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  • 1
    Online Resource
    Online Resource
    Changes in waist circumference and incidence of chronic kidney disease
    Wiley ; 2014
    In:  European Journal of Clinical Investigation Vol. 44, No. 5 ( 2014-05), p. 470-476
    Details
    In: European Journal of Clinical Investigation, Wiley, Vol. 44, No. 5 ( 2014-05), p. 470-476
    Abstract: Many studies have evaluated the association of anthropometric indices with chronic kidney disease( CKD ), but the association of waist circumference( WC ) changes with CKD incidence is less clear. We evaluated the effect of WC changes on CKD incidence in participants of the T ehran L ipid and G lucose S tudy( TLGS ). Study design The risk of CKD incidence was evaluated in three serial phases with interval censoring. A group of 8,183 (46·5% men) participants, mean age 47·4 years, free of previous CKD , were followed. Waist changes were divided into four groups: (i)decrease in WC ; (ii) reference group; (iii)mild to moderate increase in WC and (iv)severe increase in WC . G lomerular filtration rate( GFR ) was estimated using the MDRD equation. Results In 8,183 participants, mean GFR was higher in men (77·1 vs. 74·4  mL /min/1·73 m 2 , P   〈   0·001). During the 9 years of follow‐up, 1477 new cases of CKD occurred(1026 in women). WC changes were not associated with the development of CKD in women. In men, decrease in WC was not related to lower risk of CKD ( HR : 0·90, 95% CI 0·6–1·4), whereas a mild to moderate increase in WC was associated with a 70% ( HR : 1·7, 95% CI 1·3–2·2) higher risk of CKD even after adjusting for covariates ( HR : 1·6, 95% CI 1·2–2·2). Severe increase in WC was associated with a fourfold risk of CKD in comparison with reference group ( HR : 3·7, 95% CI 2·7–5·1). Conclusion Changes in WC are not independent risk factors for CKD development in women, whereas waist gain can adversely influence the development of CKD in men.
    Type of Medium: Online Resource
    ISSN: 0014-2972 , 1365-2362
    URL: Issue
    URL: Article
    DOI: 10.1111/eci.2014.44.issue-5
    DOI: 10.1111/eci.12253
    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 2004971-7
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  • 2
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    Lipid accumulation product and insulin resistance in Iranian PCOS prevalence study
    Wiley ; 2014
    In:  Clinical Endocrinology Vol. 81, No. 1 ( 2014-07), p. 52-57
    Details
    In: Clinical Endocrinology, Wiley, Vol. 81, No. 1 ( 2014-07), p. 52-57
    Abstract: To evaluate diagnostic accuracy of lipid accumulation product ( LAP ) index as a marker of insulin resistance in a community‐based population with polycystic ovary syndrome ( PCOS ), compared with healthy women. Methods Anthropometric measurements, biochemical parameters, LAP index and insulin resistance ( IR ) were compared in 134 PCOS subjects and 414 healthy women recruited from 1126 reproductive aged women (18–45 years), participants of the Iranian PCOS Prevalence Study. LAP was defined as [ WC (cm)–58] × TG (mmol/l)]. PCOS was diagnosed using the Rotterdam criteria, and IR was defined using the homeostatic model assessment IR . LAP , body mass index ( BMI ), waist circumference ( WC ) and waist‐to‐hip ratio ( WHR ) were compared using the two‐tailed Spearman rank correlation test and analysing the receiver operating characteristic ( ROC ) curves for IR . Results Among the PCOS subjects, the mean ±  SD age, BMI , WC and WHR were 32·2 ± 7·7 years, 26·8 ± 5·8 kg/m 2 , 85·2 ± 13·2 cm and 0·80 ± 0·06, respectively, and the median ( IQ 25–75) of LAP index was 34·03 (17·8–66·3). There was significant correlation between HOMA ‐ IR index and LAP in patients with PCOS (r = 0·41; P  〈   0·001). Also, ROC curves analysis revealed that the optimal cut‐off value for LAP to define the presence of IR was 34·1 (sensitivity: 75%; specificity: 58%). LAP showed the highest area under curve ( AUC ) ( P  〈   0·001). Conclusion Among PCOS subjects, LAP index has the strongest diagnostic accuracy for detection of IR in comparison with BMI , WC and WHR .
    Type of Medium: Online Resource
    ISSN: 0300-0664 , 1365-2265
    URL: Issue
    URL: Article
    DOI: 10.1111/cen.2014.81.issue-1
    DOI: 10.1111/cen.12287
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 2004597-9
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  • 3
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    Predictors of incident obesity phenotype in nonobese healthy adults
    Wiley ; 2017
    In:  European Journal of Clinical Investigation Vol. 47, No. 5 ( 2017-05), p. 357-365
    Details
    In: European Journal of Clinical Investigation, Wiley, Vol. 47, No. 5 ( 2017-05), p. 357-365
    Abstract: Despite their different cardiovascular consequences, little is known about predictors of metabolically healthy ( MHO ) and metabolically unhealthy obesity ( MUHO ). This cohort study was designed to address this question in participants of the Tehran Lipid and Glucose Study. Materials and methods Employing the Joint Interim Statement ( JIS ) metabolic syndrome criteria to define MHO / MUHO phenotypes, nonobese, otherwise healthy individuals, aged 〉  20 years ( n  = 3489) were recruited and followed up for a median of 13·4 years. Results At the follow‐up, MHO incidence rate in obese individuals was 36·6%. Comparing MHO vs. MUHO , female gender [odds ratio ( OR ) = 3·28, 95% confidence interval ( CI ) 1·27, 8·46)], increased body mass index ( BMI ; OR  = 1·32, 95% CI : 1·12, 1·60) and elevated high‐density lipoprotein cholesterol ( HDL ‐C) levels ( OR  = 1·04, 95% CI : 1·02, 1·07) were related to higher odds of incident MHO , while older age ( OR  = 0·95, 95% CI : 0·92, 0·98), increased waist circumference ( WC ; OR  = 0·86, 95% CI : 0·81, 0·91), higher WC gain ( OR  = 0·91, 95% CI : 0·87, 0·95) and increased diastolic blood pressure ( DBP ; OR  = 0·94, 95% CI : 0·91, 0·98) prevented progression towards MHO . Conclusions While baseline BMI and WC were detrimental for developing MHO vs. MUHO , gender was the strongest predictor of incident obesity phenotype in healthy nonobese individuals.
    Type of Medium: Online Resource
    ISSN: 0014-2972 , 1365-2362
    URL: Issue
    URL: Article
    DOI: 10.1111/eci.2017.47.issue-5
    DOI: 10.1111/eci.12743
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2004971-7
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  • 4
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    Online Resource
    Long‐term outcomes after seton placement for perianal fistulas with and without Crohn’s disease
    Wiley ; 2021
    In:  Colorectal Disease Vol. 23, No. 9 ( 2021-09), p. 2407-2415
    Details
    In: Colorectal Disease, Wiley, Vol. 23, No. 9 ( 2021-09), p. 2407-2415
    Abstract: Perianal sepsis in Crohn's disease (CD) fistulas is managed with antibiotics and surgical drainage; a noncutting seton is used for an identified transsphincteric fistula tract. The optimal management following seton placement for initial control of perianal sepsis remains to be determined. Our main aim was to assess the success rates of curative surgery, seton removal or long‐term indwelling seton in patients with and without CD. Method This was a retrospective cohort of consecutive patients with a perianal fistula treated with a noncutting seton between 2010 and 2019, including 83 CD patients and 94 patients without CD. Initial control of symptomatic perianal infection with a seton and subsequent healing and reintervention rates were compared between the three postseton management strategies. Results A total of 177 patients, 61% male and 83.1% with complex fistulas, were followed for a median of 23 months (interquartile range 11–40 months). Immunomodulatory treatment was used in 90.4% of CD patients after seton placement. Good initial control of perianal infection was achieved with a seton in CD and non‐CD patients, at 92.9% and 96.7%, respectively ( p  = 0.11). Overall fistula healing or control for CD and non‐CD patients was, respectively, 64% and 86% ( p  = 0.1) after curative surgery, 49% and 71% after seton removal ( p  = 0.21) and 58% and 50% with long‐term seton placement ( p  = 0.72). Overall reintervention for recurrence was 83% in CD versus 53.1% in non‐CD patients during the follow‐up period ( p  = 0.002). Conclusion Definitive surgery was possible in only a minority of CD patients. Long‐term seton management was an effective option in patients with CD with acceptable improvement and recurrence rates.
    Type of Medium: Online Resource
    ISSN: 1462-8910 , 1463-1318
    URL: Issue
    URL: Article
    DOI: 10.1111/codi.v23.9
    DOI: 10.1111/codi.15771
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2004820-8
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