Protocol for systematic review: peak bone mass pattern in different parts of the world

Copyright: © 2015 Mohammadi Z. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Peak bone mass, which can be defined as the amount of bone tissue present at the end of the skeletal maturation, and also it is an important determinant of osteoporotic fracture risk. The peak bone mass of a given part of the skeleton is directly dependent upon both its genetics and environmental factors. Therefore, the aim of the proposed research is a comprehensive systematic assessment of the pattern of peak bone mass in different countries across the globe. The present article explains the protocol for conducting such a research

Burden of ischemic heart diseases in Iran, 1990-2010: Findings from the global burden of disease study 2010

Background: Cardiovascular diseases are viewed worldwide as one of the main causes of death.This study aims to report the burden of ischemic heart diseases (IHDs) in Iran by using data of the global burden of disease (GBD) study, 1990-2010. Materials and Methods: The GBD study 2010 was a systematic effort to provide comprehensive data to calculate disability-adjusted life years (DALYs) for diseases and injuries in the world. Years of life lost (YLLs) due to premature mortality were computed on the basis of cause-of-death estimates, using Cause of Death Ensemble model (CODEm). Years lived with disability (YLDs) were assessed by the multiplication of prevalence, the disability weight for a sequel, and the duration of symptoms. A systematic review of published and unpublished data was performed to evaluate the distribution of diseases, and consequently prevalence estimates were calculated with a Bayesian meta-regression method (DisMod-MR). Data from population-based surveys were used for producing disability weights. Uncertainty from all inputs into the calculations of DALYs was disseminated by Monte Carlo simulation techniques. Results: The age-standardized IHDs DALY specified rate decreased 31.25 over 20 years from 1990 to 2010 from 4720 (95% uncertainty interval (UI): 4,341-5,099) to 3,245 (95% UI: 2,810-3,529) person-years per 100,000. The decrease were 38.14% among women and 26.87% among men. The age-standardized IHDs death specefied rate decreased by 21.17% from 222) 95% UI: 207-243 (to 175 (95% UI:152-190) person-years per 100,000 in both the sexes. The age-standardized YLL and YLD rates decreased 32.05% and 4.28%, respectively, in the above period. Conclusion: Despite decreasing age-standardized IHD of mortality, YLL, YLD, and DALY rates from 1990 to 2010, population growth and aging increased the global burden of IHD. YLL has decreased more than IHD deaths and YLD since 1990 but IHD mortality remains the greatest contributor to disease burden. © 2015 Journal of Research in Medical Sciences

Metabolic risk factors and risk of Covid-19: A systematic review and meta-analysis

Objective Based on the epidemiologic findings of Covid-19 incidence; illness and mortality seem to be associated with metabolic risk factors. This systematic review and meta-analysis aimed to assess the association of metabolic risk factors and risk of Covid-19. Methods This study was designed according to PRISMA guidelines. Two independent researchers searched for the relevant studies using PubMed, Web of Science, Cochrane Library, and Scopus. The search terms developed focusing on two main roots of "Covid-19"and "metabolic risk factors". All relevant observational, analytical studies, review articles, and a meta-analysis on the adult population were included in this meta-analysis. Meta-analysis was performed using the random effect model for pooling proportions to address heterogeneity among studies. Data were analyzed using STATA package version 11.2, (Stata- Corp, USA). Results Through a comprehensive systematic search in the targeted databases we found 1124 papers, after running the proses of refining, 13 studies were included in the present meta-analysis. The pooled prevalence of obesity in Covid-19 patients was 29 (95 CI: 14-47). For Diabetes and Hypertension, these were 22 (95 CI: 12 33) and 32 (95 CI: 12 56), respectively. There was significant heterogeneity in the estimates of the three pooled prevalence without any significant small-study effects. Such warning points, to some extent, guide physicians and clinicians to better understand the importance of controlling co-morbid risk factors in prioritizing resource allocation and interventions. Conclusion The meta-analysis showed that hypertension is more prevalent than obesity and diabetes in patients with Covid-19 disease. The prevalence of co-morbid metabolic risk factors must be adopted for better management and priority settings of public health vaccination and other required interventions. The results may help to improve services delivery in COVID-19 patients, while helping to develop better policies for prevention and response to COVID-19 and its critical outcomes. © 2020 Moazzami et al

Effect of glutamine supplementation on cardiometabolic risk factors and inflammatory markers: a systematic review and meta-analysis

Background: Evidence exists that glutamine plays multiple roles in glucose metabolism, insulin sensitivity, and anti-inflammatory effects. This systematic review and meta-analysis of controlled trials aimed to assess the effect of glutamine supplementation on cardio-metabolic risk factors and inflammatory markers. Methods: The processes of systematic reviews and meta-analyses were performed according to the PRISMA checklist. PubMed, Web of Sciences, Cochrane library, and Scopus databases were search for relevant studies without time or language restrictions up to December 30, 2020. All randomized clinical trials which assessed the effect of glutamine supplementation on �glycemic indices�, �level of triglyceride, �and �inflammatory markers� were included in the study. The effect of glutamine supplementation on cardio-metabolic risk factors and inflammatory markers was assessed using a standardized mean difference (SMD) and 95 confidence interval (CI). Heterogeneity between among studies was assessed using Cochran Q-statistic and I-square. Random/fixed-effects meta-analysis method was used to estimate the pooled SMD. The risk of bias for the included trials was evaluated using the Cochrane quality assessment tool. Results: In total, 12 studies that assessed the effect of glutamine supplementation on cardio-metabolic risk factors were included in the study. Meta-analysis showed that glutamine supplementation significantly decreased significantly serum levels of FPG SMD: � 0.73, 95% CI � 1.35, � 0.11, I2: 84.1% and CRP SMD: � 0.58, 95% CI � 0.1, � 0.17, I2: 0%. The effect of glutamine supplementation on other cardiometabolic risk factors was not statistically significant (P > 0.05). Conclusion: Our findings showed that glutamine supplementation might have a positive effect on FPG and CRP; both of which are crucial as cardio-metabolic risk factors. However, supplementation had no significant effect on other cardio-metabolic risk factors. © 2021, The Author(s)

Correction to: Effect of selenium supplementation on antioxidant markers: a systematic review and meta-analysis of randomized controlled trials (Hormones, (2019), 18, 4, (451-462), 10.1007/s42000-019-00143-3)

The original version of this article, published on 10 December 2019 contained a mistake. © 2020, Hellenic Endocrine Society

Insight into blood pressure targets for universal coverage of hypertension services in Iran: the 2017 ACC/AHA versus JNC 8 hypertension guidelines

BACKGROUND: We compared the prevalence, awareness, treatment, and control of hypertension in Iran based on two hypertension guidelines; the 2017 ACC/AHA -with an aggressive blood pressure target of 130/80 mmHg- and the commonly used JNC8 guideline cut-off of 140/90 mmHg. We shed light on the implications of the 2017 ACC/AHA for population subgroups and high-risk individuals who were eligible for non-pharmacologic and pharmacologic therapies. METHODS: Data was obtained from the Iran national STEPS 2016 study. Participants included 27,738 adults aged ≥25 years as a representative sample of Iranians. Regression models of survey design were used to examine the determinants of prevalence, awareness, treatment, and control of hypertension. RESULTS: The prevalence of hypertension based on JNC8 was 29.9% (95% CI: 29.2-30.6), which soared to 53.7% (52.9-54.4) based on the 2017 ACC/AHA. The percentage of awareness, treatment, and control were 59.2% (58.0-60.3), 80.2% (78.9-81.4), and 39.1% (37.4-40.7) based on JNC8, which dropped to 37.1% (36.2-38.0), 71.3% (69.9-72.7), and 19.6% (18.3-21.0), respectively, by applying the 2017 ACC/AHA. Based on the new guideline, adults aged 25-34 years had the largest increase in prevalence (from 7.3 to 30.7%). They also had the lowest awareness and treatment rate, contrary to the highest control rate (36.5%) between age groups. Compared with JNC8, based on the 2017 ACC/AHA, 24, 15, 17, and 11% more individuals with dyslipidaemia, high triglycerides, diabetes, and cardiovascular disease events, respectively, fell into the hypertensive category. Yet, based on the 2017 ACC/AHA, 68.2% of individuals falling into the hypertensive category were eligible for receiving pharmacologic therapy (versus 95.7% in JNC8). LDL cholesterol< 130 mg/dL, sufficient physical activity (Metabolic Equivalents≥600/week), and Body Mass Index were found to change blood pressure by - 3.56(- 4.38, - 2.74), - 2.04(- 2.58, - 1.50), and 0.48(0.42, 0.53) mmHg, respectively. CONCLUSIONS: Switching from JNC8 to 2017 ACC/AHA sharply increased the prevalence and drastically decreased the awareness, treatment, and control in Iran. Based on the 2017 ACC/AHA, more young adults and those with chronic comorbidities fell into the hypertensive category; these individuals might benefit from earlier interventions such as lifestyle modifications. The low control rate among individuals receiving treatment warrants a critical review of hypertension services

Socioeconomic inequality in childhood obesity and its determinants: a Blinder�Oaxaca decomposition Desigualdade socioeconômica na obesidade infantil e seus determinantes: decomposição de Oaxaca-Blinder

Objective: Childhood obesity has become a priority health concern worldwide. Socioeconomic status is one of its main determinants. This study aimed to assess the socioeconomic inequality of obesity in children and adolescents at national and provincial levels in Iran. Methods: This multicenter cross-sectional study was conducted in 2011�2012, as part of a national school-based surveillance program performed in 40,000 students, aged 6�18-years, from urban and rural areas of 30 provinces of Iran. Using principle component analysis, the socioeconomic status of participants was categorized to quintiles. Socioeconomic status inequality in excess weight was estimated by calculating the prevalence of excess weight (i.e., overweight, generalized obesity, and abdominal obesity) across the socioeconomic status quintiles, the concentration index, and slope index of inequality. The determinants of this inequality were determined by the Oaxaca Blinder decomposition. Results: Overall, 36,529 students completed the study (response rate: 91.32); 50.79 of whom were boys and 74.23 were urban inhabitants. The mean (standard deviation) age was 12.14 (3.36) years. The prevalence of overweight, generalized obesity, and abdominal obesity was 11.51, 8.35, and 17.87, respectively. The SII for overweight, obesity and abdominal obesity was �0.1, �0.1 and �0.15, respectively. Concentration index for overweight, generalized obesity, and abdominal obesity was positive, which indicate inequality in favor of low socioeconomic status groups. Area of residence, family history of obesity, and age were the most contributing factors to the inequality of obesity prevalence observed between the highest and lowest socioeconomic status groups. Conclusion: This study provides considerable information on the high prevalence of excess weight in families with higher socioeconomic status at national and provincial levels. These findings can be used for international comparisons and for healthcare policies, improving their programming by considering differences at provincial levels. © 2017 Sociedade Brasileira de Pediatri

Protocol Design for Large–Scale Cross–Sectional Studies of Surveillance of Risk Factors of Non–Communicable Diseases in Iran: STEPs 2016

INTRODUCTION: The rise in non-communicable diseases (NCDs) has gained increasing attention. There is a great need for reliable data to address such problems. Here, we describe the development of a comprehensive set of executive and scientific protocols and instructions of STEPs 2016. METHODS/DESIGN: This is a large-scale cross-sectional study of Surveillance of Risk Factors of NCDs in Iran. Through systematic proportional to size cluster random sampling, 31,050 participants enrolled in three sequential processes, of completing questionnaires; physical measurements, and lab assessment. RESULTS: Out of 429 districts, samples were taken from urban and rural areas of 389 districts. After applying sampling weight to the samples, comparing the distribution of population and samples, compared classification was determined in accordance with the age and sex groups. Out of 31,050 expected participants, 30,541 participant completed questionnaires (52.31% female). For physical measurements and lab assessment, the cases included 30,042 (52.38% female) and 19,778 (54.04% female), respectively. DISCUSSION: There is an urgent need to focus on reviewing trend analyses of NCDs.To the best of our knowledge, the present study is the first comprehensive experience on systematic electronic national survey. The results could be also used for future complementary studies