A healthy diet is dominant in cardiovascular disease (CVD) prevention. Inflammation is pivotal for CVD development. This study aimed to evaluate the association between the pro‐inflammatory diet and the CVD risk. This cross‐sectional study involved 10,138 Fasa adult cohort study participants. After excluding participants with missing data, the Energy‐Adjusted Dietary Inflammatory Index (E‐DII) was calculated to assess the inflammatory potential of diet using the recorded Food Frequency Questionnaire. Framingham risk score (FRS) was used to predict the 10‐year risk of CVD. The association between E‐DII and high risk for CVD was investigated using multinominal regression. After exclusion, the mean age of studied individuals ( n = 10,030) was 48.6 ± 9.6 years, including 4522 men. Most participants were low risk (FRS <10%) for CVD (87.6%), while 2.7% of them were high risk (FRS ≥20%). The median FRS was 2.80 (1.70, 6.30). The E‐DII ranged from −4.22 to 4.49 (mean E‐DII = 0.880 ± 1.127). E‐DII was significantly associated with FRS. This result persisted after adjusting for confounding factors and in both genders. This study revealed that the pro‐inflammatory diet significantly increases the CVD risk. Consequently, reducing the inflammatory potential of diet should be considered an effective dietary intervention in CVD prevention.
24 May 2024 in International Journal of Cardiology Cardiovascular Risk and Prevention
Background: Framingham risk score (FRS) and Atherosclerotic Cardiovascular Disease risk score (ASCVDrs) are widely used tools developed based on the American population. This study aimed to compare the ASCVDrs and FRS in an Iranian population. Method: The participants of the Fasa Adult Cohort Study and the patients of the cardiovascular database of Vali-Asr Hospital of Fasa, aged 40-80 years, were involved in the present cross-sectional study. After excluding non-eligible participants, the individuals with a history of myocardial infarction or admission to the cardiology ward due to heart failure were considered high-risk, and the others were considered low-risk. The discriminative ability of FRS and ASCVDrs was evaluated and compared using receiver operating characteristic curve analysis. The correlation and agreement of ASCVDrs and FRS were tested using Cohen Kappa and Spearman. Results: Finally, 8983 individuals (mean age:53.9 +/- 9.5 y, 49.2 % male), including 1827 high-risk participants, entered the study. ASCVDrs detected a greater portion of participants as high-risk in comparison with FRS (28.7 % vs. 15.7 %). ASVD (AUC:0.794) had a higher discriminative ability than FRS (AUC:0.746), and both showed better discrimination in women. Optimal cut-off points for both ASCVDrs (4.36 %) and FRS (9.05 %) were lower than the original ones and in men. Compared to FRS, ASCVDrs had a higher sensitivity (79.3 % vs. 71.6 %) and lower specificity (64.5 % vs. 65.1 %). FRS and ASCVDrs had a moderate agreement (kappa:0.593,p-value<0.001) and were significantly correlated (Spearman:0.772,p-value<0.001). Conclusions: ASCVDrs had a more accurate prediction of cardiovascular events and identified a larger number of people as high-risk in the Iranian population.
Backgrounds and Aims: Type 2 diabetes and its complications are assumed to be major public health problems globally. Zinc is one of the elements that play a part in insulin secretion and signaling. Therefore, this study seeks the answer to the following question: “What are the effects of 220 mg zinc sulfate supplementation on the weight, blood pressure, and glycemic control of patients with Type 2 diabetes?”. Methods: In this randomized controlled double‐blind trial, 79 patients with Type 2 diabetes were allocated into two groups through permuted block randomization method. The study group received two capsules of 220 mg of zinc sulfate containing 50 mg of zinc, and the control group received two capsules of 220 mg of placebo ingredient per week for 12 weeks. At the start and end of the treatment period, the fasting blood glucose (FBG), glycated hemoglobin (HbA1c), zinc level, weight, waist circumference (WC), and blood pressure were measured. Results: After 12 weeks of follow‐up, 72 patients completed the study. There were no significant differences before and after the intervention in the FBG, HbA1c, zinc levels, and WC between the two groups. Intragroup analysis showed that weight and body mass index increased in the intervention group; however, these changes were not significant in comparison to the control group. Also, diastolic blood pressure significantly increased in the control group; however, changes in systolic blood pressure were not significant in both groups. Conclusion: Taking 220 mg of zinc sulfate supplement twice a week did not show significant benefit for weight, blood pressure, and glycemic control in patients with Type 2 diabetes. Trial Registration: This trial was registered on the Iranian Registry of Clinical Trials (IRCT) website with code number 29627 on September 18, 2018.
The first step to reducing the growing burden of cardiovascular disease (CVD) is to find modifiable risk factors with the highest burden in each population. Urban and rural citizens may have different priorities in this regard. This study aimed to compare the 10-year incidence probability of CVD events and its associated risk factors between rural and urban areas in Iran. Data was extracted from two big cohorts, Fasa Adults Cohort Study (FACS) and Shiraz Heart Study (SHS), with participation of over 12,000 general population. Linear regression models were used to test the difference in CVD risk between two populations. Totally, 6,258 FACS and 6,101 SHS participants entered the study. Urban participants had a significantly higher mean ASCVD score (4.43% vs. 5.51%, p-value < 0.001). Also, they significantly showed higher body mass index, waist circumference, cholesterol level, fasting blood glucose level, systolic blood pressure, educational attainment, and occupational status. However, the prevalence of smoking was higher in rural areas. Notably, socioeconomic parameters including marital, occupational, and educational statuses seem to have strong impact on cardiovascular risk factors. After adjustment for all confounders, living in the urban areas seemed to be associated with higher atherosclerotic CVD risk (β = 0.78, 95%CI: [0.69–1.05]), which was consistent across both sexes. Given the higher risk of cardiovascular events in urban areas and different profiles of risk factors between these two regions, preventive strategies should be precisely and separately designed for each population by the health authorities and policymakers in order to reduce the CVD toll efficiently.
» Traditional reliance on preoperative glycated hemoglobin (HbA1c) for surgical eligibility and periprosthetic joint infection (PJI) risk stratification has significant limitations, including surgical delays and poor reflection of short-term metabolic instability. » Perioperative hyperglycemia and glucose variability are stronger and more consistent determinants of PJI risk than static glycemic indices such as HbA1c. » Novel markers, such as fructosamine, and technologies, including continuous glucose monitoring, provide improved assessment of short-term glycemic control and variability and demonstrate superior prognostic utility for PJI compared with HbA1c. » Antidiabetic therapies may differentially influence PJI risk: insulin dependence marks higher risk, whereas oral agents, particularly metformin and glucagon-like peptide-1 receptor agonists, are increasingly associated with reduced short-term PJI risk, especially among diabetic and morbidly obese patients undergoing hip and knee arthroplasty. » Mechanistic evidence implicates effects on inflammation, angiogenesis, immune function, and bacterial biofilm formation in mediating the relationship between glycemic control, antidiabetic therapies, and PJI risk.