Search

Hypertriglyceridemia is a common form of dyslipidemia and is associated with several comorbidities, such as increased risk of pancreatitis and cardiovascular diseases (CVD). The white blood cell (WBC) count is a non-specific inflammatory marker associated with a wide variety of diseases such as diabetes, hypertension, and atherosclerotic cardiovascular disease. The objective of this study was to perform a genderstratified examination of the association between hypertriglyceridemia and hematological parameters in a large sample of Iranian population. The triglyceride (TG) levels and hematological parameters were measured in 9,780 participants (40% males and 60% females) aged 35-65 years, enrolled in a population-based cohort (MASHAD) study in northeastern Iran. Participants were stratified into three groups based on the definition of hypertriglyceridemia: TG<150 mg/dl (n=6521), TG=150-199 mg/dl (n=1597), and TG≥200 mg/dl (n=1662). A complete blood count (CBC) was obtained for all the subjects. The mean WBC count increased with increasing severity of hypertriglyceridemia among both men and women. Participants with high and very high TG levels had significantly higher WBC count, RBC count, platelet count, hemoglobin, hematocrit, and mean corpuscular hemoglobin concentration and significantly lower RDW. After performing multivariate logistic regression, WBC count and RDW were independently related to hypertriglyceridemia. In conclusion, hypertriglyceridemia is associated with elevated WBC count which may partly explain the observed association between hypertriglyceridemia and CVD. [ABSTRACT FROM AUTHOR]

BACKGROUND AND AIM: Obesity is a major risk factor for type 2 diabetes mellitus and cardiovascular disease (CVD). Little is known about the metabolic profile across categories of body mass index (BMI), particularly within Asian populations. We assessed the prevalence and distribution of body size phenotypes among Iranian adults from a representative sample from Mashhad. METHOD: The Mashhad Stroke Heart Atherosclerosis Disorder (MASHAD) study cohort of 9761 adults (3903 men) aged 35-65 years were cross-categorized by BMI and metabolic status into: normal-weight metabolically healthy (NWMH), normal-weight metabolically abnormal (NWMA), overweight metabolically healthy (OvMH), overweight metabolically abnormal (OvMA), obese metabolically healthy (OMH) and obese metabolically abnormal (OMA). Metabolic normality/ abnormality was defined by the presence of any two of the following: 1) elevated blood pressure or known hypertension on treatment, 2) high serum fasted triglycerides; 3) low serum HDL-cholesterol, 4) high blood glucose or the presence of diabetes mellitus, 5) serum CRP > 90th percentile. RESULTS: The distribution of obesity phenotypeswas 11.6% (NWMH), 15.6% (NWMA), 10.6% (OvMH), 31.3% (OvMA), 4.9% (OMH), and 25.5% (OMA) overall. Equivalent figures were 13.1%, 24.0%, 7.7% 37.3%, 1.5% and 16.2% in men; 10.7%, 10.2%, 12.5%, 27.4%, 7.2% and 31.8% inwomen, p < 0.001 for gender differences. Multi variables logistic regression models comprising age gender and each of the metabolic factors was associated with 3.2% to 5.3% variations in BMI categories. CONCLUSION: The present study showed that a considerable proportion normal-weight Iranians display cardiometabolic abnormalities especially men, while a significant percentage of obese individuals, particularly women are metabolically healthy. [ABSTRACT FROM AUTHOR]

We aimed to determine the effects of isoproterenol on arrhythmia recurrence in atrioventricular nodal re‐entrant tachycardia (AVNRT) patients treated with catheter ablation. The present randomized controlled clinical trial was conducted on AVNRT patients candidates for radiofrequency ablation (RFA). The patients were randomly assigned to receive isoproterenol (0.5–4 μg/min) or not (control group) for arrhythmia re‐induction after ablation. The results of the electrophysiological (EP) study, the ablation parameters, and the arrhythmia recurrence rate were recorded. We evaluated 206 patients (53 males and 153 females) with a mean (SD) age of 49.87 (15.5) years in two groups of isoproterenol (n = 103) and control (n = 103). No statistically significant difference was observed between the two studied groups in age, gender, EP study, and ablation parameters. The success rate of ablation was 100% in both groups. During ~16.5 months of follow‐up, one patient (1%) in the isoproterenol group and four patients (3.8%) in the control group experienced AVNRT recurrence (HR = 0.245; 95% confidence interval [CI], 0.043–1.418; p =.173). Based on the Kaplan–Meier analysis, there was no significant difference in the incidence rate of arrhythmia recurrence during the follow‐up period between the two studied groups (p =.129). Additionally, there were no significant differences between the arrhythmia's recurrence according to age, gender, junctional rhythm, type of AVNRT arrhythmia, and DAVN persistence after ablation. Although isoproterenol administration for arrhythmia re‐induction after ablation did not alleviate the treatment outcomes and arrhythmia recurrence following RFA in AVNRT patients, further studies with a larger sample size and a longer duration of follow‐up are necessary. [ABSTRACT FROM AUTHOR]

Introduction: The association between the serum antibody titer of several heat shock proteins (HSPs) and cardiovascular disease (CVD) risk factors so far has been the subject of several previous studies. Aim: To evaluate the association of adiposity indices and HSP-27 antibody titers in healthy individuals. Materials and Methods: Overall 4823 individuals were recruited from Mashhad Stroke and Heart Atherosclerotic Disorders Study (MASHAD study), that included 1496 individuals with normal-weight (body mass index (BMI) <25 kg/m2), 1975 individuals with over-weight (BMI 25-30 kg/m2), and 1352 individuals with obesity (BMI≥ 30 kg/m2). Results: The serum anti-HSP-27 antibody titers were not significantly different among obese individuals [0.21 (0.11 - 0.34) absorbency unit (AU)], over-weight individuals [0.19 (0.10 - 0.33) AU] and normal-weight individuals [0.19 (0.10 - 0.33) AU]. Conclusions: we have found no significant relationship among anti-HSP-27 antibody concentration and degrees of adiposity among Iranian adults. [ABSTRACT FROM AUTHOR]

Introduction: Torsades de pointes may occur secondary to medication-induced prolonged QTc interval on ECG. Number of medications makes the patient prone to this deadly tachycardia. Case presentation: We report four cases of methadone-induced Torsades de pointes. Conclusion: ECG was normal after slow, gradual discontinuation of methadone and the patients were ready for discharge. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular disease (CVD) is the leading cause of mortality and one of the main challenges for health systems worldwide. In this study, we aimed to evaluate the association of socio-demographic, lifestyle, psychological and anthropometric factors and underlying diseases such as hypertension (HTN), diabetes mellitus (DM) and metabolic syndrome (MS) with CVD risk among a subpopulation of Iranian adults. Methods: In this prospective study, a total of 235 CVD patients along with 8405 healthy and nonsymptomatic individuals who participated in MASHAD cohort study were enrolled. CVD diagnosis was performed by taking electrocardiogram (ECG) and medical history and performing physical examination for each participant. Health and lifestyle questionnaires, the Beck's anxiety inventory (BAI), Beck's depression inventory (BDI) and the James and Schofield human energy requirements equations were completed for all participants. Anthropometric measurements were also recorded for all subjects. All statistical analyses including chi-square and student independent T-test were performed using SPSS 16.0 software (SPSS Inc., Chicago, IL, USA) at a significant level of 0.05. Results: We found that there were significant associations between CVD risk and age, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), diabetes mellitus (DM) and family history (FH) of CVD in both genders; though, there was a significant negative correlation between physical activity level (PAL) and risk of CVD among men and women. Also hypertension (HTN), metabolic syndrome (MS), depression and anxiety were positively and higher education level was negatively associated with CVD events only in females. While, waist-to-hip ratio (WHR) was an independent predictor of CVD among males (P-value< 0.05). Conclusion: There are several modifiable and non-modifiable risk factors that are independently considered as CVD predictors among the MASHAD study population. It is recommended to prioritize the lifestyle modification, development of local risk calculators and gender-related stratified strategies in order to prevent and manage CVD among the Iranian population. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus-2 raised in 2019 (COVID-19) affects the lung tissue and other organs, specifically the heart. The current study evaluated 120 hospitalised patients with severe COVID-19 between March 2021 and February 2022. Patients' demographics, vital signs, electrocardiogram abnormalities, clinical laboratory tests, including troponin I (TPI), mortality, and discharge type, were recorded. Among the 120 hospitalised patients with severe COVID-19, 54 (45.0%) patients were male, with an average age of 63.2 ± 1.4. Many patients have chronic comorbidities, including hypertension (51.6%), diabetes mellitus (34.1%), and ischemic heart disease (17.5%). The in-hospital and six months after the discharge mortality were 45.8% and 21.5%, respectively. Cardiac injury was observed in 14 (11.7%) patients with a mean TPI level of 8.386 ± 17.89 μg/L, and patients with cardiac injury had higher mortality than those without cardiac injury (P < 0.001). Furthermore, the cardiac injury was meaningfully correlated with age (ρ = 0.182, P = 0.019), history of ischemic heart disease (ρ = 0.176, P = 0.05), hospitalisation result and mortality (ρ = 0.261, P = 0.004), inpatient in ICU (ρ = 0.219, P = 0.016), and serum levels of urea (ρ = 0.244, P = 0.008) and creatinine (ρ = 0.197, P = 0.033). Additionally, the discharge results were significantly correlated with oxygen saturation with (ρ = −0.23, P = 0.02) and without (ρ = −0.3, P = 0.001) oxygen therapy, D-dimer (ρ = 0.328, P = 0.019), LDH (ρ = 0.308, P = 0.003), urea (ρ = 0.2, P = 0.03), and creatinine (ρ = 0.17, P = 0.06) levels. Elevated TPI levels are associated with increased mortality in severe COVID-19 patients. Therefore, TPI may be a beneficial biofactor for early diagnosis of cardiac injury and preventing a high mortality rate. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease is one of the most common causes of morbidity and mortality worldwide. The Proline and Serine Rich Coiled-Coil 1 gene in 1p13.3 locus has been reported to be associated with low density lipoprotein cholesterol (LDL-C) and coronary artery disease (CAD). The objective of this study was to investigate the association between the rs599839 polymorphism of the Proline and Serine Rich Coiled-Coil 1 (PSRC1) gene with CVD outcomes in a population sample recruited as part of the Mashhad-Stroke and Heart-Atherosclerotic-Disorders (MASHAD) cohort. Methods: Five hundred and nine individuals who had an average follow-up period of 10 years were enrolled as part of the MASHAD cohort. DNA was extracted and genotyped using the TaqMan-real-time-PCR based method. Results: The study found individuals with GA/GG genotypes were at a higher risk of CVDs (OR= 4.7; 95% CI, 2.5-8.7; p< 0.001) in comparison to those with AA genotype; however, the result was not significant for GG genotype data. Conclusions: The results suggest that the GA/GG genotypes of the PSRC1gene locus were at increased risk of CVD in a representative population-based cohort, demonstrating further functional analysis to discover the value of emerging marker as a risk stratification biomarker to recognize high risk cases. [ABSTRACT FROM AUTHOR]

The dietary inflammatory index (DII) is a novel way of describing diet that has been studied in relation to various health conditions, including cardiovascular disease (CVD) in several populations. We aimed to investigate the association between DII and CVD events among a representative population sample in northeastern Iran. This prospective cohort study was a subsample of 4,672 adults aged 35–65 years, and recruited as part of Mashhad stroke and heart atherosclerotic disorder cohort study population. The DII was computed at baseline according to a 65‐item validated food frequency questionnaire. Cox regression was used to determine the association of DII with incident CVD. One hundred twenty‐four participants developed CVD (including 24 cases of myocardial infarction [MI], 34 cases of stable angina [SA], and 66 cases of unstable angina [UA]). After adjusting for potential confounding factors, a hazard ratios of 1.06 (95% confidence interval: 0.70–1.60), 1.36 (95% confidence interval: 0.52–3.52), 1.33 (95% confidence interval: 0.60–2.94), and 0.86 (95% confidence interval: 0.48–1.53) were found for total CVD, MI, SA, and UA events, respectively, among the participants with proinflammatory diet (DII ≥ 0) versus those with anti‐inflammatory diet (DII < 0). There was no statistically significant association between the DII and total CVD, MI, SA, or UA in this population of middle‐aged Iranian men and women. [ABSTRACT FROM AUTHOR]

BACKGROUND: We aimed to compare dietary macronutrient intake and physical activity level (PAL) between community-based samples of Iranian adults with metabolic syndrome (MetS+) and without metabolic syndrome (MetS-). METHODS: This cross-sectional study was conducted among 3800 men and women aged 35-65 years. The International Diabetes Federation (IDF) criteria were used to define MetS. A 24-hour recall was used to evaluate dietary intake. The James and Schofield human energy requirements equations were used to calculate PAL and questions were categorized into time spent on activities during work (including housework), during non-work time, and in bed. RESULTS: The mean ± standard deviation (SD)age of the MetS+ and MetS-subjects was, respectively, 48.8 ± 7.8 years (521 men and 1178 women) and 47.6 ± 7.5 years (714 men and 1222 women) (P = 0.930). The mean energy intake was higher in the MetS+ men compared with MetSmen (1977.4 ± 26.6 vs. 1812.7 ± 21.7 Kcal; P < 0.001). Crude and energy-adjusted intake from total fat was lower in MetS+ women compared with MetS-women (both P < 0.010). PALs were lower in MetS+ compared with MetS-participants (P < 0.001). After adjusting for confounders, no significant association was observed between the intake of individual macronutrients and MetS. In contrast, PAL was inversely associated with the incidence of MetS [OR = 0.34 (95% CI: 0.17-0.57); P < 0.001]. CONCLUSION: In the current study, there was an inverse relationship between PAL and the risk of MetS, but no association between individual dietary macronutrients intake and the incidence of MetS. [ABSTRACT FROM AUTHOR]

Obesity is an important feature of the metabolic syndrome and is associated with an increased risk of type 2 diabetes mellitus, cardiovascular disease, and some cancers. The aim of this study was to determine the relationship between body fat percentage and an imbalance of the prooxidant/antioxidant balance (PAB), serum superoxide dismutase (SOD1) and inflammation (serum hs‐CRP) and increase risk of metabolic syndrome and diabetes mellitus. In this study, 9154 individuals were recruited as part of the Mashhad Stroke and Heart Association Disorder (MASHAD) study. Subjects were categorized into two groups according to body fat percentage as defined >25% in male and > 30% in female, according to gender. Biochemical factors, including serum PAB, SOD1, and hs‐CRP were measured in all subjects. SPSS version 18 was used for statistical analyses for all. GraphPad Prism 6 for figures was used. Of total number of subjects (9154), 6748 (73.7%) were found to have a high body fat (BF) percentage. Serum hs‐CRP and PAB were significantly higher in individuals with a high BF percentage (P < 0.05) but SOD1 was not significantly different between the two groups (P > 0.05). BF percentage, serum PAB and serum hs‐CRP were significantly higher in individuals with metabolic syndrome and diabetes versus those without metabolic syndrome and diabetes mellitus (P < 0.05), however serum SOD1 was significantly lower in individuals with metabolic syndrome (P < 0.005). Oxidative stress and inflammation are two factors that may link the presence of high BF percentage with the development of metabolic syndrome, diabetes, and cardiovascular disease. © 2018 BioFactors, 45(1):35–42, 2019 [ABSTRACT FROM AUTHOR]

Hematological parameters have emerged as independent determinants of high serum concentrations of uric acid (UA) and predictive factors in the evaluation of the total cardiovascular risk in patients with essential hypertensive. Here, we have investigated the possible relationships between hematological factors and serum uric acid levels in hypertensive patients recruited as part of Mashhad Stroke and Heart Atherosclerotic Disorders cohort study. Two‐thousand three‐hundred and thirty‐four hypertensive individuals were recruited from this cohort and these were divided into two groups; those with either high or low serum UA concentrations. Demographic, biochemical, and hematological characteristics of population were evaluated in all the subjects. Logistic‐regression analysis was performed to determine the association of hematological parameters with hypertension (HTN). Of the 2334 hypertensive subjects, 290 cases had low UA, and 2044 had high serum UA concentrations. Compared with the low UA group, the patients with high serum UA, had higher values for several hematological parameters, whilst platelet counts (PLT) were lower. Multiple linear regression analysis showed that PLT and serum high sensitivity‐c reactive protein (hs‐CRP) were correlated with serum UA level. Stepwise multiple logistic regression model confirmed that platelet distribution width (PDW) and gender were independent determinant of a high serum UA. PDW and PLT appear to be independently associated with serum UA level in patients with HTN. © 2018 BioFactors, 44(6):532–538, 2018 [ABSTRACT FROM AUTHOR]

To evaluate the effect of a computerized Decision Support System (CDSS) on improving adherence to an anticoagulation guideline for the treatment of atrial fibrillation (AF). This study had an interrupted time series design. The adherence to the guideline was assessed at fortnightly (two weeks) intervals from January 2016 to January 2017, 6 months before and 6 months after intervention. Newly diagnosed patients with AF were included in the offices of ten cardiologists. Stroke and major bleeding risks were calculated by the CDSS which was implemented via a mobile application. Treatment recommendations based on the guideline were shown to cardiologists. The segmented regression model was used to evaluate the effect of CDSS on level and trend of guideline adherence for the treatment of AF. In our analysis, 373 patients were included. The trend of adherence to the anticoagulation guideline for the treatment of AF was stable in the pre-intervention phase. After the CDSS intervention, mean of the adherence to the guideline significantly increased from 48% to 65.5% (P-value < 0.0001). The trend of adherence to the guideline was stable in the post-intervention phase. Our results showed that the CDSS can improve adherence to the anticoagulation guideline for the treatment of AF. Registration ID: IRCT2016052528070N1. [ABSTRACT FROM AUTHOR]

Abstract: There is persuasive evidence that oxidative stress and inflammation are features of the metabolic syndrome (MetS). We have investigated the relationship between serum pro‐oxidant‐antioxidant balance (PAB), serum uric acid, and high sensitive C‐reactive protein (hs‐CRP) in 7,208 participants from the MASHAD study cohort, who were categorized as having MetS, or not, using International Diabetes Foundation (IDF) criteria. Serum hs‐CRP was measured by Polyethylene glycol (PEG)‐enhanced immunoturbidimetry method using an Alycon analyzer (ABBOTT, Chicago, IL, USA). A colorimetric method was used to determine serum PAB. Serum PAB values were significantly higher in the individuals with MetS compared to those without (P < 0.001). Furthermore, there was a step‐wise increase in mean serum PAB concentrations as the number of components of the MetS increased. The combination of features of MetS had different association with serum PAB and hs‐CRP. Multiple linear regression analysis showed that body mass index (BMI, B = 2.04, P < 0.001), physical activity level (PAL, B = 18.728, P = 0.001), serum uric acid (B = −1.545, P = 0.003), and serum C‐reactive protein (B = 0.663, P < 0.001) were associated with serum PAB in individuals with MetS. Multiple logistic regression analysis showed that serum PAB (B = 0.002, P < 0.001, CI = 1.001–1.003), serum C‐reactive protein (B = 0.007, P < 0.015, CI = 1.001–1.013), and serum uric acid (B = 0.207, P < 0.001, CI = 1.186–1.277) were all significantly associated with MetS. Serum PAB was strongly associated with serum uric acid and serum hs‐CRP. Moreover, serum PAB as well as serum uric acid and serum hs‐CRP were independently associated with MetS. Individual features of MetS were also associated with serum hs‐CRP and PAB. © 2018 BioFactors, 44(3):263–271, 2018 [ABSTRACT FROM AUTHOR]

Metabolic syndrome is a clustering of metabolic abnormalities that include central obesity, dyslipidemia, insulin resistance, and increased blood pressure. The aim of this study was to evaluate and identify the risk factors associated with metabolic syndrome by using a decision tree algorithm as a data mining tool. A total of 6578 individuals were included in the analysis using a body mass index (BMI) cutoff >= 25 kg/m for the definition of overweight, in accordance with International Diabetic Federation (IDF) criteria. Subjects with obesity plus two or more of the criteria for defining metabolic syndrome were included in the metabolic syndrome group. Of the 6578 subjects, 70% (4539 subjects) were selected as a 'training' dataset and 30% (2039 cases) were used as the testing dataset to evaluate the performance of decision tree. Two models were evaluated. In model I, age, sex, educational level, marriage and job status, fasted serum triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), uric acid, fasting blood glucose (FBG), high sensitive C-reactive protein (Hs-CRP), systolic (SBP) and diastolic (DBP) blood pressure, and physical activity level were considered as input variables and in model II, age, gender, Hs-CRP, white blood cell (WBC), red blood cell (RBC), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), Platelets (PLT), red cell distribution width (RDW), and platelet distribution width (PDW) were used as input variables. The validation of the model was assessed by constructing a receiver operating characteristic (ROC) curve. The results showed that in model I, serum fasted TG was the most important associated risk factor for metabolic syndrome. In model II, serum Hs-CRP was identified as a risk factor of metabolic syndrome. The sensitivity, specificity, accuracy, and the area under the ROC curve (AUC) values for model I were 99%, 94%, 97% and 0.972 and for model II were 74%, 77%, 76% and 0.812, respectively. Our findings in model I suggest that the IDF criteria are suitable for identifying individuals within the Iranian population into those with, or without MetS. Furthermore, model II showed that serum Hs-CRP concentrations were identified as a risk factor for metabolic syndrome within the Iranian population. [ABSTRACT FROM AUTHOR]

Background Depression and anxiety are two common mood disorders that are both linked to systemic inflammation. Increased white blood cell (WBC) count and red cell distribution width (RDW) are associated with negative clinical outcomes in a wide variety of pathological conditions. WBC is a non-specific inflammatory marker and RDW is also strongly related to other inflammatory markers. Therefore, we proposed that there might be an association between these hematological inflammatory markers and depression/anxiety symptoms. Objective The primary objective of this study was to examine the association between depression/anxiety symptoms and hematological inflammatory markers including WBC and RDW in a large population-based study. Methods Symptoms of depression and anxiety and a complete blood count (CBC) were measured in 9274 participants (40% males and 60% females) aged 35–65 years, enrolled in a population-based cohort (MASHAD) study in north-eastern Iran. Symptoms of depression and anxiety were evaluated using the Beck Depression and Anxiety Inventories. Results The mean WBC count increased with increasing severity of symptoms of depression and anxiety among men. Male participants with severe depression had significantly higher values of RDW (p < 0.001); however, this relationship was less marked among women (p = 0.004). In addition, men (but not women) with severe anxiety symptoms had significantly higher values of RDW (p < 0.001). Moreover, there was a negative association between red blood cell (RBC) and mean corpuscular hemoglobin (MCH) and symptoms of depression/anxiety. Conclusion Our results suggest that higher depression and anxiety scores are associated with an enhanced inflammatory state, as assessed by higher hematological inflammatory markers including WBC and RDW, even after adjusting for potential confounders. [ABSTRACT FROM AUTHOR]

Background Depression and anxiety are two important mood disorders that are frequently associated with chronic diseases such as cardiovascular diseases (CVDs). Hyper-inflammation is related to both CVDs and psychological conditions such as depression and anxiety. Therefore, inflammation may partially explain the relationship between depression and cardiovascular disease. Objective The objective of this study was to perform a gender-stratified examination of the association between symptoms of depression/anxiety disorders and serum hs-CRP and inflammation linked conditions in a large Iranian population. Methods Symptoms of depression and anxiety disorders and serum hs-CRP levels were measured in 9759 participants (40% males and 60% females) aged 35–65 years, enrolled in a population-based cohort (MASHAD) study in north-eastern Iran. Symptoms of depression and anxiety were evaluated with Beck Depression and Anxiety Inventories. According to the scores of depression and anxiety, individuals were categorized into four groups of no or minimal, low, moderate and severe categories. Results The median serum hs-CRP concentration increased with increasing severity of depression and anxiety disorders. Male participants with severe depression had significantly higher levels of hs-CRP (p < 0.001); however, this relationship was less marked among women (p = 0.04). Subjects with severe anxiety also had significantly higher levels of hs-CRP (p < 0.001). Moreover, women with severe depression and anxiety had higher BMI. There was also a positive association between current smoking habit and depression/anxiety disorders. Conclusion Depression and anxiety disorders are associated with elevated levels of hs-CRP, particularly among men. Also, there is a significant positive association between depression/anxiety disorders and inflammation linked conditions such as smoking and obesity; however, in the case of obesity this association is only present in women. [ABSTRACT FROM AUTHOR]

Background: Potential role of computerized decision support system on management of atrial fibrillation is not well understood. Objectives: To systematically review studies that evaluate the effects of computerized decision support systems and decision aids on aspects pertaining to atrial fibrillation. Data Sources: We searched Medline, Scopus and Cochrane database. Last date of search was 2016, January 10. Selection criteria: Computerized decision support systems that help manage atrial fibrillation and decision aids that provide useful knowledge for patients with atrial fibrillation and help them to self-care. Data collection and analysis: Two reviewers extracted data and summarized findings. Due to heterogeneity, meta-analysis was not feasible; mean differences of outcomes and confidence intervals for a difference between two Means were reported. Results: Seven eligible studies were included in the final review. There was one observational study without controls, three observational studies with controls, one Non-Randomized Controlled Trial and two Randomized Controlled Trials. The interventions were three decision aids that were used by patients and four computerized decision support systems. Main outcomes of studies were: stroke events and major bleeding (one article), Changing doctor-nurse behavior (three articles), Time in therapeutic International Normalized Ratio range (one article), decision conflict scale (two articles), patient knowledge and anxiety about stroke and bleeding (two articles). Conclusions: A computerized decision support system may decrease decision conflict and increase knowledge of patients with atrial fibrillation (AF) about risks of AF and AF treatments. Effect of computerized decision support system on outcomes such as changing doctornurse behavior, anxiety about stroke and bleeding and stroke events could not be shown. We need more studies to evaluate the role of computerized decision support system in patients with atrial fibrillation. [ABSTRACT FROM AUTHOR]

Background The prevalence of metabolic syndrome (MetS) is increasing globally. It is associated with a significant risk of developing type 2 diabetes mellitus and cardiovascular disease. Materials and methods The relationship between adherence to several different dietary patterns and the presence of MetS was explored in an Iranian population sample of 5764 subjects. Results We observed that the prevalence of MetS was 13% and 18% in men and women, respectively. There were three main dietary patterns: the first pattern was characterized by protein, carbohydrate, starch, glucose, fructose, sucrose, maltose, dietary fibre, potassium, calcium, magnesium, phosphorus, iron, zinc, manganese, thiamine, riboflavin, carotene, vitamin c and lactose; second representative of fat, saturated fat, monounsaturated fat, polyunsaturated fat, cholesterol, sodium, calcium, zinc, phosphorus, iodine, vitamin D, chloride, betaine, niacin; third consisting of copper, selenium, vitamin A, riboflavin, vitamin B12. In this dietary pattern, individuals in first quintile had a higher consumption of total fat, saturated fatty acid, monounsaturated fatty acid, polyunsaturated fatty acid, cholesterol and vitamin A. In the second pattern, individuals in the fifth quintile ate less carbohydrate, dietary fibre, glucose, Fructose, potassium compared to first quintile. We found that individuals in the first quintile in pattern 3 had higher intakes of protein, zinc and calcium compared to other quintiles. Conclusions We have found that a nutrient pattern which mostly characterized by dietary protein, carbohydrate, starch, glucose, fructose, sucrose, maltose was associated with a higher risk of MetS in both genders, while a pattern which was represent of copper, selenium, Vitamin A, riboflavin, vitamin B12 was associated with greater odds of Mets, in women. [ABSTRACT FROM AUTHOR]

Abstract: The metabolic syndrome (MetS) is considered to be a major risk factor for type 2 diabetes mellitus and cardiovascular diseases. It is characterized by central adiposity, high blood pressure, glucose intolerance and abnormalities of lipoprotein metabolism. The cause of MetS is likely to be due to a complex interaction between genetic and environmental factors. Liver X receptors alpha (NR1H3) and beta (NR1H2) play a key role in lipid and carbohydrate metabolism. The aim of this study was to investigate the contribution of genetic polymorphisms in the LXRs to risk of MetS and related traits. Two common SNPs in NR1H3 (rs11039155 and rs2279238) and in NR1H2 (rs17373080 and rs2695121) were genotyped using TaqMan assays in MetS patients (n=265) and controls (n=219). Logistic regression analyses were performed to calculate the odds ratios (ORs) as a measure of association of genotypes with the presence of MetS and related phenotypes. Although The NR1H2 polymorphism rs2695121 was nominally associated with MetS but correction for multiple-testing and adjustment for age, sex and number of MetS criteria, failed to identify any significant interactions associated with prevalence of MetS. However in the haplotype analysis, a LXRα haplotype AC, was more common in controls and was associated with a significant protective effect for MetS (OR [95% CI]=0.25 [0.07–0.88], p =0.031). In conclusion, this study suggests that the above-named variants in LXRα and LXRβ genes are not potential contributors to the risk of MetS and related traits in an Iranian population. [Copyright &y& Elsevier]