1.Lipid Accumulation Product Is Associated with Insulin Resistance, Lipid Peroxidation, and Systemic Inflammation in Type 2 Diabetic Patients.
Parvin MIRMIRAN ; Zahra BAHADORAN ; Fereidoun AZIZI
Endocrinology and Metabolism 2014;29(4):443-449
BACKGROUND: Lipid accumulation product (LAP) is a novel biomarker of central lipid accumulation related to risk of diabetes and cardiovascular disease. In this study, we assessed the association of LAP with glucose homeostasis, lipid and lipid peroxidation, and subclinical systemic inflammation in diabetic patients. METHODS: Thirty-nine male and 47 female type 2 diabetic patients were assessed for anthropometrics and biochemical measurements. LAP was calculated as [waist circumference (cm)-65]x[triglycerides (mmol/L)] in men, and [waist circumference (cm)-58]x[triglycerides (mmol/L)] in women. Associations of LAP with fasting glucose, insulin, insulin resistance index, lipid and lipoprotein levels, malondialdehyde, and high-sensitive C-reactive protein (hs-CRP) were assessed. RESULTS: Mean age and LAP index were 53.6+/-9.6 and 51.9+/-31.2 years, respectively. After adjustments for age, sex and body mass index status, a significant positive correlation was observed between LAP index and fasting glucose (r=0.39, P<0.001), and homeostasis model assessment of insulin resistance (r=0.31, P<0.05). After additional adjustment for fasting glucose levels, antidiabetic and antilipidemic drugs, the LAP index was also correlated to total cholesterol (r=0.45, P<0.001), high density lipoprotein cholesterol (HDL-C) levels (r=-0.29, P<0.05), triglycerides to HDL-C ratio (r=0.89, P<0.001), malondialdehyde (r=0.65, P<0.001), and hs-CRP levels (r=0.27, P<0.05). CONCLUSION: Higher central lipid accumulation in diabetic patients was related to higher insulin resistance, oxidative stress and systemic inflammation.
Body Mass Index
;
C-Reactive Protein
;
Cardiovascular Diseases
;
Cholesterol
;
Cholesterol, HDL
;
Diabetes Mellitus, Type 2
;
Fasting
;
Female
;
Glucose
;
Homeostasis
;
Humans
;
Inflammation*
;
Insulin
;
Insulin Resistance*
;
Lipid Accumulation Product*
;
Lipid Peroxidation*
;
Lipoproteins
;
Male
;
Malondialdehyde
;
Oxidative Stress
;
Triglycerides
2.Associations between Dietary Acid-Base Load and Cardiometabolic Risk Factors in Adults: The Tehran Lipid and Glucose Study.
Zahra BAHADORAN ; Parvin MIRMIRAN ; Hadise KHOSRAVI ; Fereidoun AZIZI
Endocrinology and Metabolism 2015;30(2):201-207
BACKGROUND: In this study we investigated the associations of dietary acid-base load, identified by potential renal acid load (PRAL) and protein to potassium (Pro:K) ratio, with cardiometabolic risk factors in Tehranian adults. METHODS: A cross-sectional study was conducted within the framework of the fourth phase of the Tehran Lipid and Glucose Study (2009 to 2011) on 5,620 men and women aged 19 to 70 years. Dietary data were collected by a trained dietitian using a validated, 147-food item, semi-quantitative food frequency questionnaire, and dietary PRAL and Pro:K ratio were calculated. Multiple linear regression models with adjustment for potential confounding variables were used to evaluate the associations of dietary acid-base load with anthropometric measures, blood pressure, serum triglycerides, high density lipoprotein cholesterol (HDL-C), serum creatinine, and fasting blood glucose. RESULTS: The mean+/-SD age of the participants was 39.8+/-12.8 years and 54% of participants were women. Mean+/-SD PRAL was -22.0+/-29.1; mean PRAL was -15.6 in men and -26.8 in women. Dietary PRAL was associated with weight (beta=0.098, P<0.001), waist circumference (beta=0.062, P<0.01), serum triglycerides (beta=0.143, P<0.01), HDL-C (beta=-0.11, P<0.01), diastolic blood pressure (beta=0.062, P<0.01), and serum creatinine (beta=0.142, P<0.001). Pro:K ratio was associated with weight (beta=0.055, P<0.001), waist circumference (beta=0.04, P<0.01), serum HDL-C (beta=-0.06, P<0.01), serum triglycerides (beta=0.03, P<0.05), diastolic blood pressure (beta=0.026, P<0.05), and serum creatinine (beta=0.07, P<0.01). CONCLUSION: A more acidic dietary acid-base load may be a risk factor for the development of metabolic disorders.
Adult*
;
Blood Glucose
;
Blood Pressure
;
Cholesterol, HDL
;
Confounding Factors (Epidemiology)
;
Creatinine
;
Cross-Sectional Studies
;
Fasting
;
Female
;
Glucose*
;
Humans
;
Linear Models
;
Male
;
Nutritionists
;
Potassium
;
Risk Factors*
;
Triglycerides
;
Waist Circumference
;
Surveys and Questionnaires
3.Sugar-Sweetened Beverage Consumption Is Associated with Metabolic Syndrome in Iranian Adults: Tehran Lipid and Glucose Study.
Hanieh Sadat EJTAHED ; Zahra BAHADORAN ; Parvin MIRMIRAN ; Fereidoun AZIZI
Endocrinology and Metabolism 2015;30(3):334-342
BACKGROUND: Metabolic syndrome (MetS), a cluster of multiple metabolic abnormalities, is one of the major public health challenges worldwide. The current study was conducted to evaluate the association between sugar-sweetened beverage (SSB) consumption and MetS and its components in Iranian adults. METHODS: This cross-sectional study was conducted among 5,852 men and women, aged 19 to 70 years, who participated in the fourth phase (2009 to 2011) of the Tehran Lipid and Glucose Study. Demographics, anthropometrics, biochemical measurements, and blood pressure (BP) were assessed and MetS was defined by National Cholesterol Education Program Adult Treatment Panel III definition. Frequency and quantity of SSB intakes including carbonated drinks and synthetic fruit juices were collected using a validated semiquantitative food frequency questionnaire. RESULTS: Mean age of participants (43%, men) was 40.6+/-12.9 years. Significant positive associations between SSBs and waist circumference, triglyceride level, systolic and diastolic BP in the third and fourth quartile of SSBs were observed, after adjustment for all potential confounding variables. The odds of MetS in the third and fourth quartiles compared to the first quartile category of SSBs was 1.21 (95% confidence interval [CI], 1.01 to 1.45) and 1.30 (95% CI, 1.06 to 1.58), respectively (P for trend=0.03). The odds of MetS, abdominal obesity, low high density lipoprotein cholesterol and elevated BP had increasing trends across increasing of SSB consumption (P for trend <0.05). CONCLUSION: Higher intake of SSBs was associated with the higher odds of MetS in adults. It is suggested that reducing consumption of SSBs could be a practical approach to prevent metabolic abnormalities.
Adult*
;
Beverages*
;
Blood Pressure
;
Carbonated Beverages
;
Cholesterol
;
Cholesterol, HDL
;
Confounding Factors (Epidemiology)
;
Cross-Sectional Studies
;
Demography
;
Education
;
Female
;
Fruit
;
Glucose*
;
Humans
;
Male
;
Obesity, Abdominal
;
Public Health
;
Triglycerides
;
Waist Circumference
4.Helicobacter pylori Stool Antigen Levels and Serological Biomarkers of Gastric Inflammation are Associated with Cardio-Metabolic Risk Factors in Type 2 Diabetic Patients.
Zahra BAHADORAN ; Parvin MIRMIRAN ; Maryam ZARIF-YEAGANEH ; Homayoun ZOJAJI ; Fereidoun AZIZI
Endocrinology and Metabolism 2015;30(3):280-287
BACKGROUND: Helicobacter pylori infection and subsequent gastric inflammation have been proposed as risk factors for the development of insulin resistance and cardiovascular disease. In this study we assessed the possible association of H. pylori bacterial load, and serum biomarker of gastric inflammation with cardiometabolic risk factors in diabetic patients. METHODS: In this cross-sectional study, 84 H. pylori-infected type 2 diabetic patients were assessed for anthropometrics, biochemical and clinical measurements. Pearson correlation test, linear, and logarithmic regression curve estimation models were used to assess the association of H. pylori stool antigen (HpSAg) levels, and pepsinogen I (PGI) to pepsinogen II (PGII) ratio with fasting serum glucose, insulin, serum lipid and lipoprotein parameters, malondialdehyde, high-sensitive C-reactive protein (hs-CRP), systolic and diastolic blood pressure, body weight, waist circumference and lipid accumulation product (LAP) index. RESULTS: The mean age of participants was 54+/-10 years, and 44% were men. Mean HpSAg levels and PGI/PGII ratio were 0.24+/-0.23 microg/mL and 9.9+/-9.0, respectively. Higher HpSAg as well as lower PGI/PGII was correlated with higher anthropometric measures and LAP. A significant negative correlation between PGI/PGII ratio and blood pressure (r=-0.21 and r=-0.22, systolic and diastolic, respectively, P<0.05), serum insulin (r=-0.17, P=0.05), and hs-CRP (r=-0.17, P=0.05) was observed. A significant linear association between PGI/PGII ratio with serum triglycerides (beta=-0.24, P<0.05), serum high density lipoprotein cholesterol (HDL-C; beta=0.43, P<0.01), and triglycerides/HDL-C ratio (beta=-0.28, P<0.05) were observed. CONCLUSION: Higher H. pylori bacterial load and lower PGI/PGII ratio was associated with higher levels of cardiometabolic risk factors in H. pylori infected type 2 diabetic patients.
Bacterial Load
;
Biomarkers*
;
Blood Glucose
;
Blood Pressure
;
Body Weight
;
C-Reactive Protein
;
Cardiovascular Diseases
;
Cholesterol, HDL
;
Cross-Sectional Studies
;
Diabetes Mellitus, Type 2
;
Fasting
;
Helicobacter pylori*
;
Helicobacter*
;
Humans
;
Inflammation*
;
Insulin
;
Insulin Resistance
;
Lipid Accumulation Product
;
Lipoproteins
;
Male
;
Malondialdehyde
;
Pepsinogen A
;
Pepsinogen C
;
Pepsinogens
;
Risk Factors*
;
Triglycerides
;
Waist Circumference
5.Efficacy and Safety of Long-Term Methimazole versus Radioactive Iodine in the Treatment of Toxic Multinodular Goiter
Fereidoun AZIZI ; Navid SAADAT ; Mir Alireza TAKYAR ; Hengameh ABDI ; Ladan MEHRAN ; Atieh AMOUZEGAR
Endocrinology and Metabolism 2022;37(6):861-869
Background:
This study compared the degree of sustained control of hyperthyroidism in patients with toxic multinodular goiter (TMNG) treated with long-term methimazole (LT-MMI) or radioactive iodine (RAI).
Methods:
In this clinical trial, 130 untreated patients with TMNG were randomized to either LT-MMI or RAI treatment. Both groups were followed for 108 to 148 months, with median follow-up durations of 120 and 132 months in the LT-MMI and RAI groups, respectively. Both groups of patients were followed every 1 to 3 months in the first year and every 6 months thereafter.
Results:
After excluding patients in whom the treatment modality was changed and those who were lost to follow-up, 53 patients in the LT-MMI group and 54 in the RAI group completed the study. At the end of the study period, 50 (96%) and 25 (46%) patients were euthyroid, and two (4%) and 25 (46%) were hypothyroid in LT-MMI and RAI groups, respectively. In the RAI group, four (8%) patients had subclinical hyperthyroidism. The mean time to euthyroidism was 4.3±1.3 months in LT-MMI patients and 16.3± 15.0 months in RAI recipients (P<0.001). Patients treated with LT-MMI spent 95.8%±5.9% of the 12-year study period in a euthyroid state, whereas this proportion was 72.4%±14.8% in the RAI-treated patients (P<0.001). No major treatment-related adverse events were observed in either group.
Conclusion
In patients with TMNG, LT-MMI therapy is superior to RAI treatment, as shown by the earlier achievement of euthyroidism and the longer duration of sustained normal serum thyrotropin.
6.Prevalence of metabolic syndrome by the Adult Treatment Panel III, International Diabetes Federation, and World Health Organization definitions and their association with coronary heart disease in an elderly Iranian population.
Farzad HADAEGH ; Azadeh ZABETIAN ; Maryam TOHIDI ; Asghar GHASEMI ; Farhad SHEIKHOLESLAMI ; Fereidoun AZIZI
Annals of the Academy of Medicine, Singapore 2009;38(2):142-149
INTRODUCTIONTo determine the prevalence of the metabolic syndrome (MS) in an Iranian elderly population and show its association with coronary heart disease (CHD).
MATERIALS AND METHODSThis is a cross-sectional study on 720 Iranian men and women aged > or = 65 years who participated in the Tehran Lipid and Glucose Study (TLGS). Logistic regression analysis was used to estimate the odds ratio (OR) of developing CHD in model 1, an age-adjusted model; model 2, adjusted for age, smoking status, premature history of CHD and low-density lipoprotein (LDL) cholesterol; and model 3, adjusted for mentioned variables plus the MS components.
RESULTSThe prevalence of MS was 50.8%, 41.8% and 41.9% based on the Adult Treatment Panel (ATPIII), the World Health Organisation (WHO), and the International Diabetes Federation (IDF) definitions, respectively. The IDF definition showed high agreement with the ATPIII definition. Age-adjusted OR (95% CI) of the MS for CHD was 1.6 (1.2 to 2.2) by both the ATPIII and WHO definitions and 1.4 (1.0 to 1.9) by the IDF definition. IDF-defined MS lost its association with CHD in model 2. In model 3, obesity (WHO definition) and high blood pressure (ATPIII and WHO definitions) were associated with CHD.
CONCLUSIONSIn an elderly Iranian population MS is highly prevalent. ATPIII and WHO definitions seem to be more pertinent than IDF for screening CHD risk. None of these definitions showed association with CHD when considering their components.
Age Factors ; Aged ; Coronary Disease ; blood ; epidemiology ; etiology ; Cross-Sectional Studies ; Female ; Humans ; Insulin Resistance ; Iran ; epidemiology ; Male ; Mass Screening ; methods ; Metabolic Syndrome ; classification ; complications ; epidemiology ; Middle Aged ; Prevalence ; Prospective Studies ; Risk Assessment ; methods ; Risk Factors ; Surveys and Questionnaires ; Urban Population ; World Health Organization
7.High Incidence of Chronic Kidney Disease among Iranian Diabetic Adults: Using CKD-EPI and MDRD Equations for Estimated Glomerular Filtration Rate
Seyyed Saeed MOAZZENI ; Reyhane Hizomi ARANI ; Mitra HASHEMINIA ; Maryam TOHIDI ; Fereidoun AZIZI ; Farzad HADAEGH
Diabetes & Metabolism Journal 2021;45(5):684-697
Background:
To investigate the population based incidence rate of chronic kidney disease (CKD) and its potential risk factors among Iranian diabetic adults during over 14 years of follow-up.
Methods:
Two different equations (Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI] and Modification of Diet in Renal Disease [MDRD]) were applied for the calculating the estimated glomerular filtration rate (eGFR). Among a total of 1,374 diabetic Tehranian adults, 797 and 680 individuals were eligible for CKD-EPI and MDRD analyses, respectively. CKD was defined as eGFR lower than 60 mL/min/1.73 m2. Multivariable Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CI) for all potential risk factors.
Results:
The incidence rates (95% CI) of CKD per 1,000 person-years were 43.84 (39.49 to 48.66) and 55.80 (50.29 to 61.91) based on CKD-EPI and MDRD equations, respectively. Being older, a history of cardiovascular disease, and having lower levels of eGFR were significant risk factors in both equations. Moreover, in CKD-EPI, using glucose-lowering medications and hypertension, and in MDRD, female sex and fasting plasma glucose ≥10 mmol/L were also independent risk factors. Regarding the discrimination index, CKD-EPI equation showed a higher range of C-index for the predicted probability of incident CKD in the full-adjusted model, compared to MDRD equation (0.75 [0.72 to 0.77] vs. 0.69 [0.66 to 0.72]).
Conclusion
We found an incidence rate of more than 4%/year for CKD development among our Iranian diabetic population. Compared to MDRD, it can be suggested that CKD-EPI equation can be a better choice to use for prediction models of incident CKD among the Iranian diabetic populations.
8.High Incidence of Chronic Kidney Disease among Iranian Diabetic Adults: Using CKD-EPI and MDRD Equations for Estimated Glomerular Filtration Rate
Seyyed Saeed MOAZZENI ; Reyhane Hizomi ARANI ; Mitra HASHEMINIA ; Maryam TOHIDI ; Fereidoun AZIZI ; Farzad HADAEGH
Diabetes & Metabolism Journal 2021;45(5):684-697
Background:
To investigate the population based incidence rate of chronic kidney disease (CKD) and its potential risk factors among Iranian diabetic adults during over 14 years of follow-up.
Methods:
Two different equations (Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI] and Modification of Diet in Renal Disease [MDRD]) were applied for the calculating the estimated glomerular filtration rate (eGFR). Among a total of 1,374 diabetic Tehranian adults, 797 and 680 individuals were eligible for CKD-EPI and MDRD analyses, respectively. CKD was defined as eGFR lower than 60 mL/min/1.73 m2. Multivariable Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CI) for all potential risk factors.
Results:
The incidence rates (95% CI) of CKD per 1,000 person-years were 43.84 (39.49 to 48.66) and 55.80 (50.29 to 61.91) based on CKD-EPI and MDRD equations, respectively. Being older, a history of cardiovascular disease, and having lower levels of eGFR were significant risk factors in both equations. Moreover, in CKD-EPI, using glucose-lowering medications and hypertension, and in MDRD, female sex and fasting plasma glucose ≥10 mmol/L were also independent risk factors. Regarding the discrimination index, CKD-EPI equation showed a higher range of C-index for the predicted probability of incident CKD in the full-adjusted model, compared to MDRD equation (0.75 [0.72 to 0.77] vs. 0.69 [0.66 to 0.72]).
Conclusion
We found an incidence rate of more than 4%/year for CKD development among our Iranian diabetic population. Compared to MDRD, it can be suggested that CKD-EPI equation can be a better choice to use for prediction models of incident CKD among the Iranian diabetic populations.