Overweight and Obesity in the Eastern Mediterranean Region
Arch Iran Med. 2010 Sep;13(5):384-90. Association Study of The -866G/A UCP2 Gene Promoter
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Arch Iran Med. 2010 Sep;13(5):384-90. Association Study of The -866G/A UCP2 Gene Promoter Polymorphism with Type 2 Diabetes and Obesity in a Tehran Population: A Case Control Study. Heidari J, Akrami SM, Heshmat R, Amiri P, Fakhrzadeh H, Pajouhi M. Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran. Abstract BACKGROUND: A functional polymorphism in the uncoupling protein 2 (UCP2) gene promoter has been associated with obesity and type 2 diabetes (T2D) in some popula ons. The impact of UCP2 polymorphisms on diabetes and obesity is still under debate. Contradictory results have been reported in different populations world-wide. To clarify the contribution of the UCP2 gene -866 G/A polymorphism in the Iranian popula on, we studied its associa on with obesity and T2D.
without obesity, 75 obese pa ents without diabetes and 75 control subjects. The UCP2 -866 G/A polymorphism was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS: In the normal Iranian population, GG polymorphism was significantly associated with an increased HDL-C level (P=0.027). G/A polymorphism was not associated with obesity and T2D in our study population, but the odds ratio (OR) between GG and G/A polymorphism was 0.61 with a confidence interval (CI) range of 0.34 - 1.08 in obese patients. Subjects with AA genotypes in all of the studied groups showed a lower body mass index (BMI) than subjects with the GG genotype.
significant, the A allele in the UCP2 gene promoter seems to be protective against obesity. This may suggest the possibility of UCP2 as a target molecule for studies on the etiology and treatment of obesity. 120
Med Oncol. 2010 Jul 27. [Epub ahead of print] Body Mass Index and Waist Circumference are Predictor Biomarkers of Breast Cancer Risk in Iranian Women. Hajian-Tilaki KO, Gholizadehpasha AR, Bozorgzadeh S, Hajian-Tilaki E. Department of Social Medicine and Health, Babol University of Medical Sciences, Babol, Iran, drhajian@yahoo.com. Abstract Both obesity and breast cancer incidence increased dramatically during two recent decades in a rapidly changing society in northern Iran. In this study, we examined the ability of body mass index (BMI) and waist circumference (WC) as predictor biomarkers of breast cancer risk in Iranian women. In a case-control study of 100 new cases of histological confirmed breast cancer and 200 age-matched controls, in Babol, we measured weight, height, waist and hip circumference at time of diagnosis with standard methods. The data of demographic, characteristics, reproductive and lifestyle factors were collected by interview. We used both regression and receiver operator characteristics (ROC) analysis to estimate the predictive ability of BMI and WC for breast cancer as estimated by area under the curve (AUC). The results showed a significant difference in the mean of weight, BMI and WC between patients and controls in pre- and postmenopausal women (P < 0.001). While a er adjus ng for BMI, no longer an associa on between WC and breast cancer was found. The overall accuracy of observed BMI and WC were 0.79 (95% CI: 0.74-0.84) and 0.68 (95% CI: 0.61-0.74), respec vely. The accuracy of BMI and WC were 0.82 (95% CI: 0.76-0.89), 0.75(0.67-0.83) for premenopausal and 0.77(0.68-0.85), 0.60 (0.50-0.71) for postmenopausal women, respectively. BMI and WC are predictor biomarkers of breast cancer risk in both pre- and postmenopausal Iranian women while after adjusting for BMI, no longer an association between WC and breast cancer was observed. These findings imply to perform breast cancer screening program in women with a higher BMI and WC. 121
J Res Med Sci. 2010 Jul;15(4):191-201. The Influence of Calcium Supplement on Body Composition, Weight Loss and Insulin Resistance in Obese Adults Receiving Low Calorie Diet. Shalileh M, Shidfar F, Haghani H, Eghtesadi S, Heydari I. Nutrition Sciences Department, Faculty of Health, Iran University of Medical Sciences, Tehran, Iran. Abstract BACKGROUND: Obesity and diabetes are the most important problems of public health. Evidence from molecular animal research and epidemiologic investigations indicate that calcium intake may have an influence on body composition, weight and insulin resistance. The objective of this study was to determine the effects of calcium supplementation on body composition, weight, insulin resistance and blood pressure in the face of calorie restriction in obese adults.
adults with Body Mass Index > 25kg/m(2) was conducted. Subjects were maintained for 24 weeks on a balanced deficit diet (-500 kcal/d deficit) and randomly assigned into two groups with 1000 mg ca/d as calcium carbonate or placebo.
24th week between the two groups. The lean mass showed no significant increase in the calcium group at the 12th week compared to baseline and in placebo group at the 24th week compared to the 12th week. The insulin concentration showed a significant decrease in the calcium group at the 12th week compared to the baseline (p < 0.05). The diastolic blood pressure had a significant decrease at the 24th week compared to the 12th week in both groups (p = 0.013-0.009). CONCLUSIONS: Results from this study suggest that 24 weeks of supplementa on with 1000 mg ca/d did not have any effect on weight, body composition, insulin resistance and blood pressure beyond what can be achieved in an energy restricted diet in obese adults. 122
Matern Child Nutr. 2010 Jul 1;6(3):275-86. Effects of a Lifestyle Modification Trial among Phenotypically Obese Metabolically Normal and Phenotypically Obese Metabolically Abnormal Adolescents in Comparison with Phenotypically Normal Metabolically Obese Adolescents. Kelishadi R, Hashemipour M, Sarrafzadegan N, Mohammadifard N, Alikhasy H, Beizaei M, Sajjadi F, Poursafa P, Amin Z, Ghatreh-Samani S, Khavarian N, Siadat ZD. Pediatric Preventive Cardiology Department, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Iran. kroya@aap.net
This study aimed to assess the effects of a 2-month lifestyle modification trial on cardio-metabolic abnormalities and C-reactive protein (CRP) among obese adolescents with metabolic syndrome [phenotypically obese metabolically abnormal (POMA)] and obese adolescents without a cardio- metabolic disorder [phenotypically obese metabolically normal (POMN)], as well as in normal-weight adolescents with at least one cardio-metabolic disorder [phenotypically normal metabolically obese (PNMO)]. The study comprised 360 adolescents assigned in three groups of equal number of POMN, POMA and PNMO. They were enrolled in a trial consisting of aerobic ac vity classes, diet and behaviour modifica on, and were recalled a er 6 months. Overall, 94.7% of par cipants completed the 2-month trial, and 87.3% of them returned a er 6 months. The mean CRP was not significantly different between the POMA and PNMO groups, but was higher than in the POMN group. After the trial, body mass index (BMI) and waist circumference (WC) decreased in obese participants, and the mean body fat mass decreased in all groups. At 2 months, the mean total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) and CRP decreased in the POMA and PNMO groups. A er 2 and 6 months, the decrease in mean TC, LDL-C, TG, CRP and systolic blood pressure was greater in the POMA than in the POMN group. The magnitude of decrease in CRP correlated with that of BMI, WC, fat mass, TG, TC and LDL-C. Lifestyle modification programmes for primordial/primary prevention of chronic diseases would be beneficial at the population level and should not be limited to obese children.
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Ther Clin Risk Manag. 2010 Jul 21;6:345-9. Prevalence of Impaired Glucose Tolerance and Insulin Resistance among Obese Children and Adolescents. Ghergherechi R, Tabrizi A. Department of Pediatrics Endocrinology, Tabriz University of Medical Sciences, Tabriz, Iran; Abstract PURPOSE: Obesity is one of the most important nutritional disorders in the world which has an obvious relationship with the incidence of metabolic diseases. Obesity prevalence has increased among children and adolescents during recent decades, leading to a rise in Type 2 diabetes mellitus (DM II) prevalence in these two age brackets. Hence, the aim of this study was to assess impaired glucose tolerance and insulin resistance, and gather metabolic findings in obese children and adolescents.
adolescents (body mass index > 95th percen le for age and gender) 4-18 years of age referred to the endocrine clinic of the Children's Hospital at Tabriz University in a descriptive cross-sectional study. Fasting glucose, insulin, and lipid profile in all subjects were determined. Oral glucose tolerance test a er ea ng 75 g/kg glucose was performed. Homeostatic model assessment was used to estimate insulin resistance.
68 obese adolescents was 14.7% and 31.8%, respec vely. Impaired glucose tolerance and insulin resistance was not seen in 23.8% of 42 obese children. No case of DM II was seen. There was a significant statistical difference in glucose (P = 0.003) and insulin (P < 0.001) level at minute 120 in individuals with impaired glucose tolerance compared to obese children and adolescents without impaired glucose tolerance. Rate of insulin resistance in patients with impaired glucose tolerance was greater and had a significant sta s cal difference (P = 0.03).
impaired glucose tolerance and insulin resistance in children and adolescents. Oral glucose tolerance test, unlike fasting glucose test, is a benefit test to predict impaired glucose tolerance. With prompt identification and treatment of obese children with impaired glucose tolerance, we can prevent it from progression towards DM II. 124
J Public Health (Oxf). 2010 Jun;32(2):202-9. Epub 2009 Aug 18. Association of Educational Level with Risk of Obesity and Abdominal Obesity in Iranian Adults. Hajian-Tilaki KO, Heidari B. Department of Social Medicine and Health, Babol Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran. drhajian@yahoo.com Abstract BACKGROUND: The impact of education on obesity may vary according to population and geographic region. The objective of the present study was to determine the association between education and obesity.
conducted by using a cluster sampling technique in an adult population residing in the north of Iran, in 2004. Weight, height, waist and hip circumference were measured and data concerning education level, demographic characteristics and physical activities were collected by interview. Logistic regression analysis was used to estimate the association between educa on and general obesity (body mass index >or=30) as well as abdominal obesity (waist circumference >88 cm in women and 102 cm in men).
level of high school and college compared with illiterate and primary level was 0.55 [95% confidence interval (CI): 0.43-0.71]. A greater nega ve associa on was observed for educa on at university level (OR = 0.32, 95% CI: 0.22-0.47) irrespec ve to sex. However, with regard to abdominal obesity, after controlling for confounding factors, the adjusted OR for education at university level remained significant only in women but not in men. CONCLUSION: The findings of this study indicate that education level is inversely associated with general obesity in both sexes but with abdominal obesity only in women.
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J Clin Epidemiol. 2010 Jun;63(6):655-9. Epub 2009 Nov 12. Pictogram Use Was Validated for Estimating Individual's Body Mass Index. Keshtkar AA, Semnani S, Pourshams A, Khademi H, Roshandel G, Boffetta P, Malekzadeh R. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.
pictogram for estimating body mass index (BMI). STUDY DESIGN AND SETTING: Participants of Golestan cohort study during 2000-2004 were recruited in this study. Demographic and anthropometric information (weight, height, and BMI) were collected on all participants. A set of drawings (pictogram) ranging from very lean to obese were used to assess the individual's perception of their body size. Sensitivity and specificity of each pictogram score were calculated and cutoff points were determined using sensitivity/specificity plots. We used receiver operating characteristic curves to assess the validity of pictogram scores. RESULTS: Of the 15,437 subjects enrolled in the study, 6,574 (42.6%) were males and 8,863 (57.4%) were females. Their mean+/-standard deviation age was 52.58+/-9.28 years. Pictogram scores 1, 2, and 3 were assigned to normal par cipants; pictogram score 4 was selected by overweight subjects, and finally, pictogram scores equal or higher than 5 were selected by obese ones (area under curve: 0.83-0.85). CONCLUSION: According to our results, pictogram is a valid measure for discriminating obese or overweight from normal individuals, and for distinguishing obese from overweight or normal individuals. So it can be concluded that body image pictogram is valid for discriminating normal and obese individuals.
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Metab Syndr Relat Disord. 2010 Jun;8(3):209-13. Secular Trends of Obesity in Iran between 1999 and 2007: National Surveys of Risk Factors of Non-Communicable Diseases. Esteghamati A, Khalilzadeh O, Mohammad K, Meysamie A, Rashidi A, Kamgar M, Abbasi M, Asgari F, Haghazali M. Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. esteghamati@tums.ac.ir Abstract BACKGROUND: Obesity is a rapidly progressing pandemic and a central feature of the metabolic syndrome. There is no solid evidence on the recent trends of obesity in Iran. In this study we present the secular trends of overweight and obesity among Iranian adults (25-64 years old) within an 8- year period (1999-2007).
sectional national surveys: The National Health Survey-1999 (n = 21,576), National Surveys of Risk Factors for Non-Communicable Diseases (SuRFNCD)-2005 (n = 70,945), and SuRFNCD-2007 (n = 4,186). RESULTS: The overall prevalence of obesity increased from 13.6% in 1999 to 19.6% in 2005 and 22.3% in 2007 [odds ra o (OR) = 1.08 per year; P < 0.001]. For overweight subjects, the rates were, respec vely, 32.2%, 35.8% and 36.3% (OR = 1.02 per year; P < 0.001). During these years, the mean body mass index (BMI) (kg/m(2)) increased from 25.03 in 1999, to 26.14 in 2005, and 26.47 and 2007 (P < 0.001). The increase in prevalence of obesity was seen in both males (OR = 1.09 per year; P < 0.001) and females (OR = 1.07 per year; P < 0.001) and both urban (OR = 1.07 per year; P < 0.001) and rural (OR = 1.10 per year; P < 0.001) residents.
growth of obesity during recent years in Iran. Our findings indicate the crucial necessity of primary prevention programs to counteract this undesired condition. 127
Obes Rev. 2010 May;11(5):335-7. Epub 2010 Feb 23. Prevalence of Obesity and Overweight among Adults in Iran. Ayatollahi SM, Ghoreshizadeh Z. Department of Biostatistics, Medical School, Shiraz University of Medical Science, Shiraz, Iran. ayatolahim@sums.ac.ir Abstract The prevalence of overweight and obesity in most developed and developing countries have been increasing markedly over the past two decades. This increase includes all ages, genders, racial and ethnic groups, income, and educational levels. This study examined the prevalence of overweight and obesity among adults aged 25-55 years in Shiraz (Southern Iran). The data are based on a random mul stage sample survey of 2282 married adults (1141 pairs) living is Shiraz, whose heights and weights were measured in the 2002-2003 academic year. The prevalence of overweight or obesity (body mass index > or = 25) was 49.7% in men and 63.9% in women. The prevalence of obesity (body mass index > or = 30) was 10.5% and 22.5% in men and women, respec vely, which shows an increased secular change of 5.8% in men and 17.4% in women during a 14-year period. Overweight and obesity are common in Iran. Obesity and overweight were significantly more common among women than among men (P-valve = 0.000). There is a need to establish programmes for prevention and treatment of obesity especially Iranian's women.
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Diabetes Res Clin Pract. 2010 Apr;88(1):117-24. Epub 2010 Jan 21. Waist Circumference Has Heterogeneous Impact on Development of Diabetes in Different Populations: Longitudinal Comparative Study between Australia and Iran. Rostambeigi N, Shaw JE, Atkins RC, Ghanbarian A, Cameron AJ, Forbes A, Momenan A, Hadaegh F, Mirmiran P, Zimmet PZ, Azizi F, Tonkin AM. Endocrine Research Unit, Mayo Clinic, Rochester, MN 55902, USA. Rostambeigi.Nassir@mayo.edu
and diagnosis of metabolic syndrome (MS) in different populations. METHODS: Population-based samples from Australia (n=9026) and Iran (n=8259) were studied in 2000 and followed for approximately 4 years. Follow-up a endance was approximately 58% and mean age was 51 vs. 47. Pearson correlations calculated between WC and other MS components. ROC for the role of WC in the prediction of incident diabetes was used.
54.5%), low HDL-C (35% vs. 11.2%), high triglyceride (52.2% vs. 29.6%) were significantly higher in Iran. Fas ng glucose >or=5.6mmol/L was higher in Australia (26% vs. 23%). Hypertension was no different ( approximately 38%). Pearson correla ons between WC and other MS components were stronger in Australians: FPG (0.32 vs. 0.2), HDL (0.47 vs. 0.16), TG (0.38 vs. 0.30) and SBP (0.38 vs. 0.36). Among women, area under ROC curve for WC as a predictor for diabetes was significantly higher for Australians (0.76 vs. 0.68, p<0.001) with no difference among men (0.69 vs. 0.71, p=0.4).
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