First report on the validity of a continuous Metabolic Syndrome score as an indicator for Metabolic Syndrome in a national sample of paediatric population - The CASPIAN-III study

Introduction: The aim of this study was to assess the validity of a continuous Metabolic Syndrome score (cMetS) in a nationally representative sample of Iranian children and to identify sex and age-specific optimal cut-off points of cMetS that are associated with MetS. Material and methods: This study was conducted among 3,254 schoolchildren aged 10-18 years. cMetS was derived by aggregating age and sex-standardised residuals of waist circumference (WC), mean arterial pressure (MAP), glucose, high density lipoprotein-cholesterol (HDL-C) and triglycerides (TG). To determine the optimal cut-off points of cMetS for predicting MetS, receiver operator characteristic (ROC) curve analysis was used with an estimation of the variables' sensitivity and specificity. Results: A graded relationship was documented between cMetS and the number of risk factors. Increasing mean values of cMetS with increasing numbers of components were apparent for both genders. The overall optimal cMetS cut-off point for predicting the presence of MetS was 2.93 sensitivity = 92%, specificity = 91%, area of the curve = 0.96 (0.95-0.97). The values for boys and girls were 2.97 and 3.26 respectively in the total study. Conclusion: This nationwide study confirmed the validity of the cMetS score in a population-based sample of Iranian children. cMetS appears to be an appropriate index for investigating the association between potential risk factors and MetS in epidemiological research in Iran

Association of anthropometric measures with cardiovascular risk factors and metabolic syndrome in normal-weight children and adolescents: The CASPIAN III study

Objective: This nationwide study was conducted to determine the association of anthropometric measures with cardiovascular risk factors and metabolic syndrome (MetS) in Iranian normal-weight children and adolescents. Methods: We analyzed the data of 3,565 children and adolescents (50.3 boys), aged 10-18 years, with a normal BMI (5th-84th percentile) obtained from the third survey of 'Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease' (CASPIAN III) study. The diagnostic criteria for MetS were defined by the International Diabetes Federation consensus. Results: The prevalence of MetS for 10- to 13.9-year-old boys, 14- to 18-year-old boys, 10- to 13.9-year-old girls, and 14- to 18-year-old girls were 1.4, 2.8, 2.3, and 3.3, respectively. After adjustment for age and sex, each unit increase in BMI (within normal range) and waist circumference increased the odds of MetS from 6 to 72 and from 1 to 20, respectively. The dominant pattern of dyslipidemia among the participants was high triglycerides and low high-density lipoprotein cholesterol. Conclusion: This study complements recent research about the high frequency of metabolic risk factors among normal-weight individuals in the pediatric age group. © 2013 S. Karger GmbH, Freiburg

The relationship of air pollution and surrogate markers of endothelial dysfunction in a population-based sample of children

<p>Abstract</p> <p>Background</p> <p>This study aimed to assess the relationship of air pollution and plasma surrogate markers of endothelial dysfunction in the pediatric age group.</p> <p>Methods</p> <p>This cross-sectional study was conducted in 2009-2010 among 125 participants aged 10-18 years. They were randomly selected from different areas of Isfahan city, the second large and air-polluted city in Iran. The association of air pollutants' levels with serum thrombomodulin (TM) and tissue factor (TF) was determined after adjustment for age, gender, anthropometric measures, dietary and physical activity habits.</p> <p>Results</p> <p>Data of 118 participants was complete and was analyzed. The mean age was 12.79 (2.35) years. The mean pollution standards index (PSI) value was at moderate level, the mean particular matter measuring up to 10 μm (PM₁₀) was more than twice the normal level. Multiple linear regression analysis showed that TF had significant relationship with all air pollutants except than carbon monoxide, and TM had significant inverse relationship with ozone. The odds ratio of elevated TF was significantly higher in the upper vs. the lowest quartiles of PM₁₀, ozone and PSI. The corresponding figures were in opposite direction for TM.</p> <p>Conclusions</p> <p>The relationship of air pollutants with endothelial dysfunction and pro-coagulant state can be an important factor in the development of atherosclerosis from early life. This finding should be confirmed in future longitudinal studies. Concerns about the harmful effects of air pollution on children's health should be considered a top priority for public health policy; it should be underscored in primordial and primary prevention of chronic diseases.</p

Air Pollution and Hospitalization for Respiratory Diseases Among Children in Isfahan, Iran

Background: Adverse effects of urban air pollution on human health notably the paediatric age group is of great importance. Limited data exist from developing countries. This study investigates the hospitalization of children because of respiratory diseases and air pollu-tion levels in Isfahan, the second large city in Iran.Methods: Hospital admission data were collected ret-rospectively from 120 randomly selected respiratory patients in Pediatric wards from the main referral hos-pital in Isfahan from March 2005 -2006, and simulta-neous air pollution data were collected from two moni-toring stations located in south and north parts of the city.Results: The result of statistical modeling using gener-alized linear Poisson regression showed that PM10 and sulfur dioxide (SO2) concentrations had statistically significant positive association with number of respira-tory admissions of children.Conclusion: This study confirms the findings of previ-ous studies about the association of air pollutants’ lev-els with hospitalization because of respiratory diseases in young children. Air pollution continues to pose a threat to public health notably in the paediatric age group, and underscores the need to re-examine national environmental health policies and standards in devel-oping countries

Nationwide Report on the Findings of Integrated School Health Screening Program in Iran

Background: Screening of students&acute; health problems could lead to timely prevention and control of many health disorders. This study aimed to determine the nationwide prevalence of common disorders through school health screening program in Iran Methods: This cross-sectional national screening program was conducted in 2007-2008 among first- and third-grade- students in primary schools, first- grade-students of middle and high schools of all provinces in Iran.Results: Data were obtained from 3,124,021 (81.9%) students reported from the whole country classified into 33 geographical zones. Of total students studied, 12.48% had weight abnormalities, 4.77%&nbsp;had visual disorders, 3.95 % had head lice, 2.24% had behavioral disorders, and 0.6% had hearing disorders. Among students studied, 0.4%, 0.7%, 0.4% and0.8% had endocrine, psychological, neurological and genitourinary disorders, respectively. In addition, 2.1%, 1.9%, 1.8%, 0.8%0.5%, 0.3% and 0.3% of students had ear, nose &amp; pharynx disorder, anemia ,skin &amp; hair , cardiac ,abdominal, vertebral and lung problems, respectively. In elementary schools;57.6% of first-grade- students with at least one disorder were managed in outpatient settings and 6% of them were hospitalized for more investigation. Among third- grade- students of elementary schools, these values corresponded to 13.2% and 1.1%, respectively. Among first grade students of middle and high schools, this prevalence was 58.5% and 44.6% and 1.2% and 0.3% of students were hospitalized for more investigation.Conclusion: This integrated school screening program revealed a considerably high prevalence of health disorders among school students. These results might help health policy makers to design future health promoting programs

Is there any association between urinary metabolites of polycyclic aromatic hydrocarbons and thyroid hormone levels in children and adolescents?

Considering the possible effects of polycyclic aromatic hydrocarbons (PAHs) on thyroid function, the current study aims to investigate the association of PAH urinary metabolites with the level of thyroid hormones in a sample of Iranian children and adolescents. This cross-sectional study was conducted from September 2015 to July 2016 in Isfahan, Iran. Participants were 150 students, aged 6-18 years, who were selected by multistage cluster random sampling from schools of Isfahan province. Blood and urine samples of participants were obtained for measurement of thyroid hormone levels (measured by immunoradiometric assay) and PAH urinary metabolites, including 1-hydroxynaphthalene, 2-hydroxynaphthalene, 9-hydroxyphenanthrene, and 1-hydroxypyrene. The association of serum thyroid-stimulating hormone (TSH) and PAH urinary metabolites was determined by correlation and regression analyses. Multivariate regression analysis revealed significant association between serum TSH and PAH urinary metabolites; this association remained significant after adjustment for gender and age. The corresponding figures were r = 0.85 for 1-naphthol, r = 0.86 for 2-naphthol, r = 0.87 for 1-hydroxypyrene, and r = 0.42 for 9-phenantrol, respectively, all p values < 0.001. The mean levels of 1-hydroxypyrene and 9-phenanthrol were higher in boys than those in girls (p < 0.05). The findings of this study indicated significant positive association between urinary PAH biomarkers and the TSH level in children and adolescents. It can be suggested that long-term exposure to PAHs might result in thyroid function impairment. The clinical implication of the current findings should be confirmed by future longitudinal studies