Iranian Adults Research Articles

Breast cancer screening patterns and associated factors in Iranian women over 40 years

Screening is a key component of breast cancer early detection programs that canconsiderably reduce relevant mortality rates. The purpose of this study was to determinethe breast cancer screening behavioral patterns and associated factors in women over40 years of age. In this descriptive‑analytical cross‑sectional study, 372 over 40 years of agewomen visiting health centers in Tabriz, Iran, in 2023 were enrolled using cluster sampling.The data were collected using the sociodemographic characteristics questionnaire, breastcancer perception scale, health literacy for Iranian adults scale, and the Breast CancerScreening Behavior Checklist. The obtained data were analyzed in SPSS version 16 usingdescriptive statistics (frequency, percentage, mean, and standard deviation) and inferentialstatistics (univariate and multivariate logistic regression analyses). In total, 68.3% of allparticipants performed breast self‑examination (BSE) (9.9% regularly, once per month),60.2% underwent clinical breast examination (CBE) (8.9% regularly, twice per year),51.3% underwent mammography (12.3% regularly, once per year), and 36.2% underwentsonography (3.8% regularly, twice per year). The findings also showed that women withbenign breast diseases were more likely to undergo CBE (OR = 8.49; 95% CI 2.55 to 28.21;P < 0.001), mammography (OR = 8.84; 95% CI 2.98 to 10; P < 0.001), and sonography(OR = 18.84; 95% CI 6.40 to 53.33; P < 0.001) than others. Participants with low and moderatebreast cancer perception scores were more likely to perform BSE than women with highbreast cancer perception scores (OR = 2.20; 95% CI 1.21 to 4.00; P = 0.009) and women whohad a history of benign breast disease were more likely to perform screening behaviors thanothers (OR = 2.47; 95% CI 1.27 to 4.80; P = 0.008). Women between the ages of 50 and 59 weremore likely to undergo mammography (OR = 2.33; 95% CI 1.29 to 4.77; P = 0.008) and CBE(OR = 2.40; 95% CI 1.347 to 4.20; P = 0.003) than those ≥ 60 years. Given the low participationof women in regular breast cancer screening, it is suggested that health care providershighlight the need for screening at the specified intervals in their training programs. Inaddition, health authorities are recommended to use reminder systems to remind women,especially those over 40 years of age, of the best time for breast screening. Moreover, healthcare providers must seek to improve breast cancer knowledge, attitudes, and perceptionsof women who visit health centers, which are the first level of contact with the healthcaresystem for the general population.

The prevalence of the risk factors associated with cardiovascular diseases among Iranian adults: Findings of a cross-sectional study.

Cardiovascular diseases are among the leading causes of death worldwide. Lack of accurate estimation of the risk factors associated with these diseases can impair the designing of effective interventions in this field; the present study aimed to investigate the risk factors attributable to cardiovascular diseases in males and females visiting comprehensive health service centers in 2018. This cross-sectional study is part of the national health transformation plan shaped in response to the emerging epidemic of noncommunicable diseases. In the present study, 6,331 participants aged 30 years and older were randomly and census selected from comprehensive urban and rural health service centers in Naein County, in Isfahan, Iran, respectively. The data were collected using the electronic health record from the IraPEN program in two sections: demographic information and the prevalence of cardiovascular disease risk factors. They were then analyzed with Statistical Package for the Social Sciences (SPSS) 24 software using descriptive statistics, Chi-square test, one-way ANOVA, and logistic regression. The participants' mean age was 55.09 ± 16.11 years. The main risk factor was insufficient consumption of fruits and vegetables while smoking was a negligible risk factor. Low physical activity, diabetes, hypertension, hypercholesterolemia, and high body mass index were more prevalent in females than in males, whereas smoking was more frequently reported in males (P < 0.001). Risk factors such as age, gender, education level, place of residence, and marital status, played a significant role in determining CVD risk factors. More than half of Iranian adults had one or older cardiovascular disease-related risk factors, and the prevalence of such factors was higher in females than in males. Given the importance of gender differences in cardiovascular disease-related health habits, it is necessary to reduce the majority of these diseases in society, especially in women, by controlling modifiable risk factors.

Prevalence, awareness, treatment, and control of hypertension in community-dwelling older adults with chronic kidney disease: the Irish longitudinal study on ageing.

Hypertension is highly prevalent in chronic kidney disease (CKD), posing a significant but modifiable risk for adverse clinical outcomes. This study explored the prevalence, awareness, treatment, and control of hypertension in older Irish adults with CKD. Data were analysed from participants in Wave 1 of The Irish Longitudinal Study on Ageing (TILDA) who were aged 50 years and older. CKD was defined as eGFR <60ml/min/1.72 m2, hypertension defined as systolic blood pressure (SBP) ≥140mmHg and/or diastolic blood pressure (DBP) ≥90mmHg and/or self-reported use of antihypertensive medication. Participant awareness and treatment of hypertension was based on self-report and SBP/DBP <140/90mmHg. Multivariable logistic regression examined relationships with awareness, treatment, and control of hypertension expressed as adjusted odds ratios. Prevalence of hypertension was significantly higher in participants with CKD than without (81.9%vs 59.7%, P<.001). Among hypertensive individuals, 70.1% (95% CI: 65.8-74.1) were aware, 83.5% (95% CI 80.0-86.6) were on treatment, yet blood pressure control <140/90mmHg and SBP <120mmHg were achieved in only 49.3% (CI 44.0-54.7%) and 17.9% (CI 14.4-22.1), respectively. In multivariable analysis, advancing age 1.05 (CI 1.01-1.10), obesity 6.23 (CI 2.51-15.5), diabetes 5.78 (CI 1.55-21.5), and cardiovascular disease 9.89 (CI 3.27-29.9) were associated with higher odds of treatment, while cardiovascular disease 2.35 (CI 1.39-3.99) and combination antihypertensive therapy 1.76 (CI 1.03-3.01) were associated with blood pressure control. The prevalence of hypertension is substantial in older Irish adults with CKD; however, control is poor. Approximately, one-third of participants were unaware of their hypertensive status and approximately one-fifth were untreated.

Distribution and prevalence of refractive error in Iranian adult population results of the PERSIAN eye cohort study PECS

The Persian Eye Cohort Study, a population-based cross-sectional study from 2015 to 2020, examined refractive error prevalence among 48,618 Iranian adults aged 31 to 70. The study encompassed six centers in Iran, employing random cluster sampling for demographic, medical, and socioeconomic data collection through interviews. Ophthalmic exams included visual acuity, automated and manual objective refraction, subjective refraction, slit lamp, and fundus examinations. Using the spherical equivalent definition, the sample population was categorized into groups. Results indicated a mean age of 49.52 ± 9.31 and a mean refractive error of 0.26 diopters (D) ± 1.6 SD (95% CI − 0.27 to -0.24), ranging from -26.1 to + 18.5 SD. Prevalence of myopia (< −0.5D) and hyperopia (> + 0.5D) was 22.6% (95% CI 22.2–23%) and 12.5% (95% CI 12.1–12.8%), respectively. Regarding different age groups, the prevalence of hyperopia and astigmatism exhibited a steady and significant rise with increasing age (p-value < 0.001 for both). The prevalence of Myopia, however, showed a distinctive pattern, initially increasing in adults under 45, declining in those aged 55–64, and rising again among individuals aged 60 and older. Female gender, older age, urban residency, higher education, higher income, and Fars ethnicity were significantly related to a higher prevalence of myopia (p-value < 0.001 for all). Female gender (p-value < 0.001), aging (p-value < 0.001), urban residency (p-value = 0.029), and lower-income (p-value = 0.005) were significantly related to higher prevalence of hyperopia. Astigmatism (> 1D) was prevalent in 25.5% of participants (95% CI 25.1–25.9%) and correlated with male gender, aging, urban residency, illiteracy, and higher income (p-value < 0.001, < 0.001, < 0.001, < 0.001, 0.014, respectively). The study’s comparison with regional and international surveys highlighted the increase in myopia among those over 65 due to higher nuclear cataract rates in older adults. Myopia positively related to education, income, and urban residency, while hyperopia did not exhibit such associations.

The Relationship between Pesticide Exposure and Liver and Renal Enzyme Disorders in Adults Aged 35-70: The Results of the First Phase of the Shahedieh Cohort Study

Introduction: Liver and kidney are known as important organs in detoxification of the body and may be exposed to pesticide damage. This study aims to investigate the relationship between pesticide exposure and disorders of liver and renal enzymes. Material and methods: This cross-sectional study was conducted on 5637 Iranian adults aged 35-70 from the first phase of Shahedieh Cohort Study. The investigated variables included age, sex, BMI, smoking, liver enzymes (SGPT, SGOT, ALP, GGT), renal enzymes (Urea, Creatinine), and the information related to exposure to pesticides in the yard, home, and agricultural land during the last 12 months. Data were analyzed using SPSS software version 24. Results: The findings showed that 8% of the people were exposed to pesticides/ insecticides on agricultural land, 2% in yard, and 59.6% at home. The mean of liver and renal enzymes in people exposed to pesticides in agricultural land was higher than in non-exposed individuals. This relationship was significant for all the enzymes except GGT. People exposed to pesticides in the yard had significantly higher levels of renal enzymes than non-exposed individuals. People exposed to pesticides at home had significantly higher levels of liver enzymes and renal enzymes than the non-exposed ones. Moreover, the mean of liver and renal enzymes were lower in people who used personal protective equipment. Conclusion: This study suggests that exposure to pesticides may impact liver and kidney functions, and taking precautions like using personal protective equipment can help minimize potential health risks.

Prevalence of cognitive frailty and its associated factors in a population of Iranian older adults

BackgroundIn recent years cognitive frailty has emerged as an important predictor of adverse health outcomes in older adults. Herein, we aimed to investigate the prevalence and associated factors of cognitive frailty in a population of community-dwelling older adults in Iran.MethodThis cross-sectional study was conducted as part of the second cycle of the Amirkola Health and Aging Project (AHAP). Physical frailty and cognitive impairment were evaluated using the FRAIL questionnaire and the mini-mental state examination (MMSE) respectively. Cognitive frailty was defined as co-existence of frailty and cognitive impairment without presence of dementia. Depression and disability were assessed using the Persian version of geriatric depression scale (GDS) and instrumental activities of daily living (IADL) questionnaire.ResultsOverall 1775 individuals (47.1% female) with mean age of 69.7 ± 7.3 years were included in the final analysis. The prevalence of cognitive frailty was 12.0%. The prevalence of cognitive frailty among males and females was 4.3% and 20.7%, respectively. After adjusting for all possible confounders through binary logistic regression analysis, factors such as older age (OR 1.06, CI 1.03–1.09), female gender (OR 2.25, CI 1.42–3.57), illiteracy (OR 3.84, CI 2.03–8.29), more comorbidities (OR 1.21, CI 1.12–1.31), depression (OR 2.01, CI 1.40–2.86), and greater IADL disability (OR 1.68, CI 1.44–3.96), were independently and significantly associated with cognitive frailty.ConclusionIn this population of Iranian older adults, prevalence of cognitive frailty was consistent with its estimated mean global prevalence. Age, gender, illiteracy, comorbidities, depression and IADL disability were associated with cognitive frailty. Further research is required to develop screening tools and prevention strategies.

The association of dietary indices for hyperinsulinemia and insulin resistance with the risk of metabolic syndrome: a population-based cross-sectional study.

We aimed to investigate the association between an empirical dietary index for hyperinsulinemia (EDIH), empirical dietary index for insulin resistance (EDIR), and MetS and its components in an adult Iranian population. In this cross-sectional study, a total of 6482 participants aged 35-65 years were recruited as part of the MASHAD cohort study. Dietary intakes were assessed using a validated food frequency questionnaire (FFQ). The International Diabetes Federation (IDF) criteria were used to define MetS. Multivariable logistic regression models were applied to determine the association between EDIH, EDIR, and MetS and its components. The mean age and BMI of participants were 48.44±8.20 years, and 27.98±4.73 kg/m2, respectively. Around 59% of the population was female. Of the total population, 35.4% had MetS. According to the full-adjusted model, there was no significant association between higher quartiles of EDIH and EDIR and odds of MetS (Q4 EDIH; OR (95%CI):0.93 (0.74-1.18), Q4 EDIR; OR (95%CI):1.14 (0.92-1.40). Regarding MetS components, EDIR was associated with increased odds of hypertension and diabetes (Q4 EDIR; OR (95%CI):1.22 (1.04-1.44) and 1.22 (1.01-1.47), respectively). EDIH was also associated with decreased odds of hypertriglyceridemia (Q4 EDIH; OR (95%CI): 0.72 (0.60-0.87)). This study showed no significant association between hyperinsulinemia and insulin resistance potential of diet and odds of MetS among Iranian adults. However, EDIR was significantly associated with increased odds of hypertension and diabetes as MetS components.

Association between Alzheimer's disease and Toxocara infection/exposure: a case-control study.

Infections may contribute to Alzheimer's disease (AD) risk. Limited evidence suggests Toxocara spp. infection/exposure could influence AD development. We investigated Toxocara seropositivity and AD in Iranian adults using a matched case-control study. Our sample included 90 AD cases and 91 healthy older adults. Anti-Toxocara immunoglobulin G (IgG) antibodies were assessed via enzyme-linked immunosorbent assay. We computed the odds ratios (ORs) and 95% confidence intervals (CIs) through univariable and multivariable analyses, adjusting for potential confounders. There were 33/90 (36.67% [95% CI 26.75 to 47.48]) anti-Toxocara IgG seropositive individuals identified among the AD cases and 21/91 (23.07% [95% CI 14.89 to 33.09]) among the healthy controls. In univariable analysis, a significant association was identified between anti-Toxocara IgG seropositivity and AD (OR 1.93 [95% CI 1.01 to 3.69], p<0.001). Moreover, the association remained significant (OR 2.18 [95% CI 1.05 to 4.49], p<0.001) in multivariable analysis after adjustment for covariates. There was no association between anti-Toxocara IgG seropositivity and the severity of AD (OR 0.75 [95% CI 0.21 to 2.61], p=0.47). Our findings indicated that Toxocara exposure/infection could be a potential risk factor for development of AD. To better understand a real causality between Toxocara exposure/infection and AD and related dementias, follow-up designed and adequately powered studies are needed.

Factors influencing smoking cessation attempts and success in Iranian male adults: national survey data

BackgroundSmoking cessation is a dynamic process that often involves a series of unsuccessful quit attempts before long-term abstinence is achieved. To implement interventions that lead to long-term abstinence, it will be necessary to understand the determinants of smoking cessation. Therefore, the main objective of the present study was to determine the effect of factors influencing both smoking cessation attempts and successful smoking cessation in the general population of Iran.MethodsThe data of 1293 participants whose information was obtained through a national cross-sectional study entitled “Survey of Risk Factors of Noncommunicable Diseases in 2016” were analyzed. There were three response levels: “quit attempt and successful quit”, “quit attempt and unsuccessful quit”, and “no quit attempt and unsuccessful quit”. A multinomial logistic regression model was used to assess the effect of covariates on response.ResultsThe mean (sd) age of all participants was 47.21 (13.65) years. According to the results, 883 people (68.29%) did not attempt to quit smoking, and of those who attempted to quit smoking, only 64 (15.61%) men were successful. The factors of living in an urban area (OR = 1.71) and past smoking intensity (OR = 1.967) were associated with no quit attempt and unsuccessful quitting. In addition, physician recommendation to quit smoking was a protective factor for no quit attempt and unsuccessful quit (OR = 0.599). Alcohol consumption was also a protective factor against successful quitting for both attempters (OR = 0.351) and nonattempters (OR = 0.359).ConclusionsTobacco control programs should be implemented with a greater focus on heavy smokers and alcohol users. In addition, the role of health professionals in encouraging smokers to quit smoking should not be ignored.

Factor Structure and Reliability of the Persian Version of Body Esteem Scale Among Iranian Adults: Exploratory Graph Analysis Approach.

Background and Purpose: The present study aimed to examine the psychometric properties of the Persian version of the Mendelson and White Body Esteem Scale in Iranian adults. Methods: This cross-sectional study design was used and carried out in 2023. Following the inclusion criteria, 500 adults were gathered from Tehran (Tehran, Iran) with an accessible sampling method. After translation of Body Esteem Scale to Persian language, construct validity (with factor analysis and exploratory graph analysis) and reliability were assessed. Results: The mean age of the participants was 30.66 (standard deviation = 7.40) years. The results of Maximum Likelihood Exploratory Factor Analysis (MLEFA) with Promax with Kaiser normalization rotation extracted three factors accounting for 43.4% of the variance comprising 21 items. Also, after necessary modifications during confirmatory factor analysis, the final model was approved. As for construct reliability, the Cronbach's alpha, Composite Reliability, and Maximal Reliability for all constructs were greater than 0.7, demonstrating good internal consistency and construct reliability. Conclusions: According to results, the Persian version of Body Esteem Scale has a valid structure and acceptable reliability. This scale can be used by health professionals in many ways.

Higher global diet quality score is inversely associated with odds of metabolic syndrome among Iranian adults.

Growing research underscores the significance of diet quality in the development of Metabolic Syndrome (MetS). Our study investigates the correlation between the Global Diet Quality Score (GDQS) and MetS, along with its components, in Iranian adults. This study utilizes data from the Yazd Health Study (YaHS) and includes a final analysis of 2,904 participants aged 20-70 years. Dietary data were gathered using food frequency questionnaires. MetS was defined in line with the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. GDQS was derived by totaling the points across all 25 food groups, with scores ranging from 0 to 49. To examine the association between GDQS and MetS, multivariable logistic regression analyses were conducted in both crude and adjusted models. Participants who had the highest adherence to GDQS had a 20% lower chance of having MetS than those who had the lowest adherence after adjusting for confounding variables in Model II (T3 vs. T1: OR = 0.80; 95% CI: 0.46-0.99, P-trend = 0.045). There was no association between GDQS and MetS components including increased blood pressure, fasting blood glucose (FBG), triglyceride, abdominal obesity and reduced high-density lipoprotein (HDL) in crude and adjusted models. higher adherence to GDQS was inversely related to odds of MetS. Further longitudinal and clinical trials investigations are required to confirm these associations.

Neighborhood Social Cohesion and Psychological Well-Being Among Older Adults: The Mediating Role of Home Attachment, Neighborhood Attachment, and Social Capital

This study aimed to examine the association between neighborhood social cohesion and psychological well-being among older adults in Iran in 2020. A cross-sectional design was employed, with 414 older adults recruited using a clustered sampling technique. The data collection instruments included the WHO-5 Well-Being Index, the Perceived Neighborhood Social Cohesion scale, the Place Attachment Scale for Older Adults, and the Social Capital Assessment Tool. Data were analyzed using Pearson correlation and the PROCESS Macro model 4 in SPSS24. Neighborhood social capital was found to completely mediate the association between neighborhood cohesion and psychological well-being among older adults. These results suggest that policymakers should consider implementing targeted policies to enhance neighborhood cohesion in order to improve the psychological well-being of older adults.

Determinants of medication adherence among elderly with high blood pressure living in deprived areas.

The current study was conducted to determine the impact of health literacy and factors related to adherence to drug treatment, using the model proposed by the World Health Organization, in older adults with hypertension residing in informal settlements in Hamadan. This cross-sectional study was conducted on 405 patients in Hamadan city, located in the western part of Iran. Data were collected using an interviewer-administered questionnaire that included the 5-dimensional model proposed by the World Health Organization, Health Literacy for Iranian Adults, and Morisky Medication Adherence Scale-8. A two-stage sampling procedure was used to select patients from 14 comprehensive health service centers and health bases. The data were analyzed using SPSS v.24. The study found that medication adherence was suboptimal in 63% of the participants. Additionally, 87.5% of patients had inadequate or insufficient health literacy. Factors related to medication adherence included age (odds ratio (OR) = 1.07), annual income (OR = 0.17), duration of hypertension (OR = 7.33), health literacy (OR = 1.03), self-reported health status (P < 0.05), and regular medication use (P < 0.008). The results of this study indicate that more than half of the older adults in the study had suboptimal medication adherence and insufficient health literacy. The study also found that various factors, such as socioeconomic status, disease and treatment-related factors, and patient-related factors, influence medication adherence among older adults.

Investigating the relationship between health literacy and preconceptual care components during the first 14 weeks of pregnancy: a cross-sectional study

Background and AimPreconceptual care aiming to improve health is influenced by various factors including health literacy. Considering the importance and necessity of high quality preconceptual care, this study aimed to determine the relationship between health literacy and receiving components of preconceptual care prior to pregnancy.MethodsThis cross-sectional study included 693 participants with pregnancies of less than 14 weeks gestation referred to health centers and gynecologists in Shiraz city, Iran. Multi-stage sampling was done from May 2021 to February 2022 in 18 comprehensive urban health centers and 20 gynecology offices via proportional allocation method. The data collection tool comprised a questionnaire consisting of 3 parts: (1) individual and fertility characteristics, (2) information related to the components of preconceptual care and (3) health literacy for Iranian adults. This was completed by individual participants via the self-reporting method.ResultsThe majority of participants were between 30 and 34 years old. They also identified as women with a university education and were predominantly unemployed. The mean health literacy of participants was 76.81%. Health literacy obtained the highest mean score in the dimension of ‘understanding’ and the lowest mean score in the dimension of ‘access’. The frequency of preconceptual counseling, folic acid supplement consumption, exercise, blood testing, dental visits, genetic counseling, Pap smear testing and rubella, diphtheria, and hepatitis vaccinations prior to pregnancy was 66.8%, 53.8%, 45.6%, 71.86%, 44.44%, 12%, 53.4%, 10.83%, respectively. Many (> 64%) received preconceptual care at specialist gynecology offices. Results demonstrated that health literacy had a statistically significant relationship with preconceptual care, folic acid consumption, exercise and dental care, (p < 0.001), along with blood testing and Pap smear testing (p < 0.05).ConclusionOverall, our results demonstrate that despite health literacy being optimal, uptakes of some components of preconceptual care are low. As such, it will be important to further raise awareness of the importance of preconceptual care for people prior to pregnancy as a priority in health promotion and education.

Assessment of the appropriate cutoff points for anthropometric indices and their relationship with cardio-metabolic indices to predict the risk of metabolic associated fatty liver disease

BackgroundResearch on Metabolic Associated Fatty Liver Disease (MAFLD) is still in its early stages, with few studies available to identify and predict effective indicators of this disease. On the other hand, early diagnosis and intervention are crucial to reduce the burden of MAFLD. Therefore, the aim of this research was to investigate the effectiveness of eleven anthropometric indices and their appropriate cut-off values as a non-invasive method to predict and diagnose MAFLD in the Iranian population.MethodsIn this cross-sectional study, we analyzed baseline data from the Hoveyzeh Cohort Study, a prospective population-based study conducted in Iran that enrolled a total of 7836 subjects aged 35 to 70 years from May 2016 through August 2018.ResultsThe optimal cut-off values of anthropometric indices for predicting MAFLD risk were determined for waist circumference(WC) (102.25 cm for males and 101.45 cm for females), body mass index (BMI) (27.80 kg/m2 for males and 28.75 kg/m2 for females), waist-to-hip ratio (WHR) (0.96 for both males and females), waist-to-height ratio (WHtR) (0.56 for males and 0.63 for females), body adiposity index (BAI) (23.24 for males and 32.97 for females), visceral adiposity index (VAI) (1.64 for males and 1.88 for females), weight-adjusted waist index (WWI) (10.63 for males and 11.71 for females), conicity index (CI) (1.29 for males and 1.36 for females), body roundness index (BRI) (4.52 for males and 6.45 for females), relative fat mass (RFM) (28.18 for males and 44.91 for females) and abdominal volume index (AVI) (18.85 for males and for 21.37 females). VAI in males (sensitivity: 77%, specificity: 60%, Youden’s Index: 0.37) and RFM in females (sensitivity: 76%, specificity: 59%, Youden’s Index: 0.35) were found to have higher sensitivity and specificity compared to other anthropometric indices. Furthermore, anthropometric indices demonstrated statistically significant correlations with various hepatic and cardiometabolic indices. Among these, the strongest positive correlations were observed between WC, BMI, BAI, BRI, and AVI with the Hepatic Steatosis Index (HSI), TyG-BMI, and TyG-WC, as well as between VAI and the Atherogenic Index of Plasma (AIP), Lipid Accumulation Product (LAP), Cardiometabolic Index (CMI), and the Triglyceride and Glucose (TyG) Index.ConclusionAnthropometric indices are effective in predicting MAFLD risk among Iranian adults, with WWI, VAI, and RFM identified as the strongest predictors. The proposed cutoff values could serve as a straightforward and non-invasive methods for the early diagnosis of MAFLD.

P329 Assessment of diet quality in Irish adults with cystic fibrosis using validated diet quality index tools: Healthy Eating Index 2020 (HEI-2020) & Diet Quality Index – International (DQI-I)

P329 Assessment of diet quality in Irish adults with cystic fibrosis using validated diet quality index tools: Healthy Eating Index 2020 (HEI-2020) & Diet Quality Index – International (DQI-I)

Characterising dietary protein intake in Irish adults on the island of Ireland

Shifting dietary protein intakes from animal to plant-based sources is suggested as a path to sustain the world’s food consumption and maintain planetary resources (1). However, to facilitate change, it is important to characterise baseline dietary protein patterns. This study aimed to examine dietary protein intakes on the island of Ireland in order to determine population characteristics and food sources influencing protein intake.Analyses were performed on the Northern Ireland sub cohort of the UK National Dietary Nutrition Survey (NDNS 2016-2019) (2) and the Irish National Adult Nutrition Survey (2008-2010) (3). Both surveys used a four-day food diary and a final sample of 1484 adults, aged 18-64 years was extracted (NANS; n =1274 and NI NDNS; n=210). Mean daily intakes for protein (MDI; % total energy, TE) for the total population were calculated and the population was divided into three tertile groups based on low, medium and high protein intake (%TE). Differences in population characteristics, energy MDI, key nutrients (%TE or per 10MJ) and contributing food sources were examined across these tertiles, using chi-square and one-way ANOVA with covariates (age and BMI) and correcting for multiple comparisons as appropriate (P&lt;0.005).Overall, 17.1% of TE was obtained from protein and 77% of participants met their protein DRV based on EFSA recommendations of 0.83g/kg/body weight (4). The difference in protein intakes between the highest and lowest tertiles was 7.8% TE (21.2 % TE vs 13.4% TE) with high protein consumers reporting lower energy intakes (1734 ± 564kcal) compared to low consumers (2185 ± 661 kcal). High protein consumers were older (42.5 ± 12.8 years) and had a higher BMI (27.7 ± 6.0 kg/m2). They also had higher MDI of dietary fibre, calcium, zinc, sodium, iron, folate and vitamins A, C, D and B12 (per 10MJ) (p&lt;0.001) and lower MDI of carbohydrates, fat, saturated fat (%TE) in comparison to low consumers (p&lt;0.001). The % contribution of ‘chicken, turkey and dishes’ (18.3%), ‘beef, veal and dishes’ (12.8%) and ‘fish and fish products (7.0%) to protein intakes were significantly higher in the high versus the low consumption group (10%, 7.4%, 4.4% TE respectively; P&lt;0.001). In contrast, those in the lowest protein intake group had a significantly higher intakes of protein coming from dietary sources including ‘burgers, sausages and meat products (9.9 vs 5.9%), ‘white bread and rolls’ (6.9 vs 3.9%), ‘potatoes (including chips)’ (4.1 vs 2.9 %) and ‘cakes, pastries, buns and fruit pies’ (1.7 vs 0.8%) compared to high consumers.In general, animal protein sources contributed more to total daily protein intakes than plant sources, however, the pattern of protein foods differed according to level of protein intake. These findings will aid in the development of strategies to diversify protein intakes on the Island of Ireland.

Mediating Role of Resilience in the Relationship Between Religiosity and Psychological Well-being in Iranian older adults

Mediating Role of Resilience in the Relationship Between Religiosity and Psychological Well-being in Iranian older adults

Evaluation of elevated serum liver enzymes and metabolic syndrome in the PERSIAN Guilan cohort study population

ObjectiveThe purpose of this study is to evaluate the association between elevated serum liver enzymes and Metabolic Syndrome (MetS) in Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan Cohort Study (PGCS) population. MethodsThis cross-sectional study involved 10,519 individuals between the ages of 35 and 70 enrolled in the PGCS. The gathered data encompassed demographic information, anthropometric measurements, blood pressure, and biochemical indicators. MetS was defined by the National Cholesterol Education Program–Adult Treatment Panel III criteria (NCEP-ATP III). The associations between elevated liver enzymes and MetS were examined using logistic regression analysis. Odds ratio (OR) and 95 % confidence interval (CI) were calculated. ResultsThe prevalence of MetS was 41.8 %, and the prevalence of elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP) were 19.4, 4.6, 11.6, and 5.1 %, respectively. In the unadjusted model, elevated ALT, AST, and GGT were associated with increased odds of MetS (OR = 1.55, 95 % CI: 1.41–1.71; OR = 1.29, 95 % CI: 1.07–1.55, and OR = 1.90, 95 % CI: 1.69–2.14, respectively). These associations remained significant for ALT and GGT after adjustment for some demographic and clinical characteristics (aOR = 1.31, 95 % CI: 1.17–1.46 and aOR = 1.30, 95 % CI: 1.14–1.49, respectively). In addition, the odds of MetS increased with the number of elevated liver enzymes, up to almost 1.32-fold among subjects with three/four elevated liver enzymes. ConclusionThe higher incidence of elevated liver enzymes was associated with an increased likelihood of MetS. Including liver markers in diagnosing and predicting MetS holds promise and is considered a possible approach.

Cost‐Effectiveness and Budget Impact Analysis of Apixaban and Rivaroxaban Versus Warfarin in the Prevention of Stroke in Patients With Non‐Valvular Atrial Fibrillation (NVAF) in Iran

ABSTRACTIntroductionThis study evaluates the cost‐effectiveness of Apixaban and Rivaroxaban, compared to Warfarin, for stroke prevention in patients with non‐valvular atrial fibrillation in Iran.MethodA Markov model with a 30‐year time horizon was employed to simulate and assess different treatment strategies' cost‐effectiveness. The study population comprised Iranian adults with NVAF, identified through specialist consultations, hospital visits, and archival record reviews. Direct medical costs, direct nonmedical, and indirect costs were included. Quality‐adjusted life years (QALY) were assessed using an EQ‐5D questionnaire. This study utilized a cost‐effectiveness threshold of $11 134 per QALY.ResultsApixaban demonstrated superior cost‐effectiveness compared to Rivaroxaban and Warfarin. Over 30 years, total costs were lower in the Apixaban and Rivaroxaban groups compared to the Warfarin group ($126.18 and $109.99 vs. $150.49). However, Apixaban showed higher total QALYs gained compared to others (0.134 vs. 0.133 and 0.116). The incremental cost‐effectiveness ratio for comparing Apixaban to Warfarin was calculated at −1332.83 cost per QALY, below the threshold of $11 134, indicating Apixaban's cost‐effectiveness. Sensitivity analyses confirmed the robustness of the findings, with ICER consistently remaining below the threshold. Over 5 years (2024−2028) of Apixaban usage, the incremental cost starts at USD 70 250 296 in the first year and gradually rises to USD 71 770 662 in the fifth year. DSA and PSA were assessed to prove the robustness of the results.ConclusionThis study shows that Apixaban is a cost‐effective option for stroke prevention in non‐valvular atrial fibrillation patients in Iran compared to Warfarin.