Arya Atherosclerosis
Volume:1 Issue: 3, Autumn 2005

Liposuction is a surgical procedure effective in reducing body fat, withgrowing application in conjunction with diet and exercise therapy in the treatment of obesity.In view of the positive effect of weight reduction on cardiovascular disease (CVD) riskfactors, such as body mass index (BMI), waist circumference (WC), waist-to-hip ratio(WHR), systolic and diastolic pressure, lipid profile, fasting blood sugar, insulin resistance,inflammatory markers (e.g. chronic reactive protein: CRP), antioxidant capacity, fibrinogenand lipoprotein A (Lpa), this study was conducted to assess the effect of liposuction as atherapeutic procedure in the treatment of obesity. A total of 24 non-diabetic obese women (BMI>30) with a mean age of48.7±7.3 years were studied. Before liposuction, the subjects filled out questionnairesobtaining demographic information. Complete physical examination, measurement of waistand hip circumference, height, weight and calculation of WHR and BMI were performed.Fasting blood samples were taken to measure fasting blood glucose, total cholesterol, highdensity lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG), fibrinogen,antioxidant capacity, CRP, lipoprotein A, serum insulin, and insulin resistance. Allmeasurements and physical examinations were repeated 12-14 weeks after liposuction.Data were analyzed with SPSS11 software using paired t-test and repeated measureANOVA. WHR, BMI and LDL decreased significantly following liposuction (P<0.05).Other parameters, however, did not change significantly, although there were signs ofpositive changes. Liposuction decreases BMI, WHR and LDL within 12-14 weeks ofliposuction. Providing these reductions are maintained, liposuction may prove valuable inreducing CVD risk factors, besides offering a means for obesity control.

Coronary artery disease (CAD) is the main cause of mortality inindustrial and developing countries. New risk factors including infections are underinvestigation as potential factors. One of these infectious agents is Helicobacter pylori,which has been investigated in numerous studies. This study was designed in view of thecontroversies surrounding the impact of Helicobacter pylori on the prognosis of patients with acute coronary syndrome (ACS). All patients with ACS including unstable angina and myocardial infarction whowere referred to Fatemieh Hospital between 20 February 2003 and 19 February 2004 andwere admitted to the CCU ward were enrolled in this cohort study. A total of 411 patients with ACS were evaluated for Helicobacter pylori serologically, and the occurrence of cardiac events needing angioplasty or coronary surgery was assessed. Mean age of patients was 59.97±38.12 years and 56% of them were male. The serology test for Helicobacter pylori infection was positive in 45.6±12.38%, negative in 43.8%, and borderline in 10.6% of patients. 191 patients had unstable angina and 220patients had myocardial infarction. In a one-month follow-up, 10% of the patients developed cardiac events and PCI or CABG was performed in 6.1% (16.1% totally). One-month occurrence of cardiac events in the group with Helicobacter pylori infection was 11.9% vs.19.3% in the group without infection (χ2 =3.078, P=0.079). This prospective study showed that Helicobacter pylori infection has noeffect on short term prognosis of patients with ACS.

Doppler echocardiography is used to evaluate global myocardialperformance. An index of myocardial performance (Tei Index) can be of great prognosticvalue in heart failure. This study was performed to assess the correlation between Tei Index (TI) and left ventricular end diastolic pressure (LVEDP). The study group consisted of 38 patients. Each patient underwentventriculographic evaluation (all had EF≤45). Eighteen patients had LVEDP<15 (14 males,4 females, 57±6 years old) and 20 subjects (15 males, 5 females, 56±7 years old) hadLVEDP≥15. Using Doppler echocardiography, TI was determined for all patients andcompared. Mean TI value was significantly different between subjects with LVEDP<15 andthose with LVEDP<15 (0.55±0.18 vs. 0.76±0.19, P<0.001, T=4.1). In patients with systolic heart failure (EF≤45), TI was significantly lower insubjects with LVEDP<15 compared to those with LVEDP≥15. Thus, TI may be useful fornoninvasive assessment of LVEDP in heart failure.

Hypertension is one of the most prevalent chronic diseases worldwide.Because of its chronicity, hypertension requires life-long therapy. Many patients tend todiscontinue therapy and seek alternative treatments. In this study, we evaluated the efficacy of two behavioral therapeutic techniques, namely relaxation and biofeedback-assisted relaxation in reducing blood pressure. Fifty-six mildly hypertensive men (aged between 30 and 60 years) who did notuse any pharmacological treatment, took part in this study. The participants were randomly divided into three groups, relaxation (group one), biofeedback-assisted relaxation (group two) and control (group three). The treatment course consisted of ten sessions (every other day). Relaxation was performed in groups one and two for 15 minutes during each session.In group 2, for another 15 minutes at the end of each relaxation session, blood pressure was measured at 2- to 3-minute intervals and declared to the patient. Heart rate and blood pressure were measured and recorded before and after each session. In the control group, only blood pressure was measured at each session. Stress was measured using Malekpoor questionnaire with 67% validity. Anxiety was measured by Ketel''s questionnaire. The patients filled stress and anxiety questionnaires before and after the study period (20 days). Mean systolic and diastolic blood pressures decreased after the study period ingroups one and two. There was a significant difference between groups one and three(P<0.05) and between groups two and three (P<0.05). Relaxation and biofeedback-assisted relaxation techniques can reducesystolic and diastolic blood pressure, hence their benefits in the treatment of hypertensioncan be used in appropriate settings.

Adequate intake of fruits and vegetables as part of the daily diet couldhelp prevent major non-communicable diseases including osteoporosis. Some nutrientsabundant in fruits and vegetables have been shown to affect bone health. In the presentstudy we evaluated fruit and vegetable intake in postmenopausal women with osteopeniawho had referred to bone mineral densitometry center of Shariati hospital in Tehran. The present cross-sectional study was carried out on 51 healthypostmenopausal women aged 45-60 years. Bone mineral density was measured by DualEnergy X-ray Absorptiometry at lumbar spine and total hip. All women were osteopenicaccording to WHO criteria. Food groups’ intake was assessed by 2 days 24 hour recall.Bone resorption was calculated by measuring carboxy-terminal telopeptide of type Ι collagen (crosslaps) and bone formation by measuring serum osteocalcin. No significant correlation was found for current food groups’ intake and bonemineral density at either lumbar spine or total hip. Fruit and vegetable intake wassignificantly negatively correlated with osteocalcin level (r = -0.4, P< 0.001). Serumosteocalcin level in those who consumed more than 400 grams of fruit and vegetable dailywas significantly lower than in the others (18±6.5 compared with 30±13.7, P<0.05). Increasing fruit and vegetable intake up to WHO recommendations forprevention of many chronic diseases can also be effective in prevention of osteoporosis and reducing fracture risk in postmenopausal osteopenic women. Intake of at least 400 grams of fruits and vegetables daily can complement what is currently recommended for osteoporosis prevention.

The clustering of several cardiovascular disease risk factors such asabdominal obesity, hypertension, dyslipidemia and disturbances in glucose metabolism hasbeen termed the Metabolic Syndrome (MS). The MS has been shown to predictcardiovascular disease (CVD) and diabetes. Epidemiological studies have demonstratedthat CVD is the main cause of worldwide mortality; they have also linked diabetes to anincreased risk of mortality due to CVD. According to the ATP III (Adult Treatment Panel) reports, individuals havingthree or more of the following criteria are defined as having the MS: abdominal obesity(waist circumference > 102 cm in men and >88 cm in woman), hypertriglyceridemia(triglyceride ≥ 150 mg/dl), low high-density lipoprotein (HDL) cholesterol (HDL<40 mg/dl in men and <50 mg/dl in women), high fasting blood sugar (FBS) (FBS≥110 mg/dl) and high blood pressure (BP) (BP≥130/85 mmHg). The SPSS package (SPSS Chicago IL) was used and the significance level was set at P<0.05. Overall, the age-adjusted prevalence of the MS was 25.4% and 21.7% in the urban and rural areas of Isfahan, respectively. It was the highest among 50-59-year-old rural Isfahani women (68.9%) and the lowest among rural Araki men (5.6%). We found approximately 21.9% of Iranian adults living in Central Iran tohave the MS. In summary, this study showed an increasing risk of the MS among middleaged woman in urban areas owing to their physical quality of life. The results indicate that primary prevention should not only consider biological risk factors, but also take account of sociodemographic variables to identify individuals at high risk for diabetes and cardiovascular disease.

Adequate intake of fruits and vegetables (at least five servings a day) isrecommended as a nutritional behavior of great importance in prevention of chronicdiseases. This study aimed to compare the intake of fruits and vegetables in adult malesand females of Isfahan and to assess its association with personal and demographic factors,as well as seasons. This cross-sectional study was performed on 123 healthy adults (64 malesand 59 females) during the cold season (fall and winter) and warm seasons (spring andsummer). Study samples were aged 30 to 60 years and were residents of Isfahan. Fruit and vegetable consumption was assessed using a 110-item semi-quantitative food frequency questionnaire on fruits and vegetables. Validity of the questionnaire was evaluated in a pilot study through comparison with two 24-hour food recalls and four food diaries. Mean consumption of fruits and vegetables was analyzed in males and females, as well as in age and educational groups. The relationship between the amount of fruit and vegetableconsumption and different factors including age, sex, level of education and occupation was determined through stepwise linear regression. Mean fruit consumption in men and women in cold seasons was 275.3±100.8 and 234.5±116.5 grams per day, respectively (P<0.05), and in warm seasons 217.6±95.5 and 185.3±77.1 grams per day, respectively (P<0.05). Vegetable consumption in men and women in cold seasons was 291.5±93.5 and 245.7±76.6 grams per day, respectively (P<0.05) and in warm season 197±76.3 and 166.4±60.7 grams per day, respectively (P<0.05). The proportion of men who consumed more than 5 servings of fruits and vegetables in a day was significantly greater than women (P<0.05). Fruit and vegetable intake in men educated below junior school and high school was significantly higher than in their female counterparts (P<0.05). Fruit and vegetable intake in single men was significantly lower than in their female counterparts (P<0.05). The findings show the effectiveness of social and cultural factors on the pattern of fruit and vegetable intake.

Prevalence of cardiovascular diseases (CVD) is 19.4% in Iran anddiabetes mellitus is an important CVD risk factor in this country. Non-insulin-dependentdiabetes mellitus (type II DM) is associated with increased morbidity and mortality due toatherosclerosis. With cardiac rehabilitation (CR) we can modify CVD risk factors such astype II DM and play an important role in decreasing its mortality and morbidity. Weinvestigated the effects of CR on cardiac patients with and without type II DM. In this retrospective before-and-after study we analyzed data from 496 cardiacpatients (419 with type II DM and 77 without type II DM). All of the subjects completeddemographic data questionnaires and underwent weight and height measurement, exercise test to assess exercise capacity (EC), echocardiography, and blood test to assess lipid profile and fasting blood glucose. The subjects then participated in a 24-session CRprogram. Each session consisted of 10 minutes warm-up, 40 minutes aerobic exercise, 10minutes cool-down and 20 minutes relaxation. They also took part in 8 educational sessions on life style modification, diet therapy and stress management supervised by CR team (a cardiologist, a physician, a physiotherapist, a nurse, a nutritionist and a psychiatrist). At the end of the program, all measurements, exams and tests were repeated. Data were analyzed with SPSS11.5 using independent t-test at level of P<0.05. We studied 419 non-diabetics (mean age: 55.61±9.41 years) and 77 diabetics(mean age: 58.59±7.76 years). Mean EC increased significantly after CR in both groups. Inthe diabetic group, EC increased significantly compared to the non-diabetic group(62.21±133.40 vs. 33.68±31/42, P=0.02). Mean levels of triglyceride, cholesterol, LDLcholesterol, as well as body mass index and heart rate decreased significantly after CR in both groups. However, no significant difference was seen between the two groups in respect of these variables. CR is an effective intervention in diabetics as well as non-diabeticsespecially given its remarkable effects in improving EC as a critical indicator of mortality andmorbidity of diabetic patients. Hence we suggest these patients undergo CR programs.

Lifelong behavior and risk factors of chronic diseases extend from earlylife to adulthood. It seems that dietary habits and unhealthy food consumption, as well aspassive smoking play an important role in the development of such diseases. Multiplestudies have shown that healthy lifestyle education in preschool children improves theirknowledge, attitude and practice about healthy lifestyle. This study was conducted toevaluate the effect of lifestyle education with educational posters in daycare centers onpreschool children. In an interventional study, 250 preschool children were selected via 2-stagerandom cluster sampling and taught tips on healthy lifestyle via educational posters. Theirknowledge on healthy lifestyle was assessed before and after (1 week and 3 months)education via a picture-questionnaire, and their practice and behavior were assessed before and after education via their favorite choice of snack in daycare centers. Collected data were analyzed using SPSS13 by paired t-test and Man Whitney test. The knowledge and practice scores of the studied subjects improvedsignificantly one week after intervention compared with baseline, and persisted until the third month after education. Healthy lifestyle education via poster for preschool children can significantlyimprove their knowledge and practice towards healthy lifestyle.

Loud noise is more than a hazard to hearing. Noise can hindercommunication, isolate workers, and impact on production and in some cases causephysiological health problems. It can also cause an array of health problems and create adangerous workplace. Hence it is important for workers to reduce their exposure to noise.Noise is defined as sounds that are unwanted, unpredictable and uncontrollable. If noiselevels are not reduced, their impact (physiological impact in particular) on health will begrave. This study measured and evaluated sound levels and assessed their adverse healthimpacts on textile industries workers. Time-weighted average sound level was measured with B & KEJ 2231 soundlevel meter. Sound levels were measured at all locations in textile factories. Two groups ofworkers were selected according to location (group A: major, group B: minor). Group Acomprised workers exposed to more than 85 dB (A). Their age range was 20-50 years with a working history of 5-30 years. Noise-related physiological parameters were evaluated using questionnaires. The questionnaires obtained information on blood pressure, gastrointestinal and cardiovascular condition, bowl disorders, dizziness, sleep problems, and fatigue. Mean systolic and diastolic blood pressure was 117.5 mmHg and 74 mmHgrespectively in group A, and 118 mmHg and 77.8 mmHg respectively in group B. There is no evidence to support the relationship between noise levels above85 db (A) and high blood pressure, loss of sleep and gastrointestinal problems, however,there is significant evidence supporting the relationship between noise levels above 85 dBand adverse physiological effects.