Papers by Farhad Hosseinpanah
European Journal of Nutrition, 2021
To assess the efficacy of different doses of vitamin D3 on serum 25-hydroxyvitamin D (25(OH)D), i... more To assess the efficacy of different doses of vitamin D3 on serum 25-hydroxyvitamin D (25(OH)D), intact parathyroid hormone(iPTH), calcium, phosphorus, and alkaline phosphatase concentrations in overweight and obese school-children. A total of 378 children and adolescents, 6–13 years of age, with age- and sex-specific body mass index(BMI) Z-score ≥ 1(according to the World Health Organization criteria) were allocated to receive 600, 1000, and 2000 IU vitamin D3/days. 25(OH)D, iPTH, calcium, phosphorus, and alkaline phosphatase concentrations were measured at baseline, 6, and 12 months. In this intention-to-treat analysis, we fitted a linear mixed effect model involving a random effect of participants within treatment groups and fixed effects of dose, time, and their interactions. Mean(SD) of age and BMI Z-score were 9.3 (1.7) years and 2.55 (0.73), respectively. The median (IQR) for 25(OH)D was 11.5 (8.9), 11.7 (10.5), 12.2 (10.2) ng/mL (28.75, 29.25, and 30.50 nmol/L) at baseline and 23.1 (8.0), 25.6 (8.3), 28.6 (10.4) ng/mL (57.75, 64.00, and 71.50 nmol/L) at the end of 12 months in 600, 1000, and 2000 IU, respectively (p values for dose, time, and the interaction being < 0.0001, < 0.0001,and 0.082, respectively). Prevalence of vitamin D deficiency (< 20 ng/mL) was 80.2, 77.5, and 75.5% in 600, 1000, and 2000 IU groups at baseline, respectively, which decreased to 34, 18.4, and 7.5%, respectively, at 12 months. Patterns of iPTH, calcium, phosphorus, and alkaline phosphatase response over time did not differ significantly among groups (p values = 0.452, 0.670, 0.377, 0.895, respectively). Increases in 25(OH)D concentration were found with supplementation of 1000 and 2000 IU, compared with 600 IU/days, whereas there was no evidence of iPTH suppression or change in serum calcium, phosphorus, and alkaline phosphatase among children with excess weight.
International Journal of Cardiology, 2021
Background: The prevalence of metabolic syndrome (MetS) during adolescence has shown an increasin... more Background: The prevalence of metabolic syndrome (MetS) during adolescence has shown an increasing trend. This study aimed to investigate the association of MetS and metabolic phenotypes with a high carotid intima-media thickness (CIMT) in early adulthood in the framework of a large cohort study. Methods: MetS was de ned as proposed by Cook, de Ferranti, the National Cholesterol Education Program (NCEP), and the pediatric International Diabetes Federation (IDF). Metabolic phenotypes were de ned based on the binary clustering of cardiovascular risk factors. The participants were followed up for 18.2 years. Multivariate-adjusted odds ratios (ORs) were calculated for a high CIMT incidence (≥95 th percentile). Results: In this study, 862 adolescents (52.3% males), with the mean age of 13.4±2.2 years, were included. The presence of MetS, based on the de nitions proposed by Cook (OR=1.90, 95% CI: 1.01-3.57, P=0.046) and de Ferranti (OR=1.74; 95% CI: 1.04-2.90, P=0.033), was associated with the increased risk of a high CIMT in early adulthood. Metabolic phenotypes, including high waist circumference (WC)/hypertension (HTN), high WC/low high-density lipoprotein-cholesterol (HDL-C), and high triglyceride (TG)/high WC, showed higher risks of a high CIMT. However, these positive associations become insigni cant after adjusting for the adulthood BMI, except for the high WC/low HDL-C phenotype (OR=2.04, 95% CI: 1.02-4.11, P=0.044). Conclusion: The high WC/low HDL-C phenotype had a better predictive value and could be used as a simpler alternative for MetS to identify adolescents with a higher risk of high CIMT during early adulthood.
Iranian Journal of Endocrinology and Metabolism, 2011
Introduction: Several studies have shown that goiter is more prevalent in females than in males, ... more Introduction: Several studies have shown that goiter is more prevalent in females than in males, although before puberty there is no difference between genders, indicating that sex steroids may play a role in thyroid volume. Iodine deficiency may result in an increase prevalence in goiter prevalence but the difference between genders is not clear. This study is a metaanalysis of studies that have compared goiter prevalence between genders at different ages, with differing iodine status. Materials and Methods: This is a systematic review and metaanalysis based on Cochrane’ criteria. Databases of MEDLINE-EMBASE-Cochrane and Persian databases of Iranmedex– MagiranSIDIrondoc were searched and all articles on goiter in both sexes goiter were examined were included. Results: A hundred and five studies, with total number of 429252 individuals, age range 1-80 y, were included. Odds ratio of female to male goiter was OR=1.39 (95%CI=1.28-1.51), a ratio higher in longstanding iodine insufficie...
PLOS ONE, 2020
Considering that the data available on the cardiovascular (CV) risk of metabolically healthy obes... more Considering that the data available on the cardiovascular (CV) risk of metabolically healthy obesity phenotype, and the effect of transition to an unhealthy status are inconsistent, the aim of this study was to investigate the possible role of transition to unhealthy status among metabolically healthy overweight/obese (MHO) subjects on CVD incidence over a median follow-up of 15.9 years. In this large population-based cohort, 6758 participants (41.6% men) aged � 20 years, were enrolled. Participants were divided into 4 groups based on their obesity phenotypes and follow-up results, including persistent metabolically healthy normal weight (MHNW), persistent MHO, transitional MHO and metabolically unhealthy overweight/obese (MUO). Metabolic health was defined as not having metabolic syndrome based on the Joint Interim Statement (JIS) criteria. Multivariable adjusted hazard ratios (HRs) were calculated for cardiovascular events. During follow-up, rate of CVD Incidence per 1000 person-years were 12 and 7 in males and females, respectively. Multivariable adjusted HRs (CI 95%) of CVD incidence among males and females were 1.37 (.78-2.41) and .85 (.34-2.15) in persistent MHO group, 1.55 (1.02-2.37) and .93 (.41-2.12) in transitional MHO group and 2.64 (1.89-3.70) and 2.65 (1.24-5.68) in MUO group. Our findings showed that CVD risk did not increase in the persistent MHO phenotype over a 15.9-year follow-up in both sexes. However, transition from MHO to MUO status during follow-up increased the CVD risk just in male individuals. Further studies are needed to provide conclusive evidence in favor of benign nature of transitional MHO phenotype in females.
BMC Psychiatry, 2021
Background The present study aimed to investigate the associations of obesity phenotypes with dep... more Background The present study aimed to investigate the associations of obesity phenotypes with depression, anxiety, and stress symptoms among adults in the Tehran Lipid and Glucose Study (TLGS). Methods Depression, anxiety, and stress levels of participants from the TLGS were examined among different obesity phenotypes in this cross-sectional study. Obesity was defined as body mass index (BMI) ≥30 kg/m2, and metabolically unhealthy status based on having metabolic syndrome (MetS) or type 2 diabetes. Four obesity phenotypes were defined: 1) Metabolically Healthy Non-Obese (MHNO), 2) Metabolically Healthy Obese (MHO) 3) Metabolically Unhealthy Non-Obese (MUNO), and 4) Metabolically Unhealthy Obese (MUO). Emotional states of different obesity phenotypes were assessed by the Persian version of depression, anxiety, and stress scale-21 items (DASS-21). Ordinal logistic regression analysis was used to compare sex-specific odds ratios of depression, anxiety, and stress in different obesity p...
Obesity surgery, Jan 8, 2018
Micronutrient deficiencies are major concerns after bariatric surgery, although these conditions ... more Micronutrient deficiencies are major concerns after bariatric surgery, although these conditions often go undiagnosed pre-surgery. To assess pre-surgery micronutrient status of an Iranian population of morbidly obese candidates of bariatric surgery in a cross-sectional study. A cross-sectional analysis of 2008 candidates for bariatric surgery, aged 15-65 years, with either body mass index (BMI) ≥ 40 kg/mor 30 < BMI < 35 kg/mwith a medical comorbidity was conducted. In order to determine the micronutrient status of participants, blood samples were collected to assess serum concentrations of vitamins (B12 and D), minerals (copper, calcium, phosphate, and zinc), and iron profiles (total iron binding capacity, iron concentration, ferritin, and iron saturation), according to standard protocol. The mean age and BMI of patients (79.3% female) were 37.8 years and 44.8 kg/m, respectively. Deficiencies were found for 25(OH) D (53.6%), vitamin B12 (34.4%), serum iron (10.2%), and low lev...
International Journal of Endocrinology and Metabolism, 2016
Background: Although current data shows a positive association between obesity and development of... more Background: Although current data shows a positive association between obesity and development of coronary heart disease (CHD) in general population, there is limited data on the important protective role of central or general obesity in patients with prevalent CHD or the "obesity paradox", from this region. Objectives: The objective of the present investigation was to describe the relationship between BMI categories and the recurrence of CHD in patients with a history of CHD using data from a large population-based study, the Tehran lipid and glucose study (TLGS). Patients and Methods: The study was conducted on 440 adults, aged ≥ 30 years, with a history of CHD at baseline who attended the first (1999-2001) or second (2001-2003) phases of the Tehran Lipid and Glucose Study and had at least one year of follow-up until March 31, 2010. Cox proportional hazard models were used to evaluate the association among various BMI groups and recurrent CHD incidence. Results: During a median follow-up of 8.44 years, 169 new cases of CHD occurred (incidence density of: 54.53 per 1000 personyears). The incidence of recurrent CHD was higher in the normal BMI compared with overweight and obese categories (68.71, 47.56 and 54.46 per 1000 person-years, respectively). In multivariable models, using the forward stepwise selection approach, compared to the overweight group (0.48 95% CI, 0.30-0.80), the obese group (0.55 95% CI, 0.28-1.06) lost its significant protective effect. Conclusions: Results of this study demonstrated an apparently protective effect for overweight in comparison with normal weight against long-term recurrent CHD in patients with history of CHD.
PLOS ONE, 2015
Objective To see the changes of cardio-metabolic risk factors overtime in polycystic ovary syndro... more Objective To see the changes of cardio-metabolic risk factors overtime in polycystic ovary syndrome vs. control women. Methods This study was conducted on 637 participants (85 PCOS and 552 control reproductive aged, 18-45 years) of Tehran Lipid and Glucose Study (TLGS), an ongoing populationbased cohort study with 12 years of follow-up. The cardiovascular risk factors of these groups were assessed in three-year intervals using standard questionnaires, history taking, anthropometric measures, and metabolic/endocrine evaluation. Generalized estimating equation was used to analyze the data. Results Overall mean of insulin (3.55, CI: 0.66-6.45), HOMA-IR (0.63, CI: 0.08-1.18), and HOMA-β (45.90, CI: 0.86-90.93) were significantly higher in PCOS than in healthy women after adjustment for age, BMI, and baseline levels. However, the negative interaction (follow-up years × PCOS status) of PCOS and normal women converged overtime. Comparing third follow-up with first, insulin and HOMA-IR decreased 10.6% and 5%, respectively in PCOS women; and increased 6.7% and 14.6%, respectively in controls (P<0.05). The results did not show any significant result for other cardio-metabolic variables including WC, lipid profile, FPG, 2-h PG, SBP, and DBP.
Diabetes Research and Clinical Practice, 2015
Objective: To investigate the predictive role of adolescent metabolic phenotypes in development o... more Objective: To investigate the predictive role of adolescent metabolic phenotypes in development of early adult metabolic syndrome (MetS). Study design: A group of 1446 adolescents (44.8% boys), participants of the Tehran Lipid and Glucose Study, with a mean (SD) of age 14.6 (2.2) years, followed for 10.4 years. Logistic regression models were developed to evaluate the predictive power of different metabolic phenotypes for adult MetS. Moreover, areas under the receiver operating characteristic (ROC) curve were estimated to compare the prediction power of metabolic phenotypes for adult MetS. Results: The prevalence of MetS was 14.6% (29.7% and 2.4% for adult males and females, respectively) at the end of follow up. The most frequent metabolic phenotype in adolescent was high TGs/low HDL-C (23.7%), while the prevalence of high TGs/high WC was 10.4% and the other phenotypes were less than 10%. After adjustment for baseline BMI Z-Score and BMI
The Journal of pediatrics, 2014
Introduction: The risk of obesity among children increases in proportion to parental obesity. Thi... more Introduction: The risk of obesity among children increases in proportion to parental obesity. This study aimed at investigating the familial clustering of central obesity and cardiovascular disease risk factors. Materials and Methods: In this observational cross-sectional survey, enrolling 787 mother-daughter pairs in three age stratum (3-9 y, 10-15 y, 16-20 y), familial associations for central obesity and cardiovascular disease risk factors were assessed. Results: Mothers with central obesity had higher probability of having daughters with central obesity compared to normal mothers (p=0.0001). Central obesity indices among daughters were positively correlated with those of their mothers (r=0.39, r=0.42 and r=0.46 for waist circumferences in the three age strata, respectively). The correlations were significant and positive between central obesity indices and systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, triglycerides, and LDL-C in mothers (r=0.34, 0.30, 0.28, 0.19, 0.32 and 0.13 respectively) and their daughters (r=0.33, 0.27, 0.17, 0.16, 0.26 and 0.20). Correlation between central obesity indices and HDL-C were negative and significant in mothers (r=-0.18) and daughters (r=-0.21). There was an increase with age in mother-daughter central obesity correlations. After subjects' cardiovascular risk factor levels were adjusted for mother and daughter waist circumferences, the motherdaughter correlations remained significant. Conclusion: The close association of central obesity indices between mothers and daughters may indicate the key role of the mother for the primary prevention of obesity and its complications, particularly in high-risk families.
International Journal of Obesity, 2014
This study aims to assess the natural course of metabolically healthy abdominal obese (MHAO) phen... more This study aims to assess the natural course of metabolically healthy abdominal obese (MHAO) phenotype and determine the predictors of change in the metabolic status in this population over 10 years of follow-up. METHODS: A total of 916 MHAO subjects from the Tehran Lipid and Glucose Study were followed for changes in their metabolic health status. Anthropometric and metabolic indices were measured at baseline and were compared between subjects with healthy and unhealthy metabolic conditions at the end of follow-up. Predictors of change in metabolic health were assessed in logistic regression models. National waist circumference cutoffs were used for definition of abdominal obesity. Metabolic health was defined as ⩽1 metabolic components of metabolic syndrome according to the Joint Interim Statement criteria. RESULTS: At the end of the follow-up, nearly half of the MHAO subjects lost their metabolic health and 42.1% developed metabolic syndrome by definition. Low high-density lipoprotein cholesterol, hypertriglyceridemia and homeostasis model assessment-insulin resistance at baseline were significant predictors of change in metabolic health condition. CONCLUSION: MHAO is a relatively unstable condition and a considerable percentage of these individuals will lose their metabolic health as time passes. Baseline metabolic characteristics may be useful predictors of this change and should be considered in the care of these individuals.
Cholesterol, 2012
Aims. To investigate the trend of metabolic syndrome and its components in Tehran children and ad... more Aims. To investigate the trend of metabolic syndrome and its components in Tehran children and adolescents during a median followup of 6.6 years. Methods. Data from 1999–2001 (phase I), 2002–2005 (phase II), and 2006–2008 (phase III) of the Tehran, Lipid and Glucose Study were analyzed (; age 6–18 years) for the trend of metabolic syndrome (MetS) and its components. General estimation equation (GEE) models were used to analyze this correlated data. Results. The crude prevalence of MetS for boys at baseline was 13.2%, which increased to 16.4% in the third phase. In girls, the prevalence of Mets decreased from 11.8% at baseline to 6% during followup. The odd ratios (OR) of obesity over the whole study period were raised in both sexes. The OR of abdominal obesity increased significantly in boys, but no change was observed in girls. No significant OR was observed in boys, while OR for MetS was shown to have a decreasing trend in girls during the followup. In the three time points, the O...
Preventing Chronic Disease, 2013
We examined the association between leisure-time physical activity (LTPA) and metabolic syndrome ... more We examined the association between leisure-time physical activity (LTPA) and metabolic syndrome (MetS) among 4,665 randomly selected adults who participated in the Tehran Lipid and Glucose Study, 2005-2008. Normal-weight participants with light LTPA had higher risk of low high-density lipoprotein cholesterol and elevated levels of triglycerides than those with vigorous LTPA. Overweight adults with moderate LTPA had higher risk of having elevated levels of fasting blood glucose than adults with vigorous LTPA and, in the same group, we found an inverse association between light LTPA and MetS after adjustment for sex, age, education levels, smoking, and calorie intake. Although participants in the normal-weight and obese groups with vigorous LTPA had higher risk of high systolic blood pressure than participants with moderate LTPA, this finding had no clinical significance. Increased LTPA is associated with decreased risk of any damaging changes in the markers of MetS. Objective Metabolic syndrome (MetS) is caused by a combination of an unhealthy diet, sedentary lifestyle, and genetic predisposition (1). Prevalence of MetS in South Asian populations is approximately 30%, depending on the region, duration and extent of urbanization, and lifestyle, and in Iranian populations is 32% (2). Recommendations for prevention and treatment of MetS and its components are engaging in physical activity, losing weight, and eating a healthful diet. Leisure-time physical activity (LTPA) plays an important role in controlling MetS (3,4). The aim of this study was to examine the association between LTPA and MetS among adults in the Tehran Lipid and Glucose Study (TLGS). Methods Initially, 9,376 adults aged 20 to 70 years were selected randomly from among TLGS participants (5) for this crosssectional study; after excluding participants who had diabetes mellitus (n = 390), body mass index (BMI) less than 18 kg/m (n = 152), or lacked complete data for variables (n = 4,169), 4,665 remained (1,976 men and 2,689 women). This study was approved by the institutional review board of the Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences. Demographic and biochemical variables were measured (5), and people were classified on the basis of BMI levels. We defined MetS according to the Joint Interim Statement (JIS) guidelines issued by the
PloS one, 2012
To examine, the predictors of incident chronic kidney disease (CKD) in a community-based cohort o... more To examine, the predictors of incident chronic kidney disease (CKD) in a community-based cohort of Middle East population, during a mean follow-up of 9.9 years. In a sample of 3313 non-CKD Iranian adults ≥20 years the estimated glomerular filtration rate (eGFR) was calculated at baseline and at three year intervals during three consecutive phases. The eGFR <60 mL/min/1.73 m2 was defined as CKD. Multivariate Logistic regression analysis was used to determine the independent variables associated with incident CKD. The incidence density rates of CKD were 285.3 and 132.6 per 10,000 person-year, among women and men, respectively. Female gender per se was associated with higher risk of CKD, compared with males. Among women, age, eGFR, known diabetes, being single or divorced/widowed, hypertension (marginally significant) and current smoking were independent risk factors for CKD; however the intermediate degree of education and family history of diabetes decreased the risk by 40% (P<...
International Journal of Endocrinology and Metabolism, 2014
Background: Most existing reports indicate that body weight gradually increases following marital... more Background: Most existing reports indicate that body weight gradually increases following marital status and thereby enhances health status and decreases mortality; however, the association between marital status and the metabolic syndrome (MetS) has not been thoroughly investigated in a longitudinal study. Objectives: The aim of this study was to investigate the potential effects of marital status and marital transition on MetS during a 9.6-year follow-up in Tehran Lipid and Glucose Study. Patients and Methods: For this study, 5221 participants (2060 males and 3161 females), aged 15 to 90 years at baseline, were followed for a median of 9.6 years. Marital status was categorized as consistent marital status and marital transition. We measured MetS risk z score and its components and calculated their changes. Then the effects of marital status and marital transition on MetS risk z score and its components were assessed using multivariable linear regression. Results: In comparison to participants who were married, no significant changes in MetS risk z score was found in single participants. Employed females in the transition to married group had significant increase in MetS risk z score than single employed females. No significant changes in MetS risk z score were observed between widowed/divorced subjects and compared to consistently married subjects. Conclusions: Marital status may affect MetS risk z score differently in both genders.
Nutrition & Metabolism, 2011
Background Studies have shown that the excessive fructose intake may induce adverse metabolic eff... more Background Studies have shown that the excessive fructose intake may induce adverse metabolic effects. There is no direct evidence from epidemiological studies to clarify the association between usual amounts of fructose intake and the metabolic syndrome. Objective The aim this study was to determine the association of fructose intake and prevalence of metabolic syndrome (MetS) and its components in Tehranian adults. Methods This cross-sectional population based study was conducted on 2537 subjects (45% men) aged 19-70 y, participants of the Tehran Lipid and Glucose Study (2006-2008). Dietary data were collected using a validated 168 item semi-quantitative food frequency questionnaire. Dietary fructose intake was calculated by sum of natural fructose (NF) in fruits and vegetables and added fructose (AF) in commercial foods. MetS was defined according to the modified NCEP ATP III for Iranian adults. Results The mean ages of men and women were 40.5 ± 13.6 and 38.6 ± 12.8 years, respec...
Genetics Research, 2012
SummaryGrowing evidence suggests that metabolic syndrome (MetS) has both genetic and environmenta... more SummaryGrowing evidence suggests that metabolic syndrome (MetS) has both genetic and environmental bases. We estimated the heritability of the MetS and its components in the families from the Tehran Lipid and Glucose Study (TLGS). We investigated 904 nuclear families in TLGS with two biological parents and at least one offspring (1565 parents and 2448 children), aged 3–90 years, for whom MetS information was available and had at least two members of family with MetS. Variance component methods were used to estimate age and sex adjusted heritability of metabolic syndrome score (MSS) and MetS components using SOLAR software. The heritability of waist circumference (WC), HDL-cholesterol (HDL-C), triglycerides (TGs), fasting blood sugar (FBS), systolic blood pressure (SBP) and diastolic blood pressure (DBP) as continuous traits after adjusting for age and gender were 27, 46, 36, 29, 25, 26 and 15%, respectively, and MSS had a heritability of 15%. When MetS components were analysed as di...
European Journal of Clinical Nutrition, 2013
BACKGROUND/OBJECTIVE: There is limited data from long-term prospective studies on the natural cou... more BACKGROUND/OBJECTIVE: There is limited data from long-term prospective studies on the natural course of metabolic syndrome (MetS) incidence in healthy obese phenotypes. The aim of this study was to determine the incidence and predictors of the MetS in healthy obese subjects without the MetS at baseline after a decade of follow-up. SUBJECTS/METHODS: In this prospective cohort study, 438 obese subjects free from MetS at baseline, aged X20 years, were selected from among the participants of the Tehran Lipid and Glucose Study and followed up for 10 years for development of MetS. Based on national data, central obesity was defined as waist circumference cutoff point of 89 cm for men and 91 cm for women. RESULTS: Initially, subjects had a mean age of 41.1 ± 11.8 years and a body mass index of 32.7 ± 2.7 kg/m 2. At the end of follow-up, the cumulative incidence (95% confidence interval) of MetS was 44.0 (36.8-51.1)%. In the multivariable analysis, the adjusted odds ratios of hypertension, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C) and insulin resistance for the development of MetS were 3.08 (1.39-6.79), 2.84 (1.26-6.42), 6.49 (3.18-13.25) and 2.87 (1.55-5.32), respectively. The area under receiver operating characteristic curve of all the components was significantly higher than various combinations of MetS components, except for the two models including combinations of three components, that is, triglycerides (TGs), HDL-C and fasting blood sugar, as well as, TGs, HDL-C and systolic blood pressure. CONCLUSIONS: Our findings demonstrate that MetS developed in nearly half of the individuals during the 10 years of follow-up. Predictors of MetS in healthy obese subjects may differ from the general population, and waist circumference does not have an independent role.
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Papers by Farhad Hosseinpanah