فهرست مطالب farshad amirkhizi

Food insecurity and poor quality of diet are among risk factors of cardiovascular diseases (CVD). The main objective of this study was to assess the association of food insecurity with atherogenic glucose and lipid profile in women.

In this cross-sectional study, 630 women between 18 and 50 years of age were selected by cluster sampling and interviewed face-to-face. To assess the household’s food security status, we used a household food insecurity access scale (HFIAS) questionnaire, which its validity and reliability had been determined in the Iranian population. The serum levels of glucose (FBS), triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were measured and LDL/HDL, TC/HDL, and TG/HDL ratios were calculated.

The mean serum concentrations of TG and TG/HDL ratio were significantly higher in the women suffering from moderate and severe food insecurity compared to those in the food-secure women (p=0.002). Compared with the food secure group, women with moderate and severe food security were more likely to develop hypertriglyceridemia (adjusted OR, 1.63; p=0.018) and a high TG/HDL ratio (adjusted OR, 1.52; p=0.030). However, food security status showed no significant associations with the probability of having the impaired fasting glucose, hypercholesterolemia, high LDL, low HDL, and abnormal ratios of LDL/HDL and TC/HDL.

Food insecurity may be associated with increased risk of hypertriglyceridemia and high TG/HDL in women.

Considering that the prevalence of obesity has increased dramatically in recent years, one of the key targets of public health is obesity and its associated pathological conditions. Recent evidence suggests that oxidative stress (OS) may be the mechanistic link between obesity and the development of metabolic and vascular diseases related to obesity. In this study, it was hypothesized that obesity would be associated with lipid peroxidation (LP) and antioxidant enzyme activities in erythrocytes.

In this case-control study, 80 subjects with obesity and 80 age- and gender-matched subjects with normal weight were selected from the health centers affiliated with Zabol University of Medical Sciences, Iran. General information was gathered from each participant using questionnaires. Serum malondialdehyde (MDA) and total antioxidant capacity (TAC), as well as, superoxide dismutase (SOD), glutathione peroxidase (GPX), and catalase (CAT) activities underwent assessment.

The study sample consisted of 160 obese adults (42.5% males and 57.5% females, with a mean age of 41.0 ± 7.6 years). Serum MDA levels (P = 0.016) and erythrocyte SOD activity (P = 0.013) were significantly higher in subjects with obesity compared to non-obese controls. Moreover, subjects with obesity had significantly lower serum TAC (P = 0.008) in comparison to the controls. There were no significant differences in erythrocyte GPX and CAT activities between subjects with obesity and non-obese controls. Significant positive correlations were observed between body mass index (BMI) and serum MDA levels (r = -0.461, P < 0.001) and erythrocyte SOD activity (r = -0.442, P = 0.002). Furthermore, a significant inverse correlation was found between BMI and serum TAC levels (r = -0.426, P = 0.008).

The present findings provide further evidence suggesting that obesity leads to substantial LP and OS, which, in turn, may contribute to the development of obesity-related diseases.

Biopsy is the standard criterion for the diagnosis of liver fibrosis, but it is not widely used for liver fibrosis monitoring due to its invasive nature, risk of complications, and sampling errors. This study aimed to evaluate the clinical significance of several noninvasive indices in diagnosis of the disease and in prediction of advanced liver fibrosis in children with autoimmune hepatitis (AIH).

In a prospective cross-sectional study, in 40 children with AIH, complete blood count and liver function tests were performed and their derived indices were calculated. Based on liver biopsy, all patients with AIH were divided into two groups: absent/mild fibrosis and moderate/severe fibrosis (advanced fibrosis).

In patients with AIH, aspartate aminotransferase to platelet ratio index (APRI) and fibrosis index based on four factors (FIB-4) increased significantly (P<0.001) and neutrophil to lymphocyte ratio index (NLR) decreased significantly (P=0.041) compared to healthy individuals. In patients with advanced fibrosis, direct bilirubin (DBIL) and APRI levels were considerably higher and albumin levels were considerably lower compared to the absent/mild fibrosis group. Analysis of the area under the receiver operating characteristic curve (AUC) showed that FIB-4 and APRI have clinical value for the diagnosis of AIH in children while DBIL and APRI had clinical value in diagnosis of advanced liver fibrosis in these children.

APRI can be used as a reference index in diagnosis of AIH in children and to monitor liver fibrosis in children with autoimmune hepatitis.

Since vitamin D has been shown to have an important function in the regulation of metabolic pathways, this study aimed to investigate the association between serum levels of vitamin D with a number of metabolic indicators in patients with non-alcoholic fatty liver disease (NAFLD).

This descriptive study was conducted on 122 patients with NAFLD referred to Sheikh Alreis Clinic in Tabriz, who were categorized into "vitamin D sufficient" (n=46) and "vitamin D deficient" (n=76) based on their serum vitamin D concentrations. NAFLD was diagnosed by upper abdomen ultrasonography, and the fasting serum concentrations of glucose (FBS), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), high- density lipoprotein cholesterol (HDL-c) as well as Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) were measured as metabolic markers. Serum concentration of liver transaminase enzymes and liver steatosis severity were assessed as liver function criteria.

Serum concentrations of insulin (p=0.024), LDL-c (p<0.001), and HOMA-IR (p=0.011) were significantly higher in the NAFLD patients with vitamin D deficiency compared to the patients with sufficient vitamin D. Moreover, vitamin D deficient patients had higher NAFLD histologic severity (p=0.042) and serum concentrations of alanine aminoteransferase (ALT) compared to the NAFLD patients with vitamin D sufficiency (p=0.005). Vitamin D-deficient patients were at higher odds for having hypercholesterolemia (p=0.009) and high LDL-c (p=0.011) than ones with sufficient vitamin D status even when adjusted for confounders.

Vitamin D deficiency in the patients with NAFLD was found to be associated with higher odds of an unfavorable lipid profile and NAFLD histologic severity.

Considering the pathologic importance of oxidative stress in osteoarthritis (OA), this study aimed to investigate the association between dietary total antioxidant capacity (DTAC) and oxidative stress markers in patients with knee OA.

In a cross-sectional study, dietary intakes of 152 patients with knee OA attending health centers in Zabol, Iran (January-May 2022) were evaluated using food frequency questionnaire (FFQ). Demographic and anthropometric data were collected and DTAC was calculated using ferric-reducing antioxidant power (FRAP) assay. Then, serum concentrations of malondialdehyde (MDA), total oxidant status (TOS), total antioxidant capacity (TAC), erythrocyte activities of superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT) were measured. The oxidative stress index (OSI) was also calculated by dividing TOS by TAC.

The mean serum concentrations of MDA (P< 0.001), TOS (P-trend< 0.001), and OSI (P-trend= 0.001) showed decreasing trends by increase in DTAC after adjustment for potential confounders. Serum TAC concentrations had increasing trend when DTAC increased (P-trend=0.027). No significant trend was found between erythrocyte activities of SOD, GPx, and DTAC.

Higher DTAC was favorably associated with oxidative stress markers in patients with knee OA. Further prospective studies are required to confirm these findings.

Statistical significance does not necessarily mean clinical significance. A P value less than 0.05 does not guarantee the clinical effectiveness of a treatment. To assess the clinical valuable of a treatment, the effect size must be calculated. The number needed to treat (NNT) is an example of an effect size measure that can be very helpful in determining the clinical significance of a treatment. Therefore, it is recommended for all researchers and physicians to look beyond the P value and calculate the NNT for assessing the clinical significance of therapeutic measures and agents.

Obesity and vitamin D deficiency are both have become major public health challenges worldwide which are associated with an increased risk of metabolic diseases. The aim of this study was to investigate the association between vitamin D status with metabolic and inflammatory markers in adults with obesity.

In this case-control study, 90 obese subjects with vitamin D deficiency were selected as the case group and 90 obese subjects with adequate vitamin D status were selected as the control group. Demographic, anthropometric, and dietary data were collected for each participant. Then, the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and fasting serum concentrations of glucose (FBS), insulin, total cholesterol (TC), low-density lipoprotein (LDL-c), high-density lipoprotein (HDL-c) and triglyceride (TG) as metabolic factors and serum levels of high-sensitivity C-reactive protein (hs-CRP) as inflammatory marker were measured in the participants.  

The obese subjects with vitamin D deficiency had higher serum concentrations of TC (p=0.001), LDL-C (p=0.003), hs-CRP (p=0.004), parathyroid hormone (p=0.001), and HOMA-IR (p=0.020) compared to the counterparts in the vitamin D sufficiency group. Likewise, vitamin D deficient subjects were at higher risk for having hypercholesrolemia (OR: 2.7, p=0.012), high LDL-c (OR: 2.34, p=0.017), and high hs-CRP (OR: 1.97, p=0.032) than vitamin D sufficient subjects, after controlling for confounders.

vitamin D deficiency in obese subjects was found to be strongly related to higher risk of metabolic and inflammatory disorders.

Epilepsy, which develops in the elderly, is recognized as a major health burden. Although health-related quality of life (HRQoL) is an essential element in the medical treatment of elderly patients with epilepsy, it is a question whether epilepsy and its treatment effectively influence the quality of life (QoL) in the elderly.

The current study aimed at evaluating the relationship between demographic and clinical aspects of epilepsy in HRQoL of elderly patients. Since HRQoL scores are bounded, the Kumaraswamy (Kum) regression model was used to analyze the data.

The current study was conducted on 766 elderly patients diagnosed with epilepsy taking at least one antiepileptic drug (AED) selected from six neurologic clinics in Iran. In addition to demographic information, the Liverpool seizure severity scale (LSSS), medication adherence report scale (MARS-5), and quality of life in epilepsy (QoLIE-31) questionnaire were completed for patients. Data were analyzed using multiple linear regression (MLR) and the Kum regression models.

Most of the patients included in the study had focal (70.2%) epilepsy. Mean duration of disease was 17.71 ± 4.56 years and the average number of seizures was 3.4 ± 3.2 episodes per month. The Kum regression model indicated that seizure frequency (β = -0.157, P < 0.0001) and LSSS score (β = -0.003, P = 0.009) were significant and negative predictors of overall QoLEI-31 score; MARS-5 score was a positive predictor of overall QoLEI-31 score (β = 0.014, P = 0.002). However, disease duration and serum AED level had no significant effects on overall QoLEI-31 score.

The findings suggested that increased seizure frequency and severity were associated with lower QoL and medication adherence was directly associated with HRQoL. The Kum regression could be a suitable alternative to the methods currently used in the analysis of HRQoL data

Several mechanisms have been suggested to explain the pathogenesis of nonalcoholic fatty liver disease (NAFLD) and its progression, one of which is increased oxidative stress.

This study aimed to evaluate the effect of alpha-lipoic acid (ALA) supplementation on anthropometric indices, dietary intake and oxidative stress-related parameters in obese patients with NAFLD.

In this double-blind, placebo-controlled trial, 50 NAFLD patients were assigned to two groups of receiving 1200 mg ALA (two 600 mg capsules of ALA) and placebo (two 600 mg capsules of placebo) for 12 weeks. Serum liver enzymes, malondialdehyde (MDA) level, total antioxidant status (TAS), and the activities of copper-zinc superoxide dismutase (Cu/Zn-SOD) and glutathione peroxidase (GSH-Px) were assessed at baseline and after 12 weeks of intervention.

Serum concentrations of liver enzymes decreased significantly in the ALA group (P < 0.05 for all), while a noticeable decline was observed for alanine aminotransferase (ALT) in the placebo group (32.5 ± 18.9 vs. 25.9 ± 11.2; P = 0.034). Nonetheless, there were no significant differences between the study groups concerning serum liver enzymes concentrations post-intervention. Although ALA supplementation significantly reduced the serum concentration of MDA (2.52 ± 0.35 vs. 2.77 ± 0.49; P < 0.040) and increased serum TAS (1.73 ± 0.55 vs. 1.52 ± 0.34; P < 0.048), other oxidative stress-related parameters such as Cu/Zn-SOD and GSH-Px activities were not affected.

These findings suggest that daily supplementation of 1200 mg ALA for 12 weeks improves oxidative stress markers in patients with NAFLD and it could be considered as adjunctive therapy for the prevention of NAFLD progression

Insulin resistance has a pivotal role in occurrence of impaired glucose tolerance and dyslipidemia in patients with nonalcoholic fatty liver disease (NAFLD). There is evidence of possible beneficial effects of Alpha lipoic acid (ALA) on insulin resistance and metabolic disorders.
This study aimed at examining the effects of ALA supplementation on liver enzymes, insulin sensitivity, glucose markers, and lipid profile in obese patients with NAFLD.
In this double-blind placebo-controlled randomized clinical trial, 50 obese patients with NAFLD were randomly allocated to “ALA group” (received 1200 mg ALA as two capsules per day) or “Placebo group” (received placebo containing cornstarch as two capsules per day) for 12 weeks. Anthropometric measures, dietary intakes, liver enzymes as well as glucose markers and lipid profile were assessed at baseline and after 12 weeks of intervention.
Forty-five patients completed the study (ALA group = 23; placebo group = 22). Liver enzymes were not significantly altered by the intervention group. Alpha Lipoic Acid supplementation led to a significant attenuation in serum levels of insulin (13.4 ± 5.4 vs. 18.1 ± 8.6; P = 0.019) and triglyceride (146.9 ± 60.6 vs. 186.3 ± 54.2; P = 0.037) in comparison with the placebo group, yet did not affect other lipid profile parameters, Fasting Serum Glucose (FSG) and β-cell function index (HOMA-B) in patients with NAFLD. furthermore, quantitative insulin sensitivity check index (QUICKI) increased significantly in the ALA group compared to the placebo (0.329 ± 0.025 versus 0.317 ± 0.020; P = 0.033).
Patients with NAFLD may benefit from ALA supplementation, at least partially through augmented insulin sensitivity and improvement of lipid profile.

Elevated body iron stores have been suggested to be a risk factor for cardiovas-cular disease (CVD). We examined whether elevated plasma ferritin concentrations as indicator of iron stores, affect the oxidative stress markers in a reproductive age women population. One hundred sixty, 20-45-year-old women were randomly selected. We investigated body iron stores by measuring the concentrations of plasma ferritin. Furthermore, we assessed oxidative stress markers by measuring the concentrations of plasma malondialdehyde (MDA) and activities of erythrocyte cytoprotective enzymes, including superoxide dismutase (CuZn-SOD), catalase (CAT) and glutathione peroxidase (GPX) in a random sample of cardiovascular disease-free women in reproductive age. Subjects in the highest tertile of plasma ferritin presented the highest levels of plasma MDA (p<0.001) and CAT activity (p<0.05). Furthermore, these Subjects presented the lowest levels of CuZn-SOD activity (p<0.01). No significant associations were found between the tertile of plasma ferritin in GPX activ-ity. Plasma ferritin was significantly directly associated with plasma MDA levels and inversely associated with CuZn-SOD activity. Using multiple regression, Plasma ferritin levels was positively correlated with MDA levels and inversely correlated with CuZn-SOD activity. Our findings revealed an association between body iron stores and oxidative stress markers linked to atherosclerosis process. The results emphasize that iron overload would elevate the risk of coronary artery disease by promoting the lipid peroxidation.

Many factors are known to be involved in a number of human pathologies of obesity including serum leptin and thyroid hormones levels. The purpose of this study was to compare the serum levels of leptin and thyroid hormones in obese and non-obese women, in Shiraz-Iran during 2006. In this case- control study, 35 women with BMI≥30 Kg/m2 recruited as an obese group (Case group) and 35 women with healthy BMI (BMI<25 Kg/m2) were selected as a control group. General information data were gathered from each sample using questionnaires and face-to-face interviews. Body weight, height, waist and hip circumferences were measured and BMI, WHR and percent of body fat (%TBF) were calculated for each subject. Venous blood samples were drawn from subjects and serum was separated to determine the concentrations of serum leptin and thyroid hormones (T4, T3 and TSH) levels. Mean serum concentration of leptin was significantly higher in obese group than control group (p<0.001). Serum leptin levels positively correlated to anthropometric indices (BMI, WHR, %TBF). No significant difference was observed between obese and non-obese groups in serum thyroid hormones concentration. Serum leptin levels positively related to serum T3 levels (P<0.05). This study indicated that obese women had higher leptin levels compared to non-obese. The interaction between thyroid hormone in particular T3 and leptin can be one of the reason for increasing the serum leptin level among obse women.

The aim of this study was to investigate whether the lipid peroxidation levels and activities of erythrocytecytoprotective enzymes can be affected by iron deficiency anemia (IDA) in menstruating women. In this case-control study, 43 women with IDA, 43 women with iron deficiency (ID) and 43 healthy controls were included. Lipid peroxidation levels were assessed by measuring the concentrations of plasma malondialdehyde (MDA) (as byproduct of lipid peroxidation). We also evaluated the activities of erythrocyte cytoprotective enzymes by measuring activities of copper zinc-superoxide dismutase (CuZn-SOD), glutathione peroxidase (GPX) and catalase (CAT) in selected groups. Furthermore, total antioxidant capacity (TAC) of plasma was assessed for each subject.Comparisons between continuous variables across groups were performed by the calculation of one-way analysis of variance (ANOVA). Mean plasma concentration of MDA was significantly higher in IDA group than that in ID group (3.49 ± 0.84 vs. 2.76 ± 0.59,? mol/L, respectively, p < 0.01) and healthy group women (3.49 ± 0.84 vs. 2.94 ± 0.71? mol/L, respectively, p < 0.01). No significant difference was observed between ID and healthy groups in plasma MDA concentration (2.76 ± 0.59 vs. 2.94 ± 0.71, respectively). The mean erythrocyte CuZn-SOD activity in IDA group was significantly lower than that in healthy group women (674 ± 89 vs. 796 ± 82, respectively, p < 0.01). Furthermore, erythrocyte CAT activity was significantly lower in IDA group compared to both ID (162 ± 52 vs. 193 ± 72, respectively, p < 0.01) and healthy women groups (162 ± 52 vs. 234 ± 68, respectively, p < 0.001). No significant difference was observed between study groups in erythrocyte GPX activity. In addition, plasma TAC levels were significantly lower in IDA and ID groups compared to healthy women group (1.97 ± 0.42 and 2.16 ± 0.64 vs. 3.76 ± 0.86, respectively, p < 0.01). Our findings showed that activities of erythrocyte cytoprotective enzymes decrease and lipid peroxidation increases in women with IDA. The consequence of the low activity of the cytoprotective enzymes in human is progressive tissue damage, which may eventually lead to atherosclerosis and other degenerative diseases.

The incidence of atherosclerosis increases with age, as do variousindices of free-radical-mediated damage, e.g. lipid peroxidation. Because Antioxidantenzymes are the major defense system of cells in normal aerobic reactions, we aimed toassess the age-related alterations in the activity of erythrocyte cytoprotective enzymesamong women. One hundred sixty 20-45-year-old women were randomly selected amongwomen receiving the services of rural health centers of Kerman Province, Iran. Data weregathered by using questionnaires and face-to-face interviews. We assessed lipidperoxidation by measuring the concentrations of plasma malondialdehyde (MDA), totalantioxidant capacity (TAC), and the activities of erythrocyte copper-zinc superoxidedismutase (CuZn-SOD), glutathione peroxidase (GPX) and catalase (CAT). Those individuals in the highest quartiles of age and number of pregnanciespresented the highest levels of plasma MDA (P<0.001). We also observed an inverserelationship between age and erythrocyte CuZn-SOD and GPX activities. Although wefound no significant difference between age groups in respect of erythrocyte CAT activityand/or plasma TAC levels, erythrocyte GPX activity was negatively correlated with thenumber of pregnancies (P<0.001). No significant difference was found between agegroups and/or between quartiles of number of pregnancies for either energy or nutrientintake. Plasma MDA levels were positively related to age (r=0.307; P<0.0001), number ofpregnancies (r=0.250; P<0.001), fat intake (r=0.281; P<0.05) and Vitamin E intake(r=0.356; P<0.01). Furthermore, there were negative correlations both between age and GPX activity (r= -0.280; P<0.0001) as well as with CuZn-SOD(r= -0.228; P<0.005). Lipid peroxidation and antioxidants were affected by age. Erythrocyte cytoprotective enzymes have an important role in detoxification of free radicals in the body; the age-related decrease in the activities of these enzymes might contribute to atherogenesis, along with classic risk factors.

Lipid peroxidation is a free radical-generating process which occurs on every membranous structure of the cell. Free radicals are known to be involved in a number of human pathologies including atherosclerosis. The purpose of this cross-sectional study was to examine the association between pre-hypertension status and oxidative stress markers [total antioxidant capacity (TAC) and malonedialdehyde (MDA) levels] in a random sample of cardiovascular disease-free women. In this study, 160 women of 20-45 years of age were randomly selected. General information data were gathered from each sample using questionnaires and face-to-face interviews. Blood pressure (BP) was measured for each subject. Body weight, height, and waist and hip circumferences were measured and body mass index (BMI)and waist-to-hip ratio (WHR) were calculated for each subject. Venous blood samples were drawn from the subjects, and plasma was separated. In this study, the oxidative stress status was assessed by measuring the concentrations of plasma MDA and TAC levels Our results show that both systolic and diastolic blood pressures were inversely correlated with TAC (p<0.01) and positively correlated with MDA levels (p<0.01). Particularly, compared to the normotensive subjects, the pre-hypertensives had 19% lower TAC (p<0.05) and 22% higher MDA levels (p<0.01), after correcting for multiple comparisons and adjusting for age, body mass index, waist-to-hip ratio, and other potential confounders. Our findings revealed an association between pre-hypertension and oxidative stress markers linked to atherosclerosis process. Thus, the identification of the underlying molecular mechanisms in pre-hypertension, which seem to include oxidative stress, may serve as an important lead for developing potentially new treatment modalities in this group of patients at risk for future cardiovascular complications.

It has been suggested that the risk of coronary heart disease increases with increase of body iron stores. Free iron catalyzes the generation of free radicals and free radicals promote the oxidation of lipids. The aim of this cross-sectional study was to examine the association of plasma iron and factors that could affect its levels (antioxidant enzymes), with the concentration of plasma malondialdehyde (MDA) as a marker of lipid peroxidation.In this study, 160 women aged 20-45 years were randomly selected. A medical history was obtained for each subject prior to enrolment. We assessed lipid peroxidation and the activity of antioxidant enzymes by measuring the concentration of plasma MDA and the activities of erythrocyte copper zinc superoxide dismutase (CuZn-SOD) and glutathione peroxidase (GPX).Our results show that those in the highest tertile of plasma iron were at least twice as likely to have higher plasma MDA levels. Among the factors affecting plasma iron levels, we found that the upper tertile of erythrocyte CuZn-SOD was inversely associated with higher plasma iron. No associations were found between the highest TIBC and MDA levels. There was no significant association between GPX and plasma iron.These findings support the concept that iron, as an important transition metal, might contribute to atherogenesis, along with the classic risk factors. A longitudinal study should confirm whether or not these MDA levels are connected to vascular disease and mortality.