Iranian Journal of

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Background:Obesity is a serious public health problem in developing countries due to its association with the cardiovascular risk factors. Childhood obesity is responsible for a number of different complications both during childhood and adulthood. The aim of the present study was to determine the cardiovascular risk factors in overweight and obese Iranian children.
Methods: We screened 13086 children aged 7-12 years by measuring waist circumference. Those with a waist circumference ≥61 cm were selected for further evaluation. Anthropometric measurements were done and blood samples were taken from 563 enrolled overweight/obese children (284 boys and 279 girls). We determined cardiovascular risk factors (including fasting total cholesterol, LDL-C, HDL-C, triglycerides, blood pressure). In addition we measured the fasting blood sugar, insulin, apo-A , apo-B and leptin levels.
Results: Only 2.7% of overweight or obese children had no risk factors. While, 20.6% had one and 70.85% had two or more risk factors. The prevalence of high total Cholestrol levels was 42.6%. HDL-C showed an acceptable level in 92.4%of children .There were strong correlations between BMI and serum apoB and leptin levels (p<0.005).
Conclusion: The high prevalence of cardiovascular risk factors in overweight and obese Iranian children emphasizes the need for prevention and control of childhood obesity from early childhood in our country.

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Background: Leptin is an adipocyte- derived hormone that plays an important role in the pathogenesis of obesity. Obesity is associated with insulin resistance and hyperinsulinemia. Insulin resistance is one of the factors which have been suggested to affect leptin serum levels. There are few studies evaluating the relation between leptin level and insulin resistance in childhood and adolescence obesity. The aim of the present study is to investigate this relationship in Iranian obese children. Methods: We screened 13089 primary school students aged 7-12 years. Children were divided to overweight and normal based on the recently published National Center for Health Statistics growth charts. The number of children which were overweight was 498, of whom 347 subjects particiated in the study. Fasting blood glucose, insulin and leptin levels were measured and homeostasis model assessment (HOMA) of insulin resistance (HOMA-IR) and fasting glucose to insulin ratio (FGIR) were calculated and compared between two groups. Results: Serum leptin levels were significantly higher in overweight compared to normal group. (11.58±8.1 and 8.1±5.2 respectively p<0.05). Before adjustment for BMI, there was a significant correlation between leptin and fasting insulin, HOMA –IR index and FGIR. (r=0.1, p< 0.05, r=0.1 , p<0.01, r=0.07, p<0.05 respectively). After adjustment for BMI, no significant correlation was found (r=0.097, p=0.20). Conclusion: The relation between leptin and insulin resistance was weak and disappeared after adjustment for BMI. It seems that many other factors including BMI and total fat amount may affect this relationship. Further studies in this field are required.

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Background: It is well recognized that an increased body weight is often associated with increased blood pressure. Moreover, leptin an adipocyte-derived hormone is strongly suggested to have an important role in pathogenesis of the obesity. We aimed to evaluate the levels of serum leptin in association with obesity and hypertension in a sample of Iranian obese children.
Methods: Children from all the primary schools of a distinct of Tehran were screened for obesity. Children with a waist circumference equal to or above 90th percentile for their age and height were invited for the study. Anthropometric measurements were done and blood samples for fasting serum leptin levels were collected from 563 enrolled obese children. Multivariate linear regression analysis was used to evaluate relationship of various factors with obesity.
Results: Mean Serum leptin levels were 8.65 ±2.18 (ng/ml). Serum Leptin levels were higher in girls than boys (P=0.009). There were significant correlations between body mass index (BMI) and serum Leptin levels, child age, systolic and diastolic blood pressure. Systolic blood pressure and diastolic blood pressure lost their association with serum Leptin level in multivariate linear regression analysis.
Conclusion: BMI is independently associated with Leptin levels among obese children. This may affirm a role for this hormone in the pathogenesis of childhood obesity. It seems unlikely that plasma Leptin be a major mediator of association between obesity and hypertension. However, severe hyperleptinemia may act as a risk factor for increased blood pressure.

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Background: Existing studies show that a poor diet has an effect on the progression of non-alcoholic fatty liver disease (NAFLD). The aim of the present study was to systematically summarize the results of studies on the relationship between dietary intakes and NAFLD. Methods: A review of Scopus, PubMed, Cochrane Library, Magiran, Medlib and SID databases and theses in the National Library of the Islamic Republic of Iran was conducted to identify epidemiological studies concerning NAFLD, food groups and dietary patterns. Cross-sectional, case-control and cohort studies with documented in English were selected for this systematic review. Duplication, topic, type of study, study population, variables examined and quality of data reporting of articles were evaluated. Results: Of 2128 articles found in the initial search, 33 were reviewed in full-text of these 6 articles were included in the systematic review. The literature review showed patients with NAFLD consumed more red meat, fats and sweets and less whole grains, fruits and vegetables. The Western dietary pattern was positively associated with the risk of NAFLD and adherence to the Mediterranean diet was negatively correlated to hepatic steatosis. Conclusion: The results of the systematic review indicate that different dietary intakes may be associated with development of NAFLD and its related factors. Due to limited research documented on this topic, further prospective studies are recommended.

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Non-Communicable Diseases (NCDs) are the major cause of premature death and disability due to diseased globally, imposing a heavy burden on the health systems. Four main categories of NCDs are cardiovascular diseases, neoplasms, diabetes, and chronic respiratory diseases. Iran, the second greatest country in the Middle East Region, has been through an important transition period of communicable diseases toward NCDs in the last decades. One of the effective approaches to control NCDs is implementation of population-based studies and interventions, trying to reduce risk factors and incidence of NCDs through investigations in the populations. Endocrinology and Metabolism Research Institute (EMRI) and Non-Communicable Diseases Research Center (NCDRC) are the pioneers trying to study and control various NCDs during the last decades in Iran. In this review, we are going to inspect some of the major completed and ongoing projects of this research institute to highlight valuable efforts to reduce burden of NCDs in Iran, and make a successful example for national and regional public health policy makers and authorities.