Papers by Parinaz Poursafa
International journal of preventive medicine, 2014
The aim of this study is to investigate the association of calcium and magnesium concentration of... more The aim of this study is to investigate the association of calcium and magnesium concentration of drinking water with cardiovascular disease (CVDs) in urban and rural areas of a city in Iran. This case-control study was conducted in 2012 in Khansar County in Isfahan province, Iran. We used the official data of the Provincial health center regarding the chemical analysis data of urban and rural areas including the hardness, calcium and magnesium content of drinking water. Data of patients hospitalized for CVD in the only specialty hospital of the city was gathered for the years of 2010 and 2011. In 2010, water calcium content above 72 mg/L was associated with reduced number of CVDs in 1000 population; whereas in 2011 this decrease in CVDs was observed for calcium levels of more than 75 mg/L. In 2010, the level of water Mg content ranged from 23 to 57 mg/L. By increasing Mg hardness level above 31 mg/L in 2010 and above 26 mg/L in 2011 were associated with decreased number of CVDs in ...
Journal of Pediatrics Review, 2017
Context: Exposure to endocrine-disrupting chemicals (EDCs) can contribute to the risk of childhoo... more Context: Exposure to endocrine-disrupting chemicals (EDCs) can contribute to the risk of childhood and adolescent obesity. Objectives: The aim of this study was to systematically review the literature concerning the association of bisphenol A (BPA) and phthalates with obesity in children and adolescents. Data Sources: Scopus, ISI Web of Science, PubMed, Google Scholar, and Medline were searched to identify studies published up to January 2017. A secondary reference review of all extracted articles was also conducted. Study Selection: All studies that had assessed the relationship between BPA and phthalates with obesity in children and adolescents were included in the present systematic review. Finally, 35 studies were relevant. Data Extraction: The current review was conducted and reported in accordance with the Preferred Reporting Items for systematic reviews and meta-analyses (PRISMA) statement. Results: Thirty-five original studies met the inclusion criteria, consisting of 20 cross sectional, 3 case control, 11 cohort studies and one clinical trial study. Nineteen studies reported that childhood exposure to environmental chemicals including BPA and phthalic acid esters (PAEs) during childhood could increase the risk of excess weight. In addition, 10 studies found no correlation between these compounds and obesity. Conclusions: The effects of BPA and phthalates have diverse mechanisms; these chemicals disrupt some functional, structural, and epigenetic mechanisms that control energy homeostasis, appetite regulation, lipid metabolism, and adipogenesis. However, additional longitudinal studies are needed to confirm and validate the current findings.
Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 2012
This study aims to determine the association of some genetic polymorphisms in the relationship of... more This study aims to determine the association of some genetic polymorphisms in the relationship of air pollutants on the serum levels of thrombomodulin (TM) and tissue factor (TF) in a population-based sample of children and adolescents. This cross-sectional study was conducted among 110 participants (52.8% girls) with a mean age of 12.7 + 2.3 years, in Isfahan, Iran. Genotypes of TM G33-A and + 5466A > G polymorphisms were determined by the polymerase chain reaction - restriction length fragment polymorphism method (PCR-RFLP). The enzyme-linked immunosorbent assay (ELISA) was used for measurement of serum TM and TF. THE FOLLOWING GENOTYPES WERE IDENTIFIED FOR TM: GG in 69.2%, GA in27.2%, and AA in 3.6% of the participants. Considering TF, 108 participants were homozygous for the + 5466A allele, and two subjects had + 5466AG genotype. The mean pollution standards index (PSI) value was at a moderate level; the mean particulate matter measured up to 10 μm (PM(10)); and ozone (O(3)),...
Iranian journal of public health, 2010
Screening of students' health problems could lead to timely prevention and control of many he... more Screening of students' health problems could lead to timely prevention and control of many health disorders. This study aimed to determine the nationwide prevalence of common disorders through school health screening program in Iran This cross-sectional national screening program was conducted in 2007-2008 among first- and third-grade-students in primary schools, first-grade-students of middle and high schools of all provinces in Iran. Data were obtained from 3,124,021 (81.9%) students reported from the whole country classified into 33 geographical zones. Of total students studied, 12.48% had weight abnormalities, 4.77% had visual disorders, 3.95 % had head lice, 2.24% had behavioral disorders, and 0.6% had hearing disorders. Among students studied, 0.4%, 0.7%, 0.4% and0.8% had endocrine, psychological, neurological and genitourinary disorders, respectively. In addition, 2.1%, 1.9%, 1.8%, 0.8%0.5%, 0.3% and 0.3% of students had ear, nose & pharynx disorder, anemia, skin & hair, ...
The Southeast Asian journal of tropical medicine and public health, 2012
Metabolic syndrome (MetS) increases the risk of developing many chronic diseases and originates e... more Metabolic syndrome (MetS) increases the risk of developing many chronic diseases and originates early in life; its prevalence varies by population. The present study investigated the prevalence of MetS and the association between MetS and obesity in a population of adolescents in northern Iran. A total of 450 Iranian high school students (50% boys), aged 15-18 years, were enrolled in the study. Physical examination and biochemical analyses were conducted according to standard protocols; MetS was defined according to the modified NHANES III criteria. The prevalence of MetS among subjects was 3.3%. Eight percent of subjects had a body mass index (BMI) >75th percentile, and 10.5% had a BMI >85th percentile. Overall, 42.1% of students did not have any components of MetS. Waist circumferences (WC), Body Mass Index (BMI), serum level of triglycerides (TG) and high density lipoprotein-cholesterol (HDL-C) were significantly higher among girls than boys. Systolic blood pressure (SBP) a...
Iranian journal of pediatrics, 2011
This study aimed to develop and test the validity of a risk score to be used as a simple tool to ... more This study aimed to develop and test the validity of a risk score to be used as a simple tool to identify those children at high risk of sonographic non-alcoholic fatty liver disease (NAFLD). This cross-sectional study was conducted among 962 participants aged 6-18 years in Isfahan, Iran. They consisted of three groups of nearly equal number of normal-weight, overweight and obese individuals. Coefficients of the logistic regression models were used to assign a score value for each variable and the composite sonographic NAFLD risk score was calculated as the sum of those scores. Performance of model was assessed by receiver operating characteristic (ROC) curve procedure. Data of 931 participants was included in the analysis. The sonographic findings of 16.8% of participants were compatible with NAFLD. Age, sex, body mass index, waist circumference and serum triglycerides level were diagnosed as factors associated with NAFLD. The risk score was calculated as 50 for sonographic NAFLD. ...
Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 2011
This study aimed to determine the secular trends in the national prevalence of overweight and obe... more This study aimed to determine the secular trends in the national prevalence of overweight and obesity among 6-year-old Iranian children, and to compare the results in Northern, Central and Southern parts of the country. The data were collected as part of a routine and mandatory national screening program on children entering elementary schools in 2007, 2008 and 2009. The study population comprised 2,600,065 children including 862,433 in 2007, 782,244 in 2008 and 955,388 in 2009. Of total children 12.8%, 13.5% and 10.9% were overweight in 2007, 2008 and 2009, respectively (P > 0.05). The corresponding figures for obesity were 3.4%, 3.5% and 3.4%, respectively (P > 0.05). In all surveys, the prevalence of overweight was higher in Southern region than in the other two regions. P for trend was not significant for prevalence rates of overweight and obesity in any of the regions. To the best of our knowledge, this study was the first of its kind in presenting the nationwide trend of...
International journal of preventive medicine, 2011
The purpose of this study was to assess the effects of exercise on the aerobic power, serum lacta... more The purpose of this study was to assess the effects of exercise on the aerobic power, serum lactate level, and cell blood count among active individuals in the environments with similar climatic characteristics differing in their level of air pollution. This trial comprised 20 volunteer students of Physical education in The University of Isfahan, Iran. Two places with the same climate (altitude, temperature, and humidity), but low and high level of air pollutants air were selected in Isfahan, Iran. Participants underwent a field Cooper test with a 12-minute run for fitness assessment. Then the aerobic power, serum lactate, and cell blood counts were measured and compared between the two areas. The study participants had a mean (SD) age of 21.70 (2.10) years and body mass index (BMI) of 24.44 (2.32) Kg/m2. We found a significant decrease in mean Vo2 max, red blood cell count, hemoglobin, hematocrit, and mean corpuscular hemoglobin, as well as significant increase in mean lactate leve...
Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 2011
Some experimental studies revealed that exposure to air pollution increases the expression of tis... more Some experimental studies revealed that exposure to air pollution increases the expression of tissue factor (TF) in atherosclerotic lesions. We aimed to investigate the role of TF +5466A>G (rs3917643) polymorphism in the association of air pollution on serum levels of TF as a biomarker of vascular injury in children. This cross-sectional study was conducted among 110 children, consisting of 58 (52.8%) girls and 52 (47.2%) boys with a mean age of 12.7 ± 2.3 years, living in Isfahan, Iran. Enzyme-linked immunosorbent assay were used for measurement of serum TF. Genotype of +5466A>G (rs3917643) polymorphism was determined by the polymerase chain reaction-restriction length fragment polymorphism (PCR-RFLP) method. We identified 2 individuals with +5466AG genotype and 108 homozygous for the +5466A allele (no +5466GG homozygotes). The mean pollution standards index (PSI) value was at moderate level, the mean particular matter measuring up to 10 μm (PM(10)) was more than twice the no...
Pakistan Journal of Medical Sciences, 2015
Objectives: Air pollution is a hazardous environmental problem with several adverse health effect... more Objectives: Air pollution is a hazardous environmental problem with several adverse health effects including its impact on the development of chronic diseases as diabetes mellitus. This study aimed to investigate the association of geographical distribution of air quality index (AQI) and type 2 diabetes mellitus in an air-polluted city by using geographic information system (GIS). Methods: This cross-sectional study was conducted in Isfahan, Iran. The records that have been registered from 2009 to 2012 in major referral public diabetes clinics were gathered; they included data of 1467 diabetic patients. Their living area was represented with spots in the city map. AQI data were also interpolated from monitoring stations spreading around the city. The GIS maps of air pollutants and diabetes were developed and the associations were determined. Results: The density of diabetic population was higher in highly polluted areas compared with areas with the lower levels of air pollution. No significant correlation was documented between the distribution of diabetic patients and air pollution level throughout the city. Conclusion: Although the density of diabetic patients was higher in areas with higher air pollution, but the lack of association between AQI and the prevalence of diabetes might be because the air of different parts of the city was highly polluted, and we could not compare the prevalence of diabetes in areas with clean and polluted air.
Endokrynologia Polska, 2013
Introduction: The aim of this study was to assess the validity of a continuous Metabolic Syndrome... more Introduction: The aim of this study was to assess the validity of a continuous Metabolic Syndrome score (cMetS) in a nationally representative sample of Iranian children and to identify sex and age-specific optimal cutoff points of cMetS that are associated with MetS. Material and methods: This study was conducted among 3,254 schoolchildren aged 10-18 years. cMetS was derived by aggregating age and sex-standardised residuals of waist circumference (WC), mean arterial pressure (MAP), glucose, high density lipoprotein-cholesterol (HDL-C) and triglycerides (TG). To determine the optimal cutoff points of cMetS for predicting MetS, receiver operator characteristic (ROC) curve analysis was used with an estimation of the variables' sensitivity and specificity. Results: A graded relationship was documented between cMetS and the number of risk factors. Increasing mean values of cMetS with increasing numbers of components were apparent for both genders. The overall optimal cMetS cutoff point for predicting the presence of MetS was 2.93 [sensitivity = 92%, specificity = 91%, area of the curve = 0.96 (0.95-0.97)]. The values for boys and girls were 2.97 and 3.26 respectively in the total study. Conclusion: This nationwide study confirmed the validity of the cMetS score in a population-based sample of Iranian children. cMetS appears to be an appropriate index for investigating the association between potential risk factors and MetS in epidemiological research in Iran.
Jornal de Pediatria, 2014
Objective: this study aimed to simplify the diagnostic criteria of pre-hypertension (pre-HTN) and... more Objective: this study aimed to simplify the diagnostic criteria of pre-hypertension (pre-HTN) and hypertension (HTN) in the pediatric age group, and to determine the accuracy of these simple indexes in a nationally-representative sample of Iranian children and adolescents. Method: the diagnostic accuracy of the indexes of systolic blood pressure-to-height ratio (SBPHR) and diastolic BPHR (DBPHR) to define pre-HTN and HTN was determined by the area under the curve of the receiver operator characteristic curves. Results: the study population consisted of 5,738 Iranian students (2,875 females) with mean (SD) age of 14.7 (2.4) years. The prevalences of pre-HTN and HTN were 6.9% and 5.6%. The optimal thresholds for defining pre-HTN were 0.73 in males and 0.71 in females for SBPHR, and 0.47 in males and 0.45 in females for DBPHR, respectively. The corresponding figures for HTN were 0.73, 0.71, 0.48, and 0.46, respectively. In both genders, the accuracies of SBPHR and DBPHR in diagnosing pre-HTN and HTN were approximately 80%.
Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 2012
This study aimed to determine the association of particulate matters with endothelial function, m... more This study aimed to determine the association of particulate matters with endothelial function, measured by flow mediated dilation (FMD) of brachial artery, in children with or without exposure to secondhand smoke. This cross-sectional study was conducted from January to March 2011 in Isfahan, which is the second large and air-polluted city in Iran. The areas of the city with lowest and highest air pollution were determined, and in each area, 25 prepubescent boys with or without exposure to daily tobacco smoke in home were selected, i.e. 100 children were studied in total. FMD was significantly smaller in those living in high-polluted area and those exposed to secondhand smoke. Multiple linear regression analysis, adjusted for age and body mass index, showed that both passive smoking status and living area in terms of particulate air pollution were effective determinants of the brachial artery diameter. The standardized coefficient of passive smoking status was -0.36 (SD = 0.09, P &...
Dyslipidemia - From Prevention to Treatment, 2012
Hepatitis Monthly, 2011
Nonalcoholic fatty liver disease (NAFLD) is becoming as an important health problem for children ... more Nonalcoholic fatty liver disease (NAFLD) is becoming as an important health problem for children and adolescents.In addition to excess weight, the role of environmental factors, as smoking and air pollution should be considered in this regard. This study is recommended to specialists in internal medicine, pediatrics,environmental health , general practitioners, health policy makers, and health professionals.
Air Pollution - New Developments, 2011
Jornal de Pediatria, 2011
Objective: To assess the relationship of air pollution and hematologic parameters in a population... more Objective: To assess the relationship of air pollution and hematologic parameters in a population-based sample of children and adolescents. Methods: This cross-sectional study was conducted in 2009-2010 among school students randomly selected from different areas of Isfahan city, the second largest and most air-polluted city in Iran. The association of air pollutants levels with hemoglobin, platelets, red and white blood cells (RBC and WBC, respectively) levels was determined by multiple linear and logistic regression analyses, after adjustment for age, gender, anthropometric measures, meteorological factors, and dietary and physical activity habits. Results: The study participants consisted of 134 students (48.5% boys) with a mean age of 13.10±2.21 years. While the mean Pollutant Standards Index (PSI) was at moderate level, the mean particulate matter ≤ 10 µm (PM 10) was more than twice the normal level. Multiple linear regression analysis showed that PSI and most air pollutants, notably PM 10 , had significant negative relationship with hemoglobin and RBC count, and positive significant relationship with WBC and platelet counts. The odds ratio of elevated WBC increased as the quartiles of PM 10 , ozone and PSI increased, however these associations reached to significant level only in the highest quartile of PM 10 and PSI. The corresponding figures for hemoglobin and RBC were in opposite direction. Conclusions: The association of air pollutants with hematologic parameters and a possible pro-inflammatory state is highlighted. The presence of these associations with PM 10 in a moderate mean PSI level underscores the necessity to reexamine environmental health policies for the pediatric age group.
Archives of Medical Science, 2014
Introduction: This study aims to investigate the relationship of water hardness and its calcium a... more Introduction: This study aims to investigate the relationship of water hardness and its calcium and magnesium content with endothelial function in a population-based sample of healthy children and adolescents. Material and methods: This case-control study was conducted in 2012 among 90 individuals living in two areas with moderate and high water hardness in Isfahan County, Iran. The flow-mediated dilatation (FMD) of the brachial artery and the serum levels of soluble adhesion molecules (sICAM-1, sVCAM-1) were measured as surrogate markers of endothelial function, and high-sensitivity C-reactive protein (hs-CRP), as a marker of inflammation. Results: Data of 89 participants (51% boys, mean age 14.75 (2.9) years) were complete. Those participants living in the area with high water hardness had higher FMD, hs-CRP, and soluble adhesion molecules (sICAM-1, sVCAM-1) than their counterparts living in the area with moderate water hardness. Multiple linear regression analysis showed that after adjustment for confounding factors of age, gender, body mass index, healthy eating index and physical activity level, total water hardness, as well as water content of calcium and magnesium, had a significant positive relationship with FMD. The corresponding associations were inverse and significant with soluble adhesion molecules (p < 0.05). Conclusions: This study, which to the best of our knowledge is the first of its kind in the pediatric age group, suggests that water hardness, as well as its calcium and magnesium content, may have a protective role against early stages of atherosclerosis in children and adolescents.
Pakistan Journal of Medical Sciences, 2013
Backgroun & Objectives: High-sensitivity C-reactive protein (hs-CRP) and the adipokine resistin a... more Backgroun & Objectives: High-sensitivity C-reactive protein (hs-CRP) and the adipokine resistin are suggested as predictive factors for chronic diseases; however their association with liver enzymes and cardiometabolic risk factors in overweight children remain to be determined. This study aimed to determine the association of resistin and hs-CRP with liver enzymes and cardiometabolic risk factors in a nationally-representative sample of Iranian obese children and adolescents. Methodology: This cross-sectional multi-center study was performed on 100 overweight and or obese adolescents. It was performed as a sub-study of a nationwide survey entitled CASPIAN-III Study, conducted among 5570 students living in 27 provinces in Iran. Participants were randomly selected from students with age-and gender-specific body mass index (BMI) of >+1 z-score. Results: Data from 96 participants (49 boys) were complete and are included in the statistical analysis. The mean (SD) age of participants was 15.01 (2.4) years. Resistin had significant correlations with indexes of generalized and abdominal obesity, as well as with serum alanine aminotransaminase, aspartate aminotransaminase, fasting blood glucose, and triglycerides. It had inverse association with serum HDL-C concentration, and marginally significant correlations with total-and LDL-cholesterol. Hs-CRP had significant correlation with indexes of abdominal obesity, inverse marginal association with HDL-C, and marginally significant association with BMI and triglycerides. Multiple regression analysis, adjusted for age and gender, revealed nearly similar associations. Conclusions: Our findings suggest that resistin seems to have a contributory role in childhood obesity and its metabolic consequences as fatty liver and metabolic syndrome. The common significant association of resistin and hs-CRP with other variables was mainly their correlation with abdominal obesity. Further studies should be considered for the underlying pathophysiological process of resistin, as well as for the clinical implications of the current findings.
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Papers by Parinaz Poursafa