[The prevalence of menstrual disorders in reproductive aged women and its related factors]

Normal menstruation is one of important indicators of the general health of reproductive-aged women. We aimed to investigate the prevalence of menstrual disorders and its related factors. This cross-sectional study was conducted among women participants of the Tehran Lipid and Glucose Study, a population-based study aimed identify the prevalence of noncommunicable diseases from March 2013 to 2014. A total of 1393 women, aged 15-49 yr were included and all pregnant, breastfeeding and menopausal women were excluded. Socio-demographic characteristics and menstruation patterns were assessed by a standardized ad-hoc questionnaire. Menstruation was categorized based on last FIGO definitions. Data analyzed using SPSS version 11.0 [SPSS-Inc., Chicago-IL], 0.05 was set as significant level. Mean age of participants was 37.7 [11] y. The results showed that 64.1% of subjects had normal menstruation and 35.8% experienced different forms of menstrual disorders. Heavy menstrual bleeding was one of the most prevalent disorders [17.2%]. Prevalence of menstrual disorders was statistically higher in women <20 yr [47.7%] and >/=40yr [45.5%] than women between the 20-40 yr age range [P=0.001]. Irregular menstrual bleeding in >20 yr, heavy menstrual bleeding in 20-40 yr and >/= 40yr were the most common menstrual disorders. The results remain unchanged for age and BMI after adjustment for potential confounders [OR: 1.08, CI 95%: 1.07-3.97; P<0.03], [OR: 1.05, CI 95%: 1.02-5.04; P<0.04], respectively. Our findings showed that menstrual disorders are prevalent as one-third of reproductive aged women suffer from one or more menstrual disorders. Understanding the prevalence of menstrual disorders could help health care providers to identify some serious diseases, and prioritize strategies to promote these women's quality of life

[Inefficient education and process of obesity in Tehranian adolescents: a qualitative study]

This study aimed to determine inefficiencies in current educational programs for promoting of healthy lifestyles and prevention of obesity from the perspective of adolescents and mothers. This was a qualitative study conducted based on a grounded theory approach. To collect data, 23 personal interviews and 12 semi-structured focus group discussions were conducted with overweight/obese adolescents and mothers who had at least one overweight/obese child. To maximize the variation of participants' experiences with different socio-economic backgrounds, two demographically diverse areas from the north and south of Tehran were selected and followed with theoretical sampling. All the interviews and focus group discussions were audio recorded and transcribed verbatim. Data collection and analysis were done simultaneously, using the Strauss and Corbin analysis method. In the current study, inefficient education was explored using two main themes including "Single dimensional curriculum of schools" and "Inefficient public education". The single dimensional curriculum of schools was found to be characterized by "lesson-based curriculum" and "burdensome educational programs" and the inefficient public education was characterized by "inappropriate content", "lack of comprehensive educational program", "inappropriate ways of messaging" and "contradictory messages". Based on the findings of this study, "single dimensional curriculum of schools" and "Inefficient public education" were the main correlates of inefficient education in our society, which led to obesity-related behaviors and consequently excessive weight gain in Tehranian adolescents. The results of this study may be effective in prioritizing and designing health promotion programs aimed at promoting healthy lifestyles and prevention of obesity in children and adolescents

[Related factors with obesity in Tehranian households: a cross-sectional study]

In 21[st] century obesity has rapidly increased and it has become one of the greatest public health problems worldwide. The aim of this study was to determine related factors with obesity in Tehranian households. In this descriptive study, multivariate analysis was used to estimate the odds of obesity [BMI >/= 30 kg/m2] as a function of age, sex, marital status, educational level and smoking by using data from" Tehran Lipid and Glucose Study [TLGS]" database. In this study 3,935 households participants who were equal or more than 20 years old, were recruited from phase III [2006-2008] of this study. Height of participants was measured to the nearest 5 mm without considering their shoe heels. Weight and height were measured using digital electric scale and meter tape. Data were analyzed by SPSS/16 and SAS version 9.1. The mean BMI was 26.59 [kg/m[2]] in men and 27.96 [kg/m[2]] in women. After adjustment for other variables, obesity odds ratios were 1.01 [P<0.001], 2.10 [P<0.001], and 1.54 [P<0.001] for age, women and married individuals, respectively. There was an inverse significant association between education and obesity. Obesity ORS were 0.83 [P<0.028] for high school and 0.50 [P<0.001] for university educational levels. The results of this study show that related factors in this research are similar to other countries. Therefore, obesity with related factors should be considered in health programming

[Association between vitamin D deficiency and cardiovascular disease]

In cross-sectional studies, low serum levels of 25-hydroxyvitamin D are associated with a higher prevalence of cardiovascular risk factors. This study aimed to determine whether vitamin D deficiency is related to cardiovascular disease. This nested case-control study was performed within the framework of a population-based Cohort study [Tehran Lipid and Glucose Study, TLGS] among male and female participants, aged 30 years or older [mean [SD] age, 56.7 [10.6] years], free of diagnosed cardiovascular disease at initial blood collection. Using risk set sampling, controls [n=251] were selected in a 1:1 ratio and matched for age, sex and date of blood collection. We measured serum 25-hydroxyvitamin D levels in serum specimens, kept at -80°C until assay. Median serum 25 [OH] D was significantly lower in the CVD group than in controls [p<0.001]. For 25 [OH] D values of less than 10 ng/ml, compared with values more than 20 ng/ml [reference], the multivariable-adjusted OR [with 95% confidence intervals] for incident cardiovascular events was 3.21 [1.75-5.88]. Low levels of 25[OH]D are independently associated with higher risk of cardiovascular events in a graded manner, even after adjustment for factors known to be associated with coronary artery disease

[Dietary fructose and cardiovascular disease risk factors in adults: Tehran lipid and glucose study]

The aim of this study was to investigate the association between fructose intake and cardiovascular disease risk factors in Tehranian adults. This study was conducted using data from adults, aged 19-70 years, who participated in the third phase of Tehran Lipid and Glucose study. Dietary data were collected using a validated semi-quantitative food frequency questionnaire with 168 food items. The sum of natural dietary fructose in fruits and vegetables, and fructose in industrialized foods containing added sweeteners, was calculated as total dietary fructose. Forty-five and fifty-five percent of participants were men and women, with mean ages of 40.5 +/- 13.6 and 38.6 +/- 12.8 years, respectively. Mean dietary intakes of total fructose were 46.5 +/- 24.5 g/d in men and 37.3 +/- 24.2 g/d in women. Significant positive associations were observed between dietary fructose intake and body mass index [beta =0.03 and 0.11, p<0.001, in men and women respectively], systolic blood pressure [beta =0.09 and 0.12, p<0.01, in men and women respectively], diastolic blood pressure [beta =0.13 and 0.80, p<0.01, in men and women respectively] and fasting blood glucose in men [beta =0.01, p<0.05]. Dietary fructose intake may have adverse effects on cardiovascular disease risk factors

[Difference in goiter prevalence between genders: a metaanalysis of literature]

Several studies have shown that goiter is more prevalent in females than in males, although before puberty there is no difference between genders, indicating that sex steroids may play a role in thyroid volume. Iodine deficiency may result in an increase prevalence in goiter prevalence but the difference between genders is not clear. This study is a metaanalysis of studies that have compared goiter prevalence between genders at different ages, with differing iodine status. This is a systematic review and metaanalysis based on Cochrane' criteria. Databases of MEDLINE-EMBASE-Cochrane and Persian databases of Iranmedex- Magiran- SID- Irondoc were searched and all articles on goiter in both sexes goiter were examined were included. A hundred and five studies, with total number of 429252 individuals, age range 1-80 y, were included. Odds ratio of female to male goiter was OR=1.39 [95%CI=1.28-1.51], a ratio higher in longstanding iodine insufficient areas, than in areas of recent iodine sufficiency [1.94 vs. 1.36], the difference in iodine sufficient area being non significant. This ratio for grade 2 of goiter was higher than grade 1[1.78 vs. 1.30], and in persons> 15 years old rose significantly, especially in iodine deficient areas. Goiter is more prevalent in females than in males

[ prevalence of metabolic syndrome in adolescents with varying degrees of body weight: Tehran lipid and glucose study [TLGS]]

The metabolic syndrome is a constellation of risk factors that increase the incidence of cardiovascular disease and type 2 diabetes mellitus. The prevalence of obesity and metabolic syndrome could help decrease the occurrence of fatal cardiovascular and diabetic complications. The present study was carried out to determine the prevalence of metabolic syndrome in adolescents with varying degrees of obesity, in order to conduct and implement, timely screening and interventions. In a cross-sectional study conducted within the framework of the Tehran Lipid and glucose Study [TLGS], phase 3, 1523 adolescents, 708 boys and 815 girls 10-19 years of age, were investigated. The prevalence of metabolic syndrome, based on modified definitions for ATP III, AHA, NHASES III and IDF, was determined in varing degrees of body weight [normal, at risk of overweight, moderate and severe overweight]; and compared in different sex, age groups, menarche status and familial history of diabetes mellitus. Data was analyzed using the and Mann-Witney tests and multiple logistic regression. Overall, 15 percent of adolescents were at risk of overweight, 4. 2 percent had moderate overweight and 4.6 percent were severly overweight, with no significant difference between the two sex groups [P=0.381]. Overall, the prevalence of metabolic syndrome, based on definitions for ATP III, AHA, NHANES III and IDF, was 9. 5, 5. 1, 17. 8 and 5. 8 percent, respectively, which was significantly higher in boys than in girls. Based on the 4 definitions, the prevalence of metabolic syndrome in the normal weight group was 2.2, 0.9, 8.6, 0.8 percent respectively, in the at risk of overweight group it was 21.5, 11, 36.4 and 11 percent, in moderate overweight group it was 42.2, 23.4, 64.1 and 32.8 percent, and in the severe overweight group it was 62.9, 38.6. 67.1 and 47.1 percent, respectively [P<0.001]. the prevalence of each metabolic risk factor and the number of these factors was higher in overweight adolescents. Only by the IDF definition, the prevalence of metabolic syndrome was significantly higher after-menarche than before it [P=0.04]. All definitions showed the higher prevalence of metabolic syndrome in positive familial history of diabetes mellitus [P<0.001]. This study showed a high prevalence of overweight, obesity and metabolic syndrome in Tehranian adolescents, with significantly higher prevalence of metabolic syndrome in more obese adolescents. Metabolic syndrome was more prevalent, in boys, those persons with positive familial history of diabetes mellitus and in after-menarche aged girls, which data can be put to use in lifestyle modification programs

[Familial clustering of central obesity and cardiovascular disease risk factors]

The risk of obesity among children increases in proportion to parental obesity. This study aimed at investigating the familial clustering of central obesity and cardiovascular disease risk factors. In this observational cross-sectional survey, enrolling 787 mother-daughter pairs in three age stratum [3-9 y, 10-15 y, 16-20 y], familial associations for central obesity and cardiovascular disease risk factors were assessed. Mothers with central obesity had higher probability of having daughters with central obesity compared to normal mothers [p=0.0001]. Central obesity indices among daughters were positively correlated with those of their mothers [r=0.39, r=0.42 and r=0.46 for waist circumferences in the three age strata, respectively]. The correlations were significant and positive between central obesity indices and systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, triglycerides, and LDL-C in mothers [r=0.34, 0.30, 0.28, 0.19, 0.32 and 0.13 respectively] and their daughters [r=0.33, 0.27, 0.17, 0.16, 0.26 and 0.20]. Correlation between central obesity indices and HDL-C were negative and significant in mothers [r=-0.18] and daughters [r=-0.21]. There was an increase with age in mother-daughter central obesity correlations. After subjects' cardiovascular risk factor levels were adjusted for mother and daughter waist circumferences, the mother-daughter correlations remained significant. The close association of central obesity indices between mothers and daughters may indicate the key role of the mother for the primary prevention of obesity and its complications, particularly in high-risk families

Effects of conjugated linoleic acid supplementation on body composition and leptin concentration in post-menopausal women

Animal studies reveal that conjugated linoleic acid [CLA] alters body composition, but few studies have examined the effects of CLA supplementation on body composition and leptin concentration in post menopausal women. In the present study, A randomized, double blind, placebo-controlled trial was performed to examine the changes in body composition and leptin concentration following 12 week supplementation of either 4 capsules of CLAG80 containing 3.2g CLA [50: 50 ratios of cis-9, trans-11 and trans-10, cis-12 isomers] or 4 placebo capsules [high oleic sunflower] in post-menopausal women. Seventy-six healthy post-menopausal women were randomized to receive placebo or 3.2g CLA for 12 weeks. Dual-Energy X-Ray Absorptiometry was used to measure body composition at baseline and after 12 weeks. Blood samples were collected after 10-12 hours fasting before and after intervention in order to determine leptin levels. Subjects completed 3 day dietary records during the trial, at week 0 [baseline], and at weeks 6 and 12. These dietary records were coded by the same dietitian, and analyzed using Food Processor II. Anthropometric measurements were done according to standard methods. Baseline data for time since menopausal age, BMI, fat mass, lean mass, waist circumference, physical activity and systolic and diastolic pressure were similar in both groups. Dietary CLA in the CLA and placebo groups were 104.5 +/- 43.2 mg and 99.5 +/- 38.2 mg respectively. Although lean body mass increased by 0.87 kg in the CLA group [p<0.00] after 12 weeks of intervention, leptin concentration did not change in either group. Conjugated Linoleic Acid supplementation improves loss of skeletal muscle in postmenopausal women

[Mothers' perceptions on familial correlates of overweight and obesity related behaviors in adolescents: a qualitative study]

There is convincing evidence that family environment plays an important role in influencing the obesity related-behaviors in adolescents. Considering the necessity of understanding the familial correlates of obesity in adolescents, and the lack of related studies in Iran, this study aimed to explore mothers' perceptions and experiences regarding these associated factors of overweight and obesity related behaviors in adolescents. A grounded theory approach was used for analyzing the participants' experiences, and their perceptions. To collect data, 6 semi-structured focus group discussions were conducted with 25 mothers who had at least one overweight or obese child. Based on open sampling, with the aim of maximal variation of the participants' experiences, two demographically diverse areas from the north and south of Tehran were selected and then followed with theoretical sampling. All the focus group discussions were audio recorded and transcribed verbatim. Data collection and analysis were done simultaneously using the Strauss and Corbin analysis method. Five main familial correlates of overweight and obesity in adolescents emerged from data: 1] Parents with inadequate knowledge, 2] Parents' modeling of unhealthy behaviors, 3] Dissimilarity of members, 4] Maternal employment and 5] Children's studies being the top priority for parents. Conclusion: Findings demonstrate familial correlates of overweight and obesity in adolescents as perceived by mothers, correlates that must be addressed by effective interventions for tackling overweight and obesity in adolescents

[Effects of combined administration of lipoic acid and pyridoxine on serum systemic and vascular inflammatory factors in patients with diabetic nephropathy]

Systemic and vascular inflammation are two risk factors for the development of diabetic nephropathy. In diabetic patients, serum systemic and vascular inflammatory factors have positive correlations with albuminuria. The present study was designed to investigate the effects of combined administration of lipoic acid and pyridoxine on the serum concentrations of these factors in patients with diabetic nephropathy. The study was a double-blind randomized clinical trial in which 38 patients with diabetic nephropathy [23 females and 15 males] were randomly assigned to either the supplement-taking or the placebo group. The patients in the supplement group received 800 mg lipoic acid and 80 mg pyridoxine daily for 12 weeks, while the placebo group received corresponding placebos. At baseline and the end of week 12, a urine sample and 10 ml blood was collected from each patient after a 12 to 14-hour fast and serum high sensitive C-reactive protein [hs-CRP], soluble intercellular adhesion molecule type 1 [sICAM-1], soluble vascular cell adhesion molecule type 1 [sVCAM-1], sE-selectin, Interleukine-6 [IL-6], glucose, percent of blood hemoglobin A1c and urinary albumin were measured. In the present study, no significant differences were observed between the two groups in mean changes of hs-CRP, IL-6, sICAM-1, sVCAM-1, sE-selectin, glucose, percent of blood hemoglobin A1c. Mean urinary albumin concentration decreased significantly in the supplement-taking group at the end of week 12, compared to the baseline [P<0.05] and the reduction was significant in comparison with the placebo group [P<0.05]. The results of the present study indicate that combined administration of lipoic acid and pyridoxine has no effect on serum systemic and vascular inflammatory factors, but it reduces urinary albumin concentration significantly. Therefore, combined administration of lipoic acid and pyridoxine may have an effective role in retarding the progression of diabetic nephropathy with a mechanism different from the effects of these supplements on inflammation

Evaluation of power of components of metabolic syndrome for prediction of its development: a 6.5 year longitudinal study in Tehran lipid and glucose study [TLGS]

This study amis at determining which components of the metabolic syndrome are the best predictors of its development. In this cohort study, from the participants of the cross sectional phase of the Tehran Lipid and Glucose Study [TLGS], 2279 subjects [aged 20-87] who did not have the metabolic syndrome, based on modified ATP III criteria, and 2310 subjects [aged 20-87] without the metabolic syndrome according to IDF criteria were followed. After a mean interval of 6.5 years, 462 and 602 new cases of the metabolic syndrome were diagnosed on basis of the modified ATP III and IDF criteria, respectively. The adjusted odds ratio for development of the metabolic syndrome by ATP III criteria was highest for central obesity in men, 2.8 [2.2-3.7] and for triglycerides in women, 2.8 [2.0-4.1]. The adjusted odds ratio for development of the metabolic syndrome by IDF criteria was highest for triglycerides in both men and women, OR being: 2.8 [2.2-3.7] and 2.9 [1.9-4.3] respectively. The area under the ROC curves for waist circumference, triglycerides and HDL were the highest. A model that included waist circumference and triglycerides or waist circumference and HDL predicted the metabolic syndrome as well as a model that included all five metabolic syndrome components. High risk subjects should undergo periodic screening, including measurement of waist circumference, triglycerides and plasma HDL, for timely prediction of development of metabolic syndrome

Personal barriers to life style modification in overweight/obese adolescents: a qualitative study

Existing data show a rising prevalence of overweight and obesity among Iranian adolescents. Considering the lack of related studies from Iran, the current study investigates personal barriers to life style Modification among overweight/obese adolescents. This is a qualitative study, conducted according to the grounded theory approach. Participants were 35 school children [19 girls and 16 boys], aged 15-17 years, who were either overweight or obese. To collect data, 5 semi-structured focus group discussions and 10 in-depth interviews were conducted. To obtain views across a range of socioeconomic backgrounds, two demographically diverse areas in Tehran were selected, and in each area, participants were recruited from schools. All interviews and focus group discussions were audio recorded and transcribed verbatim. Data collection and analysis were done simultaneously according to the Strauss and Corbin analysis method. Based on data analysis, positive perception of conditions, priority of studying, lack of willingness, negative experiences, low self-esteem, and perceived lack of control were the major personal barriers to adolescents' healthy lifestyles. Study results demonstrated the main personal barriers for a healthy life style as perceived by adolescents, barriers that any effective interventions require to address for tackling overweight and obesity in adolescents

Relationship between dhea and dhea-s with anthropometric indices in women with different grades of obesity

Dehydroepiandrosterone [DHEA] and dehydroepiandrosterone sulfate [DHEA-S] are the most abundant steroids in human plasma. The aim of this study was to evaluate the relationship between DHEA and DHEA-S and anthropometric indices in women with different grades of obesity. This cross- sectional study investigated 170 women; 35 normal weight [BMI= 18.9-24.9], 33 overweight, [BMI = 25-29.9] as 36 women [BMI= 30-34.9] as obese grade I, 33 [BMI = 35-39.9] as obese grade II and 33 [BMI>40] as obese grade III. Body mass index was defined as weight in kilograms divided by the square of the height in meters. Serum levels of dehydroepiandrosterone, dehydroepiandrosterone sulfate and glucose were measured by commercially available enzyme immunoassay kits and the glucose oxidase method, respectively. There was a negative and significant correlation between DHEA and age in the normal [r=-0.457, P=0.006] overweight [r=-0.414, P=0.017] obese l [r=-0.402, P=0.015] obese ll [r=-0.391, P=0.024] and obese III [r=-0.354, P=0.043] groups, respectively. Also a negative and significant correlation was found between DHEA-S and age in overweight [r=-0.394, P=0.019], obese grade I [r=-0.455, P=0.005] and obese grade II [r=-0.390, P=0.023] groups respectively. We found a positive and significant correlation between DHEA and frame size in individuals of the Obese I, Obese II and Obese III groups, and also a positive and significant correlation between DHEA-S and frame sizes in individuals of these three groups. Results showed that serum levels of DHEA decrease with increasing grades of obesity, whereas serum levels of DHEA-S increase with increasing obesity

Effects of combined administration of lipoic acid and pyridoxine on albuminuria, oxidative stress, blood pressure, serum advanced glycated end products, nitric oxide and endothelin-1 in patients with diabetic nephropathy

Diabetic nephropathy is the most common cause of kidney failure. High serum concentrations of advanced glycated end products, oxidative stress, and hypertension are three important risk factors for diabetic nephropathy. As individual administration of lipoic acid or pyridoxine is not effective in improving diabetic nephropathy, the present study was designed to investigate the effects of combined administration of lipoic acid and pyridoxine on albuminuria, oxidative stress, blood pressure, serum advanced glycated end products, nitric oxide and endothelin-1 in patients with diabetic nephropathy. The study was a double-blind randomized clinical trial, in which 38 patients with diabetic nephropathy [23 females and 15 males] were randomly assigned to either a supplement-taking group or a placebo group. The patients in the supplement group received 800 mg lipoic acid and 80 mg pyridoxine daily for 12 weeks, while the placebo group received placebos. At baseline and at the end of week 12, a urine sample and 8 ml blood were collected from each patient after a 12- to 14-hour fast and serum pentosidine, carboxymethyl lysine, malondialdehyde, endothelin-1, nitric oxide, glucose, urinary albumin, systolic and diastolic blood pressures were measured. The serum concentrations of pentosidine and carboxymethyl lysine decreased significantly in the supplement-taking group at the end of week 12 as compared to the baseline values [P<0.05] The combined supplement also brought about significant reductions in the serum malondialdehyde [25%], systolic blood pressure [2 mmHg] and urinary albumin concentration [74 mg/g creatinine]; the reductions were significantly different from the placebo group values [P<0.05]. On the other hand, the serum nitric oxide concentration increased significantly in the supplement-taking group as compared to the placebo group [P<0.05]. No significant differences were observed between the two groups in the mean changes of serum endothelin-1, glucose or diastolic blood pressure. The results indicate that combined administration of lipoic acid and pyridoxine reduces significantly serum pentosidine, carboxymethyl lysine, malondialdehyde, systolic blood pressure and urinary albumin concentration, and increases serum nitric oxide. This treatment may, thus, have an effective role in retarding the progression of diabetic nephropathy

Variation of adiponectin levels in normal and obese subjects: possible correlation with lipid profiles

Data available suggests that Adiponectin, an adipocyte-derived peptide, is associated with adiposity and could effect the regulation of glucose and lipid metabolism in humans. The aim of this study was to evaluate the association between serum adiponectin concentrations and anthropometric indices and lipid profiles among Iranian women with different grades of obesity. In this analytical descriptive study of 157 non-diabetic women [33 normal weight, BMI< 25 kg/m2 and 124 overweight and obese, BMI >/= 25kg/m2], serum adiponectin and leptin levels were measured using an enzyme-linked immunoassay. Fasting glucose and lipid profile levels determined by the glucose oxidize and enzymatic methods, respectively. Mean serum adiponectin concentration significantly decreased with obesity [p<0.05]. Although adiponectin showed a significant negative correlation with BMI [r=-0.321], it was correlated with serum leptin [r=-0.139], glucose [r=0.259], LDL-C [r=-0.125], TGs [r=-0.210] levels, TSF [r=-0.145], WHR [r=-0.159], and positively with serum HDL-C concentration [r=0.218] in all subjects [p<0.05]. Results of multiple regression analyses showed that adiponectin as a dependent variable had a significant correlation with BMI [beta =-0.605, P=0.017], waist circumference [beta =0.624, p=0.029], WHR [beta =-0.251, p=0.048], frame [beta =0.260, p=0.018], TC/HDL-C ratio [beta =-0.1.309, p=0.040] and LDL/HDL ratio [beta =-1.343, p=0.007] and changes in waist size had a significant effect on serum adiponectin levels. Our results suggested that adiponectin had an inverse correlation with adiposity indices and unfavorable lipid profiles, and that variation of waist circumference mostly affected Iranian women

Comparison between diabetes incidence using different cut points of IFG in Tehran

In 2003 the American diabetes Association [ADA] recommended that the definition of impaired fasting glucose [IFG] be changed from 110-125 to 100-125 mg/dL. This study examined the effect of different cut points for IFG on the incidence of diabetes in Tehran's urban population. From among the participants of the Tehran Lipid Glucose Study, after excluding subjects aged < 20 years, those with known or newly diagnosed type 2 diabetes, and those with missing values of weight, height, or other variables or lost to follow-up, data of 4728 subjects was used in this cohort study. They were followed for diabetes incidence [based on fasting plasma glucose [FPG] and glucose tolerance test] for 3.6 years. Participants were divided into different groups: Normoglycemia <100, original-IFG 110-125, added IFG 100-110 and the new IFG 100-125 mg/dL, groups. Odds ratios of diabetes incidence after adjustment for relevant confounders were calculated. The median age of participants was 42.9 +/- 13.7y and 59.1% [n=2916] were female. The prevalence of original-IFG, added IFG and new IFG were 3.7% [n=183], 11.8% [n=584], and 15.5% [n=767], respectively. After a mean follow-up duration of 3.6 years, 188 cases [3.8%] of incident diabetes were diagnosed. Diabetes incidence in the nor-moglycemia, original-IFG, added IFG and new IFG groups, were 1.8% [n=76], 26.2% [n=48], 11% [n=64], 14.6% [n=112], respectively. Odds ratio for diabetes incidence after adjustment for age, sex and other relevant confounders for the original-IFG, added IFG and new IFG groups, compared to the normoglycemia group as the reference, were 11.45 [95% confidence interval [CI], 7.45-17.57], 4.73 [95% CI, 3.28-6.8], 6.32 [95% CI, 4.51-8.5], respectively. The new IFG [100-125 mg/dL] is not superior to the original IFG [110-125 mg/dL] in terms of predicting forth-coming diabetes in Tehranian adults

Agreement level of definitions of the metabolic syndrome by modified ATP III and IDF with insulin resistance in the lipid and glucose study [TLGS]

The aim of the present study was to assess the diagnostic accuracy of the modified ATP III and IDF definitions of the metabolic syndrome in identifying of insulin resistant individuals by HOMA-IR and to assess levels of agreement between these definitions and insulin resistance. The sample consisted of 347 nondiabetic subjects from the TLGS population [140 men and 207 women aged 27-87 years]. The reference standard for insulin resistance was determined by HOMA-IR and insulin resistance was defined as HOMA-IR >/= 2.5. According to ATP III and IDF criteria 38.9%, 45% had metabolic syndrome respectively. The sensitivity and specificity of ATP III was 52.3% and 65% respectively, and this was 60% and 59% for IDF criteria respectively. Kappa agreement between modified ATP III and IDF with HOMA-IR was 0.14 and 0.15. Based on the area under the receiver operating characteristic curve constructed by counting metabolic syndrome components as recommended by modified ATP III and IDF diagnostic accuracy was fair. When each component of metabolic syndrome measures were considered as continuous traits, waist circumference and fasting plasma glucose each separately had diagnostic accuracy equal or grater than at all the metabolic syndrome as a whole by ATP III and IDF criteria. ATP III and IDF definition have low sensitivities for detecting insulin resistance and there is poor agreement between those criteria and insulin resistance. Measuring just waist circumference and fasting plasma glucose is simpler and may provide greater accuracy for identifying insulin resistance

Identifying isolated impaired glucose tolerance using common clinical data Tehran lipid and glucose study

To determine the clinical traits of subjects with isolated impaired glucose tolerance [isolated-IGT] defined as fasting plasma glucose [FPG]<100 mg/dl and 2-hour plasma glucose [2h-PG] between 140 mg/dl and 200 mg/dl. In this cross-sectional study, we evaluated the data and results of oral glucose tolerance test [OGTT] from 8212 participants of the Tehran Lipid and Glucose Study [4742 women and 3470 men] aged >/= 20 years, without diabetes. Logistic regression models for having isolated-IGT were developed among 7012 subjects with FPG<100 mg/dl to predict isolated-IGT. The overall prevalence of IGT was 13.6% [n=1120] of these subjects, 59.6% [n=668] were isolated-IGT. In the clinical model, the adjusted odds ratios [OR] for having isolated-IGT were statistically significant for age >/= 40 years [2.6], hypertension [1.9], overweight [1.7] or obesity [2.2], family history of diabetes [1.3], and female gender [1.2]. Adding the lipid profiles to the clinical model increased the area under the receiver-operating characteristics curve [AUC] only slightly [72.5% vs. 71.4%, P=0.001]. The other clinical model including waist circumference had similar predictive power compared to the clinical This analysis showed that in Tehranian adults with FPG<100 mg/dl, female gender, older age, family history of diabetes, overweight and obesity, and hypertension were significantly associated with a higher likelihood of isolated-IGT OGTT should hence be recommended in subjects with the above mentioned characteristics

[ association between vitamin D and bone mineral density in postmenopausal women]

There are inconsistent data regarding the role of vitamin-D in determining bone mineral density [BMD] especially in less severe vitamin-D deficiency. The aim of this study was to investigate the possible association between 25[OH]D and BMD in healthy free-living postmenopausal women in a population-based study. We enrolled 245 postmenopausal women, aged between 40 to 80 years, randomly selected from the Tehran Lipid and Glucose Study. Measurements of BMD were taken at the lumbar spine and upper femur by dual X-ray absorptiometry; additional to demographic and anthropometric data, serum 25[OH]D, PTH, calcium, phosphorus and alkaline phosphatase were measured according to the currently used laboratory methods. Bivariate and multivariate analyses were used to explore the association between 25[OH]D, BMD and other clinical and biochemical variables. Mean age and duration of menopause were 58 +/- 7 and 9.4 +/- 6.8 years, respectively; 25[OH]D [29.3 +/- 24.9 ng/ml] was <10 ng/ml and 11-20 ng/ml in 5.2% [n=13] and 37.6% [n=92] of women, respectively; 25[OH]D correlated inversely with LnPTH [r=-0.25, p<0.01]. However no association was found between 25[OH]D level and BMD at any of the skeletal scanning sites in bivariate analysis or multiple linear regression analyses, after adjusting for age, years since menopause, body mass index [BMI], calcium and LnPTH. In the multivariate analyses, BMD correlated inversely with LnPTH, in addition to age and BMI [R2=20%, p=0.03] only in femoral neck, but not at any other sites. This study showed no association between 25[OH]D and BMD in postmenopausal women