Impact of Ramadan Fasting on Metabolic Syndrome Criteria: Among Treated Hypertensive and Diabetic Females of Halabja

https://doi.org/10.24017/Science.2022.1.11

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Authors

  • Halgord Ali Farag Nursing Department, Technical College of Applied Sciences, Halabja Research Center, Sulaimani Polytechnic University, Sulaimani, Iraq –

Abstract

Background and aim

The effect of Ramadan fasting (RF) among Metabolic Syndrome (MetS) patients is still argumentative. However, the majority of evidences demonstrated a beneficial effect on nearly most of metabolic criteria reduce the risk of MetS. Hypoglycemia is a significant consequence of diabetes that has been linked to an elevated the risk of cardiovascular disease (CVD) and hypertensions. However, conflicted results have been reported. Therefore, the aim of this study was to evaluate the impact of RF on Metabolic criteria among treated hypertensive and diabetic patients.

Method

This prospective observational study was carried out in a group of 73 female patients with MetS aged (20-45) years were evaluated week before and after Ramadan month having hypertension and diabetics of more than 2 years. All attending to Halabja Hospital and were treated with one daily medication based on doctor prescription. The sample random technic was used to calculate sample size and the computed sample size. The eligibility criteria for female patients having diabetic and hypertension were based on the International Diabetic Federation (IDF) definition criteria. A fasting blood sample was obtained, blood pressure was measured and BMI was calculated, fasting blood sugar, lipid profile were analyzed on all blood sample.

Result

There was a significant weight reduction and WC decreased. This result has been reflected on BMI as well ( p ? 0.0001).  The systolic and diastolic blood pressure showed significant changes during the month of fasting.  Overall, Ramadan fasting was found to decrease fasting glucose level. With regards to changes in lipid profile, fasting Ramadan was found to significant decrease in TC, and TG level. There was no significant change in serum LDL-C after Ramadan compared to baseline, however, we found a decrease in serum HDL-C levels but this change were not paralleled by any significant changes.

Conclusions

This study shows a significant improvement in cardiovascular risk factors such as lipids profile, systolic blood pressure, weight, BMI and waist circumference in subjects with a previous history of hypertensions and hyperglycemia.

 

Keywords:

Ramadan fasts, metabolic syndrome, Blood pressure, Type 2 Diabetic

References

[1] G. Hu, P. Jousilahti, and J. Tuomilehto, "Joint effects of history of hypertension at baseline and type 2 diabetes at baseline and during follow-up on the risk of coronary heart disease," pp. 3059-3066, 2007.
https://doi.org/10.1093/eurheartj/ehm501
[2] K. Asadollah, N. Beeching, and G. Gill, "Hyperglycaemia and mortality," J R Soc Med, vol. 100, no. 11, pp.503-507, 2007.
https://doi.org/10.1177/014107680710001112
[3] C. S. Fox et al., "Increasing Cardiovascular Disease Burden Due to," vol. 115, no. 12, pp. 1544-1551, 2007.
https://doi.org/10.1161/CIRCULATIONAHA.106.658948
[4] K. Tadesse, H. Amare, T. Hailemariam, and T. Gebremariam, "Prevalence of Hypertension among Patients with Type 2 Diabetes Mellitus and Its Socio Demographic Factors in Nigist Ellen Mohamed Memorial Hospital Hosanna, Southern Ethiopia," J. Diabetes Metab., vol. 9, no. 4, pp. 4-10, 2018.
https://doi.org/10.4172/2155-6156.1000792
[5] K. Tunceli, C. J. Bradley, D. Nerenz, L. K. Williams, M. Pladevall, and J. E. Lafata, "The Impact of Diabetes on Employment and Work Productivity," Diabetes Care, vol. 28, no. 11, pp. 2662-2667, 2005.
https://doi.org/10.2337/diacare.28.11.2662
[6] P. M. Kearney, M. Whelton, K. Reynolds, P. Muntner, P. K. Whelton, and J. He, "Global burden of hypertension?: analysis of worldwide data," Lancet, vol. 365, no. 9455, pp. 217-223, 2005.
https://doi.org/10.1016/S0140-6736(05)17741-1
[7] K. Ogurtsova, J. D. Rocha, Y. Huang, U. Linnenkamp, and L. Guariguata, "IDF Diabetes Atlas?: Global estimates for the prevalence of diabetes for 2015 and 2040," Diabetes Res. Clin. Pract., vol. 128, pp. 40-50, 2017.
https://doi.org/10.1016/j.diabres.2017.03.024
[8] I. H. De Boer et al., "Diabetes and Hypertension?: A Position Statement by the American Diabetes Association," Diabetes Care, vol. 40, no. 9, pp. 1273-1284, 2017.
https://doi.org/10.2337/dci17-0026
[9] F. Chentli, S. Azzoug, M. El, A. Amani, and A. Elgradechi, "Brief Communication Diabetes mellitus and Ramadan in Algeria," vol. 17, no. 7, 2013.
https://doi.org/10.4103/2230-8210.119622
[10] N. Khan, A. Rasheed, H. Ahmed, F. Aslam, and F. Kanwal, "Effect of Ramadan fasting on glucose level ,lipid profile , HbA1c and uric acid among medical students in Karachi , Pakistan," vol. 23, no. 4, 2017.
https://doi.org/10.26719/2017.23.4.274
[11] S. A. Meo and A. Hassan, "Physiological changes during fasting in Ramadan," J PakMed Assoc, vol. 65, no. 5, pp. S6-S14, 2015.
[12] A. El Bilbeisi, A. El Afifi, H. Farag, K. Wahedy, M. Srour, and K. Djafarian, "Effects of Ramadan Fasting on Anthropometric Measures , Blood Pressure and Glucose Level among Type 2 Diabetic Patients on Metformin Treatment," J. Nutr. Heal. Sci., vol. 6, no. 2, 2019.
[13] A. Temizhan, T. Izzet, Ö. Dönderici, and B. Demirbas, "THE EFFECTS OF RAMADAN FASTING ON BLOOD LIPID LEVELS," Am J Med., vol. 109, no. 4, p. 1, 2000.
https://doi.org/10.1016/S0002-9343(00)00498-8
[14] I. Salim, J. Al Suwaidi, W. Ghadban, H. Alkilani, and A. M. Salam, "Impact of religious Ramadan fasting on cardiovascular disease: a systematic review of the literature," Curr. Med. Res. Opin., vol. 29, no. 4, pp. 343-354, 2013.
https://doi.org/10.1185/03007995.2013.774270
[15] P. Zimmet, K. G. M. M. Alberti, and M. Serrano Ríos, "A New International Diabetes Federation (IDF) Worldwide Definition of the Metabolic Syndrome: the Rationale and the Results," Rev. Española Cardiol. (English Ed., vol. 58, no. 12, pp. 1371-1375, 2005.
https://doi.org/10.1016/S1885-5857(06)60742-1
[16] S. A. Saleh, S. A. Elsharouni, B. Cherian, and M. Mourou, "Effects of Ramadan fasting on Waist Circumference , Blood Pressure , Lipid Profile , and Blood Sugar on a Sample of healthy Kuwaiti men and women," Malays. J. Nutr., vol. 11, no. 2, pp. 143-150, 2005.
[17] S. Saiyad, M. Saiyad, U. Patel, and A. Verma, "Effect of Ramadan fasting on anthropological and physiological parameters," vol. 3, no. 1, pp. 59-62, 2014.
[18] B. M. J. Ziaee V, Razaei M, Ahmadinejad Z, Shaikh H, Yousefi R, Yarmohammadi L, Bozorgi F, "The changes of metabolic profile and weight during Ramadan fasting," Singapore Med J, vol. 47, no. 475, pp. 409409-414, 2006.
[19] A.-H. Memari, R. Kordi, N. Panahi, L. R. Nikookar, M. Abdollahi, and A. Akbarnejad, "Effect of Ramadan Fasting on Body Composition and Physical Performance in Female Athletes," Asian J. Sports Med., vol. 2, no. 3, pp. 161-166, 2011.
https://doi.org/10.5812/asjsm.34754
[20] O. Rahman and M. R. Islam, "Association between fasting of ramadan and risk factors of diabetes: A study from Rajshahi city in Bangladesh," Adv. J. Food Sci. Technol., vol. 3, no. 5, pp. 360-365, 2011.
[21] A. D. Saada et al., "Effect of Ramadan fasting on glucose, glycosylated haemoglobin, insulin, lipids and proteinous concentrations in women with non-insulin dependent diabetes mellitus," African J. Biotechnol., vol. 9, no. 1, pp. 87-94, 2010.
[22] M. Jaleel, B. F. Jaleel, and F. Fathima, "Nutrition, energy intake- output, exercise, and fluid homeostasis during fasting in Ramadan," J. Med. Nutr. Nutraceuticals, vol. 2, no. 2, p. 63, 2013.
https://doi.org/10.4103/2278-019X.114722
[23] M. Ünalacak, ?. H. Kara, D. Baltaci, Ö. Erdem, and P. G. E. Bucaktepe, "Effects of Ramadan Fasting on Biochemical and Hematological Parameters and Cytokines in Healthy and Obese Individuals," Metab. Syndr. Relat. Disord., vol. 9, no. 2, pp. 157-161, 2011.
https://doi.org/10.1089/met.2010.0084
[24] M. A. K. Rohin, N. Rozano, N. A. Hadi, M. N. M. Nor, S. Abdullah, and M. D. Venkateshaiah, "Anthropometry and body composition status during ramadan among higher institution learning centre staffs with different body weight status," Sci. World J., vol. 2013, 2013.
https://doi.org/10.1155/2013/308041
[25] H. A. M. Farag et al., "Effects of Ramadan fasting on anthropometric measures, blood pressure, and lipid profile among hypertensive patients in the Kurdistan region of Iraq," SAGE open Med., vol. 8, p. 2050312120965780, 2020.
https://doi.org/10.1177/2050312120965780
[26] M. Denise Robertson, R. Alex Henderson, G. E. Vist, and R. D. E. Rumsey, "Extended effects of evening meal carbohydrate-to-fat ratio on fasting and postprandial substrate metabolism1-3," Am. J. Clin. Nutr., vol. 75, no. 3, pp. 505-510, 2002.
https://doi.org/10.1093/ajcn/75.3.505
[27] G. Akhan, S. Kutluhan, and H. R. Koyuncuoglu, "Is there any change of stroke incidence during Ramadan?," Acta Neurol. Scand., vol. 101, no. 4, pp. 259-261, 2000.
https://doi.org/10.1034/j.1600-0404.2000.101004259.x
[28] A. BaHammam, "Sleep pattern, daytime sleepiness, and eating habits during the month of Ramadan," Sleep Hypn., vol. 5, no. 4, pp. 165-174, 2003.
[29] K. S. Stote et al., "A controlled trial of reduced meal frequency without caloric restriction in healthy , normal-weight , middle-aged adults 1 - 3," no. February, pp. 7-9, 2018.
[30] R. M. A. Khalili, S. E. Shafekh, A. H. Norhayati, M. A. I. S. Munira, M. N. M. Nasir, and D. V Muralidara,"Cardiovascular and Blood Glucose Adaptation during Ramadan Fasting among Different Weight Status Subjects," vol. 4, no. 24, pp. 3771-3779, 2014.
https://doi.org/10.9734/ARRB/2014/11624
[31] A. Shehab, A. Abdulle, A. El Issa, J. Al Suwaidi, and N. Nagelkerke, "Favorable Changes in Lipid Profile: The Effects of Fasting after Ramadan," PLoS One, vol. 7, no. 10, pp. 1-4, 2012.
https://doi.org/10.1371/journal.pone.0047615
[32] M. Salah, "Effect of Ramadan Fasting on Body Weight , Blood Pressure and Biochemical Parameters in Middle Aged Hypertensive Subjects?: An Observational Trial," no. January 2014, 2019.
[33] G. Perk, J. Ghanem, S. Aamar, D. Ben-Ishay, and M. Bursztyn, "The effect of the fast of Ramadan on ambulatory blood pressure in treated hypertensives," J. Hum. Hypertens., vol. 15, no. 10, pp. 723-725, 2001.
https://doi.org/10.1038/sj.jhh.1001262
[34] Y. Chen et al., "Association between body mass index and cardiovascular disease mortality in east Asians and south Asians: Pooled analysis of prospective data from the Asia Cohort Consortium," BMJ, vol. 347, no. 7927, pp. 1-19, 2013.
https://doi.org/10.1136/bmj.f5446
[35] D. GIUGLJANO et al., "Metformin improves glucose, lipid metabolism, and reduces blood pressure in hypertensive, obese women.," Diabetes Care, vol. 16, no. 10, p. , 1993.
https://doi.org/10.2337/diacare.16.10.1387
[36] K. LANDIN, L. TENGBORN, and U. SMITH, "Treating insulin resistance in hypertension with metformin reduces both blood pressure and metabolic risk factors," J. Intern. Med., vol. 229, no. 2, pp. 181-187, 1991.
https://doi.org/10.1111/j.1365-2796.1991.tb00328.x
[37] E. J. Abbink, P. Pickkers, A. J. van Rosendaal, and et al, "Vascular effects of glibenclamide vs glimepiride and metformin in type 2 diabetic patients," Diabet Med, vol. 19, pp. 136-143, 2002.
https://doi.org/10.1046/j.1464-5491.2002.00663.x
[38] M. G. Wulffelé, A. Kooy, P. Lehert, D. Bets, A. J. M. Donker, and C. D. A. Stehouwer, "Does metformin decrease blood pressure in patients with Type 2 diabetes intensively treated with insulin?," Diabet. Med.,vol. 22, no. 7, pp. 907-913, 2005.
https://doi.org/10.1111/j.1464-5491.2005.01554.x
[39] N. V. CHU et al., "Differential Effects of Metformin and Troglitazone on Cardiovascular Risk Factors in Patients With Type 2 Diabetes," 2002.
https://doi.org/10.2337/diacare.25.3.542
[40] M. Yee et al., "Investigators from Tan Tock Seng Hospital Release New Data on Hypoglycemia (Evaluating the Effect of Ramadan Fasting on Muslim Patients with Diabetes in relation to Use of Medication and Lifestyle Patterns: A Prospective Study)," Diabetes Week, vol. 2014, p. 171, 2014.
https://doi.org/10.1155/2014/308546
[41] S. Çomo?lu, A. Temizhan, E. Pe?inci, I. Tando?an, and ?. Özbakir, "Effects of Ramadan fasting on stroke," Turkish J. Med. Sci., vol. 33, no. 4, pp. 237-241, 2003.
[42] J. Karalliedde and L. Gnudi, "Diabetes mellitus, a complex and heterogeneous disease, and the role of insulin resistance as a determinant of diabetic kidney disease," Nephrol. Dial. Transplant., vol. 31, no. 2, pp. 206-213, 2016.
[43] T. McLaughlin, F. Abbasi, C. Lamendola, and G. Reaven, "Heterogeneity in the prevalence of risk factors for cardiovascular disease and type 2 diabetes mellitus in obese individuals: effect of differences in insulin sensitivity," Arch.Intern.Med., vol. 167, no. 0003-9926 (Print), pp. 642-648, 2007.
https://doi.org/10.1001/archinte.167.7.642
[44] S. Suzuki et al., "Body mass index and colorectal cancer risk?: A Mendelian randomization study," Cancer Sci., no. January, pp. 1579-1588, 2021.
https://doi.org/10.1111/cas.14824
[45] R. A. Sulimani, F. O. Famuyiwa, and M. A. Laajam, "Diabetes Mellitus and Ramadan Fasting: The Need for a Critical Appraisal," Diabet. Med., vol. 5, no. 6, pp. 589-591, 1988.
https://doi.org/10.1111/j.1464-5491.1988.tb01057.x
[46] J. Ahmad et al., "Diabetic emergencies including hypoglycemia during Ramadan," Indian J. Endocrinol. Metab., vol. 16, no. 4, p. 512, 2012.
https://doi.org/10.4103/2230-8210.97996
[47] F. Azizi and H. A. Rasouli, "SERUM GLUCOSE , BILIRUBIN , CALCIUM , PHOSPHORUS , PROTEIN AND ALBUMIN CON - CENTRATIONS DURING RAMADAN," vol. 1, pp. 38-41, 1987.
[48] J. Ahmad, F. Pathan, M. A. Jaleel, F. N. Fathima, and S. A. Raza, "South Asian Guidelines for Management of Endocrine Disorders in Ramadan Diabetic emergencies including hypoglycemia during Ramadan," vol. 16, no. 4, pp. 2-5, 2012.
https://doi.org/10.4103/2230-8210.97996
[49] S. R. A. Hosseini and K. Hejazi, "The effects of Ramadan fasting and physical activity on blood hematological-biochemical parameters," Iran. J. Basic Med. Sci., vol. 16, no. 7, pp. 845-849, 2013.
[50] J. V. Gnanou, B. A. Caszo, K. M. Khalil, S. L. Abdullah, V. F. Knight, and M. Z. Bidin, "Effects of Ramadan fasting on glucose homeostasis and adiponectin levels in healthy adult males," J. Diabetes Metab. Disord., vol. 14, no. 1, pp. 4-9, 2015.
https://doi.org/10.1186/s40200-015-0183-9
[51] H. K. Momen, A. N. Y. Elzouki, J. Gatie, A. M. El-Mansoury, and A. Tashani, "Effect of Ramadan fasting on blood glucose and serum lipid profiles in Libyan diabetic patients," J. Sci. its Appl., vol. 1, no. 1, pp. 14- 17, 2007.
[52] K. S. Aljaloud, "The Effect of Ramadan Fasting on Metabolic Syndrome (MetS)," in Blood Glucose Levels, 2019.
https://doi.org/10.5772/intechopen.89333
[53] D. L. Tahapary, C. Astrella, M. Kristanti, D. S. Harbuwono, and P. Soewondo, "The impact of Ramadan fasting on metabolic profile among type 2 diabetes mellitus patients: A meta-analysis," Diabetes Metab. Syndr. Clin. Res. Rev., vol. 14, no. 5, pp. 1559-1570, 2020
https://doi.org/10.1016/j.dsx.2020.07.033

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[1]
H. A. Farag, “Impact of Ramadan Fasting on Metabolic Syndrome Criteria: Among Treated Hypertensive and Diabetic Females of Halabja”, KJAR, vol. 7, no. 1, pp. 125–132, Aug. 2022, doi: 10.24017/Science.2022.1.11.

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16-08-2022

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Pure and Applied Science