Obesity paradox versus frailty syndrome in first-ever ischemic stroke survivors

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The prevalence of metabolic syndrome increases with serum hs-CRP concentration in individuals without a history of cardiovascular disease: a report from a large Persian cohort

BACKGROUND: Metabolic syndrome (MetS) is defined by a clustering of cardiovascular (CV) risk factors and is associated with a heightened inflammatory state. A raised serum high-sensitivity C-reactive protein (hs-CRP), a marker of inflammation, is also known to associate with CV risk. We have investigated the relationship between the presence of MetS and serum hs-CRP concentration in a large representative Persian population cohort without a history of cardiovascular disease (CVD). METHODS: The MASHAD study population cohort comprised 9 778 subjects, who were recruited from the city of Mashhad, Iran, between 2007 and 2008. Several cardiovascular risk factors were measured in this population without CVD. Individuals were categorized into quartiles of serum hs-CRP concentration: 1st quartile - 0.72 (0.59-0.85) [median (range)] mg/L, 2nd quartile - 1.30 (1.14-1.4) mg/L, 3rd quartile - 2.29 (1.92-2.81) mg/L and 4th quartile - 6.63 (4.61-11.95) mg/L respectively. The prevalence of MetS in each quartile was determined using either International Diabetes Federation (IDF) or Adult Treatment Panel III (ATPIII) criteria. RESULTS: The prevalence of MetS was highest in the 4th quartile for serum hs-CRP [1220 subjects (50.0%)], and significantly higher than that in the 1st quartile (reference group) [634 subjects (25.9%)] (p<0.001). A positive smoking habit [OR, 1.47 (1.26-1.70), p<0.001] and the presence of either MetS-IDF [OR, 1.35 (1.18-1.55), p<0.001] or Mets-ATPIII [OR, 1.40 (1.18-1.50), p<0.001] were strong predictors of a 4th quartile for serum hs-CRP concentration. CONCLUSIONS: There was a significant association between high levels of serum hs-CRP and the presence of MetS among individuals without a history of CVD in our Persian cohort

Omega-3 fatty acid supplements improve the cardiovascular risk profile of subjects with metabolic syndrome, including markers of inflammation and auto-immunity

OBJECTIVE Fish-oil contains high concentrations of omega-3 fatty acids that have been shown to have anti-inflammatory properties. We have evaluated the effects of purified omega-3 fatty acid supplements on several anthropometric and biochemical parameters, including heat shock protein (Hsp) 27 antibody titres in subjects with metabolic syndrome. METHODS Subjects (n = 120) with metabolic syndrome (mean age of 52.9 +/- 11.9 years) were randomly allocated to one of two groups: sixty subjects were given 1 gram of fish oil as a single capsule, containing 180 mg eicosapentaenoic acid and 120 mg docosahexaenoic acid daily for 6 months. Control subjects did not receive any supplementation over the same period. RESULTS The study was completed by 47 subjects in the intervention group and 42 subjects in the control group. Treatment with omega 3 supplements was associated with a significant fall in body weight (P < 0.05), systolic blood pressures (P < 0.05), serum low density lipoprotein cholesterol (P < 0.05), and total cholesterol (P < 0.05), triglycerides (P < 0.05), high-sensitivity C-reactive protein (hs-CRP) (P < 0.01), and Hsp27 antibody titres (P < 0.05). No significant changes were observed in the control group. CONCLUSION It appears that omega 3 improves the cardiovascular risk profile of subjects with metabolic syndrome, having effects on weight, systolic blood pressure, lipid profile and markers of inflammation and autoimmunit

Concept of Atherosclerosis Velocity: Is It a Better Measure of Cardiovascular Risk?

In most cases atherosclerosis is the underlying cause of vascular diseases, including heart disease and stroke. It is believed that endothelial injury is the earliest change in the artery wall and that this precedes the formation of lesions of atherosclerosis. Recent developments in the field of atherosclerosis have led to a renewed interest in the recognition of the parameter of time in the atherosclerosis process. We believe that the factors determining the time-dependent rate of atherosclerosis progression are important, and it is in this context that we wish to propose for the first time the term “atherosclerosis velocity”. In this review article, we summarize the existing evidence regarding atherosclerosis velocity and discuss the importance of this issue

Lipid Clinics Are Urgently Required in the Iranian Public Health System

OBJECTIVES Lipid Clinics are specialized centers for clinical assessment and follow up of patients with dyslipidaemia in order to deliver an acceptable improvement in their lipid profiles. We assessed the changes in lipid profile of dyslipidemic patients attending a Lipid Clinic over a 1 year period on lipid-lowering therapy. METHODS Dyslipidemic patients (n=238) were recruited from the Lipid Clinic at the Royal Surrey County Hospital, Guildford, UK. All patients were regularly seen at the clinic and the compliance of lipid-lowering drug consumption, prescribed by the consultant was assessed over a period of one year. RESULTS The mean age of the patients was 55.2 ± 0.86 years and the male/female ratio was 143/95. The lipid profiles of patients attending the Lipid Clinic over the period of one year of close monitoring changed significantly. Triglyceride, total cholesterol and low density lipoprotein cholesterol were reduced by 27.04%, 20.48% and 22.67%, respectively (P<0.001) and high density lipoprotein cholesterol rose by 8.96% (P<0.001); the 10-year calculated coronary risk factor of all patients decreased significantly (39.29%, P<0.001). CONCLUSIONS Our findings confirmed the effectiveness of a Lipid Clinic in the management of lipid profile and cardiovascular risk of dyslipidemic patients

Serum selenium and glutathione peroxidase concentrations in Iranian patients with angiography-defined coronary artery disease

This study investigated the relationship between serum selenium (Se) and glutathione peroxidase (GPx) levels and the presence of coronary artery disease (CAD) among Iranian patients. Three groups were compared: patients undergoing angiography with angiographically defined CAD, individuals with a normal angiogram, and apparently healthy controls with no evidence of overt CAD. Anthropometric measurements, blood pressure, fasting blood glucose and lipid profiles, serum Se and GPx measurements, and angiographic assessment were carried out using standard protocols. Mean serum Se concentrations were not significantly different between patients with and without CAD and the control group. The mean value of serum GPx in the control group was significantly higher than in patients with or without CAD. Selenium status did not differentiate between patients with and without CAD, which may be related to the fact that angiography is not a very sensitive index of global atherosclerosis, and it is possible that patients who were CAD negative by angiogram still have significant disease. It may also be that Se is not a good marker of CA

Prevalence of chest wall deformities in a large sample of Iranian children aged 7-14 years

Objective: Pectus excavate rn (PE) and pectus carinatum (PC) are two common chest deformities. We investigated the prevalence of chest wall deformities including PE and PC in Iranian population. Methods: 25587 children and adolescents aged 7-14 years consisting of 13586 (53.1%) males and 12001 (46.9%) females were studied using cluster-stratified sampling method. Screening was clinical and based on descriptive findings. Suspected subjects with chest wall deformity were referred to the expert surgeon to confirm the diagnosis. Findings: The prevalence of chest deformities in our population was 204 (1.03%). The mean age of subjects was 10.2΁3.0 years. Of these subjects 124 (0.49%) [74 (54%) males and 50 (42%) females)] had PE and 80 (0.31%) [58 (72.5%) males and 22 (17.5%) females)] had PC. Conclusion: The prevalence of PE seems to be very high in Iran. Special attention must be paid to diagnose and treat this problem in our population

Metabolic syndrome may not be a good predictor of coronary artery disease in the Iranian population: population-specific definitions are required

The inability of two definitions of metabolic syndrome (MS) to predict the presence of coronary artery disease (CAD) in a non-Caucasian population was demonstrated. Angiography was used as the gold standard method for identifying patients with (cases) or without (controls) CAD. It is possible that the current definitions of MS are not appropriate for some non-Caucasian populations