Vitamin D insufficiency and its association with adipokines and atherogenic indices in patients with metabolic syndrome: A case-control study

IntroductionVitamin D deficiency is one of the most common nutritional disorders in most countries of the world. The present study was designed and implemented with the aim of investigating the relationship between vitamin D deficiency and the level of adipokines, atherogenesis indicators and factors related to metabolic syndrome.MethodsThis case-control study was done on 195 patients with metabolic syndrome aged 20-50 y who attended the health centers in Zabol County, northeast Iran, between April 2021 and January 2022. Anthropometric and biochemical parameters were measured for all subjects with standard methods. To determine serum 25(OH)D levels, we used enzymatic linked immunosorbent assay (ELISA) kits. Atherogenic index of plasma (AIP) was calculated as log (TG/HDL-c). The visceral adiposity index (VAI) and the lipid accumulation product (LAP) were estimated according to standard formulas.Results and DiscussionParticipants in the case group had lower serum levels of 25(OH)D compared to controls (19.8 ± 6.2 ng/ml vs. 41.2 ± 9.7ng/ml, P<0.001). We found that the mean serum levels of fasting blood sugar (P=0.023) and TG (P=0.008) as well as HOMA-IR (P=0.023) were significantly higher in the cases compared to controls. Also, patients with MetS and vitamin D insufficiency (cases) had higher AIP (P=0.040) and LAP (P=0.012) than controls. Furthermore, serum 25(OH)D levels showed significant inverse correlations with serum RBP-4 and a positive correlation with serum omentin-1 concentrations. The results of the present study showed that vitamin D deficiency correlated with some of the cardiometabolic risk factors among the patients with MetS

Health-related quality of life and medication adherence in elderly patients with epilepsy

Objective. Considering the high prevalence of epilepsy in the elderly and the importance of maximising their quality of life (QoL), this study aimed to investigate the relationship between medication adherence and QoL, and the mediating effects of medication adherence on the association between serum antiepileptic drug (AED) level and seizure severity with QoL in elderly epileptics. Methods. In a longitudinal study, 766 elderly patients with epilepsy who were prescribed a minimum of one antiepileptic drug were selected by convenience sampling method. A Medication Adherence Report Scale (MARS-5) questionnaire was completed at the baseline. Seizure severity and QoL were assessed after six months using the Liverpool Seizure Severity Scale (LSSS) and the QoL in Epilepsy (QOLIE-31) questionnaires respectively. Serum level of AED was also measured at six-month follow-up. Results. Medication adherence was significantly correlated with both seizure severity (β = –0.33, p < 0.0001) and serum AED level (β = 0.29, p < 0.0001) after adjusting for demographic and clinical characteristics. Neither QoL nor its sub-classes were correlated with seizure severity. In addition, a significant correlation was not observed between serum AED level and QoL. However, medication adherence was significantly correlated with QoL (β = 0.30, p < 0.0001). The mediating effects of medication adherence on the association between serum AED level (Z = 3.39, p < 0.001) and seizure severity (Z = –3.47, p < 0.001) with QoL were supported by the Sobel test. Conclusion. This study demonstrates that medication adherence has a beneficial impact on QoL in elderly epileptics. Therefore, adherence to treatment should be monitored to improve their QoL

Dietary total antioxidant capacity is associated with lower disease severity and inflammatory and oxidative stress biomarkers in patients with knee osteoarthritis

Abstract Background This study was designed to evaluate the association between dietary total antioxidant capacity and clinical and biochemical variables in patients with osteoarthritis. Methods This cross-sectional study was conducted among 160 patients with mild-to-moderate knee osteoarthritis. The Likert version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC Index) was used to assess the severity of clinical symptoms in patients with knee osteoarthritis. The secondary outcomes included inflammatory and oxidative stress biomarkers. The participants' usual diets were assessed using a food frequency questionnaire (FFQ), and the dietary total antioxidant capacity (TAC) was calculated based on the ferric reducing antioxidant power method. Additionally, clinical and biochemical variables were evaluated using standard methods. Results The mean age of the participants was 57.2 ± 8.1 years, and 55.6% of them were females. The dietary TAC scores in this study ranged from 3.67 to 24.72, with a mean of 12.05 ± 5.3. We found a significant inverse trend between the dietary TAC score and the total Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score (P = 0.001), as well as the WOMAC stiffness (P = 0.008) and WOMAC physical function scores (P = 0.001). Furthermore, dietary TAC was inversely associated with serum concentrations of interleukin-6 (IL-6) (β = − 0.18, P = 0.020), tumor necrosis factor-α (TNF-α) (β = − 0.67, P < 0.001), matrix metalloproteinase-1 (MMP-1) (β = − 0.33, P < 0.001), and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) (β = − 0.22, P = 0.005) levels. Conclusion The results of this study demonstrate an inverse association between dietary total antioxidant capacity and clinical and biochemical variables in patients with osteoarthritis

Compliance with antimicrobial therapy: Evaluating the related factors

Background: Uncontrolled and irrational use of antibiotics increases the rate of antimicrobial resistance and treatment failure. Compliance with antibiotics is an important indicator to show how patients use their prescribed drugs and it can explain the relationship between drug administration and treatment outcome that needs to be monitored and promoted. We decided to evaluate compliance to antimicrobial drugs in this study. Methods: In a cross-sectional study, 100 patients referring to 4 different specialists’ offices were enrolled. The rate and type of non prescribed antibiotic administration were evaluated using predesigned questionnaires. The data were analyzed by SPSS 17.0 software using descriptive statistics and chi-square test for categorical data. Results: Our results showed that 62.4% of the study population had poor compliance and 37.6 % had good compliance with their prescribed regimen. “Feeling better “and “getting worse” on prescribed regimen were major reasons for drug discontinuation. About 70% of our study population get non prescribed antibiotic from pharmacies at least once a year. Most of the requested antibiotics were not first line options. Level of education was the only factor significantly related to the rate of patient compliance. Conclusion: This study shows the high rate of non prescribed antibiotic administration and low rate of compliance among the study population that emerge the need for particular patient education and putting restrictive rules to bound  non-prescribed and unsupervised  antibiotic marketing

Association of Food Security with Atherogenic Glucose and Lipid Profile among Women: A Population-Based Cross-Sectional Study in Zabol, Southeast of Iran

Background and Aim: Food insecurity and poor quality of diet are among risk factors of cardiovascular diseases (CVD). The main objective of this study was to assess the association of food insecurity with atherogenic glucose and lipid profile in women. Materials and Methods: In this cross-sectional study, 630 women between 18 and 50 years of age were selected by cluster sampling and interviewed face-to-face. To assess the household’s food security status, we used a household food insecurity access scale (HFIAS) questionnaire, which its validity and reliability had been determined in the Iranian population. The serum levels of glucose (FBS), triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were measured and LDL/HDL, TC/HDL, and TG/HDL ratios were calculated. Results: The mean serum concentrations of TG and TG/HDL ratio were significantly higher in the women suffering from moderate and severe food insecurity compared to those in the food-secure women (p=0.002). Compared with the food secure group, women with moderate and severe food security were more likely to develop hypertriglyceridemia (adjusted OR, 1.63; p=0.018) and a high TG/HDL ratio (adjusted OR, 1.52; p=0.030). However, food security status showed no significant associations with the probability of having the impaired fasting glucose, hypercholesterolemia, high LDL, low HDL, and abnormal ratios of LDL/HDL and TC/HDL. Conclusion: Food insecurity may be associated with increased risk of hypertriglyceridemia and high TG/HDL in women

Sex differences in MDMA-induced toxicity in Sprague-Dawley rats

Recent evidence demonstrates that female subjects show exaggerated responses to 3,4-methylenedioxymethamphetamine (MDMA) compared with males. The aim of our study was to evaluate sex differences and the role of endogenous gonadal hormones on the effects of MDMA. Fifty-six intact and gonadectomized male and female Sprague-Dawley rats were randomly assigned to either MDMA (5 mg/kg) or saline treatment. Learning and memory were assessed using the Morris water maze (MWM). The expression of Bax and Bcl-2 in the hippocampus was detected by Western blotting. Behavioral analysis showed that MDMA led to memory impairment in both male and female rats. The female rats showed more sensitivity to impairment than the males, as assessed using all the memory parameters in the MWM. Ovariectomy attenuated the MDMA-induced memory impairment. By contrast, orchiectomized rats showed more impairment than MDMA-treated intact male rats. Bcl-2 and Bax were down-regulated and up-regulated in MDMA-treated male and female rats, respectively. MDMA treatment in the orchiectomized rats led to up-regulation of Bax and down-regulation of Bcl-2. Ovariectomy attenuated the MDMA-induced up-regulation of Bax and caused more expression of Bcl-2 compared with what was observed in the MDMA-treated intact female rats. In summary, female rats showed exaggerated responses to the effects of MDMA and this may be explained by endogenous gonadal hormones

Kumaraswamy regression modeling for Bounded Outcome Scores

In this paper, we use a regression model for modeling bounded outcome scores (BOS), where the outcome is Kumaraswamy distributed. Similar to the Beta distribution, this distribution can take a variety of shapes while being computationally easier to use. Thus, it is deemed as a suitable alternative distribution to the Beta in modeling bounded random processes. In the proposed model, the median of a bounded response is modeled by the linear predictors which is defined through regression parameters and explanatory variables. We obtained the maximum likelihood estimates (MLE) of the parameters, provided closed-form expressions for the score functions and Fisher information matrix, and presented some diagnostic measures. We conducted Monte Carlo simulations to investigate the finite-sample performance of the MLEs of the parameters. Finally, two practical applications of this model to the real data sets are presented and discussed

Assessing the clinical and biochemical efficacy of alpha-lipoic acid in patients with non-alcoholic fatty liver disease: A randomized placebo-controlled clinical trial

Given the importance of inflammatory and metabolic markers in the pathophysiology of non-alcoholic fatty liver disease (NAFLD), this study was designed to evaluate the effects of alpha-lipoic acid (ALA) supplementation on inflammatory and serum levels of fetuin-A, sirtuin1 (SIRT-1), cytokeratin 18 (CK-18), and hepatic steatosis in patients with NAFLD. In a double-blind, placebo-controlled, randomized clinical trial, 50 patients with NAFLD were randomized to receive daily supplementation with either two capsules of ALA (each capsule containing 600 mg ALA plus 400 mg/day of vitamin E) or two placebo capsules (two placebo capsules plus 400 mg/day of vitamin E) for 12 weeks. Significant reductions in homeostasis model assessment for insulin resistance (HOMA-IR) score and serum levels of insulin and fetuin-A were observed in the ALA group compared to the placebo group (all P < 0.05). ALA supplementation was significantly more effective than placebo in reducing hepatic steatosis by at least one grade