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Background and objective: Gastroesophageal reflux disease (GERD) is a digestive complication that is common in adults and defined by heartburn and regurgitation. Due to the increasing frequency and problems of the disease, epidemiological features of GERD have been considered in recent years. Therefore, we examined the factors related to GERD in different body mass index (BMI) categories. Materials and methods: We did a cross-sectional analysis of the primary information from a populationbased cohort study of 10520 people in Guilan Province, Iran. Demographic characteristics such as age, gender, smoking history, and alcohol consumption were collected using a self-administered questionnaire; also, anthropometric and clinical information were surveyed. Data analyzed with SPSS version 21.0. Results and conclusion: A total of 10520 participants were aged 35 to 70 years and included 5633 (53.55%) females and 4887 (46.45%) males. The frequency of GERD was 13.2% in the present study and was more prevalent in people with high BMI levels. According to analysis, GERD was significantly associated with female gender and low physical activity. Alcohol and smoke use was inversely associated with GERD. This large population-based study indicated risk factors in people with high BMI increased occurrence of GERD that altering these variables may reduce or prevent GERD indications must be elucidated in controlled trials. [ABSTRACT FROM AUTHOR]

Background and objective: The development of health indexes in recent years drag more attention to everyday life style and the impacts of socioeconomic status (SES) on individual's health state. In this regard, we aimed to investigate the socioeconomic status (SES) among the PERSIAN Guilan cohort population by considering the prevalence of gastroesophageal reflux disease (GERD) in these participants. Materials and methods: This cross-sectional study was conducted based on the PERSIAN cohort study from October 2014 to January 2017 on 10520 individuals. Data including age, gender, body mass index (BMI), educational level, habitat, and SES of patients were collected from all individuals and analyzed using SPSS.16 with a significant level <0.05. Results and conclusion: The results illustrated that out of 10520 participants, 1385 patients had GERD that its distribution was 34.9%, 33.6%, and 31.6% in low, moderate, and high levels of SES, respectively. Due to results, age, gender, educational status, and habitat significantly associated with GERD according to three levels of SES (P<0.05). GERD was more frequent in patients with low, moderate, and high levels of SES, respectively. Age, gender, educational status, and habitat, represented a significant association with different levels of SES among patients with GERD (P<0.05). This large population-based study indicated the increased risk of GERD in the low SES group compare to middle and high-SES groups, which highlighted the role of SES in the health status of individuals. [ABSTRACT FROM AUTHOR]

Introduction: Non-alcoholic fatty liver disease (NAFLD) is an obesity-associated health problem that causes other liver diseases for the patient. Four anthropometric indices: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were analyzed as NAFLD predictors in the present study. Methods: From the total number of individuals who referred to the PERSIAN Guilan Cohort study (PGCS) located in the north of Iran during the period of study, a total of 960 people were enrolled in the present study. NAFLD was diagnosed using through an abdominal ultrasound exam. Height, weight, WC, BMI, WHR and WHtR were later calculated. Chi-square, ANOVA and logistic regression analyses were used to analyze the risk factors. Results: Out of the 960 individuals who were enrolled in the study, 597 (62.2%) were male and 363 (37.8%) were female (with an average age of 47.21 ± 7.29 years). There was a significant relationship between weight and NAFLD (P<0.001). There was also a significant relationship between BMI (OR= 8.41; 95% CI = 5.59-12.75), WC (OR= 2.67; 95% CI = 2.05-3.48), WHR (OR= 3.84; 95% CI = 2.26-6.52), WHtR (OR= 28.53; 95% CI = 6.94-117.31) and NAFLD (P<0.001). The results of the logistic regression analysis showed that WHtR, BMI and WC were effective predictors for the risk of NAFLD while WHtR played a more important role in the prediction of NAFLD. Conclusion: Anthropometric indices, especially WHtR, as a simple screening tool, seem to be an important criterion for the detection of NAFLD. [ABSTRACT FROM AUTHOR]

Background: As Methotrexate (MTX) may induce liver side effects or damage, evaluating the liver of the consumers of this drug by a noninvasive method, such as FibroScan, may be effective. Objectives: The present study aimed at evaluating the progression of liver fibrosis and steatosis using the transient elastography (FibroScan) technique in patients, who are treated with MTX. Methods: Onehundredandone patients,whowere treated withMTXbecause of different rheumatologic diagnosis and/or dermatologic disease, were included in the study. Liver stiffness was measured using FibroScan. Hepatic fibrosis was identified by converting the FibroScan results measured in kPa to the Metavir scale. Also, F0-F4 and steatosis were graded. Results: The assessment of steatosis using FibroScan showed mild, moderate, and severe stenosis in 15.8%, 13.9%, and 26.7%, respectively. With regards to grading of hepatic fibrosis, 67.0% were graded as F0 to F1, 7.0% as F2, 7.0% as F2 to F3, 2.0% as F3, 11.0% as F3 to F4, and 6.0% as F4. A significant association was found between body mass index, waist circumferences, and fibrosis. The association between the severity of hepatic fibrosis and indices of alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), and serum albumin was significant. No relationship was revealed between the severity of hepatic fibrosis and MTX dosage as well as duration of MTX use. Conclusions: The authors found significant associations between hepatic steatosis and anthropometric parameters, level of albumin, drug dosage higher than 10 mg, and cumulative dosage of MTX. The severity of hepatic fibrosis and steatosis induced by MTX was mainly affected by the patients' obesity. [ABSTRACT FROM AUTHOR]

Context: Non-alcoholic fatty liver disease (NAFLD) is progressing considerably worldwide. Identifying the risk factors of NAFLD is a critical step in preventing its progression. Methods: In November 2022, two independent researchers studied seven databases, including PubMed, ISI/WoS, ProQuest, Scopus, SID, Magiran, and Google Scholar, and reference list of relevant articles, searching studies that assessed NAFLD risk factors in the Iranian adult population. Heterogeneity between studies was assessed by Cochran's test and its composition using I² statistics. A random-effects model was used when heterogeneity was observed; otherwise, a fixed-effects model was applied. Egger's regression test and Trim-and-Fill analysis were used to assess publication bias. Comprehensive Meta-analysis software (version 3) was used for the analyses of the present study. Results: The results of this study showed significant associations between NAFLD with age (n = 15, odds ratio (OR) = 2.12,95% CI: 1.79 - 2.51), body mass index (n = 46, OR= 5.00,95% CI: 3.34 - 7.49), waist circumference (n = 20, OR = 6.37,95% CI: 3.25 -12.48), waist-to-hip ratio (n = 17, OR = 4.72, 95% CI: 3.93 - 5.66), total cholesterol (n = 39, OR = 1.80, 95% CI: 1.52 - 2.13), high-density lipoprotein (n = 37, OR = 0.53, 95% CI: 0.44-0.65), low-density lipoprotein (n = 31, OR = 1.68, 95% CI: 1.38 - 2.05), triglyceride (n = 31, OR = 3.21, 95% CI: 2.67-3.87), alanine aminotransferase (n = 26, OR = 4.06,95% CI: 2.94 - 5.62), aspartate aminotransferase (n = 27, OR = 2.16,95% CI: 1.50-3.12), hypertension (n =13, OR = 2.53,95% CI: 2.32 - 2.77), systolic blood pressure (n = 13, OR = 1.83,95% CI: 1.53 - 2.18), diastolic blood pressure (n = 14, OR=1.80,95% CI: 1.48-2.20), fasting blood sugar (n = 31, OR=2.91,95% CI: 2.11-4.01), homeostatic model assessment for insulin resistance (n = 5, OR = 1.92,95% CI: 1.48 - 2.59), diabetes mellitus (n =15, OR = 3.04,95% CI: 2.46-3.75), metabolic syndrome (n = 10, OR = 3.56,95% CI: 2.79 - 4.55), and physical activity (n = 11, OR= 0.32, 95% CI: 0.24-0.43) (P< 0.05). Conclusions: In conclusion, several factors are significantly associated with NAFLD. However, anthropometric indices had the strongest relationship with NAFLD in the Iranian adult population. [ABSTRACT FROM AUTHOR]

Background: Ultrasound is an important method to determine the volume of the gallbladder and check its structure. Considering the variation in the size and volume of the gallbladder in disease and physiological conditions, determining the volume of the gallbladder is clinically valuable. This study was carried out to evaluate the gallbladder volume and its association with patients' demographic data in the Prospective Epidemiological Research Studies of Iranian Adults (PERSIAN) Guilan cohort study (PGCS) population. Methods: In this cross-sectional study, 957 individuals aged 35–70 participated in determining the gallbladder volume by a radiologist based on the ultrasound method. The demographical data were collected using a questionnaire. After fasting for 12 h, the ultrasound was performed with an Ultrasonic device (Sonix SP series) with a 3.5 to 5 MHz probe. Results: The total frequency of gallbladder lesions was 2.2%. The results showed a significant association between marriage and gender with the presence or absence of lesions in the studied participants (P < 0.05). Also, significant differences were reported between the volume of gallbladder and gender, body mass index (BMI), social and economic status (SES), metabolic equivalent of task (MET), history of cardiovascular disease (CVD), and hypertension (P < 0.05). The results of a linear regression represented a significant association between gender, BMI, MET, and CVD and the mean volume of the gallbladder (P < 0.05). However, there was no significant association between the presence or absence of a lesion and the individuals' average gallbladder volume (P > 0.05). Conclusion: According to our results, gender, BMI, MET, and CVD were significantly associated with gallbladder volume. [ABSTRACT FROM AUTHOR]

Background Laboratory studies have shown that gastric epithelial infection cells with Helicobacter pylori (H. pylori) can increase autophagy. Disruption in this process can cause various diseases, including cancer. Objective This study aims to compare the serum level of Autophag -Related Gene 5 (ATG5 ) in individuals with and without H. pylori infection. Methods This case-control pilot study was conducted in 2018 on 44 individuals aged 35-50 years referred to the endoscopy ward of Razi Hospital in Rasht, Iran. Their age, gender, Body Mass Index (BMI), smoking, and symptoms were first recorded in a form. Based on Rapid Urease Test and pathology results, they included in two groups of patient (n=22) and healthy (n=22). Serum ATG5 levels were quantitatively assessed by an ELISA kit (EIAab, USA). Results Most of participants (56.8%) were male, aged over 40 years (77.3%), a BMI < 25 kg/m2 (52.3%) and not smoking cigarettes (70.5%). The mean serum levels of ATG5 in individuals with and without H. pylori infections were 63.5 ± 15.4 and 57.1±18.9, respectively (P>0.05). The mean ATG5 level was higher in women than in men (P= 0.0047). Conclusion Serum level of ATG5 is not significantly different between people with and without H. pylori infection. Further study is recommended using a larger sample size and based on a comparing gastrointestinal lesions. [ABSTRACT FROM AUTHOR]

Background & Aims: Nonalcoholic fatty liver disease (NAFLD) is a growing problem and the commonest cause of chronic liver disease throughout the world. Given the strong association between NAFLD and insulin resistance and obesity, as well as the central role of ghrelin in these metabolic disorders, we explored whether ghrelin (GHRL) and ghrelin receptor (GHSR) gene polymorphisms were associated with susceptibility to NAFLD. Methods: In this case-control retrospective study which was conducted between April 2010 and July 2013, GHRL (rs696217 or Leu72Met) and GHSR (rs2922126) gene polymorphisms were genotyped in 153 cases with biopsy-proven NAFLD and 157 controls using the polymerase chain reaction - restriction fragment length polymorphism method. Results: The GHRL rs696217 "GT+TT" genotype or "GT" genotype compared with the "GG" genotype occurred less frequently in the patients with NAFLD than the controls and the differences remained significant after adjustment for confounding factors such as age and body mass index (p=0.018; OR=0.35, 95%CI: 0.14-0.84 and p=0.046; OR=0.40, 95%CI: 0.16-0.98, respectively). Furthermore, the GHRL rs696217 'T' allele compared with 'G' allele was significantly underrepresented in the cases (p=0.007; OR=0.33, 95%CI: 0.15-0.76). Nevertheless, no significant difference was found for GHSR rs2922126 gene polymorphism. Conclusions: Our findings suggested, for the first time, that the GHRL rs696217 or Leu72Met "GT+TT" genotype and "GT" genotype compared with "GG" genotype, as well as the "T" or Met72 allele compared with "G" or Leu72 allele had a protective effect for NAFLD susceptibility. However, other studies are required to confirm these findings. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to assess the prevalence of central and general obesity and compare nine anthropometric indices as predictors of the risk factors for cardiovascular disease (CVD) in Iranian adults. Methods: A total of 10,520 adults between ages 35 and 70 years old who were referred to the PERSIAN Guilan Cohort Study were included in this study. Anthropometric indices, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), conicity index, hip circumference (HC), waist-to-hip-to-height ratio (WHHR), body adiposity index, and a body shape index (ABSI), were measured using the standard methods. The risk factors for CVD (diabetes mellitus, hypertension, and out-of-range lipid profiles) were defined by laboratory tests and medical history. The odds ratio of the risk factors based on a unit increase in anthropometric indices was examined by an adjusted logistic model. Results: The mean of all anthropometric indices was higher in women than in men (p<0.01). After adjusting for confounders, the risk of diabetes mellitus, hypertension, and hypertriglyceridemia increased with an increase in all anthropometric indices. The highest risk of diabetes mellitus and hypertriglyceridemia was found in higher WHHR. The highest risk of low high-density lipoprotein cholesterol (HDL-C) and high low-density lipoprotein cholesterol (LDL-C) was found in an increase in the WHR and ABSI, respectively. Conclusion: Our findings emphasize higher levels of general and central obesity in adults in the north of Iran. The WHHR and WHtR seem to be more valuable indices than BMI and WC for predicting distinct risk factors for CVD. However, the WHR was the strongest index for the prediction of high LDL-C/HDL-C ratio. [ABSTRACT FROM AUTHOR]