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Showing 21 results for Body Mass Index
Elevated CRP levels during first trimester of pregnancy and subsequent preeclampsia: a prospective study
Beigi A, Saeedi L, Samiei H, Zarrinkoub F, Zarrinkoub H,
Volume 66, Issue 1 (3-2008)
Abstract

Background: Whatever its etiology, the inflammatory reactions of preeclampsia lead to the activation of endothelium and result in vascular damage. CRP is considered a sensitive index of systemic inflammation, so it is used as predictive factor for disease. This study was carried out to test the screening and predictive abilities of the CRP test in order to detect and diagnose pregnant women prone to preeclampsia prior to the onset of symptoms.

Methods: In this prospective cohort study, conducted in Arash Hospital between 2005 and 2006, we determined the CRP levels of 201 pregnant women at 10-16 weeks of pregnancy. Based on exclusion criteria and illness, 31 patients were excluded and 170 patients were followed until the end of their pregnancies.

Results: In this study, the mean serum CRP values of those who had preeclamptic and those who had normal pregnancies were compared and the statistical differences were significant: 6.18 mg/L for preeclamptic patients compared with 4.12 mg/L for normal patients (p=0.003). Using a chi-square test, we found that patients whose CRP level was ≥4 were six times more likely to have preeclampsia than those with CRP levels <4 (k=9.4 p=0.002 OR=6.15 95% CI=0.69-22.28).

Conclusion: This study confirms the results of previous reports indicating a significant relationship between rising serum CRP in the first trimester of pregnancy and preeclampsia at third trimester. More studies consisting of other inflammation factors are necessary to find an acceptable and reasonable screening test to diagnose pregnant women who are prone to preeclampsia.


Anthropometric assessment to predict hypertension among women in Tehran, Iran
Esmaillzadeh A, Azadbakht L,
Volume 66, Issue 6 (9-2008)
Abstract

Background: Identification of the best screening measure for the risk of chronic disease is essential. This study aims to comparatively assess the ability of waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR) to predict hypertension among women in Tehran.

Methods: In this population-based cross-sectional study, a representative sample of 926 adult women aged 40-60 years were selected using a multi-stage cluster random sampling method. Demographic data were collected and anthropometric measures including weight, height, WC and hip circumference were assessed according to a standard protocol. BMI was calculated as weight in kilograms divided by the square of the height in meters. Cut-off points of 80 cm for waist circumference, 25kg/m2 for BMI, 0.87 for WHpR and 0.5 for WHtR were used. Blood pressure was measured and hypertension defined according to the sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 6).

Results: In this study, the mean age of women is 48.7±5.6 years. Mean WC, BMI, WHpR and WHtR are 85.1±9.9cm, 29.4±4.6kg/m2, 0.82±0.06 and 0.55±0.06, respectively. Although all anthropometric indicators have a significant association to hypertension, WC has the highest sensitivity, specificity and accuracy in predicting hypertension in both age groups of 40-50 and 50-60 years. This measure also has the greatest area under the ROC curve compared to other anthropometric measures: 0.70(0.69-0.71) for WC, 0.65(0.62-0.67) for BMI, 0.62(0.60-0.64) for WHpR and 0.65(0.63-0.67) for WHtR.

Conclusions: Among this group of women in Tehran, waist circumference is the best screening measure for hypertension. However, no data are available regarding similar patients who have emigrated thus similar studies on Iranian women who have emigrated are recommended.


Risk factors of knee osteoarthritis, WHO-ILAR-COPCORD study
Dahaghin S, Tehrani-Banihashemi Sa, Frouzanfar Mh, Barghamdi M, Norollahzadeh E, Gholami J, Faezi St, Davatchi F,
Volume 66, Issue 10 (1-2009)
Abstract

Background: To evaluate the association between age, sex, BMI, waist/hip ratio, smoking, religion, ethnicity, education and knee osteoarthritis.

Methods: Eligible subjects were randomly included from participants of Tehran COPCORD study, of whom 480 subjects with knee osteoarthritis were compared to 490 subjects without (case-control study). Using a questionnaire developed by COPCORD group (Asia & Oceania), we enquired about the risk factors of knee osteoarthritis i.e. age, sex, BMI, Waist/Hip ratio, religion, ethnicity, education and smoking. Knee osteoarthritis was defined using ACR criteria. Each knee was unit of analysis using GEE technique to evaluate these associations.

Results: Age (OR 1.096 CI95%: 1.091-1.1 P: 0.00) and sex (OR 2.85 CI95%: 2.49-3.28 P: 0.00) showed significant association with knee osteoarthritis. Overweight (OR 1.81 CI95%: 1.28-2.55 P: 0.00) and obesity (OR 3.3 CI95%: 2.34-4.66 P: 0.00) both showed higher risk for knee osteoarthritis. The association between waist/hip ratio and knee osteoarthritis showed an OR of 5.28, CI95%: 0.89-31.44 P: 0.07. However, this association was only borderline significant. People with different religion or ethnicity and smokers had no extra risks for knee osteoarthritis. Higher education is a protective factor for knee osteoarthritis as people who had university education compared to people with no/primary education showed a lower risk for knee osteoarthritis (OR 0.54 CI95%: 0.38-0.78 P: 0.00).

Conclusions: Our study confirmed that elderly, females, overweight and obese people are at higher risk to develop knee osteoarthritis as found in western societies. Higher education is a protective factor against knee osteoarthritis. Ethnicity, religion and smoking showed no extra risk of knee osteoarthritis.


The effect of maternal body mass index on spontaneous versus induced preterm birth: a prospective study
Moghadami N, Aminikhah B, Davari Tanha F,
Volume 67, Issue 3 (6-2009)
Abstract

Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 B ackground: Preterm birth which is defined as delivery before 37 completed weeks was implicated in approximately two thirds of neonatal death. Also preterm labors are the most common cause of mortality and morbidity of infants in recent years and it costs high prices for health system. We evaluate the relationship between prepregnancy maternal body mass Index (BMI) and spontaneous and indicated preterm birth.
Methods: This study included 250 healthy pregnant women, without any risk factors of preterm birth, were classified into categories that were based on their body mass index. Association between BMI, weight gain and rout of delivery were examined. Rates of indicated and spontaneous preterm birth were compared.
Results: Obese women delivered at a more advanced gestational age. (38/34±1/66 weeks vs 37/61±2/44, p=0/006). Obese patients had significantly lower incidence of spontaneous preterm birth at < 37 weeks of gestation (16/8% vs 31/2% p=0/008). Obese women had larger infants (3354/95±596/75 vs 311.24±558/357 p=0/001), and had more frequent cesarean delivery (69/6% vs 52/8%, p=0/006). Weight gain during pregnancy is poorly correlated with prepregnancy BMI (14/41±7/93 kg vs 13/78±4/94kg, p=0/4) and preterm birth.
Conclusion: In this survey, there was adverse correlation between body mass index (BMI) before pregnancy and preterm labor less than 37 completed weeks and we suggest more study for evaluation between spontaneous and induced preterm labor mechanism and in obese and non obese women. However according to this survey obesity before pregnancy is associated with a lower rate of spontaneous preterm birth.


Assessment of obesity in children: Fat Mass Index versus Body Mass Index
Behnaz Haeri Behbahani , Ahmad Reza Dorosty , Mohammad Reza Eshraghian ,
Volume 67, Issue 6 (9-2009)
Abstract
Background: The sensitivity and specificity of body mass index (BMI) percentiles of CDC2000 standard which is used in determining obesity in Iranian children was compared with child real obesity identified by fat mass index (FMI) and obesity status in these children based on BMI and FMI was compared too.
Methods: Weight, height and triceps skinfold (TSF) thickness were measured in 1800 primary school children in Sabzevar, Iran. Fat mass (estimated from TSF) and weight were divided by height squared to calculate FMI and BMI, respectively. FMI at or above the 90th percentile of age- and sex- specific data in this study was considered as criterion for real obesity, and BMI≥95th and 85thResults: Based on the CDC cut-offs, the prevalence of overweight and obesity in our children were 7.9% and 4.8%, respectively. From the real obese and non-obese children identified by the FMI, 43.3% and 0.6% were identified as obese according to BMI, respectively. In addition, the sensitivity and specificity of 90th percentile of BMI to identify children as obese, were 71.1% and 98% respectively.
Conclusions: The efficacy of BMI in determining childhood obesity may be less than expected and it appears that FMI in comparison with BMI, is a better indicator of obesity in children, but more studies in this area are required.

Influence of GnRH analogue on body mass index in girls with precocious puberty: a prospective study
Heshmat Moaieri , Zeinab Modarresi Mosalla, Mamak Shariat, Zahra Haghshenas, Fariba Naderi ,
Volume 72, Issue 3 (6-2014)
Abstract
Background: Gonadotropin-releasing hormone analog (GnRHa) therapy is used in central precocious puberty (CPP) worldwide and it is the treatment of choice for this condition. Many of the previous studies concerning the effect of gonadotropin-releasing hormone analog (GnRHa) therapy on height. Much less attention has been paid to changes in body weight. However, concerns have been expressed that CPP may be associated with increased body mass index (BMI) both at initial presentation and during GnRH agonist treatment, but it is controversial in some studies. Methods: We have retrospectively reviewed 52 female patients that the majority of them had CPP. We assessed height, height SDS, weight, weight SDS, BMI and BMI SDS. All patients were treated with GnRHa over 12 months. The variables were evalu-ated at 0, 6 and 12 months after initiation of treatment.8 girls received growth hormone concomitantly. Also bone age and sexual maturity were measured. Bone age was assessed according to the Greulich-Pyle method and sexual maturation was classified according to the Marshall-Tanner method. Results: Before the initiation of therapy, the girls had a mean BMI SD score for chronological age of 0.80± 1.18 after 6 months of therapy BMI SDS was 0.82± 1.15 and after 12 months was 0.82± 1.28 the P value is 0.909 and it is not statistically signif-icant. Height SD score for chronological age was 0.41± 1.65 before the initiation of therapy and was 0.41± 1.65 after 6 months and 0.43± 1.60 after 12 months of therapy. The P= 0.66 and it is not statistically significant. Eight girls received growth hormone concomitantly, in this group increasing height SDS is statistically significant P= 0.044 but increasing BMI SDS is not significant. Conclusion: Gonadotropin-releasing hormone analog (GnRHa) therapy in central precocious puberty (CPP) is safe for BMI and increasing of BMI is not significant, long- term follow-up study is required to elucidate whether GnRHa treatment affects adult obesity. Using growth hormone concomitantly, the effect on increasing height is significant.
Long-term results of open gastric bypass with Roux-en-Y method for morbid obesity: brief report
Ghodratolah Maddah , Hossein Shabahang , Mohammad Reza Barband , Abbas Abdollahi , Alireza Tavassoli ,
Volume 72, Issue 9 (12-2014)
Abstract
Background: This study aims to evaluate the outcomes and late complications of open Roux-en-Y gastric bypass surgery in the treatment of morbid obesity. Methods: Over a 15 year-period between May 1997 and May 2012, we reviewed our experiments with 39 patients who underwent open gastric bypass for morbid obesity. The weight of the patient and surgical complications were recorded. Ideal weight, body mass index, weight loss and excess weight loss were calculated. Results: The follow up period ranged from 6 to 180 months with a mean of 100 months after operation. Average weight loss was 3.9 and 0.28 kg per month during the first and second years after operation weight loss was slower from the third year on-wards. Weight loss generally was stabilized between 12 and 18 months after operation. Only one patient (2.6%) had a weight loss failure criterion. Concomitant condition ex-isted in 14 patients (48.2%) of our series. These included hypertension in 3 cases (10.3%) that was resolved in 100%, diabetes mellitus in 4 (13.7%) that was resolved in 75%, cholelithiasis in 7 cases (24.1%) that was resolved by cholecystectomy during the operation. There was no early postoperative death. Early complications occurred in 2 patients (5.1%), including pulmonary embolism (2.6%) and gastrointestinal bleeding (2.6%). The late complications occurred in 7 patients (17.9%) involved 2 patients with anastomotic stricture at the gastrojejunostomy (5.1%), One patient with symptomatic cholelithiasis (2.6%), three patient with anemia (7.7%), and one patient had Wernicke ’s disease who died of this complication (2.6%). Conclusion: The results of the study showed that the open Roux-en-Y gastric bypass surgery is an effective procedure in the treatment of morbid obesity with minimal late complications.
Relationship between body mass index of third trimester of pregnancy and type of delivery
Soroosh Aminolsharieh Najafi Aminolsharieh Najafi, Mahin Nomali , Zahra Goudarzi , Azita Maslahati , Elham Mobasheri ,
Volume 72, Issue 12 (3-2015)
Abstract
Background: Maternal Body Mass Index (BMI) is considered as one of most effective determinant of delivery rout, by increase in this index, risk factor of cesarean section enhanced. Based on high prevalence of obesity in women, this study designed to assess the relationship between admission BMI and type of delivery. Methods: Five hundred and forty pregnant women in third trimester of pregnancy (≥37weeks) were studied within 1 year (from June 2012 to June 2013), at Sayad Shirazi Referral Hospital, Gorgan, Iran, through a analytic cross-sectional study. BMI was calculated for each mother at the time of labor admission. Height and weight were measured, and were categorized into 3 groups according to their BMI which included of underweight and normal (BMI<25), overweight (BMI=25-29.9) and obese (BMI≥30). And in each group route of delivery (cesarean or natural delivery) were assessed. Pregnant women with the previous cesarean delivery, history of diabetes type 1, 2 or gestational diabetes, hypertension, twin pregnancy and unwilling to participate in study were excluded from study. Results: Mean of age and mean of gestational age were 25.8±5.4 years and 38.2±2.6 week, respectively. 50.6% of mothers were undergone cesarean delivery and there was a significant relationship between BMI and type of delivery (P<0.0001). For each unit increase in BMI, risk of cesarean section rose 1.08 times (CI95%=1.04-1.13, P<0.0001) and the risk of cesarean delivery in obese pregnant women was 2.8 (CI95%=1.7-4.4, P<0.0001) times higher than those with underweight and normal weight. Conclusion: There is a significant relationship between maternal BMI at the time of labor admission and type of delivery and increasing of BMI is associated with increasing of cesarean section rate. Thus, keeping the BMI in normal range during pregnancy is suggested to pregnant women to reduce the pregnancy complications.
Vitamin D deficiency in population with BMI greater than 25 kg/m2 and its association with demographic and anthropometric indices
Zahra Alizadeh , Farzin Halabchi , Mastaneh Rajabian Tabesh,
Volume 73, Issue 6 (9-2015)
Abstract
Background: Today obesity and overweightness are the major health problem all over the world. The relation between decreasing serum level of vitamin D and some chronic diseases such as diabetes and obesity was shown in the available studies. The aim of this study was to determine the prevalence of vitamin D deficiency among obese and overweight Iranian population and its relation with age, sex, occupation, body fat percentage and body weight according to body mass index. Methods: In a descriptive cross-sectional study, all patients who were referred to obesity clinic of Imam Khomeini Hospital, Tehran, for weight management throughout one year were included to the study. The prevalence of vitamin D deficiency with serum level lower than 30 ng/ml among 107 subjects was evaluated. The data were analyzed by SPSS, ver. 19 (SPSS, Inc., Chicago, IL, USA). Quantitative variables were presented as mean±SD and qualitative variables were presented as relative frequency. The groups were compared with independent samples t-test and Chi-square test. The level of significance for comparing the groups was considered at P<0.05. Results: In 107 participants, vitamin D deficiency in 81 subjects (75.7%) was reported. The prevalence of deficiency in participants with body mass index between 25 to 29.9, 30 to 34.9 and equal or greater than 35 kg/m2 was 77.3%, 83.7% and 69.4%, respectively. However, the differences between overweight and obese groups were not significant (P=0.193). The prevalence of moderate and severe vitamin D deficiencies among the participants was 50.5% and 25.2 %, respectively. Vitamin D deficiency was more common in participants below 50 years of age compared with those older than fifty (P=0.001). Conclusion: The prevalence of vitamin D deficiency was high in obese and overweight population especially among individuals younger than 50 years. It seems that, it is necessary to add prevention and management of this deficiency to obesity treatment protocols especially in the young adults.
The measurement of polychlorinated biphenyl level in breast milk after delivery, and its association with breast milk fat and mother's BMI
Fatemeh Nayeri , Hosein Dalili , Mamak Shariat , Tahere Esmaeilnia , Elahe Amini , Vafa Ghorban Sabagh ,
Volume 74, Issue 8 (11-2016)
Abstract

Background: Human breast milk contains high levels of fat and toxins. These substances which exist in our country based on many reports. This study aimed to evaluate the concentration of polychlorinated biphenyls (PCBs) in the mother’s milk during the first postnatal week.

Methods: This study was accomplished on 50 mothers who gave birth to a healthy infant at Vali-e-Asr University Hospital, Tehran University of Medical Sciences, Tehran, Iran, from 2014 through 2015. Within the first postnatal week a 20 cc sample of mother’s breast milk was obtained and was sent for laboratory analysis to measure PCB levels via GC-Mass method. Except of PCBs, triglycerides (TG), high-density cholesterol in breast milk was also measured. Also the relation between fat and polychlorinated bi phenyl was assessed. The association between PCBs and body mass index of mothers was investigated.

Results: Mean age of mothers was 29.41±6.14 year. PCB180 was significantly correlated with TG values, while this correlation was not observed for other types of PCBs. There was no correlation between cholesterol and fat high-density with PCBs. Other PCB isomers 138, 153, 180 and 101, had not correlation with triglyceride, cholesterol and high density fat. There was a significant correlation between increasing weight and the concentration of PCB101, and PCB180 concentrations. It was also observed between increasing weight and the concentration of PCB101 (P=0.033, r=0.293) and concentrations of PCB180 (P=0.034, r=0.428), there was a significant correlation. In our study PCB101, (r=0.278, P=0.048) and PCb28 (r=0.328, P=0.021) were significantly correlated with body mass index (BMI).

Conclusion: The present study showed a higher than normal concentration of polychlorinated biphenyls in breast milk. And therefore these compounds will be transferred to the baby. Due to the damaging effects of these toxins, it is recommended additional studies on larger groups and other types of samples (mother blood, cord blood etc.).


Risk factors of nonalcoholic fatty liver disease: a case-control study
Zeinab Moradi Kohnaki , Khairollah Asadollahi, Ghobad Abangah , Kourosh Sayehmiri ,
Volume 74, Issue 9 (12-2016)
Abstract

Background: Considering the high incidence and prevalence of nonalcoholic fatty liver disease (NAFLD) in the Iranian society and the limited number of studies to investigate its associated risk factors, the current study was designed to identify any relevant risk factor of this disease.

Methods: The present case-control study was performed among 150 nonalcoholic fatty liver disease patients and 150 normal liver participants who attended to gastroenterology clinics in Ilam city, Iran during 2014-2015. All demographic data, clinical trials and health behaviors associated with lifestyle such as nutritional status, smoking, physical activities were collected and compared between two groups.

Results: Among a total of 300 participants in the current study, the male female ratio was 46.54% and the mean±standard deviation of all participants was 42.13±12.15 years. The mean values of total cholesterol, triglycerides (TG), low density lipoprotein (LDL), alanine transaminase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were significantly higher in cases than controls group (P< 0.0001). A significant relationship was revealed between positive familial history, marriage, and low physical activities with NAFLD (P< 0.05). In the patient's group, consumption of red meat was significantly higher and dairy intake was significantly lower compared to the control group (P< 0.05). Using the multivariate logistic regression analysis, the adjusted odds ratio for variables of waist circumference, triglyceride, ALT and body mass index (BMI) were statistically significant [1.11, (1.04-1.18); 2.58, (1.01-6.67); 5.34, (1.84-15.52) and 7.28,) 1.89-27.99) respectively] (P< 0.05). Also, a significant association was observed among the variables of ALT, AST and BMI with the severity grade of NAFLD (P< 0.05).

Conclusion: The results of this study showed that waist circumference, BMI, serum level of ALT and TG concentrations can predict the occurrence of non-alcoholic fatty liver disease. BMI, ALT, and AST seem to be associated with the ultrasonography staging of liver in NAFLD. Therefore, these parameters could be used to predict the ultrasonography staging of liver in these patients.


The function of factors and exacerbation of polycystic ovary syndrome: brief report
Sepideh Mousazadeh , Atefeh Rahimi , Roya Gosili , Azadeh Ghaheri , Fatemeh Khaksar ,
Volume 76, Issue 3 (6-2018)
Abstract
Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder and one of the main reasons of infertility in women. PCOS causes many symptoms in women, one of the most important of them is ovulation failure. It affects the women at the age of fertility. Many factors are detected to exacerbate PCOS including insulin, anti-Mullerian hormone, obesity and androgen. The aim of this study was to evaluate endocrine and metabolic factors and its relation with obesity in patients with polycystic ovary syndrome in exacerbation of disease.
Methods: This cross-sectional study was carried out at the Caucasus Infertility Treatment Center of Ardabil from July 2015 to March 2016 and on 321 patients with polycystic ovary syndrome. Blood samples were investigated to measure serum levels of fasting insulin, dehydroepiandrosterone sulfate (DHEAS), 17OHP, fasting blood sugar, sex hormone binding globulin (SHBG), anti-Mullerian hormone, vitamin D, total testosterone, free testosterone, prolactin, FSH, LH and TSH. Also, body mass index (BMI), duration of infertility and age were measured. BMI was evaluated to measure the obesity of patients.
Results: We were able to demonstrate significantly high level of total testosterone and fasting insulin in PCOS women by having weight gain (P< 0.05). Response to drug was significantly increased with reduced weight of these patients (P= 0.02). The level of fasting blood sugar (P= 0.01) and anti-Mullerian hormone (P< 0.05) were increased significantly with access in PCOS. On the other hand, our data showed that duration of infertility was increased by growing the age of patients (P< 0.05).
Conclusion: Insulin resistance, obesity, hyperandrogenism and metabolic syndrome are very important factors in pathogenesis of PCOS. These factors could affect the fertility of women by effecting the reproductive processes. Therefore, it is better in the patients who are older, treatment strategies further underline on reduce these factors (insulin resistance, obesity and hyperandrogenism) to prevent disease progression and increase duration of infertility.

Comparison of ordinary logistic regression and robust logistic regression models in modeling of pre-diabetes risk factors
Fateme Azizi Mayvan , Mehdi Jabbari Nooghabi , Ali Taghipour , Mohammad Taghi Shakeri , Mahsa Mokarram ,
Volume 76, Issue 7 (10-2018)
Abstract
Background: Regarding the increased risk of developing type 2 diabetes in pre-diabetic people, identifying pre-diabetes and determining of its risk factors seems so necessary. In this study, it is aimed to compare ordinary logistic regression and robust logistic regression models in modeling pre-diabetes risk factors.
Methods: This is a cross-sectional study and conducted on 6460 people, over 30 years old, who have participated in the screening of diabetes plan in Mashhad city that it was done by Mashhad University of Medical Sciences from October to December 2010. According to the fasting blood sugar criteria, 5414 individuals were identified as healthy and 1046 individuals were identified as pre-diabetic. Age, gender, body mass index, systolic blood pressure, diastolic blood pressure and waist-to-hip ratio were measured for every participant. The data was entered into the Microsoft Excel 2013 (Microsoft Corp., Redmond, WA, USA) and then analysis of the data was done in R Project for Statistical Computing, Version R 3.1.2 (www.r-project.org). Ordinary logistic regression model was fitted on the data. The outliers were identified. Then Mallow, WBY and BY robust logistic regression models were fitted on the data. And then, the robust models were compared with each other and with ordinary logistic regression model according to goodness of fit and prediction ability using Pearson's chi-square and area under the receiver operating characteristic (ROC) curve respectively.
Results: Among the variables that were included in the ordinary logistic regression model and three robust logistic models, age, body mass index and systolic blood pressure were statistically significant (P< 0.01) but waist-to-hip ratio was not statistically significant (P> 0.1). There were 552 outliers with misclassification error in the ordinary logistic regression model. Pearson's chi-square value and area under the ROC curve value in the Mallow model were almost the same as for ordinary logistic regression model. But it was relatively higher in BY and WBY models.
Conclusion: Based on results of this study age, overweight and hypertension are risk factors of prediabetes. Also, WBY and BY models were better than ordinary logistic regression model, according to goodness of fit criteria and prediction ability.

Correlation between serum levels of cystatin C and coronary slow flow and body mass index in men
Roghaiyeh Afsargharehbagh, Mirhosein Seyedmohammadzad , Aliakbar Nasiri , Kamal Khademvatan , Sima Ghaemimirabad , Abbas Malandish ,
Volume 76, Issue 9 (12-2018)
Abstract
Background: Cystatin C (Cys C) as a cysteine protease inhibitor is produced in a constant level from all nucleated cells. The purpose of this study was to investigate the correlation between serum levels of Cys C and coronary slow flow (CSF) and body mass index (BMI) in men.
Methods: This investigation is in the form of a descriptive-analytical study. The statistical population was all non-active male aged 34-73 years with CSF candidate for angiography referring to Seyedoshohada University Hospital, Urmia, Iran, from March 2015 to February 2017. After obtaining an inform consent, 74 male patients (mean age 54.77±9.00 years, height 1.74±0.12 cm, weight 73.13±6.85 kg, and BMI 26.98±3.83 kg/m2) were selected by convenience non-random sampling as the sample size (patients were eligible for diagnostic coronary artery angiography for the first time and referring to Seyedoshohada University Hospital in Urmia). Then all the patients were placed under angiography with one mobile angiography system. Patients were assessed for coronary blood flow with a quantitative method using corrected thrombolysis frame count in myocardial infarction (CTFC). All the patients with TFC larger than two standard deviation pre-published area for a specific vessel were counted as CSF. Demographic characteristics of age, height, weight, and BMI in male patients were measured by wall-meter with an accuracy of one millimeter, digital scale with precision of 100 g, and weight/hieght2 formula, respectively. The traditional risk factors including smoking, diabetes mellitus (DM), high blood pressure (HBP), dyslipidemia, and family history were also assessed using a checklist. Serum levels of Cys C were measured by ELISA machine.
Results: The mean demographic and physiological variables of subjects were: age 54.77±9.00 yr, height 1.74±0.12 cm, weight 73.13±6.85 kg, and BMI 26.98±3.83 kg/m2. Also, the results of this study showed that there were no significant correlations between serum levels of Cys C with CSF and BMI in male patients’ candidate for angiography referring to Seyedoshohada University Hospital (P=0.871 and P=0.494, respectively).
Conclusion: The results of this study suggest that serum levels of Cys C had no significant correlations with the CSF and BMI in male patients’ candidate for angiography aged 34-73 years.

The healing effect of total contact casting on diabetic foot ulcers
Azadeh Zahedi, Seyed Mokhtar Esmaeilnejadganji , Sekineh Kamali Ahangar , Rahmatollah Jokar,
Volume 77, Issue 1 (4-2019)
Abstract
Background: Diabetes Mellitus is a prevalent disease worldwide and foot ulcer is one of the serious complications of chronic uncontrolled diabetes which could lead to various complications such as amputation of the extremity if left untreated. Total contact casting (TCC) is the gold standard in treatment of neuropathic and neuro ischemic diabetic foot ulcers (DFU) on which less emphasize is seen on routine medical practice. The aim of this study was to emphasize on healing effect of this off-loading method and to study the possible influence of variants on the healing rate of this technique.
Methods: In this cohort study, 92 diabetic patients with complaint of plantar foot ulcer grade 0, 1 and 2 according to Wagner classification had participated in Shahid Beheshti Hospital, Babol City, Iran, from March 2014 to February 2016. The demographic and biochemical information along with dimensions of foot ulcers were carefully recorded. After the primary cleansing, surgical debridement and dressing, TCC was applied on foot by the specialist and they were requested to return weekly for changing the TCC and re-evaluation of ulcers. The healing rate was calculated as decline in ulcer surface area per week.
Results: 92 patients of study sample with mean age of 63.9±10.56 year consisted of 76 patients with DM type 2 with BMI of 31.16±3.8 kg/m² and 58 male patients. The average healing rate of ulcers treated with TCC was 0.406 ±0.168 cm²/week. The duration of diabetes on average was 17.23±6.93 years. Most of the patients (n=45) had an ulcer on the forefoot and the healing rate of midfoot ulcers was slower. The average amount of baseline HbA1c was 8.2±0.19%. There was no relation between smoking history (P=0.94) and anti-diabetic regimen used by patients (P=0.754) with the healing rate.
Conclusion: The healing rate is slower in elderly patients and those with longer duration of diabetes. So in these two groups, TCC is to be applied for a longer duration in order to achieve complete healing.

Relationship between body mass index and gestational diabetes mellitus
Mansour Rezaei , Fateme Rajati , Negin Fakhri ,
Volume 77, Issue 4 (7-2019)
Abstract
Background: Gestational diabetes mellitus (GDM) is one of the most common medical complications in pregnancy, which is associated with many serious consequences for mother and her fetus. Body mass index (BMI) in pregnant women is considered as one of most effective factor for the incidence of GDM. The aim of this study was to determine the relationship between BMI at pregnant women in the early months of pregnancy and the incidence of GDM.
Methods: In this retrospective cohort study, the case of six hundred fifty-nine pregnant women who referred to health centers in Kermanshah City from September 2010 to September 2012 by convenience sampling method were selected and investigated. This study was sponsored by Kermanshah University of Medical Sciences. Height and weight were measured for each woman at the beginning of pregnancy and maternal body mass index (BMI) was calculated based on height and weight measurements. Then the pregnant women were divided into four groups based on BMI: thin (BMI less than 18.9 kg/m2), normal (BMI between 19 kg/m2 and 24.9 kg/m2), overweight (BMI between 25 kg/m2 and 29.9 kg/m2) and obese (BMI more than 30 kg/m2). Those women who had diabetes at the beginning of pregnancy were excluded from the study. GDM was considered as fasting blood glucose ≥92 between 26-30 weeks of gestation.
Results: The mean±SD age of pregnant women was 27.7±5.85 year and the mean of BMI was 24.4±4.0 kg/m2. The GDM was shown in 30.7% of women. Association between BMI and GDM were statistically significant (P<0.001). The risk of GDM onset was 1.24 times, for each unit increased in BMI, (P<0.001). The risk of GDM was significantly higher in overweight [OR=2.97, CI (2.01-4.39)] and obese [OR=16.89, CI (8.46-33.70)] women. Being underweight increased the risk of GDM onset up to 1.19 times, but not significant.
Conclusion: There is a significant relationship between maternal BMI in pregnant women at the beginning of pregnancy with GDM onset. Increased BMI is correlated with an increase in the incidence of GDM.

Association between obesity types and anthropometric indices with rheumatoid arthritis disease
Mahshad Ali Karoosi , Farideh Shishehbor , Karim Mola , Meysam Alipour ,
Volume 77, Issue 5 (8-2019)
Abstract
Background: Obesity is one of the causes of onset and exacerbation of rheumatoid arthritis. However, limited studies have examined the association between body composition and severity of disease. The aim of this study was to evaluate the association between severity of rheumatoid arthritis with various types of obesity and the comparison of anthropometric indices between patients with rheumatoid arthritis and healthy subjects.
Methods: This case-control study was conducted on 95 patients (48.8±10.4 years) with rheumatoid arthritis as a case group and 95 healthy people (46±9.3 years) as a control group carried in Golestan Hospital, Ahvaz, Iran, from April 2016 to February 2017. Weight, height, waist circumference (WC), hip circumference (HC) and body fat percentage (BFP) were measured. The anthropometric indices were calculated. The disease severity was calculated according to disease activity score 28 (DAS28).
Results: There was no significant difference between two groups regarding their gender ratio (1:1), age (P=0.16) and height (P=0.58). The weight, body mass index (BMI), body fat (BF), WC, HC, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and other obesity indices include a body shape index (ABSI), body adiposity index (BAI), abdominal volume index (AVI), body surface area (BSA) and Conicity index (CI) in patients with rheumatoid arthritis are significantly higher than healthy subjects (P<0.05). No difference in fat free mass was observed between two groups. Waist to height ratio and BAI compared with other indicators had the highest correlation with the DAS28 score. In addition, prevalence of obesity by waist circumference (82% vs. 61%), obesity by BMI (47% vs. 33%), and obesity by BFP (91% vs. 83%) was higher in patients with rheumatoid arthritis than healthy subjects. The risk of rheumatoid arthritis in people with central obesity by waist circumference (OR=2.92, 95% CI 1.50-5.70) was greater than obesity defined by BMI (OR=1.77, 95% CI 0.98-3.18) or BFP (OR=2.37, 95% CI 1.01-5.53).
Conclusion: The results of present study indicate association of rheumatoid arthritis disease severity with obesity types (especially central obesity) and anthropometric indices.
 

Prevalence of overweight and obesity in preschool children in Kerman: brief report
Mohsen Momeni , Elham Amirmijani , Hossein Safizadeh ,
Volume 77, Issue 12 (3-2020)
Abstract
Background: Today, overweight and obesity are major health concerns in developed and developing countries. Meanwhile, the issue is particularly important in children due to its consequences in adulthood. This study aimed to investigate the frequency of overweight and obesity in preschool children in Kerman, Iran.
Methods: This cross-sectional survey was conducted from December to March of 2016 among 731 preschool children (5 to 6 years old) who were selected using convenience sampling. The nutritional status of children was assessed according to the World Health Organization (WHO) expert committee guideline and based on body mass index (BMI) curves for age for boys and girls. Data were analyzed by SPSS software, version 21 (SPSS Inc., Chicago, IL, USA). Chi-square test was used for data analysis, and the significance level was considered less than 0.05.
Results: In this study, 376 boys (51.5%) and 355 girls (48.5%) were investigated. The mean and standard deviation of the age of the participants was 68.7±4.2 months, 53% of these children were first children of the family and 30% of them were only children. The prevalence of overweight and obesity was 9.2% and 8.1% respectively. There was no significant relationship between overweight and obesity with gender, number of siblings and parents' education. There was a borderline difference in birth order (P=0.05) and the frequency of overweight and obesity in the firstborn children was more than other birth orders.
Conclusion: The prevalence of overweight and obesity was high in preschool children. Since these risk factors in children are predictors of chronic diseases during adulthood, we need to design and implement interventions to decrease the prevalence of overweight and obesity in children.

The effect of body indexes on presence of ocular symptoms in covid-19 patients
Mansour Babaei, Mehran Shokri, Seyed Ahmad Rasoulinejad ,
Volume 80, Issue 7 (10-2022)
Abstract
Background: During the COVID-19 pandemic, the presence of ocular symptoms was common in COVID-19 patients, which can cause secondary complications in the treatment of ocular diseases. On the other hand, obesity can cause secondary symptoms in infectious diseases by impairing the function of the immune system, which indicates the relationship between involvement of different tissues and dysfunction of the cellular immune system. The aim of this study was to investigate the relationship between body indexes (i.e., age, height, weight, and BMI) and the presence of ocular symptoms in patients with COVID-19.
Methods: In this cross-sectional study (from March 2021 to May 2021), ocular symptoms (including blurred vision, epiphora, photophobia, discharge and exudate, redness, pain, and itching of the eyes) and body indexes (age, height, weight and BMI) were evaluated in 108 patients with COVID-19, who were referred to Ayatollah Rouhani hospital, Babol, Iran. The independent t-test and Kruskal-Wallis statistical tests were used to examine the data relationship in SPSS software.
Results: The results showed that the mean body weight in COVID-19 patients with blurred vision was significantly higher than COVID-19 patients without blurred vision (P=0.003, t=-3.056). The mean height of COVID-19 patients with epiphora was significantly lower than the mean height of COVID-19 patients without epiphora (P=0.018, t=2.398). Also, the BMI of COVID-19 patients with epiphora was 30.00 ±4.07 kg/m2, while the BMI of COVID-19 patients without epiphora was 27.68±4.42 kg/m2 (P=0.047, t=0.026). In COVID-19 patients with at least one ocular symptom, height was significantly lower than heigh of COVID-19 patients without any ocular symptoms (P=0.001, t=3.397).
Conclusion: Our results indicate the essential role of obesity in the occurrence of eye symptoms in COVID-19 patients. In this study, it was found that blurred vision, epiphora and the presence of at least one eye symptom in COVID-19 patients were significantly associated with the upward trend of BMI (as an index of obesity).

Assessment of success factors in normal vaginal delivery in late term pregnant women
Sargol Movagharnejad, Maryam Javadian , Hoda Shirafkan, Shahla Yazdani,
Volume 80, Issue 8 (11-2022)
Abstract
Background: The aim of this study was to find the causes of failure of natural childbirth in late-term pregnancy that can be useful for managing childbirth in these pregnant mothers and to design a solution to increase natural childbirth.
Methods: This cross-sectional study was conducted in the community of pregnant women with a late-term pregnancy of more than 41 weeks. The studied sample includes 148 pregnant mothers who were referred to Ayatollah Rouhani Hospital in Babol from March 2018 to February 2020. Mother's age, Body Mass Index, gestational age, number of pregnancies, number of deliveries, length of hospitalization, the state of the cervix and preparation method of the cervix for termination of pregnancy were extracted and recorded from patients' files. Data were compared in two groups of pregnancy termination methods (natural childbirth and cesarean delivery). Statistical analysis was done using SPSS software, version 22 (IBM SPSS, Armonk, NY, USA) and Chi-square test and Student’s t-test statistical tests and logistic regression model fitting. P-value less than 0.05 was considered significant.
Results: In this study, 167 pregnant women with late-term pregnancy were studied. The age of pregnant women is reported with mean of 26.03 and standard deviation 5.98 of years. The high Bishop variable, with odds ratio of 0.44, is a variable protective factor for cesarean delivery (P=0.001). Higher body mass index with odds ratio of 1.09, is also known as a risk factor for cesarean delivery (P=0.01), so that for each unit of increase in Bishop score, the chance of cesarean delivery decreases by 56% and for each unit of increase in body mass index, the chance of cesarean delivery increases by 9%.
Conclusion: This study showed that nearly half of cases of late pregnancies lead to normal delivery. High body mass index reduces the chance of normal delivery in late term pregnancies. But a higher Bishop score can be effective in the success of natural delivery.

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