The Association between Dietary Antioxidant Indices and Cardiac Disease: Baseline Data of Kharameh Cohort Study

Abstract Background: Oxidative stress contributes to the development of cardiovascular disease. Tools for evaluating the anti-inflammatory and antioxidative characteristics of an individual’s diet as a whole may be valuable for assessing the combined effects of dietary antioxidants on health. This population-based study aimed to investigate the association between dietary antioxidants and cardiac disease. Methods: In this population-based cross-sectional study, 10439 individuals aged 40-70 years were recruited during 2014-2017 in Kherameh cohort study which is a part of the Prospective Epidemiological Research Studies in Iran (PERSIAN). The food frequency questionnaire (FFQ) with 130 food items was used to assess the dietary intakes. Vitamin A, E, C, selenium, zinc and Manganese intakes were used to compute dietary antioxidant index (DAI) and dietary antioxidant quality score (DAQs). Results: The participants’ mean age was 52.1± 8.3 years. Among all, 4356 (41.7%) were overweight and 1892 (18.1%) were obese. According to the results, odds of cardiac diseases decreased by increasing DAI score (OR=0.80, Pvalue <0.001). , Odds of cardiac diseases increased by lower DAQS after  adjusting for demographic variables including age, sex, BMI, Marital status and hypertension (OR=0.799, P value=0.002) Conclusion: The role of anti-oxidants in reducing the odds of cardiovascular disease is very important. Our results highlighted that DAQS and DAI had protective effect on the odds of cardiovascular disease. Therefore, it is suggested that anti-oxidants as zinc, manganese, selenium, and vitamins A, E and C should be taken through food to reduce the risk of the disease

Risk of dry eye disease with aromatase inhibitors among women with breast cancer : a retrospective cohort study

Background: Estrogen-positive breast cancer (BC) makes up to 75% of all BC patients. With aromatase inhibitors (AIs) and tamoxifen considered mainstay therapies, several small cross-sectional studies have found an association between AI use and ocular adverse events, including dry eye disease (DED), but data on a head-to-head comparison between AIs and tamoxifen are scant. In this study we aim to quantify DED risk in women with BC taking AIs, compared to tamoxifen users. Methods: The IQVIA health claims database was the main data source. This database captures medical diagnoses, procedures, prescriptions, and demographic data on approximately 200 million United States residents. Using a retrospective, new-user, cohort design we identified all users of AIs or tamoxifen, from 2006 to 2020. Cohort members were followed to the first mutually exclusive outcome of DED defined by the first ICD 9th or 10th edition code or the use of a drug that is exclusively used to treat DED. Cox regression was used to estimate hazard ratios (HR), adjusting for confounders and risk factors. Subsequent analyses were conducted to test robustness of findings. Results: Our study included 6,177 and 4,239 patients taking AIs and tamoxifen, respectively. AI users had a mean age of 61.5 (± 16.8 years), whereas tamoxifen users had a mean age of 54.6 (± 12.6 years). The mean follow-up time was 17.5 months. The crude HR for DED with AI use was 1.41(95%CI: 1.07-1.86), compared to tamoxifen use. The adjusted HR for DED was 1.23(95%CI: 0.92-1.64). We found a positive duration response with AI use compared to tamoxifen use, with an adjusted HR for exposure of less than 6 months, 6-18 months, more than 18 months of, 1.34(0.91-1.97), 1.68(1.01-2.78), 1.77(0.82-3.83), respectively. Lastly, for participants older than 55, the HR was 1.07(95% CI:0.74-1.54), while for participants 55 or younger, the HR was 1.43(95% CI:0.88-2.31). Conclusion: Our study demonstrated an increased risk of DED among AI users compared to tamoxifen, although the estimates were mostly not precise. Given that most women with BC are either on AIs or tamoxifen, these findings need to be used for a more personalized risk-benefit assessment for each patient.Medicine, Faculty ofMedicine, Department ofGraduat

Epidemiology and predictors of multimorbidity in Kharameh cohort study: A population‐based cross‐sectional study in southern Iran

Abstract Background and Aim Multimorbidity is one of the problems and concerns of public health. The aim of this study was to estimate the prevalence and identify the risk factors associated with multimorbidity based on the data of the Kherameh cohort study. Methods This cross‐sectional study was performed on 10,663 individuals aged 40–70 years in the south of Iran in 2015 to 2017. Demographic and behavioral characteristics were investigated. Multimorbidity was defined as the coexistence of two or more of two chronic diseases in a person. In this study, the prevalence of multimorbidity was calculated. Logistic regression was used to identify the predictors of multimorbidity. Results The prevalence of multimorbidity was 24.4%. The age‐standardized prevalence rate was 18.01% in males and 29.6% in females. The most common underlying diseases were gastroesophageal reflux disease with hypertension (33.5%). Multiple logistic regression results showed that the age of 45–55 years (adjusted odds ratio [ORadj]] = 1.22, 95% confidence interval [CI], 1.07–1.38), age of over 55 years (ORadj = 1.21, 95% CI, 1.06–1.37), obesity (ORadj = 3.65, 95% CI, 2.55–5.24), and overweight (ORadj = 2.92, 95% CI, 2.05–4.14) were the risk factors of multimorbidity. Also, subjects with high socioeconomic status (ORadj = 1.27, 95% CI, 1.1–1.45) and very high level of socioeconomic status (ORadj = 1.53, 95% CI, 1.31–1.79) had a higher chance of having multimorbidity. The high level of education, alcohol consumption, having job, and high physical activity had a protective role against it. Conclusion The prevalence of multimorbidity was relatively high in the study area. According to the results of our study, age, obesity, and overweight had an important effect on multimorbidity. Therefore, determining interventional strategies for weight loss and control and treatment of chronic diseases, especially in the elderly, is very useful

The prevalence and predictors of cardiovascular diseases in Kherameh cohort study: a population-based study on 10,663 people in southern Iran

Background The prevalence of cardiovascular disease (CVD) is rapidly increasing in the world. The present study aimed to assess the prevalence and Predictors factors of CVD based on the data of Kherameh cohort study. Methods The present cross-sectional, analytical study was done based on the data of Kherameh cohort study, as a branch of the Prospective Epidemiological Studies in Iran (PERSIAN). The participants consisted of 10,663 people aged 40–70 years. CVD was defined as suffering from ischemic heart diseases including heart failure, angina, and myocardial infarction. Logistic regression was used to model and predict the factors related to CVD. Additionally, the age-standardized prevalence rate (ASPR) of CVD was determined using the standard Asian population. Results The ASPR of CVD was 10.39% in males (95% CI 10.2–10.6%) and 10.21% in females (95% CI 9.9–10.4%). The prevalence of CVD was higher among the individuals with high blood pressure (58.3%, p < 0.001) as well as among those who smoked (28.3%, p = 0.018), used opium (18.2%, p = 0.039), had high triglyceride levels (31.6%, p = 0.011), were overweight and obese (66.2%, p < 0.001), were unmarried (83.9%, p < 0.001), were illiterate (64.2%, p < 0.001), were unemployed (60.9%, p < 0.001), and suffered from diabetes mellitus (28.1%, p < 0.001). The results of multivariable logistic regression analysis showed that the odds of having CVD was 2.25 times higher among the individuals aged 50–60 years compared to those aged 40–50 years, 1.66 folds higher in opium users than in non-opium users, 1.37 times higher in smokers compared to non-smokers, 2.03 folds higher in regular users of sleeping pills than in non-consumers, and 4.02 times higher in hypertensive individuals than in normotensive ones. Conclusion The prevalence of CVD was found to be relatively higher in Kherameh (southern Iran) compared to other places. Moreover, old age, obesity, taking sleeping pills, hypertension, drug use, and chronic obstructive pulmonary disease had the highest odds ratios of CVD.Medicine, Faculty ofNon UBCExperimental Medicine, Division ofMedicine, Department ofReviewedFacultyResearche

Kharameh cohort study (KHCS) on non-communicable diseases and preliminary findings of 3-year follow-up

Purpose The Kharameh cohort study (KHCS) is one branch of the ‘Prospective Epidemiological Research Studies in Iran’, located in the south of Iran. The enrolment phase of KHCS spanned from April 2015 to March 2017, during which urban and rural residents of Kharameh were enrolled in the study. KHCS aims to investigate the incidence of non-communicable diseases (NCDs) such as hypertension, diabetes mellitus, cardiovascular diseases and cancer, and its related risk factors in a 15-year follow-up.Participants KHCS was designed to recruit 10 000 individuals aged 40–70 years old from both urban and rural areas of Kharameh. Thus, a total of 10 800 individuals aged 40–70 years of age were invited and, finally, 10 663 subjects were accepted to participate, with a participation rate of 98.7%.Findings to date Of the 10 663 participants, 5944 (55.7%) were women, and 6801 (63.7%) were rural residents. The mean age of the participants was 51.9±8.2 years. 41.8% of the participants were aged 40–49, 35.2% were aged 50–59 and the remaining 23% were 60–70 years old. Until March 2020 (first 3 years of follow-up), the total number of patients diagnosed with NCDs was 1565. Hypertension, type 2 diabetes and acute ischaemic heart disease were the most common NCDs. Furthermore, the total number of deaths during the first 3 years of follow-up was 312, with cardiovascular diseases (38.7%) as the most common cause of death, followed by cerebrovascular diseases (11.8%) and cancer (16.2%).Future plans The remaining 12 years of follow-up will inevitably shed light on the genetic, lifestyle/socioeconomic status, and environmental risk and protective factors of NCDs