ABSTRACT
Context: smoking is a global public health priority and accurate data of the local population is essential to improve the health policies against its use. Hence, this study aimed to summarize the important findings available on the prevalence of smoking and its association with non-communicable diseases, documented by one of the largest prospective community-based studies of Iran
Evidence Acquisition: all articles derived from the Tehran Lipid and Glucose Study [TLGS] in the last two decades, from the earliest publications until 30 January 2018 were reviewed for their findings on tobacco smoking
Results: the prevalence of smoking in non-diabetic adults >/= 20 years increased between baseline [phase I, 1999 - 2001] and followup [phase V, 2008 - 2011] from 25.5% to 35.4% among men and from 3.4% to 6.8% among women. In TLGS adolescents [10 - 18 years] water pipe use increased between 2003 and 2005 from 35.5% to 40.9% among boys and from 19.7% to 26.1% among girls. Regarding health hazards, smoking in men was associated with increased risk of combined impaired fasting glucose/impaired glucose tolerance [hazard ratio [HR] 1.69; confidence interval [CI] 95% 1.15 - 2.48] and hypertension [HR 1.26; CI 95% 0.98 - 1.63]. Moreover, men, even smoking less than 10 cigarettes per day, were at increased risk for cardiovascular diseases by HR 2.12 [CI 95% 1.14 - 3.95]. For women, the risk of chronic kidney disease dramatically increased 5.74-fold [CI 95% 2.71 - 12.15] among smokers. In the whole population, smoking contributed to 7.7% of all-cause mortality with HR 1.75 [CI 95% 1.38 - 2.22]. Other health aspects of tobacco smoke, including its impact on metabolic status, thyroid function, female reproductive system and life style have also been reviewed
Conclusion: considering hazards of smoking, there is the urgency for more effective preventive measures in Iran; emphasizing the need for further local studies on the hazards of smoking with special attention to women and adolescents and the independent hazards of water pipe use
ABSTRACT
Context: we describe here the contributions of the Tehran lipid and glucose study [TLGS] to understanding different aspects of the nitrate [NO3]-nitrite [NO2]-nitric oxide [NO] pathway in health and disease
Evidence Acquisition: all English-language documents from the TLGS, focused on NO pathway were searched using the PubMed, Scopus, and Embase databases
Results: reference values of serum concentrations of NO metabolites [nitrate + nitrite or NOx] were 11.5 - 76.4, 10.1 - 65.6, and 10.3 - 66.8_mol/L in men, women, and the total population, respectively. Circulating NOx was affected by age, smoking habits, menopause status, thyroid hormones, and various pathologic conditions. Elevated serum NOx was related to increased incidence of metabolic syndrome [odds ratio [OR] = 1.75, 95% confidence interval [CI] = 1.19 - 2.59], hypertriglyceridemic-waist phenotype [OR = 1.39, 95% CI = 1.05 - 1.93], chronic kidney disease [OR = 1.86, 95% CI = 1.10 - 3.14] in women, and cardiovascular disease [hazard ratio [HR] = 1.35, 95% CI = 1.01 - 1.80] in the total population. In participants with low vitamin C intake, higher intakes of NO2 [ >/= 8.77 mg/d] were accompanied with increased risk of diabetes [HR = 2.43, 95% CI = 1.45 - 4.05]. A decreased risk of hypertension [OR = 0.58, 95% CI = 0.33 - 0.98] and chronic kidney disease [OR = 0.50, 95% CI = 0.24 - 0.89] was observed in response to higher intakes of NO2
Conclusions: circulating NOx is associated with and could predict the risk of metabolic disorders in a general population. Moreover, dietary NO3/NO2 exposure from usual diets seems to contribute to development of noncommunicable diseases
ABSTRACT
Context: the Tehran lipid and glucose study [TLGS] is one of the oldest population-based longitudinal cohort studies, providing knowledge about the incidence and risk factors of some non-communicable diseases [NCDs] in West Asia which hitherto was relatively scarce. We reviewed the methods and results related to the outcome measurements of this study
Evidence Acquisition: we reviewed all the TLGS papers which reported the incidence of NCDs
Results: the TLGS was initiated in 1999 - 2001 on a population in district no. 13 of Tehran with the same age distribution of the overall Tehran population and with a middle socioeconomic status. Totally, 15005 individuals, aged >/= 3 years, participated in the first examination; reexaminations were conducted in a triennial manner and 3550 individuals were added in the second examination. All participants were also followed up annually and asked about any medical event leading to hospitalization or death. A part of participants was assigned to an educational program for lifestyle modification. High incidence of cardiovascular disease [CVD], premature CVD, diabetes and hypertension [around 19, 6, 10 and 31 in men and 11, 5, 11 and 29 in women per 1000 person-year, respectively] besides the high incidence of pre-diabetes and pre-hypertension [around 46 and 76 in men and 37 and 49 in women per 1000 person-year, respectively] showed a worrying situation. Fortunately, the results of the community interventions were promising with around 20% reduction in the risk of metabolic syndrome up to six years
Conclusions: these precise detections of different outcomes in the TLGS provided valuable evidences for prediction and prevention of NCDs in Iran with some novelties in the middle-income countries in the world. The Tehran thyroid study [TTS] and the Tehran cardiometabolic genetic study [TCGS], conducted in the framework of the TLGS, are among few studies aiming to determine the natural course of thyroid function and to identify patterns of genetic polymorphisms related to cardiometabolic outcomes, respectively