Assessment of airborne asbestos fiber concentrations in urban area of Tehran, Iran

Air quality in ambient outdoor air has seldom been evaluated in Iran. Accordingly, we evaluated airborne asbestos fiber concentrations in the urban environment of Tehran, Iran between January 2006 and March 2007. The airborne fiber concentrations of 80 air samples collected from 40 different sites in five areas of Tehran were analyzed by energy-dispersive X-ray analysis in combination with phase-contrast optical microscopy (PCM) and scanning electron microscopy (SEM). The geometric means of the airborne asbestos fiber concentrations were 3.4 × 10⁻³ PCM f/ml (0.1 SEM f/ml) and 3.3 × 10⁻³ PCM f/ml (0.20 SEM f/ml) according to areas and seasons, respectively. There were significant differences in the asbestos fiber concentrations between the areas and seasons (p = 0.02; p = 0.04), respectively. In the areas, the average concentration was 3.4 × 10 ⁻³ PCM f/ml (0.1 SEM f/ml), which is considerably higher than those reported for the levels of asbestos in outdoor air in the USA and the urban environment of the Europe. The SEM analyses revealed that the fibrous particles consisted, approximately, of chrysotile (60%), tremolite (10%), anthophyllite (10%), and non-asbestos fibers (20%). We conclude that the high volume of traffic, industrial consumption of asbestos, and geographical and climate conditions are responsible for the high airborne asbestos levels in non-occupational environments in Tehran. Thus, it is to be expected that inhabitants of Tehran will suffer negative health effects due to exposure to asbestos airborne fibers.     

Asbestos Exposure among Construction Workers During Demolition of Old Houses in Tehran,Iran

Air quality in demolition practices has seldom been evaluated in Iran. Accordingly, we evaluated asbestos exposure among Tehran construction workers during the demolition of old houses. To identify possible sources of asbestos exposure, including thermal insulations, chimney pipes and cement sheets, were all sampled. This study also were taken the personal air samples to evaluate any asbestos exposure during the demolition. The asbestos fibers found in the samples were analyzed by phase-contrast optical microscopy (PCM), scanning electron microscopy (SEM) equipped with an energy dispersive X-ray analysis, and polarized light microscopy (PLM) methods. Personal monitoring of asbestos fiber levels indicated a range from 0.01 to 0.15 PCM f/ml (0.02–0.42 SEM f/ml). The geometric mean concentrations were 0.07 PCM f/ml (0.20 SEM f/ml), which is considerably higher than the threshold limit value (TLV) proposed by American Conference of Governmental Industrial Hygienist (ACGIH), which is 0.1 f/ml. The analysis showed a presence in the bulk samples only chrysotile asbestos and an absence of the other type asbestos. Therefore, it might be expected that workers who worked in the demolition of old houses will suffer from negative effects of exposing to the asbestos fibers.     

Evaluation of asbestos exposure during brake repair and replacement

Occupational exposure to asbestos fiber of brake repair job (auto mechanics) has seldom been evaluated in Iran. Accordingly, we evaluated asbestos fiber concentrations in the breathing zone of auto mechanics between July 2008 and December 2008. The asbestos fiber concentrations of 60 personal air samples collected from 30 cars and trucks brake replacement and they were analyzed by phase-contrast optical microscopy (PCM) and scanning electron microscopy (SEM) by energy-dispersive X-ray analysis. The geometric means of the personal monitoring fiber concentrations were 0.92 PCM f/ml and 0.46 PCM f/ml respectively in car and passenger heavy truck auto shops. There was a significant differences in the asbestos fiber concentrations between the car and truck auto shops (p=0.006). Based on these findings, auto mechanics who worked with asbestos containing brake may have been exposed to asbestos concentrations approximately 7 times higher than the current occupational safety and health agency (OSHA) permissible exposure limit (PEL) of 0.1 f/ml. Fiber morphology and energy dispersive X-ray analysis by SEM revealed that amphibole fibers such as tremolite and actinolite existed in the brakes dust and that the vast majority (>30%) of the airborne chrysotile fibers were greater than 1 μm in diameter. It can be concluded that the imported chrysotile asbestos contains trace amounts of tremolite and actinolite fibers and they are responsible for the high airborne asbestos levels and occupational exposure to amphibole asbestos in auto mechanics job in Iran. Thus, it is to be expected that the auto mechanics will suffer negative health effects due to exposure to the serpentine and amphibole asbestos fibers.     

Increased Risk of Lung Cancer Mortality among Residents near an Asbestos Product Manufacturing Plant

Abstract

We investigated whether individuals exposed to asbestos by living near an asbestos-manufacturing facility experienced increased lung cancer mortality. We studied a neighborhood around such a plant in the central Japanese city of Hashima. From 1943 to 1991 this plant produced insulation and packing material using amosite- and chrysotile-type asbestos fibers. The study group was comprised of 577 households. We obtained demographic information by a questionnaire and determined the underlying cause of death for deceased household members from death certificates. Using hourly meteorological data from local observatories, we estimated relative asbestos concentrations in the plant's vicinity, determined the quartile boundaries, and designated each study subject's quartile of ambient exposure. Finally, we calculated standardized mortality ratios to evaluate the association of residential asbestos with lung cancer risk. Our findings strongly suggest that neighborhood asbestos exposure can increase the risk of lung cancer mortality in men and probably in women.     

Sense of control and wellbeing decades after exposure to blue asbestos at Wittenoom,Western Australia

Abstract

Objective: The objective of this study was to examine the impact of the knowledge of past asbestos exposure on psychosocial health.

Methods: Blue asbestos was mined and milled at Wittenoom in Western Australia between 1943 and 1966. In 2007, SF-12 and Locus of Control (LOC) questionnaires were sent to 5,101 surviving Wittenoom workers and residents. Wellbeing scores and LOC scores were then examined in relation to quantitative exposure measures using linear regression.

Results: Wellbeing scores were lower among Wittenoom workers and residents compared with the Western Australian population, although an exposure-response relationship with cumulative asbestos exposure was not found. Those who arrived in Wittenoom as children had a more external sense of control than those who arrived there as adults. There was a 0·12 increase in LOC with a 2·7-fold increase in cumulative asbestos exposure (f/ml-years) (P<0·01).

Conclusions: The study concluded that asbestos operation at Wittenoom may have had a detrimental impact on former workers’ and residents’ sense of control over their lives.     

A meta-analysis of airborne asbestos fiber concentrations from work with or around asbestos-containing floor tile

In this meta-analysis, exposures to airborne asbestos during work with or around floor tiles were characterized according to several variables: study, sample type, activity, and task. Personal breathing zone, bystander, and area sample exposure concentrations were differentiated and compared against current occupational exposure limits to asbestos. In total, 22 studies, including 804 personal, 57 bystander, and 295 area samples, were included in the analysis. The arithmetic mean airborne fiber concentrations were 0.05, 0.02, and 0.01 f/cm³ for personal, bystander, and area samples, respectively. Arithmetic mean time-weighted-average fiber concentrations over an 8-h working day were 0.02 and 0.01 f/cm³ for personal and bystander samples, respectively. Phase contrast microscopy (PCM) personal airborne fiber concentrations were highest for maintenance activities, followed by removal and installation. Tasks that involved buffing or burnishing, scoring or snapping, and scraping or lifting had the highest personal PCM concentrations, while stripping floor tile and removing it with chemical solvent had the lowest concentrations. Exposures associated with handling asbestos floor tiles, under working conditions normally encountered, do not generally produce airborne concentrations at levels that exceed the current OSHA PEL nor do they appear to approach the threshold cumulative asbestos dose concentrations that have been previously associated with an increased risk of asbestos-related disease.     

Chrysotile asbestos exposure associated with removal of automobile exhaust systems (ca. 1945-1975) by mechanics: results of a simulation study

For decades, asbestos-containing gaskets were used in virtually every system that involved the transport of fluids or gases. Prior to the mid-1970s, some automobile exhaust systems contained asbestos gaskets either at flanges along the exhaust pipes or at the exhaust manifolds of the engine. A limited number of automobile mufflers were lined with asbestos paper. This paper describes a simulation study that characterized personal and bystander exposures to asbestos during the removal of automobile exhaust systems (ca. 1945-1975) containing asbestos gaskets. A total of 16 pre-1974 vehicles with old or original exhaust systems were studied. Of the 16 vehicles, 12 contained asbestos gaskets in the exhaust system and two vehicles had asbestos lining inside the muffler. A total of 82 samples (23 personal, 38 bystander, and 21 indoor background) were analyzed by Phase Contrast Microscopy (PCM) and 88 samples (25 personal, 41 bystander, and 22 indoor background) by Transmission Electron Microscopy (TEM). Only seven of 25 worker samples analyzed by TEM detected asbestos fibers and 18 were below the analytical sensitivity limit (mean 0.013 f/cc, range 0.001-0.074 f/cc). Applying the ratio of asbestos fibers:total fibers (including non-asbestos) as determined by TEM to the PCM results showed an average (1 h) adjusted PCM worker exposure of 0.018 f/cc (0.002-0.04 f/cc). The average (1 h) adjusted PCM airborne concentration for bystanders was 0.008 f/cc (range 0.0008-0.015 f/cc). Assuming a mechanic can replace four automobile single exhaust systems in 1 workday, the estimated 8-h time-weighted average (TWA) for a mechanic performing this work was 0.01 f/cc. Under a scenario where a mechanic might repeatedly conduct exhaust work, these results suggest that exposures to asbestos from work with automobile exhaust systems during the 1950s through the 1970s containing asbestos gaskets were substantially below 0.1 f/cc, the current PEL for chrysotile asbestos, and quite often were not detectable.     

Heme Iron Concentrate and Iron Sulfate Added to Chocolate Biscuits: Effects on Hematological Indices of Mexican Schoolchildren

Objective: Food fortification is one of the most effective strategies for increasing iron intake in the population. A simple blind trial was conducted to compare the effect of 2 forms of iron fortification and assess the changes in hemoglobin and iron status indices among preschool children from rural communities.

Methods: Hemoglobin was evaluated in 47 children aged 3–6 years old. For 72 days (10-week period), children ate Nito biscuits. Thirteen pupils with elevated hemoglobin levels were assigned to the biscuit control group, and pupils with hemoglobin equal to 13.5 mg/dL or less were randomly allocated to consume fortified biscuits with a heme iron concentrate (n = 15) or iron sulfate (n = 19). Changes in hemoglobin, plasma ferritin, and other hematological indices were evaluated with analysis of variance (ANOVA) for repeated measurements.

Results: Except mean corpuscular hemoglobin concentrations (+1.27 ± 2.25 g/dL), hematological indices increased significantly across the study: Mean corpuscular volume (+2.2 ± 1.0 f/dL), red blood cells (+0.30 ± 0.37 M/μL), mean corpuscular hemoglobin (+1.8 ± 1.74 pg), hemoglobin (+1.68 ± 0.91 g/dL), hematocrit (+3.43% ± 3.03%), and plasma ferritin (+18.38 ± 22.1 μg/L) were all p < 0.05. After 10 weeks, the adjusted effect of the iron-fortified chocolate biscuits in the hemoglobin levels was higher than the control group (+1.1 ± 0.2 g/dL) but no difference was found between consumers of fortified biscuits with heme iron concentrate or iron sulfate (+1.9 ± 0.2 g/dL and +2.0 ± 0.2 g/dL, respectively).

Conclusion: Heme iron concentrate and iron sulfate were equally effective in increasing Hb levels and hematological indices. Processed foods were shown to be an effective, valuable, and admissible intervention to prevent anemia in preschool children.     

Occupational and leisure-time physical activity and workload among construction workers – a randomized control study

Background: There is a lack of quantification of occupational physical activity (OPA) and leisure time physical activity (LTPA) among construction workers.

Objectives: To describe physical activity energy expenditure (PAEE), physical workload, and the effect of a PA-intervention among construction workers.

Methods: Sixty-seven Construction workers self-reported their physical activity (PA), had PA assessed directly (PAEE), and observed OPA using the tool “Posture, Activity, Tools and Handling.” The PA-intervention (Intervention; n = 29, Controls; n = 24) included 3x20-min training/week for 12 weeks.

Results: Baseline median OPA was 5036 MET-min/week and LTPA 2842 MET-min/week, p < 0.01. OPA directly recorded was (mean ± SE): 56.6 ± 3.2 J/kg/min and LTPA was: 35.7 ± 2.2 J/kg/min (p < 0.001). Manual material handling was performed for ≥ 25% of working time by more than 50% of the participants. Post-intervention, the training group reduced overall PAEE compared to the control group but not specifically during work.

Conclusions: OPA was within the maximum recommended level of 1/3 proposed in consensus guidelines but did not decrease with PA-intervention.     

Source apportionment of BTEX compounds in Tehran,Iran using UNMIX receptor model

Understanding the distribution levels and sources of volatile organic compounds (VOC), mainly benzene, toluene, ethyl benzene and xylenes (BTEX), in the ambient atmosphere is important for efficiently managing and implementing the associated control strategies. We measured BTEX compounds at an industrial location in the west Tehran city (Iran), which is highly influenced by industrial activities and traffic during the winter and spring seasons during 2014–2015. A multivariate receptor model, UNMIX, was applied on the measured data for the identification of the sources and their contributions to BTEX compounds in a highly industrialised and trafficked atmospheric environment of Tehran city. Three main groups of sources were identified. These included solvent and painting sources (e.g. vehicle manufacturing), motorised road vehicles and mixed origin sources. Whilst the solvent and painting sources and vehicle exhaust emissions contributed to about 5 and 29 % of total BTEX mass, respectively, the mixed origin source contributed to about two third (～66 %) of the remaining mass. These mixed origin sources included rubber and plastic manufacturing (39 %), leather industries (28 %) and the unknown sources (33 %). The mean concentrations of benzene, toluene, ethyl benzene and average xylene (o, p.m.) compounds were measured as 28.96?±?9.12 μg m^?3, 29.55?±?9.73 μg m^?3, 28.61?±?12.2 μg/m^?3 and 25.68?±?10.58 μg m^?3, respectively. A high correlation coefficient (R ²?>?0.94) was also found between predicted (modelled) and measured concentrations for each sample. Further analyses from UNMIX receptor model showed that the average weekday contributions of BTEX compounds were significantly higher during winter compared with those during spring. This higher concentration during winter may be attributed to calm wind conditions and high stability of the atmosphere, along with the after effect of government policies on the use of cleaner fuel in refineries that became operational in winter 2014.     

Asbestos in commercial cosmetic talcum powder as a cause of mesothelioma in women

Abstract

Background:

Cosmetic talcum powder products have been used for decades. The inhalation of talc may cause lung fibrosis in the form of granulomatose nodules called talcosis. Exposure to talc has also been suggested as a causative factor in the development of ovarian carcinomas, gynecological tumors, and mesothelioma.

Purpose:

To investigate one historic brand of cosmetic talcum powder associated with mesothelioma in women.

Methods:

Transmission electron microscope (TEM) formvar-coated grids were prepared with concentrations of one brand of talcum powder directly, on filters, from air collections on filters in glovebox and simulated bathroom exposures and human fiber burden analyses. The grids were analyzed on an analytic TEM using energy-dispersive spectrometer (EDS) and selected-area electron diffraction (SAED) to determine asbestos fiber number and type.

Results:

This brand of talcum powder contained asbestos and the application of talcum powder released inhalable asbestos fibers. Lung and lymph node tissues removed at autopsy revealed pleural mesothelioma. Digestions of the tissues were found to contain anthophyllite and tremolite asbestos.

Discussion:

Through many applications of this particular brand of talcum powder, the deceased inhaled asbestos fibers, which then accumulated in her lungs and likely caused or contributed to her mesothelioma as well as other women with the same scenario.     

Environmental asbestos exposure sources in Korea

Background: Because of the long asbestos-related disease latencies (10–50 years), detection, diagnosis, and epidemiologic studies require asbestos exposure history. However, environmental asbestos exposure source (EAES) data are lacking.

Objectives: To survey the available data for past EAES and supplement these data with interviews.

Methods: We constructed an EAES database using a literature review and interviews of experts, former traders, and workers. Exposure sources by time period and type were visualized using a geographic information system (ArcGIS), web-based mapping (Google Maps), and OpenWeatherMap. The data were mounted in the GIS to show the exposure source location and trend.

Results: The majority of asbestos mines, factories, and consumption was located in Chungnam; Gyeonggi, Busan, and Gyeongnam; and Gyeonggi, Daejeon, and Busan, respectively. Shipbuilding and repair companies were mostly located in Busan and Gyeongnam.

Conclusions: These tools might help evaluate past exposure from EAES and estimate the future asbestos burden in Korea.     

The Effects of Coenzyme Q10 Supplementation on Glucose Metabolism,Lipid Profiles,Inflammation, and Oxidative Stress in Patients With Diabetic Nephropathy: A Randomized,Double-Blind,Placebo-Controlled Trial

Objective: Data on the effects of coenzyme Q10 (CoQ10) supplementation on glucose metabolism, lipid profiles, inflammation, and oxidative stress in subjects with diabetic nephropathy (DN) are scarce. This research was done to determine the effects of CoQ10 supplementation on metabolic status in subjects with DN.

Methods: This randomized double-blind placebo-controlled clinical trial was done in 50 subjects with DN. Participants were randomly assigned into two groups to intake either 100 mg/day CoQ10 supplements (n = 25) or placebo (n = 25) for 12 weeks. Fasting blood samples were obtained at first and after 12-week intervention to quantify metabolic profiles.

Results: After 12 weeks of treatment, compared with the placebo, CoQ10 supplementation resulted in significant decreases in serum insulin levels (?3.4 ± 6.8 vs +0.8 ± 6.4 µIU/mL, p = 0.02), homeostasis model of assessment-estimated insulin resistance (?1.0 ± 2.0 vs +0.2 ± 1.8, p = 0.03), homeostasis model of assessment-estimated B cell function (?12.3 ± 26.3 vs +3.5 ± 23.1, p = 0.02) and HbA1c (?1.1 ± 1.0 vs ?0.1 ± 0.2%, p < 0.001), and a significant improvement in quantitative insulin sensitivity check index (+0.009 ± 0.01 vs ?0.006 ± 0.01, p = 0.01). In addition, CoQ10 supplementation significantly decreased plasma malondialdehyde (MDA) (?0.6 ± 0.5 vs +0.5 ± 1.0 µmol/L, p < 0.001) and advanced glycation end products levels (AGEs) (?316.4 ± 380.9 vs +318.6 ± 732.0 AU, p < 0.001) compared with the placebo. Supplementation with CoQ10had no significant impacts on fasting plasma glucose (FPG), lipid profiles, and matrix metalloproteinase-2 (MMP-2) compared with the placebo.

Conclusions: Taken together, our study demonstrated that CoQ10 supplementation for 12 weeks among DN patients had favorable effects on glucose metabolism, MDA, and AGEs levels, but unchanged FPG, lipid profiles, and MMP-2 concentrations.     

Pistachio Nuts Reduce Triglycerides and Body Weight by Comparison to Refined Carbohydrate Snack in Obese Subjects on a 12-Week Weight Loss Program

Objective: There is a widely held view that, due to high fat content, snacking on nuts will lead to weight gain, ultimately causing unhealthy changes in lipid profiles. This study is designed to study the effects of pistachio snack consumption on body weight and lipid levels in obese participants under real-world conditions.

Methods: Participants were randomly assigned to consume 1 of 2 isocaloric weight reduction diets for 12 weeks, with each providing 500 cal per day less than resting metabolic rate. Each diet included an afternoon snack of either 53 g (240 cal) of salted pistachios (n = 31) or 56 g of salted pretzels (220 cal; n = 28).

Results: Both groups lost weight during the 12-week study (time trend, p < 0.001), but there were significant differences in the changes in body mass index between the pretzel and pistachio groups (pistachio, 30.1 ± 0.4 to 28.8 ± 0.4 vs. pretzel, 30.9 ± 0.4 to 30.3 ± 0.5). At 6 and 12 weeks, triglycerides were significantly lower in the pistachio group compared with the pretzel group (88.04 ± 9.80 mg/dL vs. 144.56 ± 18.86 mg/dL, p = 0.01 at 6 weeks and 88.10 ± 6.78 mg/dL vs. 132.15 ± 16.76 mg/dL, p = 0.02 at 12 weeks), and there was a time trend difference between the 2 groups over the 12 weeks (p < 0.01). There were no significant differences in total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, insulin, or glucose between the 2 groups.

Conclusion: Pistachios can be consumed as a portion-controlled snack for individuals restricting calories to lose weight without concern that pistachios will cause weight gain. By comparison to refined carbohydrate snacks such as pretzels, pistachios may have beneficial effects on triglycerides as well.     

Economic burden of hospital admissions for patients with acute bacterial skin and skin structure infections in the United States

ABSTRACT

Objectives: We estimated the total US hospital costs associated with acute bacterial skin and skin structure infection (ABSSSI) admissions as well as the admissions that may have been potential candidates for outpatient parenteral antimicrobial therapy (OPAT).

Methods: We assessed inpatient admissions for ABSSSI from the Premier database (2011–2014), focusing on all admissions of adults with length of stay (LOS) ≥ 1 days and a primary diagnosis of erysipelas, cellulitis/abscess, or wound infection. We performed a detailed analysis of 2014 admissions for patient, treatment, hospital, and economic characteristic variables. Using published selection criteria, we identified a subset of patients admitted in 2014 who may have been potential candidates for OPAT.

Results: We analyzed 277,971 admissions. In 2014, most admissions were for cellulitis without major complications or comorbidities; mean ± SD LOS was 4.0 ± 3.0 days, and total hospital cost per admission was $6400 ± $6874, 54% of which was attributable to room costs. Among 2014 admissions, 14% involved patients with clinical characteristics suggesting that they were consistent with guideline recommendations for exclusive treatment with OPAT. Compared with all admissions in the year, these admissions were of younger patients (aged 50 vs. 55 years), admitted more frequently for cellulitis (90% vs. 70%), with shorter LOS (2.8 ± 1.8 days), and lower mean total hospital cost per admission ($4080 ± $3066).

Conclusions: Admissions for ABSSSI impose a substantial cost to US hospitals, with half of costs attributable to room costs. When extrapolated to all US patients admitted to the hospital for ABSSSI during 2014, had OPAT guidelines been universally followed, admissions may have been reduced by 14%, thereby saving US hospitals $161 million.     

Simulation tests to assess occupational exposure to airborne asbestos from asphalt-based roofing products

This study sought to evaluate exposure from specific products to evaluate potential risk from roof repair activities. Five asbestos-containing fibered roof coatings and plastic cements, representing a broad range of these types of products, were tested in exposure simulations. These products were applied to representative roof substrates. Release of asbestos fibers during application and sanding of the product shortly thereafter (wet sanding) were tested initially. Other roof substrates were cured to simulate a product that had been on a rooftop for several months and then were tested to evaluate release of fibers during hand sanding and hand scraping activities. Additional tests were also conducted to evaluate asbestos release during product removal from tools and clothing. Two personal (n = 84) and background/clearance (n = 49) samples were collected during each 30-min test and analyzed for total fiber concentration [phase-contrast microscopy (PCM)] and for asbestos fiber count [transmission electron microscopy (TEM)]. PCM concentrations ranged from <0.005 to 0.032 fibers per cubic centimeter (f cc(-1)). Chrysotile fibers were detected in 28 of 84 personal samples collected. TEM concentrations ranged from <0.0021 to 0.056 f cc(-1). Calculated 8-h time-weighted averages (TWAs) ranged from 0.0003 to 0.002 f cc(-1) and were comparable to the background TWA concentration of 0.0002 f cc(-1) measured in this study. Based on these results, it is unlikely that roofers were exposed to airborne asbestos concentrations above the current or historical occupational guidelines during scraping and sanding of these products during roof repair.     

Bio-monitoring of DNA damage in matchstick industry workers from Peshawar Khyber Pakhtunkhwa,Pakistan

Background: Safety protocols are usually neglected in most of the matchstick industries rendering the laborer prone to various occupational hazards.

Objective: The present study highlights DNA damage among matchstick factory workers (n = 92) against a control group (n = 48) of healthy individuals.

Methods: Genotoxicity was measured in peripheral blood lymphocytes of the test subjects using a Single Cell Gel Electrophoresis assay (SCGE/comet assay).

Results: Our results substantiate a high Total Comet Score (TCS) for factory workers (74.5 ± 47.0) when compared to the control group (53.0 ± 25.0) (P ≤ 0.001). Age and duration of occupational exposure had no significant effect (P > 0.05) on TCS value. As for job function, the TCS value was greatest in sweepers (91.0 ± 56.1) and lowest in box-making operators (26.0 ± 25.0) indicating that waste disposal poses the higher risk of DNA damage.

Conclusions: Our study corroborates that matchstick chemicals can potentially damage the DNA of exposed subjects.     

Longitudinal Examination of Links Between Risk Factors for the Metabolic Syndrome and Both Age and Fasting Glucose Levels in Nondiabetic Subjects

Background: Previous evaluations in nondiabetic subjects revealed statistically significant correlations between fasting blood glucose (FBG) levels used as an estimate of insulin resistance and many components constituting the metabolic syndrome. Similar significant correlations were not found employing chronological age as the independent variable in the same nondiabetic individuals.

Objective: The major purpose here was to replicate as well as corroborate the previous cross-sectional observations, emphasizing results obtained from data collected longitudinally.

Methods: Material was assessed from 99 nondiabetic volunteers who had undergone 2 separate baseline measurements carried out over a minimum of 5 and up to a maximum of 20 years.

Results: Findings from the starting baseline measurements mimicked many observations perceived in the earlier published cross-sectional material. The following correlations with elements constituting the metabolic syndrome using FBG as an independent variable were once more statistically significantly positive: scale weight, fat mass, circulating levels of triglycerides and high-sensitivity C-reactive protein (hsCRP). High-density lipoprotein (HDL) cholesterol was once again appropriately significant in a negative direction. In contrast, the same correlations were generally nonsignificant when age replaced FBG as the independent variable. Examining the 2 data sets over the 5–20-year intervals, FBG increased statistically significantly over time. However, the average increase clinically was relatively minor: ?92.1 mg/dL ± 1.1 (SEM) vs 95.1 mg/dL ± 1.1 (SEM), p < 0.007. When the actual changes (delta) in the dependent parameters were correlated with the individual passages of time (intervals in years), only downward changes in aspartate aminotransferase (AST) levels were statistically significant. Fat-free mass showed a trend downward, whereas fat mass, trunk fat, and triglycerides merely demonstrated trends upward.

Conclusion: Current findings gathered over years are consistent with the original hypothesis that maintaining relatively low, stable circulating glucose levels during aging retards the development and intensity of many common manifestations of the metabolic syndrome.     

Potential Cardioprotective Effects of Sumac Capsule in Patients With Hyperlipidemia: A Triple-Blind Randomized,Placebo-Controlled Crossover Trial

Objective: Alternative medicine and herbal drugs have been taken into account for managing cardiovascular risk factors. Sumac (Rhus coriaria L.) is rich in biologically active ingredients known to improve cardiovascular health. We investigated the effect of sumac on systolic (SBP) and diastolic (DBP) blood pressure, flow-mediated dilation (FMD), body mass index (BMI), and serum concentrations of lipids and fasting blood sugar (FBS) in participants with hyperlipidemia in a triple-blind randomized placebo- controlled crossover trial.

Methods: Thirty adults with dyslipidemia (mild to moderate elevation of plasma total cholesterol and/or triglycerides [TG; total cholesterol ≥ 6.0 mmol/L or TG ≥ 1.7 mmol/L and TG ≤ 5.0 mmol/L]) were assigned randomly to a sumac or a placebo group. Participants in the sumac group received sumac capsules (500 mg/twice daily) for the first 4 weeks, followed by 2 weeks’ washout period; the patients were then switched to a 4-week interval and received placebo for 4 weeks in the second period. The placebo group received these treatments in reverse order. FMD, BMI, SBP, DBP, lipids, and FBS were measured at baseline and after each period.

Results: Differences between placebo group and sumac group (placebo-sumac) were significantly decreased for BMI (0.21 ± 0.075 kg/m²), SBP (1.87 ± 0.83 mm Hg), DBP (1.32 ± 0.46 mm Hg), and total cholesterol (14.42 ± 4.95 mmol/L) and significantly increased for FMD (?0.23% ± 0.065%). Plasma level of TG did not change significantly across the treatment.

Conclusion: Sumac consumption may decrease cardiovascular risk factors in persons with mild to moderate hyperlipidemia.