scores and the factor analysis of ECRF were considered as the concurrent and construct validity respectively. The Factor affecting the fall occurrence was assessed using the Cox-regression model.

Result: The mean age of the participants was 76.02 (SD 8.82). Fifty two individuals (27.3%) fell at least once during the mean 756 (SD 187)-day follow up. The Spearman correlation coefficient between ECRF and POMA scores was -0.458 (P<0.01). Three components were detected in the factor analysis of the ECRF. In the univariate Cox-regression model, the hazard ratio was 1.04 (CI: 1.00-1.07) for each score increase of the ECRF. For the six-month follow-up, at the ECRF cut-off point two of eight, the sensitivity and specificity were calculated as 85.7% and 64.5% respectively.

Conclusion: It seems that the ECRF is a valid tool for predicting the next 6 months' fall incidents in older adults.
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http://dx.doi.org/10.1016/j.archger.2015.06.014DOI Listing
December 2015

Anti-hyperlipidemic and anti-atherosclerotic effects of Pinus eldarica Medw. nut in hypercholesterolemic rabbits.

Daru 2015 Jun 9;23:32. Epub 2015 Jun 9.

Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, 4th floor, No 4, Ostad Nejatollahi Street, Engelab Avenue, Tehran, Iran.

Background: Previous studies suggest that chemical constituents present in Pinus eldarica Medw (P. eldarica) nut possess antioxidant properties that may positively influence lipid profile. The present study was conducted to evaluate the efficacy of P. eldarica nut on the experimental atherosclerosis development in hypercholesterolemic rabbits.

Methods: Forty male 6 months old white New Zealand rabbits (1.8-2 kg) were randomly assigned into five equal groups. One group was kept as control (normal) group, fed on standard rabbit diet and other 4 groups were fed on high cholesterol diet (HCD). Out of four HCD groups one group was kept as control (HCD) and other three groups were treated with different doses (50, 100 and 200 mg/kg/day) of P. eldarica nut for 8 weeks. Percentage of aortic wall area changes as indication of atherosclerosis development and fasting blood cholesterol, LDL, HDL and triglyceride levels were determined in all groups.

Results: The results indicate that fasting blood cholesterol and aortic atherosclerotic involvements in 200 mg/kg/day and 100 mg/kg/day P. eldarica nut extract treated groups significantly decreased as compared to the high cholesterol-diet control group.

Conclusion: P. eldarica nut lowers blood cholesterol level and aortic atherosclerotic involvement in hypercholesterolemic rabbits.
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http://dx.doi.org/10.1186/s40199-015-0114-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4483207PMC
June 2015

National and sub-national trend of prevalence and burden of dementia in Iran, from 1990 to 2013; study protocol.

Arch Iran Med 2014 Dec;17(12):816-20

Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran Iran.

Background: Dementia is a disabling syndrome, which generally affects aged population more than any other age groups. This syndrome has a growing prevalence and incidence worldwide. The prevalence and burden of this group of diseases in Iran have not been estimated in a community-based study yet. This paper aims to explain the systematic approach, data sources, research methodology, and statistical analysis that will be used to quantify the prevalence and burden of dementia at national and sub-national levels.

Methods: This is the protocol of a secondary data study that explains the design and method of conducting the study. We will use several sources of data that will include a systematic review of articles and gray literature which have reported the prevalence or incidence of dementia and its uncertainty at national and sub-national levels in Iran, in addition to data about dementia-specific drug sales per each year at provincial levels, as well as data extracted from 23 million health insurance prescriptions over 8 years and some data from medical documents of Iranian Alzheimer's Association members. The technical groups of National and Sub-national Burden of Disease will collect some covariate data, such as age and sex structure of population, urbanization status, mean years of schooling, plasma cholesterol, fasting plasma glucose, and systolic and diastolic blood pressure at provincial levels which will be used in our models. Two statistical models, namely spatio-temporal and hierarchical autoregressive models, will be used for interpolation and extrapolation of missing data.

Conclusion: It seems that the study of national and sub-national burden of dementia could provide more accurate estimation of prevalence and burden of dementia in Iran with an acceptable level of uncertainty than the previous studies.
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http://dx.doi.org/0141712/AIM.007DOI Listing
December 2014

Prevalence of dyslipidemia in iran: a systematic review and meta-analysis study.

Int J Prev Med 2014 Apr;5(4):373-93

Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

More than 80% cardiovascular disease (CVD) is preventable despite the fact that it is currently the ultimate cause of disability in the world. Assessment of the nationwide prevalence of dyslipidemia as a major CVD risk factor is essential to efficiently conduct prevention programs. We extracted data according to the cut-off points of dyslipidemia used in each study. All published papers on this topic in Iranian and international journals with affiliation of "Iran" were reviewed using standard keywords up to September 2011. We included all available population-based studies and national surveys conducted in individuals aged ≥ 15 years. We excluded studies with < 300 individuals, non-population-based studies, or duplicated citations. We analyzed by random effect method due to between-study heterogeneity. The estimated prevalence and 95% confidence intervals in 29 eligible articles and one un-published data for hypercholesterolemia (≥200 mg/dl), hypertriglyceridemia (≥150 mg/dl), high levels of low density lipoprotein cholesterol ([LDL-C] [≥ 130 mg/dl]) and low levels of high density lipoprotein cholesterol ([HDL-C] <40 mg/dl in males, <50 mg/dl in females), in Iranian people were 41.6% (36.1-47.0), 46.0% (43.3-48.7), 35.5% (24.0-47.1) and 43.9% (33.4-54.4), respectively among both sexes and in both rural and urban areas. Hypercholesterolemia, high LDL-C and low HDL-C were more prevalent in women, whereas hypertriglyceridemia was more prevalent in men. All types of lipid component abnormalities were more prevalent in urban residents. Prevalence of dyslipidemia is considerable in Iran. It is necessary to enforce current measures of dyslipidemia control in the Iranian people to reduce CVD burden.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4018586PMC
April 2014

Electrocardiogram abnormalities and risk of cardiovascular mortality and all-cause mortality in old age: the Kahrizak Elderly Study (KES).

Arch Gerontol Geriatr 2014 Jul-Aug;59(1):69-73. Epub 2014 Apr 5.

Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Resting electrocardioghic (ECG) abnormalities might be value for mortality prediction. The aim of this study is to evaluate whether ECG abnormalities are associated with increased mortality in older residents of Kahrizak Charity Foundation (KCF). A total of 247 participants ≥60-years of KES were enrolled in this study. Adjudicated all cause mortality was collected over 3 years between 2006 and 2009. The subjects were classified as having major, minor or no ECG abnormalities according to the Minnesota Code. The addition of ECG to risk factors were examined to predict cardiovascular diseases (CVD) and all-cause mortality by using Cox proportional hazards regression models. At baseline, 104(42.1%) had major ECG abnormalities and 73(29.6%) had minor abnormalities. During a median follow-up of 3.2 years, 73 participants died from all-cause mortality and 31 deaths from CVD. Major ECG abnormalities were associated with an increased risk of CVD mortality in all models. The associations between minor ECG abnormalities at baseline and CVD mortality were not statistically significant. After adjustment for age and sex, Body mass index (BMI), smoking, diabetes, hypertension (HTN), hyperlipidemia and history of CVD, the participants with the major ECG abnormalities had higher risks of CVD mortality (HR: 3.12(95% CI, 1.02-9.57) and all-cause mortality (HR: 2.45(95% CI, 1.23-4.85) compared with those with normal ECG.
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http://dx.doi.org/10.1016/j.archger.2014.03.011DOI Listing
October 2014

Effect of low dose ω-3 poly unsaturated fatty acids on cognitive status among older people: a double-blind randomized placebo-controlled study.

J Diabetes Metab Disord 2014 Feb 7;13(1):34. Epub 2014 Feb 7.

Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No 4, Ostad Nejatollahi Street, Engelab Avenue, Tehran, Iran.

Background: Cognitive impairment is a prevalent health problem in older people and its global prevalence tends to increase parallel to the extended life expectancy in world. The beneficial effect of ω-3 PUFAs on cognitive impairment has been demonstrated in some experimental and cohort studies. In this study we aimed to assess the effect of low dose docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) supplementation on cognitive status in the elderly.

Methods: In a double-blind, randomized placebo-controlled study, 199 individuals aged ≥65 years with normal or mild to moderate cognition impairment were assigned to receive either 180 mg of DHA plus 120 mg of EPA or placebo for 180 days. Cognitive status was assessed using Mini-Mental State Examination (MMSE) and Abbreviated Mental Test (AMT) score.

Results: MMSE and AMT scores were not different at the time of allocation [18.84 (5.37), 18.55 (5.12), (P = 0.70) and 4.81 (2.79) and 4.64 (2.77), (P = 0.67) respectively] and over 6 months between the ω-3 PUFA- and placebo- treated groups [18.57 (5.21), 18.39 (5.10), (P = 0.80) and 4.64 (2.77) and 4.48 (2.69) and (P = 0.67)]. The participants were categorized based on MMSE score into normal cognition, mild and moderate cognitive impairment. After multivariate adjustment, there was no significant difference among categorized groups regarding the ω-3 PUFA effect except in normal cognition group, that amount of decline in AMT in ω-3 poly unsaturated fatty acids (PUFAs) was less than placebo group.

Conclusions: It seems that prescription of low dose ω-3 PUFAs for 6 months had no significant beneficial effects on improvement of cognition or prevention of cognitive decline in older people.
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http://dx.doi.org/10.1186/2251-6581-13-34DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3937051PMC
February 2014

Waist circumference and insulin resistance in elderly men: an analysis of Kahrizak elderly study.

J Diabetes Metab Disord 2014 Feb 4;13(1):28. Epub 2014 Feb 4.

Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Diagnosis of the metabolic syndrome (MS) is crucial for health care practitioners to identify at risk people for early treatment. Visceral obesity may make unnecessary other laborious measures of insulin resistance. The aim of this study was to see whether waist circumference (WC) can predict insulin resistance as well as MS in a group of Iranian elderly.

Methods: Out of 94 nondiabetic elderly, thirty three subjects were recognized with MS. MS diagnosis was based on NCEP ATP III (National Cholesterol Education Program Adult Treatment Panel III) and IDF (International Diabetes Federation) definitions. HOMA (Homeostasis Model Assessment) index was used to measure insulin sensitivity. Insulin resistance (IR) was defined as top quartile of HOMA.

Results: In both sexes, WC and HOMA index were significantly positively correlated. The optimal waist circumference (OWC) cutoff point was 94.5 cm for men and 90.5 cm for women. The high sensitivity (0.80) and specificity (0.84) of WC in males indicates the proportion of IR which is correctly identified and recognizes all non-IR males as such. In regression model only the TG level was associated with WC. But the WC is strongly associated with HOMA-IR.

Conclusions: While OWC is very likely a good measure to exclude non-IR subjects in our study, determination of optimal WC to identify elderly IR subjects warrants further study in a larger sample of the general population.
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http://dx.doi.org/10.1186/2251-6581-13-28DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3929157PMC
February 2014

Impact of hypertension on various markers of subclinical atherosclerosis in early type 2 diabetes.

J Diabetes Metab Disord 2014 Jan 29;13(1):24. Epub 2014 Jan 29.

Elderly Health Research Center, Endocrinology and Metabolism population Sciences Institute, Tehran University of Medical Sciences, North Karegar Avenue, Dr Shariati Hospital, 5th floor, Tehran 1411413137, Iran.

Background: Presence of Diabetes Mellitus increases the risk of subclinical atherosclerosis. In this study was aimed to determine the influence of hypertension (HTN) on surrogate markers of atherosclerosis in a population of patients with early type 2 diabetes.

Methods: 125 diabetic subjects drawn from Dr. Shariati outpatient's clinic list and 153 non- diabetic subjects who were the relatives in law of diabetic participants were recruited. Participants with type 2 diabetes were free of clinical evidence of cardiovascular disease and renal involvement. Two groups of diabetic and control were further divided into two subgroups of hypertensive (known case of HTN or blood pressure ≥140/90 mmHg) and normotensive, and anthropometric characteristics, metabolic biomarkers as well as markers of subclinical atherosclerosis including Carotid intima media thickness (CIMT), flow mediated dilation (FMD) and Ankle Brachial Index (ABI) were measured.

Results: Diabetic group with a mean age of 49.9 ± 7.5 years had significantly higher CIMT (0.64 ± 0.14 vs 0.76 ± 0.19, p = 0.001) and lower FMD (16.5 ± 8.1 vs 13.3 ± 7.1, p = 0.003) and ABI (1.2 ± 0.1 vs 1.1 ± 0.1, p = 0.01) than control with mean age of 52.9 ± 10.1 years. 34% of control and 59.2% of diabetic were hypertensive. Fasting blood sugar, insulin levels and calculated insulin resistance index of HOMA IR. of hypertensive subjects were higher than normotensive subjects in both groups of diabetic and non-diabetic. Similar pattern was presented for measured inflammatory mediators of hs-CRP and IL-6. Among subclinical atherosclerosis markers, only CIMT was significantly different between hypertensive and normotensive subjects in both groups. In adjusted linear regression analysis, a constant significant association existed between age and CIMT, ABI and FMD in non-diabetic, while in diabetic, age only correlated with CIMT and not the other two markers. In multiple regression model, HTN was recognized as a risk factor for increasing CIMT (OR = 2.93, 95% CI = 1.03-8.33, p = 0.04) but not attenuating FMD or ABI.

Conclusions: Since FMD and CIMT may measure a different stage of subclinical atherosclerosis in diabetic patients, influence of HTN on these markers might be different.
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http://dx.doi.org/10.1186/2251-6581-13-24DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3933380PMC
January 2014

Association of cardiac autonomic neuropathy with arterial stiffness in type 2 diabetes mellitus patients.

J Diabetes Metab Disord 2013 Dec 20;12(1):55. Epub 2013 Dec 20.

Elderly Health Research Center, Endocrinology and Metabolism population Sciences Institute, Tehran University of Medical Sciences, North Karegar Avenue, Dr Shariati Hospital, 5th floor, Tehran 1411413137, Iran.

Background: Diabetic patients are at the risk of cardiac autonomic neuropathy (CAN) and arterial stiffness. This study aimed to investigate the association of heart rate variability (HRV) as an index for CAN and pulse wave velocity (PWV) as an index for arterial stiffness.

Methods: Uncomplicated diabetes type-2 patients who had no apparent history of cardiovascular condition underwent HRV and PWV measurements and the results were compared with the control group consisting of non-diabetic peers. Also, the findings were adjusted for the cardiovascular risk factors and other confounding factors.

Results: A total of 64 diabetic patients (age= 52.08±8.50 years; males=33 [51.6%]) were compared with 57 controls (age= 48.74±6.18 years; males=25 [43.9%]) in this study. Hypertension, dyslipidemia, and thereby systolic blood pressure and statin use were significantly more frequent in the diabetic group, while the serum levels of cholesterol, HDL-C and LDL-C were significantly higher in the controls. Pulse wave was significantly increased in the diabetic patients (p<0.001). Main HRV parameters were significantly lower in diabetics than in controls. After adjustment for the confounders, PWV and HRV remained significantly different between the groups (p=0.01 and p=0.004, respectively). Multiple logistic regression of the association between pulse wave velocity and HRV index was independently significant both in diabetics and controls.

Conclusions: There exists a significant relationship between heart rate variability and arterial stiffness as a measure for atherosclerosis in diabetic patients, although the role of the confounding factors is noteworthy.
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http://dx.doi.org/10.1186/2251-6581-12-55DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983836PMC
December 2013

Correlation of serum homocysteine and previous history of gestational diabetes mellitus.

J Diabetes Metab Disord 2013 2;12:34. Epub 2013 Jul 2.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Gestational diabetes mellitus (GDM) is a common pregnancy condition. In this study, the risk of having a history of previous GDM (pGDM) on serum homocysteine level was assessed.

Methods: Biomedical parameters, serum homocysteine, Insulin, homeostatic model assessment (HOMA) in women with (n = 52) and without pGDM (n = 51) were assessed. According to their current status of Oral Glucose Tolerance Test (GTT), the participants in each group were divided into two subgroups of normal or impaired GTT.

Results: Mean serum homocysteine in normal women was 8.56 ± 3.19 vs 11.44 ± 7.34 μmol/L (p < 0.01) in women with pGDM. Two groups had significant differences in respect to serum insulin levels (8.35 ± 5.12 vs 12.48 ± 5.44, p < 0.002), and HOMA-IR (1.90 ± 1.30 vs 2.91 ± 1.30, p < 0.002). In women without pGDM, serum homocysteine in normal and impaired GTT were 7.60 ± 1.69 and 10.52 ± 3.65 μmol/L (p = 0.03), respectively, while in women with pGDM, the figures were 8.38 ± 2.52 and 14.00 ± 10.17 (p < 0.01), respectively. In multi regression analysis an association between history of GDM and homocysteine levels was presented (OR: 7.71, 95% CI: 1.67-35.42, p < 0.001).

Conclusion: A trend of elevation of homocysteine is presented in women with pGDM, that is more prominent in women with impaired GTT, and shows a significant correlation with history of GDM. Further studies with larger sample size are suggested.
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http://dx.doi.org/10.1186/2251-6581-12-34DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3933000PMC
May 2014

Translation and validation of the activities of daily living scale with Iranian elderly cancer patients treated in an oncology unit.

Asian Pac J Cancer Prev 2013 ;14(5):2731-7

School of Public Health, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: This study evaluated the validity and reliability of applying the Katz's Activities of Daily Living (ADL) scale in an Iranian sample of elderly oncologic patients following initial cancer treatment.

Materials And Methods: The scale was translated with the forward-backward procedure to give an Iranian version. The ADL scale was then applied in a random sample of 400 oncologic patients aged 60 and older following initial cancer treatment. Assessment of the scale stability was twice, with a 14-days (two weeks) interval, to 30 (of the 400) eligible elderly cancer patients in March 2012. To measure treatment effects, the index was run with 150 patients in a three month recall, following oncology processing. Exploratory and confirmatory factor analysis was performed for assessment of construct validity of the Katz's ADL. Reliability was measured with internal consistency (Cronbach's alpha co-efficient), and test/retest (Spearman's r value) of the instrument. Criterion validity was evaluated by comparing the Katz with Physical Function (PF) subscale of SF 36. Known-group validity was approved by comparing of Katz' ADL between quartile groups of PF subscale of SF 36.

Results: In our study the ADL demonstrated a high degree of internal homogeneity (Cronbach's alpha 0.923). There was a high correlation between scores of two time measurement of Katz's ADL (p value of two- related- samples test was 0.3). Construct validity showed a correlation coefficient of 0.572 between the ADL and PF scores. In factor analysis, 2 factors were extracted. Evidence for the reliability of the questionnaire was good and known group validity was approved by significant differences of ADL score between quartiles of the PF subscale of SF36.

Conclusions: The results suggest that the Iranian version of ADL applied for oncologic older adult patients following initial cancer treatment is a reliable and a valid clinical instrument and comparable to those reported in other studies.
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http://dx.doi.org/10.7314/apjcp.2013.14.5.2731DOI Listing
January 2015

Association of vitamin D receptor with longevity and healthy aging.

Acta Med Iran 2013 May 7;51(4):236-41. Epub 2013 May 7.

Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Longevity is a multifaceted trait in which variety of genes and environmental factors are involved. Newly, the role of vitamin D has been revived regarding its potential advantage on delaying the aging process. Vitamin D exerts its effect through vitamin D receptor (VDR). VDR-FokI is the only polymorphism which alters the VDR length. We examined the frequency of FokI genotypes in old age population as compared to young adults to determine the discerning genotype of FokI polymorphism leading to longer living. In addition, to highlight the position of FokІ polymorphism in quality of life; a cognitive function assessment was performed. 728 participants participated in this study of which 166 individuals were elderly residents of Kahrizak Charity Foundation. The rest were participants of Iranian Multicenter Osteoporosis Study (IMOS). Genomic DNA was extracted from peripheral blood and VDR genotype was detected by the polymerase chain reaction. The participants in the elderly group underwent a cognitive function assessment. Cognitive function was measured with the mini mental state examination (MMSE). Data were analyzed by SPSS 16.5. The prevalence of ff genotype showed 48% decrease in elderly population as compared to young adults (P=0.06). In addition, F allele was over-represented in the elderly group as compared to controls (P=0.05). Also, "FF" participants of elderly group had higher MMSE as compared to "ff" genotype (18.16Vs17.12). Our data suggest that single nucleotide polymorphisms (SNPs) in FokI may be possibly involved in longevity and cognitive function.
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May 2013

Association of metabolic syndrome with inflammatory mediators in women with previous gestational diabetes mellitus.

J Diabetes Metab Disord 2013 Jan 22;12(1). Epub 2013 Jan 22.

Associate Professor of Cardiology, Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: An increased risk of metabolic syndrome (MS) has been observed among women with previous gestational diabetes mellitus (pGDM). Increased inflammatory markers such as C-reactive protein (CRP) and interleukin 6 (IL-6) usually accompany. We performed this survey to examine the relationship between pGDM and MS, CRP and IL-6.

Methods: 77 women with pGDM and 67 randomly sampled women free from GDM participated in this study, 2-3 years after index pregnancy. Laboratory and anthropometric measurements were performed. MS was defined according to ATP III criteria. Statistical analyses were conducted using SPSS 18.

Results: CRP were different between groups with and without pGDM [2.69 (2.86 mg/dl and 1.56 (1.39) mg/dl, respectively; p < 0.01]. The presence of each MS component by itself was associated with significantly higher CRP Levels, except for fasting blood glucose. In linear regression models, CRP and IL-6 were significantly associated with BMI (β =0. 25, 0.23; p < 0.01), waist circumference (β=0. 27, 0.05; p < 0.01) and HOMA-IR (β=0. 39, 0.39; p < 0.01). After adjustment for age and BMI the occurrence of pGDM in the group with both high CRP and MS was significantly associated with CRP level (OR= 5.11; CI=1.59-16.43; p < 0.01).

Conclusion: Since CRP and Il-6 were higher in women with both pGDM and MS it appears that the presence of pGDM with MS components have a synergistic effect on the elevation of serum levels of inflammatory markers which can be partly as a result of visceral obesity. Further long-term studies are necessary to confirm the relationship between CRP, IL-6 and MS in women with pGDM.
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http://dx.doi.org/10.1186/2251-6581-12-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3610287PMC
January 2013

Cardiac autonomic neuropathy measured by heart rate variability and markers of subclinical atherosclerosis in early type 2 diabetes.

ISRN Endocrinol 2012 4;2012:168264. Epub 2012 Dec 4.

Elderly Health Research Center, Endocrinology & Metabolism Research Center, Tehran University of Medical Sciences, Dr Shariati University Hospital, North Kargar Avenue, Tehran, Iran ; Tehran Heart Center, Tehran University of Medical Sciences, North Kargar Avenue, Tehran, Iran.

Cardiac autonomic neuropathy (CAN) is a critical complication of type 2 diabetes mellitus (T2DM). Heart rate variability (HRV) is a noninvasive tool to assess cardiac autonomic function. We aimed to evaluate whether CAN is associated with increased risk of atherosclerosis in T2DM. A total of 57 diabetic and 54 nondiabetic subjects, free of coronary heart disease, were recruited. Carotid intima media thickness (CIMT), coronary calcium score (CAC), and brachial Flow Mediated Dilation (FMD) were measured. Heart rate variability and vagal components of autonomic function were determined. Significant reduction of normalized HF power (P < 0.05) and total power (P < 0.01) was observed in T2DM. CIMT and CAC scores were significantly higher while FMD was significantly lower in diabetics (P < 0.01 for all). Median HbA(1c) levels were significantly higher in diabetics. CIMT was inversely and independently associated with total power both in diabetics and controls (P < 0.01 for both groups). There was also an inverse association between total power and median HbA(1c). Autonomic dysfunction, especially parasympathetic neuropathy, was present since early-stage T2DM. This was related to subclinical atherosclerosis. Early detection of cardiac autonomic neuropathy can help us detect the development of atherosclerosis earlier in T2DM to prevent unfavorable outcomes.
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http://dx.doi.org/10.5402/2012/168264DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3521488PMC
December 2012

Optimization and comparison of two different 3D culture methods to prepare cell aggregates as a bioink for organ printing.

Biocell 2012 Apr;36(1):37-45

Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran.

The ultimate goal of tissue engineering is to design and fabricate functional human tissues that are similar to natural cells and are capable of regeneration. Preparation of cell aggregates is one of the important steps in 3D tissue engineering technology, particularly in organ printing. Two simple methods, hanging drop (HD) and conical tube (CT) were utilized to prepare cell aggregates. The size and viability of the aggregates obtained at different initial cell densities and pre-culture duration were compared. The proliferative ability of the cell aggregates and their ability to spread in culture plates were also investigated. In both methods, the optimum average size of the aggregates was less than 500 microm. CT aggregates were smaller than HD aggregates. 5,000 cells per drop HD aggregates showed a marked ability to attach and spread on the culture surface. The proliferative ability reduced when the initial cell density was increased. Comparing these methods, we found that the HD method having better size controlling ability as well as enhanced ability to maintain higher rates of viability, spreading, and proliferation. In conclusion, smaller HD aggregates might be a suitable choice as building blocks for making bioink particles in bioprinting technique.
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April 2012

Carotid intima media thickness, brachial flow mediated dilation and previous history of gestational diabetes mellitus.

J Obstet Gynaecol Res 2012 Aug 8;38(8):1057-63. Epub 2012 May 8.

Endocrinology and Metabolism Research Center Radiology Department, Tehran University of Medical Sciences, Tehran, Iran.

Aim: Gestational diabetes mellitus (GDM) is a common pregnancy condition with long-term complications. We examined the association between inflammatory mediators and early atherosclerosis process by measuring the flow mediated dilatation (FMD) of brachial artery and carotid intima media thickness (CIMT) in women with previous GDM (pGDM).

Material And Methods: Women with and without pGDM with an average of 4 years following the indexed pregnancy, participated in this study. Serum levels of IL-6, hs-CRP, adiponectin, homocystein and other biomedical parameters were measured. The existence of early atherogenesis process was evaluated by measuring CIMT and FMD.

Results: HOMA-IR and insulin were significantly higher in women with pGDM. Women with pGDM had slightly higher CIMT and significantly lower percent of brachial FMD. FMD and CIMT, adjusted for age and blood pressure, showed the same pattern. FMD showed no correlation with biochemical or inflammatory markers.

Conclusion: Follow-up of this group of women, who are at increased risk of cardiovascular disease, with FMD should be considered.
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http://dx.doi.org/10.1111/j.1447-0756.2011.01829.xDOI Listing
August 2012

Association between late-life body mass index, waist circumference, and dementia: Kahrizak Elderly Study.

J Am Geriatr Soc 2012 Jan;60(1):173-4

Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.1111/j.1532-5415.2011.03751.xDOI Listing
January 2012

Gender differences in association between metabolic syndrome and carotid intima media thickness.

J Diabetes Metab Disord 2012 Sep 7;11(1):13. Epub 2012 Sep 7.

Endocrinology & Metabolism Research Center, Tehran University of Medical Sciences, Fifth floor, Dr, Shariati Hospital, North Kargar Ave, Tehran, 14114, Iran.

Background: Metabolic syndrome (Mets) is a cluster of cardiovascular risk factors which can predicts cardiovascular disease (CVD). Carotid intima-media thickness (CIMT) is known as a surrogate measure of subclinical atherosclerosis and predictor of CVD. Although, it has shown the association between Mets and CIMT, this relation regarding sex differences is limited. We aimed to find out whether gender differences in this association.

Methods: In this cross-sectional study, we recorded height, weight, waist circumference (WC), blood pressure, and lipid profiles. We used Mets; defined based on NCEP ATP III definition, and traditional cardiovascular risk factors; age, body mass index (BMI), WC, hyperlipidemia, and hypertension, in multivariate regression models which including;. The CIMT measurement < 0.73 or ≥0.73 mm was considered as low- or high risk to CVD.

Results: Overall, 150 subjects were enrolled to study that their ages were 36-75 years. The 47.3% of them (71 subjects) had Mets. CIMT was increased in Mets group compared non-Mets group (P = 0.001). In logistic regression analysis, a significant association was found between Mets and CIMT in women, but not in men (p = 0.002, and p = 0.364, respectively). After adjustment to age, WC, BMI, hypertension and hyperlipidemia, this association was significant just in women (p = 0.011) independent of WC, BMI, hyperlipidemia and hypertension.

Conclusion: Our data showed that MetS is a stronger risk factor for subclinical atherosclerosis in women than in men. So, we suggest the assessment of CIMT along with definition Mets in middle-aged women could be lead to earlier detection of at risk individuals to CVD.
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http://dx.doi.org/10.1186/2251-6581-11-13DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3598192PMC
September 2012