دانشگاه علوم پزشکی ایران
Iran University of Medical Sciences

Publications of Amol Cohort Study Publications of Amol Cohort Study (AmolCS), Phases I and II

 | Post date: 2017/10/23 | 

Publications of AmolCS, Phases I and II

 

Updated: 01 Nov 2017
  1. Discriminatory Ability of Visceral Adiposity Index (VAI) in Diagnosis of Metabolic Syndrome: A Population Based Study
  2. Parity, duration of lactation and prevalence of maternal metabolic syndrome: A cross-sectional study
  3. Lipid accumulation product and metabolic syndrome: A population-based study in northern Iran, Amol
  4. The relationship between mental health and quality of life with gastroesophageal reflux
  5. A population based study on hepatitis B virus in Northern Iran, Amol
  6. Prevalence of non-alcoholic fatty liver disease and its predictors in North of Iran
  7. Prevalence and risk factors of cholelithiasis in Amol city, Northern Iran: A population based study
  8. Prevalence of metabolic syndrome in Amol and Zahedan, Iran: A population based study
  9. Prevalence and risk factors of hepatitis C virus infection in Amol city, north of Iran: A population-Based study (2008-2011)
  10. Patient-to-patient transmission of hepatitis C at Iranian thalassemia centers shown by genetic characterization of viral strains
  11. The six obesity indices, which one is more compatible with metabolic syndrome? A population based study
  12. Prevalence and risk factors of cholelithiasis in Amol city, northern Iran: a population based study
  13. Conicity Index and Waist-to-Hip Ratio Are Superior Obesity Indices in Predicting 10-Year Cardiovascular Risk Among Men and Women
  14. The Best Obesity Indices to Use in a Single Factor Model Indicating Metabolic Syndrome: a Population Based Study
  15. Assessment of Personality in Inflammatory Bowel Disease by Using Minnesota Multiphasic Personality Inventory-2-Restructured Questionnaire
  16. Association of Liver Enzymes with 10-year Cardiovascular Disease Risk: A Population-Based Study
  17. The Factor Structure of the Twelve Items General Health Questionnaire (GHQ-12): a Population Based Study
  18. Non-alcoholic fatty liver disease (NAFLD) and 10-year risk of cardiovascular diseases.
  19. Comparison of cardiovascular risk assessment tools and their guidelines in evaluation of 10-year CVD risk and preventive recommendations: A population based study.
  20. The Prevalence of Non-alcoholic Fatty Liver Disease and Diabetes Mellitus in an Iranian Population.
  21. Obesity Measures and Elevated Levels of Alanine Aminotransferase: A Population Based Study
  22. Gastro esophageal reflux disease (GERD) prevalence and related risk factors in north of Iran
  23. Optimal cutoff points for HOMA-IR and QUICKI in the diagnosis of metabolic syndrome and non-alcoholic fatty liver disease: A population based study.
  24. Fatty liver index vs waist circumference for predicting non-alcoholic fatty liver disease
  25. The Best Obesity Indices to Discriminate Type 2 Diabetes Mellitus.
  26. Rural Residency has a Protective Effect and Marriage is a Risk Factor for NAFLD
  27. The Epidemiology of Metabolic Syndrome in Iran: The Need to Reconsider the Definitions
  28. The 10-year Absolute Risk of Cardiovascular (CV) Events in Northern Iran: a Population Based Study
  29. Nonalcoholic Fatty Liver: The Association with Metabolic Abnormalities, Body Mass Index and Central Obesity--A Population-Based Study
  30. FATTY LIVER INDEX VALUE FOR NON-ALCOHOLIC FATTY LIVER DISEASE: A POPULATION BASED STUDY
  31. Body Roundness Index and Waist-to-Height Ratio are Strongly Associated With Non-Alcoholic Fatty Liver Disease: A Population-Based Study.

 


 

Motamed, N., Khonsari, M.R., Rabiee, B., Ajdarkosh, H., Hemasi, G.R., Sohrabi, M.R., Maadi, M., Zamani, F.

Discriminatory Ability of Visceral Adiposity Index (VAI) in Diagnosis of Metabolic Syndrome: A Population Based Study

(2017) Experimental and Clinical Endocrinology and Diabetes, 125 (3), pp. 202-207.

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85014953512&doi=10.1055%2fs-0042-119032&partnerID=40&md5=56fabd23a33a0a064f032cdd80964563

DOI: 10.1055/s-0042-119032

AFFILIATIONS: Department of Social Medicine, Zanjan University of Medical Sciences, Zanjan, Iran;
Gastrointestinal and Liver Diseases Research Center (GILDRC), Tehran Firoozgar Hospital, Iran University of Medical Sciences, Department of Gastroenterology and Liver Disease, Beh Afarin St., Karim Khan Zand Ave., Tehran, Iran

ABSTRACT: Background Visceral adiposity index (VAI) has been suggested as an index of visceral adiposity. This study was conducted to determine the discriminatory ability of VAI in diagnosis of metabolic syndrome (MetS). Methods and materials We used the data of 5 312 subjects aged 18-74 years of a cohort study conducted among 6 140 individuals aged 10-90 years in Amol, northern Iran. The city population was divided into 16 strata based on gender and age groups in 10-year intervals. The subjects were randomly selected from each stratum. MetS was defined based on National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATPIII), American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) update of Adult Treatment Panel III (ATPIII), International Diabetes Federation (IDF) and joint interim statement (JIS) definitions. The discriminatory ability of VAI and other obesity measures were evaluated using receiver operating characteristic (ROC) curves. Results While waist circumference (WC) showed the highest discriminatory ability for MetS in IDF definition in men (AUC=0.899 [CI=0.888-0.910]), VAI had the greatest discriminatory ability according to other definitions in men and women. The related AUCs of VAI were 0.866 (95%CI: 0.850-0.881), 0.829 (95%CI: 0.813-0.846), 0.859 (95%CI: 0.844-0.873) and 0.876 (95%CI: 0.863-0.889) based on NCEP/ATPIII, AHA/NHLBI update of ATPIII, IDF and JIS definition in men, and also 0.888 (95%CI: 0.875-0.902), 0.894 (95%CI: 0.881-0.907), 0.883 (95%CI: 0.869-0.897) and 0.879 (95%CI: 0.864-0.894) in women, respectively. Conclusion VAI showed an excellent discriminatory ability in diagnosis of MetS. Considering its relatively simple calculation, this index could be suggested as a reliable tool in medical practice. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart - New York.

Moradi, S., Zamani, F., Pishgar, F., Ordookhani, S., Nateghi, N., Salehi, F.

Parity, duration of lactation and prevalence of maternal metabolic syndrome: A cross-sectional study

(2016) European Journal of Obstetrics Gynecology and Reproductive Biology, 201, pp. 70-74.

https://www.scopus.com/inward/record.uri?eid=2-s2.0-84964047877&doi=10.1016%2fj.ejogrb.2016.03.038&partnerID=40&md5=0d49c3005b833213102bf2bac93d5483

DOI: 10.1016/j.ejogrb.2016.03.038

AFFILIATIONS: Endocrine Research Center (Firouzgar), Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Valadi St., Behafarin St., Karimkhan Ave., Vali-asr Sq, Tehran, Firouzgar Alley, Iran;
Gastrointestinal and Liver Diseases Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran;
SSRC, Tehran University of Medical Sciences (TUMS), Tehran, Iran

ABSTRACT: Objective Pregnancy is associated with insulin resistance in tissues. Although this condition is resolved after termination of pregnancy, subtle metabolic changes can remain and prompt incidence of metabolic syndrome. However, lactation causes increased metabolic load and energy needs and it may confer with unfavorable effects of pregnancy in metabolic status. We conduct this study to evaluate impacts of lactation on development of metabolic syndrome (MetS) among women. Study design In this cross-sectional study, we enrolled 978 women aged between 40 and 70 years who had at least one previous live birth, referred to population research center of Amol, Iran in 2011. We surveyed medical registries of participants of Amol health cohort and filled the checklist we had designed for our study. The checklist included main variables like age, number of pregnancies, life-time lactation duration, waist size, systolic and diastolic blood pressures, blood triglyceride level, and blood glucose level. Results We included 978 women among which, the mean age of participants was 53.24 ± 7.8 years. Calculated odds ratio (OR) for relationship of number of parities and metabolic syndrome (OR = 1.14 [95% CI = 1.02-1.28] p-value = 0.017) was found to be statistically significant. However, calculated odds ratio for relationship of lactation duration and MetS (OR = 0.99 [95% CI = 0.99-1.00], p-value = 0.322) was not statistically meaningful. Moreover, we calculated OR and Pearson correlation coefficient in different strata of number of parities, none of which were statistically significant and hence did not support protective roles of lactation in development of metabolic syndrome. Conclusions Our data did not support protective roles of lactation in development of metabolic syndrome, since in our study longer lactation durations as well as higher number of parities were seen among participants with metabolic syndrome. © 2016 Elsevier Ireland Ltd. All rights reserved.

Motamed, N., Razmjou, S., Hemmasi, G., Maadi, M., Zamani, F.

Lipid accumulation product and metabolic syndrome: A population-based study in northern Iran, Amol

(2016) Journal of Endocrinological Investigation, 39 (4), pp. 375-382. Cited 6 times.

https://www.scopus.com/inward/record.uri?eid=2-s2.0-84962586309&doi=10.1007%2fs40618-015-0369-5&partnerID=40&md5=0963c9d9490fe26da25a73eba0edb41b

DOI: 10.1007/s40618-015-0369-5

AFFILIATIONS: Department of Social Medicine, Zanjan University of Medical Science, Zanjan, Iran;
Department of Neuroscience, Carleton University, Ottawa, Canada;
Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran

ABSTRACT: Purpose: Lipid accumulation product (LAP) demonstrated a strong predictive accuracy for metabolic syndrome (MetS) in previous studies. This study was conducted to determine the predictive performance of LAP compared to obesity indexes. Moreover, the optimal cutoff point of LAP based on the study population waist circumference threshold was estimated in both men and women. Methods: 5797 subjects with an average age of 44.77 ± 16.77 years for men and 43.78 ± 15.43 years for women were included in the present study. The ROC analysis was performed to assess the predictive accuracy of LAP in the diagnosis of MetS. The optimal cutoff point of LAP was determined according to maximal Youden index in both men and women. Results: The optimal cutoff points determined for LAP were 49.71 (sensitivity = 85.2 %, specificity = 82.3 %) for women and 39.89 (sensitivity = 86 %, specificity = 79.6 %) for men. Based on the assigned cutoff points, the prevalence of high LAP was obtained 44.1 % in men and 45.1 % in women. LAP also showed a significantly higher predictive performance for MetS compared to obesity measures and also TG. Conclusion: LAP has a strong and reliable diagnostic accuracy for MetS in Iranian population in the north of Iran. LAP showed a better predictability than other obesity indexes assessed in the present study. © 2015 Italian Society of Endocrinology (SIE).

Hosseini, S.H., Kiadehi, N.K., Fakhri, K., Alipour, A., Zamani, F.

The relationship between mental health and quality of life with gastroesophageal reflux

(2015) Journal of Mazandaran University of Medical Sciences, 24 (122), pp. 81-87.

https://www.scopus.com/inward/record.uri?eid=2-s2.0-84944034651&partnerID=40&md5=3b765315761f735d4c01d513f7217928

AFFILIATIONS: Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran;
Islamic Azad University, Sari Branch, Sari, Iran;
Department of Psychology, Islamic Azad University, Sari Branch, Sari, Iran;
Department of Epidemiology, Mazandaran University of Medical Sciences, Sari, Iran;
Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran

ABSTRACT: Background and purpose: Gastroesophageal reflux is the most common disease of the digestive tract which could have adverse effects on mental health and quality of life. Unfortunately, there is an increasing incidence of this disease in Iran. In this study we examined the relationship between mental health and quality of life in people with acid reflux disease in general population in Amol, 2012. Materials and methods: This cross sectional study included 473 people who were randomly selected via cluster sampling. Among the subjects 229 had gastroesophageal reflux disease while 224 people did not suffer from the disease. The questionnaires for demographic characteristics, mental health and quality of life and reflux were completed. To analyze the data t test, chi-square and Spearman correlation were applied. Results: Patients with reflux had lower scores in mental health status. Also, eight domains of quality of life in people with gastroesophageal reflux disease was lower for the domains of physical role, body pain, general health perception, vitality, social functioning, and mental health. Conclusion: In this study we found that mental health in people with gastroesophageal reflux is lower than that of the normal subjects. Also, the quality of life in these people, especially in six domains of physical role, body pain, general health perception, vitality, social functioning and mental health, was lower than those of the healthy people. © 2015 Mazandaran University of Medical Sciences. All rights reserved.

Keyvani, H., Sohrabi, M., Zamani, F., Poustchi, H., Ashrafi, H., Saeedian, F., Mooadi, M., Motamed, N., Ajdarkosh, H., Khonsari, M., Hemmasi, G., Ameli, M., Kabir, A., Khodadost, M.

A population based study on hepatitis B virus in Northern Iran, Amol

(2014) Hepatitis Monthly, 14 (8), art. no. e20540, . Cited 12 times.

https://www.scopus.com/inward/record.uri?eid=2-s2.0-84928992703&doi=10.5812%2fhepatmon.20540&partnerID=40&md5=68078e816916a0154557521dc657c51c

DOI: 10.5812/hepatmon.20540

AFFILIATIONS: Department of Virology, Iran University of Medical Sciences, Tehran, IR, Iran;
Gastrointestinal and Liver Diseases Research Center (GILDRC), Iran University of Medical Sciences, Tehran, IR, Iran;
Liver and Pancreatobiliary Disease Research Center, Digestive Disease Research institute (DDRI), Tehran University of Medical Sciences, Tehran, IR, Iran;
Department of Pathology, Kingston University, London, United Kingdom;
Department of Epidemiology, School of Publich Health, Shahid Beheshti University of Medical Sciences, Tehran, IR, Iran

ABSTRACT: Background: Viral hepatitis is a major health problem worldwide. Change in transmission patterns of hepatitis B makes it necessary to re-evaluate its prevalence and risk factors. Objectives: We aimed to determine the prevalence of HBV infection and its related risk factors in Amol city, Northern Iran. Patients and Methods: As a population based study, a cluster sampling approach was used and 6146 individuals from the general population of urban and rural areas of Amol, Iran, from both genders and different ages were enrolled. Inclusion criteria were willingness to participate in the study, being a lifelong resident in Amol city or its surrounding areas with Iranian nationality. Ten milliliters (10 mL) of blood was taken from each study subject and checked regarding hepatitis B markers including HbsAg, HBsAb and HBcAb using a third generation ELISA. The prevalence of HBV infections and its potential risk factors were recorded. Results: The prevalence of HBsAg, HBsAb and HBcAb were estimated as 0.9%, 30.7% and 10.5%, respectively. The mean age of all participants was 43.9 (95% CI: 43.4, 44.3) in females and 55.6 in (n = 3472) males. In our study, there was a significant association between family history of hepatitis, rural residency and presence of HBsAg. There was also a positive correlation between HBcAb and family history of hepatitis, history of other types of hepatic diseases, history of tattooing, traditional phlebotomy, male gender and age. In backward logistic regression, a significant association was found between history of hepatitis in first-degree family members (OR = 13.35; 95% CI: 6.26, 28.47) and place of residence (OR = 2.32; 95% CI: 1.27, 4.22) with presence of HBsAg. There was also a positive correlation between history of hepatitis among first-degree family members (OR = 2.49; 95% CI: 1.52, 4.08), history of tattooing (OR = 2.13; 95% CI: 1.33, 3.42), history of previous hepatitis (OR = 1.87; 95% CI: 1.06, 3.28), male sex (OR = 1.36; 95% CI: 1.12, 1.66) and age (OR = 1.03; 95% CI: 1.03, 1.04) with presence of HBcAb. Conclusions: The prevalence of hepatitis B in Amol City and its surrounding areas was about one percent, a lower rate than other reports from Iran. © 2014, Kowsar Corp.; Published by Kowsar Corp.

Amirkalali, B., Poustchi, H., Keyvani, H., Khansari, M.R., Ajdarkosh, H., Maadi, M., Sohrabi, M.R., Zamani, F.

Prevalence of non-alcoholic fatty liver disease and its predictors in North of Iran

(2014) Iranian Journal of Public Health, 43 (9), pp. 1275-1283. Cited 16 times.

https://www.scopus.com/inward/record.uri?eid=2-s2.0-84911465799&partnerID=40&md5=62a82abcd6a4bba115dfc002f304dec1

AFFILIATIONS: Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran;
Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran;
School of Medicine, Iran University of Medical Sciences, Tehran, Iran

ABSTRACT: Background: Nonalcoholic fatty liver disease (NAFLD) is one of the aspects of metabolic syndrome (MetS). Due to the increase of MetS in Iran, this study was conducted to determine the prevalence of NAFLD, its potential predictors and their sex distribution in north of Iran, Amol.
Methods: In 2008 this population based cross-sectional study included 5023 adult individuals who were randomly selected from Amol healthcare centers. Blood analysis and hepatic sonography was performed for each individual and Clinical histories were reviewed. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III. Chi-square test, univariate and multivariate logistic regression were used to analyze data.
Results: The prevalence of NAFLD and metabolic syndrome was 43.8% and 29.6% respectively. Both NAFLD and metabolic syndrome were significantly more prevalent in women. There was a stronger association between these two factors in women which may indicate MetS has a much more potency to result in NAFLD in women. The strongest predictors of NAFLD in men were waist circumference>102 cm, serum ALT ≥40 (U/L) and the age group of 40-60 years. The strongest predictors of NAFLD in women were waist circumference>88 cm, the age groups of 40-60 and >60 years.
Conclusions: The observed prevalence is alarming because almost 7out of 10 subjects with MetS had NAFLD. As high waist circumference was an important predictor of NAFLD in both sexes, health care policies to reduce the incidence of obesity in the country will have an important impact on the occurrence of NAFLD. © 2014, Iranian Journal of Public Health. All rights reserved.

Zamani, F., Sohrabi, M., Alipour, A., Motamed, N., Saeedian, F.S., Pirzad, R., Abedi, K., Maadi, M., Ajdarkosh, H., Hemmasi, G., Khonsari, M.

Prevalence and risk factors of cholelithiasis in Amol city, Northern Iran: A population based study

(2014) Archives of Iranian Medicine, 17 (11), pp. 750-754. Cited 15 times.

https://www.scopus.com/inward/record.uri?eid=2-s2.0-84908373011&partnerID=40&md5=9647a8e61f513c542e810ac9eb3174b7

AFFILIATIONS: Gastrointestinal and Liver Disease Research Center (GILDRC), Iran university of medical science, Firoozgar Hospital, Tehran, Iran;
Community Medicine Department, Medical School, Mazandaran University of Medical Sciences, Mazandaran, Iran;
17 shahrivar Hospital, Amol, Mazandaran University of Medical Sciences, Mazandaran, Iran

ABSTRACT: Background: Cholelithiasis is one of the most prevalent gastrointestinal disorders requiring hospitalization. While different factors influence gallstone formation in patients, these factors are not the same in different societies or in different geographical locations. Aim: To evaluate the epidemiology and risk factors associated with gallstone formation in a large population group, the present survey was conducted in northern Iran.
Methods: In 6143 asymptomatic subjects, the incidence of gallstone formation as well as risk factors were evaluated through a structured questionnaire, physical examination and ultrasonography study. Sample selection was based on stratified clustersystemic randomization. Results: Of these enrolled subjects 3507 (57.1%) were male and 2636 (42.9%) were female with a mean age of 42.71 ± 17.1 years. The prevalence of gallstones was 0.80%. On multivariate analysis, the risk of gallstone disease is correlated to rural locale, diastolic hypertension, age, and TG levels. However, systolic hypertension, glucose serum levels and obesity were also significantly associated with the presence of gallstones.
Conclusion: The present study proposes that the rate of gallstone disease in northern Iran is lower than previous studies have reported, and that most of the risk factors can be prevented by changes in lifestyle and diet. © 2014 Academy of Medical Sciences of I.R. Iran. All rights reserved.

Ostovaneh, M.R., Zamani, F., Sharafkhah, M., Ansari-Moghaddam, A., Akhavan Khaleghi, N., Saeedian, F.S., Rohani, Z., Motamed, N., Maadi, M., Malekzadeh, R., Poustchi, H.

Prevalence of metabolic syndrome in Amol and Zahedan, Iran: A population based study

(2014) Archives of Iranian Medicine, 17 (7), pp. 477-482. Cited 7 times.

https://www.scopus.com/inward/record.uri?eid=2-s2.0-84904200148&partnerID=40&md5=82c070f4ea194f3f2da40d12323164ef

AFFILIATIONS: Digestive Diseases Research Institute (DDRI), Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran;
Gastrointestinal and Liver Diseases Research Center (GLDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran;
Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran

ABSTRACT: Purpose: So far, a variety of prevalence rates have been reported for the metabolic syndrome (MetS) according to several definitions. The aim of this study was to assess the prevalence of MetS in Iran according to two definitions and compare the characteristics of the subjects who met the MetS criteria according to the different definitions. Methods: Participants were recruited from family registries of public health centers. After obtaining demographic and clinical data, the subjects underwent anthropometric measurements and laboratory evaluations. MetS was defined according to the NCEP-ATPIII and IDF criteria. The subjects were then categorized into 3 groups: 1) Healthy non-MetS subjects based on either definition, 2) Individuals with MetS according to only one of the definitions, and 3) Individuals who met both NCEP-ATPIII and IDF criteria for MetS. Results: Totally, 5826 subjects in Amol and 2243 subjects in Zahedan were enrolled in the study. The weighted prevalence of MetS ac¬cording to the NCEP-ATPIII and IDF criteria was 27.8% and 26.9% in Amol and 12% and 11.8% in Zahedan, respectively. Overall, 18.9% of the subjects fulfilled both criteria for MetS. However, a considerable proportion (8.5%) met the MetS criteria according to only one definition but not both. Conclusions: MetS is increasingly prevalent in Iran as well as other parts of the world. Due to non-uniform definitions of MetS, some of the subjects who meet MetS according to one set of criteria might be considered healthy according to another definition and consequently would not receive the preventive health services.

Zamani, F., Sohrabi, M., Poustchi, H., Keyvani, H., Saeedian, F.S., Ajdarkosh, H., Khoonsari, M., Hemmasi, G., Moradilakeh, M., Motamed, N., Maadi, M.

Prevalence and risk factors of hepatitis C virus infection in Amol city, north of Iran: A population-Based study (2008-2011)

(2013) Hepatitis Monthly, 13 (12), art. no. e13313, . Cited 13 times.

https://www.scopus.com/inward/record.uri?eid=2-s2.0-84889802394&doi=10.5812%2fhepatmon.13313&partnerID=40&md5=7295d81eac63146af27c9b5eab639f34

DOI: 10.5812/hepatmon.13313

AFFILIATIONS: Gastrointestinal and Liver Diseases Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran;
Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran;
Department of Virology, Tehran University of Medical Sciences, Tehran, Iran

ABSTRACT: Background: Hepatitis C Virus (HCV) infection is one of the most important causes of chronic liver disease and related problems in the world.There are few population-based studies on the prevalence and risk factors of hepatitis C infection in Iran, which could not provide enough information. Moreover, the prevalence and risk factors of hepatitis C infection are not similar in all parts of Iran. Objectives: The aim of this survey was to determine the prevalence and risk factors of HCV infection in the general population of the city of Amol, north of Iran. Patients and Methods: This was a population-based study. Using a cluster sampling approach, 6145 individuals of both genders and different ages were involved from general population of urban and rural areas of Amol, The inclusion criteria were Iranian nationality, willing to participate in the study, and lifelong residence in Amol city and surrounding areas. Anti-hepatitis C antibody was measured by a third generation of ELISA. The positive results were confirmed by Recombinant Immuno Blot Assay (RIBA) and quantitative HCV-RNA polymerase chain reaction (PCR) tests. Potential risk factors of HCV transmission were recorded. Results: The mean age of participants was 42.70 ± 17.10 years. Of these participants, 57.2% (n = 3483) were male. Anti-HCV antibody was positive in 12 individuals from which five were RIBA positive. Three of these subjects were PCR positive. The prevalence of HCV was more predominant among males than females. The common risk factors among the study subjects included history of minor or major surgery (34.7%), unsterile punctures (21.2%), history of traditional phlebotomy (5.8%), and history of hepatitis among close relatives (5.7%). In univariate regression analysis, unsterile punctures and history of infection in family members were associated with HCV infection. Conclusions: We confirm that in Amol city and surrounding areas, the prevalence of true HCV infection is 0.05%, which is lower than that previously reported from Iran. © 2013, Kowsar Corp.; Published by Kowsar Corp.

Samimi-Rad, K., Asgari, F., Nasiritoosi, M., Esteghamati, A., Azarkeyvan, A., Eslami, S.M., Zamani, F., Magnius, L., Alavian, S.-M., Norder, H.

Patient-to-patient transmission of hepatitis C at Iranian thalassemia centers shown by genetic characterization of viral strains

(2013) Hepatitis Monthly, 13 (1), . Cited 8 times.

https://www.scopus.com/inward/record.uri?eid=2-s2.0-84874037440&doi=10.5812%2fhepatmon.7699&partnerID=40&md5=8ad15352dbf80d9ed91f93708181af2f

DOI: 10.5812/hepatmon.7699

AFFILIATIONS: Department of Virology, School of Public Health, Tehran University of Medical Sciences, P. O. Box: 6446, Tehran, IR, Iran;
Center for Disease Control, Deputy of Health, Ministry of Health and Medical Education, Tehran, IR, Iran;
Department of Internal Medicine, Gastroenterology and Hepatology Section, Tehran University of Medical Sciences, Tehran, IR, Iran;
Department of Pediatric, Tehran University of Medical Sciences, Tehran, IR, Iran;
Iranian Blood Transfusion Organization (IBTO), Thalassemia Center, Tehran, IR, Iran;
Gastrointestinal and Liver Disease Research Center, Firoozgar Hospital, Tehran University of Medical Sciences, Tehran, IR, Iran;
Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institute, Solna, Sweden;
Research Center for Gastroenterology and Liver Disease, Baqiatallah University of Medical Sciences, Tehran, IR, Iran;
Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden

ABSTRACT: Background: Hepatitis C is prevalent among thalassemia patients in Iran. It is mainly transfusion mediated, in particular among patients treated before 1996 when blood screening was introduced. Objectives: The current study aimed to investigate why patients still seroconvert to anti-HCV in Iranian thalassemia centers. Patients and Methods: During 2006-2007 sera were sampled from 217 anti-HCV positive thalassemia patients at nine thalassemia centers in Tehran and Amol city, where 34 (16%) patients had been infected after 1996. The HCV subtype could be determined by sequencing and phylogenetic analysis of partial NS5B and/or 5?NCR-core region in 130 strains. Results: 1a (53%) was predominant followed by 3a (30%), 1b (15%), and one strain each of 2k, 3k and 4a. Phylogenetic analysis revealed 19 clades with up to five strains diverging with less than six nucleotides from each other within subtypes 1a and 3a. Strains in seven clades were from nine patients infected between 1999 and 2005 and similar to strains from eight patients infected before 1996, indicating ongoing transmission at the centers. Further epidemiological investigation revealed that 28 patients infected with strains within the same clade had frequently been transfused at the same shift sitting on the same bed. An additional eight patients with related strains had frequently been transfused simultaneously in the same room. Conclusions: The results suggest nosocomial transmission at these thalassemia centers both before and after the introduction of blood screening. Further training of staff and strict adherence to preventive measures are thus essential to reduce the incidence of new HCV infections. © 2013, Kowsar Corp.

Motamed N, Sohrabi M, Poustchi H, Maadi M, Malek M, Keyvani H, et al.

The six obesity indices, which one is more compatible with metabolic syndrome? A population based study.

Diabetes Metab Syndr. 2017;11(3):173-7.

https://www.ncbi.nlm.nih.gov/pubmed/27658893

OBJECTIVES: The present study was conducted to determine the best discriminators in the diagnosis of the metabolic syndrome (MetS) among six obesity indexes. Furthermore the optimal cutoff points for all obesity indexes were determined. METHODS: The baseline data of 5910 subjects of Haraz cohort study which was conducted in northern Iran were analyzed. Receiver operating characteristic (ROC) analyses were separately performed to determine discriminatory power of six obesity indexes, including, body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtR), abdominal volume index (AVI) and conicity index (CI) for diagnosis of at least two other components of MetS. Youden index was used to determine the optimal cutoff points. RESULTS: While the optimal cutoff points in men were 26.0kg/m2 for BMI, 90cm for WC, 0.90 for WHR, 0.53 for WHtR, 16.6 (cm2) for AVI and 1.24(m32/kg12) for CI, the optimal values in women were 29.0kg/m2 for BMI, 91cm for WC, 0.86 for WHR, 0.58 for WHtR, 17.0(cm2) for AVI and 1.23 (m32/kg12) for CI. The prevalence of overweight or obesity was 46.1% to 54.1% in women and 49.5% to 53.6% in men based on various obesity indexes. The area under the ROC curves (AUCs) varied from 0.671(0.651-0.690) for CI to 0.718(0.700-0.736) for WC in men and from 0.668 (0.646-0.690) for BMI to 0.755(0.735-0.774) for WHR and CI in women. CONCLUSION: Except for CI in men and BMI in women, other obesity indexes were good discriminator in the diagnosis of the MetS.

Zamani F, Sohrabi M, Alipour A, Motamed N, Saeedian FS, Pirzad R, et al.

Prevalence and risk factors of cholelithiasis in Amol city, northern Iran: a population based study.

Arch Iran Med. 2014;17(11):750-4.

https://www.ncbi.nlm.nih.gov/pubmed/25365614

BACKGROUND: Cholelithiasis is one of the most prevalent gastrointestinal disorders requiring hospitalization. While different factors influence gallstone formation in patients, these factors are not the same in different societies or in different geographical locations. AIM: To evaluate the epidemiology and risk factors associated with gallstone formation in a large population group, the present survey was conducted in northern Iran. METHODS: In 6143 asymptomatic subjects, the incidence of gallstone formation as well as risk factors were evaluated through a structured questionnaire, physical examination and ultrasonography study. Sample selection was based on stratified cluster systemic randomization. RESULTS: Of these enrolled subjects 3507 (57.1%) were male and 2636 (42.9%) were female with a mean age of 42.71 +/- 17.1 years. The prevalence of gallstones was 0.80%. On multivariate analysis, the risk of gallstone disease is correlated to rural locale, diastolic hypertension, age, and TG levels. However, systolic hypertension, glucose serum levels and obesity were also significantly associated with the presence of gallstones. CONCLUSION: The present study proposes that the rate of gallstone disease in northern Iran is lower than previous studies have reported, and that most of the risk factors can be prevented by changes in lifestyle and diet.

Motamed N, Perumal D, Zamani F, Ashrafi H, Haghjoo M, Saeedian FS, et al.


Conicity Index and Waist-to-Hip Ratio Are Superior Obesity Indices in Predicting 10-Year Cardiovascular Risk Among Men and Women.

Clin Cardiol. 2015;38(9):527-34.

https://www.ncbi.nlm.nih.gov/pubmed/26418518

BACKGROUND: Central obesity has been recognized as a main risk factor for cardiovascular (CV) events. Three popular central obesity indices are waist circumference, waist-to-hip ratio (WHR), and waist-to-height ratio; abdominal volume index and conicity index are 2 recent novel obesity indices. The main aim of this study is to determine the performance of these indices to best predict 10-year CV events. HYPOTHESIS: Some obesity indices can be used to predict cardiovascular risk. METHODS: In total, 3199 subjects (age range, 40-79 years) were enrolled in this cross-sectional study. The American College of Cardiology/American Heart Association and Framingham risk score tools were used to estimate the 10-year CV events. Receiver operating characteristic curve analysis was used to determine the optimal discriminator(s) among the central obesity measures in the estimation of a 10-year risk of CV events >/=7.5%, >/=10%, and >/=20% separately. RESULTS: Among the 5 central obesity indices, conicity index showed the most discriminatory power in estimation of a 10-year CV risk. In men, based on the American College of Cardiology/American Heart Association tool, the areas under the curve (AUCs) were from 0.671 to 0.682 based on the 3 above thresholds, whereas with the Framingham tool, AUCs were from 0.651 to 0.659. In women, all AUCs were >0.7. Our results also showed WHR to be an almost comparable discriminator of CV disease risk in the Iranian study population. CONCLUSION: Conicity index and WHR had a more discriminatory accuracy for 10-year CV events compared with the other obesity indices.

Motamed N, Zamani F, Rabiee B, Saeedian FS, Maadi M, Akhavan-Niaki H, et al.

The Best Obesity Indices to Use in a Single Factor Model Indicating Metabolic Syndrome: a Population Based Study.

Arch Iran Med. 2016;19(2):110-5.

https://www.ncbi.nlm.nih.gov/pubmed/26838081

OBJECTIVE: Although metabolic syndrome (MetS) is a major health problem worldwide, there is no universal agreement on its definition. One of the major disagreements is dealing with the issue of obesity in this definition. This study was conducted to determine a preferably better index of obesity which can be interrelated with other components of MetS in a single factor model of MetS. DESIGN: Out of 6140 participants of a cohort study of subjects aged 10-90 years in northern Iran, the baseline data of 5616 participants aged 18-75 was considered. Confirmatory factor analysis was conducted using AMOS software to evaluate a single factor model of MetS in which blood pressure, triglyceride (TG), high density lipoprotein (HDL), fasting blood sugar (FBS) and obesity measures including waist circumference (WC), body mass index (BMI), waist to hip ratio (WHR) and waist to height ratio (WHtR) were used as indicators of metabolic syndrome. Four single factor models differing from each other by obesity indices were evaluated. The models were evaluated in all 5616 subjects and 4931 subjects without diabetes mellitus according to sex separately. RESULTS: All single factor models had appropriate fit indices with CFI > 0.95, GFI > 0.95 and RMSEA < 0.08 in non-diabetic population, wherein all models obtained the best values of fit indices in men and good fit indices in women. In the general population of men, the single factor models built based on WHR (Chi-square=6.9, df=2, P-value=0.031, RMSEA = 0.028, CI = 0.007-0.052, CFI = 0.994, GFI = 0.999 and AIC = 22.9) and WHtR (Chi-square = 9.97, df = 2, P-value = 0.007, RMSEA = 0.036, CI = 0.016-0.059, CFI = 0.992, GFI = 0.998 and AIC = 25.97) were fitted properly with data while in th general population of women, the model based on WHR obtained better fit indices (Chi-square = 7.5, df = 2, P-value = 0.023, RMSEA = 0.033, CI = 0.011-0.060, CFI = 0.994, GFI = 0.998 and AIC = 23.5). Models based on WHtR obtained better regression weights than WHR. CONCLUSION: While single factor validity of MetS was confirmed in almost all models, the best models were different according to sex and population of study.

Shohreh Shokrzadeh, Kambiz Kamkari, Farhad Zamani, Mansooreh Maadi.

Assessment of Personality in Inflammatory Bowel Disease by Using Minnesota Multiphasic Personality Inventory-2-Restructured Questionnaire

GOVARESH 2017. 22(3):164-170.

http://www.govaresh.org/index.php/dd/article/view/1890.pdf

Background : Inflammatory bowel diseases (IBDs), including ulcerative colitis and Crohn’s disease, are chronic and debilitating conditions that their prevalence are growing. These diseases have association with psycho-cognitive factors. This study aimed to evaluate the personality traits of such patients by applying the Minnesota Multiphasic Personality Inventory-2-Restructured Questionnaire

Material and Methods: We included 100 patients with biopsy proven IBD in this case control study. 100 individuals (57 subjects of the patients’ family members and 43 subjects of non-family members) were considered as controls. We applied MMPI-2RF to evaluate the personality traits of the participants. ANOVA was used to compare the mean scales between the three groups.

Results: Of this fifty scale-questionnaire, only the scales of emotional inadequacy (mean=59.83±10.42 p=0.047), demoralization (mean=63.00±11.21 p =0.025), malaise (mean=64.99±14.58 p =0.001), cognitive complaints (mean=64.66±15.25 p =0.008), self-doubt (mean=57.55±11.04 p =0.34), and neuroticism (mean=61.43±11.94 p =0.048) had a significant difference between the three groups.

Conclusion: The patients with IBD had a higher scales of emotional inadequacy, demoralization, malaise, cognitive complaints, self-doubt, and neuroticism than the controls of non-family and family members. However the differences were significant only between patients with IBD and their non-family controls. We suggest regular psychological and psychiatric counseling for patients with IBD.

KEYWORDS: Personality, Minnesota Multiphasic Personality Inventory-2Restructured Questionnaire Inflammatory bowel diseases

Nima Motamed 1 , Behnam Rabiee 2 , Behzad Farahani 3 , Mahmood Reza Khonsari 2 , Zahedin Kheyri 4 , Gholam Reza Hemasi 2 , Mansooreh Maadi 2 and Farhad Zamani 2 , *

Association of Liver Enzymes with 10-year Cardiovascular Disease Risk: A Population-Based Study

Hepatitis Monthly: January 2017, 17(1); e43901.Published Online: December 31, 2016

http://hepatmon.com/en/articles/15696.html

Background: The association between liver enzymes and cardiovascular disease (CVD) was previously demonstrated. This study investigated the possible association between liver enzymes and the 10-year risk of cardiovascular events.

Methods: The study consisted of 3199 subjects. Two risk-assessment methods, the framingham risk score (FRS) and American college of cardiology and American heart association (ACC/AHA) tools, were used to predict 10-year cardiovascular risks. The association between liver enzymes and ≥ 7.5%, ≥ 10%, and ≥ 20% 10-year CVD risks were evaluated.

Results: In the multivariate analysis, alkaline phosphatase (ALP) was significantly associated with 10-year CVD risks in both men and women (P < 0.05). No significant association was detected between 10-year CVD risks and gamma glutamyl transferase (GGT). According to both risk-assessment tools, alanine aminotransferase (ALT) showed a significant inverse association with 10-year CVD risks in men (all P < 0.001). In contrast, this association was significant in women only for ≥ 7.5% and ≥ 10% 10-year risks using the ACC/AHA (P = 0.018) and Framingham tools, respectively (P = 0.028).

Conclusions: While ALP exhibited an independent positive association with 10-year CVD risks in both genders, ALT showed an inverse association with10-year CVD risks in men and with some levels of risks in women.

Keywords: Liver Enzymes; Cardiovascular Disease; Alanine Aminotransferase; Gamma-Glutamyl Transferase

 

Nima MotamedShiva Edalatian ZakeriBehnam RabieeMansooreh MaadiMahmood Reza KhonsariHossein KeyvaniSeyed Hamzeh HosseiniFarhad Zamani

The Factor Structure of the Twelve Items General Health Questionnaire (GHQ-12): a Population Based Study

Applied Research Quality Life (2017). https://doi.org/10.1007/s11482-017-9522-y

https://link.springer.com/article/10.1007/s11482-017-9522-y

Mental health is a key component of general health based on world health organization (WHO) definition of health. A short form of the general health questionnaire (GHQ-12) has been widely used as an assessment tool of general and mental health. This study was designed to evaluate the properties of the Persian version of this questionnaire. Of 6140 subjects aged 10–90 years of a cohort study of Northern Iran, the relevant data of 5074 individuals aged ≥18 years were considered for analysis. Confirmatory factor analysis was conducted to evaluate the six models including one-dimensional model, one-dimensional model with correlated errors on negative items, two-dimensional model based on negative and positive statement items, two-dimensional model based on social dysfunction and psychological distress, three-dimensional model based on anxiety/depression, social dysfunction and loss of confidence and finally one-dimensional model with an additional factor for the negatively phrased items. The best fit indices belonged to one-dimensional model with correlated errors on negative items with χ2 = 686.8, df = 39, CFI = 0.953, RMSEA = 0.057 (95%CI: 0.054–0.061), SRMR = 0.0317, AGFI = 0.952, TLI = 0.920 and AIC = 764.8 and also three-dimensional model with χ2 = 860.7, df = 51, CFI = 0.941, RMSEA = 0.056 (95%CI: 0.053–0.059), SRMR = 0.0343, AGFI = 0.955, TLI = 0.923 and AIC = 915.0. In the comparison between these two best models we had ∆χ2 = 174.2, ∆df = 12, p-value < 0.001 in favor of the one-dimensional model. One-dimensional model with correlated errors on negative items showed the best fitting indices with our population.

Motamed N1, Rabiee B2, Poustchi H3, Dehestani B4, Hemasi GR5, Khonsari MR6, Maadi M7, Saeedian FS8, Zamani F9.

Non-alcoholic fatty liver disease (NAFLD) and 10-year risk of cardiovascular diseases.

Clin Res Hepatol Gastroenterol. 2017 Feb;41(1):31-38. doi: 10.1016/j.clinre.2016.07.005. Epub 2016 Aug 31.

https://www.ncbi.nlm.nih.gov/pubmed/27597641

Abstract
BACKGROUND AND AIMS: The association between cardiovascular diseases (CVD) and non-alcoholic fatty liver disease (NAFLD) was confirmed by a large body of evidence. This study was conducted to determine the association between NAFLD and 10-year CVD risk.

METHODS: This study utilized the data of 2804 subjects aged 40-74 years from a cohort study of northern Iran. Two CVD risk assessment tools, American College of Cardiology/American Heart Association and Framingham general cardiovascular risk profile for use in primary care, were utilized to determine the 10-year CVD risk in patients with NAFLD and the individuals without this condition. The mean risks were compared between these two groups.

RESULTS: Using ACC/AHA approach, the mean risk in male participants suffering NAFLD was 14.2%, while in men without NAFLD was 11.7% (P-value < 0.0001). Using Framingham approach, the mean risks were 16.0 and 12.7% in men with and without NAFLD, respectively (P-value < 0.0001). Using ACC/AHA approach, the mean risks in female participants with and without NAFLD were 6.7 and 4.6%, respectively (P-value < 0.0001). Applying Framingham approach, the mean risk was 8.2% in women with NAFLD and 5.4% in women without NAFLD (P-value < 0.0001).

CONCLUSION: The individuals with NAFLD had a higher risk of 10-year CVD events than individuals without NAFLD, according to both ACC/AHA tool and primary care version of Framingham tool. A large proportion of NAFLD patients fulfill the criteria of statin therapy recommendation, suggesting that statin therapy could reduce 10-year CVD risk in NAFLD patients.

 

KEYWORDS: 10-years cardiovascular risk; Epidemiology; Non-alcoholic fatty liver disease

Motamed N1, Rabiee B2, Perumal D3, Poustchi H4, Miresmail SJ5, Farahani B2, Maadi M2, Saeedian FS2, Ajdarkosh H2, Khonsari MR2, Hemasi GR2, Zamani F6.

Comparison of cardiovascular risk assessment tools and their guidelines in evaluation of 10-year CVD risk and preventive recommendations: A population based study.

Int J Cardiol. 2017 Feb 1;228:52-57. doi: 10.1016/j.ijcard.2016.11.048. Epub 2016 Nov 10.

https://www.ncbi.nlm.nih.gov/pubmed/27863362

BACKGROUND: Identification of individuals at risk of cardiovascular diseases (CVDs) results in better clinical outcomes and may help policy makers in conscious decision making for community based and national intervention strategies. The main aim of this study was to compare various CVD risk assessment tools and their related guidelines in estimation of 10-year CVD risk and subsequent therapeutic recommendations, respectively.

METHODS: Data of 3086 subjects aged 40-74years from a cohort study of northern Iran were utilized in this cross-sectional study. The risks were calculated based on American College of Cardiology/American Heart Association (ACC/AHA) tool, two versions of Systematic Coronary Risk Evaluation (SCORE) equations (for low and high risk European countries) and Framingham approach. We also detected participants who ought to be recommended for treatment based on the specific guidelines related to each of the risk assessment tools.

RESULTS: Mean cardiovascular risks were 12.96%, 8.84%, 1.90% and 3.45% in men and 5.87%, 2.13%, 0.8% and 1.13% in women based on ACC/AHA, Framingham, SCORE equation for low-risk European countries and high-risk European countries, respectively. Based on ACC/AHA, Adult Treatment Panel III (ATPIII) and European Society of Cardiology (ESC) guidelines related to SCORE equations for low and high risk European countries 58.2%, 27.1%, 21.1% and 28.6% of men and 39.7%, 33.0%, 29.5% and 30.7% of women were recommended to statin therapy, respectively.

CONCLUSIONS: In conclusion, more individuals were recommended for treatment by ACC/AHA guideline than the other guidelines.

KEYWORDS: 10-Year cardiovascular risk; ACC/AHA guidelines; Cardiovascular diseases; Cardiovascular risk assessment tools; Framingham guidelines; SCORE risk charts

Rabiee B1, Roozafzai F1, Hemasi GR1, Poustchi H2, Keyvani H3, Khonsari MR1, Ajdarkosh H1, Maadi M1, Sima Saeedian F1, Zamani F1.

The Prevalence of Non-alcoholic Fatty Liver Disease and Diabetes Mellitus in an Iranian Population.

Middle East J Dig Dis. 2017 Apr;9(2):86-93. doi: 10.15171/mejdd.2017.56.

https://www.ncbi.nlm.nih.gov/pubmed/28638584

BACKGROUND Type II diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) are important causes of morbidity and mortality worldwide. We aimed to estimate the prevalence of DM in the context of NAFLD. METHODS In this cross-sectional study, we studied 5052 participants, aged 18 years and older, of a baseline population-based cohort in northern Iran (N=6143). The prevalence of DM was estimated in individuals with and without NAFLD. The association between NAFLD and T2DM was evaluated using logistic regression with the adjustment of confounding effects of age, sex, body mass index, lipid profiles, and fasting insulin. RESULTS In men, the prevalence (95% confidence interval) of T2DM was 5.34% (4.35%-6.34%) and 15.06% (13.12%-17.00%) in individuals without and with NAFLD, respectively (p <0.001). In women without NAFLD, the prevalence was 8.27% (6.83%-9.71%) while in the presence of NAFLD, the prevalence was 27.21% (24.59%-29.83%), (p <0.001). In univariate analysis, the chance of having T2DM was 3.700 (3.130-4.380) times more in patients with NAFLD compared with subjects without NAFLD (p<0.001). This chance was reduced (Odds Ratio=1.976, 95% CI: 1.593-2.451, p <0.001) after removing the effects of other variables. CONCLUSION The prevalence of T2DM is increased in the context of NAFLD. This condition may be considered as an independent predictor of T2DM.

KEYWORDS: Diabetes mellitus; Iran; Non-alcoholic fatty liver disease; Non-communicable disease; Prevalence

Nima Motamed, Mahmoodreza Khoonsari, Mehdi Nikkah, Ramak Ghavam, Gholamreza Hemmasi, Behzad Farahani, Masoudreza Sohrabi, Farhad Zamani

Obesity Measures and Elevated Levels of Alanine Aminotransferase: A Population Based Study

GOVARESH 2016. 21(2):118-125.

http://www.govaresh.org/index.php/dd/article/viewFile/1512/1824

Background: Obesity may lead to various morbidity including liver diseases. The present study was done to determine which obesity indices, including body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), and waist to height ratio (WHtR) have the stronger association with rising levels of alanine aminotransferase (ALT).

Material and Methods: Of 6143 subjects aged ≥ 10 years of a cohort study in northern Iran, the data of 5052 subjects were analyzed. We performed multivariate logistic regression analyses for data of men and women, separately. In multivariate analyses the obesity measures were separately included in model in addition to other potential confounders. A high value of ALT was considered as outcome. The capability of obesity indices to discriminate an elevated level of ALT was evaluated using receiver operating characteristic (ROC).

Results: Based on our results, men and women with obesity showed significantly higher values of liver enzymes for all obesity indices. In multivariate analysis, while WHtR showed the strongest association with a high value of ALT in men [Wald=91.44; OR=3.348, 95%CI (2.613-4.289); P<0.001], WC showed the strongest association in women [Wald=26.76; OR=1.724, 95%CI (1.402-2.119)].

Conclusion: WHtR in men and WC in women have more independent association with elevated levels of ALT.

KEYWORDS: Obesity indices, Alanine aminotransferase, Non-alcoholic fatty liver disease

Behnam RabieeNima MotamedVahid HosseiniGholam Reza HemasiMansooreh MaadiFarhad Zamani

Gastro esophageal reflux disease (GERD) prevalence and related risk factors in north of Iran

Esophagus (2016) 13: 330. https://doi.org/10.1007/s10388-016-0536-6

https://link.springer.com/article/10.1007/s10388-016-0536-6

Background: Gastroesophageal reflux disease (GERD) is one of the most frequent disorders in daily clinical practice with numerous associated consequences. A large number of studies were conducted to determine the prevalence of GERD and its associated risk factors which led to inconsistent results. The present study was performed to evaluate the prevalence of GERD and its related risk factors in north of Iran.

Methods: Nine hundred and thirty-three educated participants aged 18–77 years who had at least a High School Diploma were enrolled in the present study. Validated Persian version of Gastroesopahageal reflux questionnaire was used to collect the data. To determine the GERD associated risk factors, logistic regression was performed.

Results: The prevalence of GERD was 53.5 % (frequent GERD: 12.1 %). Among seven potential risk factors, the positive history of reflux in first relatives (OR = 2.37, CI = 1.76–3.20, p value < 0.001) and asthma (OR = 2.605, CI = 1.553–4.368, p < 0.001) were significantly associated with GERD. Spouse history of GERD in interaction with first relatives history of GERD and smoking was significantly associated with GERD too.

Conclusion: The prevalence of GERD is increasing in our country compared to previus studies, which may lead to serious increment of malignant conditions such as esophagus adenocarcinoma.

Keywords: Gastroesophageal reflux disease GERD Prevalence Risk factors Epidemiology

Motamed N1, Miresmail SJ2, Rabiee B3, Keyvani H4, Farahani B3, Maadi M3, Zamani F5.

Optimal cutoff points for HOMA-IR and QUICKI in the diagnosis of metabolic syndrome and non-alcoholic fatty liver disease: A population based study.

J Diabetes Complications. 2016 Mar;30(2):269-74. doi: 10.1016/j.jdiacomp.2015.11.019. Epub 2015 Dec 2.

https://www.ncbi.nlm.nih.gov/pubmed/26718936

AIMS: The present study was carried out to determine the optimal cutoff points for homeostatic model assessment (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) in the diagnosis of metabolic syndrome (MetS) and non-alcoholic fatty liver disease (NAFLD).

METHODS: The baseline data of 5511 subjects aged ≥18years of a cohort study in northern Iran were utilized to analyze. Receiver operating characteristic (ROC) analysis was conducted to determine the discriminatory capability of HOMA-IR and QUICKI in the diagnosis of MetS and NAFLD. Youden index was utilized to determine the optimal cutoff points of HOMA-IR and QUICKI in the diagnosis of MetS and NAFLD.

RESULTS: The optimal cutoff points for HOMA-IR in the diagnosis of MetS and NAFLD were 2.0 [sensitivity=64.4%, specificity=66.8%] and 1.79 [sensitivity=66.2%, specificity=62.2%] in men and were 2.5 [sensitivity=57.6%, specificity=67.9%] and 1.95 [sensitivity=65.1%, specificity=54.7%] in women respectively. Furthermore, the optimal cutoff points for QUICKI in the diagnosis of MetS and NAFLD were 0.343 [sensitivity=63.7%, specificity=67.8%] and 0.347 [sensitivity=62.9%, specificity=65.0%] in men and were 0.331 [sensitivity=55.7%, specificity=70.7%] and 0.333 [sensitivity=53.2%, specificity=67.7%] in women respectively.

CONCLUSION: Not only the optimal cutoff points of HOMA-IR and QUICKI were different for MetS and NAFLD, but also different cutoff points were obtained for men and women for each of these two conditions.

KEYWORDS: Diagnostic index; Homeostatic model assessment index; Metabolic syndrome; Non-alcoholic fatty liver disease; Quantitative insulin sensitivity check index

Nima Motamed, Masoudreza Sohrabi, Hossein Ajdarkosh, Gholamreza Hemmasi, Mansooreh Maadi, Fatemeh Sima Sayeedian, Reza Pirzad, Khadijeh Abedi, Sivil Aghapour, Mojtaba Fallahnezhad, and Farhad Zamani

Fatty liver index vs waist circumference for predicting non-alcoholic fatty liver disease

World J Gastroenterol. 2016 Mar 14; 22(10): 3023–3030. doi: 10.3748/wjg.v22.i10.3023

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779925/

AIM: To determine the discriminatory performance of fatty liver index (FLI) for non-alcoholic fatty liver disease (NAFLD).

METHODS: The data of 5052 subjects aged over 18 years were analyzed. FLI was calculated from body mass index, waist circumference (WC), triglyceride, and gamma glutamyl transferase data. Logistic regression analysis was conducted to determine the association between FLI and NAFLD. The discriminatory performance of FLI in the diagnosis of NAFLD was evaluated by receiver operating characteristic analysis. Area under the curves (AUCs) and related confidence intervals were estimated. Optimal cutoff points of FLI in the diagnosis of NAFLD were determined based on the maximum values of Youden’s index.

RESULTS: The mean age of men and women in the study population were 44.8 ± 16.8 and 43.78 ± 15.43, respectively (P = 0.0216). The prevalence of NAFLD was 40.1% in men and 44.2% in women (P < 0.0017). FLI was strongly associated with NAFLD, so that even a one unit increase in FLI increased the chance of developing NAFLD by 5.8% (OR = 1.058, 95%CI: 1.054-1.063, P < 0.0001). Although FLI showed good performance in the diagnosis of NAFLD (AUC = 0.8656 (95%CI: 0.8548-0.8764), there was no significant difference with regards to WC (AUC = 0.8533, 95%CI: 0.8419-0.8646). The performance of FLI was not significantly different between men (AUC = 0.8648, 95%CI: 0.8505-0.8791) and women (AUC = 0.8682, 95%CI: 0.8513-0.8851). The highest performance with regards to age was related to the 18-39 age group (AUC = 0.8930, 95%CI: 0.8766-0.9093). The optimal cutoff points of FLI were 46.9 in men (sensitivity = 0.8242, specificity = 0.7687, Youden’s index = 0.5929) and 53.8 in women (sensitivity = 0.8233, specificity = 0.7655, Youden’s index = 0.5888).

CONCLUSION: Although FLI had acceptable discriminatory power in the diagnosis of NAFLD, WC was a simpler and more accessible index with a similar performance.

Keywords: Non-alcoholic fatty liver disease, Fatty liver index, Waist circumference, Body mass index, Optimal cutoff points, Discriminatory performance

Motamed N1, Rabiee B2, Keyvani H3, Hemasi GR2, Khonsari M2, Saeedian FS2, Maadi M2, Zamani F2.

The Best Obesity Indices to Discriminate Type 2 Diabetes Mellitus.

Metab Syndr Relat Disord. 2016 Jun;14(5):249-53. doi: 10.1089/met.2015.0133. Epub 2016 Apr 8.

https://www.ncbi.nlm.nih.gov/pubmed/27058358

BACKGROUND: It is expected that the number of people with diabetes will reach 435 million by 2030. Obesity is considered the most important predictor of type 2 diabetes mellitus (T2DM). We conducted the present study to determine the best usual discriminator indices of obesity to diagnose diabetes mellitus (DM).

METHODS: Of 6143 subjects aged 10-90 years from a baseline cohort study, the data of 5772 participants aged >18 years and without history of type 1 diabetes were utilized to analyze in this study. The cohort study was carried out in northern Iran and sampling frame was provided from related local health centers. The capability of obesity indices, including body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and body adiposity index (BAI), in the discrimination of DM was evaluated. Discriminatory capabilities were evaluated using the receiver operating characteristic (ROC) curve. Logistic regression analysis was performed to determine the strength of association between obesity indices and DM.

RESULTS: The areas under ROC curve of BAI, BMI, WC, and WHR were 0.6244 (0.5918-0.6570), 0.6214 (0.5908-0.6520), 0.6636 (0.6341-0.6930), and 0.7303 (0.7032-0.7575) in men and 0.5961 (0.5674-0.6249), 0.5963 (0.5690-0.6235), 0.6850 (0.6593-0.7108), and 0.7529 (0.7297-0.7761) in women, respectively. In the multivariate model, one unit increase in Z-score of BMI, WC, and WHR increased the chance of DM by 49%, 65%, and 51% in men and by 17%, 51%, and 67% in women, respectively. No association was found between DM and BAI in this model.

CONCLUSIONS: While WHR had an appropriate discriminatory capability for T2DM in the population of northern Iran, BAI and BMI did not.

Nima Motamed,1 Mansooreh Maadi,2 Masoudreza Sohrabi,2 Hossein Keyvani,2 Hossein Poustchi,3 and Farhad Zamani2,*

Rural Residency has a Protective Effect and Marriage is a Risk Factor for NAFLD

Hepat Mon. 2016 Jul; 16(7): e38357. Published online 2016 Jun 19. doi: 10.5812/hepatmon.38357

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5018359/

 

Background: Non-alcoholic fatty liver disease (NAFLD) is considered the leading cause of liver disease worldwide. Although many previous studies have evaluated the potential risk factors of NAFLD, few studies have determined the effect of residency or marriage status on NAFLD.

Objectives: We aim to evaluate whether residency and marriage status increased the risk factors for NAFLD.

Materials and Methods: We utilized data from 5,052 participants, 18 years and older, from a cohort study conducted using 6,140 participants in northern Iran. The population was divided into 16 subgroups according to sex and age; the age groups had an interval of 10 years. We randomly selected the subjects from each subgroup in proportion to the size of each subpopulation group. Logistic regression analyses were conducted on NAFLD as an outcome of marriage status, residency (rural vs. urban), and other potential risk factors.

Results: We found that NAFLD had an inverse association with rural living in men (OR = 0.513, 0.422 - 0.622, P value < 0.001) and women (OR = 0.431, 0.345 - 0.539, P value < 0.001). Furthermore, we determined that NAFLD had a direct association with marriage status for men (OR = 2.770, 2.004 - 3.831, P value < 0.001) and women (OR = 1.241, 1.033 - 1.490, P value = 0.0209).

Conclusions: While rural living has a protective effect on NAFLD, marriage may be a potential risk factor for this condition.

Keywords: Rural Living, Marriage, NAFLD

Farhad Zamani , Alireza Ansari-Moghaddam , Mohammad Reza Ostovaneh , Maryam Sharafkhah , Niloofar Akhavan Khaleghi , Fatemeh Sima Saeedian , Zohreh Rohani , Nima Motamed , Mansoreh Maadi , Reza Malekzadeh , Hossein Poustchi

The Epidemiology of Metabolic Syndrome in Iran: The Need to Reconsider the Definitions

Iranian Congress of Gastroenterology and Hepatology. 27 till 29 November 2013، Tehran - Iran

http://health.barakatkns.com/seminar-article/315297/the-epidemiology-of-metabolic-syndrome-in-iran-the-need-to-reconsider-the-definitions

 

Introduction: A variety of prevalence rates for metabolic syndrome according to several definitions have been reported. There are 2 widely used definitions: First, proposed by National Cholesterol Education Panel-Adult Treatment Panel III and the second by the International Diabetes Federation.The aim of this study was to assess the prevalence of MetS according to two definitions in Iran and compare the characteristics of the subjects who met the MetS criteria according to the different definitions.

Method: Participants were recruited from family registry of public health centers. Following to the obtaining demographic and clinical data, subjects underwent anthropometric measurements and laboratory assays. MetS was defined according to the NCEP-ATPIII and IDF criteria. Subjects were then categorized into 3 groups: 1.Healthy non-MetS subjects based on both definitions, 2.Individuals with MetS only by one of the definitions, and 3.Individuals who met both NCEP-ATPIII and IDF criteria for MetS.

Results: Totally, 8693 subjects were enrolled to the study. Prevalence of MetS according to the NCEPGovaresh ATPIII and IDF criteria was 26% and 25.3% in Amol and 9.9% and 9.7% in Zahedan, respectively. Totally, 17.0% of the subjects fulfilled both criteria for MetS. However 7.8% met the MetS criteria according to only one definitions. Older age, higher BMI, TC and HOMA-IR were also independently associated with an increase in risk of MetS based.

Conclusion: MetS is increasingly prevalent in Iran. Due to non-uniform definition of MetS, some of the inhabitants who meet MetS according to one criteria might be considered healthy according to another definition. This hampers the health care providers of serving the preventive health care to a substantial proportion of individuals at risk. Our study proposes that ethnic differences should be taken into account while defining the HDL-C and waist circumference cut off values for definition of MetS.

Nima Motamed,1 Alireza Mardanshahi,2 Benyamin Mohseni Saravi,3 Hasan Siamian,4 Mansooreh Maadi,5 and Farhad Zamani6eh Sima Saeedian , Zohreh Rohani , Nima Motamed , Mansoreh Maadi , Reza Malekzadeh , Hossein Poustchi

The 10-year Absolute Risk of Cardiovascular (CV) Events in Northern Iran: a Population Based Study

Mater Sociomed. 2015 Jun; 27(3): 158–162. Published online 2015 Jun 8. doi: 10.5455/msm.2015.27.158-162

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4499282/

 

Background: The present study was conducted to estimate 10-year cardiovascular disease events (CVD) risk using three instruments in northern Iran.

Material and methods: Baseline data of 3201 participants 40-79 of a population based cohort which was conducted in Northern Iran were analyzed. Framingham risk score (FRS), World Health Organization (WHO) risk prediction charts and American college of cardiovascular / American heart association (ACC/AHA) tool were applied to assess 10-year CVD events risk. The agreement values between the risk assessment instruments were determined using the kappa statistics.

Results: Our study estimated 53.5%of male population aged 40-79 had a 10 –year risk of CVD events≥10% based on ACC/AHA approach, 48.9% based on FRS and 11.8% based on WHO risk charts. A 10 –year risk≥10% was estimated among 20.1% of women using the ACC/AHA approach, 11.9%using FRS and 5.7%using WHO tool. ACC/AHA and Framingham tools had closest agreement in the estimation of 10-year risk≥10% (κ=0.7757) in meanwhile ACC/AHA and WHO approaches displayed highest agreement (κ=0.6123) in women.

Conclusion: Different estimations of 10-year risk of CVD event were provided by ACC/AHA, FRS and WHO approaches.

Keywords: 10-year cardiovascular risk, Framingham risk score, ACC/AHA tool, WHO risk prediction charts, Northern Iran

Ostovaneh MR1,2, Zamani F3, Ansari-Moghaddam A4, Sharafkhah M2, Saeedian FS3, Rohani Z4, Khoonsari M4, Barzin G2, Hemmasi G3, Ajdarkosh H3, Katoonizadeh A2, Maadi M3, Malekzadeh R5, Poustchi H2.

Nonalcoholic Fatty Liver: The Association with Metabolic Abnormalities, Body Mass Index and Central Obesity--A Population-Based Study.

Metab Syndr Relat Disord. 2015 Sep;13(7):304-11. doi: 10.1089/met.2014.0131. Epub 2015 Jun 4.

https://www.ncbi.nlm.nih.gov/pubmed/26042518

 

Background: To assess the prevalence of nonalcoholic fatty liver (NAFL) in Iran and to evaluate correlates of NAFL in categories of body mass index (BMI).

METHODS: Using a cluster random sampling approach, 7723 subjects over 18 years of age underwent abdominal ultrasonography, laboratory evaluations, blood pressure, and anthropometric measurements and were interviewed to obtain baseline characteristics. Prevalence of NAFL according to BMI and waist to hip ratio and its association with metabolic abnormalities in categories of BMI were assessed in multivariate analysis.

RESULTS: The overall prevalence of NAFL was 35.2% [95% confidence interval (CI) 34.1-36.3]. A significant number of subjects with BMI < 30 had NAFL [22.1% (CI 21.0-23.2)]. Waist to hip ratio for 38.2% (CI 35.6-40.8) of the subjects with NAFL, and BMI < 30 was higher than normal values. The odds ratio for association of NAFL and dyslipidemias were higher in subjects with BMI < 30 versus those with BMI ≥ 30: (1) hypertriglyceridemia: 2.21 vs. 1.57, P = 0.006; (2) lower high-density lipoprotein: 1.29 versus 0.98, P = 0.046. Higher low-density lipoprotein also revealed greater association with NAFL in subjects with BMI < 25 than those with BMI ≥ 25 (odds ratio 1.84 vs. 1.1, P = 0.015).

CONCLUSIONS: NAFL shows stronger association with central obesity compared to high BMI. NAFL has stronger association with dyslipidemias in subjects with low compared with high BMI.

Ostovaneh MR1,2, Zamani F3, Ansari-Moghaddam A4, Sharafkhah M2, Saeedian FS3, Rohani Z4, Khoonsari M4, Barzin G2, Hemmasi G3, Ajdarkosh H3, Katoonizadeh A2, Maadi M3, Malekzadeh R5, Poustchi H2.

Nonalcoholic Fatty Liver: The Association with Metabolic Abnormalities, Body Mass Index and Central Obesity--A Population-Based Study.

Metab Syndr Relat Disord. 2015 Sep;13(7):304-11. doi: 10.1089/met.2014.0131. Epub 2015 Jun 4.

https://www.ncbi.nlm.nih.gov/pubmed/26042518

 

Background: To assess the prevalence of nonalcoholic fatty liver (NAFL) in Iran and to evaluate correlates of NAFL in categories of body mass index (BMI).

METHODS: Using a cluster random sampling approach, 7723 subjects over 18 years of age underwent abdominal ultrasonography, laboratory evaluations, blood pressure, and anthropometric measurements and were interviewed to obtain baseline characteristics. Prevalence of NAFL according to BMI and waist to hip ratio and its association with metabolic abnormalities in categories of BMI were assessed in multivariate analysis.

RESULTS: The overall prevalence of NAFL was 35.2% [95% confidence interval (CI) 34.1-36.3]. A significant number of subjects with BMI < 30 had NAFL [22.1% (CI 21.0-23.2)]. Waist to hip ratio for 38.2% (CI 35.6-40.8) of the subjects with NAFL, and BMI < 30 was higher than normal values. The odds ratio for association of NAFL and dyslipidemias were higher in subjects with BMI < 30 versus those with BMI ≥ 30: (1) hypertriglyceridemia: 2.21 vs. 1.57, P = 0.006; (2) lower high-density lipoprotein: 1.29 versus 0.98, P = 0.046. Higher low-density lipoprotein also revealed greater association with NAFL in subjects with BMI < 25 than those with BMI ≥ 25 (odds ratio 1.84 vs. 1.1, P = 0.015).

CONCLUSIONS: NAFL shows stronger association with central obesity compared to high BMI. NAFL has stronger association with dyslipidemias in subjects with low compared with high BMI.

ZAMANI FARHAD, KHOONSARI MAHMOOD, SOHRABI MASOUDREZA, MAADI MASOUMEH, MOTAMED NIMA*

FATTY LIVER INDEX VALUE FOR NON-ALCOHOLIC FATTY LIVER DISEASE: A POPULATION BASED STUDY

GOVARESH JOURNAL FALL 2015 , Volume 20 , Number SUPPLEMENT; Page(s) 41 To 42.

http://en.journals.sid.ir/ViewPaper.aspx?ID=510321

 


Introduction: This study was conducted to determine the discriminatory performance of Fatty liver index (FLI) for nonalcoholic fatty liver disease (NAFLD).
Methods: The data of 5052 subjects aged over 18 years were analyzed. FLI was calculated based on data of body mass index (BMI), waist circumference (WC), triglyceride (TG) and gamma glutamyl transferase (GGT).
Logistic regression analysis was conducted to determine the association between FLI and NAFLD.
The discriminatory performance of FLI in the diagnosis of NAFLD was evaluated by receiver operating characteristic (ROC) analysis. Area under the curves (AUCs) and related confidence intervals were estimated. Optimal cutoff points of FLI in the diagnosis of NAFLD were determined based on the maximum values of youden index.
Results: The mean age of men and women were 44.8?} 16.8 and 43.78± 15.43, respectively (p-value =0.0216). The prevalence of NAFLD was 40.1 % in men and 44.2% in women (p-value<0.0017). FLI was strongly associated with NAFLD, so that one unit increase in FLI increased the chance of developing NAFLD 5.8% (OR=1.058, [95%CI= (1.054-1.063)], p-value<0.0001).
Although FLI revealed a good performance in the diagnosis of NAFLD (AUC=0.8656 (95% CI=0.8548-0.8764), its performance had not significant difference with WC (AUC=0.8533, 0.95% CI=0.8419-0.8646).
According sex the performance of FLI was not different between men (AUC=0.8648 [0.95% CI=0.8505- 0.8791]) and women (AUC=0.8682- [0.95% CI=0.8513- 0.8851]) while based on age the highest performance was related to the age group of 18-39 (AUC=0.8930 [0.95% CI=0.8766- 0.9093]).
The optimal cutoff points of FLI were 46.9 in men (sensitivity=0.8242, specificity=0.7687, Youden index=0.5929) and 53.8 in women (sensitivity= 0.8233, specificity=0.7655, Youden index=0.5888).
Conclusion: FLI had an acceptable discriminatorypower in the diagnosis of NAFLD, however WC as a more simple and accessible index revealed similar performance.

Motamed N1, Rabiee B2, Hemasi GR2, Ajdarkosh H2, Khonsari MR2, Maadi M2, Keyvani H3, Zamani F2.

Body Roundness Index and Waist-to-Height Ratio are Strongly Associated With Non-Alcoholic Fatty Liver Disease: A Population-Based Study.

Hepat Mon. 2016 Aug 14;16(9):e39575. eCollection 2016 Sep.

https://www.ncbi.nlm.nih.gov/pubmed/27822266

 

BACKGROUND: A strong association between obesity and non-alcoholic fatty liver disease (NAFLD) has been reported.

OBJECTIVES: This study was conducted to evaluate if new obesity indices, including a body shape index (ABSI) and body roundness index (BRI), have stronger associations with NAFLD than waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR).

METHODS: In this cross-sectional study, we utilized the data of 4,872 participants aged 18 - 74 years from a cohort study conducted among 6,143 subjects in northern Iran. Logistic regression analysis was performed on NAFLD as the outcome and obesity measures (based on Z-score values) as potential predictors. Receiver operating characteristic (ROC) analyses were conducted, in which NAFLD was considered as a reference variable and obesity measures as classification variables. The discriminatory ability of the obesity measures was reported based on area-under-the-curves, and the related cut-off points of BRI and WHtR were determined using the Youden index (YI).

RESULTS: Based on our results, BRI (OR = 5.484 for men and OR = 3.482 for women) and WHtR (OR = 5.309 for men and OR = 3.854 for women) showed a higher association with NAFLD than ABSI (OR = 1.363 for men and OR = 1.003 for women) and WHR (OR = 3.123 for men and OR = 1.628 for women). The optimal cut-off points for BRI were 4.00 (sensitivity = 82.7%, specificity = 70.8%) for men and 5.00 (sensitivity = 83.3%, specificity = 71.7%) for women. The optimal cut-off points for WHtR were 0.533 (sensitivity = 82.7%, specificity = 70.8%) for men and 0.580 (sensitivity = 83.3%, specificity = 71.7%) for women.

CONCLUSIONS: While BRI and WHtR have equally strong associations with NAFLD, ABSI and WHR have weaker associations with NAFLD than BRI and WHtR.

KEYWORDS: Non-Alcoholic Fatty Liver Disease; Obesity; Waist-to-Height Ratio


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