PERSIAN Guilan Cohort Study Research Articles

Exploratory factor analysis of gender-based metabolic syndrome components: Results from the PERSIAN Guilan cohort study (PGCS)

One of the important issues related to metabolic syndrome is the underlying factor that remains controversial. The purpose of this study was estimating exploratory factor analysis (EFA) to reveal underlying factors that may explain the observed variants of metabolic syndrome (MetS) components in a population-based study. In this cross-sectional study, the target population consisted of 10,520 individuals aged 35-70 years from Phase 1 of the PERSIAN Guilan cohort study conducted between 2014 and 2017. Exploratory factor analysis (EFA) of components of the metabolic syndrome, including waist circumference (WC), systolic (SBP) and diastolic (DBP) blood pressure, triglyceride (TG), high-density lipoprotein (HDL) and fasting blood glucose (f-Glc) was performed across the population as well as by gender. EFA results in the whole population based on eigen values>1 showed two factors that explain 55.46% of the total variance. Taking factor loadings above 0.3, the first factor included systolic blood pressure, diastolic blood pressure, and waist circumference - called the blood pressure factor. Also, the second factor included triglycerides, negative-loaded HDL, and fasting blood glucose, which was named as lipid factor. In terms of gender, the first factor was similar to the whole population pattern, but in the second factor, in addition to the two components of blood lipids, waist size for men and in fasting blood glucose for women was launched. Hypertension and lipids were substantial factors, and obesity is an important factor in this study. Hypertension, having the highest factor load, can generally be a valuable screening parameter for cardiovascular and metabolic risk assessment.

Validation of Omron HBP-1100-E Professional Blood Pressure Measuring Device According to the American Association for the Advancement of Medical Instrumentation Protocol: The PERSIAN Guilan Cohort Study (PGCS).

BackgroundBlood pressure (BP) measurement accuracy is critical to the diagnosis and management of hypertension. The aim of the present study was to validate the Omron HBP-1100-E professional blood pressure measuring device in accordance with the American Association for the Advancement of Medical Instrumentation in Iranian adults.Materials and MethodsSimultaneous blood pressure auscultator measurements were obtained by two observers using mercury sphygmomanometers as a reference, sequentially with a measurement by using the Omron HBP-1100-E device. Absolute device-reference blood pressure differences were categorized into three error categories (within 5, 10, and 15 mmHg), and mean device-reference blood pressure difference (standard deviation) was calculated and evaluated using the American Association for the Advancement of Medical Instrumentation criteria.ResultsA total of 85 participants (250 paired readings) were enrolled to the study. 26.8%, 55.6%, and 79.6% of the device-reference blood pressure differences agreed to within 5, 10 and 15 mmHg, respectively, for systolic blood pressure, and 39.6%, 69.2%, and 81.6% of measurements for diastolic blood pressure, respectively, and failed to pass the protocol criteria. The mean device-reference blood pressure difference was 8.0 ± 13.1 mmHg for systolic BP and 2.2 ± 11.3 mmHg for diastolic BP, and was >5.0 ± 8.0 mmHg (required criteria).ConclusionOmron HBP-1100-E professional blood pressure monitor is not desirable for measuring the BP for Iranian adults as it overestimates blood pressure in this population.

Vitamin D deficiency associated with reproductive factors in northern Iranian women: The PERSIAN Guilan Cohort Study (PGCS).

One of the public health concerns is Vitamin D deficiency. The aim of this study was to determine the prevalence of vitamin D inadequacy and to determine its reproductive factor correlates in northern Iranian women. This study, conducted on 5096 females aged 35-70 years. The study was based on data from PERSIAN Guilan Cohort Study (PGCS), a prospective, population-based cohort study in Guilan, Iran. History of reproductive and gynecologic factors, including age at menarche, age at first marriage, number of pregnancies or live births, age at first pregnancy, duration of breastfeeding, number of abortions, age and type of menopause status, use of oral contraceptives or hormone replacement therapy, history of hysterectomy, tubectomy or oophorectomy and history of gestational diabetes and hypertension was collected. Serum 25(OH) vitamin D was measured. The mean 25(OH)-D concentration was 21.78ng/mL, and 53.5% of women had vitamin D inadequacy. The multivariate analyses revealed that younger age (36-45 years) [>66 years adjusted odds ratio (aOR)=2.1, 95% CI 1.7-2.7, 56-65 years aOR=1.7, 95% CI 1.3-2.1 and 46-55 years aOR=1.4, 95% CI 1.1-1.7], not consuming oral contraceptives [aOR=1.1, 95% CI 1.05-1.3] and pre-menopausal status [aOR=1.4, 95% CI 1.2-1.6] were significantly independently associated with vitamin D inadequacy. Vitamin D inadequacy is common in northern Iranian women. The reproductive factors that independently correlated with vitamin D statues are oral contraceptive consumption and menopausal statue.

Validity and inter-observers reliability of blood pressure measurements using mercury sphygmomanometer in the PERSIAN Guilan cohort study.

Accurate measuring of blood pressure is a vital step in both clinical and para-clinical settings. The aims of the present study were to evaluate the validity and inter-observer reliability of measured blood pressures by two trained observers and one expert supervisor in the PERSIAN Guilan cohort study (PGCS). In a quasi-experimental study, two trained observers and one expert supervisor measured systolic and diastolic blood pressures (SBP and DBP) in 85 included participants. All measurements were done using Riester mercury sphygmomanometer as duplicate for each people. Lack of validity in the total SBP (P = 0.017), DBP in age <50 years (P = 0.039), and DBP in BMI >25 (P=0.019) of first observer and total SBP (P = 0.045), SBP of male (P = 0.019), both SBP and DBP in age >50 years (P = 0.034, P = 0.012) and DBP in BMI <25 (P = 0.001) of second observer were seen. In addition, total inter-rater reliability was found as 12.2% and 27.2% in SBP and DBP, respectively. Age, sex and BMI categorized inter-observer reliability were not more than 15% in SBP of BMI <25 kg/m and 31.6% in DBP of female. The final inter-observer agreement after educational course was higher than 0.7 totally and in all categorical evaluations. Based on lack of validity in some conditions and low level of reliability, education of all observers to measure both SBP and DBP accurately is needed. This is more necessary to done before performing the high population surveys.

Association of Serum Levels of Vitamin D with Blood Pressure Status in Northern Iranian Population: The PERSIAN Guilan Cohort Study (PGCS).

BackgroundEvidence in the last decades has indicated an association between vitamin D and cardiovascular risk factors including blood pressure. The present study aimed to determine whether serum 25-hydroxyvitamin D is independently associated with blood pressure in a large population-based study.MethodsThe study was based on subjects from PERSIAN Guilan Cohort Study (PGCS), a prospective, population-based cohort study in Guilan, Iran. In 9520 men and women, aged 35–70 years, serum 25-hydroxyvitamin D, systolic and diastolic blood pressure were measured. Multiple logistic and linear regression analyses were conducted with adjustments for demographic factors (age and gender), anthropometric characteristics (waist circumference and body mass index), lifestyle variables (physical activity, alcohol, and smoking consumption), and renal function (serum creatinine).ResultsFully adjusted linear regression analyses revealed a weak but statistically significant negative association between serum 25-hydroxyvitamin D levels and systolic blood pressure (β = –0.02, 95% CI= −0.052 to −0.0001, P-value=0.04), whereas vitamin D status was not significantly associated with diastolic blood pressure (β = –0.01, 95% CI= −0.026 to 0.009, P-value=0.3). Serum 25-hydroxyvitamin D status showed no significant association with the presence of hypertension (OR 1.09, 95% CI=0.94 to 1.25 for the lowest (25OHD <12 ng/mL) versus the highest (25OHD ≥20 ng/mL) category).ConclusionLower serum vitamin 25 (OH) D levels were associated with higher systolic blood pressure; however, it was not associated with diastolic blood pressure and presence of hypertension.

Comparison of anthropometric indices as predictors of the risk factors for cardiovascular disease in Iran: The PERSIAN Guilan Cohort Study.

This study was conducted to assess the prevalence of central and general obesity and compare nine anthropometric indices as predictors of the risk factors for cardiovascular disease (CVD) in Iranian adults. A total of 10,520 adults between ages 35 and 70 years old who were referred to the PERSIAN Guilan Cohort Study were included in this study. Anthropometric indices, including body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), waist to hip ratio (WHR), conicity index, hip circumference (HC), waist to hip to height ratio (WHHR), body adiposity index, and a body shape index (ABSI), were measured using the standard methods. The risk factors for CVD (diabetes mellitus, hypertension, and out of range lipid profiles) were defined by laboratory tests and medical history. The odds ratio of the risk factors based on a unit increase in anthropometric indices was examined by an adjusted logistic model. The mean of all anthropometric indices was higher in women than in men (p<0.01). After adjusting for confounders, the risk of diabetes mellitus, hypertension, and hypertriglyceridemia increased with an increase in all anthropometric indices. The highest risk of diabetes mellitus and hypertriglyceridemia was found in higher WHHR. The highest risk of low high density lipoprotein cholesterol (HDL C) and high low density lipoprotein cholesterol (LDL C) was found in an increase in the WHR and ABSI, respectively. Our findings emphasize higher levels of general and central obesity in adults in the north of Iran. The WHHR and WHtR seem to be more valuable indices than BMI and WC for predicting distinct risk factors for CVD. However, the WHR was the strongest index for the prediction of high LDL C/HDL C ratio.

The Lifestyle Characteristics in Non-Alcoholic Fatty Liver Disease in the PERSIAN Guilan Cohort Study.

BACKGROUND:Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common cause of chronic liver disease worldwide. Since the effect and safety of pharmacotherapy for NAFLD are unknown, the proper management of lifestyle is crucial.AIM:The present study was conducted to determine the status of food, Physical Activity (PA), and sleep in patients with and without NAFLD.METHODS:In this analytical- cross-sectional study, 630 clients with 36-60 years old who referred to the PERSIAN Guilan cohort study were included through simple non-random sampling. The developed questionnaire and lifestyle characteristics, including the status of nutrition, physical activity, and sleep, were completed for all samples. BMI was also calculated by determining weight and height, and fatty liver was confirmed based on abdominal ultrasound.RESULTS:The prevalence of NAFLD in this study was by 43.7% (275 / 630). Smoking, alcohol consumption, BMI, and weight loss over the past six months, regular exercise and exercise intensity, sedentary living, speed of eating, consuming fatty food, red meat, sweets beverages, and use of saturated fatty acid (SFA), and consuming fruits and vegetables were associated with presence of NAFLD (all p < 0.05). However, no significant relationship was observed between the parameters of sleep duration, the interval between dinner and night sleep, consuming breakfast and snack during the day and NAFLD (All p > 0.05).CONCLUSION:The onset and progression of NAFLD are associated with lifestyle. Therefore, dietary therapy solutions, physical activity, and sleep and rest situations should be paid attention for people with or at risk of NAFLD.

Biochemical markers and lipid profile in nonalcoholic fatty liver disease patients in the PERSIAN Guilan cohort study (PGCS), Iran.

Background and Aim:Nonalcoholic fatty liver disease (NAFLD) is a global epidemic that is often asymptomatic and silent, and progresses slowly. This study aimed to determine the biochemical markers and lipid profile among NAFLD patients and their possible relationship with degrees of fatty liver.Methods:This is analytical cross-sectional study, in which, 950 individuals referred to the PERSIAN Guilan cohort study were included through sequential sampling method. The demographic information and blood pressure of the subjects were taken and the blood sample was prepared to investigate the biochemical markers and lipid profile. Also, abdominal ultrasonography was performed to investigate NAFLD and its grades. For data analysis, independent sample t-test, one-way ANOVA, and logistic regression model were used, where P < 0.05 was considered significant.Results:The systolic blood pressure (SBP) (P < 0.001), diastolic blood pressure (DBP) (P < 0.001), hepatic enzymes (aspartate aminotransferase [AST], P < 0.001, alanine aminotransferase [ALT], P < 0.001; gamma-glutamyle transferase [GGT], P < 0.001; AST/ALT ratio, P < 0.001), lipid profile (triglyceride [TG], P < 0.001; total cholesterol [TC], P = 0.008; high density lipoprotein [HDL], P < 0.001; LDL-C/HDL-C (ratio), P = 0.003; TC/HDL-C (ratio), P < 0.001); and fasting blood sugar [FBS], P < 0.001 correlated with NAFLD. However, there was no relationship between age (P = 0.34), alkaline phosphatase [ALP] (P = 0.26) and low-density lipoprotein [LDL] (P = 0.72). Further, a significant relationship was observed between AST (P < 0.001), ALT (P < 0.001), and GGT (P = 0.004) and NAFLD degrees based on the ultrasonography.Conclusion:Biochemical markers and lipid profile are associated with NAFLD. Thus, it is recommended to investigate NAFLD in clinical settings in cases in which their changes are observed in patients through ultrasonography.

The role of anthropometric indices in the prediction of non-alcoholic fatty liver disease in the PERSIAN Guilan Cohort study (PGCS).

Introduction: Non-alcoholic fatty liver disease (NAFLD) is an obesity-associated health problem that causes other liver diseases for the patient. Four anthropometric indices: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were analyzed as NAFLD predictors in the present study.Methods: From the total number of individuals who referred to the PERSIAN Guilan Cohort study (PGCS) located in the north of Iran during the period of study, a total of 960 people were enrolled in the present study. NAFLD was diagnosed using through an abdominal ultrasound exam. Height, weight, WC, BMI, WHR and WHtR were later calculated. Chi-square, ANOVA and logistic regression analyses were used to analyze the risk factors.Results: Out of the 960 individuals who were enrolled in the study, 597 (62.2%) were male and 363 (37.8%) were female (with an average age of 47.21 ± 7.29 years). There was a significant relationship between weight and NAFLD (P<0.001). There was also a significant relationship between BMI (OR= 8.41; 95% CI = 5.59–12.75), WC (OR= 2.67; 95% CI = 2.05–3.48), WHR (OR= 3.84; 95% CI = 2.26–6.52), WHtR (OR= 28.53; 95% CI = 6.94–117.31) and NAFLD (P<0.001). The results of the logistic regression analysis showed that WHtR, BMI and WC were effective predictors for the risk of NAFLD while WHtR played a more important role in the prediction of NAFLD.Conclusion: Anthropometric indices, especially WHtR, as a simple screening tool, seem to be an important criterion for the detection of NAFLD.